Imaging prices at Bayside Community Hospital
Anahuac, TX · every code in this section with a posted price and a Medicare benchmark.
475 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) | $491 | $491 | 0.4× |
| Abdomen 1 View (74018) | $411 | $411 | 4.7× |
| Abdomen 2 views (74019) | $555 | $555 | 5.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $354 | $354 | 0.9× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $325 | $325 | 0.2× |
| Adrenal Cortex & Medulla Img (78075) | $430 | $430 | 0.3× |
| Angio internal mammary (75756) | $185 | $185 | 0.1× |
| Angio pulmonary bilat (75743) | $192 | $192 | 0.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $206 | $206 | 0.1× |
| Angiography extremity bilateral rs&i (75716) | $212 | $212 | 0.1× |
| Angiography extremity unilateral rs&i (75710) | $178 | $178 | 0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $165 | $165 | 0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $171 | $171 | 0.1× |
| Ankle 2 views (73600) range across 10 matching MRF lines |
$29–$381 | $29–$381 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$155 | $155 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $210 | $210 | 0.1× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$166 | $166 | 0.0× |
| Artery X-Rays Adrenal Gland (75731) | $184 | $184 | 0.1× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$175 | $175 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$253 | $253 | 0.0× |
| Arthrogram ankle (73615) | $105 | $105 | 0.3× |
| Arthrogram hip (73525) | $105 | $105 | 0.3× |
| Arthrogram Wrist (73115) | $113 | $113 | 0.3× |
| Basic radiation dosimetry calculation (77300) | $68 | $68 | 0.5× |
| Bone age studies (77072) range across 4 matching MRF lines |
$24–$575 | $24–$575 | varies |
| Bone Imaging 3 Phase (78315) | $354 | $354 | 0.9× |
| Bone Imaging Limited Area (78300) | $184 | $184 | 0.5× |
| Bone Imaging Multiple Areas (78305) | $235 | $235 | 0.6× |
| Bone Imaging Whole Body (78306) | $255 | $255 | 0.6× |
| Bone marrow imaging limited area (78102) | $172 | $172 | 0.4× |
| Bone marrow imaging; multiple areas (78103) | $228 | $228 | 0.6× |
| Bone marrow imaging; whole body (78104) | $247 | $247 | 0.6× |
| Bone survey infant (77076) | $109 | $109 | 1.0× |
| Brain Flow Imaging Only (78610) | $176 | $176 | 0.3× |
| Brain Image W/Flow < 4 Views (78601) | $219 | $219 | 0.5× |
| Brain imaging < 4 static views (78600) | $186 | $186 | 0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $334 | $334 | 0.6× |
| Brain Imaging Minimum 4 Static Views (78605) | $201 | $201 | 0.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $78 | $78 | 0.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $232 | $232 | 0.6× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $247 | $247 | 0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $439 | $439 | 1.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $517 | $517 | 0.7× |
| Cardiac Shunt Detection (78428) | $186 | $186 | 0.5× |
| Cat Scan Follow-Up Study (76380) | $154 | $154 | 1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $327 | $327 | 0.6× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $343 | $343 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $342 | $342 | 0.6× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$386–$447 | $386–$447 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$422–$485 | $422–$485 | varies |
| Cholecystography Oral Contrast (74290) | $72 | $72 | 0.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $94 | $94 | 0.9× |
| Cisternography Positive Contrast Rs&I (70015) | $156 | $156 | 0.2× |
| Clavicle complete (73000) range across 8 matching MRF lines |
$30–$442 | $30–$442 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $415 | $415 | 4.0× |
| Continuing medical physics consltj pr wk (77336) | $74 | $74 | 0.5× |
| Contrast Exam Abdominl Aorta (75625) | $154 | $154 | 0.0× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$42–$1,012 | $42–$1,012 | varies |
| Contrast X-Ray Of Elbow (73085) | $104 | $104 | 0.3× |
| Contrast X-Ray Of Knee Joint (73580) | $129 | $129 | 0.4× |
| Contrast Xray Throat/Cerv Esopha (74210) | $80 | $80 | 0.5× |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$61–$65 | $61–$65 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 9 matching MRF lines |
$382–$5,688 | $382–$5,688 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$221–$4,194 | $221–$4,194 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$243–$3,116 | $243–$3,116 | varies |
| CT abdomen w wo contrast (74170) range across 9 matching MRF lines |
$280–$3,568 | $280–$3,568 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$158–$2,596 | $158–$2,596 | varies |
| CT Angio Abdomen and Pelvis (74174) | $547 | $547 | 1.6× |
| CT Angio Chest (71275) range across 5 matching MRF lines |
$378–$3,211 | $378–$3,211 | varies |
