Imaging prices at Chapman Global Medical Center

Orange, CA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $6,699 $6,699 3.8×
Abdomen 1 View (74018) $484 $484 4.3×
Abdomen 2 views (74019) $652 $652 4.8×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,820 $1,820 3.5×
Angio internal mammary (75756) $17,145 $17,145 4.2×
Angio pulmonary bilat (75743) $17,145 $17,145 4.2×
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines		 $17,145–$25,718 $17,145–$25,718 varies
Angiography extremity unilateral rs&i (75710) $17,145 $17,145 4.2×
Angiography pulmonary unilateral slctv rs&i (75741) $17,145 $17,145 4.2×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $17,145 $17,145 4.2×
Ankle 2 views (73600) $484 $484 4.3×
Aortography thoracic serialography rs&i (75605) $28,561 $28,561 4.0×
Aortography thoracic w/o serialography rs&i (75600) $17,145 $17,145 4.2×
Artery X-Rays Abdomen (75726) $28,561 $28,561 4.0×
Artery X-Rays Pelvis (75736) $28,561 $28,561 4.0×
Artery X-Rays Spine (75705) $28,561 $28,561 4.0×
Arthrogram ankle (73615) $2,206 $2,206 4.9×
Arthrogram hip (73525) $2,206 $2,206 4.9×
Arthrogram Wrist (73115) $2,206 $2,206 4.9×
Basic radiation dosimetry calculation (77300) $673 $673 3.9×
Bone age studies (77072) $652 $652 4.8×
Bone Imaging 3 Phase (78315) $1,838 $1,838 3.6×
Bone Imaging Limited Area (78300) $1,135 $1,135 2.2×
Bone Imaging Multiple Areas (78305) $1,583 $1,583 3.1×
Bone Imaging Whole Body (78306) $1,977 $1,977 3.8×
Bone marrow imaging limited area (78102) $1,308 $1,308 2.5×
Bone survey infant (77076) $652 $652 4.8×
Brain Flow Imaging Only (78610) $564 $564 0.8×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,232 $2,232 3.2×
Brain Imaging Minimum 4 Static Views (78605) $1,881 $1,881 2.7×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $2,944 $2,944 5.7×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $3,093 $3,093 4.4×
Cat Scan Follow-Up Study (76380) $1,688 $1,688 15.1×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $2,094 $2,094 3.0×
Cerebrospinal Fluid Scan (78630) $2,372 $2,372 3.4×
Chest 1 view (71045) $598 $598 5.3×
Chest 2 views (71046) $484 $484 4.3×
Chest 3 views (71047) $484 $484 4.3×
Chest 4 or more views (71048) $652 $652 4.8×
Cholecystography Oral Contrast (74290) $1,070 $1,070 4.7×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $652 $652 4.8×
Cisternography Positive Contrast Rs&I (70015) $4,285 $4,285 4.2×
Clavicle complete (73000)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
Continuing medical physics consltj pr wk (77336) $673 $673 3.9×
Contrast Exam Abdominl Aorta (75625) $17,145 $17,145 4.2×
Contrast X-Ray Bladder (74430) $2,206 $2,206 4.9×
Contrast X-Ray Of Elbow (73085) $2,206 $2,206 4.9×
Contrast X-Ray Of Knee Joint (73580) $2,206 $2,206 4.9×
Contrast Xray Throat/Cerv Esopha (74210) $1,070 $1,070 4.7×
CT abdomen and pelvis without and with contrast (74178) $7,682 $7,682 17.1×
CT abdomen and pelvis without contrast (74176) $5,653 $5,653 18.4×
CT abdomen w contrast (74160) $3,727 $3,727 16.5×
CT abdomen w wo contrast (74170) $3,727 $3,727 16.5×
CT abdomen w/o contrast (74150) $2,271 $2,271 16.9×
CT Angio Abdomen and Pelvis (74174) $7,682 $7,682 17.1×
CT Angio Chest (71275) $3,727 $3,727 16.5×
CT Angio Head (70496) $3,727 $3,727 16.5×
CT angio hrt w/3d image (75574) $3,727 $3,727 8.3×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines		 $3,727–$5,590 $3,727–$5,590 varies
