Imaging prices at Aspire Hospital
Conroe, TX · every code in this section with a posted price and a Medicare benchmark.
340 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) | $280 | $5,050 | 0.2× |
| Abdomen 1 View (74018) | $80 | $261 | 0.9× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$80 | $309–$316 | 0.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $432 | $1,054 | 1.1× |
| Adrenal Cortex & Medulla Img (78075) | $546 | $578 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $232 | $1,801 | 0.1× |
| Angiography extremity unilateral rs&i (75710) | $213 | $1,056 | 0.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$80 | $272–$449 | 0.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$188 | $477–$787 | 0.5× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$189 | $693–$1,144 | 0.5× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$189 | $423–$699 | 0.5× |
| Basic radiation dosimetry calculation (77300) | $37 | $311 | 0.3× |
| Bone age studies (77072) | $80 | $227 | 0.8× |
| Bone Imaging 3 Phase (78315) | $429 | $1,740 | 1.1× |
| Bone Imaging Limited Area (78300) | $282 | $1,443 | 0.7× |
| Bone Imaging Whole Body (78306) | $366 | $1,443 | 0.9× |
| Bone marrow imaging; whole body (78104) | $313 | $788 | 0.8× |
| Bone survey infant (77076) | $80 | $305 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $406 | $760 | 0.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $253 | $630 | 0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,035 | $3,035 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $188 | $245 | 2.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $402 | $655 | 0.7× |
| Cerebrospinal Fluid Scan (78630) | $416 | $790 | 0.8× |
| Chest 1 view (71045) | $80 | $488 | 0.9× |
| Chest 2 views (71046) | $80 | $322 | 0.9× |
| Chest 3 views (71047) | $80 | $355 | 0.9× |
| Chest 4 or more views (71048) | $80 | $482 | 0.8× |
| Cholecystography Oral Contrast (74290) | $80 | $239 | 0.5× |
| Cisternography Positive Contrast Rs&I (70015) | $228 | $647 | 0.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$80 | $323–$485 | 0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $250 | $1,591 | 2.4× |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$98 | $425–$553 | 0.7× |
| Contrast X-Ray Bladder (74430) | $59 | $552 | 0.2× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$136 | $477–$787 | 0.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$166 | $951–$1,569 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$250 | $2,730–$2,961 | 0.7× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$250 | $1,576–$2,112 | 1.0× |
| CT abdomen w contrast (74160) | $300 | $2,574 | 1.7× |
| CT abdomen w wo contrast (74170) | $350 | $2,790 | 2.0× |
| CT abdomen w/o contrast (74150) | $250 | $1,900 | 2.4× |
| CT Angio Abdomen and Pelvis (74174) | $350 | $3,027 | 1.0× |
| CT Angio Chest (71275) | $350 | $1,774 | 2.0× |
| CT Angio Head (70496) | $300 | $1,473 | 1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$350 | $1,510–$4,823 | 2.0× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$350 | $1,350–$1,360 | 2.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$350 | $1,256–$5,308 | 2.0× |
| CT bone density (77078) | $140 | $362 | 1.6× |
| CT cervical spine w/ contrast (72126) | $300 | $2,191 | 0.9× |
| CT cervical spine w/o contrast (72125) | $250 | $1,573 | 2.4× |
| CT cervical spine w/wo cont (72127) | $350 | $2,849 | 2.0× |
| CT chest w contrast (71260) | $300 | $2,276 | 1.7× |
| CT chest w/wo contrast (71270) | $350 | $2,585 | 2.0× |
| CT head/brain with contrast (70460) | $300 | $1,651 | 1.7× |
| CT head/brain without and with contrast (70470) | $350 | $1,912 | 2.0× |
| CT iac w contrast (70481) | $300 | $2,011 | 1.7× |
| CT l-spine w&w/o contrast (72133) | $350 | $3,400 | 2.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$250 | $971–$1,603 | 2.4× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$300 | $1,483–$2,447 | 1.7× |
| CT lumbar spine w contrast (72132) | $300 | $2,440 | 0.9× |
| CT lumbar spine w/o contrast (72131) | $250 | $1,752 | 2.4× |
| CT maxillofacial w contrast (70487) | $300 | $2,068 | 1.7× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$250 | $1,925–$2,009 | 2.4× |
| CT neck tissue combo (70492) | $350 | $2,143 | 2.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $350 | $2,800 | 2.0× |
| CT orbits w/o contrast (70480) | $250 | $1,443 | 2.4× |
| CT pelvis w&w/o contrast (72194) | $350 | $2,081 | 2.0× |
