Imaging prices at Aspirus St. Luke's Hospital
Duluth, 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 |
$927.52–$2,536.67 | $1,705–$4,663 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$56.03–$176.26 | $103–$324 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$66.37–$176.80 | $122–$325 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$191.49–$1,863.20 | $352–$3,425 | varies |
| Angio internal mammary (75756) | $969.41 | $1,782 | 0.3× |
| Angio pulmonary bilat (75743) | $683.26 | $1,256 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $681.63 | $1,253 | 0.2× |
| Angiography extremity unilateral rs&i (75710) | $715.36 | $1,315 | 0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $789.89 | $1,452 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $746.91 | $1,373 | 0.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$36.99–$166.46 | $68–$306 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$636.48 | $1,170 | 0.1× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$743.65 | $1,367 | 0.1× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$813.28–$1,219.92 | $1,495–$2,242.50 | varies |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,315.39 | $2,418 | 0.2× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$166.46–$660.42 | $306–$1,214 | varies |
| Arthrogram Wrist (73115) | $729.50 | $1,341 | 2.0× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$133.28–$281.79 | $245–$518 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$77.25–$200.74 | $142–$369 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$223.58–$1,785.41 | $411–$3,282 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$134.91–$1,237.06 | $248–$2,274 | varies |
| Bone Imaging Multiple Areas (78305) | $1,565.63 | $2,878 | 3.8× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$187.68–$1,567.26 | $345–$2,881 | varies |
| Bone marrow imaging; whole body (78104) | $1,417.12 | $2,605 | 3.4× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$240.45–$523.87 | $442–$963 | varies |
| Brachytx Isodose Plan Simple (77316) | $1,201.70 | $2,209 | 3.1× |
| Brain Image W/Flow < 4 Views (78601) | $1,213.12 | $2,230 | 2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,202.27 | $9,563 | 3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,039.20 | $7,425 | 11.2× |
| Cardiac Shunt Detection (78428) | $609.28 | $1,120 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $1,099.97 | $2,022 | 12.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,017.15 | $3,708 | 3.6× |
| Cerebrospinal Fluid Scan (78630) | $1,997.02 | $3,671 | 3.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$68.54–$135.46 | $126–$249 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$83.78–$179.52 | $154–$330 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$103.36–$208.90 | $190–$384 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$79.97–$153.41 | $147–$282 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$50.05–$157.76 | $92–$290 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$300.83–$1,880.06 | $553–$3,456 | varies |
| Continuing medical physics consltj pr wk (77336) | $838.85 | $1,542 | 6.0× |
| Contrast Exam Abdominl Aorta (75625) | $633.22 | $1,164 | 0.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$84.86–$180.61 | $156–$332 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $931.87 | $1,713 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$544–$3,122.56 | $1,000–$5,740 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$470.56–$2,102.02 | $865–$3,864 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$420.51–$1,974.18 | $773–$3,629 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$331.84–$2,365.31 | $610–$4,348 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$394.40–$1,056.45 | $725–$1,942 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$590.78–$3,778.62 | $1,086–$6,946 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$492.32–$1,931.74 | $905–$3,551 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$613.63–$2,313.63 | $1,128–$4,253 | varies |
| CT angio hrt w/3d image (75574) | $3,081.22 | $5,664 | 8.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$576.64–$3,072.51 | $1,060–$5,648 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$613.63–$2,206.46 | $1,128–$4,056 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$528.77–$2,806.50 | $972–$5,159 | varies |
| CT bone density (77078) | $1,212.03 | $2,228 | 13.5× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,411.14 | $2,594 | 7.8× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,957.31–$2,362.05 | $3,598–$4,342 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$361.76–$1,310.50 | $665–$2,409 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$300.83–$2,392.51 | $553–$4,398 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$314.98–$1,592.83 | $579–$2,928 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$456.96–$1,927.94 | $840–$3,544 | varies |
| CT colonography screening (74263) | $7,272.74 | $13,369 | 29.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $4,670.78 | $8,586 | 25.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $4,083.26 | $7,506 | 37.7× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$358.50–$1,291.46 | $659–$2,374 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$445.54–$1,538.98 | $819–$2,829 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,025.31 | $3,723 | 5.