CT Angio Neck (70498) $3,727 $3,727 16.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,727 $3,727 16.5×
CT bone density (77078) $3,095 $3,095 27.7×
CT cervical spine w/ contrast (72126) $7,682 $7,682 17.1×
CT cervical spine w/o contrast (72125) $2,785 $2,785 20.7×
CT cervical spine w/wo cont (72127) $3,727 $3,727 16.5×
CT chest w contrast (71260) $4,558 $4,558 20.2×
CT chest w/wo contrast (71270) $3,727 $3,727 16.5×
CT head/brain with contrast (70460) $3,727 $3,727 16.5×
CT head/brain without and with contrast (70470) $3,727 $3,727 16.5×
CT heart no contrast quant eval coronry calcium (75571) $1,688 $1,688 15.1×
CT iac w contrast (70481) $3,727 $3,727 16.5×
CT l-spine w&w/o contrast (72133) $3,727 $3,727 16.5×
CT lower ext w/o (73700)
range across 3 matching MRF lines		 $2,271–$3,407 $2,271–$3,407 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines		 $3,727–$5,590 $3,727–$5,590 varies
CT lumbar spine w contrast (72132) $7,682 $7,682 17.1×
CT lumbar spine w/o contrast (72131) $2,785 $2,785 20.7×
CT maxillofacial w contrast (70487) $3,727 $3,727 16.5×
CT maxillofacial wo contrast (70486) $2,271 $2,271 16.9×
CT neck tissue combo (70492) $3,727 $3,727 16.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,727 $3,727 16.5×
CT orbits w/o contrast (70480) $2,271 $2,271 16.9×
CT pelvis w&w/o contrast (72194) $3,727 $3,727 16.5×
CT pelvis w/o contrast (72192) $2,271 $2,271 16.9×
CT scan of leg combo (73702)
range across 3 matching MRF lines		 $3,727–$5,590 $3,727–$5,590 varies
CT scans face/jaw combo (70488) $3,727 $3,727 16.5×
CT soft tissue neck w contrast (70491) $3,727 $3,727 16.5×
CT soft tissue neck w/o contrast (70490) $2,271 $2,271 16.9×
CT thoracic spine w contrast (72129) $3,727 $3,727 16.5×
CT thoracic spine w/o contrast (72128) $2,785 $2,785 20.7×
CT thoracic spine w/wo cont (72130) $3,727 $3,727 16.5×
CT thorax w/o contrast (71250) $2,785 $2,785 20.7×
CT upper ext wo (73200)
range across 3 matching MRF lines		 $2,271–$3,407 $2,271–$3,407 varies
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines		 $3,727–$5,590 $3,727–$5,590 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines		 $7,682–$11,524 $7,682–$11,524 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,727 $3,727 16.5×
Cta Abdomen (74175) $3,727 $3,727 16.5×
CTA pelvis (72191) $3,727 $3,727 16.5×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) $1,378 $1,378 4.5×
Dilation ureters/urethra rs&i (74485) $10,724 $10,724 4.0×
Discography Cerv/Thor Spine (72285) $10,517 $10,517 4.2×
Diskography lumbar (72295) $10,517 $10,517 4.2×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $583 $583 4.3×
Doppler Echo Fetal Spectral Display Complete (76827) $988 $988 7.3×
Dxa Bone Density Axial (77080) $652 $652 4.8×
Dxa bone density study (77085) $652 $652 4.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $484 $484 4.3×
Echo exam of fetal heart (76825) $1,398 $1,398 2.0×
Echo exam uterus (76831) $1,296 $1,296 4.2×
Echo Guide For Artery Repair (76936) $1,032 $1,032 3.7×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,022 $1,022 3.3×
Esophagram (74220) $1,070 $1,070 4.7×
Fetal Biophys Profile W/Nst (76818) $1,345 $1,345 10.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,345 $1,345 10.0×
Fluoroscopy up to 1 hr (76000) $1,378 $1,378 4.5×
Follow-Up Angiography (75898) $17,145 $17,145 4.2×
