Imaging prices at Aspirus Eagle River Hospital
Eagle River, WI · every code in this section with a posted price and a Medicare benchmark.
368 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) range across 2 matching MRF lines |
$1,055.60–$2,832.70 | $1,624–$4,358 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$63.70–$204.75 | $98–$315 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$75.40–$205.40 | $116–$316 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$213.85–$2,120.30 | $329–$3,262 | varies |
| Angio internal mammary (75756) | $1,103.05 | $1,697 | 0.4× |
| Angio pulmonary bilat (75743) | $777.40 | $1,196 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $775.45 | $1,193 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $813.80 | $1,252 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $898.95 | $1,383 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $850.20 | $1,308 | 0.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$42.25–$198.90 | $65–$306 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$724.10 | $1,114 | 0.1× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$846.30 | $1,302 | 0.2× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$925.60–$1,388.40 | $1,424–$2,136 | varies |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,496.95 | $2,303 | 0.3× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$189.15–$751.40 | $291–$1,156 | varies |
| Arthrogram Wrist (73115) | $830.05 | $1,277 | 2.4× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$144.30–$314.60 | $222–$484 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$87.75–$232.70 | $135–$358 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$254.15–$2,031.90 | $391–$3,126 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$161.20–$1,407.90 | $248–$2,166 | varies |
| Bone Imaging Multiple Areas (78305) | $1,781.65 | $2,741 | 4.6× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$213.85–$1,783.60 | $329–$2,744 | varies |
| Bone marrow imaging; whole body (78104) | $1,612.65 | $2,481 | 4.2× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$287.30–$607.75 | $442–$935 | varies |
| Brachytx Isodose Plan Simple (77316) | $1,380.60 | $2,124 | 3.8× |
| Brain Image W/Flow < 4 Views (78601) | $1,380.60 | $2,124 | 3.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,920.20 | $9,108 | 4.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,596.15 | $7,071 | 13.6× |
| Cat Scan Follow-Up Study (76380) | $1,251.90 | $1,926 | 14.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,295.15 | $3,531 | 4.4× |
| Cerebrospinal Fluid Scan (78630) | $2,272.40 | $3,496 | 4.3× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$78–$154.05 | $120–$237 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$95.55–$204.10 | $147–$314 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$117.65–$242.45 | $181–$373 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$91–$174.85 | $140–$269 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$57.20–$183.30 | $88–$282 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$342.55–$2,180.75 | $527–$3,355 | varies |
| Continuing medical physics consltj pr wk (77336) | $963.95 | $1,483 | 7.4× |
| Contrast Exam Abdominl Aorta (75625) | $720.85 | $1,109 | 0.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$96.85–$205.40 | $149–$316 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,060.15 | $1,631 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$618.80–$3,553.55 | $952–$5,467 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$535.60–$2,438.15 | $824–$3,751 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$478.40–$2,289.95 | $736–$3,523 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$343.85–$2,743.65 | $529–$4,221 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$448.50–$1,225.25 | $690–$1,885 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$672.10–$4,299.75 | $1,034–$6,615 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$560.30–$2,241.20 | $862–$3,448 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$698.10–$2,683.85 | $1,074–$4,129 | varies |
| CT angio hrt w/3d image (75574) | $3,506.10 | $5,394 | 10.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$689–$3,496.35 | $1,060–$5,379 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$698.10–$2,559.70 | $1,074–$3,938 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$631.80–$3,193.45 | $972–$4,913 | varies |
| CT bone density (77078) | $1,379.30 | $2,122 | 16.3× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$455.65–$2,227.55 | $701–$3,427 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$411.45–$1,520.35 | $633–$2,339 | varies |
| CT cervical spine w/wo cont (72127) | $2,722.85 | $4,189 | 16.0× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$358.15–$1,847.95 | $551–$2,843 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$520–$2,193.75 | $800–$3,375 | varies |
| CT colonography screening (74263) | $8,275.80 | $12,732 | 35.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $5,315.05 | $8,177 | 31.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $4,646.85 | $7,149 | 45.8× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$408.20–$1,469.65 | $628–$2,261 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$507–$1,751.10 | $780–$2,694 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,304.90 | $3,546 | 6.