Imaging prices at Baptist Beaumont Hospital
Beaumont, TX · every code in this section with a posted price and a Medicare benchmark.
328 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 |
$182.13–$900.12 | $1,401–$6,924 | varies |
| Abdomen 1 View (74018) | $176.80 | $1,360 | 2.0× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$144.04–$227.37 | $1,108–$1,749 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $934.44 | $7,188 | 2.3× |
| Angio pulmonary bilat (75743) | $780 | $6,000 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $1,718.21 | $13,217 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,708.46 | $13,142 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $657.93 | $5,061 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $422.11 | $3,247 | 0.1× |
| Ankle 2 views (73600) | $149.37 | $1,149 | 1.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $815.88 | $6,276 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,490.45 | $11,465 | 0.3× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$967.04 | $7,438.80 | 0.2× |
| Arthrogram hip (73525) | $256.49 | $1,973 | 0.7× |
| Arthrogram Wrist (73115) | $239.59 | $1,843 | 0.7× |
| Basic radiation dosimetry calculation (77300) | $154.31 | $1,187 | 1.1× |
| Bone age studies (77072) | $36.27 | $279 | 0.3× |
| Bone Imaging 3 Phase (78315) | $1,275.43 | $9,811 | 3.2× |
| Bone Imaging Limited Area (78300) | $362.70 | $2,790 | 0.9× |
| Bone Imaging Whole Body (78306) | $860.21 | $6,617 | 2.1× |
| Bone survey infant (77076) | $35.62 | $274 | 0.3× |
| Brachytx isodose complex (77318) | $120.25 | $925 | 0.3× |
| Brachytx Isodose Plan Simple (77316) | $48.75 | $375 | 0.1× |
| Brain Flow Imaging Only (78610) | $71.37 | $549 | 0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $578.37 | $4,449 | 0.4× |
| Cat Scan Follow-Up Study (76380) | $196.43 | $1,511 | 2.2× |
| Cerebrospinal Fluid Scan (78630) | $712.40 | $5,480 | 1.3× |
| Chest 1 view (71045) | $157.17 | $1,209 | 1.8× |
| Chest 2 views (71046) | $286 | $2,200 | 3.3× |
| Chest 3 views (71047) | $270.50 | $2,080.80 | 3.1× |
| Chest 4 or more views (71048) | $355.94 | $2,738 | 3.4× |
| Clavicle complete (73000) | $169.26 | $1,302 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$50 | $112–$134 | 0.5× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$37.67–$143.26 | $289.80–$1,102 | varies |
| Contrast Exam Abdominl Aorta (75625) | $1,718.21 | $13,217 | 0.5× |
| Contrast X-Ray Bladder (74430) | $359.84 | $2,768 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $109.20 | $840 | 0.3× |
| Contrast X-Ray Of Knee Joint (73580) | $383.11 | $2,947 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,624.74 | $12,498 | 4.6× |
| CT abdomen and pelvis without contrast (74176) | $1,127.88 | $8,676 | 4.7× |
| CT abdomen w contrast (74160) | $722.15 | $5,555 | 4.1× |
| CT abdomen w wo contrast (74170) | $833.56 | $6,412 | 4.7× |
| CT abdomen w/o contrast (74150) | $659.75 | $5,075 | 6.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,356.16 | $10,432 | 3.9× |
| CT Angio Chest (71275) | $1,065.09 | $8,193 | 6.0× |
| CT Angio Head (70496) | $671.58 | $5,166 | 3.8× |
| CT angio hrt w/3d image (75574) | $264.94 | $2,038 | 0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $581.10 | $4,470 | 3.3× |
| CT Angio Neck (70498) | $834.86 | $6,422 | 4.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $461.89 | $3,553 | 2.6× |
| CT cervical spine w/ contrast (72126) | $556.27 | $4,279 | 1.6× |
| CT cervical spine w/o contrast (72125) | $538.85 | $4,145 | 5.1× |
| CT cervical spine w/wo cont (72127) | $597.61 | $4,597 | 3.4× |
| CT chest w contrast (71260) | $699.79 | $5,383 | 4.0× |
| CT chest w/wo contrast (71270) | $1,126.72 | $8,667.11 | 6.4× |
| CT head/brain with contrast (70460) | $531.44 | $4,088 | 3.0× |
| CT head/brain without and with contrast (70470) | $754.26 | $5,802 | 4.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $236.73 | $1,821 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $75 | $812 | 0.9× |
| CT hrt w/3d image congen (75573) | $94.38 | $726 | 0.3× |
| CT iac w contrast (70481) | $533 | $4,100 | 3.0× |
| CT l-spine w&w/o contrast (72133) | $580.71 | $4,467 | 3.3× |
| CT lower ext w/o (73700) | $487.37 | $3,749 | 4.6× |
| CT lower extremity w/contrast material (73701) | $520 | $4,000 | 3.0× |
| CT lumbar spine w contrast (72132) | $552.24 | $4,248 | 1.6× |
| CT lumbar spine w/o contrast (72131) | $532.48 | $4,096 | 5.1× |
