Imaging prices at Boston Medical Center Brighton

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

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $2,254.18 $5,009.28 1.4×
Abdomen 2 views (74019) $140.34 $311.87 1.1×
Acute gi blood loss imaging (78278) $587.75 $1,306.11 1.2×
Angio Adrenal Bilat Select (75733) $3,701.56 $8,225.70 1.0×
Angiography extremity bilateral rs&i (75716) $5,231.68 $11,625.95 1.4×
Angiography extremity unilateral rs&i (75710) $4,501.61 $10,003.57 1.2×
Angiography internal mammary rs&i (75756) $3,740.70 $8,312.66 1.0×
Angiography pelvic slctv/supraslctv rs&i (75736) $6,967.67 $15,483.71 1.0×
Angiography pulmonary bilateral slctv rs&i (75743) $4,246.80 $9,437.33 1.1×
Angiography pulmonary unilateral slctv rs&i (75741) $4,246.80 $9,437.33 1.1×
Angiography Spinal Selective Rs&I (75705) $6,573.28 $14,607.28 1.0×
Angiography visceral slctv/supraslctv rs&i (75726) $6,967.67 $15,483.71 1.0×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $1,673.70 $3,719.34 0.4×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $1,807.13 $4,015.85 0.5×
Ankle 2 views (73600) $122.65 $272.55 1.2×
Aortogram thoracic (75605) $6,573.28 $14,607.28 1.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $4,501.61 $10,003.57 1.2×
Aortography abdominal serialography rs&i (75625) $4,501.61 $10,003.57 1.2×
Aortography Thoracic W/O Serialography Rs&I (75600) $4,246.80 $9,437.33 1.1×
Artery X-Rays Adrenal Gland (75731) $2,608.06 $5,795.69 0.7×
Arthrogram ankle (73615) $1,042.89 $2,317.54 2.5×
Arthrogram elbow (73085) $1,042.89 $2,317.54 2.5×
Arthrogram hip (73525) $1,105.47 $2,456.59 2.6×
Arthrogram knee (73580) $1,042.89 $2,317.54 2.5×
Arthrogram shoulder (73040) $1,020.37 $2,267.48 2.4×
Arthrogram wrist (73115) $949.46 $2,109.92 2.3×
Basic dosimetry (77300) $238.71 $530.47 1.5×
Bone &/Joint Imaging Limited Area (78300) $587.75 $1,306.11 1.2×
Bone &/Joint Imaging Multiple Areas (78305) $587.75 $1,306.11 1.2×
Bone &/joint imaging whole body (78306) $672.86 $1,495.24 1.4×
Bone age studies (77072) $188.82 $419.60 1.5×
Bone Imaging 3 Phase (78315) $672.86 $1,495.24 1.4×
Bone Marrow Imaging Limited Area (78102) $587.75 $1,306.11 1.2×
Bone survey complete (77075) $229.10 $509.11 1.8×
Bone survey infant (77076) $223.71 $497.13 1.8×
Bowel imaging (78290) $587.75 $1,306.11 1.2×
Brachytx isodose complex (77318) $542.85 $1,206.34 1.2×
Brachytx isodose intermed (77317) $542.85 $1,206.34 1.2×
Brachytx isodose pln smpl w/dosimetry cal (77316) $313.31 $696.24 0.7×
Brain imaging < 4 static views (78600) $551.76 $1,226.14 1.2×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $588.39 $1,307.53 1.2×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $756.19 $1,680.42 1.2×
Brain Imaging Vascular Flow Only (78610) $786.90 $1,748.67 1.2×
Brain imaging, minimum 4 static views; Non-Facility (78605) $756.19 $1,680.42 1.2×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $587.75 $1,306.11 1.2×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $587.75 $1,306.11 1.2×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $1,424.07 $3,164.60 1.5×
Cardiac MRI w/w/o contrast & further seq (75561) $749.99 $1,666.64 1.8×
Cardiac shunt detection (78428) $587.75 $1,306.11 1.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $742.36 $1,649.68 1.1×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $756.19 $1,680.42 1.2×
Cervical spine 2 or 3 views (72040) $119.40 $265.34 1.1×
Chest 1 view (71045) $112.64 $250.32 1.1×
Chest xray 3 views (71047) $112.64 $250.32 1.1×
