Imaging prices at Baptist Health La Grange

La Grange, KY · every code in this section with a posted price and a Medicare benchmark.

467 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $15,732.58 $20,976.77 11.8×
Abdomen 2 views (74019) $799.33 $1,065.77 8.0×
Acute gastrointestinal blood loss imaging (78278) $1,849.20 $2,465.60 4.8×
Acute venous thrombus image (78456) $5,067.86 $6,757.15 4.1×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $14,724.53 $19,632.71 4.9×
Angiography extremity bilateral rs&i (75716) $10,823.85 $14,431.80 3.6×
Angiography extremity unilateral rs&i (75710) $10,823.85 $14,431.80 3.6×
Angiography internal mammary rs&i (75756) $14,670.66 $19,560.88 4.8×
Angiography pelvic slctv/supraslctv rs&i (75736) $10,823.85 $14,431.80 2.0×
Angiography pulmonary bilateral slctv rs&i (75743) $10,823.85 $14,431.80 3.6×
Angiography pulmonary unilateral slctv rs&i (75741) $10,823.85 $14,431.80 3.6×
Angiography Spinal Selective Rs&I (75705) $10,823.85 $14,431.80 2.0×
Angiography visceral slctv/supraslctv rs&i (75726) $10,823.85 $14,431.80 2.0×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $5,351.96 $7,135.94 1.8×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $5,351.96 $7,135.94 1.8×
Ankle 2 views (73600) $1,325.47 $1,767.30 15.8×
Antegrade urography radiological supvj & interpj (74425) $1,562.37 $2,083.16 4.7×
Aortogram thoracic (75605) $10,507.94 $14,010.59 2.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $10,183.63 $13,578.17 3.4×
Aortography abdominal serialography rs&i (75625) $10,763.97 $14,351.96 3.5×
Artery X-Rays Adrenal Gland (75731) $15,826.55 $21,102.06 5.2×
Arthrogram elbow (73085) $2,424.04 $3,232.06 7.2×
Arthrogram hip (73525) $1,575.82 $2,101.09 4.7×
Arthrogram shoulder (73040) $3,164.26 $4,219 9.4×
Arthrogram wrist (73115) $2,223.74 $2,965 6.6×
Arthrography knee lt (73580) $1,620.73 $2,160.97 4.8×
Basic radiation dosimetry calculation (77300) $1,938.29 $2,584.38 15.0×
Bone &/Joint Imaging Limited Area (78300) $4,440.35 $5,920.47 11.6×
Bone &/Joint Imaging Multiple Areas (78305) $1,892.76 $2,523.68 4.9×
Bone &/joint imaging whole body (78306) $5,214.14 $6,952.19 13.6×
Bone age studies (77072) $972.74 $1,296.99 9.7×
Bone Imaging 3 Phase (78315) $5,214.14 $6,952.19 13.6×
Bone survey complete (77075) $2,201.63 $2,935.50 21.9×
Brachytx isodose complex (77318) $5,104.92 $6,806.56 14.2×
Brachytx isodose intermed (77317) $4,384.20 $5,845.60 12.2×
Brachytx isodose pln smpl w/dosimetry cal (77316) $3,392.87 $4,523.83 9.4×
Brain image w/flow 4 + views (78606) $2,005.81 $2,674.41 3.8×
Brain imaging < 4 static views w vascular flow (78601) $1,969.23 $2,625.64 5.1×
Brain Imaging Minimum 4 Static Views (78605) $2,309.66 $3,079.55 4.4×
Brain Imaging Pet Metabolic Evaluation (78608) $5,824.41 $7,765.88 4.2×
Brain Imaging Vascular Flow Only (78610) $1,379.16 $1,838.88 2.6×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $2,121.22 $2,828.29 5.5×
Cardiac MRI w/w/o contrast & further seq (75561) $7,833.56 $10,444.75 23.4×
Cardiac shunt detection (78428) $2,193.08 $2,924.11 5.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,877.81 $2,503.74 3.6×
Cervical spine 2 or 3 views (72040) $1,163 $1,550.66 13.9×
Chest 1 view (71045) $361.94 $482.59 4.3×
Chest 3 views (71047) $361.94 $482.59 4.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $1,252.79 $1,670.39 7.4×
Cisternography Positive Contrast Rs&I (70015) $3,125.30 $4,167.06 4.1×
Clavicle complete (73000) $1,527.34 $2,036.46 18.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $577.50 $770 5.7×
Continuing medical physics consltj pr wk (77336) $1,466.62 $1,955.49 11.3×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $844.89 $1,126.52 5.0×
CT abdomen and pelvis without and with contrast (74178) $8,935.98 $11,914.64 26.6×
CT abdomen and pelvis without contrast (74176) $5,009.63 $6,679.51 21.8×
CT abdomen w contrast (74160) $2,895.12 $3,860.16 17.2×
