Imaging prices at Cape Fear Valley Hoke Hospital
Raeford, NC · every code in this section with a posted price and a Medicare benchmark.
361 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) | $3,818.40 | $6,364 | 2.8× |
| Abdomen 1 View (74018) | $234 | $390 | 2.7× |
| Abdomen 2 views (74019) | $276 | $460 | 2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $693.60 | $1,156 | 1.7× |
| Angio pulmonary bilat (75743) | $3,145.20 | $5,242 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $4,145.40 | $6,909 | 1.3× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,842.40–$7,684.50 | $6,404–$12,807.50 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,842.40 | $6,404 | 1.2× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$232.20–$621.90 | $387–$1,036.50 | varies |
| Artery X-Rays Abdomen (75726) | $5,971.80 | $9,953 | 1.1× |
| Artery X-Rays Adrenal Gland (75731) | $4,296.60 | $7,161 | 1.4× |
| Artery X-Rays Pelvis (75736) | $6,387.60 | $10,646 | 1.2× |
| Artery X-Rays Spine (75705) | $6,169.80 | $10,283 | 1.1× |
| Arthrogram ankle (73615) | $518.40 | $864 | 1.5× |
| Arthrogram Wrist (73115) | $518.40 | $864 | 1.5× |
| Basic radiation dosimetry calculation (77300) | $364.80 | $608 | 2.7× |
| Bone age studies (77072) | $135 | $225 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,378.20 | $2,297 | 3.5× |
| Bone Imaging Limited Area (78300) | $766.80 | $1,278 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $534.60 | $891 | 1.3× |
| Bone Imaging Whole Body (78306) | $1,114.20 | $1,857 | 2.8× |
| Bone marrow imaging limited area (78102) | $697.80 | $1,163 | 1.8× |
| Bone survey infant (77076) | $105 | $175 | 1.0× |
| Brachytx isodose intermed (77317) | $650.40 | $1,084 | 1.7× |
| Brachytx Isodose Plan Simple (77316) | $503.40 | $839 | 1.4× |
| Brain Flow Imaging Only (78610) | $504 | $840 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $657.60 | $1,096 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,122.40 | $5,204 | 2.2× |
| Cat Scan Follow-Up Study (76380) | $757.80 | $1,263 | 8.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $490.20 | $817 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $966 | $1,610 | 1.8× |
| Chest 1 view (71045) | $162.60 | $271 | 1.9× |
| Chest 2 views (71046) | $196.20 | $327 | 2.3× |
| Chest 3 views (71047) | $201 | $335 | 2.3× |
| Chest 4 or more views (71048) | $202.20 | $337 | 1.9× |
| Cisternography Positive Contrast Rs&I (70015) | $955.20 | $1,592 | 1.2× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$231–$618.30 | $385–$1,030.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $127.80 | $213 | 1.2× |
| Continuing medical physics consltj pr wk (77336) | $484.20 | $807 | 3.6× |
| Contrast Exam Abdominl Aorta (75625) | $4,468.80 | $7,448 | 1.4× |
| Contrast X-Ray Bladder (74430) | $463.80 | $773 | 1.3× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$541.80–$606.60 | $903–$1,011 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$435.60–$870.60 | $726–$1,451 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,865.20 | $6,442 | 11.1× |
| CT abdomen and pelvis without contrast (74176) | $2,807.40 | $4,679 | 11.8× |
| CT abdomen w contrast (74160) | $2,179.20 | $3,632 | 12.5× |
| CT abdomen w wo contrast (74170) | $2,598.60 | $4,331 | 14.9× |
| CT abdomen w/o contrast (74150) | $1,894.80 | $3,158 | 18.2× |
| CT Angio Abdomen and Pelvis (74174) | $897.60 | $1,496 | 2.6× |
| CT Angio Chest (71275) | $2,010.60 | $3,351 | 11.5× |
| CT Angio Head (70496) | $1,834.80 | $3,058 | 10.5× |
| CT angio hrt w/3d image (75574) | $532.80 | $888 | 1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,648.80–$4,417.20 | $2,748–$7,362 | varies |
| CT Angio Neck (70498) | $2,222.40 | $3,704 | 12.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,536–$3,072 | $2,560–$5,120 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $600 | $1,000 | 3.4× |
| CT cervical spine w/ contrast (72126) | $1,636.80 | $2,728 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,486.80 | $2,478 | 14.3× |
| CT cervical spine w/wo cont (72127) | $1,485 | $2,475 | 8.5× |
| CT chest w contrast (71260) | $1,714.80 | $2,858 | 9.8× |