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $64.35 | $99 | 0.8× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$551.85–$2,648.75 | $849–$4,075 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$478.40–$2,748.85 | $736–$4,229 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$245.70–$1,767.35 | $378–$2,719 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$437.45–$2,191.15 | $673–$3,371 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$460.20–$2,176.85 | $708–$3,349 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$308.75–$1,767.35 | $475–$2,719 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$468.65–$1,526.85 | $721–$2,349 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$339.30–$1,326 | $522–$2,040 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$647.40–$2,365.35 | $996–$3,639 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$573.95–$3,110.25 | $883–$4,785 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$511.55–$2,226.25 | $787–$3,425 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$558.35–$2,642.90 | $859–$4,066 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$266.50–$1,240.20 | $410–$1,908 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$542.10–$2,854.15 | $834–$4,391 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$503.10–$1,877.20 | $774–$2,888 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$551.85–$1,821.95 | $849–$2,803 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$511.55–$1,380.60 | $787–$2,124 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$442.65–$2,247.05 | $681–$3,457 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$245.70–$1,777.10 | $378–$2,734 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$478.40–$2,661.75 | $736–$4,095 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$424.45–$1,366.95 | $653–$2,103 | varies |
| CT unlisted procedure (76497) | $1,689.35 | $2,599 | 20.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$245.70–$1,738.10 | $378–$2,674 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$282.10–$1,321.45 | $434–$2,033 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$437.45–$2,250.30 | $673–$3,462 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$579.80–$3,969.55 | $892–$6,107 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$660.40–$3,066.05 | $1,016–$4,717 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$618.80–$2,873 | $952–$4,420 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,270.10 | $1,954 | 5.5× |
| Diskography lumbar (72295) | $794.95 | $1,223 | 0.4× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$386.75–$629.85 | $595–$969 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$98.80–$286.65 | $152–$441 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$154.70–$277.55 | $238–$427 | varies |
| Echo exam uterus (76831) | $402.35 | $619 | 1.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$159.25–$547.95 | $245–$843 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$297.70–$493.35 | $458–$759 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$248.95–$393.90 | $383–$606 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$71.50–$432.25 | $110–$665 | varies |
| Follow-Up Angiography (75898) | $3,180.45 | $4,893 | 1.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$42.90–$170.30 | $66–$262 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$90.35–$172.90 | $139–$266 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$194.35–$2,029.95 | $299–$3,123 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,602.25 | $2,465 | 4.1× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$555.75–$2,158.65 | $855–$3,321 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$65.65–$183.30 | $101–$282 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,181.10 | $4,894 | 4.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,354.30 | $3,622 | 3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $783.90 | $1,206 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$245.70–$2,513.55 | $378–$3,867 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$202.15–$2,135.25 | $311–$3,285 | varies |
| Ht Musc Image Planar Mult (78454) | $2,744.30 | $4,222 | 2.2× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$710.45–$1,920.75 | $1,093–$2,955 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$90.35–$568.10 | $139–$874 | varies |
| Image fusion (77399) | $674.70 | $1,038 | 5.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$352.95–$540.15 | $543–$831 | varies |
| Infant hip ultrasound, limited static exam (76886) | $379.60 | $584 | 4.5× |
| Infusion Ivp (74410) | $913.90 | $1,406 | 5.4× |
| K Flow/Funct Image Multiple (78709) | $2,043.60 | $3,144 | 3.9× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$347.10–$852.80 | $534–$1,312 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,311.70 | $2,018 | 2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,424.15 | $2,191 | 3.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$49.40–$247 | $76–$380 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$98.80–$1,197.30 | $152–$1,842 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,957.15–$2,139.15 | $3,011–$3,291 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$177.45–$1,214.20 | $273–$1,868 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$265.20–$1,931.80 | $408–$2,972 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,575.60–$1,983.15 | $2,424–$3,051 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,527.55 | $5,427 | 1.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$974.35–$3,629.60 | $1,499–$5,584 | varies |
| Mammary ductogram or galactogram multiple (77054) | $692.25 | $1,065 | 3.0× |
| Mammary ductogram or galactogram single (77053) | $519.35 | $799 | 2.2× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$144.30–$2,036.45 | $222–$3,133 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$988–$3,475.55 | $1,520–$5,347 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$585.65–$4,988.10 | $901–$7,674 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$448.50–$3,643.25 | $690–$5,605 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$382.20–$3,864.25 | $588–$5,945 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$713.05–$5,487.95 | $1,097–$8,443 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$965.90–$3,301.35 | $1,486–$5,079 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$785.20–$4,219.80 | $1,208–$6,492 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$518.70–$3,071.25 | $798–$4,725 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$605.15–$4,529.85 | $931–$6,969 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$761.15–$5,265.65 | $1,171–$8,101 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$605.15–$4,457.70 | $931–$6,858 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$573.30–$3,112.85 | $882–$4,789 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,155.10 | $4,854 | 13.6× |
