Imaging prices at Ascension St. Vincent's Riverside
Jacksonville, FL · every code in this section with a posted price and a Medicare benchmark.
320 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $5,399.69 | $14,593.75 | 3.7× |
| Abdomen 1 View (74018) | $162.99 | $440.50 | 1.8× |
| Abdomen 2 views (74019) | $174.46 | $471.50 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,550.95 | $4,191.75 | 3.7× |
| Angio internal mammary (75756) | $1,745.20 | $4,716.75 | 0.5× |
| Angio pulmonary bilat (75743) | $2,192.25 | $5,925 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $1,990.79 | $5,380.50 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $1,729.01 | $4,673 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $907.06 | $2,451.50 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$1,213.88–$2,211.12 | $3,280.75–$5,976 | varies |
| Ankle 2 views (73600) | $191.48 | $517.50 | 2.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,767.68 | $4,777.50 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,320.35 | $3,568.50 | 0.2× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,832.61 | $4,953 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$401.91 | $1,086.25 | 0.1× |
| Basic radiation dosimetry calculation (77300) | $750.73 | $2,029 | 5.3× |
| Bone age studies (77072) | $165.02 | $446 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,550.95 | $4,191.75 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,436.06 | $3,881.25 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,665.83 | $4,502.25 | 4.0× |
| Bone marrow imaging limited area (78102) | $1,550.95 | $4,191.75 | 3.7× |
| Bone survey infant (77076) | $610.87 | $1,651 | 5.6× |
| Brachytx isodose complex (77318) | $4,042.44 | $10,925.50 | 10.3× |
| Brachytx isodose intermed (77317) | $3,537.11 | $9,559.75 | 9.0× |
| Brachytx Isodose Plan Simple (77316) | $2,938.82 | $7,942.75 | 7.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,550.95 | $4,191.75 | 2.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 3 matching MRF lines |
$999–$1,550.95 | $2,700–$4,191.75 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) | $761.46 | $2,058 | 2.1× |
| Cerebrospinal Fluid Scan (78630) | $1,550.95 | $4,191.75 | 2.7× |
| Chest 1 view (71045) | $130.98 | $354 | 1.4× |
| Chest 2 views (71046) | $141.90 | $383.50 | 1.6× |
| Chest 3 views (71047) | $156.60 | $423.25 | 1.7× |
| Chest 4 or more views (71048) | $171.40 | $463.25 | 1.6× |
| Clavicle complete (73000) | $179.64 | $485.50 | 2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $647.32 | $1,749.50 | 5.9× |
| Continuing medical physics consltj pr wk (77336) | $707.81 | $1,913 | 5.0× |
| Contrast Exam Abdominl Aorta (75625) | $1,281.31 | $3,463 | 0.4× |
| Contrast X-Ray Bladder (74430) | $366.02 | $989.25 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $738.98 | $1,997.25 | 2.0× |
| CT abdomen and pelvis without contrast (74176) | $647.32 | $1,749.50 | 2.6× |
| CT abdomen w contrast (74160) | $647.32 | $1,749.50 | 3.5× |
| CT abdomen w wo contrast (74170) | $693.10 | $1,873.25 | 3.8× |
| CT abdomen w/o contrast (74150) | $601.44 | $1,625.50 | 5.5× |
| CT Angio Abdomen and Pelvis (74174) | $647.32 | $1,749.50 | 1.8× |
| CT Angio Chest (71275) | $647.32 | $1,749.50 | 3.5× |
| CT Angio Head (70496) | $647.32 | $1,749.50 | 3.5× |
| CT angio hrt w/3d image (75574) | $647.32 | $1,749.50 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $647.32 | $1,749.50 | 3.5× |
| CT Angio Neck (70498) | $647.32 | $1,749.50 | 3.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $647.32 | $1,749.50 | 3.5× |
| CT cervical spine w/ contrast (72126) | $693.10 | $1,873.25 | 1.9× |
| CT cervical spine w/o contrast (72125) | $647.32 | $1,749.50 | 5.9× |
| CT cervical spine w/wo cont (72127) | $785.70 | $2,123.50 | 4.3× |
| CT chest w contrast (71260) | $693.10 | $1,873.25 | 3.8× |
| CT chest w/wo contrast (71270) | $738.98 | $1,997.25 | 4.0× |
| CT head/brain with contrast (70460) | $722.43 | $1,952.50 | 3.9× |
| CT head/brain without and with contrast (70470) | $768.31 | $2,076.50 | 4.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $647.32 | $1,749.50 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $38.85 | $105 | 0.4× |
| CT iac w contrast (70481) | $624.28 | $1,687.25 | 3.4× |
| CT l-spine w&w/o contrast (72133) | $693.10 | $1,873.25 | 3.8× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$555.56–$833.24 | $1,501.50–$2,252 | varies |
| CT lower extremity w/contrast material (73701) | $601.44 | $1,625.50 | 3.3× |
| CT lumbar spine w contrast (72132) | $647.32 | $1,749.50 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $601.44 | $1,625.50 | 5.5× |