CT abdomen w wo contrast (74170) $3,899.80 $5,199.73 23.1×
CT abdomen w/o contrast (74150) $2,842 $3,789.33 28.3×
CT angio hrt w/3d image (75574) $3,425.07 $4,566.76 10.2×
CT angiography upper extremity lt (73206) $5,157.25 $6,876.33 30.6×
CT c-spine w/o contrast (72125) $3,290.19 $4,386.92 32.7×
CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) $4,480.73 $5,974.30 26.6×
CT cervical spine w&w/o contrast (72127) $4,121.76 $5,495.68 24.4×
CT cervical spine with contrast (72126) $3,396.38 $4,528.51 10.1×
CT chest w/wo contrast (71270) $5,874.66 $7,832.87 34.8×
CT chest with contrast (71260) $3,140.45 $4,187.26 18.6×
CT colonography screening (74263) $1,167.19 $1,556.25 5.1×
CT colonography w/dye (74262) $1,200.11 $1,600.14 7.1×
CT head/brain with contrast (70460) $3,682.09 $4,909.45 21.8×
CT head/brain without and with contrast (70470) $3,902.99 $5,203.98 23.1×
CT heart contrast eval cardiac structure&morph (75572) $3,425.07 $4,566.76 10.2×
CT heart no contrast quant eval coronry calcium (75571) $131.25 $175 1.6×
CT hrt w/3d image congen (75573) $3,425.07 $4,566.76 10.2×
CT iac w contrast (70481) $2,895.12 $3,860.16 17.2×
CT limited/localized follow up study (76380) $1,252.15 $1,669.53 15.0×
CT lower ext w/o (73700) $6,386.56 $8,515.41 63.5×
CT lower extremity w wo contrast (73702) $6,695.61 $8,927.48 39.7×
CT lower extremity with contrast (73701) $6,531.53 $8,708.70 38.7×
CT lumbar spine w & w/o contrast (72133) $4,751.55 $6,335.40 28.2×
CT lumbar spine w/o contrast (72131) $3,438.88 $4,585.17 34.2×
CT lumbar spine with contrast (72132) $3,823.33 $5,097.77 11.4×
CT maxillofacial w contrast (70487) $3,046.99 $4,062.65 18.1×
CT maxillofacial w/o contrast (70486) $2,842 $3,789.33 28.3×
CT maxillofacial w/wo contrast (70488) $3,588.64 $4,784.85 21.3×
CT neck soft tissue w contrast (70491) $3,133.01 $4,177.35 18.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,964.15 $3,952.20 17.6×
CT orbits w/o contrast (70480) $2,842 $3,789.33 28.3×
CT pelvis w & w/o contrast (72194) $4,711.19 $6,281.59 27.9×
CT pelvis w/o contrast (72192) $2,598.80 $3,465.07 25.9×
CT soft tissue neck w/o & w/contrast material (70492) $3,194.61 $4,259.48 18.9×
CT soft tissue neck w/o contrast (70490) $3,058.67 $4,078.23 30.4×
CT thoracic spine w/contrast (72129) $3,823.33 $5,097.77 22.7×
CT thoracic spine w/o contrast (72128) $3,358.16 $4,477.55 33.4×
CT thoracic spine w/wo contrast (72130) $4,290.63 $5,720.84 25.4×
CT thorax w/o contrast (71250) $3,023.62 $4,031.49 30.1×
CT upper extremity w/o & w/contrast material (73202) $5,910.24 $7,880.32 35.0×
CT upper extremity w/o contrast rt (73200) $4,263.01 $5,684.01 42.4×
CT upper extremity with contrast (73201) $5,094.58 $6,792.78 15.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,695.89 $4,927.85 21.9×
Cta Abdomen (74175) $3,411.27 $4,548.36 20.2×
CTA abdomen pelvis (74174) $5,671.28 $7,561.71 16.9×
CTA chest (71275) $3,329.48 $4,439.30 19.7×
Cta Head (70496) $3,394.10 $4,525.46 20.1×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,131.78 $4,175.70 9.3×
CTA lwr ext w&w/o contrast (73706) $4,615.09 $6,153.46 27.4×
Cta Neck (70498) $2,842 $3,789.33 16.9×
Cta Pelvis (72191) $3,100.09 $4,133.45 18.4×
Cystography minimum 3 views rs&i (74430) $1,041.04 $1,388.05 3.1×
Diskogram cervical (72285) $4,210.58 $5,614.11 2.2×
Diskography lumbar (72295) $8,165.15 $10,886.86 4.3×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $168.75 $225 1.7×
Doppler Echo Fetal Spectral Display Complete (76827) $336.75 $449 3.4×
Doppler Fetal Mid Cerebral Artery (76821) $438 $584 4.4×
Dxa bone density study 1/> sites axial skel (77080) $525 $700 5.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $1,147.46 $1,529.95 13.7×
Dxa bone density study axial skeleton (77085) $971.54 $1,295.38 9.7×
Echo exam of fetal heart (76825) $861.92 $1,149.23 1.6×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $861.92 $1,149.23 3.8×
Echoencephalography real time imaging (76506) $942.66 $1,256.88 9.4×
