Imaging prices at Aspirus Lake View Hospital
Two Harbors, MN · every code in this section with a posted price and a Medicare benchmark.
381 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 |
$1,403.22–$3,837.65 | $1,705–$4,663 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$84.77–$266.65 | $103–$324 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$100.41–$267.48 | $122–$325 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$289.70–$2,818.78 | $352–$3,425 | varies |
| Angio internal mammary (75756) | $1,466.59 | $1,782 | 0.5× |
| Angio pulmonary bilat (75743) | $1,033.69 | $1,256 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $1,031.22 | $1,253 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $1,082.24 | $1,315 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,195 | $1,452 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,129.98 | $1,373 | 0.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$55.96–$251.84 | $68–$306 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$962.91 | $1,170 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,125.04 | $1,367 | 0.2× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$1,230.38–$1,845.58 | $1,495–$2,242.50 | varies |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,990.01 | $2,418 | 0.3× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$251.84–$999.12 | $306–$1,214 | varies |
| Arthrogram Wrist (73115) | $1,103.64 | $1,341 | 3.1× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$201.64–$426.31 | $245–$518 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$116.87–$303.69 | $142–$369 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$338.25–$2,701.09 | $411–$3,282 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$204.10–$1,871.50 | $248–$2,274 | varies |
| Bone Imaging Multiple Areas (78305) | $2,368.59 | $2,878 | 5.7× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$283.94–$2,371.06 | $345–$2,881 | varies |
| Bone marrow imaging; whole body (78104) | $2,143.92 | $2,605 | 5.2× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$363.77–$792.55 | $442–$963 | varies |
| Brachytx Isodose Plan Simple (77316) | $1,818.01 | $2,209 | 4.7× |
| Brain Image W/Flow < 4 Views (78601) | $1,835.29 | $2,230 | 4.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,870.35 | $9,563 | 5.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $6,110.78 | $7,425 | 17.0× |
| Cardiac Shunt Detection (78428) | $921.76 | $1,120 | 2.2× |
| Cat Scan Follow-Up Study (76380) | $1,664.11 | $2,022 | 18.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $3,051.68 | $3,708 | 5.4× |
| Cerebrospinal Fluid Scan (78630) | $3,021.23 | $3,671 | 5.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$103.70–$204.93 | $126–$249 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$126.74–$271.59 | $154–$330 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$156.37–$316.03 | $190–$384 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$120.98–$232.09 | $147–$282 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$75.72–$238.67 | $92–$290 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$455.12–$2,844.29 | $553–$3,456 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,269.07 | $1,542 | 9.1× |
| Contrast Exam Abdominl Aorta (75625) | $957.97 | $1,164 | 0.3× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$128.39–$273.24 | $156–$332 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,409.80 | $1,713 | 3.9× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$823–$4,724.02 | $1,000–$5,740 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$711.90–$3,180.07 | $865–$3,864 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$636.18–$2,986.67 | $773–$3,629 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$502.03–$3,578.40 | $610–$4,348 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$596.68–$1,598.27 | $725–$1,942 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$893.78–$5,716.56 | $1,086–$6,946 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$744.82–$2,922.47 | $905–$3,551 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$928.34–$3,500.22 | $1,128–$4,253 | varies |
| CT angio hrt w/3d image (75574) | $4,661.47 | $5,664 | 12.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$872.38–$4,648.30 | $1,060–$5,648 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$928.34–$3,338.09 | $1,128–$4,056 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$799.96–$4,245.86 | $972–$5,159 | varies |
| CT bone density (77078) | $1,833.64 | $2,228 | 20.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,134.86 | $2,594 | 11.8× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$2,961.15–$3,573.47 | $3,598–$4,342 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$547.30–$1,982.61 | $665–$2,409 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$455.12–$3,619.55 | $553–$4,398 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$476.52–$2,409.74 | $579–$2,928 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$691.32–$2,916.71 | $840–$3,544 | varies |
| CT colonography screening (74263) | $11,002.69 | $13,369 | 44.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $7,066.28 | $8,586 | 39.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $6,177.44 | $7,506 | 57.3× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$542.36–$1,953.80 | $659–$2,374 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$674.04–$2,328.27 | $819–$2,829 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $3,064.03 | $3,723 | 8.