Imaging prices at Bryan Medical Center
Lincoln, NE · every code in this section with a posted price and a Medicare benchmark.
412 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) | $6,582.60 | $10,971 | 4.6× |
| Abdomen 1 View (74018) | $201 | $335 | 2.2× |
| Abdomen 2 views (74019) | $264 | $440 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,288.20 | $2,147 | 3.1× |
| Angio internal mammary (75756) | $2,827.20 | $4,712 | 0.9× |
| Angio pulmonary bilat (75743) | $1,993.20 | $3,322 | 0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,234.60 | $5,391 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,763.60 | $4,606 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,451.60 | $4,086 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,993.20 | $3,322 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,184.60 | $3,641 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$177.60–$178.80 | $296–$298 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,438 | $5,730 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,666.40 | $4,444 | 0.8× |
| Artery X-Rays Abdomen (75726) | $3,917.40 | $6,529 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $2,444.40 | $4,074 | 0.7× |
| Artery X-Rays Pelvis (75736) | $3,438 | $5,730 | 0.6× |
| Artery X-Rays Spine (75705) | $3,438 | $5,730 | 0.6× |
| Arthrogram ankle (73615) | $754.80 | $1,258 | 2.1× |
| Arthrogram hip (73525) | $754.80 | $1,258 | 2.1× |
| Arthrogram Wrist (73115) | $448.80 | $748 | 1.2× |
| Basic radiation dosimetry calculation (77300) | $506.40 | $844 | 3.6× |
| Bone age studies (77072) | $223.80 | $373 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,872 | $3,120 | 4.5× |
| Bone Imaging Limited Area (78300) | $861.60 | $1,436 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,647 | $2,745 | 4.0× |
| Bone marrow imaging; whole body (78104) | $1,127.40 | $1,879 | 2.7× |
| Bone survey infant (77076) | $365.40 | $609 | 3.4× |
| Brachytx isodose complex (77318) | $2,450.40 | $4,084 | 6.3× |
| Brachytx isodose intermed (77317) | $1,611.60 | $2,686 | 4.1× |
| Brachytx Isodose Plan Simple (77316) | $1,245.60 | $2,076 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,003.20 | $1,672 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,630 | $6,050 | 2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,659 | $2,765 | 4.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,799.40 | $2,999 | 2.2× |
| Cardiac Shunt Detection (78428) | $1,588.20 | $2,647 | 3.8× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$375.60–$616.80 | $626–$1,028 | varies |
| Cerebrospinal Fluid Scan (78630) | $1,725.60 | $2,876 | 3.1× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$198–$204.60 | $330–$341 | varies |
| Chest 2 views (71046) | $216 | $360 | 2.4× |
| Chest 3 views (71047) | $282 | $470 | 3.1× |
| Chest 4 or more views (71048) | $300.60 | $501 | 2.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $315 | $525 | 2.9× |
| Cisternography Positive Contrast Rs&I (70015) | $1,467 | $2,445 | 1.8× |
| Clavicle complete (73000) | $228 | $380 | 2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $428.40 | $714 | 3.9× |
| Continuing medical physics consltj pr wk (77336) | $501.60 | $836 | 3.6× |
| Contrast Exam Abdominl Aorta (75625) | $2,455.80 | $4,093 | 0.7× |
| Contrast X-Ray Bladder (74430) | $487.20 | $812 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $342.60 | $571 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $754.80 | $1,258 | 2.1× |
| Contrast Xray Throat/Cerv Esopha (74210) | $418.80 | $698 | 2.3× |
| Corpora cavernosography (74445) | $318.60 | $531 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,738 | $6,230 | 10.3× |
| CT abdomen and pelvis without contrast (74176) | $2,002.80 | $3,338 | 8.1× |
| CT abdomen w contrast (74160) | $1,908 | $3,180 | 10.5× |
| CT abdomen w wo contrast (74170) | $2,131.80 | $3,553 | 11.7× |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$1,120.20–$1,440 | $1,867–$2,400 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,943.80 | $6,573 | 10.9× |
| CT Angio Chest (71275) | $1,852.80 | $3,088 | 10.2× |
| CT Angio Head (70496) | $1,715.40 | $2,859 | 9.4× |
| CT angio hrt w/3d image (75574) | $1,621.80 | $2,703 | 4.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,717.80 | $2,863 | 9.4× |
| CT Angio Neck (70498) | $2,188.80 | $3,648 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,954.20 | $3,257 | 10.7× |
| CT cervical spine w/ contrast (72126) | $1,633.80 | $2,723 | 4.5× |
| CT cervical spine w/o contrast (72125) | $1,299.60 | $2,166 | 12.0× |
| CT cervical spine w/wo cont (72127) | $1,734 | $2,890 | 9.5× |
| CT chest w contrast (71260) | $1,504.80 | $2,508 | 8.3× |