| CT chest w/wo contrast (71270) | $1,432.20 | $2,387 | 8.2× |
| CT head/brain with contrast (70460) | $1,641.60 | $2,736 | 9.4× |
| CT head/brain without and with contrast (70470) | $1,864.80 | $3,108 | 10.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $390 | $650 | 1.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $259.20 | $432 | 3.0× |
| CT hrt w/3d image congen (75573) | $348 | $580 | 1.0× |
| CT iac w contrast (70481) | $1,712.40 | $2,854 | 9.8× |
| CT l-spine w&w/o contrast (72133) | $1,646.40 | $2,744 | 9.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,026.60–$1,833 | $1,711–$3,055 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,204.20–$2,149.80 | $2,007–$3,583 | varies |
| CT lumbar spine w contrast (72132) | $1,884 | $3,140 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,559.40 | $2,599 | 15.0× |
| CT maxillofacial w contrast (70487) | $1,665.60 | $2,776 | 9.5× |
| CT maxillofacial wo contrast (70486) | $1,357.80 | $2,263 | 13.0× |
| CT neck tissue combo (70492) | $1,909.80 | $3,183 | 10.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,882.20 | $3,137 | 10.8× |
| CT orbits w/o contrast (70480) | $1,394.40 | $2,324 | 13.4× |
| CT pelvis w&w/o contrast (72194) | $1,725 | $2,875 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,297.20 | $2,162 | 12.5× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,016.40–$2,032.80 | $1,694–$3,388 | varies |
| CT scans face/jaw combo (70488) | $1,785.60 | $2,976 | 10.2× |
| CT soft tissue neck w contrast (70491) | $1,751.40 | $2,919 | 10.0× |
| CT soft tissue neck w/o contrast (70490) | $1,428.60 | $2,381 | 13.7× |
| CT thoracic spine w contrast (72129) | $1,677 | $2,795 | 9.6× |
| CT thoracic spine w/o contrast (72128) | $1,369.20 | $2,282 | 13.2× |
| CT thoracic spine w/wo cont (72130) | $1,891.20 | $3,152 | 10.8× |
| CT thorax w/o contrast (71250) | $1,332.60 | $2,221 | 12.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,318.80–$2,355 | $2,198–$3,925 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,016.40–$2,032.80 | $1,694–$3,388 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,341.60–$3,594.60 | $2,236–$5,991 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,732.20 | $2,887 | 9.9× |
| Cta Abdomen (74175) | $3,152.40 | $5,254 | 18.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,600 | $6,000 | 10.4× |
| CTA pelvis (72191) | $2,059.80 | $3,433 | 11.8× |
| Diskography lumbar (72295) | $3,175.80 | $5,293 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $114.60 | $191 | 1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $462.60 | $771 | 4.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $190.80 | $318 | 1.8× |
| Dxa Bone Density Axial (77080) | $451.20 | $752 | 4.3× |
| Echograp Trans R Pros Study (76873) | $537 | $895 | 5.2× |
| Esophagram (74220) | $438 | $730 | 2.5× |
| Fetal Biophys Profile W/Nst (76818) | $651 | $1,085 | 6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $291.60 | $486 | 2.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $463.80 | $773 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $792.60 | $1,321 | 3.3× |
| Follow-Up Angiography (75898) | $1,651.80 | $2,753 | 0.5× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$242.40–$648.90 | $404–$1,081.50 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$271.80–$815.40 | $453–$1,359 | varies |
| Gastric emptying imaging study (78264) | $1,239 | $2,065 | 3.1× |
| Gastroesophageal Reflux Exam (78262) | $604.80 | $1,008 | 1.5× |
| Gated Heart Planar Single (78472) | $1,106.40 | $1,844 | 2.8× |
| Gated Heart, Multiple (78473) | $1,471.20 | $2,452 | 3.7× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$221.40–$592.20 | $369–$987 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,104.20 | $3,507 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,608.60 | $2,681 | 2.3× |
| Heart first pass single,planar (78481) | $790.20 | $1,317 | 1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,188.60 | $6,981 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,242.60 | $7,071 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $415.20 | $692 | 0.8× |
| Hepatobiliary System Imaging (78226) | $1,383.60 | $2,306 | 3.5× |