| CT maxillofacial w contrast (70487) | $647.32 | $1,749.50 | 3.5× |
| CT maxillofacial wo contrast (70486) | $601.44 | $1,625.50 | 5.5× |
| CT neck tissue combo (70492) | $693.10 | $1,873.25 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $670.16 | $1,811.25 | 3.7× |
| CT orbits w/o contrast (70480) | $578.40 | $1,563.25 | 5.3× |
| CT pelvis w&w/o contrast (72194) | $716.04 | $1,935.25 | 3.9× |
| CT pelvis w/o contrast (72192) | $624.28 | $1,687.25 | 5.7× |
| CT scan of leg combo (73702) | $647.32 | $1,749.50 | 3.5× |
| CT scans face/jaw combo (70488) | $693.10 | $1,873.25 | 3.8× |
| CT soft tissue neck w contrast (70491) | $647.32 | $1,749.50 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $601.44 | $1,625.50 | 5.5× |
| CT thoracic spine w contrast (72129) | $624.28 | $1,687.25 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $578.40 | $1,563.25 | 5.3× |
| CT thoracic spine w/wo cont (72130) | $670.16 | $1,811.25 | 3.7× |
| CT thorax w/o contrast (71250) | $647.32 | $1,749.50 | 5.9× |
| CT upper ext wo (73200) | $601.44 | $1,625.50 | 5.5× |
| CT upper extremity w/o & w/contrast material (73202) | $693.10 | $1,873.25 | 3.8× |
| CT upper extremity with contrast (73201) | $647.32 | $1,749.50 | 1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $647.32 | $1,749.50 | 3.5× |
| Cta Abdomen (74175) | $647.32 | $1,749.50 | 3.5× |
| CTA pelvis (72191) | $647.32 | $1,749.50 | 3.5× |
| Diskography lumbar (72295) | $2,805.80 | $7,583.25 | 1.4× |
| Dxa Bone Density Axial (77080) | $250.40 | $676.75 | 2.3× |
| Dxa bone density study (77085) | $245.68 | $664 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$129.69–$162.06 | $350.50–$438 | varies |
| Echo exam uterus (76831) | $460.93 | $1,245.75 | 1.8× |
| Echograp Trans R Pros Study (76873) | $1,963.78 | $5,307.50 | 18.0× |
| Esophagram (74220) | $419.77 | $1,134.50 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$446.41–$616.05 | $1,206.50–$1,665 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $640.38 | $1,730.75 | 5.9× |
| Fluoroscopy up to 1 hr (76000) | $248.27 | $671 | 1.0× |
| Foot 2 views (73620) | $194.90 | $526.75 | 2.1× |
| Forearm 2 views (73090) | $185.37 | $501 | 2.0× |
| Gastric emptying imaging study (78264) | $1,550.95 | $4,191.75 | 3.7× |
| Gated Heart Planar Single (78472) range across 4 matching MRF lines |
$999–$1,550.95 | $2,700–$4,191.75 | varies |
| Hand 2 views (73120) | $189.53 | $512.25 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,228.51 | $19,536.50 | 9.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,901.89 | $18,653.75 | 9.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,587.85 | $17,805 | 9.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,359.25 | $11,781.75 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,148.57 | $3,104.25 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,550.95 | $4,191.75 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,550.95 | $4,191.75 | 3.7× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$962–$1,493.51 | $2,600–$4,036.50 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$591.54–$739.45 | $1,598.75–$1,998.50 | varies |
| Interstitial radiation source applic complex (77778) | $4,118.29 | $11,130.50 | 5.7× |
| K Flow/Funct Image W/Drug (78708) | $1,550.95 | $4,191.75 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,550.95 | $4,191.75 | 2.7× |
| Knee 3 Views (73562) | $235.51 | $636.50 | 2.6× |
| Leveen/Shunt Patency Exam (78291) | $752.49 | $2,033.75 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,550.95 | $4,191.75 | 3.7× |
| Lung perfusion differential (78597) | $1,550.95 | $4,191.75 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,550.95 | $4,191.75 | 2.7× |
| Lymph System Imaging (78195) | $1,550.95 | $4,191.75 | 2.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$590.15–$761.46 | $1,595–$2,058 | varies |
| Meckels Divert Exam (78290) | $1,550.95 | $4,191.75 | 3.7× |
| Mlc imrt design & construction per imrt plan (77338) | $916.68 | $2,477.50 | 2.3× |
| Mr safety determination physician/other qhp (76016) | $156.42 | $422.75 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $135.88 | $367.25 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $638.34 | $1,725.25 | 1.8× |
| MRA head w/o contrast (70544) | $574.06 | $1,551.50 | 2.3× |
| MRA neck w contrast (70548) | $590.15 | $1,595 | 1.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $622.25 | $1,681.75 | 1.7× |
| MRA neck w/o contrast (70547) | $558.05 | $1,508.25 | 2.2× |
| MRI abdomen w contrast (74182) | $590.15 | $1,595 | 1.6× |