Cholecystography, oral contrast Non-Facility (74290) $224.50 $498.90 1.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $202.42 $449.81 1.0×
Cisternography Positive Contrast Rs&I (70015) $892.90 $1,984.21 1.0×
Clavicle complete (73000) $119.40 $265.34 1.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $157.45 $349.89 1.3×
Continuing medical physics consltj pr wk (77336) $238.71 $530.47 1.5×
Contrast Xray Throat/Cerv Esopha (74210) $224.50 $498.90 1.1×
CT abdomen and pelvis without and with contrast (74178) $639.88 $1,421.95 1.5×
CT abdomen and pelvis without contrast (74176) $376.56 $836.80 1.3×
CT abdomen w contrast (74160) $442.32 $982.93 2.1×
CT abdomen w wo contrast (74170) $442.32 $982.93 2.1×
CT abdomen w/o contrast (74150) $216.79 $481.75 1.7×
CT angio hrt w/3d image (75574) $442.32 $982.93 1.1×
CT angio lwr extr w/o&w/dye (73706) $417.28 $927.30 2.0×
CT angiography upper extremity lt (73206) $386.37 $858.60 1.8×
CT c-spine w/contrast (72126) $664.31 $1,476.25 1.6×
CT c-spine w/o contrast (72125) $229.79 $510.65 1.8×
CT cere prfu aly c+wo CT/CTA (70473) $118.35 $263 0.6×
CT cervical spine w&w/o contrast (72127) $386.37 $858.60 1.8×
CT chest w contrast (71260) $442.32 $982.93 2.1×
CT chest w/wo contrast (71270) $386.37 $858.60 1.8×
CT colonography screening (74263) $1,113.33 $2,474.06 3.9×
CT colonography w/dye (74262) $386.37 $858.60 1.8×
CT colonography w/o cntrst (74261) $179.40 $398.66 1.4×
CT head/brain with contrast (70460) $417.28 $927.30 2.0×
CT head/brain without and with contrast (70470) $417.28 $927.30 2.0×
CT heart contrast eval cardiac structure&morph (75572) $383.70 $852.67 0.9×
CT heart w/o contrast quant eval coronary calcium (75571) $81.62 $181.38 0.8×
CT hrt w/3d image congen (75573) $386.37 $858.60 0.9×
CT iac w contrast (70481) $386.37 $858.60 1.8×
CT limited/localized follow up study (76380) $104.30 $231.78 1.0×
CT lower ext w/o (73700) $215.26 $478.36 1.7×
CT lower extremity w wo contrast (73702) $409.55 $910.12 1.9×
CT lower extremity w/contrast material (73701) $386.37 $858.60 1.8×
CT lumbar spine w & w/o contrast (72133) $386.37 $858.60 1.8×
CT lumbar spine w/contrast (72132) $738.30 $1,640.66 1.8×
CT lumbar spine w/o contrast (72131) $216.79 $481.75 1.7×
CT maxillofacial w contrast (70487) $417.28 $927.30 2.0×
CT maxillofacial w/wo contrast (70488) $417.28 $927.30 2.0×
CT maxillofacial wo contrast (70486) $215.26 $478.36 1.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $386.37 $858.60 1.8×
CT orbits w/o contrast (70480) $215.26 $478.36 1.7×
CT pelvis w/o contrast (72192) $203.08 $451.28 1.6×
CT pelvis w/wo contrast (72194) $417.28 $927.30 2.0×
CT scan of arm combo (73202) $386.37 $858.60 1.8×
CT soft tissue neck w contrast (70491) $442.32 $982.93 2.1×
CT soft tissue neck w/o & w/contrast material (70492) $386.37 $858.60 1.8×
CT soft tissue neck w/o contrast (70490) $215.26 $478.36 1.7×
CT thoracic spine w/contrast (72129) $427.39 $949.75 2.0×
CT thoracic spine w/o contrast (72128) $216.79 $481.75 1.7×
CT thoracic spine w/wo contrast (72130) $386.37 $858.60 1.8×
CT thorax w/o contrast (71250) $203.08 $451.28 1.6×
CT unlisted procedure (76497) $104.30 $231.78 1.0×
CT upper ext wo (73200) $215.26 $478.36 1.7×
CT upper extremity with contrast (73201) $704.17 $1,564.83 1.7×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $417.28 $927.30 2.0×
Cta Abdomen (74175) $417.28 $927.30 2.0×
CTA abdomen pelvis (74174) $603.66 $1,341.46 1.4×
CTA chest (71275) $417.28 $927.30 2.0×
Cta Head (70496) $417.28 $927.30 2.0×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $235.35 $523 0.6×
Cta Neck (70498) $417.28 $927.30 2.0×
