Imaging prices at Camden Clark Medical Center
Parkersburg, WV · every code in this section with a posted price and a Medicare benchmark.
399 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$4,437–$4,650.50 | $8,874–$9,301 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$168.50–$194.50 | $337–$389 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$194.50–$229.50 | $389–$459 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,045–$1,273 | $2,090–$2,546 | varies |
| Angio internal mammary (75756) | $2,870 | $5,740 | 0.9× |
| Angio pulmonary bilat (75743) | $2,870 | $5,740 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,870 | $5,740 | 0.9× |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$3,129.50–$7,163 | $6,259–$14,326 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$3,270.50–$3,762.50 | $6,541–$7,525 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,878 | $7,756 | 1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,870 | $5,740 | 0.9× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$166.50–$391 | $333–$782 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,039.50 | $10,079 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,870 | $5,740 | 0.9× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$6,792.50–$17,078 | $13,585–$34,156 | varies |
| Artery X-Rays Adrenal Gland (75731) | $2,870 | $5,740 | 0.9× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$4,761–$5,039.50 | $9,522–$10,079 | varies |
| Artery X-Rays Spine (75705) | $5,039.50 | $10,079 | 0.9× |
| Arthrogram ankle (73615) | $942 | $1,884 | 2.8× |
| Arthrogram hip (73525) | $532 | $1,064 | 1.6× |
| Arthrogram Wrist (73115) | $1,077 | $2,154 | 3.2× |
| Basic radiation dosimetry calculation (77300) range across 5 matching MRF lines |
$325.50–$1,270 | $651–$2,540 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$209.50–$213.50 | $419–$427 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,138.50–$1,214 | $2,277–$2,428 | varies |
| Bone Imaging Limited Area (78300) | $718 | $1,436 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $1,054.50 | $2,109 | 2.7× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,138.50–$1,348.50 | $2,277–$2,697 | varies |
| Bone marrow imaging limited area (78102) | $677 | $1,354 | 1.8× |
| Bone survey infant (77076) range across 3 matching MRF lines |
$205.50–$245 | $411–$490 | varies |
| Brachytx isodose complex (77318) | $1,292.50 | $2,585 | 3.6× |
| Brachytx isodose intermed (77317) | $907.50 | $1,815 | 2.5× |
| Brachytx Isodose Plan Simple (77316) | $619 | $1,238 | 1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,113.50 | $2,227 | 2.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $978.50 | $1,957 | 1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,541.50 | $3,083 | 1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$948.50–$1,142 | $1,897–$2,284 | varies |
| Cat Scan Follow-Up Study (76380) | $374.50 | $749 | 4.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $988.50 | $1,977 | 1.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $729.50 | $1,459 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $1,447 | $2,894 | 2.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$100.50–$164 | $201–$328 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$149.50–$188.50 | $299–$377 | varies |
| Chest 3 views (71047) | $143.50 | $287 | 1.7× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$149.50–$232.50 | $299–$465 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$167.50–$368 | $335–$736 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $120 | $240 | 1.2× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$468.50–$579.50 | $937–$1,159 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,129.50–$3,270.50 | $6,259–$6,541 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$487.50–$684.50 | $975–$1,369 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $2,894 | $5,788 | 8.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,415.50–$2,536.50 | $2,831–$5,073 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$849–$1,781.50 | $1,698–$3,563 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,097–$1,316.50 | $2,194–$2,633 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,235.50–$1,448.50 | $2,471–$2,897 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$560–$926.50 | $1,120–$1,853 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,716–$1,827 | $3,432–$3,654 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,259.50–$2,277 | $2,519–$4,554 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$1,259.50–$1,660.50 | $2,519–$3,321 | varies |
| CT angio hrt w/3d image (75574) range across 4 matching MRF lines |
$875–$1,278 | $1,750–$2,556 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,188–$1,881.50 | $2,376–$3,763 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,099–$1,395 | $2,198–$2,790 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,354–$1,827 | $2,708–$3,654 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,259.50 | $2,519 | 7.5× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$949.50–$1,085.50 | $1,899–$2,171 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$560–$589 | $1,120–$1,178 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,085.50–$1,568.50 | $2,171–$3,137 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,099–$1,327 | $2,198–$2,654 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,235.50–$1,531.50 | $2,471–$3,063 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,179.50–$1,294.50 | $2,359–$2,589 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,235.50–$1,421.50 | $2,471–$2,843 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$875–$997.50 | $1,750–$1,995 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$90.50–$99 | $181–$198 | varies |