Foot 2 views (73620) $484 $484 4.3×
Forearm 2 views (73090)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
Gastric emptying imaging study (78264) $4,359 $4,359 8.5×
Gastric Mucosa Imaging (78261) $1,516 $1,516 2.9×
Gastroesophageal Reflux Exam (78262) $1,516 $1,516 2.9×
Gastrointestinal Protein Loss (78282) $728 $728 1.4×
Gated Heart Planar Single (78472) $2,352 $2,352 4.6×
Gated Heart, Multiple (78473) $3,517 $3,517 6.8×
Hand 2 views (73120) $652 $652 4.8×
Heart first pass single,planar (78481) $2,254 $2,254 3.2×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $17,145 $17,145 4.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $17,145 $17,145 4.2×
Hepatobil Syst Image W/Drug (78227) $5,728 $5,728 8.2×
Hepatobiliary System Imaging (78226) $4,179 $4,179 8.1×
Ht Musc Image Planar Mult (78454) $2,360 $2,360 1.4×
Ht Muscle Image Spect Sing (78451) $2,831 $2,831 1.7×
Hysterosalpingogram (74740) $1,378 $1,378 4.5×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,305 $1,305 11.7×
Infant hip ultrasound, limited static exam (76886) $1,163 $1,163 10.4×
Infusion Ivp (74410) $1,070 $1,070 4.7×
Joint Survey Single View (77077) $652 $652 4.8×
K Flow/Funct Image Multiple (78709) $2,561 $2,561 3.7×
K Flow/Funct Image W/Drug (78708) $2,182 $2,182 3.1×
K Flow/Funct Image W/O Drug (78707) $2,706 $2,706 3.9×
Kidney Imaging Morphol (78700) $1,092 $1,092 2.1×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,680 $1,680 3.3×
Knee 3 Views (73562) $484 $484 4.3×
Liver & Spleen Imaging Static Only (78215) $1,213 $1,213 2.4×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,596 $1,596 3.1×
Liver imaging static only (78201) $1,092 $1,092 1.6×
Liver imaging w/vascular flow (78202) $1,685 $1,685 2.4×
Lung Perf&Ventilat Diferentl (78598) $3,839 $3,839 5.5×
Lung perfusion differential (78597) $2,490 $2,490 4.8×
Lung Ventilat&Perfus Imaging (78582) $4,079 $4,079 5.8×
Lung Ventilation Imaging (78579) $2,215 $2,215 4.3×
Lymph System Imaging (78195) $2,658 $2,658 3.8×
Lymphangiography extremity only unilateral rs&i (75801) $3,237 $3,237 4.0×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $17,145 $17,145 4.2×
Lymphangiography, pelvic/abdominal, unilateral (75805) $17,145 $17,145 4.2×
Mammary ductogram or galactogram multiple (77054) $1,378 $1,378 4.5×
Mammary ductogram or galactogram single (77053) $1,378 $1,378 4.5×
Meckels Divert Exam (78290) $1,516 $1,516 2.9×
Mlc imrt design & construction per imrt plan (77338) $1,796 $1,796 3.7×
Myelogram cervical (72240) $4,285 $4,285 4.2×
Myelogram Lumbar (72265) $4,285 $4,285 4.2×
Myelography thoracic (72255) $4,285 $4,285 4.2×
Myelograpy 2/more regions rs&i (72270) $4,285 $4,285 4.2×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,227 $1,227 2.4×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $1,626 $1,626 2.3×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $2,476 $2,476 1.5×
Myocardial Spect Multiple Studies (78452) $6,414 $6,414 3.9×
Neck soft tissue (70360) $484 $484 4.3×
Nm csf leak detection (78650) $2,075 $2,075 1.2×
Nm myocard infarct spect (78469) $1,626 $1,626 2.3×
Ntsty modul radthx pln dose-vol histos (77301) $6,699 $6,699 3.8×
Nuclear Rx Oral Admin (79005) $1,670 $1,670 5.6×
Ob us nuchal meas 1 gest (76813) $1,868 $1,868 13.9×
Optic foramina (70190) $484 $484 4.3×
Panoramic X-ray of jaws (70355) $484 $484 4.3×
Parathyroid Planar Imaging (78070) $1,348 $1,348 2.6×