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $53.86 | $99 | 0.6× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$461.86–$2,327.78 | $849–$4,279 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$420.51–$2,415.36 | $773–$4,440 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$237.18–$1,553.12 | $436–$2,855 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$384.61–$1,925.76 | $707–$3,540 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$404.19–$1,912.70 | $743–$3,516 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$271.46–$1,553.12 | $499–$2,855 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$411.81–$1,315.94 | $757–$2,419 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$298.11–$1,165.25 | $548–$2,142 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$569.02–$2,078.62 | $1,046–$3,821 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$504.29–$2,733.06 | $927–$5,024 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$428.13–$1,919.23 | $787–$3,528 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$467.30–$2,322.34 | $859–$4,269 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$257.86–$1,068.96 | $474–$1,965 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$476.54–$2,508.38 | $876–$4,611 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$442.27–$1,649.41 | $813–$3,032 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$484.70–$1,600.99 | $891–$2,943 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$449.34–$1,190.27 | $826–$2,188 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$388.96–$1,974.72 | $715–$3,630 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$237.18–$1,531.90 | $436–$2,816 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$420.51–$2,339.20 | $773–$4,300 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$373.18–$1,201.15 | $686–$2,208 | varies |
| CT unlisted procedure (76497) | $1,484.58 | $2,729 | 16.5× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$237.18–$1,498.18 | $436–$2,754 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$288.32–$1,161.44 | $530–$2,135 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$384.61–$1,977.44 | $707–$3,635 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$559.23–$3,488.13 | $1,028–$6,412 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$580.45–$2,643.30 | $1,067–$4,859 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,359.20 | $6,175 | 9.3× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$560.32–$2,524.70 | $1,030–$4,641 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,116.29 | $2,052 | 4.5× |
| Diskography lumbar (72295) | $698.50 | $1,284 | 0.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $298.11 | $548 | 2.8× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$203.46–$333.47 | $374–$613 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$87.04–$246.98 | $160–$454 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$129.47–$239.36 | $238–$440 | varies |
| Echo exam uterus (76831) | $353.60 | $650 | 1.4× |
| Echo Guide For Artery Repair (76936) | $1,580.86 | $2,906 | 7.1× |
| Esophagram (74220) range across 2 matching MRF lines |
$139.81–$481.44 | $257–$885 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$261.66–$433.57 | $481–$797 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$218.69–$345.98 | $402–$636 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$63.10–$379.71 | $116–$698 | varies |
| Follow-Up Angiography (75898) | $2,795.07 | $5,138 | 0.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$37.54–$146.88 | $69–$270 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$75.62–$149.06 | $139–$274 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$170.82–$1,783.78 | $314–$3,279 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,407.87 | $2,588 | 3.4× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$465.12–$1,896.93 | $855–$3,487 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$57.66–$157.76 | $106–$290 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,795.62 | $5,139 | 3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,068.83 | $3,803 | 2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $688.70 | $1,266 | 0.2× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$215.97–$2,208.64 | $397–$4,060 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$177.89–$1,876.26 | $327–$3,449 | varies |
| Ht Musc Image Planar Mult (78454) | $2,411.55 | $4,433 | 1.8× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$594.59–$1,688.03 | $1,093–$3,103 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$79.42–$489.60 | $146–$900 | varies |
| Image fusion (77399) | $587.52 | $1,080 | 4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$295.39–$474.91 | $543–$873 | varies |
| Infant hip ultrasound, limited static exam (76886) | $333.47 | $613 | 3.7× |
| Infusion Ivp (74410) | $802.94 | $1,476 | 4.4× |
| K Flow/Funct Image Multiple (78709) | $1,795.74 | $3,301 | 3.2× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$305.18–$749.63 | $561–$1,378 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$190.94–$1,152.74 | $351–$2,119 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,251.74 | $2,301 | 3.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$43.52–$212.70 | $80–$391 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$87.04–$1,052.10 | $160–$1,934 | varies |
| Liver imaging static only (78201) | $794.24 | $1,460 | 1.4× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,720.13–$1,880.06 | $3,162–$3,456 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$156.13–$1,066.78 | $287–$1,961 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$232.83–$1,697.82 | $428–$3,121 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,318.66–$1,742.98 | $2,424–$3,204 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,099.71 | $5,698 | 0.9× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$815.46–$3,189.47 | $1,499–$5,863 | varies |
| Mammary ductogram or galactogram multiple (77054) | $608.19 | $1,118 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $456.42 | $839 | 1.8× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$126.75–$1,789.76 | $233–$3,290 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$884.54–$2,908.77 | $1,626–$5,347 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $74.53 | $137 | 2.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $201.28 | $370 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$514.62–$4,383.55 | $946–$8,058 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$394.40–$3,140.51 | $725–$5,773 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$335.65–$3,395.65 | $617–$6,242 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$626.69–$4,730.62 | $1,152–$8,696 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$808.38–$2,901.15 | $1,486–$5,333 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$689.79–$3,708.45 | $1,268–$6,817 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$455.87–$2,647.65 | $838–$4,867 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$532.03–$3,980.45 | $978–$7,317 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$669.12–$4,539.14 | $1,230–$8,344 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$532.03–$3,917.34 | $978–$7,201 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$503.74–$2,735.23 | $926–$5,028 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,772.77 | $5,097 | 11.2× |