Cta Pelvis (72191) $386.37 $858.60 1.8×
Cystography minimum 3 views rs&i (74430) $472.56 $1,050.13 1.1×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $2,861.82 $6,359.59 1.1×
Diskogram cervical (72285) $2,852.70 $6,339.33 1.2×
Diskography lumbar (72295) $3,023.86 $6,719.69 1.3×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $200.73 $446.06 1.6×
Doppler Echo Fetal Spectral Display Complete (76827) $237.59 $527.97 1.9×
Doppler Fetal Mid Cerebral Artery (76821) $200.87 $446.37 1.6×
Dxa bone density study 1/> sites axial skel (77080) $184.87 $410.82 1.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $103.38 $229.73 1.0×
Dxa bone density study axial skeleton (77085) $161.49 $358.86 1.3×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $476.69 $1,059.31 1.7×
Esophagus (74220) $257.02 $571.15 1.2×
Facial bones min 3 views (70150) $202.42 $449.81 1.6×
Fetal biophysical profile non-stress testing (76818) $205.92 $457.59 1.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $235.73 $523.84 1.9×
Fetal Echo (76825) $756.60 $1,681.33 1.2×
Fluoroscopy up to 1 hr (76000) $334.94 $744.32 1.2×
Foot 2 views (73620) $119.40 $265.34 1.1×
Forearm 2 views (73090) $130 $288.90 1.2×
Functional MRI brain by tech (70554) $392.52 $872.27 1.4×
Hand 2 views (73120) $183.74 $408.31 1.5×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $1,257.39 $2,794.19 1.5×
Heart first pass single,planar (78481) $756.19 $1,680.42 1.2×
Heart Infarct Image (78466) $587.75 $1,306.11 1.2×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $4,246.80 $9,437.33 1.1×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $4,246.80 $9,437.33 1.1×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $849.85 $1,888.56 1.3×
Hepatobiliary syst imaging including gallbladder (78226) $587.75 $1,306.11 1.2×
Hysterosalpingogram (74740) $399.16 $887.01 1.4×
Intracavitary Radiation Source Applic Complex (77763) $1,085.84 $2,412.97 1.3×
Intracavitary Radiation Source Applic Intermed (77762) $749.28 $1,665.06 1.1×
Intracavitary Radiation Source Applic Simple (77761) $880.06 $1,955.70 1.3×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $173.34 $385.21 1.4×
Kidney function study, non-imaging radioisotopic study Non-Facility (78725) $569.05 $1,264.56 1.2×
Kidney imaging morphology (78700) $643.93 $1,430.95 1.3×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $756.19 $1,680.42 1.2×
Kidney img morphology vascular flow 1 w/rx (78708) $865.68 $1,923.74 1.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $756.19 $1,680.42 1.2×
Knee 3 views (73562) $119.40 $265.34 1.1×
Liver & spleen imaging static only (78215) $587.75 $1,306.11 1.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $587.75 $1,306.11 1.2×
Liver imaging w/vascular flow (78202) $1,481.98 $3,293.28 2.3×
Lung perf&ventilat diferentl (78598) $816.68 $1,814.85 1.3×
Lung perfusion differential (78597) $660.40 $1,467.55 1.4×
Lung ventilation imaging (78579) $587.75 $1,306.11 1.2×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,943.52 $6,541.16 0.8×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $1,446.38 $3,214.18 0.4×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) $1,264.34 $2,809.65 0.7×
Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) $800.36 $1,778.57 1.1×
Lymphoscintigraphy (78195) $742.36 $1,649.68 1.1×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,055.46 $2,345.46 1.1×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $655.13 $1,455.84 1.6×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $749.99 $1,666.64 1.8×
