Imaging prices at Beth Israel Deaconess Medical Center

Boston, MA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $7,512 $7,512 4.5×
Abdomen 1 View (74018) $397 $397 3.8×
Abdomen 2 views (74019) $397 $397 3.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $2,279 $2,279 4.8×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $1,632 $1,632 1.1×
Angio internal mammary (75756) $6,818 $6,818 1.8×
Angio pulmonary bilat (75743) $6,604 $6,604 1.7×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $1,761 $1,761 0.5×
Angiography extremity bilateral rs&i (75716) $8,891 $8,891 2.3×
Angiography extremity unilateral rs&i (75710) $4,038 $4,038 1.1×
Angiography pulmonary unilateral slctv rs&i (75741) $6,493 $6,493 1.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $3,736 $3,736 1.0×
Ankle 2 views (73600) $338 $338 3.2×
Aortography thoracic serialography rs&i (75605) $3,666 $3,666 0.5×
Aortography thoracic w/o serialography rs&i (75600) $14,412 $14,412 3.8×
Artery X-Rays Abdomen (75726) $4,516 $4,516 0.7×
Artery X-Rays Adrenal Gland (75731) $3,174 $3,174 0.8×
Artery X-Rays Pelvis (75736) $4,516 $4,516 0.7×
Artery X-Rays Spine (75705) $5,990 $5,990 0.9×
Arthrogram ankle (73615) $740 $740 1.8×
Arthrogram hip (73525) $633 $633 1.5×
Arthrogram Wrist (73115) $533 $533 1.3×
Basic radiation dosimetry calculation (77300) $659 $659 4.1×
Bone age studies (77072) $564 $564 4.5×
Bone Imaging 3 Phase (78315) $2,035 $2,035 4.2×
Bone Imaging Whole Body (78306) $1,244 $1,244 2.6×
Bone marrow imaging limited area (78102) $1,362 $1,362 2.8×
Bone marrow imaging; whole body (78104) $1,437 $1,437 3.0×
Bone survey infant (77076) $564 $564 4.5×
Brachytx isodose complex (77318) $2,130 $2,130 4.7×
Brachytx isodose intermed (77317) $1,073 $1,073 2.4×
Brachytx Isodose Plan Simple (77316) $628 $628 1.4×
Brain Flow Imaging Only (78610) $965 $965 1.5×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,140 $1,140 1.8×
Brain Imaging Pet Metabolic Evaluation (78608) $6,735 $6,735 3.9×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $2,049 $2,049 4.3×
Cardiac MRI w/w/o contrast & further seq (75561) $4,616 $4,616 11.0×
Cardiac MRI w/w/o contrast w/stress (75563) $4,616 $4,616 4.9×
Cardiac Shunt Detection (78428) $1,837 $1,837 3.8×
Cat Scan Follow-Up Study (76380) $553 $553 5.3×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $2,448 $2,448 3.8×
Cerebrospinal Fluid Scan (78630) $1,596 $1,596 2.5×
Chest 1 view (71045) $325 $325 3.1×
Chest 2 views (71046) $325 $325 3.1×
Chest 3 views (71047) $286 $286 2.7×
Chest 4 or more views (71048) $321 $321 2.6×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $708 $708 5.7×
Cholecystography Oral Contrast (74290) $1,372 $1,372 6.5×
Cisternography Positive Contrast Rs&I (70015) $944 $944 1.0×
Clavicle complete (73000) $319 $319 3.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $580 $580 4.6×
Continuing medical physics consltj pr wk (77336) $1,324 $1,324 8.2×
Contrast Exam Abdominl Aorta (75625) $4,033 $4,033 1.1×
Contrast X-Ray Bladder (74430) $973 $973 2.3×
Contrast X-Ray Of Elbow (73085) $527 $527 1.3×
Contrast X-Ray Of Knee Joint (73580) $687 $687 1.6×
Contrast Xray Throat/Cerv Esopha (74210) $1,193 $1,193 5.7×
Corpora cavernosography (74445) $2,269 $2,269 18.1×
CT abdomen and pelvis without and with contrast (74178) $3,721 $3,721 8.9×
CT abdomen and pelvis without contrast (74176) $2,359 $2,359 8.2×
CT abdomen w contrast (74160) $2,288 $2,288 10.9×
CT abdomen w wo contrast (74170) $2,542 $2,542 12.1×
CT abdomen w/o contrast (74150) $1,352 $1,352 10.8×
CT Angio Abdomen and Pelvis (74174) $3,721 $3,721 8.9×
CT Angio Chest (71275) $2,620 $2,620 12.5×
