Imaging prices at Baptist Health Louisville
Louisville, 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.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $15,732.58 | $20,976.77 | 11.8× |
| Abdomen 1 View (74018) | $753.87 | $1,005.16 | 9.0× |
| 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 thrombosis imaging, peptide Non-Facility (78456) | $5,067.86 | $6,757.15 | 4.1× |
| Adrenal Cortex & Medulla Img (78075) | $7,925.44 | $10,567.25 | 6.4× |
| Angio internal mammary (75756) | $14,670.66 | $19,560.88 | 4.8× |
| Angio pulmonary bilat (75743) | $10,823.85 | $14,431.80 | 3.6× |
| 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 pulmonary unilateral slctv rs&i (75741) | $10,823.85 | $14,431.80 | 3.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,351.96 | $7,135.94 | 1.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$883.68–$1,767.26 | $1,178.24–$2,356.35 | varies |
| Aortography thoracic serialography rs&i (75605) | $10,507.94 | $14,010.59 | 2.0× |
| Artery X-Rays Abdomen (75726) | $10,823.85 | $14,431.80 | 2.0× |
| Artery X-Rays Adrenal Gland (75731) | $15,826.55 | $21,102.06 | 5.2× |
| Artery X-Rays Pelvis (75736) | $10,823.85 | $14,431.80 | 2.0× |
| Artery X-Rays Spine (75705) | $10,823.85 | $14,431.80 | 2.0× |
| Arthrogram ankle (73615) | $2,637.18 | $3,516.24 | 7.9× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,050.55–$2,101.09 | $1,400.73–$2,801.45 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,482.50–$2,964.99 | $1,976.67–$3,953.32 | varies |
| Basic radiation dosimetry calculation (77300) | $1,938.29 | $2,584.38 | 15.0× |
| 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 Imaging Limited Area (78300) | $4,440.35 | $5,920.47 | 11.6× |
| Bone Imaging Multiple Areas (78305) | $1,892.76 | $2,523.68 | 4.9× |
| Bone Imaging Whole Body (78306) | $5,214.14 | $6,952.19 | 13.6× |
| Bone marrow imaging; multiple areas (78103) | $1,457.13 | $1,942.84 | 3.8× |
| Bone survey infant (77076) | $1,080.49 | $1,440.65 | 10.7× |
| 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 Plan Simple (77316) | $3,392.87 | $4,523.83 | 9.4× |
| Brain Flow Imaging Only (78610) | $1,379.16 | $1,838.88 | 2.6× |
| Brain Image W/Flow < 4 Views (78601) | $1,969.23 | $2,625.64 | 5.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,005.81 | $2,674.41 | 3.8× |
| 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× |
| 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 MRI w/w/o contrast w/stress (75563) | $10,892.21 | $14,522.94 | 14.5× |
| Cardiac Shunt Detection (78428) | $2,193.08 | $2,924.11 | 5.7× |
| Cat Scan Follow-Up Study (76380) | $1,252.15 | $1,669.53 | 15.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,877.81 | $2,503.74 | 3.6× |
| Cerebrospinal Fluid Scan (78630) | $4,168.22 | $5,557.63 | 8.0× |
| Chest 1 view (71045) | $361.94 | $482.59 | 4.3× |
| Chest 2 views (71046) | $361.94 | $482.59 | 4.3× |
| Chest 3 views (71047) | $361.94 | $482.59 | 4.3× |
| Chest 4 or more views (71048) | $1,120.18 | $1,493.57 | 11.1× |
| Cholecystography Oral Contrast (74290) | $892.65 | $1,190.20 | 5.3× |
| Cisternography Positive Contrast Rs&I (70015) | $3,125.30 | $4,167.06 | 4.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$1,018.20–$2,036.49 | $1,357.60–$2,715.32 | varies |
| 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 Exam Abdominl Aorta (75625) | $10,763.97 | $14,351.96 | 3.5× |
| Contrast X-Ray Bladder (74430) | $1,041.04 | $1,388.05 | 3.1× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,616.03–$3,232.06 | $2,154.71–$4,309.41 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,080.49–$2,160.97 | $1,440.65–$2,881.29 | varies |
| Contrast Xray Throat/Cerv Esopha (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 Abdomen and Pelvis (74174) | $5,671.28 | $7,561.71 | 16.9× |
| CT Angio Chest (71275) | $3,329.48 | $4,439.30 | 19.7× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,842–$3,946.19 | $3,789.33–$5,261.58 | varies |
| CT angio hrt w/3d image (75574) | $3,425.07 | $4,566.76 | 10.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,076.73–$6,153.45 | $4,102.31–$8,204.60 | varies |