| MRI cardiac w/o contrast (75557) | $2,909.86 | $5,349 | 11.8× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,112.48–$3,327.65 | $2,045–$6,117 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$523.87–$2,626.43 | $963–$4,828 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$456.42–$4,653.38 | $839–$8,554 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$703.94–$6,112.93 | $1,294–$11,237 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$552.16–$3,411.97 | $1,015–$6,272 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$669.12–$3,578.43 | $1,230–$6,578 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$422.69–$2,581.28 | $777–$4,745 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$578.82–$3,369.54 | $1,064–$6,194 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$711.55–$3,819.97 | $1,308–$7,022 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$447.17–$2,835.33 | $822–$5,212 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$583.71–$2,715.10 | $1,073–$4,991 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$705.57–$5,412.26 | $1,297–$9,949 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$536.38–$3,499.01 | $986–$6,432 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$765.41–$4,135.49 | $1,407–$7,602 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$455.87–$2,600.32 | $838–$4,780 | varies |
| MRI spectroscopy (76390) | $2,179.26 | $4,006 | 24.2× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$464.03–$2,853.82 | $853–$5,246 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$4,412.38–$4,852.48 | $8,111–$8,920 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,523.74–$3,749.25 | $2,801–$6,892 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$670.75–$4,901.44 | $1,233–$9,010 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$685.44–$3,903.74 | $1,260–$7,176 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$711.55–$4,025.60 | $1,308–$7,400 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$551.62–$3,406.53 | $1,014–$6,262 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$477.09–$2,221.15 | $877–$4,083 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$670.75–$4,548.38 | $1,233–$8,361 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$814.37–$3,615.97 | $1,497–$6,647 | varies |
| Myelograpy 2/more regions rs&i (72270) | $980.29 | $1,802 | 1.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,093.44 | $2,010 | 2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,525.92 | $2,805 | 1.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$580.45–$2,585.63 | $1,067–$4,753 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,668.19 | $6,743 | 2.5× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $7,290.14 | $13,401 | 3.2× |
| N-invas est c ffr sw aly CTA (75580) | $2,353.34 | $4,326 | 2.6× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$61.47–$175.71 | $113–$323 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $368.83 | $678 | 0.9× |
| Nm myocard infarct spect (78469) | $1,227.26 | $2,256 | 2.2× |
| Nm whole blood volume (78122) | $466.75 | $858 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $645.73 | $1,187 | 6.0× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$1,710.88–$11,232.51 | $3,145–$20,648 | varies |
| Nuclear Rx Intra-Arterial (79445) | $324.22 | $596 | 1.3× |
| Nuclear Rx Oral Admin (79005) | $324.22 | $596 | 1.3× |
| Ob us nuchal meas 1 gest (76813) | $244.80 | $450 | 2.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$136.54–$205.63 | $251–$378 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 7 matching MRF lines |
$225.76–$510.82 | $415–$939 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$23.39–$41.89 | $43–$77 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$331.30–$1,938.82 | $609–$3,564 | varies |
| Parathyroid Planar Imaging (78070) | $1,612.96 | $2,965 | 3.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,935.55 | $3,558 | 4.7× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$58.21–$185.50 | $107–$341 | varies |
| Peritoneogram Rs&I (74190) | $183.87 | $338 | 0.3× |
| Pet Image W/Ct Lmtd (78814) | $5,103.81 | $9,382 | 3.4× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$615.26–$5,051.04 | $1,131–$9,285 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$601.66–$5,202.27 | $1,106–$9,563 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $618.53 | $1,137 | 0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $699.04 | $1,285 | 0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,289.82 | $2,371 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$77.25–$231.74 | $142–$426 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$101.73–$250.24 | $187–$460 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$42.43–$187.68 | $78–$345 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$37.54–$139.81 | $69–$257 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$81.60–$160.48 | $150–$295 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$55.49–$251.33 | $102–$462 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$38.62–$204.54 | $71–$376 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$41.89–$201.82 | $77–$371 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$81.60–$294.58 | $150–$541.