CT Angio Head (70496) $3,040 $3,040 14.5×
CT angio hrt w/3d image (75574) $2,060 $2,060 4.9×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,808 $3,808 18.1×
CT Angio Neck (70498) $3,040 $3,040 14.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,620 $2,620 12.5×
CT cervical spine w/ contrast (72126) $2,656 $2,656 6.4×
CT cervical spine w/o contrast (72125) $1,872 $1,872 14.9×
CT cervical spine w/wo cont (72127) $4,033 $4,033 19.2×
CT chest w contrast (71260) $2,288 $2,288 10.9×
CT chest w/wo contrast (71270) $2,530 $2,530 12.0×
CT colonography screening (74263) $1,856 $1,856 6.5×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $2,288 $2,288 10.9×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,338 $1,338 10.7×
CT head/brain with contrast (70460) $2,656 $2,656 12.6×
CT head/brain without and with contrast (70470) $2,949 $2,949 14.0×
CT heart contrast eval cardiac structure&morph (75572) $2,056 $2,056 4.9×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $275–$377 $275–$377 varies
CT hrt w/3d image congen (75573) $2,060 $2,060 4.9×
CT iac w contrast (70481) $2,656 $2,656 12.6×
CT l-spine w&w/o contrast (72133) $3,647 $3,647 17.3×
CT lower ext w/o (73700) $1,338 $1,338 10.7×
CT lower extremity w/contrast material (73701) $2,288 $2,288 10.9×
CT lumbar spine w contrast (72132) $2,282 $2,282 5.5×
CT lumbar spine w/o contrast (72131) $1,090 $1,090 8.7×
CT maxillofacial w contrast (70487) $2,656 $2,656 12.6×
CT maxillofacial wo contrast (70486) $1,553 $1,553 12.4×
CT neck tissue combo (70492) $2,949 $2,949 14.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,807 $2,807 13.4×
CT orbits w/o contrast (70480) $1,553 $1,553 12.4×
CT pelvis w&w/o contrast (72194) $2,542 $2,542 12.1×
CT pelvis w/o contrast (72192) $1,407 $1,407 11.2×
CT scan of leg combo (73702) $2,542 $2,542 12.1×
CT scans face/jaw combo (70488) $2,814 $2,814 13.4×
CT soft tissue neck w contrast (70491) $2,656 $2,656 12.6×
CT soft tissue neck w/o contrast (70490) $1,553 $1,553 12.4×
CT thoracic spine w contrast (72129) $2,285 $2,285 10.9×
CT thoracic spine w/o contrast (72128) $1,670 $1,670 13.3×
CT thoracic spine w/wo cont (72130) $2,542 $2,542 12.1×
CT thorax w/o contrast (71250) $1,338 $1,338 10.7×
CT unlisted procedure (76497) $550 $550 5.3×
CT upper ext wo (73200) $1,338 $1,338 10.7×
CT upper extremity w/o & w/contrast material (73202) $2,542 $2,542 12.1×
CT upper extremity with contrast (73201) $2,288 $2,288 5.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,620 $2,620 12.5×
Cta Abdomen (74175) $2,620 $2,620 12.5×
CTA pelvis (72191) $2,613 $2,613 12.4×
Dilation ureters/urethra rs&i (74485) $1,486 $1,486 0.6×
Discography Cerv/Thor Spine (72285) $4,278 $4,278 1.8×
Diskography lumbar (72295) $4,376 $4,376 1.9×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $538 $538 4.3×
Doppler Fetal Mid Cerebral Artery (76821) $455 $455 3.6×
Dxa Bone Density Axial (77080) $291 $291 2.3×
Dxa bone density study (77085) $507 $507 4.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $131 $131 1.3×
Echo exam uterus (76831) $1,101 $1,101 3.9×
Echo Guide For Artery Repair (76936) $1,330 $1,330 5.1×
Echograp Trans R Pros Study (76873) $602 $602 4.8×
Esophagram (74220) $933 $933 4.4×
Fetal Biophys Profile W/Nst (76818) $838 $838 6.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $663 $663 5.3×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $1,640 $1,640 5.7×
Fluoroscopy up to 1 hr (76000) $414 $414 1.4×
Follow-Up Angiography (75898) $1,502 $1,502 0.4×
Foot 2 views (73620) $362 $362 3.5×
Forearm 2 views (73090) $552 $552 5.3×
Gastric emptying imaging study (78264) $1,548 $1,548 3.2×
