Imaging prices at Brookdale Hospital Medical Center
Brooklyn, NY · every code in this section with a posted price and a Medicare benchmark.
476 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 4 matching MRF lines |
$199.36 | $2,791.91–$2,792 | 0.1× |
| Abdomen 1 View (74018) | $30.65 | $146 | 0.3× |
| Abdomen 2 views (74019) | $30.65 | $279 | 0.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $883.77 | $828 | 1.8× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $404.95 | $2,879.65 | 0.3× |
| Adrenal Cortex & Medulla Img (78075) range across 4 matching MRF lines |
$883.77 | $2,576–$2,879.65 | 0.5× |
| Angio internal mammary (75756) | $420.12 | $6,187.39 | 0.1× |
| Angio pulmonary bilat (75743) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $420.12 | $6,187.39 | 0.1× |
| Angiography extremity bilateral rs&i (75716) | $420.12 | $6,414 | 0.1× |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$420.12 | $6,187.39–$6,496 | 0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 4 matching MRF lines |
$420.12 | $2,561.68–$7,148 | 0.1× |
| Ankle 2 views (73600) | $30.65 | $224 | 0.3× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,097.21 | $10,251.39 | 0.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $420.12 | $6,187.39 | 0.1× |
| Artery X-Rays Abdomen (75726) range across 8 matching MRF lines likely a partial charge, not the full procedure |
$1,097.21 | $5,845–$15,992 | 0.2× |
| Artery X-Rays Adrenal Gland (75731) | $420.12 | $6,032 | 0.1× |
| Artery X-Rays Pelvis (75736) range across 4 matching MRF lines likely a partial charge, not the full procedure |
$1,097.21 | $10,773–$15,992 | 0.2× |
| Artery X-Rays Spine (75705) range across 4 matching MRF lines likely a partial charge, not the full procedure |
$1,097.21 | $10,773–$15,992 | 0.2× |
| Arthrogram ankle (73615) range across 8 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| Arthrogram Wrist (73115) range across 8 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$523 | $289.91–$290 | 3.1× |
| Bone age studies (77072) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Bone Imaging 3 Phase (78315) | $404.95 | $828 | 0.8× |
| Bone Imaging Limited Area (78300) | $404.95 | $863 | 0.8× |
| Bone Imaging Multiple Areas (78305) range across 4 matching MRF lines |
$404.95 | $649–$828 | 0.8× |
| Bone Imaging Whole Body (78306) | $404.95 | $828 | 0.8× |
| Bone marrow imaging limited area (78102) range across 4 matching MRF lines |
$404.95 | $863–$871 | 0.8× |
| Bone marrow imaging; multiple areas (78103) | $404.95 | $871 | 0.8× |
| Bone marrow imaging; whole body (78104) | $404.95 | $871 | 0.8× |
| Bone survey infant (77076) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Brachytx isodose complex (77318) | $523 | $753.82 | 1.1× |
| Brachytx isodose intermed (77317) | $523 | $753.82 | 1.1× |
| Brachytx Isodose Plan Simple (77316) | $553.78 | $753.82 | 1.2× |
| Brain Flow Imaging Only (78610) range across 4 matching MRF lines |
$404.95 | $1,313–$1,513 | 0.6× |
| Brain Image W/Flow < 4 Views (78601) | $404.95 | $863 | 0.8× |
| Brain imaging < 4 static views (78600) | $404.95 | $863 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 4 matching MRF lines |
$404.95 | $1,513–$1,592 | 0.6× |
| Brain Imaging Minimum 4 Static Views (78605) range across 4 matching MRF lines |
$404.95 | $1,106–$1,313 | 0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 4 matching MRF lines |
$1,340.82 | $2,776–$3,222.01 | 0.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $404.95 | $828 | 0.8× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) range across 4 matching MRF lines |
$883.77 | $999–$1,066.99 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $580.49 | $1,072 | 1.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $580.49 | $2,615 | 0.6× |
| Cardiac Shunt Detection (78428) range across 4 matching MRF lines |
$404.95 | $813–$828 | 0.8× |
| Cardiovasc nucl exam unlisted (78499) | $404.95 | $3,032 | 0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 4 matching MRF lines |
$883.77 | $601–$1,066.99 | 1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $404.95 | $1,517 | 0.6× |
| Chest 1 view (71045) | $30.65 | $146 | 0.3× |
| Chest 2 views (71046) | $30.65 | $146 | 0.3× |