| CT Angio Head (70496) range across 5 matching MRF lines |
$450–$3,000 | $450–$3,000 | varies |
| CT angio hrt w/3d image (75574) | $425 | $425 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$377–$1,942 | $377–$1,942 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$467–$3,106 | $467–$3,106 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 6 matching MRF lines |
$339–$1,942 | $339–$1,942 | varies |
| CT bone density (77078) range across 3 matching MRF lines |
$113–$415 | $113–$415 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$242–$2,800 | $242–$2,800 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$198–$3,000 | $198–$3,000 | varies |
| CT cervical spine w/wo cont (72127) | $287 | $287 | 1.6× |
| CT chest w contrast (71260) range across 8 matching MRF lines |
$242–$5,507 | $242–$5,507 | varies |
| CT chest w/wo contrast (71270) range across 5 matching MRF lines |
$292–$9,420 | $292–$9,420 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $533 | $533 | 3.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $486 | $486 | 4.6× |
| CT head/brain with contrast (70460) range across 6 matching MRF lines |
$172–$2,499 | $172–$2,499 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$206–$3,130 | $206–$3,130 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $292 | $292 | 0.8× |
| CT heart no contrast quant eval coronry calcium (75571) range across 4 matching MRF lines |
$107–$572 | $107–$572 | varies |
| CT hrt w/3d image congen (75573) | $401 | $401 | 1.1× |
| CT iac w contrast (70481) | $969 | $969 | 5.5× |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$288–$2,943 | $288–$2,943 | varies |
| CT lower ext w/o (73700) range across 30 matching MRF lines |
$193–$2,287 | $193–$2,287 | varies |
| CT lower extremity w/contrast material (73701) range across 27 matching MRF lines |
$239–$2,587 | $239–$2,587 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$241–$2,838 | $241–$2,838 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$193–$2,645 | $193–$2,645 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$253–$2,498 | $253–$2,498 | varies |
| CT maxillofacial wo contrast (70486) range across 6 matching MRF lines |
$209–$2,324 | $209–$2,324 | varies |
| CT neck tissue combo (70492) range across 5 matching MRF lines |
$295–$2,759 | $295–$2,759 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $326 | $326 | 1.9× |
| CT orbits w/o contrast (70480) range across 5 matching MRF lines |
$254–$1,944 | $254–$1,944 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$278–$2,838 | $278–$2,838 | varies |
| CT pelvis w/o contrast (72192) range across 5 matching MRF lines |
$154–$2,429 | $154–$2,429 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$298–$1,076 | $298–$1,076 | varies |
| CT scans face/jaw combo (70488) | $303 | $303 | 1.7× |
| CT soft tissue neck w contrast (70491) range across 6 matching MRF lines |
$249–$2,624 | $249–$2,624 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$208–$2,328 | $208–$2,328 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$242–$2,838 | $242–$2,838 | varies |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$194–$2,714 | $194–$2,714 | varies |
| CT thoracic spine w/wo cont (72130) | $291 | $291 | 1.7× |
| CT thorax w/o contrast (71250) range across 7 matching MRF lines |
$193–$2,906 | $193–$2,906 | varies |
| CT upper ext wo (73200) range across 30 matching MRF lines |
$193–$2,287 | $193–$2,287 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $300 | $300 | 1.7× |
| CT upper extremity with contrast (73201) range across 28 matching MRF lines |
$236–$2,587 | $236–$2,587 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$423–$4,811 | $423–$4,811 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$391–$4,246 | $391–$4,246 | varies |
| CTA pelvis (72191) | $392 | $392 | 2.2× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $16 | $16 | 0.1× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $24 | $24 | 0.0× |
| Dilation ureters/urethra rs&i (74485) | $98 | $98 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $119 | $119 | 0.1× |
| Diskography lumbar (72295) | $102 | $102 | 0.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $54 | $54 | 0.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $77 | $77 | 0.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $96 | $96 | 0.9× |
| Dxa Bone Density Axial (77080) | $49 | $49 | 0.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $28 | $28 | 0.3× |
| Echo exam of fetal heart (76825) | $278 | $278 | 0.5× |
| Echo exam uterus (76831) | $126 | $126 | 0.5× |
| Echo Guide For Artery Repair (76936) | $277 | $277 | 1.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $166 | $166 | 0.7× |
| Echograp Trans R Pros Study (76873) | $176 | $176 | 1.7× |
| Esophageal Motility Study (78258) | $225 | $225 | 0.6× |