| MRI cardiac w/o contrast (75557) | $3,311.10 | $5,094 | 14.3× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,329.25–$3,786.90 | $2,045–$5,826 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$596.05–$2,988.70 | $917–$4,598 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$519.35–$5,295.55 | $799–$8,147 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$800.80–$7,091.50 | $1,232–$10,910 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$628.55–$3,882.45 | $967–$5,973 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$761.15–$4,150.90 | $1,171–$6,386 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$481–$2,994.55 | $740–$4,607 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$658.45–$3,834.35 | $1,013–$5,899 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$809.90–$4,347.20 | $1,246–$6,688 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$508.95–$3,226.60 | $783–$4,964 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$664.30–$3,089.45 | $1,022–$4,753 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$802.75–$6,278.35 | $1,235–$9,659 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$610.35–$3,981.90 | $939–$6,126 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$871–$4,706 | $1,340–$7,240 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$518.70–$3,016.65 | $798–$4,641 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$527.80–$3,247.40 | $812–$4,996 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$706.55–$5,021.25 | $1,087–$7,725 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,820.65–$4,349.15 | $2,801–$6,691 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$763.10–$5,686.20 | $1,174–$8,748 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$780–$4,442.10 | $1,200–$6,834 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$809.90–$4,581.20 | $1,246–$7,048 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$627.90–$3,876.60 | $966–$5,964 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$549.25–$2,527.85 | $845–$3,889 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$763.10–$5,276.05 | $1,174–$8,117 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$926.90–$4,114.50 | $1,426–$6,330 | varies |
| Myelograpy 2/more regions rs&i (72270) | $1,115.40 | $1,716 | 1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,244.10 | $1,914 | 3.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,736.15 | $2,671 | 1.4× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$660.40–$2,942.55 | $1,016–$4,527 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,018.30 | $6,182 | 2.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $8,295.95 | $12,763 | 3.9× |
| N-invas est c ffr sw aly CTA (75580) | $2,678 | $4,120 | 3.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$73.45–$204.10 | $113–$314 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $419.90 | $646 | 1.1× |
| Nm myocard infarct spect (78469) | $1,396.85 | $2,149 | 2.6× |
| Nm whole blood volume (78122) | $531.05 | $817 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $734.50 | $1,130 | 7.2× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$1,857.70–$12,905.10 | $2,858–$19,854 | varies |
| Nuclear Rx Intra-Arterial (79445) | $369.20 | $568 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $369.20 | $568 | 1.6× |
| Ob us nuchal meas 1 gest (76813) | $278.85 | $429 | 2.7× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $155.35 | $239 | 1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 7 matching MRF lines |
$256.75–$581.10 | $395–$894 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$26.65–$47.45 | $41–$73 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$377–$2,206.10 | $580–$3,394 | varies |
| Parathyroid Planar Imaging (78070) | $1,835.60 | $2,824 | 4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,202.85 | $3,389 | 5.7× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$66.30–$215.15 | $102–$331 | varies |
| Peritoneogram Rs&I (74190) | $209.30 | $322 | 0.4× |
| Pet Image W/Ct Lmtd (78814) | $5,807.75 | $8,935 | 4.2× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$735.15–$5,747.95 | $1,131–$8,843 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$718.90–$5,920.20 | $1,106–$9,108 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $703.95 | $1,083 | 0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $795.60 | $1,224 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,467.70 | $2,258 | 3.