Pelvis 1 or 2 views (72170) $652 $652 4.8×
Peritoneogram Rs&I (74190) $2,894 $2,894 4.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,577 $1,577 3.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $652 $652 4.8×
Radex abscess/fistula/sinus tract rs&i (76080) $2,894 $2,894 4.1×
Radex Ankle Complete Minimum 3 Views (73610) $484 $484 4.3×
Radex Calcaneus Minimum 2 Views (73650) $484 $484 4.3×
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $652 $652 4.8×
Radex fingr minimum 2 views (73140) $484 $484 4.3×
Radex foot complete minimum 3 views (73630) $484 $484 4.3×
Radex Hand Minimum 3 Views (73130) $484 $484 4.3×
Radex lower extremity infant minimum 2 views (73592) $484 $484 4.3×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $652 $652 4.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $484 $484 4.3×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $484 $484 4.3×
Radex Ribs Unilateral 2 Views (71100) $484 $484 4.3×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
Radex Sinuses Paransl < 3 Views (70210) $484 $484 4.3×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $1,070 $1,070 4.7×
Radex Spine 1 View Specify Level (72020) $484 $484 4.3×
Radex Sternum Minimum 2 Views (71120) $484 $484 4.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $484 $484 4.3×
Radex Toe Minimum 2 Views (73660) $484 $484 4.3×
Radex upper extremity infant minimum 2 views (73092) $652 $652 4.8×
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $652 $652 4.8×
Radiation treatment delivery level 1 (77402) $635 $635 4.8×
Radiation treatment delivery level 2 (77407) $1,282 $1,282 2.6×
Radiation treatment delivery level 3 (77412) $1,282 $1,282 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $652 $652 4.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $652 $652 4.8×
Radiologic exam colon double contrast study (74280) $1,070 $1,070 4.7×
Radiologic exam colon single contrast study (74270) $1,070 $1,070 4.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,070 $1,070 4.7×
Radiologic exam knee complete 4/more views (73564) $652 $652 4.8×
Radiologic exam pelvis compl minimum 3 views (72190) $652 $652 4.8×
Radiologic Exam Small Int Single Contrast Study (74250) $1,070 $1,070 4.7×
Radiologic exam swallow function contrast study (74230) $1,070 $1,070 4.7×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $1,378 $1,378 4.5×
Radiologic exam upr gi trc double contrast study (74246) $1,070 $1,070 4.7×
Radiologic examination femur 1 view (73551) $484 $484 4.3×
Radiologic examination femur minimum 2 views (73552) $484 $484 4.3×
Radiologic examination knee 1/2 views (73560) $484 $484 4.3×
Radiologic Examination Osseous Survey Limited (77074) $652 $652 4.8×
Radiologic Examination Salivary Gland Calculus (70380) $484 $484 4.3×
Radiologic examination tibia & fibula 2 views (73590) $484 $484 4.3×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $2,894 $2,894 4.1×
Renal Cyst Study (74470) $2,894 $2,894 4.1×
Ribs bilateral 3 views (71110) $652 $652 4.8×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,250 $1,250 2.4×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,856 $1,856 3.6×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,660 $2,660 3.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,172 $2,172 3.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,172 $2,172 3.1×