| CT maxillofacial w contrast (70487) | $521.69 | $4,013 | 3.0× |
| CT maxillofacial wo contrast (70486) | $501.41 | $3,857 | 4.8× |
| CT neck tissue combo (70492) | $775.45 | $5,965 | 4.4× |
| CT orbits w/o contrast (70480) | $519.87 | $3,999 | 5.0× |
| CT pelvis w&w/o contrast (72194) | $686.14 | $5,278 | 3.9× |
| CT pelvis w/o contrast (72192) | $473.98 | $3,646 | 4.5× |
| CT scan of leg combo (73702) | $596.31 | $4,587 | 3.4× |
| CT scans face/jaw combo (70488) | $556.92 | $4,284 | 3.2× |
| CT soft tissue neck w contrast (70491) | $591.37 | $4,549 | 3.4× |
| CT soft tissue neck w/o contrast (70490) | $435.50 | $3,350 | 4.1× |
| CT thoracic spine w contrast (72129) | $520.78 | $4,006 | 3.0× |
| CT thoracic spine w/o contrast (72128) | $504.14 | $3,878 | 4.8× |
| CT thorax w/o contrast (71250) | $525.72 | $4,044 | 5.0× |
| CT upper ext wo (73200) | $411.06 | $3,162 | 3.9× |
| CT upper extremity w/o & w/contrast material (73202) | $520.65 | $4,005 | 3.0× |
| CT upper extremity with contrast (73201) | $442 | $3,400 | 1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $592.67 | $4,559 | 3.4× |
| Cta Abdomen (74175) | $722.41 | $5,557 | 4.1× |
| CTA pelvis (72191) | $689.91 | $5,307 | 3.9× |
| Dilation ureters/urethra rs&i (74485) | $459.68 | $3,536 | 0.2× |
| Discography Cerv/Thor Spine (72285) | $617.37 | $4,749 | 0.3× |
| Diskography lumbar (72295) | $852.02 | $6,554 | 0.4× |
| Dxa Bone Density Axial (77080) | $215.02 | $1,654 | 2.0× |
| Echo exam uterus (76831) | $138.19 | $1,063 | 0.6× |
| Esophagram (74220) | $234.52 | $1,804 | 1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $194.38 | $1,495.20 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $304.20 | $2,340 | 1.3× |
| Follow-Up Angiography (75898) | $422.11 | $3,247 | 0.1× |
| Foot 2 views (73620) | $150.93 | $1,161 | 1.7× |
| Forearm 2 views (73090) | $315.90 | $2,430 | 3.6× |
| Gastric emptying imaging study (78264) | $764.66 | $5,882 | 1.9× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$498.55–$498.58 | $3,835–$3,835.20 | varies |
| Gated Heart, Multiple (78473) | $388.18 | $2,986 | 1.0× |
| Hand 2 views (73120) | $266.24 | $2,048 | 2.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $272.22 | $2,094 | 0.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $272.22 | $2,094 | 0.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $272.22 | $2,094 | 0.4× |
| Heart first pass single,planar (78481) | $192.27 | $1,479 | 0.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,201.98 | $9,246 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,380.73 | $10,621 | 2.5× |
| Hepatobiliary System Imaging (78226) | $860.21 | $6,617 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $664.82 | $5,114 | 0.5× |
| Hysterosalpingogram (74740) | $204.49 | $1,573 | 0.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $43.42 | $334 | 0.5× |
| Interstitial radiation source applic complex (77778) | $476.45 | $3,665 | 0.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $234.65 | $1,805 | 0.3× |
| Intracavitary Radiation Source Applic Intermed (77762) | $191.75 | $1,475 | 0.3× |
| Intracavitary radiation source applic simple (77761) | $166.79 | $1,283 | 0.3× |
| K Flow/Funct Image W/O Drug (78707) | $752.44 | $5,788 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $85.80 | $660 | 0.2× |
| Knee 3 Views (73562) | $281.06 | $2,162 | 3.2× |
| Liver & Spleen Imaging Static Only (78215) | $626.60 | $4,820 | 1.6× |
| Liver imaging static only (78201) | $290.16 | $2,232 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,731.99 | $13,323 | 3.2× |
| Lung Ventilation Imaging (78579) | $210.99 | $1,623 | 0.5× |
| Lymph System Imaging (78195) | $790.79 | $6,083 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $368.29 | $2,833 | 1.5× |
| Mammary ductogram or galactogram single (77053) | $126.88 | $976 | 0.5× |
| Meckels Divert Exam (78290) | $542.75 | $4,174.99 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $139.23 | $1,071 | 0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $9.75 | $75 | 0.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $39 | $300 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,009.32 | $7,764 | 2.9× |
| MRA head w/o contrast (70544) | $892.97 | $6,869 | 3.7× |
| MRA head with contrast (70545) | $917.54 | $7,058 | 2.6× |
| MRA neck w contrast (70548) | $702 | $5,400 | 2.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,307.02 | $10,054 | 3.7× |
| MRA neck w/o contrast (70547) | $571.22 | $4,394 | 2.4× |