Mammary ductogram or galactogram multiple (77054) $348.67 $774.82 1.2×
Mammary ductogram or galactogram single (77053) $336.34 $747.42 1.2×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $104.30 $231.78 1.0×
Mlc imrt design & construction per imrt plan (77338) $621.46 $1,381.02 1.4×
MRA head w & w/o contrast (70546) $749.99 $1,666.64 1.8×
MRA head w/o contrast (70544) $449.36 $998.58 1.6×
MRA head with contrast (70545) $649.20 $1,442.66 1.6×
MRA neck w contrast (70548) $612.45 $1,361 1.5×
Mra Neck W/O &W/Contrast Material (70549) $749.99 $1,666.64 1.8×
MRA neck w/o contrast (70547) $449.36 $998.58 1.6×
MRI abdomen w contrast (74182) $655.13 $1,455.84 1.6×
MRI abdomen w/o & w/contrast material (74183) $844.62 $1,876.94 2.0×
MRI abdomen w/o contrast (74181) $423.92 $942.05 1.5×
MRI any jt lower extrem w/contrast material (73722) $1,055.46 $2,345.46 1.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $749.99 $1,666.64 1.8×
MRI bone marrow blood supply (77084) $471.99 $1,048.86 1.7×
MRI breast w/o contrast bilateral (77047) $310.51 $690.02 1.1×
MRI breast wo contrast unilateral (77046) $392.95 $873.22 1.4×
MRI c-spine with contrast (72142) $749.99 $1,666.64 1.8×
MRI cardiac w/o cont stress (75559) $720.53 $1,601.18 1.1×
MRI cardiac w/o contrast (75557) $449.36 $998.58 1.6×
MRI cervical spine w/o contrast (72141) $449.36 $998.58 1.6×
MRI chest w/o & w/contrast material (71552) $844.62 $1,876.94 2.0×
MRI chest w/o contrast (71550) $449.36 $998.58 1.6×
MRI chest with contrast (71551) $977.28 $2,171.73 1.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $612.45 $1,361 1.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $707.54 $1,572.30 1.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $449.36 $998.58 1.6×
MRI orbit face &/neck w/o contrast (70540) $423.92 $942.05 1.5×
MRI orbit face neck w contrast (70542) $655.13 $1,455.84 1.6×
MRI orbit/face/neck w&w/o cont (70543) $844.62 $1,876.94 2.0×
MRI pelvis w/contrast (72196) $612.45 $1,361 1.5×
MRI pelvis w/o & w/contrast material (72197) $844.62 $1,876.94 2.0×
MRI pelvis w/o contrast (72195) $449.36 $998.58 1.6×
MRI spectroscopy (76390) $651.37 $1,447.49 6.2×
MRI spinal canal cervical w/o & w/contr matrl (72156) $844.62 $1,876.94 2.0×
MRI spinal canal lumbar w/contrast material (72149) $655.13 $1,455.84 1.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $844.62 $1,876.94 2.0×
MRI spinal canal thoracic w/contrast matrl (72147) $701.13 $1,558.07 1.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $796.81 $1,770.69 1.9×
MRI temporomandibular joint (70336) $416.58 $925.73 1.5×
MRI thoracic spine w/o contrast (72146) $449.36 $998.58 1.6×
MRI up ext w/o contrast (73218) $449.36 $998.58 1.6×
MRI upper ext joint w/o contrast (73221) $449.36 $998.58 1.6×
MRI, joint upper extrem combo (73223) $796.81 $1,770.69 1.9×
Myelogram Cervical (72240) $937.65 $2,083.67 1.0×
Myelogram Lumbar (72265) $993.91 $2,208.69 1.1×
Myelogram thoracic (72255) $937.65 $2,083.67 1.0×
Myelography 2 or more regions (72270) $937.65 $2,083.67 1.0×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $742.36 $1,649.68 1.1×
Myocardial infarct spect (78469) $1,574.58 $3,499.07 2.4×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,768.90 $3,930.89 1.1×
Myocardial Perfusion Planar Multiple Studies (78454) $2,029.14 $4,509.21 1.3×
Myocardial Spect Multiple Studies (78452) $2,150.89 $4,779.76 1.4×
Myocardial spect single study at rest or stress (78451) $2,029.14 $4,509.21 1.3×
Neck soft tissue (70360) $119.40 $265.34 1.1×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $569.05 $1,264.56 1.2×
