Imaging prices at Berkeley Medical Center
Martinsburg, WV · every code in this section with a posted price and a Medicare benchmark.
314 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$1,650.50–$1,791 | $3,301–$3,582 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$182–$197.50 | $364–$395 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$182–$197.50 | $364–$395 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $752 | $1,504 | 1.9× |
| Angio pulmonary bilat (75743) | $3,113.50 | $6,227 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $3,250 | $6,500 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,132 | $6,264 | 1.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,039 | $10,078 | 0.9× |
| Artery X-Rays Abdomen (75726) | $3,250 | $6,500 | 0.6× |
| Artery X-Rays Pelvis (75736) | $3,250 | $6,500 | 0.6× |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$161.50–$13,204 | $323–$26,408 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$696–$755.50 | $1,392–$1,511 | varies |
| Bone Imaging Limited Area (78300) | $696 | $1,392 | 1.8× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$696–$755.50 | $1,392–$1,511 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| Brachytx isodose complex (77318) | $440 | $880 | 1.2× |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$440–$477.50 | $880–$955 | varies |
| Brachytx Isodose Plan Simple (77316) | $477.50 | $955 | 1.3× |
| Brain Flow Imaging Only (78610) | $1,947.50 | $3,895 | 3.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$3,213.50–$3,487 | $6,427–$6,974 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$158.50–$172 | $317–$344 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$158.50–$172 | $317–$344 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$113.50–$123.50 | $227–$247 | varies |
| Chest 4 or more views (71048) | $172 | $344 | 1.7× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $120 | $240 | 1.2× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$161.50–$175.50 | $323–$351 | varies |
| Contrast Exam Abdominl Aorta (75625) | $3,250 | $6,500 | 1.1× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$608.50–$660.50 | $1,217–$1,321 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,320.50–$2,450 | $4,641–$4,900 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$1,441.50–$1,564.50 | $2,883–$3,129 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,049–$1,050 | $2,098–$2,100 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,221–$1,247 | $2,442–$2,494 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$758–$822.50 | $1,516–$1,645 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,400 | $4,800 | 7.1× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$1,418.50–$1,420.50 | $2,837–$2,841 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,260–$1,367.50 | $2,520–$2,735 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,302–$1,833.50 | $2,604–$3,667 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$1,061.50–$2,123 | $2,123–$4,246 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,260–$1,367.50 | $2,520–$2,735 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,221–$1,241 | $2,442–$2,482 | varies |
| CT cervical spine w/ contrast (72126) | $1,081.50 | $2,163 | 3.2× |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$781.50–$848 | $1,563–$1,696 | varies |
| CT cervical spine w/wo cont (72127) | $1,260 | $2,520 | 7.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,048.50–$1,050 | $2,097–$2,100 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,221–$1,247 | $2,442–$2,494 | varies |
| CT head/brain with contrast (70460) | $1,081.50 | $2,163 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,260 | $2,520 | 7.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,455 | $2,910 | 4.3× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$99–$124 | $198–$248 | varies |
| CT iac w contrast (70481) | $1,081.50 | $2,163 | 6.4× |
| CT l-spine w&w/o contrast (72133) | $1,221 | $2,442 | 7.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$758–$779 | $1,516–$1,558 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,048.50–$2,097 | $2,097–$4,194 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,048.50–$1,050 | $2,097–$2,100 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$758–$822.50 | $1,516–$1,645 | varies |
| CT maxillofacial w contrast (70487) | $1,081.50 | $2,163 | 6.4× |
| CT maxillofacial wo contrast (70486) | $781.50 | $1,563 | 7.7× |
| CT neck tissue combo (70492) | $1,260 | $2,520 | 7.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,260 | $2,520 | 7.4× |
| CT orbits w/o contrast (70480) | $781.50 | $1,563 | 7.7× |
| CT pelvis w&w/o contrast (72194) | $1,221 | $2,442 | 7.2× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$758–$822.50 | $1,516–$1,645 | varies |
| CT scan of leg combo (73702) | $1,221 | $2,442 | 7.2× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,260–$1,367.50 | $2,520–$2,735 | varies |
| CT soft tissue neck w contrast (70491) | $1,081.50 | $2,163 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $781.50 | $1,563 | 7.7× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,048.50–$1,050 | $2,097–$2,100 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$758–$822.50 | $1,516–$1,645 | varies |
| CT thoracic spine w/wo cont (72130) | $1,221 | $2,442 | 7.2× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$758–$822.50 | $1,516–$1,645 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$758–$773 | $1,516–$1,546 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,221 | $2,442 | 7.2× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,048.50–$1,050 | $2,097–$2,100 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,221 | $2,442 | 7.2× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,221–$1,325 | $2,442–$2,650 | varies |
| CTA pelvis (72191) | $1,221 | $2,442 | 7.2× |
| Diskography lumbar (72295) | $2,244.50 | $4,489 | 1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$121–$176.50 | $242–$353 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$334–$362.50 | $668–$725 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$745.50–$809 | $1,491–$1,618 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$413.50–$449 | $827–$898 | varies |
| Echograp Trans R Pros Study (76873) | $131 | $262 | 1.3× |
| Esophagram (74220) range across 2 matching MRF lines |
$385.50–$418.50 | $771–$837 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$183–$199 | $366–$398 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $403.50 | $807 | 4.0× |
| Fluoroscopy up to 1 hr (76000) | $495.50 | $991 | 2.1× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$872–$946.50 | $1,744–$1,893 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$177–$354 | $354–$708 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$693–$752 | $1,386–$1,504 | varies |