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $81.48 | $99 | 0.9× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$698.73–$3,521.62 | $849–$4,279 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$636.18–$3,654.12 | $773–$4,440 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$358.83–$2,349.66 | $436–$2,855 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$581.86–$2,913.42 | $707–$3,540 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$611.49–$2,893.67 | $743–$3,516 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$410.68–$2,349.66 | $499–$2,855 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$623.01–$1,990.84 | $757–$2,419 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$451–$1,762.87 | $548–$2,142 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$860.86–$3,144.68 | $1,046–$3,821 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$762.92–$4,134.75 | $927–$5,024 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$647.70–$2,903.54 | $787–$3,528 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$706.96–$3,513.39 | $859–$4,269 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$390.10–$1,617.20 | $474–$1,965 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$720.95–$3,794.85 | $876–$4,611 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$669.10–$2,495.34 | $813–$3,032 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$733.29–$2,422.09 | $891–$2,943 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$679.80–$1,800.72 | $826–$2,188 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$588.44–$2,987.49 | $715–$3,630 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$358.83–$2,317.57 | $436–$2,816 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$636.18–$3,538.90 | $773–$4,300 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$564.58–$1,817.18 | $686–$2,208 | varies |
| CT unlisted procedure (76497) | $2,245.97 | $2,729 | 25.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$358.83–$2,266.54 | $436–$2,754 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$436.19–$1,757.10 | $530–$2,135 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$581.86–$2,991.60 | $707–$3,635 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$846.04–$5,277.08 | $1,028–$6,412 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$878.14–$3,998.96 | $1,067–$4,859 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $5,082.02 | $6,175 | 14.1× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$847.69–$3,819.54 | $1,030–$4,641 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,688.80 | $2,052 | 6.9× |
| Diskography lumbar (72295) | $1,056.73 | $1,284 | 0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $451 | $548 | 4.2× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$307.80–$504.50 | $374–$613 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$131.68–$373.64 | $160–$454 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$195.87–$362.12 | $238–$440 | varies |
| Echo exam uterus (76831) | $534.95 | $650 | 2.2× |
| Echo Guide For Artery Repair (76936) | $2,391.64 | $2,906 | 10.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$211.51–$728.36 | $257–$885 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$395.86–$655.93 | $481–$797 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$330.85–$523.43 | $402–$636 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$95.47–$574.45 | $116–$698 | varies |
| Follow-Up Angiography (75898) | $4,228.57 | $5,138 | 1.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$56.79–$222.21 | $69–$270 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$114.40–$225.50 | $139–$274 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$258.42–$2,698.62 | $314–$3,279 | varies |
| Gastroesophageal Reflux Exam (78262) | $2,129.92 | $2,588 | 5.2× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$703.66–$2,869.80 | $855–$3,487 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$87.24–$238.67 | $106–$290 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,229.40 | $5,139 | 5.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,129.87 | $3,803 | 4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,041.92 | $1,266 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$326.73–$3,341.38 | $397–$4,060 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$269.12–$2,838.53 | $327–$3,449 | varies |
| Ht Musc Image Planar Mult (78454) | $3,648.36 | $4,433 | 2.7× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$899.54–$2,553.77 | $1,093–$3,103 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$120.16–$740.70 | $146–$900 | varies |
| Image fusion (77399) | $888.84 | $1,080 | 6.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$446.89–$718.48 | $543–$873 | varies |
| Infant hip ultrasound, limited static exam (76886) | $504.50 | $613 | 5.6× |
| Infusion Ivp (74410) | $1,214.75 | $1,476 | 6.7× |
| K Flow/Funct Image Multiple (78709) | $2,716.72 | $3,301 | 4.8× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$461.70–$1,134.09 | $561–$1,378 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$288.87–$1,743.94 | $351–$2,119 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,893.72 | $2,301 | 4.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$65.84–$321.79 | $80–$391 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$131.68–$1,591.68 | $160–$1,934 | varies |
| Liver imaging static only (78201) | $1,201.58 | $1,460 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$2,602.33–$2,844.29 | $3,162–$3,456 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$236.20–$1,613.90 | $287–$1,961 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$352.24–$2,568.58 | $428–$3,121 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,994.95–$2,636.89 | $2,424–$3,204 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,689.45 | $5,698 | 1.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,233.68–$4,825.25 | $1,499–$5,863 | varies |
| Mammary ductogram or galactogram multiple (77054) | $920.11 | $1,118 | 3.7× |