| CT hrt w/3d image congen (75573) | $1,754 | $3,508 | 5.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,097–$1,294.50 | $2,194–$2,589 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$1,085.50–$1,718 | $2,171–$3,436 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$560–$1,064.50 | $1,120–$2,129 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,097–$2,640 | $2,194–$5,280 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$926.50–$1,085.50 | $1,853–$2,171 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$478.50–$560 | $957–$1,120 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$926.50–$1,097 | $1,853–$2,194 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$560–$711.50 | $1,120–$1,423 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,235.50–$1,531.50 | $2,471–$3,063 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,235.50–$1,531.50 | $2,471–$3,063 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$560–$638 | $1,120–$1,276 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,328.50–$1,531.50 | $2,657–$3,063 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$560–$1,119 | $1,120–$2,238 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,085.50–$1,561.50 | $2,171–$3,123 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,328.50–$1,474.50 | $2,657–$2,949 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,097–$1,294.50 | $2,194–$2,589 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$560–$926.50 | $1,120–$1,853 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,085.50–$1,327 | $2,171–$2,654 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$560–$949.50 | $1,120–$1,899 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,085.50–$1,568.50 | $2,171–$3,137 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$559.50–$1,001.50 | $1,119–$2,003 | varies |
| CT unlisted procedure (76497) | $414 | $828 | 5.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$560–$926.50 | $1,120–$1,853 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,167–$1,531.50 | $2,334–$3,063 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,097–$1,294.50 | $2,194–$2,589 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 5 matching MRF lines |
$1,136.50–$1,776.50 | $2,273–$3,553 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$1,259.50–$1,440.50 | $2,519–$2,881 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,259.50 | $2,519 | 3.8× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,259.50–$1,715.50 | $2,519–$3,431 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $460 | $920 | 2.0× |
| Dilation ureters/urethra rs&i (74485) | $1,891.50 | $3,783 | 0.9× |
| Discography Cerv/Thor Spine (72285) | $3,343.50 | $6,687 | 1.8× |
| Diskography lumbar (72295) | $3,610.50 | $7,221 | 1.9× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$338–$360.50 | $676–$721 | varies |
| Echo exam uterus (76831) | $365 | $730 | 1.6× |
| Echo Guide For Artery Repair (76936) | $365.50 | $731 | 1.8× |
| Echograp Trans R Pros Study (76873) | $369.50 | $739 | 3.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$360–$394 | $720–$788 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$214–$215 | $428–$430 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$442.50–$477.50 | $885–$955 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $366.50 | $733 | 1.6× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$337.50–$446.50 | $675–$893 | varies |
| Follow-Up Angiography (75898) | $2,870 | $5,740 | 0.9× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$160.50–$368 | $321–$736 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$160.50–$184 | $321–$368 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,138.50–$1,146 | $2,277–$2,292 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,102 | $2,204 | 2.9× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,238.50–$1,422 | $2,477–$2,844 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$184–$368 | $368–$736 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,331 | $8,662 | 6.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,893.50 | $7,787 | 5.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 3 matching MRF lines |
$1,421–$2,842 | $2,842–$5,684 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$945–$1,047 | $1,890–$2,094 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$622–$1,047 | $1,244–$2,094 | varies |
| Ht Musc Image Planar Mult (78454) | $2,688.50 | $5,377 | 2.2× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,091–$2,688.50 | $4,182–$5,377 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$880–$923 | $1,760–$1,846 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$224.50–$442.50 | $449–$885 | varies |
| Infusion Ivp (74410) | $670 | $1,340 | 4.0× |
| Interstitial radiation source applic complex (77778) | $4,807 | $9,614 | 7.2× |
| K Flow/Funct Image Multiple (78709) | $2,375 | $4,750 | 4.6× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,287.50–$1,401 | $2,575–$2,802 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,235–$1,287.50 | $2,470–$2,575 | varies |
| Kidney Imaging Morphol (78700) | $873 | $1,746 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $921.50 | $1,843 | 2.4× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$184–$403 | $368–$806 | varies |
| Leveen/Shunt Patency Exam (78291) | $692.50 | $1,385 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $794 | $1,588 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,134 | $2,268 | 2.2× |
| Lung perfusion differential (78597) | $661.50 | $1,323 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$719–$1,134 | $1,438–$2,268 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$610.50–$907.50 | $1,221–$1,815 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,381–$1,730.50 | $2,762–$3,461 | varies |
| Mammary ductogram or galactogram multiple (77054) | $345.50 | $691 | 1.5× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$273.50–$567.50 | $547–$1,135 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$873–$1,273 | $1,746–$2,546 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$950–$2,490 | $1,900–$4,980 | varies |
| Mr safety determination physician/other qhp (76016) | $292.50 | $585 | 3.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $30 | $60 | 1.1× |
| Mr safety implt pos&/immoblj (76019) | $72.50 | $145 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $111.50 | $223 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,455.50–$2,665 | $4,911–$5,330 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,025.50–$1,467.50 | $2,051–$2,935 | varies |