| CT Angio Neck (70498) | $2,842 | $3,789.33 | 16.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,157.25 | $6,876.33 | 30.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $4,480.73 | $5,974.30 | 26.6× |
| CT cervical spine w/ contrast (72126) | $3,396.38 | $4,528.51 | 10.1× |
| CT cervical spine w/o contrast (72125) | $3,290.19 | $4,386.92 | 32.7× |
| CT cervical spine w/wo cont (72127) | $4,121.76 | $5,495.68 | 24.4× |
| CT chest w contrast (71260) | $3,140.45 | $4,187.26 | 18.6× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$4,954.40–$6,794.91 | $6,605.86–$9,059.88 | varies |
| CT colonography screening (74263) | $1,167.19 | $1,556.25 | 5.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (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 l-spine w&w/o contrast (72133) | $4,751.55 | $6,335.40 | 28.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$4,257.71–$8,515.41 | $5,676.94–$11,353.88 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$4,354.36–$8,708.70 | $5,805.81–$11,611.60 | varies |
| CT lumbar spine w contrast (72132) | $3,823.33 | $5,097.77 | 11.4× |
| CT lumbar spine w/o contrast (72131) | $3,438.88 | $4,585.17 | 34.2× |
| CT maxillofacial w contrast (70487) | $3,046.99 | $4,062.65 | 18.1× |
| CT maxillofacial wo contrast (70486) | $2,842 | $3,789.33 | 28.3× |
| CT neck tissue combo (70492) | $3,194.61 | $4,259.48 | 18.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) range across 2 matching MRF lines |
$4,463.74–$8,927.48 | $5,951.65–$11,903.30 | varies |
| CT scans face/jaw combo (70488) | $3,588.64 | $4,784.85 | 21.3× |
| CT soft tissue neck w contrast (70491) | $3,133.01 | $4,177.35 | 18.6× |
| 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 cont (72130) | $4,290.63 | $5,720.84 | 25.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,575–$4,472.24 | $2,100–$5,962.98 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,842–$5,684.02 | $3,789.33–$7,578.69 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,940.16–$7,880.32 | $5,253.54–$10,507.09 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$3,396.38–$6,792.79 | $4,528.51–$9,057.05 | varies |
| 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 head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,131.78 | $4,175.70 | 9.3× |
| CTA pelvis (72191) | $3,100.09 | $4,133.45 | 18.4× |
| Dilation ureters/urethra rs&i (74485) | $6,375.16 | $8,500.21 | 3.2× |
| Discography Cerv/Thor Spine (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 Axial (77080) | $525 | $700 | 5.2× |
| Dxa bone density study (77085) | $971.54 | $1,295.38 | 9.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,147.46 | $1,529.95 | 13.7× |
| Echo exam of fetal heart (76825) | $861.92 | $1,149.23 | 1.6× |
| Echo exam uterus (76831) | $884 | $1,178.67 | 3.9× |
| Echo Guide For Artery Repair (76936) | $1,224.70 | $1,632.93 | 5.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $861.92 | $1,149.23 | 3.8× |
| Esophageal Motility Study (78258) | $1,202.54 | $1,603.38 | 3.1× |
| Esophagram (74220) | $1,555.49 | $2,073.99 | 9.2× |
| Fetal Biophys Profile W/Nst (76818) | $942.66 | $1,256.88 | 9.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $861.92 | $1,149.23 | 8.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,964.08 | $3,952.11 | 12.9× |
| Fluoroscopy up to 1 hr (76000) | $1,346.12 | $1,794.83 | 5.9× |
| Follow-Up Angiography (75898) | $5,351.96 | $7,135.94 | 1.8× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$964.98–$1,929.97 | $1,286.64–$2,573.29 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$1,006.30–$2,012.57 | $1,341.73–$2,683.42 | varies |
| Gastric emptying imaging study (78264) | $6,289.43 | $8,385.91 | 16.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,526.41 | $2,035.21 | 4.0× |
| Gastroesophageal Reflux Exam (78262) | $1,288.47 | $1,717.96 | 3.4× |
| Gated Heart Planar Single (78472) | $4,792.50 | $6,390 | 12.5× |
| Gated Heart, Multiple (78473) | $2,296.76 | $3,062.34 | 6.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,024.62 | $2,699.49 | 3.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$936.89–$1,873.81 | $1,249.19–$2,498.41 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $11,039.51 | $14,719.34 | 16.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $9,768.06 | $13,024.08 | 14.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $7,411.89 | $9,882.52 | 11.1× |