| Mammary ductogram or galactogram single (77053) | $690.50 | $839 | 2.8× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$191.76–$2,707.67 | $233–$3,290 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,338.20–$4,400.58 | $1,626–$5,347 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $112.75 | $137 | 3.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $304.51 | $370 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$778.56–$6,631.73 | $946–$8,058 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$596.68–$4,751.18 | $725–$5,773 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$507.79–$5,137.17 | $617–$6,242 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$948.10–$7,156.81 | $1,152–$8,696 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,222.98–$4,389.06 | $1,486–$5,333 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,043.56–$5,610.39 | $1,268–$6,817 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$689.67–$4,005.54 | $838–$4,867 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$804.89–$6,021.89 | $978–$7,317 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,012.29–$6,867.11 | $1,230–$8,344 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$804.89–$5,926.42 | $978–$7,201 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$762.10–$4,138.04 | $926–$5,028 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,194.83 | $5,097 | 17.0× |
| MRI cardiac w/o contrast (75557) | $4,402.23 | $5,349 | 17.9× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,683.04–$5,034.29 | $2,045–$6,117 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$792.55–$3,973.44 | $963–$4,828 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$690.50–$7,039.94 | $839–$8,554 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,064.96–$9,248.05 | $1,294–$11,237 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$835.34–$5,161.86 | $1,015–$6,272 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,012.29–$5,413.69 | $1,230–$6,578 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$639.47–$3,905.14 | $777–$4,745 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$875.67–$5,097.66 | $1,064–$6,194 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,076.48–$5,779.11 | $1,308–$7,022 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$676.51–$4,289.48 | $822–$5,212 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$883.08–$4,107.59 | $1,073–$4,991 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,067.43–$8,188.03 | $1,297–$9,949 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$811.48–$5,293.54 | $986–$6,432 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,157.96–$6,256.45 | $1,407–$7,602 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$689.67–$3,933.94 | $838–$4,780 | varies |
| MRI spectroscopy (76390) | $3,296.94 | $4,006 | 36.7× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$702.02–$4,317.46 | $853–$5,246 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$6,675.35–$7,341.16 | $8,111–$8,920 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,305.22–$5,672.12 | $2,801–$6,892 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,014.76–$7,415.23 | $1,233–$9,010 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,036.98–$5,905.85 | $1,260–$7,176 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,076.48–$6,090.20 | $1,308–$7,400 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$834.52–$5,153.63 | $1,014–$6,262 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$721.77–$3,360.31 | $877–$4,083 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,014.76–$6,881.10 | $1,233–$8,361 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,232.03–$5,470.48 | $1,497–$6,647 | varies |
| Myelograpy 2/more regions rs&i (72270) | $1,483.05 | $1,802 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,654.23 | $2,010 | 4.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,308.52 | $2,805 | 1.7× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$878.14–$3,911.72 | $1,067–$4,753 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $5,549.49 | $6,743 | 3.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $11,029.02 | $13,401 | 4.9× |
| N-invas est c ffr sw aly CTA (75580) | $3,560.30 | $4,326 | 4.0× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$93–$265.83 | $113–$323 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $557.99 | $678 | 1.4× |
| Nm myocard infarct spect (78469) | $1,856.69 | $2,256 | 3.3× |
| Nm whole blood volume (78122) | $706.13 | $858 | 1.3× |
| Nonvascular Shunt X-Ray (75809) | $976.90 | $1,187 | 9.1× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,588.34–$16,993.30 | $3,145–$20,648 | varies |
| Nuclear Rx Intra-Arterial (79445) | $490.51 | $596 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $490.51 | $596 | 2.0× |
| Ob us nuchal meas 1 gest (76813) | $370.35 | $450 | 3.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$206.57–$311.09 | $251–$378 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 7 matching MRF lines |
$341.54–$772.80 | $415–$939 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$35.39–$63.37 | $43–$77 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$501.21–$2,933.17 | $609–$3,564 | varies |
| Parathyroid Planar Imaging (78070) | $2,440.20 | $2,965 | 5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,928.23 | $3,558 | 7.1× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$88.06–$280.64 | $107–$341 | varies |
| Peritoneogram Rs&I (74190) | $278.17 | $338 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $7,721.39 | $9,382 | 5.2× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$930.81–$7,641.56 | $1,131–$9,285 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$910.24–$7,870.35 | $1,106–$9,563 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $935.75 | $1,137 | 0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,057.56 | $1,285 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,951.33 | $2,371 | 4.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$116.87–$350.60 | $142–$426 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$153.90–$378.58 | $187–$460 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$64.19–$283.94 | $78–$345 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$56.79–$211.51 | $69–$257 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$123.45–$242.78 | $150–$295 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$83.95–$380.23 | $102–$462 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$58.43–$309.45 | $71–$376 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$63.37–$305.33 | $77–$371 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$123.45–$445.65 | $150–$541.