| Gated Heart Planar Single (78472) | $889 | $1,778 | 2.3× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $854 | $1,708 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $854 | $1,708 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $854 | $1,708 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$864–$937.50 | $1,728–$1,875 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$815–$884.50 | $1,630–$1,769 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,166–$2,350.50 | $4,332–$4,701 | varies |
| Hysterosalpingogram (74740) | $1,046.50 | $2,093 | 4.5× |
| Intracavitary Radiation Source Applic Complex (77763) | $854 | $1,708 | 1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) | $701 | $1,402 | 1.3× |
| Intracavitary radiation source applic simple (77761) | $701 | $1,402 | 1.3× |
| Intraop radiaj tx deliver xray single tx session (77424) | $9,274.50 | $18,549 | 1.3× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$929.50–$1,009 | $1,859–$2,018 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$929.50–$1,009 | $1,859–$2,018 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$177–$354 | $354–$708 | varies |
| Liver imaging static only (78201) | $605.50 | $1,211 | 1.2× |
| Liver imaging w/vascular flow (78202) | $624 | $1,248 | 1.2× |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$559–$607 | $1,118–$1,214 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,742.50–$1,891 | $3,485–$3,782 | varies |
| Lymph System Imaging (78195) | $718 | $1,436 | 1.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,113.50–$1,208.50 | $2,227–$2,417 | varies |
| Mammary ductogram or galactogram multiple (77054) | $288.50 | $577 | 1.3× |
| Mammary ductogram or galactogram single (77053) | $288.50 | $577 | 1.3× |
| Meckels Divert Exam (78290) | $693 | $1,386 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$440–$477.50 | $880–$955 | varies |
| Mr safety determination physician/other qhp (76016) | $272 | $544 | 3.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $27.50 | $55 | 1.0× |
| Mr safety implt pos&/immoblj (76019) | $67 | $134 | 1.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $103.50 | $207 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,793.50–$1,946 | $3,587–$3,892 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,165–$1,264.50 | $2,330–$2,529 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,793.50–$1,946 | $3,587–$3,892 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$1,165–$1,264.50 | $2,330–$2,529 | varies |
| MRI abdomen w contrast (74182) | $1,353.50 | $2,707 | 4.0× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,113.50–$1,208.50 | $2,227–$2,417 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,353.50 | $2,707 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,353.50 | $2,707 | 1.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,627.50 | $3,255 | 7.1× |
| MRI cervical spine w contrast (72142) | $1,417 | $2,834 | 4.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,165–$1,264.50 | $2,330–$2,529 | varies |
| MRI chest w/o contrast (71550) | $1,113.50 | $2,227 | 4.8× |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,113.50–$1,208.50 | $2,227–$2,417 | varies |
| MRI lumbar spine w contrast (72149) | $1,353.50 | $2,707 | 4.0× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,793.50–$1,946 | $3,587–$3,892 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,165–$1,264.50 | $2,330–$2,529 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,793–$1,945.50 | $3,586–$3,891 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,077.50–$1,169.50 | $2,155–$2,339 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,113.50–$1,208.50 | $2,227–$2,417 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,113.50–$1,208.50 | $2,227–$2,417 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,713.50–$1,859.50 | $3,427–$3,719 | varies |
| MRI, dorsal spine contrast (72147) | $1,353.50 | $2,707 | 4.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,113.50–$2,227 | $2,227–$4,454 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,713–$1,859 | $3,426–$3,718 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,713.50–$1,859.50 | $3,427–$3,719 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,148.50–$3,416.50 | $6,297–$6,833 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$182–$197.50 | $364–$395 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$440–$477.50 | $880–$955 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$537.50–$583.50 | $1,075–$1,167 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$597–$955 | $1,194–$1,910 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$133.50–$145 | $267–$290 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $118 | $236 | 1.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$189–$205.50 | $378–$411 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$834–$905 | $1,668–$1,810 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$631–$685 | $1,262–$1,370 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Peritoneogram Rs&I (74190) | $843.50 | $1,687 | 1.6× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$3,213.50–$3,487 | $6,427–$6,974 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,213.50–$3,487 | $6,427–$6,974 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $621.50 | $1,243 | 1.6× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,069.50 | $2,139 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$316–$343 | $632–$686 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $414 | $828 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$307.50–$1,481 | $615–$2,962 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $177 | $354 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $177 | $354 | 2.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $562.50 | $1,125 | 3.3× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex Sternum Minimum 2 Views (71120) | $177 | $354 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $192.50 | $385 | 1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$204–$221.50 | $408–$443 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,515.50 | $15,031 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $754 | $1,508 | 7.6× |
| Radiation treatment delivery level 2 (77407) | $754 | $1,508 | 2.0× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$320–$829.50 | $640–$1,659 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$562.50–$610.50 | $1,125–$1,221 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$385.50–$418.50 | $771–$837 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$367.50–$399 | $735–$798 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$385.50–$418.50 | $771–$837 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$385.50–$418.50 | $771–$837 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$290.50–$315.50 | $581–$631 | varies |