| Chest 3 views (71047) | $30.65 | $146 | 0.3× |
| Chest 4 or more views (71048) | $30.65 | $279 | 0.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 4 matching MRF lines |
$174.81 | $267–$315 | 1.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $30.65 | $263.54 | 0.2× |
| Cisternography Positive Contrast Rs&I (70015) | $580.49 | $1,620.33 | 0.6× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $262.99 | $190 | 2.0× |
| Continuing medical physics consltj pr wk (77336) range across 4 matching MRF lines |
$553.78 | $289.91–$290 | 3.3× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$420.12 | $4,392–$6,187 | 0.1× |
| Contrast X-Ray Bladder (74430) range across 4 matching MRF lines |
$302.50 | $903.87–$904 | 0.7× |
| Contrast X-Ray Of Elbow (73085) range across 8 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$314.30 | $903.87–$904 | 0.7× |
| CT abdomen and pelvis without contrast (74176) | $314.30 | $558 | 1.1× |
| CT abdomen w contrast (74160) | $314.30 | $568 | 1.4× |
| CT abdomen w wo contrast (74170) | $314.30 | $635 | 1.4× |
| CT abdomen w/o contrast (74150) | $262.99 | $283 | 2.0× |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$333.48 | $903.87–$904 | 0.8× |
| CT Angio Chest (71275) | $333.48 | $664 | 1.5× |
| CT Angio Head (70496) | $333.48 | $664 | 1.5× |
| CT angio hrt w/3d image (75574) | $333.48 | $559 | 0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $333.48 | $664 | 1.5× |
| CT Angio Neck (70498) | $333.48 | $664 | 1.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $333.48 | $664 | 1.5× |
| CT bone density (77078) | $145.21 | $145.93 | 1.3× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $314.30 | $530.15 | 1.4× |
| CT cervical spine w/ contrast (72126) range across 4 matching MRF lines |
$314.30 | $903.87–$904 | 0.7× |
| CT cervical spine w/o contrast (72125) | $262.99 | $283 | 2.0× |
| CT cervical spine w/wo cont (72127) | $314.30 | $635 | 1.4× |
| CT chest w contrast (71260) | $314.30 | $568 | 1.4× |
| CT chest w/wo contrast (71270) | $314.30 | $635 | 1.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $314.30 | $559 | 1.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $262.99 | $265 | 2.0× |
| CT head/brain with contrast (70460) | $314.30 | $568 | 1.4× |
| CT head/brain without and with contrast (70470) | $314.30 | $635 | 1.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $314.30 | $623 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $262.99 | $145.93 | 2.4× |
| CT hrt w/3d image congen (75573) | $314.30 | $623 | 0.7× |
| CT iac w contrast (70481) | $314.30 | $568 | 1.4× |
| CT l-spine w&w/o contrast (72133) | $314.30 | $635 | 1.4× |
| CT lower ext w/o (73700) | $262.99 | $283 | 2.0× |
| CT lower extremity w/contrast material (73701) | $314.30 | $568 | 1.4× |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$314.30 | $903.87–$904 | 0.7× |
| CT lumbar spine w/o contrast (72131) | $262.99 | $283 | 2.0× |
| CT maxillofacial w contrast (70487) | $314.30 | $568 | 1.4× |
| CT maxillofacial wo contrast (70486) | $262.99 | $283 | 2.0× |
| CT neck tissue combo (70492) | $314.30 | $635 | 1.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $314.30 | $635 | 1.4× |
| CT orbits w/o contrast (70480) | $262.99 | $283 | 2.0× |
| CT pelvis w&w/o contrast (72194) | $314.30 | $838 | 1.4× |
| CT pelvis w/o contrast (72192) | $262.99 | $283 | 2.0× |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$314.30 | $431–$527 | 1.4× |
| CT scans face/jaw combo (70488) | $314.30 | $635 | 1.4× |
| CT soft tissue neck w contrast (70491) | $314.30 | $568 | 1.4× |
| CT soft tissue neck w/o contrast (70490) | $262.99 | $283 | 2.0× |
| CT thoracic spine w contrast (72129) | $314.30 | $568 | 1.4× |
| CT thoracic spine w/o contrast (72128) | $262.99 | $283 | 2.0× |
| CT thoracic spine w/wo cont (72130) | $314.30 | $635 | 1.4× |
| CT thorax w/o contrast (71250) | $262.99 | $283 | 2.0× |
| CT upper ext wo (73200) | $262.99 | $283 | 2.0× |
| CT upper extremity w/o & w/contrast material (73202) | $314.30 | $635 | 1.4× |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$314.30 | $903.87–$904 | 0.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $333.48 | $592 | 1.5× |