Esophageal motility (78258) $1,202.54 $1,603.38 3.1×
Esophagus (74220) $1,555.49 $2,073.99 9.2×
Fetal biophysical profile non-stress testing (76818) $942.66 $1,256.88 9.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $861.92 $1,149.23 8.6×
Fluoroscopy up to 1 hr (76000) $1,346.12 $1,794.83 5.9×
Foot 2 views (73620) $1,447.48 $1,929.96 17.3×
Forearm 2 views (73090) $1,509.44 $2,012.58 18.0×
Functional MRI brain by phys/psych (70555) $3,910.93 $5,214.57 17.0×
Functional MRI brain by tech (70554) $3,872.58 $5,163.44 16.9×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $2,024.62 $2,699.49 3.9×
Gated Heart Planar Single (78472) $4,792.50 $6,390 12.5×
Hand 2 views (73120) $1,405.35 $1,873.80 14.0×
Hand 3 views (73130) $1,498.67 $1,998.22 17.9×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $7,411.89 $9,882.52 11.1×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $9,768.06 $13,024.08 14.6×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $11,039.51 $14,719.34 16.5×
Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) $9,223.34 $12,297.79 24.9×
Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) $6,998.94 $9,331.92 18.9×
Heart Infarct Image (78466) $2,800.79 $3,734.38 7.3×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $15,813.32 $21,084.43 5.2×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $4,759.49 $6,345.98 9.1×
Hepatobiliary syst imaging including gallbladder (78226) $4,045.72 $5,394.29 10.5×
Ht muscle image spect sing (78451) $10,901.67 $14,535.56 8.8×
Humerus Min 2 Views Left (73060) $1,534.57 $2,046.10 18.3×
Hysterosalpingogram (74740) $1,402.29 $1,869.72 6.1×
Image fusion (77399) $723.14 $964.18 5.6×
Interstitial radiation source applic complex (77778) $5,408.40 $7,211.20 8.1×
Intracavitary Radiation Source Applic Complex (77763) $3,164.26 $4,219.01 4.7×
Intracavitary Radiation Source Applic Intermed (77762) $2,823.02 $3,764.02 5.3×
Intracavitary radiation source applic simple (77761) $1,816.16 $2,421.54 3.4×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $819.65 $1,092.87 8.2×
Kidney funcj study non-img radioisotopic study (78725) $1,527.60 $2,036.80 4.0×
Kidney imaging morphology (78700) $1,651.28 $2,201.70 4.3×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $4,592.23 $6,122.97 8.8×
Kidney img morphology vascular flow 1 w/rx (78708) $4,910.28 $6,547.04 9.4×
Kidney Img Morphology Vascular Flow Multiple (78709) $2,595.89 $3,461.19 5.0×
Knee 3 views (73562) $1,480.75 $1,974.33 17.7×
Liver & spleen imaging static only (78215) $4,366.13 $5,821.51 11.4×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,273.20 $1,697.60 3.3×
Liver imaging w/vascular flow (78202) $5,067.86 $6,757.15 9.7×
Lung perf&ventilat diferentl (78598) $2,560.49 $3,413.99 4.9×
Lung perfusion differential (78597) $4,592.23 $6,122.97 11.9×
Lung Ventilation Imaging (78579) $1,416.92 $1,889.22 3.7×
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $17,576.30 $23,435.06 5.8×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $15,195.81 $20,261.08 5.0×
Lymphoscintigraphy (78195) $2,833.82 $3,778.43 5.4×
Mammary ductogram or galactogram multiple (77054) $1,245.60 $1,660.80 5.4×
Mammary ductogram or galactogram single (77053) $1,245.60 $1,660.80 5.4×
Meckels Diverticulum (78290) $3,986.88 $5,315.84 10.4×
Medical physics dose eval radiation expos w/rprt (76145) $812.68 $1,083.57 2.3×
Mlc imrt design & construction per imrt plan (77338) $19,895.26 $26,527.01 55.3×
Mr elastography (76391) $3,258.04 $4,344.05 14.2×
Mr safety determination physician/other qhp (76016) $305.17 $406.89 3.6×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $282.79 $377.05 5.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $116.60 $155.46 4.2×
Mr safety implt electronics prepj supvj phys/qhp (76018) $436.99 $582.65 4.8×
Mr safety med physics xm customization plng&mntr (76017) $1,150.76 $1,534.35 5.0×
MRA head w & w/o contrast (70546) $3,957.44 $5,276.58 11.8×