| CT pelvis w/o contrast (72192) | $250 | $1,831 | 2.4× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$350 | $1,717–$2,833 | 2.0× |
| CT scans face/jaw combo (70488) | $350 | $2,469 | 2.0× |
| CT soft tissue neck w contrast (70491) | $300 | $1,879 | 1.7× |
| CT soft tissue neck w/o contrast (70490) | $250 | $1,348 | 2.4× |
| CT thoracic spine w contrast (72129) | $300 | $2,226 | 1.7× |
| CT thoracic spine w/o contrast (72128) | $250 | $1,598 | 2.4× |
| CT thoracic spine w/wo cont (72130) | $350 | $3,093 | 2.0× |
| CT thorax w/o contrast (71250) | $250 | $1,591 | 2.4× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$250 | $1,417–$2,339 | 2.4× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$350 | $2,286–$3,771 | 2.0× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$300 | $1,981–$3,268 | 0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $250 | $1,801 | 1.4× |
| Cta Abdomen (74175) | $350 | $1,997 | 2.0× |
| CTA pelvis (72191) | $350 | $1,650 | 2.0× |
| Discography Cerv/Thor Spine (72285) | $206 | $1,231 | 0.1× |
| Diskography lumbar (72295) | $174 | $1,262 | 0.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $200 | $562 | 1.9× |
| Dxa Bone Density Axial (77080) | $56 | $388 | 0.5× |
| Echo exam of fetal heart (76825) | $200 | $562 | 0.4× |
| Echo exam uterus (76831) | $166 | $436 | 0.7× |
| Echo Guide For Artery Repair (76936) | $376 | $172 | 1.7× |
| Echograp Trans R Pros Study (76873) | $255 | $237 | 2.4× |
| Esophagram (74220) | $80 | $511 | 0.5× |
| Fetal Biophys Profile W/Nst (76818) | $200 | $643 | 1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $200 | $457 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $63 | $420 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$80 | $265–$437 | 0.9× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$80 | $276–$456 | 0.9× |
| Gastric emptying imaging study (78264) | $409 | $1,054 | 1.0× |
| Gastroesophageal Reflux Exam (78262) | $307 | $898 | 0.8× |
| Gated Heart Planar Single (78472) | $294 | $1,369 | 0.7× |
| Gated Heart, Multiple (78473) | $378 | $1,984 | 0.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$80 | $252–$416 | 0.8× |
| Hysterosalpingogram (74740) | $128 | $583 | 0.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $200 | $575 | 2.3× |
| Infusion Ivp (74410) | $204 | $799 | 1.2× |
| Interstitial radiation source applic complex (77778) | $1,330 | $2,905 | 1.9× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,132 | $1,642 | 1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $797 | $1,642 | 1.4× |
| K Flow/Funct Image Multiple (78709) | $462 | $1,180 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $245 | $1,297 | 0.4× |
| K Flow/Funct Image W/O Drug (78707) | $296 | $1,370 | 0.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $141 | $290 | 0.4× |
| Kidney Imaging Morphol (78700) | $217 | $1,004 | 0.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $287 | $1,136 | 0.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$80 | $309–$510 | 0.9× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $156 | $419 | 0.4× |
| Leveen/Shunt Patency Exam (78291) | $329 | $679 | 0.8× |
| Liver & Spleen Imaging Static Only (78215) | $252 | $1,245 | 0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $187 | $1,245 | 0.5× |
| Liver imaging w/vascular flow (78202) | $271 | $1,245 | 0.5× |
| Lymph System Imaging (78195) | $441 | $1,161 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $400 | $1,821 | 1.7× |
| Mammary ductogram or galactogram multiple (77054) | $97 | $553 | 0.4× |
| Mammary ductogram or galactogram single (77053) | $75 | $409 | 0.3× |
| Meckels Divert Exam (78290) | $411 | $945 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $514 | $1,359 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $500 | $3,146 | 1.4× |
| MRA head w/o contrast (70544) | $400 | $1,888 | 1.7× |
| MRA head with contrast (70545) | $500 | $2,094 | 1.4× |
| MRA neck w contrast (70548) | $500 | $2,631 | 1.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $500 | $2,637 | 1.4× |
| MRA neck w/o contrast (70547) | $400 | $1,807 | 1.7× |
| MRI abdomen w contrast (74182) | $500 | $2,816 | 1.4× |
| MRI abdomen w/o contrast (74181) | $400 | $2,479 | 1.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$500 | $2,404–$2,714 | 0.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$500 | $2,944–$5,100 | 1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$500 | $2,175–$2,388 | 0.6× |