Gastroesophageal Reflux Exam (78262) $1,146 $1,146 2.4×
Gated Heart Planar Single (78472) $1,615 $1,615 3.4×
Gated Heart, Multiple (78473) $2,758 $2,758 5.8×
Hand 2 views (73120) $413 $413 3.3×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $5,475 $5,475 6.6×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $5,475 $5,475 6.6×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $5,475 $5,475 6.6×
Heart Image (Pet) Multiple (78492) $7,044 $7,044 4.1×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,124 $3,124 0.8×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,924 $3,924 1.0×
Hepatobil Syst Image W/Drug (78227) $1,455 $1,455 2.2×
Hepatobiliary System Imaging (78226) $1,214 $1,214 2.5×
Ht Musc Image Planar Mult (78454) $3,402 $3,402 2.2×
Ht Muscle Image Spect Sing (78451) $1,946 $1,946 1.3×
Hysterosalpingogram (74740) $960 $960 3.4×
Infant hip ultrasound with hip movement (dynamic) (76885) $730 $730 7.0×
Infusion Ivp (74410) $1,151 $1,151 5.5×
Interstitial radiation source applic complex (77778) $6,640 $6,640 8.0×
Intracavitary Radiation Source Applic Complex (77763) $1,917 $1,917 2.3×
Intracavitary Radiation Source Applic Intermed (77762) $2,028 $2,028 3.1×
Intracavitary radiation source applic simple (77761) $1,018 $1,018 1.5×
K Flow/Funct Image Multiple (78709) $2,753 $2,753 4.2×
K Flow/Funct Image W/Drug (78708) $1,844 $1,844 2.8×
K Flow/Funct Image W/O Drug (78707) $1,599 $1,599 2.5×
Kidney Imaging Morphol (78700) $2,152 $2,152 4.5×
Knee 3 Views (73562) $613 $613 5.9×
Leveen/Shunt Patency Exam (78291) $1,154 $1,154 2.4×
Liver & Spleen Imaging Static Only (78215) $1,592 $1,592 3.3×
Liver imaging w/vascular flow (78202) $1,422 $1,422 2.2×
Lung Perf&Ventilat Diferentl (78598) $1,347 $1,347 2.1×
Lung perfusion differential (78597) $851 $851 1.8×
Lung Ventilat&Perfus Imaging (78582) $1,288 $1,288 2.0×
Lung Ventilation Imaging (78579) $810 $810 1.7×
Lymph System Imaging (78195) $1,555 $1,555 2.4×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $6,039 $6,039 3.2×
Lymphangiography extremity only unilateral rs&i (75801) $2,902 $2,902 3.9×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,431 $2,431 0.6×
Lymphangiography, pelvic/abdominal, unilateral (75805) $2,315 $2,315 0.6×
Magnetic Image Jaw Joint (70336) $2,928 $2,928 10.2×
Magnetic Resonance Elastography (76391) $1,412 $1,412 4.9×
Mammary ductogram or galactogram multiple (77054) $1,285 $1,285 4.5×
Mammary ductogram or galactogram single (77053) $542 $542 1.9×
Meckels Divert Exam (78290) $1,106 $1,106 2.3×
Mlc imrt design & construction per imrt plan (77338) $1,195 $1,195 2.7×
Mr safety determination physician/other qhp (76016) $273 $273 2.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $76 $76 2.2×
Mr safety implt electronics prepj supvj phys/qhp (76018) $423 $423 3.7×
Mr safety implt pos&/immoblj (76019) $202 $202 2.9×
Mr safety med physics xm customization plng&mntr (76017) $830 $830 2.9×
Mra Head W/O & W/Contrast Material (70546) $5,011 $5,011 12.0×
MRA head w/o contrast (70544) $3,177 $3,177 11.1×
MRA head with contrast (70545) $4,131 $4,131 9.9×
MRA neck w contrast (70548) $4,131 $4,131 9.9×
Mra Neck W/O &W/Contrast Material (70549) $5,011 $5,011 12.0×
MRA neck w/o contrast (70547) $3,177 $3,177 11.1×
MRI abdomen w contrast (74182) $3,806 $3,806 9.1×
MRI abdomen w/o contrast (74181) $5,036 $5,036 17.6×
MRI any jt lower extrem w/contrast material (73722) $3,806 $3,806 4.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $5,195 $5,195 12.4×
MRI any jt upper extremity w/contrast matrl (73222) $3,806 $3,806 4.1×
MRI brain functional w/o physician admnistration (70554) $2,363 $2,363 8.3×