MRA head w/o contrast (70544) $3,258.04 $4,344.05 14.2×
MRA head with contrast (70545) $3,602.77 $4,803.69 10.7×
MRA neck w contrast (70548) $3,602.77 $4,803.69 10.7×
Mra Neck W/O &W/Contrast Material (70549) $3,364.55 $4,486.06 10.0×
MRA neck w/o contrast (70547) $3,258.04 $4,344.05 14.2×
MRI abdomen w contrast (74182) $3,679.81 $4,906.41 11.0×
MRI abdomen w/o & w/contrast material (74183) $3,774.59 $5,032.79 11.3×
MRI abdomen w/o contrast (74181) $3,347.50 $4,463.34 14.6×
MRI any jnt lwr ext with con lt (73722) $5,003.34 $6,671.12 6.6×
MRI any jt upper extremity w/contrast matrl (73222) $4,887.06 $6,516.07 6.5×
MRI bone marrow blood supply (77084) $3,771 $5,028 16.4×
MRI breast w/o contrast bilateral (77047) $3,875.18 $5,166.90 16.9×
MRI breast w/o contrast unilat (77046) $3,015.20 $4,020.26 13.1×
MRI c-spine with contrast (72142) $4,277.30 $5,703.07 12.8×
MRI cardiac w/o cont stress (75559) $10,892.21 $14,522.94 20.7×
MRI cardiac w/o contrast (75557) $7,833.56 $10,444.75 34.1×
MRI cervical spine w/o contrast (72141) $3,233.54 $4,311.38 14.1×
MRI chest w/o & w/contrast material (71552) $3,474.23 $4,632.31 10.4×
MRI chest w/o contrast (71550) $3,258.04 $4,344.05 14.2×
MRI chest with contrast (71551) $3,301.71 $4,402.28 4.4×
MRI fetal sngl/1st gestation (74712) $2,964.08 $3,952.11 12.9×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $3,407.15 $4,542.86 10.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,304.55 $4,406.07 9.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,886.52 $6,515.36 21.3×
MRI orbit face &/neck w/o contrast (70540) $3,258.04 $4,344.05 14.2×
MRI orbit/face/neck w&w/o cont (70543) $3,480.63 $4,640.84 10.4×
MRI orbit/face/neck w/contrast (70542) $3,327.27 $4,436.36 9.9×
MRI pelvis w contrast (72196) $3,258.04 $4,344.05 9.7×
MRI pelvis w/o & w/contrast material (72197) $4,117.54 $5,490.05 12.3×
MRI pelvis w/o contrast (72195) $3,202.65 $4,270.20 14.0×
MRI scan of arm joint before and after contrast (73223) $6,657.20 $8,876.26 19.8×
MRI scan of heart before and after contrast with stress imaging (75563) $10,892.21 $14,522.94 14.5×
MRI scan of leg joint before and after contrast (73723) $6,352.05 $8,469.40 18.9×
MRI spectroscopy (76390) $3,258.04 $4,344.05 38.9×
MRI spinal canal cervical w/o & w/contr matrl (72156) $4,561.68 $6,082.24 13.6×
MRI spinal canal lumbar w/contrast material (72149) $3,543.47 $4,724.63 10.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,317.77 $5,757.03 12.9×
MRI spinal canal thoracic w/contrast matrl (72147) $3,258.04 $4,344.05 9.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $4,507.36 $6,009.81 13.4×
MRI thoracic spine w/o contrast (72146) $3,225.02 $4,300.03 14.1×
MRI tmj (70336) $3,556.25 $4,741.66 15.5×
MRI upper ext joint w/o contrast (73221) $4,837.52 $6,450.04 21.1×
MRI upper extrem other than jt w/o & w/contras (73220) $5,334.38 $7,112.50 15.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $5,222.15 $6,962.87 22.8×
Myelogram Cervical (72240) $5,250.42 $7,000.56 7.0×
Myelogram Lumbar (72265) $4,219.01 $5,625.34 5.6×
Myocardial Imaging Pet Metabolic Evaluation (78459) $6,222.41 $8,296.55 5.0×
Myocardial infarct spect (78469) $6,018.59 $8,024.78 11.5×
Myocardial Spect Multiple Studies (78452) $11,107.76 $14,810.35 8.9×
Myocrd img PET metab eval single study cncrnt CT (78429) $8,087.69 $10,783.59 5.9×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $8,087.69 $10,783.59 5.9×
Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) $8,468.22 $11,290.96 4.0×
Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) $10,350.01 $13,800.01 4.9×
Myocrd img PET prfuj w/metab dual radiotracer (78432) $10,350.01 $13,800.01 7.1×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $6,372.03 $8,496.04 7.7×
Neck soft tissue (70360) $968.04 $1,290.72 11.6×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $2,376.80 $3,169.07 6.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,070.66 $1,427.55 2.8×