| Ht Muscle Image Spect Sing (78451) | $2,371.20 | $3,952 | 1.8× |
| Hysterosalpingogram (74740) | $374.40 | $624 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $669.60 | $1,116 | 7.7× |
| Infant hip ultrasound, limited static exam (76886) | $514.80 | $858 | 5.9× |
| K Flow/Funct Image W/Drug (78708) | $1,620 | $2,700 | 3.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,050.60 | $1,751 | 1.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$298.80–$895.50 | $498–$1,492.50 | varies |
| Leveen/Shunt Patency Exam (78291) | $753 | $1,255 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $637.80 | $1,063 | 1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $526.20 | $877 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) | $400.20 | $667 | 0.7× |
| Lung perfusion differential (78597) | $255.60 | $426 | 0.6× |
| Lung Ventilat&Perfus Imaging (78582) | $503.40 | $839 | 0.9× |
| Lung Ventilation Imaging (78579) | $255.60 | $426 | 0.6× |
| Lymph System Imaging (78195) | $1,497 | $2,495 | 2.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,242.60 | $7,071 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $1,788 | $2,980 | 7.5× |
| Magnetic Resonance Elastography (76391) | $325.20 | $542 | 1.4× |
| Meckels Divert Exam (78290) | $993.60 | $1,656 | 2.5× |
| Mlc imrt design & construction per imrt plan (77338) | $520.80 | $868 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,550.20 | $5,917 | 10.2× |
| MRA head w/o contrast (70544) | $3,049.80 | $5,083 | 12.8× |
| MRA neck w contrast (70548) | $2,462.40 | $4,104 | 7.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,008.60 | $6,681 | 11.5× |
| MRA neck w/o contrast (70547) | $2,841.60 | $4,736 | 12.0× |
| MRI abdomen w contrast (74182) | $4,726.80 | $7,878 | 13.6× |
| MRI abdomen w/o contrast (74181) | $2,372.40 | $3,954 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,251.80–$4,503.60 | $3,753–$7,506 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,925–$5,850 | $4,875–$9,750 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,913.60–$5,203.20 | $4,856–$8,672 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $345.60 | $576 | 1.5× |
| MRI cervical spine w contrast (72142) | $2,807.40 | $4,679 | 8.1× |
| MRI cervical spine w/o cont (72141) | $3,091.80 | $5,153 | 13.0× |
| MRI chest w/o contrast (71550) | $2,878.80 | $4,798 | 12.1× |
| MRI chest wo w contrast (71552) | $3,975 | $6,625 | 11.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,192.20 | $1,987 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,823–$5,645.40 | $4,705–$9,409 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,115–$4,141.80 | $3,525–$6,903 | varies |
| MRI lumbar spine w contrast (72149) | $3,442.80 | $5,738 | 9.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,092.60 | $6,821 | 11.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,508.20 | $5,847 | 14.8× |
| MRI orbit face neck w contrast (70542) | $1,508.40 | $2,514 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,642.80 | $7,738 | 13.4× |
| MRI pelvis w contrast (72196) | $518.40 | $864 | 1.5× |
| MRI pelvis w/o & w contrast (72197) | $4,187.40 | $6,979 | 12.1× |
| MRI pelvis w/o contrast (72195) | $3,033 | $5,055 | 12.8× |
| MRI thoracic spine w/o contrast (72146) | $3,234 | $5,390 | 13.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,692–$3,161.40 | $2,820–$5,269 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$1,950–$3,899.40 | $3,250–$6,499 | varies |
| MRI, abdomen, combo (74183) | $5,437.80 | $9,063 | 15.7× |
| MRI, dorsal spine combo (72157) | $4,462.20 | $7,437 | 12.8× |
| MRI, dorsal spine contrast (72147) | $2,914.20 | $4,857 | 8.4× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,233.20–$4,467 | $3,722–$7,445 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,890.80–$5,781.60 | $4,818–$9,636 | varies |
| MRI, lumbar spine combo (72158) | $4,239 | $7,065 | 12.2× |
| Myelogram cervical (72240) | $1,059 | $1,765 | 1.4× |
| Myelogram Lumbar (72265) | $1,059.60 | $1,766 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,258.20 | $2,097 | 1.6× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $574.80 | $958 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $4,107.60 | $6,846 | 3.2× |
