Imaging prices at Cheyenne Regional Medical Center
Cheyenne, WY · every code in this section with a posted price and a Medicare benchmark.
380 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) | $9,591.25 | $13,701.78 | 6.8× |
| Abdomen 1 View (74018) | $400.25 | $571.78 | 4.5× |
| Abdomen 2 views (74019) | $473.03 | $675.75 | 4.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,906.25 | $2,723.21 | 4.7× |
| Angio pulmonary bilat (75743) | $4,654.48 | $6,649.25 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $5,365.39 | $7,664.83 | 1.7× |
| Angiography extremity unilateral rs&i (75710) | $4,569.33 | $6,527.61 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,279.68 | $1,828.11 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,514.64 | $3,592.34 | 0.8× |
| Ankle 2 views (73600) | $388.97 | $555.66 | 4.4× |
| Aortography thoracic serialography rs&i (75605) | $3,153.70 | $4,505.28 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,307.09 | $4,724.41 | 1.0× |
| Artery X-Rays Abdomen (75726) | $5,199.17 | $7,427.38 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,729.81 | $6,756.87 | 0.8× |
| Arthrogram ankle (73615) | $986.11 | $1,408.72 | 2.8× |
| Arthrogram hip (73525) | $1,152.12 | $1,645.88 | 3.2× |
| Arthrogram Wrist (73115) | $768.53 | $1,097.89 | 2.2× |
| Basic radiation dosimetry calculation (77300) | $891.39 | $1,273.41 | 6.5× |
| Bone age studies (77072) | $436.70 | $623.85 | 4.1× |
| Bone Imaging 3 Phase (78315) | $2,466.29 | $3,523.27 | 6.0× |
| Bone Imaging Limited Area (78300) | $1,252.72 | $1,789.59 | 3.1× |
| Bone Imaging Whole Body (78306) | $2,461.23 | $3,516.04 | 6.0× |
| Bone marrow imaging; whole body (78104) | $975.89 | $1,394.12 | 2.4× |
| Bone survey infant (77076) | $529.61 | $756.58 | 5.0× |
| Brachytx isodose complex (77318) | $3,136.95 | $4,481.35 | 8.2× |
| Brachytx isodose intermed (77317) | $2,442.68 | $3,489.53 | 6.4× |
| Brachytx Isodose Plan Simple (77316) | $1,944.09 | $2,777.27 | 5.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,243.34 | $3,204.77 | 4.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,919.51 | $11,313.58 | 5.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,734.35 | $2,477.64 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,724.20 | $2,463.14 | 4.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,563.26 | $3,661.80 | 3.2× |
| Cat Scan Follow-Up Study (76380) | $971.16 | $1,387.37 | 10.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,515.17 | $2,164.52 | 2.7× |
| Cerebrospinal Fluid Scan (78630) | $1,723.63 | $2,462.32 | 3.1× |
| Chest 1 view (71045) | $288.98 | $412.82 | 3.3× |
| Chest 2 views (71046) | $452.11 | $645.86 | 5.1× |
| Chest 3 views (71047) | $409.68 | $585.25 | 4.6× |
| Chest 4 or more views (71048) | $455.12 | $650.17 | 4.3× |
| Clavicle complete (73000) | $431.05 | $615.78 | 4.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $231.82 | $331.17 | 2.2× |
| Continuing medical physics consltj pr wk (77336) | $1,232.91 | $1,761.30 | 9.0× |
| Contrast Exam Abdominl Aorta (75625) | $4,667.66 | $6,668.08 | 1.4× |
| Contrast X-Ray Bladder (74430) | $658.95 | $941.35 | 1.8× |
| Contrast X-Ray Of Elbow (73085) | $824.79 | $1,178.27 | 2.3× |
| Contrast X-Ray Of Knee Joint (73580) | $790.79 | $1,129.70 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) | $5,934.70 | $8,478.14 | 16.7× |
| CT abdomen and pelvis without contrast (74176) | $4,322.15 | $6,174.50 | 17.7× |
| CT abdomen w contrast (74160) | $2,962.93 | $4,232.75 | 16.5× |
| CT abdomen w wo contrast (74170) | $3,543.85 | $5,062.63 | 19.8× |
| CT abdomen w/o contrast (74150) | $2,498.35 | $3,569.06 | 23.4× |
| CT Angio Abdomen and Pelvis (74174) | $5,112.12 | $7,303.02 | 14.3× |
| CT Angio Chest (71275) | $3,466.16 | $4,951.65 | 19.3× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,358.48–$3,364.79 | $4,797.82–$4,806.83 | varies |