Nm adrenal scan (78075) $7,925.44 $10,567.25 6.4×
Nm bone marrow multiple (78103) $1,457.13 $1,942.84 3.8×
Nm cisternogram (78630) $4,168.22 $5,557.63 8.0×
Nm csf leak detection (78650) $5,067.86 $6,757.15 4.1×
Nm gastric emptying study (78264) $6,289.43 $8,385.91 16.4×
Nm gastroesophageal reflux study (78262) $1,288.47 $1,717.96 3.4×
Nm peritoneal-venous shunt patency (78291) $1,221.36 $1,628.48 3.2×
Nm whole blood volume (78122) $1,969.23 $2,625.64 3.8×
Ntsty modul radthx pln dose-vol histos (77301) $24,146.63 $32,195.50 18.1×
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $6,129.74 $8,172.98 4.5×
Nuclear medicine of heart pumping function (78473) $2,296.76 $3,062.34 6.0×
Nuclear medicine study from skull base to mid-thigh (78812) $5,390.62 $7,187.49 3.9×
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $6,135.97 $8,181.29 4.5×
Nuclear medicine study of kidney and blood flow (78701) $1,486.39 $1,981.85 3.9×
Nuclear medicine study of limited area for thyroid cancer (78015) $1,068.29 $1,424.39 2.8×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $1,526.41 $2,035.21 4.0×
Nuclear Rx Oral Admin (79005) $6,123.37 $8,164.49 27.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $501 $668 5.0×
Ophthalmic us dx quantitative a-scan only (76511) $753.86 $1,005.14 7.5×
Orthopantogram (70355) $1,158.29 $1,544.39 13.8×
Osseous survey infant (77076) $1,080.49 $1,440.65 10.7×
Osseous survey limited (77074) $489.43 $652.57 4.9×
Parathyrd planar w/spect&CT (78072) $3,043.14 $4,057.52 5.8×
Parathyrd planar w/wo subtrj (78071) $2,970.41 $3,960.55 7.7×
Parathyroid imaging (78070) $2,970.41 $3,960.55 7.7×
Pelvis 1 or 2 views (72170) $869.92 $1,159.89 8.7×
Peritoneogram rs&i (74190) $984.76 $1,313.01 1.9×
PET image w/CT, skull-thigh (78815) $8,087.69 $10,783.59 5.9×
PET imaging CT for attenuation limited area (78814) $5,390.62 $7,187.49 3.9×
PET imaging for CT attenuation whole body (78816) $8,087.69 $10,783.59 5.9×
PET imaging limited area chest head/neck (78811) $5,390.62 $7,187.49 4.3×
PET whole body (78813) $5,390.62 $7,187.49 3.9×
Pr heart first pass single,planar (78481) $2,800.79 $3,734.38 5.4×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $5,231.79 $6,975.72 15.6×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $15,813.32 $21,084.43 5.2×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $5,351.96 $7,135.94 1.8×
Pulmonary Perfusion Imaging Particulate (78580) $2,334.40 $3,112.53 6.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $4,788.97 $6,385.29 9.2×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $3,425.07 $4,566.76 3.8×
Radex abscess/fistula/sinus tract rs&i (76080) $1,226.47 $1,635.29 2.3×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $1,049.80 $1,399.74 12.5×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $3,501.08 $4,668.10 34.8×
Radex hips bilateral with pelvis 2 views (73521) $1,591.43 $2,121.91 15.8×
Radex mastoids compl minimum 3 views pr side (70130) $922.49 $1,229.98 9.2×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $7,000.85 $9,334.46 69.6×
Radiation Delivery Stereotactic Cranial Linear (77372) $88,309.99 $117,746.65 12.5×
Radiation treatment delivery 1 mev >= complex (77412) $5,051.54 $6,735.39 9.5×
Radiation treatment delivery 1 mev >= simple (77402) $3,435.54 $4,580.72 35.0×
Radiation tx delivery 1 mev >= intermediate (77407) $4,570.86 $6,094.48 12.3×
Radiolog exam mandible compl minimum 4 views (70110) $966.84 $1,289.12 9.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $753.87 $1,005.16 9.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $1,093.61 $1,458.14 10.9×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $361.94 $482.59 4.3×
Radiologic exam colon single contrast study (74270) $2,279.42 $3,039.22 13.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,609.03 $2,145.37 9.5×
Radiologic exam upr gi trc double contrast study (74246) $1,134.36 $1,512.48 6.7×