| CT chest w/wo contrast (71270) | $1,715.40 | $2,859 | 9.4× |
| CT colonography screening (74263) | $1,581 | $2,635 | 6.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,660.20 | $2,767 | 9.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,412.40 | $2,354 | 13.0× |
| CT head/brain with contrast (70460) | $1,406.40 | $2,344 | 7.7× |
| CT head/brain without and with contrast (70470) | $1,669.80 | $2,783 | 9.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,290 | $2,150 | 3.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $75 | $125 | 0.8× |
| CT hrt w/3d image congen (75573) | $1,078.20 | $1,797 | 3.0× |
| CT iac w contrast (70481) | $1,714.80 | $2,858 | 9.4× |
| CT l-spine w&w/o contrast (72133) | $1,741.80 | $2,903 | 9.6× |
| CT lower ext w/o (73700) | $1,199.40 | $1,999 | 11.0× |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$271.80–$1,546.20 | $453–$2,577 | varies |
| CT lumbar spine w contrast (72132) | $1,667.40 | $2,779 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,419 | $2,365 | 13.1× |
| CT maxillofacial w contrast (70487) | $1,531.20 | $2,552 | 8.4× |
| CT maxillofacial wo contrast (70486) range across 5 matching MRF lines |
$806.40–$1,189.80 | $1,344–$1,983 | varies |
| CT neck tissue combo (70492) | $2,048.40 | $3,414 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,863.60 | $3,106 | 10.2× |
| CT orbits w/o contrast (70480) | $1,530.60 | $2,551 | 14.1× |
| CT pelvis w&w/o contrast (72194) | $1,881.60 | $3,136 | 10.3× |
| CT pelvis w/o contrast (72192) | $1,248.60 | $2,081 | 11.5× |
| CT scan of leg combo (73702) | $1,737 | $2,895 | 9.5× |
| CT scans face/jaw combo (70488) | $1,548.60 | $2,581 | 8.5× |
| CT soft tissue neck w contrast (70491) | $1,678.20 | $2,797 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,275.60 | $2,126 | 11.8× |
| CT thoracic spine w contrast (72129) | $1,674 | $2,790 | 9.2× |
| CT thoracic spine w/o contrast (72128) | $1,453.80 | $2,423 | 13.4× |
| CT thoracic spine w/wo cont (72130) | $1,684.80 | $2,808 | 9.3× |
| CT thorax w/o contrast (71250) | $1,023.60 | $1,706 | 9.4× |
| CT upper ext wo (73200) | $1,329 | $2,215 | 12.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,849.80 | $3,083 | 10.2× |
| CT upper extremity with contrast (73201) | $1,537.20 | $2,562 | 4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,251.20 | $3,752 | 12.4× |
| Cta Abdomen (74175) | $2,113.20 | $3,522 | 11.6× |
| CTA pelvis (72191) | $983.40 | $1,639 | 5.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $524.40 | $874 | 2.1× |
| Dilation ureters/urethra rs&i (74485) | $1,241.40 | $2,069 | 0.6× |
| Discography Cerv/Thor Spine (72285) | $3,598.80 | $5,998 | 1.8× |
| Diskography lumbar (72295) | $3,598.80 | $5,998 | 1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $223.80 | $373 | 2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $223.80 | $373 | 2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $223.80 | $373 | 2.1× |
| Dxa Bone Density Axial (77080) | $349.20 | $582 | 3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $166.80 | $278 | 1.8× |
| Echo exam of fetal heart (76825) | $991.20 | $1,652 | 1.7× |
| Echo exam uterus (76831) | $472.20 | $787 | 1.9× |
| Echo Guide For Artery Repair (76936) | $679.80 | $1,133 | 3.0× |
| Echograp Trans R Pros Study (76873) | $428.40 | $714 | 3.9× |
| Esophagram (74220) | $467.40 | $779 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $395.40 | $659 | 3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $223.80 | $373 | 2.1× |
| Fluoroscopy up to 1 hr (76000) | $472.20 | $787 | 1.9× |
| Follow-Up Angiography (75898) | $1,993.20 | $3,322 | 0.6× |
| Foot 2 views (73620) | $209.40 | $349 | 2.3× |
| Forearm 2 views (73090) | $239.40 | $399 | 2.6× |
| Gastric emptying imaging study (78264) | $1,409.40 | $2,349 | 3.4× |
| Gated Heart Planar Single (78472) | $1,566.60 | $2,611 | 3.8× |
| Gated Heart, Multiple (78473) | $1,622.40 | $2,704 | 3.9× |
| Hand 2 views (73120) | $250.20 | $417 | 2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,233.20 | $3,722 | 3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,233.20 | $3,722 | 3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,419.60 | $2,366 | 2.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,110.80 | $3,518 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,601.60 | $4,336 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,420.20 | $2,367 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,385.40 | $2,309 | 3.3× |
| Ht Muscle Image Spect Sing (78451) | $2,838 | $4,730 | 2.1× |
| Hysterosalpingogram (74740) | $529.80 | $883 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $417.60 | $696 | 4.6× |