| MRI abdomen w/o contrast (74181) | $558.05 | $1,508.25 | 2.2× |
| MRI any jt lower extrem w/contrast material (73722) | $622.25 | $1,681.75 | 0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $654.35 | $1,768.50 | 1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $622.25 | $1,681.75 | 0.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $566.01 | $1,529.75 | 2.3× |
| MRI cardiac w/o contrast (75557) | $388.59 | $1,050.25 | 1.6× |
| MRI cervical spine w contrast (72142) | $574.06 | $1,551.50 | 1.6× |
| MRI cervical spine w/o cont (72141) | $558.05 | $1,508.25 | 2.2× |
| MRI chest w/o contrast (71550) | $590.15 | $1,595 | 2.4× |
| MRI chest wo w contrast (71552) | $654.35 | $1,768.50 | 1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $622.25 | $1,681.75 | 1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $654.35 | $1,768.50 | 1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $590.15 | $1,595 | 2.4× |
| MRI lumbar spine w contrast (72149) | $622.25 | $1,681.75 | 1.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $606.15 | $1,638.25 | 1.7× |
| MRI orbit face &/neck w/o contrast (70540) | $525.86 | $1,421.25 | 2.1× |
| MRI orbit face neck w contrast (70542) | $558.05 | $1,508.25 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $590.15 | $1,595 | 1.6× |
| MRI pelvis w contrast (72196) | $720.02 | $1,946 | 2.0× |
| MRI pelvis w/o & w contrast (72197) | $590.15 | $1,595 | 1.6× |
| MRI pelvis w/o contrast (72195) | $525.86 | $1,421.25 | 2.1× |
| MRI thoracic spine w/o contrast (72146) | $558.05 | $1,508.25 | 2.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$843.05–$1,359.75 | $2,278.50–$3,675 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $558.05 | $1,508.25 | 2.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $622.25 | $1,681.75 | 1.7× |
| MRI, abdomen, combo (74183) | $622.25 | $1,681.75 | 1.7× |
| MRI, dorsal spine combo (72157) | $622.25 | $1,681.75 | 1.7× |
| MRI, dorsal spine contrast (72147) | $590.15 | $1,595 | 1.6× |
| MRI, joint upper extrem (73221) | $1,136.27 | $3,071 | 4.6× |
| MRI, joint upper extrem combo (73223) | $654.35 | $1,768.50 | 1.8× |
| MRI, lumbar spine combo (72158) | $654.35 | $1,768.50 | 1.8× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$1,036–$1,608.39 | $2,800–$4,347 | varies |
| N-invas est c ffr sw aly CTA (75580) | $1,210.55 | $3,271.76 | 1.3× |
| Neck soft tissue (70360) | $159.38 | $430.75 | 1.8× |
| Nonvascular Shunt X-Ray (75809) | $199.25 | $538.50 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,017.96 | $16,264.75 | 4.2× |
| Nuclear Rx Intra-Arterial (79445) | $403.39 | $1,090.25 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $1,550.95 | $4,191.75 | 6.4× |
| Panoramic X-ray of jaws (70355) | $145.13 | $392.25 | 1.6× |
| Parathyroid Planar Imaging (78070) | $1,550.95 | $4,191.75 | 3.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,723.28 | $4,657.50 | 4.1× |
| Pelvis 1 or 2 views (72170) | $150.50 | $406.75 | 1.4× |
| Peritoneogram Rs&I (74190) | $466.11 | $1,259.75 | 0.8× |
| Pet Image W/Ct Lmtd (78814) | $1,979.50 | $5,350 | 1.3× |
| PET image w/CT, full body (78816) | $2,016.50 | $5,450 | 1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,998 | $5,400 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,453.01 | $6,629.75 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,550.95 | $4,191.75 | 3.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$507.55–$665.91 | $1,371.75–$1,799.75 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $206.83 | $559 | 2.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $181.12 | $489.50 | 2.0× |
| Radex elbow complete minimum 3 views (73080) | $145.50 | $393.25 | 1.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $163.26 | $441.25 | 1.5× |
| Radex fingr minimum 2 views (73140) | $156.60 | $423.25 | 1.7× |
| Radex foot complete minimum 3 views (73630) | $197.03 | $532.50 | 2.2× |
| Radex Hand Minimum 3 Views (73130) | $199.15 | $538.25 | 2.2× |
| Radex lower extremity infant minimum 2 views (73592) | $110.08 | $297.50 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $173.72 | $469.50 | 1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $215.62 | $582.75 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $267.23 | $722.25 | 2.9× |
| Radex shoulder complete minimum 2 views (73030) | $210.90 | $570 | 2.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $169.09 | $457 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $241.80 | $653.50 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $207.29 | $560.25 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $148.46 | $401.25 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $130.98 | $354 | 1.4× |