| Neck soft tissue (70360) | $235.20 | $392 | 2.7× |
| Nm csf leak detection (78650) | $960 | $1,600 | 0.7× |
| Nm myocard infarct spect (78469) | $1,386.60 | $2,311 | 2.6× |
| Nonvascular Shunt X-Ray (75809) | $396.60 | $661 | 3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,917.40 | $6,529 | 2.8× |
| Nuclear Rx Intra-Arterial (79445) | $534.60 | $891 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $1,041.60 | $1,736 | 4.5× |
| Panoramic X-ray of jaws (70355) | $247.80 | $413 | 2.9× |
| Parathyroid Planar Imaging (78070) | $841.20 | $1,402 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $574.80 | $958 | 1.4× |
| Pelvis 1 or 2 views (72170) | $267 | $445 | 2.6× |
| Pet Image Skull-Thigh (78812) | $3,427.20 | $5,712 | 2.4× |
| Pet Image W/Ct Lmtd (78814) | $3,683.40 | $6,139 | 2.6× |
| PET image w/CT, full body (78816) | $4,125 | $6,875 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,952.20 | $6,587 | 2.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,854 | $3,090 | 1.4× |
| PET whole body (78813) | $3,427.20 | $5,712 | 2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,242.60 | $7,071 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $991.80 | $1,653 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $439.20 | $732 | 4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $390.60 | $651 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$298.80–$895.50 | $498–$1,492.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$241.80–$647.10 | $403–$1,078.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$372–$1,116 | $620–$1,860 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $369.60 | $616 | 3.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$198–$360 | $330–$600 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$299.40–$898.20 | $499–$1,497 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$279–$837 | $465–$1,395 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$140.40–$420.30 | $234–$700.50 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $190.80 | $318 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $257.40 | $429 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$243–$651.60 | $405–$1,086 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$327–$981 | $545–$1,635 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $258 | $430 | 3.0× |
| Radex Spine 1 View Specify Level (72020) | $270.60 | $451 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $279.60 | $466 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $451.20 | $752 | 5.2× |
| Radex Toe Minimum 2 Views (73660) | $190.80 | $318 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$257.40–$515.40 | $429–$859 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$236.40–$710.10 | $394–$1,183.50 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $325.80 | $543 | 3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,799.60 | $24,666 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $353.40 | $589 | 3.5× |
| Radiation treatment delivery level 2 (77407) | $576 | $960 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $607.80 | $1,013 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $372.60 | $621 | 3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $326.40 | $544 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $779.40 | $1,299 | 4.5× |
| Radiologic exam colon single contrast study (74270) | $639.60 | $1,066 | 3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $289.20 | $482 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$294–$879.30 | $490–$1,465.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $154.20 | $257 | 1.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $424.80 | $708 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $391.20 | $652 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $558 | $930 | 3.2× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$115.20–$309.60 | $192–$516 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$115.20–$346.50 | $192–$577.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$253.20–$507 | $422–$845 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $173.40 | $289 | 1.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$226.80–$658.80 | $378–$1,098 | varies |