Nm adrenal scan (78075) $1,960.40 $4,356.45 1.3×
Nm bone marrow multi (78103) $587.75 $1,306.11 1.2×
Nm bone marrow wb (78104) $587.75 $1,306.11 1.2×
Nm cardiac blood pool multiple (78473) $587.75 $1,306.11 1.2×
Nm cisternogram (78630) $756.19 $1,680.42 1.2×
Nm csf leak detection (78650) $1,610.19 $3,578.20 1.0×
Nm gastric emptying study (78264) $672.86 $1,495.24 1.4×
Nm gastroesophageal reflux study (78262) $587.75 $1,306.11 1.2×
Nm kidney scan w/flow (78701) $587.75 $1,306.11 1.2×
Nm peritoneal-venous shunt patency (78291) $587.75 $1,306.11 1.2×
Noncardiac Vascular Flow Imaging (78445) $580.61 $1,290.24 1.2×
Nonvascular shunt X-ray (75809) $187.42 $416.49 1.5×
Ntsty modul radthx pln dose-vol histos (77301) $2,254.18 $5,009.28 1.4×
Nuclear medicine study of endocrine organs (78099) $561.49 $1,247.76 1.2×
Nuclear Rx Oral Admin (79005) $446.14 $991.41 1.6×
Ob us nuchal meas 1 gest (76813) $215.26 $478.36 1.7×
Orthopantogram (70355) $103.38 $229.73 1.0×
Osseous survey limited (77074) $200.12 $444.71 1.6×
Parathyrd planar w/spect&CT (78072) $756.19 $1,680.42 1.2×
Parathyroid Planar Imaging (78070) $623.02 $1,384.49 1.3×
Parathyroid planar imaging w/wo subtraction (78071) $747.76 $1,661.68 1.6×
Pelvis 1 or 2 views (72170) $183.74 $408.31 1.5×
Perineogram (74775) $348.67 $774.82 1.2×
Peritoneogram after injection (74190) $795.03 $1,766.74 1.2×
PET image w/CT, skull-thigh (78815) $2,299.69 $5,110.42 1.3×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $4,246.80 $9,437.33 1.1×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $1,807.13 $4,015.85 0.5×
Pulmonary Perfusion Imaging Particulate (78580) $587.75 $1,306.11 1.2×
Pulmonary Ventilation & Perfusion Imaging (78582) $756.19 $1,680.42 1.2×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $627.30 $1,394 0.6×
Radex abscess/fistula/sinus tract rs&i (76080) $726.41 $1,614.24 1.1×
Radex Ankle Compl Minimum 3 Views (73610) $130 $288.90 1.2×
Radex Calcaneus Minimum 2 Views (73650) $119.40 $265.34 1.1×
Radex Elbw Compl Minimum 3 Views (73080) $130 $288.90 1.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $104.30 $231.78 1.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $203.08 $451.28 1.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $315.60 $701.33 2.5×
Radex fingr minimum 2 views (73140) $119.40 $265.34 1.1×
Radex Foot Compl Minimum 3 Views (73630) $119.40 $265.34 1.1×
Radex Hand Minimum 3 Views (73130) $130 $288.90 1.2×
Radex Hip Unilateral With Pelvis 1 View (73501) $112.64 $250.32 1.1×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $203.08 $451.28 1.6×
Radex Hips Bilateral With Pelvis 2 Views (73521) $108.51 $241.14 0.9×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $297.73 $661.63 2.4×
Radex Humerus Minimum 2 Views (73060) $119.40 $265.34 1.1×
Radex Kne 1/2 Views (73560) $112.64 $250.32 1.1×
Radex Kne Compl 4/More Views (73564) $164.96 $366.58 1.3×
Radex Mndbl Compl Minimum 4 Views (70110) $174.41 $387.57 1.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $119.40 $265.34 1.1×
Radex Pelvis Compl Minimum 3 Views (72190) $164.96 $366.58 1.3×
Radex Sho Compl Minimum 2 Views (73030) $119.40 $265.34 1.1×
Radex Sinuses Paransl < 3 Views (70210) $110.56 $245.69 1.1×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $143.90 $319.78 1.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $112.64 $250.32 1.1×
Radex Toe Minimum 2 Views (73660) $119.40 $265.34 1.1×
Radex upper extremity infant minimum 2 views (73092) $173.34 $385.21 1.4×
Radex Wrst Compl Minimum 3 Views (73110) $119.40 $265.34 1.1×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $292.22 $649.38 2.3×