| Infant hip ultrasound, limited static exam (76886) | $333 | $555 | 3.7× |
| Interstitial radiation source applic complex (77778) | $1,662 | $2,770 | 2.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,158 | $1,930 | 1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $693.60 | $1,156 | 1.2× |
| Intracavitary radiation source applic simple (77761) | $522 | $870 | 0.9× |
| Joint Survey Single View (77077) | $223.80 | $373 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,540.20 | $2,567 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,326.60 | $2,211 | 2.4× |
| Knee 3 Views (73562) | $339.60 | $566 | 3.8× |
| Leveen/Shunt Patency Exam (78291) | $1,020 | $1,700 | 2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,324.80 | $2,208 | 3.2× |
| Liver imaging w/vascular flow (78202) | $1,003.20 | $1,672 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,501.80 | $2,503 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,702.80 | $2,838 | 3.0× |
| Lung Ventilation Imaging (78579) | $1,030.80 | $1,718 | 2.5× |
| Lymph System Imaging (78195) | $1,422 | $2,370 | 2.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $2,882.40 | $4,804 | 1.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,450.20 | $2,417 | 2.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,748.60 | $4,581 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $1,561.80 | $2,603 | 6.3× |
| Mammary ductogram or galactogram multiple (77054) | $578.40 | $964 | 2.3× |
| Mammary ductogram or galactogram single (77053) | $617.40 | $1,029 | 2.5× |
| Meckels Divert Exam (78290) | $838.20 | $1,397 | 2.0× |
| Mlc imrt design & construction per imrt plan (77338) | $2,955.60 | $4,926 | 7.6× |
| Mr safety determination physician/other qhp (76016) | $240 | $400 | 2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$14.39–$50.40 | $23.98–$84 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $510 | $850 | 5.2× |
| Mr safety implt pos&/immoblj (76019) | $150 | $250 | 2.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $900 | $1,500 | 3.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,124.80 | $5,208 | 8.6× |
| MRA head w/o contrast (70544) | $2,159.40 | $3,599 | 8.7× |
| MRA head with contrast (70545) | $2,209.20 | $3,682 | 6.1× |
| MRA neck w contrast (70548) | $2,107.80 | $3,513 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,708.40 | $4,514 | 7.5× |
| MRA neck w/o contrast (70547) | $1,750.80 | $2,918 | 7.1× |
| MRI abdomen w contrast (74182) | $2,277 | $3,795 | 6.3× |
| MRI abdomen w/o contrast (74181) | $1,995.60 | $3,326 | 8.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$2,164.20–$2,274.60 | $3,607–$3,791 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,418.60 | $4,031 | 6.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,076.60 | $3,461 | 2.6× |
| MRI bone marrow blood supply (77084) | $1,860 | $3,100 | 7.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $600 | $1,000 | 2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $472.20 | $787 | 1.9× |
| MRI cardiac w/o cont stress (75559) | $1,284 | $2,140 | 2.3× |
| MRI cardiac w/o contrast (75557) | $717.60 | $1,196 | 2.9× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,379.60–$2,760 | $3,966–$4,600 | varies |
| MRI cervical spine w/o cont (72141) range across 6 matching MRF lines |
$1,371–$2,097.60 | $2,285–$3,496 | varies |
| MRI chest w/o contrast (71550) | $2,375.40 | $3,959 | 9.6× |
| MRI chest with contrast (71551) | $2,829.60 | $4,716 | 3.5× |
| MRI chest wo w contrast (71552) | $2,818.20 | $4,697 | 7.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,850.40 | $3,084 | 5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,990.20 | $3,317 | 5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 5 matching MRF lines |
$1,014.60–$1,704 | $1,691–$2,840 | varies |
| MRI lumbar spine w contrast (72149) | $2,500.20 | $4,167 | 6.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,073.20 | $5,122 | 8.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,850.60 | $4,751 | 11.5× |
| MRI orbit face neck w contrast (70542) | $2,948.40 | $4,914 | 8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,120 | $5,200 | 8.6× |
| MRI pelvis w contrast (72196) range across 4 matching MRF lines |
$2,310–$2,337 | $3,850–$3,895 | varies |
| MRI pelvis w/o & w contrast (72197) | $2,445 | $4,075 | 6.7× |
| MRI pelvis w/o contrast (72195) range across 9 matching MRF lines |
$1,425.60–$2,054.40 | $2,376–$3,424 | varies |
| MRI spectroscopy (76390) | $830.40 | $1,384 | 9.2× |
| MRI thoracic spine w/o contrast (72146) range across 6 matching MRF lines |