| Esophagram (74220) | $94 | $94 | 0.5× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$125–$777 | $125–$777 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$92–$574 | $92–$574 | varies |
| Fluoroscopy up to 1 hr (76000) | $51 | $51 | 0.2× |
| Follow-Up Angiography (75898) | $89 | $89 | 0.0× |
| Foot 2 views (73620) range across 9 matching MRF lines |
$28–$390 | $28–$390 | varies |
| Forearm 2 views (73090) range across 9 matching MRF lines |
$29–$439 | $29–$439 | varies |
| Gastric emptying imaging study (78264) | $292 | $292 | 0.7× |
| Gastric Mucosa Imaging (78261) | $257 | $257 | 0.6× |
| Gastroesophageal Reflux Exam (78262) | $248 | $248 | 0.6× |
| Gastrointestinal Protein Loss (78282) | $21 | $21 | 0.1× |
| Gated Heart Planar Single (78472) | $234 | $234 | 0.6× |
| Gated Heart, Multiple (78473) | $297 | $297 | 0.7× |
| GI Endoscopic US S&I (76975) | $46 | $46 | 0.2× |
| Hand 2 views (73120) range across 9 matching MRF lines |
$28–$374 | $28–$374 | varies |
| Heart first pass single,planar (78481) | $181 | $181 | 0.3× |
| Heart Image (Pet) Multiple (78492) | $97 | $97 | 0.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $158 | $158 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $159 | $159 | 0.1× |
| Hepatobil Syst Image W/Drug (78227) | $455 | $455 | 0.8× |
| Hepatobiliary System Imaging (78226) | $336 | $336 | 0.8× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $49 | $49 | 0.1× |
| Ht Musc Image Planar Mult (78454) | $443 | $443 | 0.3× |
| Ht Muscle Image Spect Sing (78451) | $350 | $350 | 0.3× |
| Hyperthermia external generated superficial (77600) | $397 | $397 | 1.0× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $988 | $988 | 1.8× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $990 | $990 | 1.8× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $365 | $365 | 0.7× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $718 | $718 | 1.0× |
| Hysterosalpingogram (74740) | $79 | $79 | 0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $151 | $151 | 1.7× |
| Infant hip ultrasound, limited static exam (76886) | $109 | $109 | 1.2× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$113–$1,703 | $113–$1,703 | varies |
| Interstitial radiation source applic complex (77778) | $893 | $893 | 1.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $743 | $743 | 1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $523 | $523 | 0.9× |
| Intracavitary radiation source applic simple (77761) | $393 | $393 | 0.7× |
| Joint Survey Single View (77077) | $41 | $41 | 0.4× |
| K Flow/Funct Image Multiple (78709) | $373 | $373 | 0.7× |
| K Flow/Funct Image W/Drug (78708) | $178 | $178 | 0.3× |
| K Flow/Funct Image W/O Drug (78707) | $236 | $236 | 0.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $111 | $111 | 0.3× |
| Kidney Imaging Morphol (78700) | $176 | $176 | 0.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $217 | $217 | 0.5× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$38–$453 | $38–$453 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $138 | $138 | 0.3× |
| Leveen/Shunt Patency Exam (78291) | $255 | $255 | 0.6× |
| Liver & Spleen Imaging Static Only (78215) | $197 | $197 | 0.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $125 | $125 | 0.3× |
| Liver imaging static only (78201) | $189 | $189 | 0.3× |
| Liver imaging w/vascular flow (78202) | $206 | $206 | 0.4× |
| Lung Perf&Ventilat Diferentl (78598) | $312 | $312 | 0.6× |
| Lung perfusion differential (78597) | $206 | $206 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $341 | $341 | 0.6× |
| Lung Ventilation Imaging (78579) | $189 | $189 | 0.5× |
| Lymph System Imaging (78195) | $363 | $363 | 0.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $63 | $63 | 0.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $47 | $47 | 0.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $63 | $63 | 0.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $44 | $44 | 0.0× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$327–$1,777 | $327–$1,777 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $174 | $174 | 1.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $181 | $181 | 0.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $175 | $175 | 1.0× |
| Mammary ductogram or galactogram multiple (77054) | $81 | $81 | 0.3× |
| Mammary ductogram or galactogram single (77053) | $60 | $60 | 0.3× |
| Meckels Divert Exam (78290) | $339 | $339 | 0.8× |
| Mlc imrt design & construction per imrt plan (77338) | $508 | $508 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $612 | $612 | 1.7× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$407–$2,944 | $407–$2,944 | varies |
| MRA head with contrast (70545) | $401 | $401 | 1.1× |