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$87.24–$269.94 | $106–$328 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $300.40 | $365 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$93–$306.98 | $113–$373 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$126.74–$283.94 | $154–$345 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$82.30–$297.10 | $100–$361 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$93–$280.64 | $113–$341 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$89.71–$176.12 | $109–$214 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$93.82–$227.97 | $114–$277 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$133.33–$466.64 | $162–$567 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$56.79–$255.13 | $69–$310 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$71.60–$238.67 | $87–$290 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$125.92–$321.79 | $153–$391 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$175.30–$1,048.50 | $213–$1,274 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,457.81 | $13,922 | 1.5× |
| Radiation treatment delivery level 1 (77402) | $599.14 | $728 | 5.7× |
| Radiation treatment delivery level 2 (77407) | $2,388.35 | $2,902 | 6.0× |
| Radiation treatment delivery level 3 (77412) | $980.19 | $1,191 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$137.44–$336.61 | $167–$409 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$154.72–$365.41 | $188–$444 | varies |
| Radiologic exam colon double contrast study (74280) | $2,192.47 | $2,664 | 12.1× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$314.39–$1,470.70 | $382–$1,787 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$208.22–$822.18 | $253–$999 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$116.87–$350.60 | $142–$426 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$97.94–$334.96 | $119–$407 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$255.95–$1,035.33 | $311–$1,258 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$159.66–$1,203.23 | $194–$1,462 | varies |
| Radiologic exam teeth complete full mouth (70320) | $281.47 | $342 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$490.51–$1,420.50 | $596–$1,726 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$76.54–$230.44 | $93–$280 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$66.66–$280.64 | $81–$341 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$69.13–$268.30 | $84–$326 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$158.02–$629.60 | $192–$765 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$62.55–$247.72 | $76–$301 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $601.61 | $731 | 1.1× |
| Renal Cyst Study (74470) | $1,367 | $1,661 | 2.4× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$130.03–$306.16 | $158–$372 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,583.45 | $1,924 | 3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,200.70 | $2,674 | 5.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,110.01 | $6,209 | 9.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,210.58 | $2,686 | 3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$395.86–$2,706.85 | $481–$3,289 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,508.45 | $4,263 | 2.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$1,338.20–$4,158.62 | $1,626–$5,053 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$467.46–$3,305.99 | $568–$4,017 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $490.51 | $596 | 2.0× |
| Rp Therapy Intravenous Administration (79101) | $490.51 | $596 | 2.0× |
| Scapula (73010) range across 2 matching MRF lines |
$92.18–$217.27 | $112–$264 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$110.28–$164.60 | $134–$200 | varies |
| Sella turcica (70240) | $103.70 | $126 | 1.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$64.19–$180.24 | $78–$219 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$158.84–$994.18 | $193–$1,208 | varies |
| Sialogram (70390) | $525.07 | $638 | 2.1× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$131.68–$309.45 | $160–$376 | varies |
| Special dosimetry (77331) | $408.21 | $496 | 2.9× |
| Special Physics Consult (77370) | $1,145.62 | $1,392 | 8.3× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$571.16–$781.03 | $694–$949 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$645.23–$3,268.96 | $784–$3,972 | varies |
| Stereotactic Body Radiation Delivery (77373) | $12,255.29 | $14,891 | 6.6× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$112.75–$339.08 | $137–$412 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$939.04–$1,983.43 | $1,141–$2,410 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $989.25 | $1,202 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$507.79–$4,429.39 | $617–$5,382 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $349.78 | $425 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$290.52–$2,480.52 | $353–$3,014 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,144.79 | $1,391 | 6.3× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$84.77–$264.18 | $103–$321 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$96.29–$292.16 | $117–$355 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$106.17–$259.24 | $129–$315 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,711.84 | $2,080 | 4.1× |
| Thyroid Met Imaging Body (78018) | $2,553.77 | $3,103 | 4.6× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$207.40–$669.92 | $252–$814 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$181.88–$2,031.99 | $221–$2,469 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$451–$1,284.70 | $548–$1,561 | varies |
| Tx devices design & construction intermediate (77333) | $1,168.66 | $1,420 | 8.4× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$155.55–$598.32 | $189–$727 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$230.44–$711.07 | $280–$864 | varies |
| Ultrasound Elastography Parenchyma (76981) | $566.22 | $688 | 5.2× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$191.76–$512.73 | $233–$623 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$404.09–$516.84 | $491–$628 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$186.82–$466.64 | $227–$567 | varies |