| Radex upper extremity infant minimum 2 views (73092) | $109.80 | $296.75 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $220.24 | $595.25 | 2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $299.79 | $810.25 | 2.7× |
| Radiation treatment delivery level 1 (77402) | $622.53 | $1,682.50 | 5.8× |
| Radiation treatment delivery level 2 (77407) | $663.60 | $1,793.50 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $759.33 | $2,052.25 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $206.46 | $558 | 1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $185.93 | $502.50 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $948.87 | $2,564.50 | 5.2× |
| Radiologic exam colon single contrast study (74270) | $538.17 | $1,454.50 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $275.74 | $745.25 | 2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $148.37 | $401 | 1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $480.17 | $1,297.75 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $216.82 | $586 | 1.2× |
| Radiologic examination femur 1 view (73551) | $114.89 | $310.50 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $227.83 | $615.75 | 2.5× |
| Radiologic examination knee 1/2 views (73560) | $210.62 | $569.25 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $215.53 | $582.50 | 2.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $883.10 | $2,386.75 | 2.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $588.49 | $1,590.50 | 1.5× |
| Ribs bilateral 3 views (71110) | $240.87 | $651 | 2.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $765.62 | $2,069.25 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,493.51 | $4,036.50 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,608.39 | $4,347 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,608.39 | $4,347 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$962–$1,493.51 | $2,600–$4,036.50 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,064.53 | $8,282.50 | 2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,260.89 | $6,110.50 | 9.3× |
| Scapula (73010) | $221.72 | $599.25 | 2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$76.04–$114.15 | $205.50–$308.50 | varies |
| Shoulder 1 view (73020) | $110.08 | $297.50 | 1.2× |
| Skull less than 4 views (70250) | $213.68 | $577.50 | 2.0× |
| Special dosimetry (77331) | $750.73 | $2,029 | 5.3× |
| Special Physics Consult (77370) | $707.81 | $1,913 | 5.0× |
| Special teletherapy port plan (77321) | $1,705.52 | $4,609.50 | 4.4× |
| Special treatment procedure (77470) | $2,882.21 | $7,789.75 | 5.0× |
| Srs Multisource (77371) | $41,814.81 | $113,013 | 5.4× |
| Stereotactic Body Radiation Delivery (77373) | $3,575.50 | $9,663.50 | 1.9× |
| Sternoclavicular joints (71130) | $245.59 | $663.75 | 2.7× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) range across 2 matching MRF lines |
$145.23–$156.42 | $392.50–$422.75 | varies |
| Tbs technical calculation only (77091) range across 2 matching MRF lines |
$145.23–$156.42 | $392.50–$422.75 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,404.45 | $6,498.50 | 6.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,469.46 | $3,971.50 | 3.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,530.32 | $4,136 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,330.71 | $3,596.50 | 3.4× |
| Ther rad simulaj-aided field setting simple (77280) | $673.77 | $1,821 | 4.8× |
| Thoracic spine 2 views (72070) | $124.51 | $336.50 | 1.1× |
| Thoracic spine 3 views (72072) | $143.56 | $388 | 1.3× |
| Thoracolumbar 2 views (72080) | $158.27 | $427.75 | 1.7× |
| Thyroid Met Imaging Body (78018) | $1,665.83 | $4,502.25 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,550.95 | $4,191.75 | 3.7× |
| Tx Devices Design & Construction Complex (77334) | $1,151.53 | $3,112.25 | 2.9× |
| Tx devices design & construction intermediate (77333) | $1,071.06 | $2,894.75 | 7.6× |
| Tx devices design & construction simple (77332) | $1,001.22 | $2,706 | 7.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$333–$666 | $900–$1,800 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$173.62–$263.63 | $469.25–$712.50 | varies |
| Ultrasound, abdomen limited (76705) | $875.70 | $2,366.75 | 8.0× |
| Umbilical-artery Doppler (OB) (76820) | $452.33 | $1,222.50 | 4.1× |
| Unlisted magnetic resonance procedure (76498) | $590.15 | $1,595 | 6.5× |
| Upper gi w/o kub (74240) | $581.27 | $1,571 | 3.2× |
| Urethrocystogram voiding (74455) | $432.81 | $1,169.75 | 1.7× |