| Heart first pass single,planar (78481) | $2,800.79 | $3,734.38 | 5.4× |
| Heart Image (Pet) Multiple (78492) | $6,129.74 | $8,172.98 | 4.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $15,826.55 | $21,102.06 | 5.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $15,813.32 | $21,084.43 | 5.2× |
| Hepatobil Syst Image W/Drug (78227) | $4,759.49 | $6,345.98 | 9.1× |
| Hepatobiliary System Imaging (78226) | $4,045.72 | $5,394.29 | 10.5× |
| Ht Muscle Image Spect Sing (78451) | $10,901.67 | $14,535.56 | 8.8× |
| Hysterosalpingogram (74740) | $1,402.29 | $1,869.72 | 6.1× |
| Image fusion (77399) | $723.14 | $964.18 | 5.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $942.66 | $1,256.88 | 11.3× |
| Infant hip ultrasound, limited static exam (76886) | $942.66 | $1,256.88 | 11.3× |
| 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 (77077) | $819.65 | $1,092.87 | 8.2× |
| K Flow/Funct Image Multiple (78709) | $2,595.89 | $3,461.19 | 5.0× |
| K Flow/Funct Image W/Drug (78708) | $4,910.28 | $6,547.04 | 9.4× |
| K Flow/Funct Image W/O Drug (78707) | $4,592.23 | $6,122.97 | 8.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,527.60 | $2,036.80 | 4.0× |
| Kidney Imaging Morphol (78700) | $1,651.28 | $2,201.70 | 4.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,486.39 | $1,981.85 | 3.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$987.16–$1,974.34 | $1,316.21–$2,632.45 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,221.36 | $1,628.48 | 3.2× |
| 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 Ventilat&Perfus Imaging (78582) | $4,788.97 | $6,385.29 | 9.2× |
| Lung Ventilation Imaging (78579) | $1,416.92 | $1,889.22 | 3.7× |
| Lymph System Imaging (78195) | $2,833.82 | $3,778.43 | 5.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $17,576.30 | $23,435.06 | 5.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $15,195.81 | $20,261.08 | 5.0× |
| Magnetic Image Jaw Joint (70336) | $3,556.25 | $4,741.66 | 15.5× |
| Magnetic Resonance Elastography (76391) | $3,258.04 | $4,344.05 | 14.2× |
| 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 Divert Exam (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 safety determination physician/other qhp (76016) | $305.17 | $406.89 | 3.6× |
| 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 implt pos&/immoblj (76019) | $282.79 | $377.05 | 5.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,150.76 | $1,534.35 | 5.0× |
| Mra Head W/O & W/Contrast Material (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 contrast (74181) range across 2 matching MRF lines |
$3,015.20–$3,679.81 | $4,020.26–$4,906.41 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,304.55–$6,702.13 | $4,406.07–$8,936.17 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$4,234.70–$8,469.40 | $5,646.26–$11,292.53 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,258.04–$6,516.07 | $4,344.05–$8,688.09 | varies |
| MRI bone marrow blood supply (77084) | $3,771 | $5,028 | 16.4× |
| MRI brain functional w/o physician admnistration (70554) | $3,872.58 | $5,163.44 | 16.9× |
| MRI brain functional w/physician admnistration (70555) | $3,910.93 | $5,214.57 | 17.0× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,719.96–$6,030.40 | $2,293.28–$8,040.53 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,015.20 | $4,020.26 | 13.1× |
| 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 contrast (72142) | $4,277.30 | $5,703.07 | 12.8× |
| MRI cervical spine w/o cont (72141) | $3,233.54 | $4,311.38 | 14.1× |
| 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 chest wo w contrast (71552) | $3,474.23 | $4,632.31 | 10.4× |
| 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 & w/contr matr (73720) range across 2 matching MRF lines |
$3,351.07–$7,112.51 | $4,468.09–$9,483.34 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,258.04–$6,515 | $4,344.05–$8,686.67 | varies |