| MRA neck w contrast (70548) | $428 | $428 | 1.2× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$616–$3,709 | $616–$3,709 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$408–$2,889 | $408–$2,889 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$467–$3,590 | $467–$3,590 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$340–$3,409 | $340–$3,409 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$399–$3,493 | $399–$3,493 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$489–$4,266 | $489–$4,266 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$393–$3,753 | $393–$3,753 | varies |
| MRI bone marrow blood supply (77084) | $397 | $397 | 1.7× |
| MRI brain functional w/o physician admnistration (70554) | $457 | $457 | 1.9× |
| MRI brain functional w/physician admnistration (70555) | $138 | $138 | 0.6× |
| MRI cardiac w/o cont stress (75559) | $451 | $451 | 0.8× |
| MRI cardiac w/o contrast (75557) | $334 | $334 | 1.4× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$338–$4,363 | $338–$4,363 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$247–$3,651 | $247–$3,651 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$419–$3,222 | $419–$3,222 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$474–$3,078 | $474–$3,078 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$597–$4,064 | $597–$4,064 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$422–$3,150 | $422–$3,150 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$520–$4,286 | $520–$4,286 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$370–$3,296 | $370–$3,296 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$334–$3,810 | $334–$3,810 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$399–$4,955 | $399–$4,955 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$364–$3,556 | $364–$3,556 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$416–$3,386 | $416–$3,386 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$510–$4,538 | $510–$4,538 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$428–$3,431 | $428–$3,431 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$522–$4,544 | $522–$4,544 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$381–$3,168 | $381–$3,168 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$247–$3,344 | $247–$3,344 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$421–$2,639 | $421–$2,639 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$370–$2,984 | $370–$2,984 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$517–$4,494 | $517–$4,494 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$524–$4,794 | $524–$4,794 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$399–$4,268 | $399–$4,268 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$335–$3,770 | $335–$3,770 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$258–$2,938 | $258–$2,938 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$488–$3,964 | $488–$3,964 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$398–$5,013 | $398–$5,013 | varies |
| Myelogram cervical (72240) | $133 | $133 | 0.2× |
| Myelogram Lumbar (72265) | $129 | $129 | 0.2× |
| Myelography thoracic (72255) | $126 | $126 | 0.2× |
| Myelograpy 2/more regions rs&i (72270) | $201 | $201 | 0.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $186 | $186 | 0.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $77 | $77 | 0.1× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $200 | $200 | 0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $312 | $312 | 0.2× |
| Myocardial Spect Multiple Studies (78452) | $485 | $485 | 0.4× |
| Neck soft tissue (70360) range across 5 matching MRF lines |
$30–$420 | $30–$420 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $379 | $379 | 1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $47 | $47 | 0.1× |
| Nm csf leak detection (78650) | $340 | $340 | 0.3× |
| Nm myocard infarct spect (78469) | $230 | $230 | 0.4× |
| Nm red cell survival study (78130) range across 2 matching MRF lines |
$35–$173 | $35–$173 | varies |
| Nm whole blood volume (78122) | $100 | $100 | 0.2× |
| Nonvascular Shunt X-Ray (75809) | $104 | $104 | 1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,956 | $1,956 | 1.4× |
| Nuclear Rx Intra-Arterial (79445) | $124 | $124 | 0.5× |
| Nuclear Rx Oral Admin (79005) | $141 | $141 | 0.6× |
| Ob us nuchal meas 1 gest (76813) | $124 | $124 | 1.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $86 | $86 | 0.8× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $98 | $98 | 0.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $182 | $182 | 1.4× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $80 | $80 | 0.8× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $82 | $82 | 0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $96 | $96 | 0.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $16 | $16 | 0.6× |
| Ophthalmic us dx quantitative a-scan only (76511) | $105 | $105 | 1.0× |
| Optic foramina (70190) range across 9 matching MRF lines |
$37–$380 | $37–$380 | varies |