MRI brain functional w/physician admnistration (70555) $2,403 $2,403 8.4×
MRI Breast W/O Contrast Bilateral (77047) $5,925 $5,925 20.7×
MRI Breast Without Contrast Material Unilateral (77046) $4,511 $4,511 15.8×
MRI cardiac w/o cont stress (75559) $2,052 $2,052 3.1×
MRI cardiac w/o contrast (75557) $2,849 $2,849 10.0×
MRI cervical spine w contrast (72142) $4,131 $4,131 9.9×
MRI cervical spine w/o cont (72141) $3,170 $3,170 11.1×
MRI chest w/o contrast (71550) $2,928 $2,928 10.2×
MRI chest with contrast (71551) $3,806 $3,806 4.1×
MRI chest wo w contrast (71552) $4,616 $4,616 11.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,806 $3,806 9.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $5,036 $5,036 12.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,928 $2,928 10.2×
MRI lumbar spine w contrast (72149) $3,806 $3,806 9.1×
Mri Neck Spine W/O & W/Dye (72156) $5,011 $5,011 12.0×
MRI orbit face &/neck w/o contrast (70540) $3,177 $3,177 11.1×
MRI orbit face neck w contrast (70542) $4,131 $4,131 9.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $5,011 $5,011 12.0×
MRI pelvis w contrast (72196) $3,799 $3,799 9.1×
MRI pelvis w/o & w contrast (72197) $4,616 $4,616 11.0×
MRI pelvis w/o contrast (72195) $2,928 $2,928 10.2×
MRI spectroscopy (76390) $119 $119 1.1×
MRI thoracic spine w/o contrast (72146) $3,237 $3,237 11.3×
MRI upper extremity oth than jt w/contr matrl (73219) $3,799 $3,799 9.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,928 $2,928 10.2×
Mri Uppr Extremity W/O&W/Dye (73220) $4,616 $4,616 11.0×
MRI, abdomen, combo (74183) $5,206 $5,206 12.5×
MRI, dorsal spine combo (72157) $4,616 $4,616 11.0×
MRI, dorsal spine contrast (72147) $3,806 $3,806 9.1×
MRI, joint upper extrem (73221) $2,928 $2,928 10.2×
MRI, joint upper extrem combo (73223) $5,195 $5,195 12.4×
MRI, lumbar spine combo (72158) $4,616 $4,616 11.0×
Myelogram cervical (72240) $848 $848 0.9×
Myelogram Lumbar (72265) $729 $729 0.8×
Myelography thoracic (72255) $1,066 $1,066 1.1×
Myelograpy 2/more regions rs&i (72270) $2,117 $2,117 2.3×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,877 $1,877 3.9×
Myocardial Imaging Pet Metabolic Evaluation (78459) $5,941 $5,941 3.8×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $2,070 $2,070 1.3×
Myocardial Spect Multiple Studies (78452) $3,695 $3,695 2.4×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $7,998 $7,998 4.7×
N-invas est c ffr sw aly CTA (75580) $11,017 $11,017 10.7×
Neck soft tissue (70360) $419 $419 4.0×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $493 $493 1.0×
Nm myocard infarct spect (78469) $2,187 $2,187 3.4×
Nonvascular Shunt X-Ray (75809) $2,286 $2,286 18.2×
Ntsty modul radthx pln dose-vol histos (77301) $4,507 $4,507 2.7×
Nuclear Rx Intra-Arterial (79445) $1,139 $1,139 4.1×
Nuclear Rx Oral Admin (79005) $917 $917 3.3×
Ob us nuchal meas 1 gest (76813) $1,535 $1,535 12.3×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $460 $460 3.7×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $667 $667 5.3×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $1,164 $1,164 9.3×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $285 $285 8.2×
Ophthalmic us dx quantitative a-scan only (76511) $838 $838 6.7×
Optic foramina (70190) $783 $783 7.5×
Parathyroid imaging w/tomographic spect & CT (78072) $691 $691 1.1×
Parathyroid Planar Imaging (78070) $1,114 $1,114 2.3×
Parathyroid planar imaging w/wo subtraction (78071) $688 $688 1.4×
Pelvis 1 or 2 views (72170) $421 $421 3.4×
Peritoneogram Rs&I (74190) $2,481 $2,481 3.8×
Pet Image W/Ct Lmtd (78814) $6,735 $6,735 3.9×
PET image w/CT, full body (78816) $6,735 $6,735 3.9×