| Cta Abdomen (74175) | $333.48 | $664 | 1.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $333.48 | $1,054.46 | 0.8× |
| CTA pelvis (72191) | $333.48 | $527 | 1.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $302.50 | $830 | 1.0× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) range across 4 matching MRF lines |
$404.95 | $813–$1,066.99 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $151.07 | $550 | 1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $151.07 | $550 | 1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 4 matching MRF lines |
$151.07 | $263.54–$264 | 1.2× |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$145.21 | $263.54–$264 | 1.1× |
| Dxa bone density study (77085) | $145.21 | $263.54 | 1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$145.21 | $145.93–$146 | 1.3× |
| Echo exam of fetal heart (76825) | $151.07 | $1,704 | 0.2× |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$758.29 | $540–$540.05 | 2.5× |
| Echo Guide For Artery Repair (76936) | $420.11 | $777 | 1.6× |
| Esophageal Motility Study (78258) range across 4 matching MRF lines |
$404.95 | $648–$828 | 0.8× |
| Esophagram (74220) range across 5 matching MRF lines |
$30.65 | $472.55–$473 | 0.1× |
| Fetal Biophys Profile W/Nst (76818) | $151.07 | $398 | 1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $151.07 | $318 | 1.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $384.88 | $645 | 1.3× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$302.50 | $540–$540.05 | 1.0× |
| Follow-Up Angiography (75898) range across 4 matching MRF lines |
$378.11 | $2,561.68–$7,148 | 0.1× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Gastric emptying imaging study (78264) | $404.95 | $828 | 0.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $404.95 | $828 | 0.8× |
| Gastric Mucosa Imaging (78261) range across 4 matching MRF lines |
$404.95 | $648–$828 | 0.8× |
| Gastroesophageal Reflux Exam (78262) range across 4 matching MRF lines |
$404.95 | $648–$828 | 0.8× |
| Gastrointestinal Protein Loss (78282) range across 4 matching MRF lines |
$404.95 | $648–$828 | 0.8× |
| Gated Heart Planar Single (78472) | $404.95 | $880 | 0.8× |
| Gated Heart, Multiple (78473) | $404.95 | $863 | 0.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) range across 4 matching MRF lines |
$404.95 | $1,066.99–$1,067 | 0.6× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $914.27 | $1,737 | 1.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $914.27 | $1,737 | 1.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $190.19 | $1,737 | 0.2× |
| Heart Image (Pet) Multiple (78492) | $1,340.82 | $3,222.01 | 0.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Hepatobil Syst Image W/Drug (78227) range across 4 matching MRF lines |
$404.95 | $1,066.99–$1,067 | 0.6× |
| Hepatobiliary System Imaging (78226) | $404.95 | $879 | 0.8× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $190.19 | $1,217.68 | 0.3× |
| Ht Musc Image Planar Mult (78454) range across 4 matching MRF lines |
$883.77 | $3,218.08–$3,862 | 0.5× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$883.77 | $2,100–$3,862 | 0.5× |
| Hysterosalpingogram (74740) range across 4 matching MRF lines |
$302.50 | $546–$715 | 1.0× |
| Image fusion (77399) | $553.78 | $289.91 | 3.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $174.81 | $217 | 1.6× |
| Infant hip ultrasound, limited static exam (76886) | $174.81 | $362 | 1.6× |
| Interstitial radiation source applic complex (77778) | $914.27 | $1,650.71 | 1.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $914.27 | $1,650.71 | 1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $914.27 | $1,217.68 | 1.3× |
| Intracavitary radiation source applic simple (77761) | $190.19 | $1,217.68 | 0.3× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) likely a partial charge, not the full procedure |
$914.27 | $17,905.56 | 0.1× |
| Intraop radiaj tx deliver xray single tx session (77424) likely a partial charge, not the full procedure |
$914.27 | $17,905.56 | 0.1× |
| K Flow/Funct Image Multiple (78709) range across 4 matching MRF lines |
$404.95 | $853–$1,067 | 0.6× |
| K Flow/Funct Image W/Drug (78708) range across 4 matching MRF lines |