| MRI lumbar spine w contrast (72149) | $3,543.47 | $4,724.63 | 10.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,561.68 | $6,082.24 | 13.6× |
| MRI orbit face &/neck w/o contrast (70540) | $3,258.04 | $4,344.05 | 14.2× |
| MRI orbit face neck w contrast (70542) | $3,327.27 | $4,436.36 | 9.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,480.63 | $4,640.84 | 10.4× |
| MRI pelvis w contrast (72196) | $3,258.04 | $4,344.05 | 9.7× |
| MRI pelvis w/o & w contrast (72197) | $4,117.54 | $5,490.05 | 12.3× |
| MRI pelvis w/o contrast (72195) | $3,202.65 | $4,270.20 | 14.0× |
| MRI spectroscopy (76390) | $3,258.04 | $4,344.05 | 38.9× |
| MRI thoracic spine w/o contrast (72146) | $3,225.02 | $4,300.03 | 14.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,407.15 | $4,542.86 | 10.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$3,376.25–$7,068.05 | $4,501.67–$9,424.07 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,556.25–$7,112.51 | $4,741.66–$9,483.34 | varies |
| MRI, abdomen, combo (74183) | $3,774.59 | $5,032.79 | 11.3× |
| MRI, dorsal spine combo (72157) | $4,507.36 | $6,009.81 | 13.4× |
| MRI, dorsal spine contrast (72147) | $3,258.04 | $4,344.05 | 9.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$3,225.02–$6,450.03 | $4,300.03–$8,600.04 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$4,438.13–$8,876.26 | $5,917.50–$11,835.01 | varies |
| MRI, lumbar spine combo (72158) | $4,317.77 | $5,757.03 | 12.9× |
| Myelogram cervical (72240) | $5,250.42 | $7,000.56 | 7.0× |
| Myelogram Lumbar (72265) | $4,219.01 | $5,625.34 | 5.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,800.79 | $3,734.38 | 7.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $6,222.41 | $8,296.55 | 5.0× |
| 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 sw aly CTA (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) range across 2 matching MRF lines |
$2,372.29–$2,381.32 | $3,163.05–$3,175.09 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,070.66 | $1,427.55 | 2.8× |
| Nm csf leak detection (78650) | $5,067.86 | $6,757.15 | 4.1× |
| Nm myocard infarct spect (78469) | $6,018.59 | $8,024.78 | 11.5× |
| Nm whole blood volume (78122) | $1,969.23 | $2,625.64 | 3.8× |
| Nonvascular Shunt X-Ray (75809) | $2,463.65 | $3,284.86 | 24.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $24,146.63 | $32,195.50 | 18.1× |
| Nuclear Rx Intra-Arterial (79445) | $2,154.24 | $2,872.32 | 9.6× |
| Nuclear Rx Oral Admin (79005) | $6,123.37 | $8,164.49 | 27.3× |
| Ob us nuchal meas 1 gest (76813) | $729 | $972 | 7.3× |
| Ophthalmic us dx quantitative a-scan only (76511) | $753.86 | $1,005.14 | 7.5× |
| Panoramic X-ray of jaws (70355) | $1,158.29 | $1,544.39 | 13.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,043.14 | $4,057.52 | 5.8× |
| Parathyroid Planar Imaging (78070) | $2,970.41 | $3,960.55 | 7.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $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 Skull-Thigh (78812) | $5,390.62 | $7,187.49 | 3.9× |
| Pet Image W/Ct Lmtd (78814) | $5,390.62 | $7,187.49 | 3.9× |
| PET image w/CT, full body (78816) | $8,087.69 | $10,783.59 | 5.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $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 Myocardial Sngl Study (78491) | $6,135.97 | $8,181.29 | 4.5× |
| PET whole body (78813) | $5,390.62 | $7,187.49 | 3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $15,813.32 | $21,084.43 | 5.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,334.40 | $3,112.53 | 6.1× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $3,425.07 | $4,566.76 | 3.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,377.16 | $1,836.21 | 13.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,226.47 | $1,635.29 | 2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$1,015.89–$2,031.70 | $1,354.52–$2,708.93 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$939.86–$1,879.69 | $1,253.14–$2,506.25 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$948.82–$1,897.73 | $1,265.09–$2,530.30 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $939.31 | $1,252.41 | 9.