Radiation Delivery Stereotactic Cranial Cobalt (77371) $11,947.15 $26,549.22 1.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $11,947.15 $26,549.22 1.4×
Radiation treatment delivery level 1 (77402) $220.40 $489.77 1.8×
Radiation treatment delivery level 2 (77407) $207.92 $462.05 0.4×
Radiation treatment delivery level 3 (77412) $425.57 $945.71 0.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $112.64 $250.32 1.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $148.77 $330.59 1.2×
Radiologic exam chest 2 views (71046) $119.40 $265.34 1.1×
Radiologic exam colon single contrast study (74270) $290.75 $646.11 1.4×
Radiologic exam upr gi trc double contrast study (74246) $290.75 $646.11 1.4×
Radiologic exam upr gi trc single contrast study (74240) $290.75 $646.11 1.4×
Radiologic examination femur 1 view (73551) $104.30 $231.78 1.0×
Radiologic Examination Salivary Gland Calculus (70380) $131.37 $291.93 1.3×
Radiologic examination tibia & fibula 2 views (73590) $119.40 $265.34 1.1×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $413.69 $919.31 0.6×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $144.10 $320.21 1.2×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $215.86 $479.68 1.7×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) $158.60 $352.44 1.5×
Radiological examination surgical specimen (76098) $665.38 $1,478.63 1.0×
Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) $389.71 $866.02 1.4×
Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) $413.09 $917.98 1.5×
Red cell survival study Non-Facility (78130) $588.39 $1,307.53 1.2×
Red cell volume determination (separate procedure); multiple samplings Non-Facility (78121) $756.19 $1,680.42 1.2×
Renal Cyst Study (74470) $747.76 $1,661.68 1.1×
Ribs bilateral 3 views (71110) $214.56 $476.80 1.7×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $587.75 $1,306.11 1.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $634.77 $1,410.60 1.3×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,029.14 $4,509.21 3.1×
Rp loclzj tum plnr whole body single day imaging (78802) $1,643.62 $3,652.50 2.5×
Rp loclzj tum spect 1 area single day imaging (78803) $1,729.84 $3,844.09 2.7×
Rp therapy intra-arterial particulate admn (79445) $389.71 $866.02 1.4×
Rp Therapy Intravenous Administration (79101) $389.71 $866.02 1.4×
Sacroiliac Joints < 3 Views (72200) $173.39 $385.32 1.4×
Saline Infus Sonohysterography W/Color Doppler (76831) $404.10 $898 1.4×
Salivary gland function study (78232) $587.75 $1,306.11 1.2×
Salivary gland imaging (78230) $587.75 $1,306.11 1.2×
Salivary gland imaging; with serial images Non-Facility (78231) $587.75 $1,306.11 1.2×
Scapula (73010) $164.74 $366.09 1.3×
Screening Digital Breast Tomosynthesis Bi (77063) $46.67 $103.71 2.0×
Sella turcica (70240) $104.30 $231.78 1.0×
Shoulder 1 view (73020) $112.64 $250.32 1.1×
Sialogram (70390) $348.67 $774.82 1.2×
Simulation intermediate (77285) $542.85 $1,206.34 1.2×
Small bowel series (74250) $187.42 $416.49 0.9×
Spec telethx port pln parts hemibdy tot bdy (77321) $542.85 $1,206.34 1.2×
Special dosimetry (77331) $208.52 $463.37 1.3×
Special Physics Consult (77370) $221.03 $491.18 1.4×
Special treatment procedure (77470) $932.87 $2,073.04 1.4×
Speech evaluation complex (70371) $291.70 $648.23 1.0×
Spine thoracic 3 views (72072) $214.56 $476.80 1.7×
Spleen imaging only (78185) $587.75 $1,306.11 1.2×
Splenoportograpy rs&i (75810) $2,608.06 $5,795.69 0.7×
Stereotactic Body Radiation Delivery (77373) $3,051.11 $6,780.25 1.4×
Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) $68.85 $153 0.6×
Surf radj ther supfc dlvr<=150 kv per fraction (77437) $68.85 $153 0.6×
Surf radj ther supfc/orthvlt treatment planning (77436) $25.20 $56 0.6×
Telethx isodose pln cplx w/basic dosimetry (77307) $475.70 $1,057.11 1.1×
Telethx isodose pln smpl w/dosimetry calculation (77306) $415.53 $923.40 0.9×
Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) $530.34 $1,178.53 1.9×
Testicular Imaging With Vascular Flow (78761) $587.75 $1,306.11 1.2×
Ther rad simulaj-aided field setting complex (77290) $621.46 $1,381.02 1.4×
Ther rad simulaj-aided field setting simple (77280) $208.52 $463.37 1.3×
Thoracolumbar 2 views (72080) $104.30 $231.78 1.0×
Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) $587.75 $1,306.11 1.2×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $587.75 $1,306.11 1.2×
Thyroid carcinoma metastases img whole body (78018) $774.45 $1,721 1.2×
Thyroid imaging w/blood flow (78013) $561.49 $1,247.76 1.2×
Thyroid uptake measurement (78012) $539.32 $1,198.48 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $672.86 $1,495.24 1.4×
Tmj unilateral (70328) $104.30 $231.78 1.0×
Tomogram (76100) $187.42 $416.49 1.5×
Treatment device complex (77334) $621.46 $1,381.02 1.4×
Treatment device intermediate (77333) $243.16 $540.35 1.5×
Treatment devices simple (77332) $257.74 $572.76 1.6×
Ultrasound breast complete (76641) $158.10 $351.34 1.3×
Ultrasound Exam Aaa Screen (76706) $216.16 $480.36 1.7×
Ultrasound, abdomen limited (76705) $235.73 $523.84 1.9×
Umbilical-artery Doppler (OB) (76820) $181.01 $402.25 1.4×
Unlisted Diagnostic Radiographic Procedure (76499) $104.30 $231.78 1.0×
Unlisted fluoroscopic procedure (76496) $114.06 $253.46 1.1×
Unlisted gastrointestinal px dx nuclear medicine (78299) $587.75 $1,306.11 1.2×
Unlisted magnetic resonance procedure (76498) $334.45 $743.23 3.2×
Unlisted ns dx nm (78699) $551.76 $1,226.14 1.2×
Unlisted ultrasound procedure (76999) $121.96 $271.01 1.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $15.82 $35.16 1.4×
Urea breath test, C-14 (isotopic); analysis Facility (78268) $135.05 $300.11 1.4×
Ureteral reflux study (78740) $587.75 $1,306.11 1.2×
Urethrocystogram voiding (74455) $401.93 $893.17 1.4×
Urethrocystography retrograde rs&i (74450) $376.56 $836.80 1.3×
Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) $336.81 $748.47 1.6×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $365.97 $813.26 1.7×
Us breast unilateral limited (76642) $151.54 $336.76 1.5×
Us chest (76604) $209.81 $466.25 1.7×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $395.54 $878.97 1.5×
Us compl joint r-t w/image documentation (76881) $235.73 $523.84 1.9×
Us elastography parenchyma (76981) $204.91 $455.36 1.6×
Us encephalogram (76506) $194.27 $431.72 1.6×
Us hips infant static (76886) $115.64 $256.98 1.1×
Us infant hips w manipulation (76885) $115.05 $255.67 1.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $181.01 $402.25 1.4×
Us ob detailed single fetus (76811) $371.96 $826.58 1.3×
Us ob limited (76815) $209.81 $466.25 1.7×
Us ob transvaginal (76817) $224.34 $498.54 1.8×
Us pelvic non ob complete (76856) $235.73 $523.84 1.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $181.01 $402.25 1.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $216.16 $480.36 1.7×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $181.01 $402.25 1.4×
Us retroperitoneal complete (76770) $222.39 $494.20 1.8×
Us retroperitoneal limited (76775) $229.79 $510.65 1.8×
Us scrotum and contents (76870) $229.79 $510.65 1.8×