$404.95 | $1,066.99–$1,067 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) range across 4 matching MRF lines |
$404.95 | $1,066.99–$1,067 | 0.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 4 matching MRF lines |
$404.95 | $485–$828 | 0.8× |
| Kidney Imaging Morphol (78700) | $404.95 | $863 | 0.8× |
| Knee 3 Views (73562) | $30.65 | $224 | 0.3× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $404.95 | $1,023 | 0.8× |
| Liver & Spleen Imaging Static Only (78215) range across 4 matching MRF lines |
$883.77 | $863–$879 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 4 matching MRF lines |
$883.77 | $762–$863 | 1.8× |
| Liver imaging w/vascular flow (78202) range across 4 matching MRF lines |
$883.77 | $2,879.65–$2,982 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) range across 4 matching MRF lines |
$883.77 | $1,066.99–$1,067 | 1.3× |
| Lung perfusion differential (78597) | $883.77 | $828 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) range across 4 matching MRF lines |
$883.77 | $1,066.99–$1,067 | 1.3× |
| Lung Ventilation Imaging (78579) | $883.77 | $863 | 1.8× |
| Lymph System Imaging (78195) range across 4 matching MRF lines |
$883.77 | $1,066.99–$1,106 | 1.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 4 matching MRF lines |
$378.11 | $3,570–$4,596 | 0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) range across 4 matching MRF lines |
$378.11 | $1,664–$1,829 | 0.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 4 matching MRF lines |
$420.12 | $8,812–$9,312 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 4 matching MRF lines |
$378.11 | $8,812–$9,312 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $384.88 | $675 | 1.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $580.49 | $1,072 | 2.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $384.88 | $1,165.30 | 0.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $580.49 | $6,414 | 2.7× |
| Meckels Divert Exam (78290) | $404.95 | $828 | 0.8× |
| Mlc imrt design & construction per imrt plan (77338) range across 4 matching MRF lines |
$523 | $753.82–$754 | 1.1× |
| Mr safety determination physician/other qhp (76016) range across 4 matching MRF lines |
— | $208–$260 | — |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 4 matching MRF lines |
— | $58–$72 | — |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 4 matching MRF lines |
— | $217–$263 | — |
| Mr safety implt pos&/immoblj (76019) range across 4 matching MRF lines |
— | $141–$176 | — |
| Mr safety med physics xm customization plng&mntr (76017) range across 4 matching MRF lines |
— | $572–$715 | — |
| Mra Head W/O & W/Contrast Material (70546) | $492.87 | $1,003 | 1.1× |
| MRA head w/o contrast (70544) | $492.87 | $675 | 1.7× |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$492.87 | $895–$1,006 | 1.1× |
| MRA neck w contrast (70548) | $492.87 | $1,006 | 1.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $492.87 | $1,138 | 1.1× |
| MRA neck w/o contrast (70547) | $492.87 | $675 | 1.7× |
| MRI abdomen w contrast (74182) | $580.49 | $1,006 | 1.3× |
| MRI abdomen w/o contrast (74181) | $384.88 | $675 | 1.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$580.49 | $1,620–$1,620.33 | 0.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $580.49 | $1,138 | 1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$580.49 | $1,620–$1,620.33 | 0.6× |
| MRI brain functional w/o physician admnistration (70554) | $384.88 | $645 | 1.3× |
| MRI brain functional w/physician admnistration (70555) | $384.88 | $645 | 1.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $384.88 | $540.05 | 1.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $384.88 | $540.05 | 1.3× |
| MRI cardiac w/o cont stress (75559) | $384.88 | $1,165.30 | 0.6× |
| MRI cardiac w/o contrast (75557) | $384.88 | $645 | 1.3× |
| MRI cervical spine w contrast (72142) | $580.49 | $1,006 | 1.3× |
| MRI cervical spine w/o cont (72141) | $384.88 | $675 | 1.3× |
| MRI chest w/o contrast (71550) | $384.88 | $675 | 1.3× |
| MRI chest with contrast (71551) | $580.49 | $1,620.33 | 0.6× |
| MRI chest wo w contrast (71552) | $580.49 | $1,138 | 1.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $580.49 | $1,006 | 1.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $580.49 | $1,138 | 1.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $384.88 | $675 | 1.3× |