| MRI abdomen w contrast (74182) | $1,220.70 | $9,390 | 3.5× |
| MRI abdomen w/o contrast (74181) | $1,099.93 | $8,461 | 4.6× |
| MRI any jt lower extrem w/contrast material (73722) | $421.59 | $3,243 | 0.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,960.53 | $15,081 | 5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,043.64 | $8,028 | 1.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $473.20 | $3,640 | 2.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $367.38 | $2,826 | 1.5× |
| MRI cervical spine w contrast (72142) | $1,179.62 | $9,074 | 3.4× |
| MRI cervical spine w/o cont (72141) | $1,123.72 | $8,644 | 4.7× |
| MRI chest w/o contrast (71550) | $975 | $7,500 | 4.1× |
| MRI chest wo w contrast (71552) | $1,596.01 | $12,277 | 4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,001 | $7,700 | 2.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,532.18 | $11,786 | 4.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $973.05 | $7,485 | 4.1× |
| MRI lumbar spine w contrast (72149) | $1,384.24 | $10,648 | 3.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,339 | $10,300 | 3.8× |
| MRI orbit face &/neck w/o contrast (70540) | $347.23 | $2,671 | 1.4× |
| MRI orbit face neck w contrast (70542) | $455 | $3,500 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $899.21 | $6,917 | 2.6× |
| MRI pelvis w contrast (72196) | $1,157 | $8,900 | 3.3× |
| MRI pelvis w/o & w contrast (72197) | $1,456.78 | $11,206 | 4.2× |
| MRI pelvis w/o contrast (72195) | $942.89 | $7,253 | 3.9× |
| MRI thoracic spine w/o contrast (72146) | $1,214.59 | $9,343 | 5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $640.25 | $4,925 | 1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $591.50 | $4,550 | 2.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,536.73 | $11,821 | 4.4× |
| MRI, abdomen, combo (74183) | $2,198.69 | $16,913 | 6.3× |
| MRI, dorsal spine combo (72157) | $1,342.64 | $10,328 | 3.8× |
| MRI, dorsal spine contrast (72147) | $1,280.50 | $9,850 | 3.7× |
| MRI, joint upper extrem (73221) | $994.24 | $7,648 | 4.1× |
| MRI, joint upper extrem combo (73223) | $1,236.74 | $9,513.35 | 3.5× |
| MRI, lumbar spine combo (72158) | $1,726.40 | $13,280 | 4.9× |
| Myelogram cervical (72240) | $282.10 | $2,170 | 0.4× |
| Myelogram Lumbar (72265) | $292.37 | $2,249 | 0.4× |
| Myelography thoracic (72255) | $192.14 | $1,478 | 0.2× |
| Myelograpy 2/more regions rs&i (72270) | $317.20 | $2,440 | 0.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $87.23 | $671 | 0.2× |
| Myocardial Spect Multiple Studies (78452) | $2,184 | $16,800 | 1.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $976.62 | $7,512.45 | 0.4× |
| N-invas est c ffr sw aly CTA (75580) | $526.50 | $4,050 | 0.6× |
| Neck soft tissue (70360) | $112.71 | $867 | 1.3× |
| Nm myocard infarct spect (78469) | $236.99 | $1,823 | 0.4× |
| Nm unlisted gi procedure (78299) | $168.09 | $1,293 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $801.06 | $6,162 | 0.6× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$147.55–$147.58 | $1,135–$1,135.20 | varies |
| Nuclear Rx Oral Admin (79005) | $796.38 | $6,126 | 3.4× |
| Parathyroid Planar Imaging (78070) | $543.14 | $4,178 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $179.14 | $1,378 | 0.4× |
| Pelvis 1 or 2 views (72170) | $256.75 | $1,975 | 2.4× |
| Peritoneogram Rs&I (74190) | $138.06 | $1,062 | 0.3× |
| Pet Image W/Ct Lmtd (78814) | $668.98 | $5,146 | 0.5× |
| PET image w/CT, full body (78816) | $1,924 | $14,800 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,861.60 | $14,320 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $680.94 | $5,238 | 0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $359.58 | $2,766 | 0.9× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $464.10 | $3,570 | 0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $319.67 | $2,459 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $113.23 | $871 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $270.53 | $2,081 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $238.68 | $1,836 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $256.62 | $1,974 | 2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $296.92 | $2,284 | 2.8× |
| Radex fingr minimum 2 views (73140) | $110.76 | $852 | 1.3× |