| MRI bone marrow blood supply (77084) | $444 | $924 | 1.9× |
| MRI cervical spine w contrast (72142) | $500 | $2,565 | 1.4× |
| MRI cervical spine w/o cont (72141) | $400 | $2,232 | 1.7× |
| MRI chest w/o contrast (71550) | $400 | $2,449 | 1.7× |
| MRI chest with contrast (71551) | $500 | $2,425 | 0.6× |
| MRI chest wo w contrast (71552) | $500 | $3,059 | 1.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$500 | $2,009–$2,201 | 1.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$500 | $2,613–$4,925 | 1.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$400 | $2,085–$4,747 | 1.7× |
| MRI lumbar spine w contrast (72149) | $500 | $2,627 | 1.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $500 | $3,101 | 1.4× |
| MRI orbit face &/neck w/o contrast (70540) | $400 | $1,874 | 1.7× |
| MRI orbit face neck w contrast (70542) | $500 | $2,811 | 1.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $500 | $2,343 | 1.4× |
| MRI pelvis w contrast (72196) | $500 | $2,432 | 1.4× |
| MRI pelvis w/o & w contrast (72197) | $500 | $2,479 | 1.4× |
| MRI pelvis w/o contrast (72195) | $400 | $2,018 | 1.7× |
| MRI spectroscopy (76390) | $1,680 | $1,680 | 19.2× |
| MRI thoracic spine w/o contrast (72146) | $400 | $2,013 | 1.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$500 | $3,079–$3,380 | 1.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$400 | $2,427–$4,004 | 1.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$500 | $2,396–$3,953 | 1.4× |
| MRI, abdomen, combo (74183) | $500 | $3,240 | 1.4× |
| MRI, dorsal spine combo (72157) | $500 | $2,679 | 1.4× |
| MRI, dorsal spine contrast (72147) | $500 | $2,049 | 1.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$400 | $2,252–$3,715 | 1.7× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$500 | $2,593–$4,278 | 1.4× |
| MRI, lumbar spine combo (72158) | $500 | $2,962 | 1.4× |
| Myelogram cervical (72240) | $159 | $1,395 | 0.2× |
| Myelogram Lumbar (72265) | $157 | $1,226 | 0.2× |
| Myelography thoracic (72255) | $148 | $1,192 | 0.2× |
| Myelograpy 2/more regions rs&i (72270) | $191 | $1,328 | 0.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $225 | $1,153 | 0.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,957 | $1,957 | 1.5× |
| Neck soft tissue (70360) | $80 | $281 | 0.9× |
| Nm whole blood volume (78122) | $143 | $601 | 0.3× |
| Nonvascular Shunt X-Ray (75809) | $121 | $431 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,554 | $5,169 | 1.1× |
| Nuclear Rx Intra-Arterial (79445) | $495 | $495 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $190 | $1,456 | 0.8× |
| Optic foramina (70190) | $80 | $152 | 0.9× |
| Panoramic X-ray of jaws (70355) | $80 | $208 | 0.9× |
| Parathyroid Planar Imaging (78070) | $369 | $1,010 | 0.9× |
| Pelvis 1 or 2 views (72170) | $80 | $217 | 0.8× |
| Pet Image Skull-Thigh (78812) | $3,667 | $3,667 | 2.6× |
| Pet Image W/Ct Lmtd (78814) | $4,222 | $4,222 | 2.9× |
| PET image w/CT, full body (78816) | $5,248 | $5,248 | 3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,716 | $4,716 | 3.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,142 | $3,142 | 2.4× |
| PET whole body (78813) | $4,191 | $4,191 | 2.9× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $137 | $645 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $296 | $1,004 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $80 | $480 | 0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $84 | $518 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$80 | $292–$481 | 0.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $80 | $256 | 0.9× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$80 | $282–$466 | 0.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $52 | $444 | 0.5× |
| Radex fingr minimum 2 views (73140) | $80 | $241 | 0.9× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$80 | $300–$495 | 0.9× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$80 | $279–$461 | 0.9× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$80 | $276–$314 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $80 | $338 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $32 | $339 | 0.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $80 | $252 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) | $80 | $306 | 0.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$80 | $330–$494 | 0.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $80 | $218 | 0.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $80 | $559 | 0.5× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$80 | $229–$267 | 0.9× |