| MRI lumbar spine w contrast (72149) | $580.49 | $1,006 | 1.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $580.49 | $1,138 | 1.3× |
| MRI orbit face &/neck w/o contrast (70540) | $384.88 | $675 | 1.3× |
| MRI orbit face neck w contrast (70542) | $580.49 | $1,006 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $580.49 | $1,138 | 1.3× |
| MRI pelvis w contrast (72196) | $580.49 | $1,006 | 1.3× |
| MRI pelvis w/o & w contrast (72197) | $580.49 | $1,138 | 1.3× |
| MRI pelvis w/o contrast (72195) | $384.88 | $675 | 1.3× |
| MRI thoracic spine w/o contrast (72146) | $384.88 | $675 | 1.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $580.49 | $1,006 | 1.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $384.88 | $675 | 1.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $580.49 | $1,138 | 1.3× |
| MRI, abdomen, combo (74183) | $580.49 | $1,138 | 1.3× |
| MRI, dorsal spine combo (72157) | $580.49 | $1,138 | 1.3× |
| MRI, dorsal spine contrast (72147) | $580.49 | $1,006 | 1.3× |
| MRI, joint upper extrem (73221) | $384.88 | $675 | 1.3× |
| MRI, joint upper extrem combo (73223) | $580.49 | $1,138 | 1.3× |
| MRI, lumbar spine combo (72158) | $580.49 | $1,138 | 1.3× |
| Myelogram cervical (72240) range across 4 matching MRF lines |
$706.31 | $1,620–$1,620.33 | 0.7× |
| Myelogram Lumbar (72265) range across 4 matching MRF lines |
$706.31 | $1,620–$1,620.33 | 0.7× |
| Myelography thoracic (72255) range across 4 matching MRF lines |
$706.31 | $1,620–$1,620.33 | 0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,340.82 | $3,755 | 0.8× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 4 matching MRF lines |
$404.95 | $813–$1,066.99 | 0.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 4 matching MRF lines |
$883.77 | $3,218.08–$3,862 | 0.5× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$883.77 | $2,879.65–$2,880 | 0.5× |
| N-invas est c ffr sw aly CTA (75580) range across 4 matching MRF lines |
$333.48 | $3,010–$3,023 | 0.3× |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Nervous system nuclear exam (78699) | $404.95 | $828 | 0.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $413.21 | $525.77 | 0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 4 matching MRF lines |
$549.41 | $828–$863 | 1.1× |
| Nm csf leak detection (78650) range across 4 matching MRF lines |
$883.77 | $1,517–$2,982 | 0.5× |
| Nm myocard infarct spect (78469) range across 4 matching MRF lines |
$883.77 | $1,592–$2,982 | 1.3× |
| Nm red cell survival study (78130) | $404.95 | $1,023 | 0.8× |
| Nm unlisted gi procedure (78299) | $404.95 | $828 | 0.8× |
| Nm whole blood volume (78122) range across 4 matching MRF lines |
$883.77 | $1,023–$1,066.99 | 1.3× |
| Nonvascular Shunt X-Ray (75809) range across 4 matching MRF lines |
$302.50 | $263.54–$264 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 4 matching MRF lines |
$199.36 | $2,791.91–$2,792 | 0.1× |
| Nuclear medicine study of endocrine organs (78099) | $404.95 | $828 | 0.8× |
| Nuclear Rx Intra-Arterial (79445) | $461.02 | $668 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $461.02 | $652 | 1.6× |
| Ob us nuchal meas 1 gest (76813) | $151.07 | $318 | 1.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $174.81 | $1,403 | 1.3× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $174.81 | $362 | 1.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $174.81 | $620 | 1.1× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 4 matching MRF lines |
$174.81 | $263.54–$264 | 1.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $124 | $217 | 1.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $174.81 | $270 | 1.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $124 | $1,403 | 3.4× |
| Ophthalmic us dx quantitative a-scan only (76511) range across 4 matching MRF lines |
$174.81 | $263.54–$264 | 1.3× |
| Optic foramina (70190) | $30.65 | $224 | 0.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $404.95 | $1,066.99 | 0.6× |