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$752.68–$1,505.34 | $1,003.57–$2,007.12 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$1,027.82–$2,054.42 | $1,370.42–$2,739.23 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$999.08–$1,998.26 | $1,332.10–$2,664.35 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$1,117.53–$2,235.16 | $1,490.04–$2,980.21 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $922.49 | $1,229.98 | 9.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,210.85 | $1,614.47 | 14.5× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$1,241.99–$2,537.84 | $1,655.99–$3,383.78 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$970.34–$1,957.50 | $1,293.78–$2,610 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $917.77 | $1,223.69 | 11.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,380.77 | $1,841.02 | 8.2× |
| Radex Spine 1 View Specify Level (72020) | $599.46 | $799.28 | 7.2× |
| Radex Sternum Minimum 2 Views (71120) | $987.16 | $1,316.21 | 11.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,103.21 | $1,470.95 | 13.2× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$929.69–$1,859.38 | $1,239.58–$2,479.17 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$832.77–$1,665.53 | $1,110.36–$2,220.70 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$1,092.39–$2,184.91 | $1,456.52–$2,913.21 | varies |
| 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 level 1 (77402) range across 3 matching MRF lines |
$961.37–$7,593.75 | $1,281.83–$10,125 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$1,547.97–$7,593.75 | $2,063.96–$10,125 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,509.34–$7,593.75 | $3,345.78–$10,125 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $966.84 | $1,289.12 | 9.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,093.61 | $1,458.14 | 10.9× |
| Radiologic exam colon double contrast study (74280) | $3,449.61 | $4,599.48 | 20.5× |
| 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 knee complete 4/more views (73564) range across 2 matching MRF lines |
$1,345.47–$2,691.05 | $1,793.96–$3,588.06 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,429.82 | $1,906.43 | 14.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,677.54 | $2,236.72 | 9.9× |
| Radiologic exam swallow function contrast study (74230) | $1,252.79 | $1,670.39 | 7.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,134.36 | $1,512.48 | 6.7× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$307.50–$614.99 | $410–$819.98 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$883.68–$1,767.26 | $1,178.24–$2,356.35 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$874.62–$1,749.35 | $1,166.16–$2,332.46 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $489.43 | $652.57 | 4.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$933.84–$1,867.78 | $1,245.12–$2,490.37 | varies |
| Radiopharm Dacryocystography (78660) | $990.53 | $1,320.71 | 2.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $2,495.75 | $3,327.66 | 11.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $9,223.34 | $12,297.79 | 24.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $6,998.94 | $9,331.92 | 18.9× |
| Renal Cyst Study (74470) | $2,205.23 | $2,940.30 | 4.2× |
| Ribs bilateral 3 views (71110) | $1,420.31 | $1,893.75 | 14.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,878.55 | $2,504.73 | 4.9× |
| 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 2+ Days Imaging (78804) | $5,237.70 | $6,983.60 | 10.0× |
| 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/acquisj 1day img (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 Intravenous Administration (79101) | $8,958.37 | $11,944.49 | 39.9× |
| Rp Therapy Unlisted Procedure (79999) | $806.83 | $1,075.77 | 3.6× |
| Salivary Gland Imaging Serial Images (78231) | $1,379.16 | $1,838.88 | 3.6× |
| Scapula (73010) range across 2 matching MRF lines |
$1,063.77–$2,127.42 | $1,418.36–$2,836.56 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.50 | $50 | 1.6× |
| Sella turcica (70240) | $436.76 | $582.34 | 5.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$650.93–$1,301.88 | $867.91–$1,735.84 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$2,109.50–$4,219.01 | $2,812.66–$5,625.34 | varies |