PET imaging CT attenuation skull base mid-thigh (78815) $6,735 $6,735 3.9×
Pet Myocardial Sngl Study (78491) $7,044 $7,044 4.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $3,899 $3,899 1.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,456 $1,456 3.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $449 $449 3.6×
Radex abscess/fistula/sinus tract rs&i (76080) $828 $828 1.3×
Radex Ankle Complete Minimum 3 Views (73610) $345 $345 3.3×
Radex Calcaneus Minimum 2 Views (73650) $445 $445 4.3×
Radex elbow complete minimum 3 views (73080) $530 $530 5.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $819 $819 6.5×
Radex fingr minimum 2 views (73140) $338 $338 3.2×
Radex foot complete minimum 3 views (73630) $362 $362 3.5×
Radex Hand Minimum 3 Views (73130) $325 $325 3.1×
Radex lower extremity infant minimum 2 views (73592) $390 $390 3.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $562 $562 4.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $552 $552 5.3×
Radex Ribs Unilateral 2 Views (71100) $521 $521 5.0×
Radex shoulder complete minimum 2 views (73030) $395 $395 3.8×
Radex Sinuses Paransl < 3 Views (70210) $481 $481 4.6×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $710 $710 3.4×
Radex Spine 1 View Specify Level (72020) $322 $322 3.1×
Radex Sternum Minimum 2 Views (71120) $544 $544 5.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $748 $748 7.2×
Radex Toe Minimum 2 Views (73660) $338 $338 3.2×
Radex upper extremity infant minimum 2 views (73092) $374 $374 3.0×
Radex Wrist Complete Minimum 3 Views (73110) $494 $494 4.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,066 $1,066 8.5×
Radiation Delivery Stereotactic Cranial Linear (77372) $28,345 $28,345 3.2×
Radiation treatment delivery level 1 (77402) $451 $451 3.7×
Radiation treatment delivery level 2 (77407) $575 $575 1.2×
Radiation treatment delivery level 3 (77412) $1,547 $1,547 2.3×
Radiolog exam mandible compl minimum 4 views (70110) $494 $494 3.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $357 $357 2.8×
Radiologic exam colon double contrast study (74280) $1,758 $1,758 8.4×
Radiologic exam colon single contrast study (74270) $1,519 $1,519 7.2×
Radiologic Exam Esophagus Double Contrast Study (74221) $950 $950 4.5×
Radiologic exam knee complete 4/more views (73564) $653 $653 5.2×
Radiologic exam pelvis compl minimum 3 views (72190) $613 $613 4.9×
Radiologic Exam Small Int Single Contrast Study (74250) $1,939 $1,939 9.2×
Radiologic exam swallow function contrast study (74230) $1,661 $1,661 7.9×
Radiologic exam upr gi trc double contrast study (74246) $1,203 $1,203 5.7×
Radiologic examination femur 1 view (73551) $507 $507 4.9×
Radiologic examination femur minimum 2 views (73552) $552 $552 5.3×
Radiologic examination knee 1/2 views (73560) $494 $494 4.7×
Radiologic Examination Osseous Survey Limited (77074) $897 $897 7.2×
Radiologic Examination Salivary Gland Calculus (70380) $563 $563 5.4×
Radiologic examination tibia & fibula 2 views (73590) $552 $552 5.3×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $509 $509 0.8×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $1,823 $1,823 3.9×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $1,823 $1,823 3.9×
Ribs bilateral 3 views (71110) $635 $635 5.1×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,077 $1,077 2.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $4,584 $4,584 9.6×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,612 $4,612 7.1×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $4,382 $4,382 6.7×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,016 $2,016 3.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $4,584 $4,584 3.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,107 $4,107 2.4×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $2,016 $2,016 1.3×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $1,470 $1,470 5.3×