| Ribs bilateral 3 views (71110) | $333 | $555 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,039.20 | $1,732 | 2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,183.80 | $1,973 | 3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,020.80 | $3,368 | 3.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,506 | $2,510 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $931.20 | $1,552 | 1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,804.80 | $3,008 | 1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,047.20 | $3,412 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,804.80 | $3,008 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $727.80 | $1,213 | 3.1× |
| Salivary Gland Function Study (78232) | $496.80 | $828 | 1.2× |
| Salivary Gland Imaging (78230) | $316.20 | $527 | 0.8× |
| Scapula (73010) range across 3 matching MRF lines |
$204.60–$365.40 | $341–$609 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $50.40 | $84 | 2.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$178.20–$318.60 | $297–$531 | varies |
| Shoulder Arthrography (73040) | $518.40 | $864 | 1.5× |
| Skull less than 4 views (70250) | $300 | $500 | 2.9× |
| Special dosimetry (77331) | $341.40 | $569 | 2.6× |
| Special Physics Consult (77370) | $679.80 | $1,133 | 5.1× |
| Special teletherapy port plan (77321) | $792 | $1,320 | 2.1× |
| Special treatment procedure (77470) | $1,474.80 | $2,458 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $4,022.40 | $6,704 | 2.3× |
| Sternoclavicular joints (71130) | $191.40 | $319 | 2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $790.80 | $1,318 | 2.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $360 | $600 | 1.0× |
| Testicular Imaging W/Flow (78761) | $492 | $820 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,213.80 | $2,023 | 3.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $796.20 | $1,327 | 2.1× |
| Ther rad simulaj-aided field setting simple (77280) | $594.60 | $991 | 4.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $451.20 | $752 | 2.6× |
| Thoracic spine 2 views (72070) | $312 | $520 | 3.0× |
| Thoracic spine 3 views (72072) | $324 | $540 | 3.1× |
| Thoracolumbar 2 views (72080) | $303 | $505 | 3.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $480 | $800 | 1.2× |
| Thyroid Imaging With Vascular Flow (78013) | $227.40 | $379 | 0.6× |
| Thyroid Met Imaging Body (78018) | $1,816.20 | $3,027 | 3.4× |
| Thyroid Uptake Measurement (78012) | $172.80 | $288 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $444.60 | $741 | 1.1× |
| Tx Devices Design & Construction Complex (77334) | $871.20 | $1,452 | 2.3× |
| Tx devices design & construction intermediate (77333) | $528 | $880 | 3.9× |
| Tx devices design & construction simple (77332) | $384.60 | $641 | 2.9× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$168–$495.90 | $280–$826.50 | varies |
| Ultrasound Exam Aaa Screen (76706) | $215.40 | $359 | 2.1× |
| Ultrasound, abdomen limited (76705) | $579.60 | $966 | 5.6× |
| Umbilical-artery Doppler (OB) (76820) | $139.20 | $232 | 1.3× |
| Unlisted Dx Radiographic Procedure (76499) | $109.20 | $182 | 1.3× |
| Unlisted magnetic resonance procedure (76498) | $126 | $210 | 1.5× |
| Upper gi w/o kub (74240) | $545.40 | $909 | 3.1× |
| Ureteral Reflux Study (78740) | $568.20 | $947 | 1.4× |
| Urethrocystogram voiding (74455) | $562.80 | $938 | 2.4× |
| Urethrocystography retrograde (74450) | $463.80 | $773 | 2.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$219.60–$438.60 | $366–$731 | varies |
| Us chest (76604) | $316.80 | $528 | 3.0× |
| Us complete joint (76881) | $477 | $795 | 4.6× |
| Us exam, pelvic, limited (76857) | $314.40 | $524 | 3.0× |
| Us head (76506) | $646.20 | $1,077 | 6.2× |
| Us kidney transplant (76776) | $265.20 | $442 | 2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $491.40 | $819 | 4.7× |
| Us ob detailed single fetus (76811) | $864 | $1,440 | 3.6× |
| Us ob limited 1 or more fetuses (76815) | $318.60 | $531 | 3.1× |