| MRA head with contrast (70545) | $2,005 | $4,010 | 6.0× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,005–$2,116.50 | $4,010–$4,233 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,974–$2,185 | $3,948–$4,370 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,467.50–$1,991 | $2,935–$3,982 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,886–$2,116.50 | $3,772–$4,233 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,381–$1,991 | $2,762–$3,982 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,367–$1,886 | $2,734–$3,772 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,527–$1,974 | $3,054–$3,948 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,060–$1,886 | $2,120–$3,772 | varies |
| MRI bone marrow blood supply (77084) | $1,232.50 | $2,465 | 5.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,035 | $2,070 | 4.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,035 | $2,070 | 4.5× |
| MRI cardiac w/o contrast (75557) | $358 | $716 | 1.6× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,042.50–$2,941.50 | $4,085–$5,883 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,467.50–$1,987.50 | $2,935–$3,975 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,381–$1,991 | $2,762–$3,982 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,886–$2,116.50 | $3,772–$4,233 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,974–$2,428 | $3,948–$4,856 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,886–$1,916.50 | $3,772–$3,833 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,309.50–$2,573 | $4,619–$5,146 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,381–$1,780 | $2,762–$3,560 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,886–$2,597 | $3,772–$5,194 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,005–$2,885.50 | $4,010–$5,771 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,467.50–$1,991 | $2,935–$3,982 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,005–$2,116.50 | $4,010–$4,233 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,372–$2,455.50 | $4,744–$4,911 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,886–$2,048 | $3,772–$4,096 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,974–$2,707 | $3,948–$5,414 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,381–$1,942.50 | $2,762–$3,885 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,381–$1,981 | $2,762–$3,962 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,886–$1,916.50 | $3,772–$3,833 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,381–$1,780 | $2,762–$3,560 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,626–$2,573 | $3,252–$5,146 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,974–$2,885.50 | $3,948–$5,771 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,886–$3,098.50 | $3,772–$6,197 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,886–$2,885.50 | $3,772–$5,771 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,381–$1,602.50 | $2,762–$3,205 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,279–$2,309.50 | $2,558–$4,619 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,886–$3,009.50 | $3,772–$6,019 | varies |
| Myelogram cervical (72240) | $1,394.50 | $2,789 | 1.9× |
| Myelogram Lumbar (72265) | $1,216 | $2,432 | 1.6× |
| Myelography thoracic (72255) | $1,305.50 | $2,611 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,847 | $3,694 | 2.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $754.50 | $1,509 | 2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,366.50 | $8,733 | 3.5× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,054.50 | $2,109 | 2.0× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,812–$2,945 | $5,624–$5,890 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,104.50 | $6,209 | 2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,104.50 | $6,209 | 2.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,840.50 | $9,681 | 2.3× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,840.50 | $9,681 | 2.3× |
| N-invas est c ffr sw aly CTA (75580) | $2,073 | $4,146 | 2.5× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$100.50–$194.50 | $201–$389 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $739.50 | $1,479 | 2.0× |
| Nm csf leak detection (78650) | $2,137 | $4,274 | 1.7× |
| Nm myocard infarct spect (78469) | $1,507 | $3,014 | 2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$4,437–$4,650.50 | $8,874–$9,301 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,159–$1,292.50 | $2,318–$2,585 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $493 | $986 | 4.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$162.50–$204.50 | $325–$409 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $51 | $102 | 1.8× |
| Optic foramina (70190) | $193.50 | $387 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,134 | $2,268 | 2.2× |
| Parathyroid Planar Imaging (78070) | $787 | $1,574 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 3 matching MRF lines |
$1,153–$1,651.50 | $2,306–$3,303 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$149.50–$249 | $299–$498 | varies |
| Perineogram (74775) range across 2 matching MRF lines |
$413.50–$537 | $827–$1,074 | varies |
| Peritoneogram Rs&I (74190) | $1,114.50 | $2,229 | 2.1× |
| Pet Image Skull-Thigh (78812) | $2,772.50 | $5,545 | 2.0× |
| Pet Image W/Ct Lmtd (78814) | $4,366.50 | $8,733 | 3.2× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,102–$5,061 | $8,204–$10,122 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$4,320.50–$4,555.50 | $8,641–$9,111 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,448.50 | $4,897 | 2.0× |