$1,617.60–$2,307 | $2,696–$3,845 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,789.20 | $2,982 | 4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,650.60 | $2,751 | 6.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,982.40 | $3,304 | 5.5× |
| MRI, abdomen, combo (74183) | $2,557.80 | $4,263 | 7.1× |
| MRI, dorsal spine combo (72157) | $2,583.60 | $4,306 | 7.1× |
| MRI, dorsal spine contrast (72147) | $2,330.40 | $3,884 | 6.4× |
| MRI, joint upper extrem (73221) | $1,745.40 | $2,909 | 7.0× |
| MRI, joint upper extrem combo (73223) | $2,215.80 | $3,693 | 6.1× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,650.60–$2,891.40 | $2,751–$4,819 | varies |
| Myelogram cervical (72240) | $982.20 | $1,637 | 1.2× |
| Myelogram Lumbar (72265) | $1,012.80 | $1,688 | 1.2× |
| Myelography thoracic (72255) | $1,467 | $2,445 | 1.8× |
| Myelograpy 2/more regions rs&i (72270) | $1,625.40 | $2,709 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $3,540.60 | $5,901 | 2.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,033.60 | $5,056 | 2.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,516.80 | $7,528 | 2.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,925 | $4,875 | 1.3× |
| N-invas est c ffr sw aly CTA (75580) | $3,439.20 | $5,732 | 3.9× |
| Neck soft tissue (70360) | $203.40 | $339 | 2.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $925.80 | $1,543 | 2.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $773.40 | $1,289 | 1.9× |
| Nm csf leak detection (78650) | $1,306.20 | $2,177 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $424.20 | $707 | 3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,480 | $10,800 | 4.5× |
| Nuclear Rx Intra-Arterial (79445) | $608.40 | $1,014 | 2.5× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$997.20–$1,347 | $1,662–$2,245 | varies |
| Ob us nuchal meas 1 gest (76813) | $223.80 | $373 | 2.1× |
| Panoramic X-ray of jaws (70355) | $166.80 | $278 | 1.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,366.80 | $2,278 | 2.4× |
| Parathyroid Planar Imaging (78070) | $935.40 | $1,559 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $999 | $1,665 | 2.4× |
| Pelvis 1 or 2 views (72170) | $223.80 | $373 | 2.1× |
| Peritoneogram Rs&I (74190) | $991.20 | $1,652 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $4,166.40 | $6,944 | 2.8× |
| PET image w/CT, full body (78816) | $4,929.60 | $8,216 | 3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,789.20 | $7,982 | 3.2× |
| PET whole body (78813) | $4,550.40 | $7,584 | 3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,512.20 | $4,187 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,057.20 | $1,762 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $357 | $595 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $991.20 | $1,652 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $270.60 | $451 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $166.80 | $278 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $282.60 | $471 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $343.20 | $572 | 3.2× |
| Radex fingr minimum 2 views (73140) | $184.80 | $308 | 2.0× |
| Radex foot complete minimum 3 views (73630) | $282.60 | $471 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $267 | $445 | 3.0× |
| Radex lower extremity infant minimum 2 views (73592) | $166.80 | $278 | 1.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $250.20 | $417 | 2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $225.60 | $376 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $246 | $410 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) | $309.60 | $516 | 3.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $218.40 | $364 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $199.20 | $332 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $166.80 | $278 | 1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $261.60 | $436 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $184.20 | $307 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) | $223.80 | $373 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $267 | $445 | 3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $265.20 | $442 | 2.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,596.80 | $19,328 | 1.5× |
| Radiation treatment delivery level 1 (77402) | $457.20 | $762 | 4.3× |
| Radiation treatment delivery level 2 (77407) | $500.40 | $834 | 1.2× |
| Radiation treatment delivery level 3 (77412) | $960 | $1,600 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $309.60 | $516 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $253.20 | $422 | 2.3× |