| Panoramic X-ray of jaws (70355) | $21 | $21 | 0.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $445 | $445 | 0.8× |
| Parathyroid Planar Imaging (78070) | $302 | $302 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $356 | $356 | 0.9× |
| Pelvis 1 or 2 views (72170) range across 8 matching MRF lines |
$30–$468 | $30–$468 | varies |
| Perineogram (74775) | $33 | $33 | 0.1× |
| Peritoneogram Rs&I (74190) | $25 | $25 | 0.0× |
| Pet Image Skull-Thigh (78812) | $102 | $102 | 0.1× |
| Pet Image W/Ct Lmtd (78814) | $118 | $118 | 0.1× |
| PET image w/CT, full body (78816) | $131 | $131 | 0.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $130 | $130 | 0.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $84 | $84 | 0.1× |
| Pet Myocardial Sngl Study (78491) | $78 | $78 | 0.1× |
| PET whole body (78813) | $107 | $107 | 0.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $100 | $100 | 0.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $95 | $95 | 0.1× |
| Platelet survival study Non-Facility (78191) | $173 | $173 | 0.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $173 | $173 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $243 | $243 | 0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$50–$597 | $50–$597 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$62–$614 | $62–$614 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 16 matching MRF lines |
$34–$492 | $34–$492 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$29–$352 | $29–$352 | varies |
| Radex elbow complete minimum 3 views (73080) range across 9 matching MRF lines |
$34–$507 | $34–$507 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 5 matching MRF lines |
$44–$458 | $44–$458 | varies |
| Radex fingr minimum 2 views (73140) range across 8 matching MRF lines |
$34–$391 | $34–$391 | varies |
| Radex foot complete minimum 3 views (73630) range across 10 matching MRF lines |
$32–$456 | $32–$456 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$34–$451 | $34–$451 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$29–$247 | $29–$247 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$59–$316 | $59–$316 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 5 matching MRF lines |
$35–$454 | $35–$454 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $82 | $82 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) range across 16 matching MRF lines |
$34–$492 | $34–$492 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 17 matching MRF lines |
$32–$476 | $32–$476 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$32–$416 | $32–$416 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$420–$492 | $420–$492 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$24–$418 | $24–$418 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 5 matching MRF lines |
$33–$363 | $33–$363 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$50–$290 | $50–$290 | varies |
| Radex Toe Minimum 2 Views (73660) range across 9 matching MRF lines |
$31–$366 | $31–$366 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$29–$247 | $29–$247 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$39–$468 | $39–$468 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,030 | $1,030 | 0.1× |
| Radiation treatment delivery level 1 (77402) | $138 | $138 | 1.3× |
| Radiation treatment delivery level 2 (77407) | $251 | $251 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $238 | $238 | 0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 5 matching MRF lines |
$41–$768 | $41–$768 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $615 | $615 | 5.9× |
| Radiologic exam colon double contrast study (74280) | $225 | $225 | 1.3× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$161–$779 | $161–$779 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$44–$598 | $44–$598 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $44 | $44 | 0.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $111 | $111 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $94 | $94 | 0.5× |
| Radiologic exam teeth complete full mouth (70320) | $54 | $54 | 0.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $39 | $39 | 0.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $132 | $132 | 0.7× |
| Radiologic examination femur 1 view (73551) | $462 | $462 | 5.3× |
| Radiologic examination femur minimum 2 views (73552) | $484 | $484 | 5.5× |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$31–$410 | $31–$410 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $73 | $73 | 0.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $39 | $39 | 0.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 9 matching MRF lines |
$28–$456 | $28–$456 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $57 | $57 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 3 matching MRF lines |
$15–$43 | $15–$43 | varies |