Rp Therapy Intravenous Administration (79101)
range across 2 matching MRF lines		 $1,230–$1,346 $1,230–$1,346 varies
Scapula (73010) $551 $551 4.4×
Screening Digital Breast Tomosynthesis Bi (77063) $183 $183 7.8×
Sella turcica (70240) $560 $560 5.4×
Shoulder 1 view (73020) $283 $283 2.7×
Shoulder Arthrography (73040) $952 $952 2.3×
Sialogram (70390) $973 $973 3.4×
Skull less than 4 views (70250) $384 $384 3.1×
Special dosimetry (77331) $455 $455 2.8×
Special Physics Consult (77370) $1,302 $1,302 8.1×
Special teletherapy port plan (77321) $1,433 $1,433 3.2×
Special treatment procedure (77470) $2,229 $2,229 3.4×
Spleen Imaging (78185) $737 $737 1.5×
Stereotactic Body Radiation Delivery (77373) $15,127 $15,127 7.1×
Sternoclavicular joints (71130) $494 $494 4.7×
Superior sagittal sinus venogram (75870) $3,924 $3,924 1.0×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,609 $1,609 3.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $802 $802 1.8×
Testicular Imaging W/Flow (78761) $2,143 $2,143 4.5×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,788 $2,788 6.2×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,880 $1,880 4.2×
Ther rad simulaj-aided field setting simple (77280) $1,488 $1,488 9.2×
Thoracic spine 2 views (72070) $534 $534 4.3×
Thoracic spine 3 views (72072) $1,013 $1,013 8.1×
Thoracolumbar 2 views (72080) $613 $613 5.9×
Thyroid Imaging With Vascular Flow (78013) $647 $647 1.4×
Thyroid Met Imaging Body (78018) $2,232 $2,232 3.4×
Thyroid Uptake Measurement (78012) $467 $467 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $946 $946 2.0×
Tx Devices Design & Construction Complex (77334) $1,513 $1,513 3.4×
Tx devices design & construction intermediate (77333) $1,030 $1,030 6.4×
Tx devices design & construction simple (77332) $1,189 $1,189 7.4×
Ultrasound Breast Limited (76642) $675 $675 6.5×
Ultrasound elastography first target lesion (76982) $960 $960 7.7×
Ultrasound Elastography Parenchyma (76981) $960 $960 7.7×
Ultrasound Exam Aaa Screen (76706) $1,035 $1,035 8.3×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $1,699 $1,699 4.1×
Ultrasound, abdomen limited (76705) $1,158 $1,158 9.2×
Umbilical-artery Doppler (OB) (76820) $455 $455 3.6×
Unlisted Dx Radiographic Procedure (76499) $356 $356 3.4×
Unlisted fluoroscopic procedure (76496) $953 $953 9.1×
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines		 $441–$2,458 $441–$2,458 varies
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $470 $470 1.0×
Unlisted respiratory px dx nuclear medicine (78599) $1,568 $1,568 3.3×
Unlisted us procedure (76999) $356 $356 3.4×
Upper gi w/o kub (74240) $1,127 $1,127 5.4×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $304 $304 27.5×
Urea breath test c-14 isotopic analysis (78268) $404 $404 4.3×
Urethrocystogram voiding (74455) $748 $748 2.6×
Urethrocystography retrograde (74450) $827 $827 2.9×
Us breast unilateral complete (76641) $589 $589 4.7×
Us chest (76604) $801 $801 6.4×
Us complete joint (76881) $448 $448 3.6×
Us exam, pelvic, limited (76857) $431 $431 3.4×
Us head (76506) $812 $812 6.5×
Us kidney transplant (76776) $1,314 $1,314 10.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $306 $306 2.4×
Us ob detailed single fetus (76811) $1,224 $1,224 4.3×
Us ob limited 1 or more fetuses (76815) $558 $558 4.5×
Us ob transvaginal (76817) $1,353 $1,353 10.8×