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$57.66–$178.43 | $106–$328 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $198.56 | $365 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$61.47–$202.91 | $113–$373 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$83.78–$187.68 | $154–$345 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$54.40–$196.38 | $100–$361 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$61.47–$185.50 | $113–$341 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$59.30–$116.42 | $109–$214 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$62.02–$150.69 | $114–$277 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$88.13–$308.45 | $162–$567 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$37.54–$168.64 | $69–$310 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$47.33–$157.76 | $87–$290 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$83.23–$212.70 | $153–$391 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$115.87–$693.06 | $213–$1,274 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,573.57 | $13,922 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $396.03 | $728 | 3.7× |
| Radiation treatment delivery level 2 (77407) | $1,578.69 | $2,902 | 4.0× |
| Radiation treatment delivery level 3 (77412) | $647.90 | $1,191 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$90.85–$222.50 | $167–$409 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$102.27–$241.54 | $188–$444 | varies |
| Radiologic exam colon double contrast study (74280) | $1,449.22 | $2,664 | 8.0× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$207.81–$972.13 | $382–$1,787 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$137.63–$543.46 | $253–$999 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$77.25–$231.74 | $142–$426 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$64.74–$221.41 | $119–$407 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$169.18–$684.35 | $311–$1,258 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$105.54–$795.33 | $194–$1,462 | varies |
| Radiologic exam teeth complete full mouth (70320) | $186.05 | $342 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$324.22–$938.94 | $596–$1,726 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$50.59–$152.32 | $93–$280 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$44.06–$185.50 | $81–$341 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$45.70–$177.34 | $84–$326 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$104.45–$416.16 | $192–$765 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$41.34–$163.74 | $76–$301 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $397.66 | $731 | 0.7× |
| Renal Cyst Study (74470) | $903.58 | $1,661 | 1.6× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$85.95–$202.37 | $158–$372 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,046.66 | $1,924 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,454.66 | $2,674 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,377.70 | $6,209 | 6.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,461.18 | $2,686 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$261.66–$1,789.22 | $481–$3,289 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,319.07 | $4,263 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$884.54–$2,748.83 | $1,626–$5,053 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$308.99–$2,185.25 | $568–$4,017 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $324.22 | $596 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $324.22 | $596 | 1.3× |
| Scapula (73010) range across 2 matching MRF lines |
$60.93–$143.62 | $112–$264 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$72.90–$108.80 | $134–$200 | varies |
| Sella turcica (70240) | $68.54 | $126 | 0.8× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$42.43–$119.14 | $78–$219 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$104.99–$657.15 | $193–$1,208 | varies |
| Sialogram (70390) | $347.07 | $638 | 1.4× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$87.04–$204.54 | $160–$376 | varies |
| Special dosimetry (77331) | $269.82 | $496 | 1.9× |
| Special Physics Consult (77370) | $757.25 | $1,392 | 5.4× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$377.54–$516.26 | $694–$949 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$426.50–$2,160.77 | $784–$3,972 | varies |
| Stereotactic Body Radiation Delivery (77373) | $8,100.70 | $14,891 | 4.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$74.53–$224.13 | $137–$412 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$620.70–$1,311.04 | $1,141–$2,410 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $653.89 | $1,202 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$335.65–$2,927.81 | $617–$5,382 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $231.20 | $425 | 0.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$192.03–$1,639.62 | $353–$3,014 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $756.70 | $1,391 | 4.2× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$56.03–$174.62 | $103–$321 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$63.65–$193.12 | $117–$355 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$70.18–$171.36 | $129–$315 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,131.52 | $2,080 | 2.7× |
| Thyroid Met Imaging Body (78018) | $1,688.03 | $3,103 | 3.0× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$137.09–$442.82 | $252–$814 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$120.22–$1,343.14 | $221–$2,469 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$298.11–$849.18 | $548–$1,561 | varies |
| Tx devices design & construction intermediate (77333) | $772.48 | $1,420 | 5.6× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$102.82–$395.49 | $189–$727 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$152.32–$470.02 | $280–$864 | varies |
| Ultrasound Elastography Parenchyma (76981) | $374.27 | $688 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$126.75–$338.91 | $233–$623 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$267.10–$341.63 | $491–$628 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$123.49–$308.45 | $227–$567 | varies |