| PET whole body (78813) | $2,772.50 | $5,545 | 2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$988.50–$1,121 | $1,977–$2,242 | varies |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,069.50 | $2,139 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$329–$335.50 | $658–$671 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$533.50–$685 | $1,067–$1,370 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$168.50–$368 | $337–$736 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$160.50–$184 | $321–$368 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$179–$403 | $358–$806 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$213.50–$241.50 | $427–$483 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$160.50–$368 | $321–$736 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$168.50–$368 | $337–$736 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$184–$368 | $368–$736 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$138.50–$153.50 | $277–$307 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$213.50–$283 | $427–$566 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$161–$213.50 | $322–$427 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$187–$220.50 | $374–$441 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$179–$368 | $358–$736 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$200–$213.50 | $400–$427 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $499.50 | $999 | 3.0× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$134–$213.50 | $268–$427 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$210–$213.50 | $420–$427 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$222.50–$224.50 | $445–$449 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$160.50–$184 | $321–$368 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$138.50–$153.50 | $277–$307 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$168.50–$403 | $337–$806 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$263–$390 | $526–$780 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,175.50 | $14,351 | 1.0× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$495–$989 | $990–$1,978 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$954.50–$1,572.50 | $1,909–$3,145 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$484–$1,747 | $968–$3,494 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$213.50–$235 | $427–$470 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $224 | $448 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $603 | $1,206 | 3.6× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$391.50–$445.50 | $783–$891 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$354–$382.50 | $708–$765 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$184–$368 | $368–$736 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$210–$328 | $420–$656 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$400.50–$402 | $801–$804 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$303–$394 | $606–$788 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$316.50–$498 | $633–$996 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$123.50–$194 | $247–$388 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$154–$338 | $308–$676 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$175–$403 | $350–$806 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$164.50–$184 | $329–$368 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $283 | $566 | 0.5× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,292.50 | $2,585 | 5.8× |
| Renal Cyst Study (74470) | $678.50 | $1,357 | 1.3× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$313–$329 | $626–$658 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$772.50–$852.50 | $1,545–$1,705 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$772.50–$1,702.50 | $1,545–$3,405 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,681.50 | $5,363 | 5.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,590.50–$2,681.50 | $3,181–$5,363 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$1,873–$2,868 | $3,746–$5,736 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,681.50 | $5,363 | 2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,104.50 | $6,209 | 2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$1,910.50–$2,736 | $3,821–$5,472 | varies |
| Rp Therapy Intravenous Administration (79101) | $952.50 | $1,905 | 4.3× |
| Scapula (73010) range across 4 matching MRF lines |
$184–$368 | $368–$736 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
$34.50–$74.50 | $69–$149 | varies |
| Sella turcica (70240) | $130.50 | $261 | 1.6× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$184–$220.50 | $368–$441 | varies |
| Shoulder Arthrography (73040) | $1,002.50 | $2,005 | 3.0× |
| Sialogram (70390) | $698 | $1,396 | 3.0× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$167.50–$213.50 | $335–$427 | varies |
| Special dosimetry (77331) | $414 | $828 | 3.2× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$336–$585 | $672–$1,170 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$978.50–$1,319.50 | $1,957–$2,639 | varies |
| Special treatment procedure (77470) range across 3 matching MRF lines |
$1,688.50–$2,120 | $3,377–$4,240 | varies |
| Srs Multisource (77371) | $8,973.50 | $17,947 | 1.3× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$2,077.50–$3,571.50 | $4,155–$7,143 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$213.50–$216 | $427–$432 | varies |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $130.50 | $261 | 1.3× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $130.50 | $261 | 1.3× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $47.50 | $95 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$973.50–$1,269.50 | $1,947–$2,539 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$484–$562.50 | $968–$1,125 | varies |
| Testicular Imaging W/Flow (78761) | $918.50 | $1,837 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,319.50–$1,578 | $2,639–$3,156 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,231–$1,456 | $2,462–$2,912 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$580–$585 | $1,160–$1,170 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$229.50–$231.50 | $459–$463 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$213.50–$234.50 | $427–$469 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$173.50–$213.50 | $347–$427 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $546 | $1,092 | 1.4× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,399–$1,560.50 | $2,798–$3,121 | varies |
| Thyroid Uptake Measurement (78012) | $406 | $812 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$256.50–$763.50 | $513–$1,527 | varies |
| Tx Devices Design & Construction Complex (77334) range across 5 matching MRF lines |