Us pelvic non ob complete (76856) $1,256 $1,256 10.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,023 $1,023 8.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $402 $402 3.2×
Us retroperitoneal complete (76770) $1,200 $1,200 9.6×
Us retroperitoneal limited (76775) $1,035 $1,035 8.3×
Us scrotum and contents (76870) $1,216 $1,216 9.7×
Us spinal canal and contents (76800) $687 $687 5.5×
Us thyroid (76536) $924 $924 7.4×
Us transrectal (76872) $1,313 $1,313 10.5×
Vascular Flow Imaging (78445) $1,562 $1,562 3.3×
Vein X-Ray Chest (75827) $2,975 $2,975 1.6×
Vein X-Ray Liver W/O Hemodyn (75887) $4,428 $4,428 1.2×
Vein X-Ray Skull Epidural (75872) $2,827 $2,827 3.8×
Vein X-Ray Spleen/Liver (75810) $11,242 $11,242 3.0×
Venogram Sinus/Jugular (75860) $3,124 $3,124 0.8×
Venography caval inferior serialography rs&i (75825) $2,975 $2,975 0.8×
Venography extremity bilateral rs&i (75822) $3,501 $3,501 1.9×
Venography extremity unilateral rs&i (75820) $1,469 $1,469 0.8×
Venography Orbital Rs&I (75880) $199 $199 0.3×
Venography Renal Bilateral (75833) $3,747 $3,747 1.0×
Venography Renal Unilateral (75831) $3,705 $3,705 1.0×
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure		 $3,124 $3,124 0.5×
Vertebral fracture assessment via dxa (77086) $229 $229 2.2×
Wrist 2 views (73100) $174 $174 1.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $379 $379 3.6×
X-ray antegrade pyelogram tube (74425) $751 $751 1.8×
X-Ray Aorta Leg Arteries (75630) $4,038 $4,038 1.1×
X-Ray Bend Only L-S Spine (72120) $950 $950 7.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $530 $530 5.1×
X-Ray Exam Breast Specimen (76098) $129 $129 0.2×
X-Ray Exam Entire Spi 1 Vw (72081) $868 $868 8.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $945 $945 7.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $1,106 $1,106 8.8×
X-Ray Exam Hip Uni 1 View (73501) $338 $338 3.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $302 $302 2.9×
X-Ray Exam Hip Uni 4/> Views (73503) $298 $298 2.4×
X-Ray Exam Hips Bi 2 Views (73521) $520 $520 4.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $501 $501 4.0×
X-Ray Exam Hips Bi 5/> Views (73523) $546 $546 4.4×
X-Ray Exam L-S Spine Bending (72114) $908 $908 7.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $424 $424 4.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $635 $635 5.1×
X-Ray Exam Unilat Ribs/Chest (71101) $914 $914 7.3×
X-ray eye for foreign body (70030) $441 $441 4.2×
X-ray humerus (73060) $552 $552 5.3×
X-ray IV pyelogram (ivp) (74400) $803 $803 3.8×
X-ray IV pyelogram+tomography (74415) $1,602 $1,602 7.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $246 $246 2.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $409 $409 3.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $494 $494 3.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,135 $1,135 9.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $653 $653 5.2×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $569 $569 4.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $552 $552 5.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $723 $723 6.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $462 $462 3.7×
X-ray thoracic spine 4 vw (72074) $571 $571 4.6×
X-Ray Tmj Unilat (70328) $372 $372 3.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $2,336 $2,336 5.6×
X-Rays Bone Length Studies (77073) $169 $169 1.3×
X-Rays Bone Survey Complete (77075) $1,280 $1,280 10.2×
Xr c-spine 4 or 5 views (72050) $566 $566 4.5×
Xr facial bones less than 3 views (70140) $475 $475 4.6×
Xr orbits complete 4 views (70200) $714 $714 5.7×
Xr Tomogram Single Plane (76100) $1,118 $1,118 8.9×

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.