| Parathyroid Planar Imaging (78070) | $883.77 | $828 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $404.95 | $828 | 0.8× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Pet Myocardial Sngl Study (78491) | $1,340.82 | $3,222.01 | 0.8× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) range across 4 matching MRF lines |
$883.77 | $2,679–$2,879.65 | 0.5× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) range across 4 matching MRF lines |
$883.77 | $2,679–$2,879.65 | 0.5× |
| Platelet survival study Non-Facility (78191) range across 4 matching MRF lines |
$404.95 | $655–$828 | 0.8× |
| Proton trmt simple w/comp (77522) | $914.27 | $2,714 | 0.6× |
| Proton tx delivery complex (77525) | $914.27 | $2,714 | 0.6× |
| Proton tx delivery intermediate (77523) | $914.27 | $2,714 | 0.6× |
| Proton tx delivery simple w/o compensation (77520) | $190.19 | $1,217.68 | 0.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $883.77 | $863 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$302.50 | $1,165–$1,165.30 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $30.65 | $224 | 0.3× |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex lower extremity infant minimum 2 views (73592) | $30.65 | $224 | 0.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $30.65 | $376 | 0.3× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex shoulder complete minimum 2 views (73030) | $30.65 | $224 | 0.3× |
| Radex Sinuses Paransl < 3 Views (70210) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 4 matching MRF lines |
$302.50 | $427–$527 | 1.4× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $30.65 | $145.93 | 0.3× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $30.65 | $531 | 0.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 4 matching MRF lines |
$5,666.51 | $17,905.56–$17,906 | 0.6× |
| Radiation treatment delivery level 1 (77402) | $413.21 | $393 | 3.2× |
| Radiation treatment delivery level 2 (77407) | $413.21 | $525.77 | 0.9× |
| Radiation treatment delivery level 3 (77412) range across 4 matching MRF lines |
$413.21 | $525.77–$526 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $30.65 | $279 | 0.2× |
| Radiologic exam colon double contrast study (74280) | $302.50 | $472.55 | 1.4× |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$302.50 | $472.55–$473 | 1.4× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$302.50 | $263.54–$264 | 1.4× |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$302.50 | $263.54–$264 | 1.4× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $30.65 | $1,058 | 0.1× |
| Radiologic examination femur 1 view (73551) | $30.65 | $145.93 | 0.3× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radiologic Examination Osseous Survey Limited (77074) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $30.65 | $1,165.30 | 0.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $30.65 | $145.93 | 0.3× |
| Radiopharm Dacryocystography (78660) range across 4 matching MRF lines |
$404.95 | $601–$863 | 0.8× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $461.02 | $572 | 1.6× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $461.02 | $919 | 1.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $461.02 | $919 | 1.6× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $404.95 | $1,023 | 0.8× |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 4 matching MRF lines |
$404.95 | $1,106–$1,480 | 0.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $190.19 | $525.77 | 0.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $190.19 | $525.77 | 0.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$883.77 | $920–$1,189 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 4 matching MRF lines |
$883.77 | $920–$1,189 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 4 matching MRF lines |
$883.77 | $2,879.65–$2,880 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $883.77 | $2,982 | 1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $883.77 | $2,982 | 1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $883.77 | $2,982 | 0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $883.77 | $3,382 | 0.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $883.77 | $2,982 | 0.5× |
| Rp Therapy Unlisted Procedure (79999) | $461.02 | $590 | 1.6× |
| Salivary Gland Function Study (78232) range across 4 matching MRF lines |