| Radiologic examination femur 1 view (73551) | $180.50 | $361 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$184–$368 | $368–$736 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$177–$354 | $354–$708 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) range across 4 matching MRF lines |
$288–$576 | $576–$1,152 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $288 | $576 | 0.8× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$793–$860.50 | $1,586–$1,721 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,986.50 | $5,973 | 5.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,752.50–$2,986.50 | $5,505–$5,973 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,186 | $6,372 | 2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$2,808.50–$3,047.50 | $5,617–$6,095 | varies |
| Rp Therapy Intravenous Administration (79101) | $616 | $1,232 | 2.7× |
| Scapula (73010) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$43.50–$73.50 | $87–$147 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Special dosimetry (77331) | $175.50 | $351 | 1.4× |
| Special Physics Consult (77370) | $161.50 | $323 | 1.2× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$161.50–$175.50 | $323–$351 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$602.50–$654 | $1,205–$1,308 | varies |
| Stereotactic Body Radiation Delivery (77373) | $2,125 | $4,250 | 1.2× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Superior sagittal sinus venogram (75870) | $2,869.50 | $5,739 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $440 | $880 | 1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $477.50 | $955 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$440–$477.50 | $880–$955 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$440–$477.50 | $880–$955 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$161.50–$175.50 | $323–$351 | varies |
| Thoracic spine 2 views (72070) | $177 | $354 | 1.8× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Thyroid Met Imaging Body (78018) | $657 | $1,314 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $631 | $1,262 | 1.6× |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$161.50–$323 | $323–$646 | varies |
| Tx devices design & construction intermediate (77333) | $477.50 | $955 | 3.7× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$161.50–$175.50 | $323–$351 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$249–$498 | $498–$996 | varies |
| Ultrasound Exam Aaa Screen (76706) | $388.50 | $777 | 3.8× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$403–$437.50 | $806–$875 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$618.50–$1,237 | $1,237–$2,474 | varies |
| Unlisted fluoroscopic procedure (76496) | $192.50 | $385 | 2.3× |
| Unlisted magnetic resonance procedure (76498) | $2,009 | $4,018 | 23.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $143 | $286 | 1.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$385.50–$418.50 | $771–$837 | varies |
| Urethrocystogram voiding (74455) | $660.50 | $1,321 | 2.9× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$608.50–$660.50 | $1,217–$1,321 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$249–$498 | $498–$996 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$404–$436.50 | $808–$873 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$250–$271.50 | $500–$543 | varies |
| Us head (76506) | $403.50 | $807 | 4.0× |
| Us kidney transplant (76776) | $403.50 | $807 | 4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$249–$847 | $498–$1,694 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$452–$490.50 | $904–$981 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$244–$251 | $488–$502 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$120.50–$452 | $241–$904 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$403.50–$438 | $807–$876 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $452 | $904 | 4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$255.50–$277.50 | $511–$555 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$403.50–$438 | $807–$876 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$403.50–$438 | $807–$876 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$403.50–$438 | $807–$876 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$404–$438.50 | $808–$877 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$403.50–$438 | $807–$876 | varies |
| Us transrectal (76872) | $272.50 | $545 | 2.7× |
| Vein X-Ray Chest (75827) | $2,032 | $4,064 | 1.3× |
| Venogram Sinus/Jugular (75860) | $2,869.50 | $5,739 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,909 | $5,818 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,205 | $2,410 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,205 | $2,410 | 0.8× |
| Venography Orbital Rs&I (75880) | $3,363 | $6,726 | 5.5× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$177–$385 | $354–$770 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $177 | $354 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $342.50 | $685 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,132 | $6,264 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $177 | $354 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$177–$385 | $354–$770 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$386.50–$419.50 | $773–$839 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$180.50–$196 | $361–$392 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$189–$205.50 | $378–$411 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $195.50 | $391 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $186 | $372 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $190.50 | $381 | 2.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$194.50–$211.50 | $389–$423 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$186–$202 | $372–$404 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$190.50–$207 | $381–$414 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$194.50–$211.50 | $389–$423 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $334 | $668 | 3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$188.50–$377 | $377–$754 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$177–$354 | $354–$708 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $177 | $354 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$182–$197.50 | $364–$395 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $307.50 | $615 | 3.0× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$608.50–$660.50 | $1,217–$1,321 | varies |
| X-Rays Bone Length Studies (77073) | $177 | $354 | 1.8× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$307.50–$334 | $615–$668 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$177–$192.50 | $354–$385 | varies |
| Xr orbits complete 4 views (70200) | $177 | $354 | 1.8× |
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.