| Unlisted magnetic resonance procedure (76498) | $4,059.33 | $7,462 | 45.1× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$301.38–$1,110.85 | $554–$2,042 | varies |
| Ureteral Reflux Study (78740) | $817.09 | $1,502 | 2.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$131.65–$583.71 | $242–$1,073 | varies |
| Urethrocystography retrograde (74450) | $763.23 | $1,403 | 3.1× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$268.74–$665.86 | $494–$1,224 | varies |
| Us chest (76604) range across 7 matching MRF lines |
$155.58–$460.22 | $286–$846 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$169.18–$378.62 | $311–$696 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$102.27–$335.10 | $188–$616 | varies |
| Us head (76506) range across 2 matching MRF lines |
$214.88–$373.73 | $395–$687 | varies |
| Us kidney transplant (76776) | $465.66 | $856 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$166.46–$331.30 | $306–$609 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$495.58–$573.92 | $911–$1,055 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$157.76–$267.65 | $290–$492 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$212.70–$285.60 | $391–$525 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$187.14–$351.42 | $344–$646 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$227.39–$357.41 | $418–$657 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$246.43–$311.17 | $453–$572 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$239.36–$459.68 | $440–$845 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$208.35–$335.65 | $383–$617 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$253.50–$379.71 | $466–$698 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$254.59–$382.98 | $468–$704 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$153.41–$375.36 | $282–$690 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$170.82–$702.85 | $314–$1,292 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$734.94–$1,102.42 | $1,351–$2,026.50 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $496.67 | $913 | 0.2× |
| Venogram Sinus/Jugular (75860) | $705.02 | $1,296 | 0.2× |
| Venography Adrenal Unilateral (75840) | $431.94 | $794 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $607.10 | $1,116 | 0.2× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$639.20–$841.57 | $1,175–$1,547 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$201.28–$606.56 | $370–$1,115 | varies |
| Venography Renal Unilateral (75831) | $660.42 | $1,214 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $328.58 | $604 | 3.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$57.66–$180.61 | $106–$332 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$87.04–$165.38 | $160–$304 | varies |
| X-ray antegrade pyelogram tube (74425) | $895.97 | $1,647 | 2.5× |
| X-Ray Aorta Leg Arteries (75630) | $1,154.91 | $2,123 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$60.93–$198.56 | $112–$365 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$46.24–$144.16 | $85–$265 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$71.26–$115.33 | $131–$212 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$80.51–$204.54 | $148–$376 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$75.07–$375.90 | $138–$691 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$224.67–$501.02 | $413–$921 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$64.74–$163.74 | $119–$301 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$53.86–$243.71 | $99–$448 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$104.99–$304.10 | $193–$559 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$53.86–$201.82 | $99–$371 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$76.16–$268.19 | $140–$493 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$74.53–$326.40 | $137–$600 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$109.89–$256.22 | $202–$471 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$62.02–$193.12 | $114–$355 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$129.47–$311.71 | $238–$573 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$82.69–$196.93 | $152–$362 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$62.02–$261.94 | $114–$481.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$79.42–$165.92 | $146–$305 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$65.28–$204.54 | $120–$376 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$43.52–$219.23 | $80–$403 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$61.47–$243.71 | $113–$448 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$36.45–$139.26 | $67–$256 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$115.33–$248.61 | $212–$457 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$63.10–$193.12 | $116–$355 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$118.05–$182.24 | $217–$335 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$56.03–$165.92 | $103–$305 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$95.20–$213.79 | $175–$393 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$123.49–$243.71 | $227–$448 | varies |
| X-Ray Stress View (77071) | $254.05 | $467 | 2.8× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$104.99–$221.41 | $193–$407 | varies |
| X-Ray Tmj Unilat (70328) | $105.54 | $194 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$100.64–$1,500.35 | $185–$2,758 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$170.27–$282.88 | $313–$520 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$194.75–$518.98 | $358–$954 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$82.69–$265.47 | $152–$488 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$71.81–$164.83 | $132–$303 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $195.84 | $360 | 1.8× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$52.77–$236.64 | $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.