$404.95 | $648–$828 | 0.8× |
| Scapula (73010) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Sella turcica (70240) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Shoulder Arthrography (73040) range across 8 matching MRF lines |
$302.50 | $895–$1,057 | 0.7× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Special dosimetry (77331) | $553.78 | $289.91 | 3.3× |
| Special Physics Consult (77370) | $553.78 | $393 | 3.3× |
| Special teletherapy port plan (77321) | $523 | $753.82 | 1.1× |
| Special treatment procedure (77470) | $190.19 | $1,217.68 | 0.3× |
| Spleen Imaging (78185) range across 4 matching MRF lines |
$404.95 | $863–$871 | 0.8× |
| Stereotactic Body Radiation Delivery (77373) range across 4 matching MRF lines |
$914.27 | $3,959.92–$3,960 | 0.4× |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $413.21 | $308.38 | 3.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $413.21 | $274.03 | 3.2× |
| Tbs technical calculation only (77091) range across 4 matching MRF lines |
$145.21 | $200–$260 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 4 matching MRF lines |
$523 | $753.82–$754 | 1.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $553.78 | $753.82 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $302.50 | $540.05 | 1.0× |
| Testicular Imaging W/Flow (78761) range across 4 matching MRF lines |
$404.95 | $863–$991 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 4 matching MRF lines |
$523 | $753.82–$754 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $523 | $753.82 | 1.1× |
| Ther rad simulaj-aided field setting simple (77280) | $553.78 | $393 | 3.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 4 matching MRF lines |
$302.50 | $472.55–$473 | 1.4× |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$30.65 | $175–$315 | 0.2× |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$30.65 | $187–$260 | 0.3× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) range across 4 matching MRF lines |
$404.95 | $863–$1,189 | 0.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 4 matching MRF lines |
$404.95 | $863–$889 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) range across 4 matching MRF lines |
$404.95 | $828–$863 | 0.8× |
| Thyroid Met Imaging Body (78018) range across 4 matching MRF lines |
$404.95 | $1,066.99–$1,067 | 0.6× |
| Thyroid Uptake Measurement (78012) | $404.95 | $828 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $404.95 | $828 | 0.8× |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$523 | $753.82–$754 | 1.1× |
| Tx devices design & construction intermediate (77333) | $553.78 | $393 | 3.3× |
| Tx devices design & construction simple (77332) | $553.78 | $289.91 | 3.3× |
| Ultrasound Breast Limited (76642) | $174.81 | $217 | 1.6× |
| Ultrasound Exam Aaa Screen (76706) | $174.81 | $263.54 | 1.3× |
| Ultrasound, abdomen limited (76705) | $174.81 | $318 | 1.3× |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$151.07 | $263.54–$264 | 1.2× |
| Unlis px ther radiol clinical tx planning (77299) | $553.78 | $289.91 | 3.3× |
| Unlisted Dx Radiographic Procedure (76499) range across 6 matching MRF lines |
$30.65 | $187–$260 | 0.3× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $404.95 | $828 | 0.8× |
| Unlisted magnetic resonance procedure (76498) | $384.88 | $146 | 3.5× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 6 matching MRF lines |
$404.95 | $414–$828 | 0.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $413.21 | $274.03 | 3.2× |
| Unlisted respiratory px dx nuclear medicine (78599) | $404.95 | $828 | 0.8× |
| Unlisted us procedure (76999) | $174.81 | $216 | 1.6× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$302.50 | $472.55–$473 | 1.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $10.86 | $22.12 | 1.0× |
| Urea breath test c-14 isotopic analysis (78268) | $63.76 | $188.82 | 0.7× |
| Ureteral Reflux Study (78740) | $404.95 | $991 | 0.8× |
| Urethrocystogram voiding (74455) | $302.50 | $625 | 1.0× |
| Urethrocystography retrograde (74450) | $302.50 | $625 | 1.0× |
| Us bone density measurement (76977) | $145.21 | $263.54 | 1.1× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$174.81 | $263.54–$264 | 1.3× |