| Radex Sternum Minimum 2 Views (71120) | $80 | $253 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $80 | $639 | 0.9× |
| Radex Toe Minimum 2 Views (73660) | $80 | $245 | 0.9× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$80 | $251–$415 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$80 | $301–$496 | 0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $80 | $656 | 0.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,036 | $11,098 | 0.1× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$116 | $277–$391 | 1.1× |
| Radiation treatment delivery level 2 (77407) range across 3 matching MRF lines |
$436 | $405–$451 | 1.1× |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$624 | $483–$536 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $48 | $400 | 0.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $80 | $161 | 0.8× |
| Radiologic exam colon double contrast study (74280) | $80 | $965 | 0.5× |
| Radiologic exam colon single contrast study (74270) | $80 | $788 | 0.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$80 | $345–$366 | 0.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $80 | $307 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $80 | $654 | 0.5× |
| Radiologic exam swallow function contrast study (74230) | $80 | $236 | 0.5× |
| Radiologic exam teeth complete full mouth (70320) | $80 | $149 | 0.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $80 | $740 | 0.5× |
| Radiologic examination femur 1 view (73551) | $80 | $193 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$80 | $213–$464 | 0.9× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$80 | $252–$416 | 0.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $80 | $396 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$80 | $295–$510 | 0.9× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $169 | $495 | 0.7× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $138 | $450 | 0.3× |
| Ribs bilateral 3 views (71110) | $80 | $680 | 0.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $327 | $1,142 | 0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $339 | $1,377 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $791 | $2,565 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $382 | $1,377 | 0.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $474 | $1,377 | 0.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $225 | $1,783 | 1.0× |
| Rp Therapy Intravenous Administration (79101) | $205 | $633 | 0.9× |
| Scapula (73010) range across 2 matching MRF lines |
$80 | $304–$456 | 0.8× |
| Sella turcica (70240) | $80 | $126 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$80 | $290–$436 | 0.9× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$190 | $923–$1,523 | 0.5× |
| Sialogram (70390) | $156 | $357 | 0.7× |
| Skull less than 4 views (70250) | $80 | $353 | 0.8× |
| Special dosimetry (77331) | $21 | $295 | 0.2× |
| Special Physics Consult (77370) | $159 | $2,580 | 1.2× |
| Special teletherapy port plan (77321) | $49 | $849 | 0.1× |
| Special treatment procedure (77470) | $156 | $2,580 | 0.3× |
| Stereotactic Body Radiation Delivery (77373) | $1,082 | $5,937 | 0.6× |
| Sternoclavicular joints (71130) | $80 | $304 | 0.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $189 | $314 | 1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$148 | $550–$760 | 0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $82 | $340 | 0.2× |
| Testicular Imaging W/Flow (78761) | $269 | $974 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $397 | $1,320 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $417 | $1,296 | 1.1× |
| Ther rad simulaj-aided field setting simple (77280) | $252 | $530 | 1.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$80 | $384–$396 | 0.8× |
| Thoracic spine 3 views (72072) | $80 | $393 | 0.8× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$80 | $162–$319 | 0.9× |
| Thyroid Met Imaging Body (78018) | $389 | $1,169 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $71 | $944 | 0.2× |
| Tx devices design & construction intermediate (77333) | $106 | $916 | 0.8× |
| Tx devices design & construction simple (77332) | $17 | $887 | 0.1× |
| Ultrasound, abdomen limited (76705) | $200 | $648 | 1.9× |
| Unlisted Dx Radiographic Procedure (76499) | $31 | $31 | 0.4× |