| Radiopharm Dacryocystography (78660) | $189 | $189 | 0.5× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $87 | $87 | 0.4× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $151 | $151 | 0.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $164 | $164 | 0.7× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $96 | $96 | 0.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $102 | $102 | 0.2× |
| Renal Cyst Study (74470) | $28 | $28 | 0.1× |
| Ribs bilateral 3 views (71110) range across 4 matching MRF lines |
$42–$470 | $42–$470 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $194 | $194 | 0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $254 | $254 | 0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $574 | $574 | 1.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $327 | $327 | 0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $345 | $345 | 0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $200 | $200 | 0.9× |
| Rp Therapy Intravenous Administration (79101) | $149 | $149 | 0.6× |
| Salivary Gland Function Study (78232) | $101 | $101 | 0.3× |
| Salivary Gland Imaging (78230) | $139 | $139 | 0.3× |
| Salivary Gland Imaging Serial Images (78231) | $132 | $132 | 0.3× |
| Scapula (73010) range across 17 matching MRF lines |
$33–$281 | $33–$281 | varies |
| Sella turcica (70240) | $32 | $32 | 0.4× |
| Shoulder 1 view (73020) range across 5 matching MRF lines |
$24–$437 | $24–$437 | varies |
| Shoulder Arthrography (73040) | $107 | $107 | 0.3× |
| Sialogram (70390) range across 2 matching MRF lines |
$103–$241 | $103–$241 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$38–$415 | $38–$415 | varies |
| Special dosimetry (77331) | $66 | $66 | 0.5× |
| Special Physics Consult (77370) | $113 | $113 | 0.8× |
| Special teletherapy port plan (77321) | $93 | $93 | 0.2× |
| Special treatment procedure (77470) | $159 | $159 | 0.3× |
| Speech evaluation, complex (70371) | $95 | $95 | 0.4× |
| Spleen Imaging (78185) | $213 | $213 | 0.5× |
| Stereotactic Body Radiation Delivery (77373) | $1,234 | $1,234 | 0.7× |
| Sternoclavicular joints (71130) range across 9 matching MRF lines |
$38–$263 | $38–$263 | varies |
| Superior sagittal sinus venogram (75870) | $160 | $160 | 0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $120 | $120 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $85 | $85 | 0.4× |
| Testicular Imaging W/Flow (78761) | $214 | $214 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $505 | $505 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $420 | $420 | 1.1× |
| Ther rad simulaj-aided field setting simple (77280) | $270 | $270 | 2.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$211–$566 | $211–$566 | varies |
| Thoracic spine 2 views (72070) range across 5 matching MRF lines |
$35–$508 | $35–$508 | varies |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$38–$617 | $38–$617 | varies |
| Thoracolumbar 2 views (72080) | $37 | $37 | 0.4× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $285 | $285 | 0.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $221 | $221 | 0.6× |
| Thyroid Imaging With Vascular Flow (78013) | $196 | $196 | 0.5× |
| Thyroid Met Imaging Body (78018) | $318 | $318 | 0.6× |
| Thyroid Uptake Measurement (78012) | $78 | $78 | 0.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $238 | $238 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $152 | $152 | 0.4× |
| Tx devices design & construction intermediate (77333) | $55 | $55 | 0.4× |
| Tx devices design & construction simple (77332) | $81 | $81 | 0.6× |
| Ultrasound Exam Aaa Screen (76706) | $348 | $348 | 3.3× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$110–$991 | $110–$991 | varies |
| Umbilical-artery Doppler (OB) (76820) | $50 | $50 | 0.5× |
| Unlisted Dx Radiographic Procedure (76499) | $305 | $305 | 3.5× |
| Unlisted us procedure (76999) | $493 | $493 | 5.6× |
| Upper gi w/o kub (74240) | $118 | $118 | 0.7× |
| Ureteral Reflux Study (78740) | $223 | $223 | 0.6× |
| Urethrocystogram voiding (74455) | $85 | $85 | 0.4× |
| Urethrocystography retrograde (74450) | $18 | $18 | 0.1× |
| Us bone density measurement (76977) | $7 | $7 | 0.1× |
| Us breast unilateral complete (76641) | $447 | $447 | 4.3× |
| Us chest (76604) range across 2 matching MRF lines |
$90–$991 | $90–$991 | varies |
| Us complete joint (76881) | $120 | $120 | 1.1× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$55–$1,120 | $55–$1,120 | varies |
| Us head (76506) | $125 | $125 | 1.2× |