Radiologic exam upr gi trc single contrast study (74240) $2,474.78 $3,299.70 14.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $1,325.47 $1,767.30 15.8×
Radiological examination surgical specimen (76098) $2,078.35 $2,771.13 4.0×
Radiopharm Dacryocystography (78660) $990.53 $1,320.71 2.6×
Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) $2,495.75 $3,327.66 11.1×
Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) $806.83 $1,075.77 3.6×
Review by radiologist of adrenal gland vein image (75840) $7,906.71 $10,542.28 2.6×
Review by radiologist of liver vein image with assessment of blood flow (75889) $15,826.55 $21,102.06 5.2×
Ribs bilateral 3 views (71110) $1,420.31 $1,893.75 14.1×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,531.14 $3,374.85 6.6×
Rp loclzj tum plnr whole body single day imaging (78802) $5,237.70 $6,983.60 10.0×
Rp loclzj tum spect 1 area single day imaging (78803) $5,788.85 $7,718.47 11.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $5,237.70 $6,983.60 4.2×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $7,856.55 $10,475.40 5.7×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $7,183.23 $9,577.64 5.8×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $6,304.71 $8,406.28 28.1×
Rp therapy intra-arterial particulate admn (79445) $2,154.24 $2,872.32 9.6×
Rp Therapy Intravenous Administration (79101) $8,958.37 $11,944.49 39.9×
Sacroiliac Joints < 3 Views (72200) $612.59 $816.78 6.1×
Saline Infus Sonohysterography W/Color Doppler (76831) $884 $1,178.67 3.9×
Salivary gland imaging serial images (78231) $1,379.16 $1,838.88 3.6×
Scanogram (77073) $635.80 $847.73 6.3×
Scapula complete (73010) $1,595.60 $2,127.46 15.9×
Screening digital breast tomosynthesis (77063) $37.50 $50 1.6×
Sella turcica (70240) $436.76 $582.34 5.2×
Shuntogram indwelling nonvascular shunt rs&i (75809) $2,463.65 $3,284.86 24.5×
Sialogram (70390) $1,226.47 $1,635.29 5.3×
Simulation intermediate (77285) $4,083.66 $5,444.88 11.3×
Small bowel series (74250) $1,677.54 $2,236.72 9.9×
Spec medical radj physics consltj (77370) $3,125.87 $4,167.83 24.2×
Spec telethx port pln parts hemibdy tot bdy (77321) $4,807.98 $6,410.64 13.4×
Special dosimetry (77331) $1,682.12 $2,242.82 13.0×
Special treatment procedure (77470) $6,807.38 $9,076.51 12.8×
Speech evaluation complex (70371) $504.84 $673.12 2.2×
Spine thoracic 3 views (72072) $1,231.28 $1,641.71 12.2×
Spleen imaging only (78185) $2,472.19 $3,296.25 6.4×
Splenoportograpy rs&i (75810) $15,813.32 $21,084.43 5.2×
Stereotactic body radiation delivery (77373) $59,800.82 $79,734.42 34.8×
Superior sagittal sinus venogram (75870) $5,657.24 $7,542.98 1.9×
Surface Applic Low Dose Rate Radionuclide Source (77789) $435.84 $581.12 4.4×
Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) $6,807.38 $9,076.51 69.4×
Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) $6,100.97 $8,134.63 169.9×
Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) $6,807.38 $9,076.51 69.4×
Tbs Technical Calculation Only (77091) $419.19 $558.92 5.0×
Telethx isodose pln cplx w/basic dosimetry (77307) $4,853.46 $6,471.28 13.5×
Telethx isodose pln smpl w/dosimetry calculation (77306) $3,236.09 $4,314.78 9.0×
Testicular Imaging With Vascular Flow (78761) $3,268.36 $4,357.81 8.5×
Ther rad simulaj-aided field setting complex (77290) $4,779.22 $6,372.29 13.3×
Ther rad simulaj-aided field setting simple (77280) $2,630.26 $3,507.01 20.4×
Therapeutic Enema (74283) $1,425.02 $1,900.02 8.5×
Thoracolumbar 2 views (72080) $1,007.48 $1,343.31 12.0×
Thyroid carcinoma metastases img whole body (78018) $3,243.62 $4,324.82 6.2×
Thyroid Imaging With Vascular Flow (78013) $2,595.89 $3,461.19 6.8×
Thyroid uptake measurement (78012) $796.17 $1,061.56 2.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $4,304.84 $5,739.78 11.2×
Tmj unilateral (70328) $151.31 $201.74 1.8×
Tomogram (76100) $3,301.50 $4,402 32.8×
Treatment device intermediate (77333) $2,147.77 $2,863.69 16.6×