| Sialogram (70390) | $1,226.47 | $1,635.29 | 5.3× |
| Skull less than 4 views (70250) | $1,259.91 | $1,679.88 | 12.5× |
| Special dosimetry (77331) | $1,682.12 | $2,242.82 | 13.0× |
| Special Physics Consult (77370) | $3,125.87 | $4,167.83 | 24.2× |
| Special teletherapy port plan (77321) | $4,807.98 | $6,410.64 | 13.4× |
| Special treatment procedure (77470) | $6,807.38 | $9,076.51 | 12.8× |
| Speech evaluation, complex (70371) | $504.84 | $673.12 | 2.2× |
| Spleen Imaging (78185) | $2,472.19 | $3,296.25 | 6.4× |
| Stereotactic Body Radiation Delivery (77373) | $59,800.82 | $79,734.42 | 34.8× |
| Sternoclavicular joints (71130) | $387.70 | $516.93 | 4.6× |
| Superior sagittal sinus venogram (75870) | $5,657.24 | $7,542.98 | 1.9× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $6,807.38 | $9,076.51 | 69.4× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $6,807.38 | $9,076.51 | 69.4× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $6,100.97 | $8,134.63 | 169.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $435.84 | $581.12 | 4.4× |
| 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 W/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 Intermed (77285) | $4,083.66 | $5,444.88 | 11.3× |
| Ther rad simulaj-aided field setting simple (77280) | $2,630.26 | $3,507.01 | 20.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,425.02 | $1,900.02 | 8.5× |
| Thoracic spine 2 views (72070) | $1,164.19 | $1,552.25 | 11.6× |
| Thoracic spine 3 views (72072) | $1,231.28 | $1,641.71 | 12.2× |
| Thoracolumbar 2 views (72080) | $1,007.48 | $1,343.31 | 12.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,068.29 | $1,424.39 | 2.8× |
| Thyroid Imaging With Vascular Flow (78013) | $2,595.89 | $3,461.19 | 6.8× |
| Thyroid Met Imaging Body (78018) | $3,243.62 | $4,324.82 | 6.2× |
| 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× |
| Tx Devices Design & Construction Complex (77334) | $3,306.71 | $4,408.95 | 9.2× |
| Tx devices design & construction intermediate (77333) | $2,147.77 | $2,863.69 | 16.6× |
| Tx devices design & construction simple (77332) | $1,623.40 | $2,164.53 | 12.6× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$942.66–$1,885.32 | $1,256.88–$2,513.76 | varies |
| Ultrasound elastography first target lesion (76982) | $942.66 | $1,256.88 | 9.4× |
| Ultrasound Elastography Parenchyma (76981) | $942.66 | $1,256.88 | 9.4× |
| Ultrasound Exam Aaa Screen (76706) | $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 Dx 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 px dx nuclear medicine (78599) | $1,457.13 | $1,942.84 | 3.8× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$942.66–$1,336.12 | $1,256.88–$1,781.49 | varies |
| Upper gi w/o kub (74240) | $2,474.78 | $3,299.70 | 14.7× |
| Urea breath test c-14 isotopic analysis (78268) | $389.18 | $518.90 | 4.1× |
| Ureteral Reflux Study (78740) | $1,879.76 | $2,506.34 | 4.9× |
| Urethrocystogram voiding (74455) | $2,184.91 | $2,913.21 | 9.5× |
| Urethrocystography retrograde (74450) | $954.82 | $1,273.09 | 4.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$942.66–$1,885.32 | $1,256.88–$2,513.76 | varies |
| Us chest (76604) | $942.66 | $1,256.88 | 9.4× |
| Us complete joint (76881) range across 2 matching MRF lines |
$942.66–$1,962.27 | $1,256.88–$2,616.36 | varies |
| Us exam, pelvic, limited (76857) | $942.66 | $1,256.88 | 9.4× |
| Us head (76506) | $942.66 | $1,256.88 | 9.4× |
| Us kidney transplant (76776) | $1,414.02 | $1,885.36 | 14.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$942.66–$3,228.37 | $1,256.88–$4,304.49 | varies |
| Us ob detailed single fetus (76811) | $861.92 | $1,149.23 | 3.8× |
| Us ob limited 1 or more fetuses (76815) | $861.92 | $1,149.23 | 8.6× |
| 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 pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $678.75 | $905 | 6.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $501 | $668 | 5.0× |
| Us retroperitoneal complete (76770) | $859.06 | $1,145.41 | 8.5× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$942.66–$1,962.27 | $1,256.88–$2,616.36 | varies |