| Us ob transvaginal (76817) | $642 | $1,070 | 6.2× |
| Us pelvic non ob complete (76856) | $631.20 | $1,052 | 6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $642 | $1,070 | 6.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $456.60 | $761 | 4.4× |
| Us retroperitoneal complete (76770) | $706.80 | $1,178 | 6.8× |
| Us retroperitoneal limited (76775) | $402 | $670 | 3.9× |
| Us scrotum and contents (76870) | $543.60 | $906 | 5.2× |
| Us spinal canal and contents (76800) | $774.60 | $1,291 | 7.4× |
| Us thyroid (76536) | $582.60 | $971 | 5.6× |
| Us transrectal (76872) | $153 | $255 | 1.5× |
| Vascular Flow Imaging (78445) | $279.60 | $466 | 0.7× |
| Vein X-Ray Chest (75827) | $1,980 | $3,300 | 1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,199.40 | $6,999 | 1.3× |
| Vein X-Ray Spleen/Liver (75810) | $2,675.40 | $4,459 | 0.9× |
| Venogram Sinus/Jugular (75860) | $3,842.40 | $6,404 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $3,842.40 | $6,404 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,723.20 | $2,872 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,150.80 | $1,918 | 0.7× |
| Venography Renal Unilateral (75831) | $3,842.40 | $6,404 | 1.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $587.40 | $979 | 1.5× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$178.80–$479.70 | $298–$799.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $253.80 | $423 | 2.9× |
| X-Ray Aorta Leg Arteries (75630) | $4,310.40 | $7,184 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $290.40 | $484 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$243.60–$486.60 | $406–$811 | varies |
| X-Ray Exam Breast Specimen (76098) | $637.20 | $1,062 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $246 | $410 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $191.40 | $319 | 1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $325.80 | $543 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$129.60–$347.40 | $216–$579 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$231.60–$648 | $386–$1,080 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$180–$360 | $300–$600 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $192 | $320 | 1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $192 | $320 | 1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $325.80 | $543 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $609.60 | $1,016 | 5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $527.40 | $879 | 6.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $534.60 | $891 | 5.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$322.20–$581.40 | $537–$969 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$244.80–$734.40 | $408–$1,224 | varies |
| X-ray IV pyelogram (ivp) (74400) | $853.80 | $1,423 | 4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $201.60 | $336 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $175.20 | $292 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $310.80 | $518 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $237.60 | $396 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $379.80 | $633 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $195.60 | $326 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $82.80 | $138 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $200.40 | $334 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $388.80 | $648 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $362.40 | $604 | 3.5× |
| X-Ray Stress View (77071) | $126 | $210 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $363 | $605 | 3.5× |
| X-Ray Tmj Unilat (70328) | $114.60 | $191 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,003.20 | $1,672 | 2.9× |
| X-Rays Bone Length Studies (77073) | $230.40 | $384 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $502.80 | $838 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $682.20 | $1,137 | 6.6× |
| Xr facial bones less than 3 views (70140) | $177 | $295 | 2.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $159.60 | $266 | 1.5× |
| Xr orbits complete 4 views (70200) | $382.80 | $638 | 3.7× |
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.