Treatment devices simple (77332) $1,623.40 $2,164.53 12.6×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $5,237.70 $6,983.60 10.0×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,878.55 $2,504.73 4.9×
Tx devices design & construction complex (77334) $3,306.71 $4,408.95 9.2×
Ultrasound elastography first target lesion (76982) $942.66 $1,256.88 9.4×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $942.66 $1,256.88 2.8×
Ultrasound, abdomen limited (76705) $942.66 $1,256.88 9.4×
Umbilical-artery Doppler (OB) (76820) $438 $584 4.4×
Unlisted Diagnostic Radiographic Procedure (76499) $978.74 $1,304.99 11.7×
Unlisted fluoroscopic procedure (76496) $580.34 $773.79 6.9×
Unlisted magnetic resonance procedure (76498) $3,258.04 $4,344.05 38.9×
Unlisted Procedure Clinical Brachytherapy (77799) $2,228.03 $2,970.70 22.7×
Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) $1,457.13 $1,942.84 3.8×
Unlisted Ultrasound Procedure (76999) $1,248.35 $1,664.47 14.9×
Upper Extremity Infant (73092) $1,249.15 $1,665.53 12.4×
Urea breath test, C-14 (isotopic); analysis (78268) $389.18 $518.90 4.1×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $1,879.76 $2,506.34 4.9×
Urethrocystography retrograde rs&i (74450) $954.82 $1,273.09 4.2×
Urethrocystography voiding (74455) $2,184.91 $2,913.21 9.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $3,034.39 $4,045.85 18.0×
Us abdl aorta screen aaa (76706) $942.66 $1,256.88 9.4×
Us breast unilateral complete (76641) $1,413.99 $1,885.32 14.1×
Us breast unilateral limited (76642) $1,413.99 $1,885.32 16.9×
Us chest (76604) $942.66 $1,256.88 9.4×
Us compl joint r-t w/image documentation (76881) $1,452.46 $1,936.62 14.4×
Us elastography parenchyma (76981) $942.66 $1,256.88 9.4×
Us fetal nuchal translucency 1st gestation (76813) $729 $972 7.3×
Us guided compression repair (76936) $1,224.70 $1,632.93 5.9×
Us infant hips dynamic (76885) $942.66 $1,256.88 11.3×
Us infant hips limited static (76886) $942.66 $1,256.88 11.3×
Us kidney transplant (76776) $1,414.02 $1,885.36 14.1×
Us ob detailed single fetus (76811) $861.92 $1,149.23 3.8×
Us ob transvaginal (76817) $861.92 $1,149.23 8.6×
Us pelvic non ob complete (76856) $861.92 $1,149.23 8.6×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $942.66 $1,256.88 9.4×
Us pregnancy ltd (76815) $861.92 $1,149.23 8.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $678.75 $905 6.8×
Us retroperitoneal complete (76770) $859.06 $1,145.41 8.5×
Us retroperitoneal limited (76775) $1,452.46 $1,936.62 14.4×
Us scrotum and contents (76870) $942.66 $1,256.88 9.4×
Us soft tissue head/neck (76536) $942.66 $1,256.88 9.4×
Us spinal canal and contents (76800) $942.66 $1,256.88 9.4×
Us transrectal (76872) $942.66 $1,256.88 9.4×
Us xtr non-vasc lmtd (76882) $1,614.18 $2,152.24 16.1×
Vascular flow imaging (78445) $1,929.22 $2,572.29 5.0×
Venogram extremity bilateral (75822) $6,899.24 $9,198.98 4.6×
Venogram orbital (75880) $4,417.56 $5,890.08 7.3×
Venography caval inferior serialography rs&i (75825) $11,809.81 $15,746.41 3.9×
Venography caval superior serialography rs&i (75827) $3,449.61 $4,599.48 2.3×
Venography epidural rs&i (75872) $5,352.04 $7,136.05 8.9×
Venography extremity unilateral rs&i (75820) $3,449.61 $4,599.48 2.3×
Venography Renal Bilateral (75833) $9,250.32 $12,333.76 3.0×
Venography renal unilateral selective rs&i (75831) $11,062.28 $14,749.71 3.6×
Venography venous sinus/jugular cath rs&i (75860) $14,670.66 $19,560.88 4.8×
Venous sampling thru cath w/wo angiography rs& (75893) $10,823.85 $14,431.80 2.0×
Vertebral fracture assessment via dxa (77086) $627 $836 7.5×
Wrist 2 views (73100) $1,559.70 $2,079.60 18.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $1,377.16 $1,836.21 13.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $972.74 $1,296.99 11.6×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $1,523.80 $2,031.72 18.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $3,449.61 $4,599.48 20.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,329.96 $1,773.28 15.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $1,423.28 $1,897.70 17.0×