| Us kidney transplant (76776) | $157 | $157 | 1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$37–$859 | $37–$859 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$191–$711 | $191–$711 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$92–$626 | $92–$626 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$104–$732 | $104–$732 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$126–$1,120 | $126–$1,120 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$129–$2,025 | $129–$2,025 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $119 | $119 | 1.1× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$135–$1,042 | $135–$1,042 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$67–$683 | $67–$683 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$76–$990 | $76–$990 | varies |
| Us spinal canal and contents (76800) | $142 | $142 | 1.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$123–$900 | $123–$900 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$95–$793 | $95–$793 | varies |
| Vascular Flow Imaging (78445) | $174 | $174 | 0.4× |
| Vasogram (74440) | $84 | $84 | 0.4× |
| Vein X-Ray Chest (75827) | $151 | $151 | 0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $172 | $172 | 0.1× |
| Vein X-Ray Skull Epidural (75872) | $153 | $153 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $62 | $62 | 0.0× |
| Venogram Sinus/Jugular (75860) | $156 | $156 | 0.0× |
| Venography Adrenal Unilateral (75840) | $166 | $166 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $149 | $149 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $158 | $158 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $126 | $126 | 0.1× |
| Venography Orbital Rs&I (75880) | $137 | $137 | 0.2× |
| Venography Renal Bilateral (75833) | $183 | $183 | 0.1× |
| Venography Renal Unilateral (75831) | $160 | $160 | 0.1× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$128 | $128 | 0.0× |
| Venous thrombosis imaging (78457) | $198 | $198 | 0.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $166 | $166 | 0.4× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$32–$260 | $32–$260 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$41–$458 | $41–$458 | varies |
| X-ray antegrade pyelogram tube (74425) | $19 | $19 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) | $186 | $186 | 0.1× |
| X-Ray Bend Only L-S Spine (72120) | $42 | $42 | 0.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 7 matching MRF lines |
$29–$419 | $29–$419 | varies |
| X-Ray Exam Breast Specimen (76098) | $20 | $20 | 0.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $610 | $610 | 7.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $357 | $357 | 4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 11 matching MRF lines |
$457–$884 | $457–$884 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $989 | $989 | 9.4× |
| X-Ray Exam L-S Spine Bending (72114) | $66 | $66 | 0.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$37–$512 | $37–$512 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $64 | $64 | 0.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 7 matching MRF lines |
$11–$570 | $11–$570 | varies |
| X-ray eye for foreign body (70030) | $30 | $30 | 0.3× |
| X-ray head for orthodontia (70350) | $22 | $22 | 0.3× |
| X-ray humerus (73060) range across 9 matching MRF lines |
$30–$433 | $30–$433 | varies |
| X-ray IV pyelogram (ivp) (74400) | $116 | $116 | 0.7× |
| X-ray IV pyelogram+tomography (74415) | $141 | $141 | 0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $35 | $35 | 0.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 5 matching MRF lines |
$36–$424 | $36–$424 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 10 matching MRF lines |
$37–$550 | $37–$550 | varies |
| X-ray nose-rectum child f.b. (76010) | $28 | $28 | 0.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $55 | $55 | 0.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 5 matching MRF lines |
$36–$383 | $36–$383 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $30 | $30 | 0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 9 matching MRF lines |
$30–$467 | $30–$467 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 5 matching MRF lines |
$40–$527 | $40–$527 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 5 matching MRF lines |
$49–$761 | $49–$761 | varies |
| X-Ray Stress View (77071) | $52 | $52 | 0.6× |
| X-ray thoracic spine 4 vw (72074) range across 5 matching MRF lines |
$45–$681 | $45–$681 | varies |
| X-Ray Tmj Unilat (70328) | $33 | $33 | 0.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $19 | $19 | 0.1× |
| X-Rays Bone Length Studies (77073) | $39 | $39 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $108 | $108 | 1.0× |
| Xr c-spine 4 or 5 views (72050) range across 5 matching MRF lines |
$50–$791 | $50–$791 | varies |
| Xr facial bones less than 3 views (70140) range across 5 matching MRF lines |
$31–$262 | $31–$262 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $37 | $37 | 0.4× |
| Xr myelogram posterior fossa (70010) | $68 | $68 | 0.2× |
| Xr orbits complete 4 views (70200) | $45 | $45 | 0.4× |
| Xr Tomogram Single Plane (76100) | $103 | $103 | 1.0× |
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.