| Urethrocystography retrograde (74450) | $370 | $1,000 | 1.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$377.40–$754.80 | $1,020–$2,040 | varies |
| Us chest (76604) | $444.56 | $1,201.50 | 4.1× |
| Us complete joint (76881) | $693.29 | $1,873.75 | 6.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$311.36–$429.66 | $841.50–$1,161.25 | varies |
| Us head (76506) | $659.80 | $1,783.25 | 6.0× |
| Us kidney transplant (76776) | $513.93 | $1,389 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $684.22 | $1,849.25 | 6.3× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$247.07–$340.96 | $667.75–$921.50 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$398.03–$549.27 | $1,075.75–$1,484.50 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$552.78–$762.76 | $1,494–$2,061.50 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$393.03–$542.33 | $1,062.25–$1,465.75 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $247.07 | $667.75 | 2.3× |
| Us retroperitoneal complete (76770) | $565.36 | $1,528 | 5.2× |
| Us retroperitoneal limited (76775) | $444.56 | $1,201.50 | 4.1× |
| Us scrotum and contents (76870) | $632.61 | $1,709.75 | 5.8× |
| Us thyroid (76536) | $656.01 | $1,773 | 6.0× |
| Us transrectal (76872) | $750.36 | $2,028 | 6.9× |
| Vein X-Ray Chest (75827) | $1,312.11 | $3,546.25 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $975.97 | $2,637.75 | 0.3× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$840.92–$4,867.81 | $2,272.75–$13,156.25 | varies |
| Venography caval inferior serialography rs&i (75825) | $1,115.09 | $3,013.75 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $590.24 | $1,595.25 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $581.83 | $1,572.50 | 0.4× |
| Venography Renal Bilateral (75833) | $4,043.45 | $10,928.25 | 1.2× |
| Venography Renal Unilateral (75831) | $4,043.45 | $10,928.25 | 1.2× |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$2,424.61–$4,416.78 | $6,553–$11,937.25 | varies |
| Wrist 2 views (73100) | $210.62 | $569.25 | 2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $230.33 | $622.50 | 2.5× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$588.49–$735.65 | $1,590.50–$1,988.25 | varies |
| X-Ray Aorta Leg Arteries (75630) | $1,235.43 | $3,339 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $448.16 | $1,211.25 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $130.24 | $352 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $130.98 | $354 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $186.57 | $504.25 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $159.47 | $431 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $175.38 | $474 | 1.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$148–$191.48 | $400–$517.50 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $203.41 | $549.75 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $212.57 | $574.50 | 1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $222.83 | $602.25 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $474.43 | $1,282.25 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $234.77 | $634.50 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $382.95 | $1,035 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $272.04 | $735.25 | 2.5× |
| X-ray eye for foreign body (70030) | $130.98 | $354 | 1.4× |
| X-ray humerus (73060) | $157.53 | $425.75 | 1.7× |
| X-ray IV pyelogram (ivp) (74400) | $743.33 | $2,009 | 4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $149.57 | $404.25 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $189.16 | $511.25 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $261.78 | $707.50 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $159.75 | $431.75 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $396.83 | $1,072.50 | 3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $141.62 | $382.75 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $166.04 | $448.75 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $210.72 | $569.50 | 2.3× |
| X-ray thoracic spine 4 vw (72074) | $148.83 | $402.25 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$555.83–$833.70 | $1,502.25–$2,253.25 | varies |
| X-Rays Bone Length Studies (77073) | $218.86 | $591.50 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $551.58 | $1,490.75 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $352.33 | $952.25 | 3.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $227.83 | $615.75 | 2.1× |
| Xr orbits complete 4 views (70200) | $144.49 | $390.50 | 1.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.