$787.50–$5,721 | $1,575–$11,442 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$665.50–$953.50 | $1,331–$1,907 | varies |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$715.50–$1,900 | $1,431–$3,800 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$206–$412 | $412–$824 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$407.50–$438 | $815–$876 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$232–$820 | $464–$1,640 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$316.50–$438.50 | $633–$877 | varies |
| Ureteral Reflux Study (78740) | $609 | $1,218 | 1.6× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$649.50–$684.50 | $1,299–$1,369 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$395.50–$595.50 | $791–$1,191 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$255.50–$511 | $511–$1,022 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$345–$410 | $690–$820 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$235–$528 | $470–$1,056 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$279–$442.50 | $558–$885 | varies |
| Us head (76506) range across 3 matching MRF lines |
$375.50–$442.50 | $751–$885 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$470.50–$718 | $941–$1,436 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 9 matching MRF lines |
$121–$954 | $242–$1,908 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$286–$415.50 | $572–$831 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$120.50–$511 | $241–$1,022 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$381.50–$442.50 | $763–$885 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$286–$331 | $572–$662 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$251–$313.50 | $502–$627 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$455.50–$659.50 | $911–$1,319 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$329–$451 | $658–$902 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$356.50–$442.50 | $713–$885 | varies |
| Us spinal canal and contents (76800) | $437.50 | $875 | 4.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$349–$896 | $698–$1,792 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$442.50–$479.50 | $885–$959 | varies |
| Vein X-Ray Chest (75827) | $3,492 | $6,984 | 2.3× |
| Vein X-Ray Spleen/Liver (75810) | $2,870 | $5,740 | 0.9× |
| Venogram Sinus/Jugular (75860) | $1,698 | $3,396 | 0.6× |
| Venography Adrenal Unilateral (75840) | $2,870 | $5,740 | 0.9× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$3,270.50–$3,762.50 | $6,541–$7,525 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$1,802.50–$2,201.50 | $3,605–$4,403 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$1,310.50–$1,802.50 | $2,621–$3,605 | varies |
| Venography Renal Bilateral (75833) | $3,621.50 | $7,243 | 1.2× |
| Venography Renal Unilateral (75831) | $2,870 | $5,740 | 0.9× |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$5,039–$5,039.50 | $10,078–$10,079 | varies |
| Venous thrombosis imaging (78457) | $762.50 | $1,525 | 1.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,153 | $2,306 | 3.0× |
| Vertebral fracture assessment via dxa (77086) | $172 | $344 | 2.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$159.50–$198 | $319–$396 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$167.50–$209 | $335–$418 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$799.50–$1,141.50 | $1,599–$2,283 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$2,006–$3,270.50 | $4,012–$6,541 | varies |
| X-Ray Bend Only L-S Spine (72120) | $359 | $718 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$169.50–$184 | $339–$368 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$386.50–$773.50 | $773–$1,547 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $123.50 | $247 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$138.50–$185.50 | $277–$371 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$258–$271.50 | $516–$543 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$123.50–$244.50 | $247–$489 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$155–$160.50 | $310–$321 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$185.50–$231 | $371–$462 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$185.50–$229.50 | $371–$459 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$230–$271.50 | $460–$543 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$225.50–$383 | $451–$766 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $338 | $676 | 3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$193.50–$213.50 | $387–$427 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$321–$367.50 | $642–$735 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$219–$247 | $438–$494 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$160.50–$367 | $321–$734 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$179–$368 | $358–$736 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$684.50–$877.50 | $1,369–$1,755 | varies |
| X-ray IV pyelogram+tomography (74415) | $715 | $1,430 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $208.50 | $417 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $316.50 | $633 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$203.50–$213.50 | $407–$427 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$285–$367.50 | $570–$735 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$200–$213.50 | $400–$427 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$179–$213.50 | $358–$427 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$213.50–$224.50 | $427–$449 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$274.50–$367.50 | $549–$735 | varies |
| X-Ray Stress View (77071) | $117 | $234 | 1.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$213.50–$293.50 | $427–$587 | varies |
| X-Ray Tmj Unilat (70328) | $220.50 | $441 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$684.50–$838 | $1,369–$1,676 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$235–$367.50 | $470–$735 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$359.50–$367.50 | $719–$735 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$274.50–$402.50 | $549–$805 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$193.50–$213.50 | $387–$427 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$213.50–$241.50 | $427–$483 | varies |
| Xr Tomogram Single Plane (76100) | $385 | $770 | 3.8× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.