X-ray exam entire spi 4/5 vw (72083) $6,301.94 $8,402.58 62.7×
X-ray exam hip uni 1 view (73501) $674.87 $899.83 8.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $788.51 $1,051.35 9.4×
X-ray exam hip uni 4/> views (73503) $954.82 $1,273.09 9.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $1,934.77 $2,579.69 19.2×
X-Ray Exam Hips Bi 5/> Views (73523) $2,920.74 $3,894.32 29.1×
X-ray exam of femur 1 (73551) $461.24 $614.99 5.5×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $1,380.77 $1,841.02 8.2×
X-ray eye for foreign body (70030) $966.84 $1,289.12 11.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $939.31 $1,252.41 9.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $795.73 $1,060.97 9.5×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $1,541.12 $2,054.82 18.4×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $6,375.16 $8,500.21 3.2×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $1,409.78 $1,879.70 16.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $966.84 $1,289.12 11.6×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $2,018.26 $2,691.01 20.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $1,061.36 $1,415.14 12.7×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $1,676.34 $2,235.12 20.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $938.10 $1,250.80 9.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $2,047.22 $2,729.62 20.4×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $936.89 $1,249.19 9.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $1,210.85 $1,614.47 14.5×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $335.03 $446.70 4.0×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $1,149.87 $1,533.16 11.4×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $1,429.82 $1,906.43 14.2×
X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) $2,205.23 $2,940.30 4.2×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $3,857.09 $5,142.78 11.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $1,889.92 $2,519.88 22.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $1,986.24 $2,648.32 19.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,742.14 $2,322.85 17.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $1,079.29 $1,439.05 10.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $1,020.60 $1,360.80 12.2×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $1,463.92 $1,951.89 17.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $994.27 $1,325.69 11.9×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $917.77 $1,223.69 11.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,817.52 $2,423.36 18.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $1,259.91 $1,679.88 12.5×
X-Ray Spine One View - Xr Spine (72020) $599.46 $799.28 7.2×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $387.70 $516.93 4.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $987.16 $1,316.21 11.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $1,164.19 $1,552.25 11.6×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $1,347.33 $1,796.44 13.4×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $1,394.54 $1,859.38 16.7×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $1,638.65 $2,184.86 19.6×
Xr arthrogram ankle (73615) $2,637.18 $3,516.24 7.9×
Xr c-spine 6 or more views (72052) $2,306.96 $3,075.94 23.0×
Xr chest 4+ views (71048) $1,120.18 $1,493.57 11.1×
Xr Cholecystography Oral Contrast (74290) $892.65 $1,190.20 5.3×
Xr finger(s) 2+ views (73140) $1,129.01 $1,505.34 13.5×
Xr shoulder 1 view (73020) $976.40 $1,301.88 11.7×
Xr spine cervical 4 or 5 views (72050) $1,500.41 $2,000.55 14.9×
Xr tibia/fibula 2 views (73590) $1,400.81 $1,867.74 16.7×
Xr tmj bilateral (70330) $1,103.21 $1,470.95 13.2×
Xray knee 1 or 2 views rt (73560) $1,311.98 $1,749.31 15.7×