| Us chest (76604) | $174.81 | $318 | 1.3× |
| Us complete joint (76881) range across 8 matching MRF lines |
$174.81 | $193–$264 | 1.3× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$174.81 | $263.54–$264 | 1.3× |
| Us head (76506) | $174.81 | $318 | 1.3× |
| Us kidney transplant (76776) range across 4 matching MRF lines |
$174.81 | $268–$315 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$174.81 | $263.54–$264 | 1.3× |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$151.07 | $540–$540.05 | 0.5× |
| Us ob limited 1 or more fetuses (76815) | $151.07 | $270 | 1.2× |
| Us ob transvaginal (76817) | $151.07 | $270 | 1.2× |
| Us pelvic non ob complete (76856) | $758.29 | $318 | 5.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $151.07 | $318 | 1.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$151.07 | $263.54–$264 | 1.2× |
| Us retroperitoneal complete (76770) | $758.29 | $318 | 5.8× |
| Us retroperitoneal limited (76775) | $174.81 | $318 | 1.3× |
| Us scrotum and contents (76870) | $174.81 | $318 | 1.3× |
| Us spinal canal and contents (76800) range across 4 matching MRF lines |
$174.81 | $315–$324 | 1.3× |
| Us thyroid (76536) | $174.81 | $318 | 1.3× |
| Vascular Flow Imaging (78445) range across 4 matching MRF lines |
$404.95 | $526–$828 | 0.8× |
| Vein X-Ray Chest (75827) | $378.11 | $1,949 | 0.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 4 matching MRF lines |
$378.11 | $2,561.68–$7,148 | 0.1× |
| Venography Adrenal Unilateral (75840) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Venography caval inferior serialography rs&i (75825) range across 4 matching MRF lines |
$420.12 | $6,187.39–$6,496 | 0.1× |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$378.11 | $2,561.68–$2,562 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $378.11 | $1,949 | 0.2× |
| Venography Renal Bilateral (75833) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$420.12 | $6,187–$6,187.39 | 0.1× |
| Venous sampling by catheter (75893) range across 4 matching MRF lines likely a partial charge, not the full procedure |
$1,097.21 | $10,251–$10,251.39 | 0.2× |
| Venous thrombosis imaging (78457) range across 4 matching MRF lines |
$883.77 | $2,879.65–$2,880 | 1.3× |
| Vertebral fracture assessment via dxa (77086) | $145.21 | $145.93 | 1.3× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $30.65 | $224 | 0.3× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$302.50 | $903.87–$904 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $30.65 | $263.54 | 0.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$302.50 | $1,165–$1,165.30 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $30.65 | $265 | 0.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $30.65 | $531 | 0.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $30.65 | $265 | 0.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $30.65 | $265 | 0.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $30.65 | $265 | 0.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $30.65 | $531 | 0.2× |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $30.65 | $224 | 0.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$302.50 | $287–$527 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| X-ray nose-rectum child f.b. (76010) | $30.65 | $146 | 0.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $30.65 | $263.54 | 0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $30.65 | $224 | 0.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| X-Ray Stress View (77071) | — | $215 | — |
| X-ray thoracic spine 4 vw (72074) range across 4 matching MRF lines |
$30.65 | $263–$315 | 0.2× |
| X-Ray Tmj Unilat (70328) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$302.50 | $903.87–$904 | 0.7× |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| X-Rays Bone Survey Complete (77075) | $302.50 | $376 | 2.3× |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$30.65 | $145.93–$146 | 0.3× |
| XR Mastoids < 3 Views Bilateral (70120) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
| Xr myelogram posterior fossa (70010) | $706.31 | $903.87 | 1.6× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$30.65 | $263.54–$264 | 0.2× |
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.