Salivary Gland Imaging (78230) $850 $850 1.7×
Salivary Gland Imaging Serial Images (78231) $984 $984 1.9×
Scapula (73010) $652 $652 4.8×
Screening Digital Breast Tomosynthesis Bi (77063) $810 $810 34.6×
Sella turcica (70240) $484 $484 4.3×
Shoulder 1 view (73020) $484 $484 4.3×
Shoulder Arthrography (73040) $2,206 $2,206 4.9×
Sialogram (70390) $1,378 $1,378 4.5×
Skull less than 4 views (70250) $652 $652 4.8×
Special dosimetry (77331) $673 $673 3.9×
Special Physics Consult (77370) $673 $673 3.9×
Special teletherapy port plan (77321) $1,796 $1,796 3.7×
Special treatment procedure (77470) $2,878 $2,878 4.0×
Spleen Imaging (78185) $1,213 $1,213 2.4×
Sternoclavicular joints (71130) $484 $484 4.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,796 $1,796 3.7×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,796 $1,796 3.7×
Testicular Imaging W/Flow (78761) $1,213 $1,213 2.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,796 $1,796 3.7×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,796 $1,796 3.7×
Ther rad simulaj-aided field setting simple (77280) $673 $673 3.9×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $1,070 $1,070 4.7×
Thoracic spine 2 views (72070) $652 $652 4.8×
Thoracic spine 3 views (72072) $652 $652 4.8×
Thoracolumbar 2 views (72080) $484 $484 4.3×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $1,135 $1,135 2.2×
Thyroid Imaging With Vascular Flow (78013) $2,533 $2,533 4.9×
Thyroid Met Imaging Body (78018) $1,820 $1,820 2.6×
Thyroid Uptake Measurement (78012) $2,533 $2,533 4.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,086 $3,086 6.0×
Tx Devices Design & Construction Complex (77334) $1,796 $1,796 3.7×
Tx devices design & construction intermediate (77333) $673 $673 3.9×
Tx devices design & construction simple (77332) $673 $673 3.9×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $1,355–$2,032 $1,355–$2,032 varies
Ultrasound Exam Aaa Screen (76706) $1,466 $1,466 10.9×
Ultrasound, abdomen limited (76705) $1,546 $1,546 11.5×
Umbilical-artery Doppler (OB) (76820) $664 $664 4.9×
Unlisted Dx Radiographic Procedure (76499) $484 $484 4.3×
Upper gi w/o kub (74240) $1,070 $1,070 4.7×
Ureteral Reflux Study (78740) $946 $946 1.8×
Urethrocystogram voiding (74455) $1,378 $1,378 4.5×
Urethrocystography retrograde (74450) $1,378 $1,378 4.5×
Us breast unilateral complete (76641)
range across 3 matching MRF lines		 $1,665–$2,497 $1,665–$2,497 varies
Us chest (76604) $1,040 $1,040 7.7×
Us complete joint (76881) $1,032 $1,032 7.7×
Us exam, pelvic, limited (76857) $723 $723 5.4×
Us head (76506) $1,068 $1,068 7.9×
Us kidney transplant (76776) $1,894 $1,894 14.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $450 $450 3.3×
Us ob detailed single fetus (76811) $2,728 $2,728 8.9×
Us ob limited 1 or more fetuses (76815) $1,080 $1,080 8.0×
Us ob transvaginal (76817) $1,410 $1,410 10.5×
Us pelvic non ob complete (76856) $1,161 $1,161 8.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,345 $1,345 10.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $889 $889 6.6×
Us retroperitoneal complete (76770) $1,385 $1,385 10.3×
Us retroperitoneal limited (76775) $881 $881 6.6×
Us scrotum and contents (76870) $1,026 $1,026 7.6×
Us spinal canal and contents (76800) $1,389 $1,389 10.3×
Us thyroid (76536) $1,025 $1,025 7.6×
Us transrectal (76872) $1,161 $1,161 8.6×
Vascular Flow Imaging (78445) $1,694 $1,694 3.3×