| Unlisted fluoroscopic procedure (76496) | $324 | $324 | 3.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $2,452 | $2,452 | 23.9× |
| Unlisted us procedure (76999) | $109 | $109 | 1.2× |
| Upper gi w/o kub (74240) | $80 | $629 | 0.5× |
| Ureteral Reflux Study (78740) | $312 | $551 | 0.8× |
| Urethrocystogram voiding (74455) | $149 | $650 | 0.6× |
| Urethrocystography retrograde (74450) | $511 | $511 | 2.1× |
| Us chest (76604) | $200 | $254 | 1.9× |
| Us complete joint (76881) | $200 | $574 | 1.9× |
| Us exam, pelvic, limited (76857) | $200 | $432 | 1.9× |
| Us head (76506) | $200 | $453 | 1.9× |
| Us kidney transplant (76776) | $200 | $358 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$200 | $368–$417 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $200 | $416 | 1.9× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$132 | $331–$521 | 1.3× |
| Us pelvic non ob complete (76856) | $200 | $708 | 1.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$200 | $345–$620 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $200 | $453 | 1.9× |
| Us retroperitoneal complete (76770) | $200 | $407 | 1.9× |
| Us retroperitoneal limited (76775) | $200 | $407 | 1.9× |
| Us scrotum and contents (76870) | $200 | $574 | 1.9× |
| Us spinal canal and contents (76800) | $200 | $604 | 1.9× |
| Us thyroid (76536) | $200 | $593 | 1.9× |
| Us transrectal (76872) | $171 | $898 | 1.6× |
| Vein X-Ray Chest (75827) | $169 | $1,053 | 0.1× |
| Venography extremity bilateral rs&i (75822) | $190 | $598 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $153 | $384 | 0.1× |
| Venous thrombosis imaging (78457) | $237 | $306 | 0.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $263 | $1,319 | 0.7× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$80 | $259–$427 | 0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $80 | $493 | 0.9× |
| X-ray antegrade pyelogram tube (74425) | $189 | $507 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $80 | $529 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$80 | $234–$386 | 0.9× |
| X-Ray Exam Breast Specimen (76098) | $61 | $215 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$80 | $200–$440 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $80 | $502 | 0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $80 | $605 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $80 | $235 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $80 | $328 | 0.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $80 | $379 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $80 | $693 | 0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $80 | $796 | 0.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $80 | $899 | 0.8× |
| X-Ray Exam L-S Spine Bending (72114) | $80 | $620 | 0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $80 | $316 | 0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $80 | $543 | 0.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $80 | $402 | 0.8× |
| X-ray eye for foreign body (70030) | $46 | $175 | 0.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$80 | $302–$498 | 0.9× |
| X-ray IV pyelogram (ivp) (74400) | $187 | $890 | 1.1× |
| X-ray IV pyelogram+tomography (74415) | $214 | $884 | 1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $80 | $321 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $80 | $321 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $80 | $429 | 0.8× |
| X-ray nose-rectum child f.b. (76010) | $80 | $175 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $80 | $765 | 0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $80 | $328 | 0.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $80 | $298 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $80 | $310 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $30 | $292 | 0.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $34 | $524 | 0.3× |
| X-ray thoracic spine 4 vw (72074) | $80 | $288 | 0.8× |
| X-Ray Tmj Unilat (70328) | $80 | $433 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $115 | $738 | 0.3× |
| X-Rays Bone Length Studies (77073) | $80 | $329 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $80 | $515 | 0.8× |
| Xr c-spine 4 or 5 views (72050) | $80 | $443 | 0.8× |
| Xr facial bones less than 3 views (70140) | $80 | $333 | 0.9× |
| Xr orbits complete 4 views (70200) | $38 | $390 | 0.4× |
| Xr Tomogram Single Plane (76100) | $80 | $725 | 0.8× |
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.