| Radiologic exam colon double contrast study (74280) | $771 | $1,285 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $618 | $1,030 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $367.20 | $612 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $355.80 | $593 | 3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $267 | $445 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $454.20 | $757 | 2.5× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$396–$418.80 | $660–$698 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $543 | $905 | 3.0× |
| Radiologic examination femur 1 view (73551) | $166.80 | $278 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $168 | $280 | 1.9× |
| Radiologic examination knee 1/2 views (73560) | $247.80 | $413 | 2.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $264.60 | $441 | 2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $166.80 | $278 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $252 | $420 | 2.8× |
| Radiopharm Dacryocystography (78660) | $773.40 | $1,289 | 1.9× |
| Renal Cyst Study (74470) | $991.20 | $1,652 | 1.7× |
| Ribs bilateral 3 views (71110) | $312.60 | $521 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,366.20 | $2,277 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,679 | $4,465 | 4.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,679 | $4,465 | 4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,679 | $4,465 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,147.20 | $6,912 | 2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,213 | $5,355 | 2.4× |
| Rp Therapy Intravenous Administration (79101) | $955.80 | $1,593 | 3.9× |
| Salivary Gland Imaging (78230) | $773.40 | $1,289 | 1.9× |
| Scapula (73010) | $223.80 | $373 | 2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $63.60 | $106 | 2.7× |
| Sella turcica (70240) | $187.20 | $312 | 2.1× |
| Shoulder 1 view (73020) | $190.80 | $318 | 2.1× |
| Shoulder Arthrography (73040) | $754.80 | $1,258 | 2.1× |
| Skull less than 4 views (70250) | $223.80 | $373 | 2.1× |
| Special dosimetry (77331) | $544.80 | $908 | 3.9× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$875.40–$1,005 | $1,459–$1,675 | varies |
| Special teletherapy port plan (77321) | $1,535.40 | $2,559 | 3.9× |
| Special treatment procedure (77470) | $2,230.80 | $3,718 | 3.9× |
| Srs Multisource (77371) | $13,259.40 | $22,099 | 1.7× |
| Stereotactic Body Radiation Delivery (77373) | $7,287.60 | $12,146 | 3.9× |
| Sternoclavicular joints (71130) | $170.40 | $284 | 1.9× |
| Superior sagittal sinus venogram (75870) | $1,993.20 | $3,322 | 0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $466.80 | $778 | 4.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,668.60 | $2,781 | 4.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,363.20 | $2,272 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,816.20 | $3,027 | 4.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,540.80 | $2,568 | 4.0× |
| Ther rad simulaj-aided field setting simple (77280) | $935.40 | $1,559 | 6.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $781.80 | $1,303 | 4.3× |
| Thoracic spine 2 views (72070) | $261 | $435 | 2.4× |
| Thoracic spine 3 views (72072) | $333 | $555 | 3.1× |
| Thoracolumbar 2 views (72080) | $238.20 | $397 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $773.40 | $1,289 | 1.9× |
| Thyroid Met Imaging Body (78018) | $1,496.40 | $2,494 | 2.7× |
| Thyroid Uptake Measurement (78012) | $459 | $765 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $883.80 | $1,473 | 2.1× |
| Tx Devices Design & Construction Complex (77334) | $1,088.40 | $1,814 | 2.8× |
| Tx devices design & construction intermediate (77333) | $715.20 | $1,192 | 5.1× |
| Tx devices design & construction simple (77332) | $379.20 | $632 | 2.7× |
| Ultrasound Breast Limited (76642) | $267.60 | $446 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $297.60 | $496 | 2.7× |
| Ultrasound, abdomen limited (76705) | $339.60 | $566 | 3.1× |
| Umbilical-artery Doppler (OB) (76820) | $223.80 | $373 | 2.1× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$90–$166.80 | $150–$278 | varies |
| Unlisted magnetic resonance procedure (76498) range across 6 matching MRF lines |
$768–$2,891.40 | $1,280–$4,819 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $773.40 | $1,289 | 1.9× |
| Unlisted us procedure (76999) | $205.20 | $342 | 2.3× |
| Upper gi w/o kub (74240) | $408.60 | $681 | 2.2× |
| Urethrocystogram voiding (74455) | $532.20 | $887 | 2.1× |
| Urethrocystography retrograde (74450) | $670.20 | $1,117 | 2.7× |
| Us breast unilateral complete (76641) | $314.40 | $524 | 2.9× |
| Us chest (76604) | $270 | $450 | 2.5× |
| Us complete joint (76881) | $471.60 | $786 | 4.3× |
| Us exam, pelvic, limited (76857) | $223.80 | $373 | 2.1× |
| Us head (76506) | $480.60 | $801 | 4.4× |