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$87.75–$269.10 | $135–$414 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$109.20–$284.70 | $168–$438 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$48.10–$217.75 | $74–$335 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$42.90–$167.05 | $66–$257 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$92.95–$185.90 | $143–$286 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$63.05–$286 | $97–$440 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$44.20–$237.25 | $68–$365 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$47.45–$234 | $73–$360 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$92.95–$341.25 | $143–$525 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$65.65–$202.80 | $101–$312 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$73.45–$242.45 | $113–$373 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$95.55–$217.75 | $147–$335 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$61.75–$227.50 | $95–$350 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$73.45–$215.15 | $113–$331 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$67.60–$135.20 | $104–$208 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$70.85–$174.85 | $109–$269 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$105.30–$351 | $162–$540 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$42.90–$195.65 | $66–$301 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$53.95–$183.30 | $83–$282 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$99.45–$247 | $153–$380 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$131.95–$788.45 | $203–$1,213 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $8,457.15 | $13,011 | 1.2× |
| Radiation treatment delivery level 1 (77402) | $450.45 | $693 | 4.5× |
| Radiation treatment delivery level 3 (77412) | $723.45 | $1,113 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$108.55–$258.05 | $167–$397 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$116.35–$274.95 | $179–$423 | varies |
| Radiologic exam colon double contrast study (74280) | $1,649.05 | $2,537 | 9.7× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$236.60–$1,106.30 | $364–$1,702 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$156–$618.15 | $240–$951 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$87.75–$269.10 | $135–$414 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$73.45–$256.75 | $113–$395 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$192.40–$778.70 | $296–$1,198 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$120.25–$904.80 | $185–$1,392 | varies |
| Radiologic exam teeth complete full mouth (70320) | $211.90 | $326 | 0.9× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$387.40–$1,068.60 | $596–$1,644 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$57.85–$176.80 | $89–$272 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$50.05–$215.15 | $77–$331 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$52–$211.90 | $80–$326 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$118.95–$473.85 | $183–$729 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$46.80–$189.80 | $72–$292 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $452.40 | $696 | 0.9× |
| Renal Cyst Study (74470) | $1,028.30 | $1,582 | 1.9× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$97.50–$234.65 | $150–$361 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,190.80 | $1,832 | 3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,655.55 | $2,547 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,843.45 | $5,913 | 7.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,662.70 | $2,558 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$297.70–$2,035.80 | $458–$3,132 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,639 | $4,060 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$1,056.90–$3,127.80 | $1,626–$4,812 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$351.65–$2,486.90 | $541–$3,826 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $369.20 | $568 | 1.6× |
| Rp Therapy Intravenous Administration (79101) | $369.20 | $568 | 1.6× |
| Scapula (73010) range across 2 matching MRF lines |
$69.55–$202.80 | $107–$312 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$83.20–$123.50 | $128–$190 | varies |
| Sella turcica (70240) | $78 | $120 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$48.10–$138.45 | $74–$213 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$122.85–$747.50 | $189–$1,150 | varies |
| Sialogram (70390) | $395.20 | $608 | 1.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$104–$237.25 | $160–$365 | varies |
| Special dosimetry (77331) | $301.60 | $464 | 2.3× |
| Special Physics Consult (77370) | $869.70 | $1,338 | 6.7× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$356.85–$576.55 | $549–$887 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$485.55–$2,482.35 | $747–$3,819 | varies |
| Stereotactic Body Radiation Delivery (77373) | $9,306.70 | $14,318 | 5.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$84.50–$260 | $130–$400 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$642.20–$1,463.80 | $988–$2,252 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $780 | $1,200 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$362.70–$3,363.75 | $558–$5,175 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $263.25 | $405 | 0.7× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$218.40–$1,883.70 | $336–$2,898 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $861.25 | $1,325 | 5.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$66.95–$202.80 | $103–$312 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$72.15–$224.25 | $111–$345 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$79.95–$198.90 | $123–$306 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,287.65 | $1,981 | 3.3× |
| Thyroid Met Imaging Body (78018) | $1,920.75 | $2,955 | 3.6× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$163.80–$503.75 | $252–$775 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$136.50–$1,528.15 | $210–$2,351 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$332.80–$948.35 | $512–$1,459 | varies |
| Tx devices design & construction intermediate (77333) | $887.25 | $1,365 | 6.8× |
| Tx devices design & construction simple (77332) | $454.35 | $699 | 3.5× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$173.55–$535.28 | $267–$823.50 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$144.30–$385.45 | $222–$593 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$304.20–$388.70 | $468–$598 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$140.40–$351 | $216–$540 | varies |