| Unlisted magnetic resonance procedure (76498) | $6,141.23 | $7,462 | 68.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$455.94–$1,680.57 | $554–$2,042 | varies |
| Ureteral Reflux Study (78740) | $1,236.15 | $1,502 | 3.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$199.17–$883.08 | $242–$1,073 | varies |
| Urethrocystography retrograde (74450) | $1,154.67 | $1,403 | 4.7× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$406.56–$1,007.35 | $494–$1,224 | varies |
| Us chest (76604) range across 7 matching MRF lines |
$235.38–$696.26 | $286–$846 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$255.95–$572.81 | $311–$696 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$154.72–$506.97 | $188–$616 | varies |
| Us head (76506) range across 2 matching MRF lines |
$325.08–$565.40 | $395–$687 | varies |
| Us kidney transplant (76776) | $704.49 | $856 | 6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$251.84–$501.21 | $306–$609 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$749.75–$868.26 | $911–$1,055 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$238.67–$404.92 | $290–$492 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$321.79–$432.08 | $391–$525 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$283.11–$531.66 | $344–$646 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$344.01–$540.71 | $418–$657 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$372.82–$470.76 | $453–$572 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$362.12–$695.44 | $440–$845 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$315.21–$507.79 | $383–$617 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$383.52–$574.45 | $466–$698 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$385.16–$579.39 | $468–$704 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$232.09–$567.87 | $282–$690 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$258.42–$1,063.32 | $314–$1,292 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,111.87–$1,667.81 | $1,351–$2,026.50 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $751.40 | $913 | 0.2× |
| Venogram Sinus/Jugular (75860) | $1,066.61 | $1,296 | 0.3× |
| Venography Adrenal Unilateral (75840) | $653.46 | $794 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $918.47 | $1,116 | 0.3× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$967.02–$1,273.18 | $1,175–$1,547 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$304.51–$917.64 | $370–$1,115 | varies |
| Venography Renal Unilateral (75831) | $999.12 | $1,214 | 0.3× |
| Vertebral fracture assessment via dxa (77086) | $497.09 | $604 | 5.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$87.24–$273.24 | $106–$332 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$131.68–$250.19 | $160–$304 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,355.48 | $1,647 | 3.8× |
| X-Ray Aorta Leg Arteries (75630) | $1,747.23 | $2,123 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$92.18–$300.40 | $112–$365 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$69.96–$218.10 | $85–$265 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$107.81–$174.48 | $131–$212 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$121.80–$309.45 | $148–$376 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$113.57–$568.69 | $138–$691 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$339.90–$757.98 | $413–$921 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$97.94–$247.72 | $119–$301 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$81.48–$368.70 | $99–$448 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$158.84–$460.06 | $193–$559 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$81.48–$305.33 | $99–$371 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$115.22–$405.74 | $140–$493 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$112.75–$493.80 | $137–$600 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$166.25–$387.63 | $202–$471 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$93.82–$292.16 | $114–$355 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$195.87–$471.58 | $238–$573 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$125.10–$297.93 | $152–$362 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$93.82–$396.27 | $114–$481.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$120.16–$251.02 | $146–$305 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$98.76–$309.45 | $120–$376 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$65.84–$331.67 | $80–$403 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$93–$368.70 | $113–$448 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$55.14–$210.69 | $67–$256 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$174.48–$376.11 | $212–$457 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$95.47–$292.16 | $116–$355 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$178.59–$275.70 | $217–$335 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$84.77–$251.02 | $103–$305 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$144.02–$323.44 | $175–$393 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$186.82–$368.70 | $227–$448 | varies |
| X-Ray Stress View (77071) | $384.34 | $467 | 4.3× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$158.84–$334.96 | $193–$407 | varies |
| X-Ray Tmj Unilat (70328) | $159.66 | $194 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$152.26–$2,269.83 | $185–$2,758 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$257.60–$427.96 | $313–$520 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$294.63–$785.14 | $358–$954 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$125.10–$401.62 | $152–$488 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$108.64–$249.37 | $132–$303 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $296.28 | $360 | 2.7× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$79.83–$358 | $97–$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.