| Us kidney transplant (76776) | $269.40 | $449 | 2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $303.60 | $506 | 2.8× |
| Us ob detailed single fetus (76811) | $587.40 | $979 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $271.80 | $453 | 2.5× |
| Us ob transvaginal (76817) | $375.60 | $626 | 3.5× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$223.80–$384.60 | $373–$641 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $330 | $550 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $322.20 | $537 | 3.0× |
| Us retroperitoneal complete (76770) | $503.40 | $839 | 4.6× |
| Us retroperitoneal limited (76775) | $376.80 | $628 | 3.5× |
| Us scrotum and contents (76870) | $504.60 | $841 | 4.6× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$329.40–$408 | $549–$680 | varies |
| Us thyroid (76536) | $480 | $800 | 4.4× |
| Us transrectal (76872) | $450.60 | $751 | 4.2× |
| Vasogram (74440) | $1,668.60 | $2,781 | 6.7× |
| Vein X-Ray Chest (75827) | $2,882.40 | $4,804 | 1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,993.20 | $3,322 | 0.6× |
| Vein X-Ray Skull Epidural (75872) | $2,241.60 | $3,736 | 3.4× |
| Vein X-Ray Spleen/Liver (75810) | $2,133 | $3,555 | 0.7× |
| Venogram Sinus/Jugular (75860) | $1,993.20 | $3,322 | 0.6× |
| Venography Adrenal Unilateral (75840) | $2,413.80 | $4,023 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,292 | $3,820 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $2,882.40 | $4,804 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $1,009.20 | $1,682 | 0.6× |
| Venography Orbital Rs&I (75880) | $2,412.60 | $4,021 | 3.7× |
| Venography Renal Bilateral (75833) | $3,307.80 | $5,513 | 1.0× |
| Venography Renal Unilateral (75831) | $2,071.80 | $3,453 | 0.6× |
| Venous sampling by catheter (75893) | $3,504.60 | $5,841 | 0.6× |
| Wrist 2 views (73100) | $186 | $310 | 2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $238.80 | $398 | 2.6× |
| X-ray antegrade pyelogram tube (74425) | $754.80 | $1,258 | 2.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,501.40 | $4,169 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $492 | $820 | 4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $178.80 | $298 | 2.0× |
| X-Ray Exam Breast Specimen (76098) | $446.40 | $744 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $166.80 | $278 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $303 | $505 | 2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $254.40 | $424 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $166.80 | $278 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $166.80 | $278 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $223.80 | $373 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $223.80 | $373 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $223.80 | $373 | 2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $266.40 | $444 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $357.60 | $596 | 3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $240.60 | $401 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $492 | $820 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $328.80 | $548 | 3.0× |
| X-ray eye for foreign body (70030) | $166.80 | $278 | 1.8× |
| X-ray humerus (73060) | $258.60 | $431 | 2.9× |
| X-ray IV pyelogram (ivp) (74400) | $472.80 | $788 | 2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $166.80 | $278 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $186 | $310 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $303.60 | $506 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $258 | $430 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $407.40 | $679 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $231 | $385 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $223.80 | $373 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $166.80 | $278 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $307.80 | $513 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $322.20 | $537 | 3.0× |
| X-ray thoracic spine 4 vw (72074) | $286.80 | $478 | 2.6× |
| X-Ray Tmj Unilat (70328) | $166.80 | $278 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $754.80 | $1,258 | 2.1× |
| X-Rays Bone Length Studies (77073) | $223.80 | $373 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $591 | $985 | 5.4× |
| Xr c-spine 4 or 5 views (72050) | $369 | $615 | 3.4× |
| Xr facial bones less than 3 views (70140) | $166.80 | $278 | 1.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $223.80 | $373 | 2.1× |
| Xr orbits complete 4 views (70200) | $359.40 | $599 | 3.3× |
| Xr Tomogram Single Plane (76100) | $223.80 | $373 | 2.1× |
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.