| Unlisted magnetic resonance procedure (76498) | $4,619.55 | $7,107 | 54.6× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$343.20–$1,264.25 | $528–$1,945 | varies |
| Ureteral Reflux Study (78740) | $929.50 | $1,430 | 2.4× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$157.30–$664.30 | $242–$1,022 | varies |
| Urethrocystography retrograde (74450) | $868.40 | $1,336 | 3.7× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$321.10–$757.58 | $494–$1,165.50 | varies |
| Us chest (76604) range across 5 matching MRF lines |
$176.80–$523.58 | $272–$805.50 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$192.40–$430.95 | $296–$663 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$116.35–$381.55 | $179–$587 | varies |
| Us head (76506) range across 2 matching MRF lines |
$244.40–$425.10 | $376–$654 | varies |
| Us kidney transplant (76776) | $529.75 | $815 | 5.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$189.15–$251.55 | $291–$387 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$564.20–$653.25 | $868–$1,005 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$179.40–$304.85 | $276–$469 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$241.80–$325 | $372–$500 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$213.20–$399.75 | $328–$615 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$258.70–$406.90 | $398–$626 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$280.15–$354.25 | $431–$545 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$272.35–$523.25 | $419–$805 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$237.25–$363.35 | $365–$559 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$288.60–$432.25 | $444–$665 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$289.90–$435.50 | $446–$670 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$174.85–$427.05 | $269–$657 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$194.35–$688.35 | $299–$1,059 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$836.55–$1,254.82 | $1,287–$1,930.50 | varies |
| Venogram Sinus/Jugular (75860) | $802.10 | $1,234 | 0.3× |
| Venography Adrenal Unilateral (75840) | $491.40 | $756 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $690.95 | $1,063 | 0.2× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$653.25–$727.35 | $1,005–$1,119 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$204.10–$690.30 | $314–$1,062 | varies |
| Venography Renal Unilateral (75831) | $751.40 | $1,156 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $384.80 | $592 | 4.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$65.65–$209.30 | $101–$322 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$104–$237.25 | $160–$365 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,019.85 | $1,569 | 3.0× |
| X-Ray Aorta Leg Arteries (75630) | $1,314.30 | $2,022 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$69.55–$282.75 | $107–$435 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$52.65–$167.05 | $81–$257 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$81.25–$133.90 | $125–$206 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$91.65–$237.25 | $141–$365 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$78–$436.15 | $120–$671 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$81.25–$598.65 | $125–$921 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$73.45–$189.80 | $113–$292 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$58.50–$282.75 | $90–$435 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$119.60–$352.95 | $184–$543 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$59.15–$241.15 | $91–$371 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$86.45–$311.35 | $133–$479 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$83.20–$378.95 | $128–$583 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$131.30–$372.45 | $202–$573 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$70.85–$224.25 | $109–$345 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$147.55–$372.45 | $227–$573 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$94.25–$228.15 | $145–$351 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$74.10–$304.20 | $114–$468 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$90.35–$192.40 | $139–$296 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$78–$237.25 | $120–$365 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$49.40–$254.15 | $76–$391 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$70.20–$282.75 | $108–$435 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$41.60–$161.85 | $64–$249 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$131.30–$288.60 | $202–$444 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$71.50–$224.25 | $110–$345 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$134.55–$211.25 | $207–$325 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$63.70–$192.40 | $98–$296 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$108.55–$248.30 | $167–$382 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$147.55–$282.75 | $227–$435 | varies |
| X-Ray Stress View (77071) | $289.25 | $445 | 3.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$125.45–$256.75 | $193–$395 | varies |
| X-Ray Tmj Unilat (70328) | $79.30 | $122 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$114.40–$1,707.55 | $176–$2,627 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$203.45–$328.25 | $313–$505 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$221.65–$601.90 | $341–$926 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$94.25–$308.10 | $145–$474 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$81.90–$191.10 | $126–$294 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $222.95 | $343 | 2.2× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$59.80–$282.75 | $92–$435 | varies |
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.