| Radex foot complete minimum 3 views (73630) | $268.84 | $2,068 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $312.39 | $2,403 | 3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $163.02 | $1,254 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $268.19 | $2,063 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $182.78 | $1,406 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $389.35 | $2,995 | 4.5× |
| Radex Spine 1 View Specify Level (72020) | $196.56 | $1,512 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $260.91 | $2,007 | 3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $123.37 | $949 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $171.73 | $1,321 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $293.93 | $2,261 | 3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,506.70 | $11,590 | 0.2× |
| Radiation treatment delivery level 1 (77402) | $42.90 | $330 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $92.56 | $712 | 0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $284.57 | $2,189 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $250.47 | $1,926.67 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $393.64 | $3,028 | 2.2× |
| Radiologic exam colon single contrast study (74270) | $312.26 | $2,402 | 1.8× |
| Radiologic exam knee complete 4/more views (73564) | $319.28 | $2,456 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $292.50 | $2,250 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $160.29 | $1,233 | 0.9× |
| Radiologic exam swallow function contrast study (74230) | $251.68 | $1,936 | 1.4× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $31.72 | $244 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $459.55 | $3,535 | 2.6× |
| Radiologic examination femur minimum 2 views (73552) | $178.88 | $1,376 | 2.0× |
| Radiologic examination knee 1/2 views (73560) | $172.51 | $1,327 | 2.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $451 | $3,469.20 | 4.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $330.72 | $2,544 | 3.8× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $14.95 | $115 | 0.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $73.97 | $569 | 0.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $73.97 | $569 | 0.2× |
| Renal Cyst Study (74470) | $103.61 | $797 | 0.2× |
| Ribs bilateral 3 views (71110) | $336.44 | $2,588 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $193.18 | $1,486 | 0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $94.12 | $724 | 0.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,880.58 | $14,466 | 3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $336.83 | $2,591 | 0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,920.36 | $14,772 | 3.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $134.03 | $1,031 | 0.6× |
| Rp Therapy Intravenous Administration (79101) | $131.56 | $1,012 | 0.6× |
| Rp Therapy Unlisted Procedure (79999) | $75.27 | $579 | 0.3× |
| Scapula (73010) | $275.86 | $2,122 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $29.38 | $226 | 1.3× |
| Shoulder 1 view (73020) | $155.74 | $1,198 | 1.8× |
| Shoulder Arthrography (73040) | $438.10 | $3,370 | 1.3× |
| Sialogram (70390) | $114.92 | $884 | 0.5× |
| Skull less than 4 views (70250) | $279.11 | $2,147 | 2.7× |
| Special dosimetry (77331) | $132.60 | $1,020 | 1.0× |
| Special Physics Consult (77370) | $113.23 | $871 | 0.8× |
| Special teletherapy port plan (77321) | $155.87 | $1,199 | 0.4× |
| Special treatment procedure (77470) | $234.39 | $1,803 | 0.4× |
| Srs Multisource (77371) likely a partial charge, not the full procedure |
$1,283.36 | $9,872 | 0.2× |
| Stereotactic Body Radiation Delivery (77373) | $1,753.70 | $13,490 | 1.0× |
| Sternoclavicular joints (71130) | $62.40 | $480 | 0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $53.56 | $412 | 0.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $48.75 | $375 | 0.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $302.38 | $2,326 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $187.07 | $1,439 | 0.5× |
| Ther rad simulaj-aided field setting simple (77280) | $155.87 | $1,199 | 1.2× |
| Thoracic spine 3 views (72072) | $275.99 | $2,123 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $115.31 | $887 | 0.3× |
| Thyroid Met Imaging Body (78018) | $801.71 | $6,167 | 1.5× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$53.95–$177.19 | $415–$1,363 | varies |
| Tx Devices Design & Construction Complex (77334) | $357.24 | $2,748 | 0.9× |
| Tx devices design & construction intermediate (77333) | $149.63 | $1,151 | 1.1× |