Vasogram (74440) $1,378 $1,378 4.5×
Vein X-Ray Chest (75827) $8,422 $8,422 4.2×
Vein X-Ray Liver W/O Hemodyn (75887) $17,145 $17,145 4.2×
Vein X-Ray Skull Epidural (75872) $3,237 $3,237 4.0×
Vein X-Ray Spleen/Liver (75810) $17,145 $17,145 4.2×
Venogram Sinus/Jugular (75860) $17,145 $17,145 4.2×
Venography Adrenal Unilateral (75840) $17,145 $17,145 4.2×
Venography caval inferior serialography rs&i (75825) $17,145 $17,145 4.2×
Venography extremity bilateral rs&i (75822) $8,422 $8,422 4.2×
Venography extremity unilateral rs&i (75820) $8,422 $8,422 4.2×
Venography Renal Bilateral (75833) $17,145 $17,145 4.2×
Venography Renal Unilateral (75831) $17,145 $17,145 4.2×
Venous sampling by catheter (75893) $28,561 $28,561 4.0×
Vertebral fracture assessment via dxa (77086) $484 $484 4.3×
Wrist 2 views (73100)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $484 $484 4.3×
X-ray antegrade pyelogram tube (74425) $2,206 $2,206 4.9×
X-Ray Aorta Leg Arteries (75630) $17,145 $17,145 4.2×
X-Ray Bend Only L-S Spine (72120) $652 $652 4.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $484 $484 4.3×
X-Ray Exam Breast Specimen (76098) $2,894 $2,894 4.1×
X-Ray Exam Entire Spi 1 Vw (72081) $484 $484 4.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $652 $652 4.8×
X-Ray Exam Entire Spi 4/5 Vw (72083) $652 $652 4.8×
X-Ray Exam Hip Uni 1 View (73501) $484 $484 4.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $484 $484 4.3×
X-Ray Exam Hip Uni 4/> Views (73503) $652 $652 4.8×
X-Ray Exam Hips Bi 2 Views (73521) $652 $652 4.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $652 $652 4.8×
X-Ray Exam Hips Bi 5/> Views (73523) $652 $652 4.8×
X-Ray Exam L-S Spine Bending (72114) $652 $652 4.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $484 $484 4.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $652 $652 4.8×
X-Ray Exam Unilat Ribs/Chest (71101) $652 $652 4.8×
X-ray eye for foreign body (70030) $484 $484 4.3×
X-ray humerus (73060)
range across 3 matching MRF lines		 $484–$727 $484–$727 varies
X-ray IV pyelogram (ivp) (74400) $1,070 $1,070 4.7×
X-ray IV pyelogram+tomography (74415) $1,070 $1,070 4.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $484 $484 4.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $484 $484 4.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $652 $652 4.8×
X-ray nose-rectum child f.b. (76010) $484 $484 4.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $652 $652 4.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $652 $652 4.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $652 $652 4.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $484 $484 4.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $484 $484 4.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $652 $652 4.8×
X-ray thoracic spine 4 vw (72074) $652 $652 4.8×
X-Ray Tmj Unilat (70328) $484 $484 4.3×
X-Ray Urinary Tract Exam With Contrast Material (74420) $2,206 $2,206 4.9×
X-Rays Bone Length Studies (77073) $652 $652 4.8×
X-Rays Bone Survey Complete (77075) $652 $652 4.8×
Xr c-spine 4 or 5 views (72050) $652 $652 4.8×
Xr facial bones less than 3 views (70140) $484 $484 4.3×
XR Mastoids < 3 Views Bilateral (70120) $652 $652 4.8×
Xr orbits complete 4 views (70200) $652 $652 4.8×
Xr Tomogram Single Plane (76100) $652 $652 4.8×

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.