| Us scrotum and contents (76870) | $942.66 | $1,256.88 | 9.4× |
| Us spinal canal and contents (76800) | $942.66 | $1,256.88 | 9.4× |
| Us thyroid (76536) | $942.66 | $1,256.88 | 9.4× |
| Us transrectal (76872) | $942.66 | $1,256.88 | 9.4× |
| Vascular Flow Imaging (78445) | $1,929.22 | $2,572.29 | 5.0× |
| Vein X-Ray Chest (75827) | $3,449.61 | $4,599.48 | 2.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,351.96 | $7,135.94 | 1.8× |
| Vein X-Ray Skull Epidural (75872) | $5,352.04 | $7,136.05 | 8.9× |
| Vein X-Ray Spleen/Liver (75810) | $15,813.32 | $21,084.43 | 5.2× |
| Venogram Sinus/Jugular (75860) | $14,670.66 | $19,560.88 | 4.8× |
| Venography Adrenal Unilateral (75840) | $7,906.71 | $10,542.28 | 2.6× |
| Venography caval inferior serialography rs&i (75825) | $11,809.81 | $15,746.41 | 3.9× |
| Venography extremity bilateral rs&i (75822) | $6,899.24 | $9,198.98 | 4.6× |
| Venography extremity unilateral rs&i (75820) | $3,449.61 | $4,599.48 | 2.3× |
| Venography Orbital Rs&I (75880) | $4,417.56 | $5,890.08 | 7.3× |
| Venography Renal Bilateral (75833) | $9,250.32 | $12,333.76 | 3.0× |
| Venography Renal Unilateral (75831) | $11,062.28 | $14,749.71 | 3.6× |
| Venous sampling by catheter (75893) | $10,823.85 | $14,431.80 | 2.0× |
| Vertebral fracture assessment via dxa (77086) | $627 | $836 | 7.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$1,039.84–$2,079.56 | $1,386.45–$2,772.74 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $972.74 | $1,296.99 | 11.6× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,041.58–$2,083.16 | $1,388.77–$2,777.54 | varies |
| X-Ray Aorta Leg Arteries (75630) | $10,183.63 | $13,578.17 | 3.4× |
| X-Ray Bend Only L-S Spine (72120) | $936.89 | $1,249.19 | 9.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$886.64–$1,773.27 | $1,182.19–$2,364.36 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,078.35 | $2,771.13 | 4.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$300–$1,799.61 | $400–$2,399.48 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $3,501.08 | $4,668.10 | 34.8× |
| 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 2 Views (73521) | $1,591.43 | $2,121.91 | 15.8× |
| 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 L-S Spine Bending (72114) | $2,047.22 | $2,729.62 | 20.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,163 | $1,550.66 | 13.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $2,306.96 | $3,075.94 | 23.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$1,324.61–$2,647.88 | $1,766.14–$3,530.51 | varies |
| X-ray eye for foreign body (70030) | $966.84 | $1,289.12 | 11.6× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$1,023.02–$2,046.12 | $1,364.03–$2,728.16 | varies |
| X-ray IV pyelogram (ivp) (74400) | $3,034.39 | $4,045.85 | 18.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $966.84 | $1,289.12 | 11.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,061.36 | $1,415.14 | 12.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $938.10 | $1,250.80 | 9.3× |
| X-ray nose-rectum child f.b. (76010) | $335.03 | $446.70 | 4.0× |
| 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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $612.59 | $816.78 | 6.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,020.60 | $1,360.80 | 12.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $994.27 | $1,325.69 | 11.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,817.52 | $2,423.36 | 18.1× |
| X-ray thoracic spine 4 vw (72074) | $1,347.33 | $1,796.44 | 13.4× |
| X-Ray Tmj Unilat (70328) | $151.31 | $201.74 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$2,571.40–$5,142.78 | $3,428.53–$6,857.04 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$597.92–$673.67 | $797.23–$898.23 | varies |
| X-Rays Bone Survey Complete (77075) | $2,201.63 | $2,935.50 | 21.9× |
| Xr c-spine 4 or 5 views (72050) | $1,500.41 | $2,000.55 | 14.9× |
| Xr facial bones less than 3 views (70140) | $795.73 | $1,060.97 | 9.5× |
| Xr orbits complete 4 views (70200) | $1,149.87 | $1,533.16 | 11.4× |
| Xr Tomogram Single Plane (76100) | $3,301.50 | $4,402 | 32.8× |
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.