Us soft tissue head/neck (76536) $229.79 $510.65 1.8×
Us spinal canal and contents (76800) $163.39 $363.08 1.3×
Us transrectal (76872) $222.39 $494.20 1.8×
Us transrectal prostate volume (76873) $214.08 $475.74 1.7×
Us,transplanted kidney, real time/ doppler (76776) $205.92 $457.59 1.6×
Vasogram (74440) $348.67 $774.82 1.2×
Venogram adrenal unilat (75840) $4,246.80 $9,437.33 1.1×
Venogram extremity bilateral (75822) $1,560.32 $3,467.37 0.8×
Venogram Extremity Unilateral (75820) $1,193.14 $2,651.41 0.6×
Venography caval inferior serialography rs&i (75825) $4,246.80 $9,437.33 1.1×
Venography caval superior serialography rs&i (75827) $1,454.65 $3,232.56 0.8×
Venography Renal Bilateral (75833) $4,246.80 $9,437.33 1.1×
Venography renal unilateral selective rs&i (75831) $4,246.80 $9,437.33 1.1×
Venography venous sinus/jugular cath rs&i (75860) $3,740.70 $8,312.66 1.0×
Venous sampling by catheter (75893) $6,573.28 $14,607.28 1.0×
Vertebral fracture assessment via dxa (77086) $104.30 $231.78 1.0×
Wrist 2 views (73100) $119.40 $265.34 1.1×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $187.42 $416.49 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $110.56 $245.69 1.1×
X-ray b.e. reductn intuss (74283) $279.85 $621.89 1.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $348.58 $774.62 1.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $119.40 $265.34 1.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $110.56 $245.69 1.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $203.08 $451.28 1.6×
X-ray exam of femur 2/> (73552) $119.40 $265.34 1.1×
X-ray eye for foreign body (70030) $179.10 $398.01 1.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $119.40 $265.34 1.1×
X-ray IV pyelogram (ivp) (74400) $336.81 $748.47 1.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $110.56 $245.69 1.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $119.40 $265.34 1.1×
X-ray leg, infant (73592) $104.30 $231.78 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $164.96 $366.58 1.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $229.10 $509.11 1.8×
X-ray nose-rectum child f.b. (76010) $104.30 $231.78 1.0×
X-ray optic foramen (70190) $170.60 $379.10 1.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $155.62 $345.82 1.2×
X-ray retrograde pyelogram (74420) $697.41 $1,549.79 1.7×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $119.40 $265.34 1.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $184.87 $410.82 1.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $198.67 $441.48 1.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $198.44 $440.98 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $119.40 $265.34 1.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $120.38 $267.51 1.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $198.67 $441.48 1.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $155.62 $345.82 1.2×
X-Ray Small Bowel Enteroclysis (74251) $361.15 $802.55 1.7×
X-Ray Spine One View - Xr Spine (72020) $112.64 $250.32 1.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $110.56 $245.69 1.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $119.40 $265.34 1.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $198.44 $440.98 1.6×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $200.15 $444.77 1.6×
Xr bone length studies (77073) $155.42 $345.37 1.2×
Xr c-spine 4 or 5 views (72050) $229.10 $509.11 1.8×
Xr c-spine 6 or more views (72052) $229.10 $509.11 1.8×
Xr chest 4+ views (71048) $129.95 $288.77 1.0×
Xr urogram antegrade (74425) $604.41 $1,343.14 1.4×