| Tx devices design & construction simple (77332) | $63.18 | $486 | 0.5× |
| Ultrasound Breast Limited (76642) | $108.29 | $833 | 1.2× |
| Ultrasound Elastography Parenchyma (76981) | $217.23 | $1,671 | 2.1× |
| Ultrasound, abdomen limited (76705) | $346.58 | $2,666 | 3.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $52.78 | $406 | 0.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 5 matching MRF lines |
$42.25–$272.22 | $325–$2,094 | varies |
| Unlisted us procedure (76999) | $26 | $200 | 0.3× |
| Upper gi w/o kub (74240) | $456.30 | $3,510 | 2.6× |
| Urethrocystogram voiding (74455) | $268.48 | $2,065.20 | 1.1× |
| Urethrocystography retrograde (74450) | $333.32 | $2,564 | 1.4× |
| Us bone density measurement (76977) | $16.64 | $128 | 0.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$210.08–$315.12 | $1,616–$2,424 | varies |
| Us chest (76604) | $255.32 | $1,964 | 2.4× |
| Us complete joint (76881) | $374.92 | $2,884 | 3.6× |
| Us exam, pelvic, limited (76857) | $326.69 | $2,513 | 3.1× |
| Us head (76506) | $55.77 | $429 | 0.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$112.19–$325 | $863–$2,500 | varies |
| Us ob limited 1 or more fetuses (76815) | $251 | $1,930.80 | 2.4× |
| Us ob transvaginal (76817) | $308.23 | $2,371 | 2.9× |
| Us pelvic non ob complete (76856) | $336.57 | $2,589 | 3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $364.10 | $2,800.80 | 3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $106.24 | $817.20 | 1.0× |
| Us retroperitoneal complete (76770) | $358.28 | $2,756 | 3.4× |
| Us retroperitoneal limited (76775) | $217.62 | $1,674 | 2.1× |
| Us scrotum and contents (76870) | $333.06 | $2,562 | 3.2× |
| Us spinal canal and contents (76800) | $98.80 | $760 | 0.9× |
| Us thyroid (76536) | $328.90 | $2,530 | 3.1× |
| Us transrectal (76872) | $336.80 | $2,590.80 | 3.2× |
| Vein X-Ray Chest (75827) | $362.83 | $2,791 | 0.2× |
| Venogram Sinus/Jugular (75860) | $422.11 | $3,247 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $764.87 | $5,883.60 | 0.2× |
| Venography extremity bilateral rs&i (75822) | $629.85 | $4,845 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $355.84 | $2,737.20 | 0.2× |
| Venography Renal Bilateral (75833) | $890.24 | $6,848 | 0.3× |
| Venous thrombosis imaging (78457) | $157.43 | $1,211 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $68.12 | $524 | 0.2× |
| Wrist 2 views (73100) | $151.84 | $1,168 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $72.70 | $559.20 | 0.8× |
| X-ray antegrade pyelogram tube (74425) | $577.46 | $4,442 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $972.66 | $7,482 | 0.3× |
| X-Ray Bend Only L-S Spine (72120) | $69.16 | $532 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $120.25 | $925 | 1.4× |
| X-Ray Exam Breast Specimen (76098) | $202.15 | $1,555 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $68.12 | $524 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $108.94 | $838 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $192.27 | $1,479 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $141.31 | $1,087 | 1.3× |
| X-Ray Exam L-S Spine Bending (72114) | $75.92 | $584 | 0.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $254.67 | $1,959 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $360.36 | $2,772 | 3.4× |
| X-ray humerus (73060) | $184.21 | $1,417 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $517.66 | $3,982 | 2.9× |
| X-ray IV pyelogram+tomography (74415) | $149.50 | $1,150 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $345.67 | $2,659 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $223.47 | $1,719 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $169 | $1,300 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $66.69 | $513 | 0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $442 | $3,400 | 5.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $325 | $2,500 | 3.1× |
| X-ray thoracic spine 4 vw (72074) | $422.50 | $3,250 | 4.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $480.22 | $3,694 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $768.30 | $5,910 | 7.3× |
| Xr c-spine 4 or 5 views (72050) | $310.31 | $2,387 | 3.0× |
| Xr facial bones less than 3 views (70140) | $170.17 | $1,309 | 1.9× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$180.70–$271.05 | $1,390–$2,085 | varies |
| Xr Tomogram Single Plane (76100) | $247.52 | $1,904 | 2.4× |
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.