| CT angio hrt w/3d image (75574) | $2,533 | $3,618.56 | 7.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,624.75 | $5,178.21 | 20.2× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$3,226.37–$3,232.42 | $4,609.09–$4,617.74 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,938.85 | $4,198.35 | 16.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $420 | $600 | 2.3× |
| CT cervical spine w/ contrast (72126) | $2,960.42 | $4,229.16 | 8.3× |
| CT cervical spine w/o contrast (72125) | $2,679.32 | $3,827.59 | 25.1× |
| CT cervical spine w/wo cont (72127) | $2,899.59 | $4,142.27 | 16.2× |
| CT chest w contrast (71260) | $2,887.78 | $4,125.40 | 16.1× |
| CT chest w/wo contrast (71270) | $3,370.07 | $4,814.38 | 18.8× |
| CT head/brain with contrast (70460) | $2,603.86 | $3,719.80 | 14.5× |
| CT head/brain without and with contrast (70470) | $3,071.88 | $4,388.39 | 17.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,812.02 | $2,588.60 | 5.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $242.51 | $346.44 | 2.7× |
| CT hrt w/3d image congen (75573) | $2,910.61 | $4,158.01 | 8.2× |
| CT iac w contrast (70481) | $2,653.32 | $3,790.45 | 14.8× |
| CT l-spine w&w/o contrast (72133) | $3,228.56 | $4,612.22 | 18.0× |
| CT lower ext w/o (73700) | $2,226.44 | $3,180.62 | 20.8× |
| CT lower extremity w/contrast material (73701) | $2,450.39 | $3,500.55 | 13.7× |
| CT lumbar spine w contrast (72132) | $3,115 | $4,449.99 | 8.7× |
| CT lumbar spine w/o contrast (72131) | $2,699.18 | $3,855.97 | 25.3× |
| CT maxillofacial w contrast (70487) | $2,786.84 | $3,981.20 | 15.6× |
| CT maxillofacial wo contrast (70486) | $2,216.68 | $3,166.68 | 20.8× |
| CT neck tissue combo (70492) | $3,142.68 | $4,489.53 | 17.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,284.79 | $4,692.55 | 18.3× |
| CT orbits w/o contrast (70480) | $2,274.23 | $3,248.89 | 21.3× |
| CT pelvis w&w/o contrast (72194) | $3,435.91 | $4,908.43 | 19.2× |
| CT pelvis w/o contrast (72192) | $2,327.95 | $3,325.64 | 21.8× |
| CT scan of leg combo (73702) | $3,216.15 | $4,594.50 | 17.9× |
| CT scans face/jaw combo (70488) | $3,266.64 | $4,666.62 | 18.2× |
| CT soft tissue neck w contrast (70491) | $2,876.92 | $4,109.88 | 16.1× |
| CT soft tissue neck w/o contrast (70490) | $2,268.42 | $3,240.59 | 21.2× |
| CT thoracic spine w contrast (72129) | $2,746.48 | $3,923.53 | 15.3× |
| CT thoracic spine w/o contrast (72128) | $2,573.65 | $3,676.63 | 24.1× |
| CT thoracic spine w/wo cont (72130) | $3,250.93 | $4,644.18 | 18.1× |
| CT thorax w/o contrast (71250) | $2,206.20 | $3,151.71 | 20.7× |
| CT upper ext wo (73200) | $2,214.71 | $3,163.87 | 20.7× |
| CT upper extremity w/o & w/contrast material (73202) | $2,894.03 | $4,134.32 | 16.1× |
| CT upper extremity with contrast (73201) | $2,657.20 | $3,795.99 | 7.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,361.51 | $4,802.15 | 18.8× |
| Cta Abdomen (74175) | $3,280.65 | $4,686.63 | 18.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $4,550 | $6,500 | 12.8× |
| CTA pelvis (72191) | $2,768.83 | $3,955.46 | 15.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $478.96 | $684.22 | 2.0× |
| Dilation ureters/urethra rs&i (74485) | $1,783.64 | $2,548.05 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $2,840.17 | $4,057.38 | 1.4× |
| Diskography lumbar (72295) | $2,852.34 | $4,074.76 | 1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $321.98 | $459.97 | 3.0× |
| Dxa Bone Density Axial (77080) | $528.66 | $755.22 | 4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $240.27 | $343.24 | 2.7× |
| Echo Guide For Artery Repair (76936) | $1,145.41 | $1,636.30 | 5.2× |
| Echograp Trans R Pros Study (76873) | $824.67 | $1,178.09 | 7.7× |
| Esophagram (74220) | $756.45 | $1,080.64 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $733.01 | $1,047.15 | 6.9× |
| Fluoroscopy up to 1 hr (76000) | $752.83 | $1,075.46 | 3.1× |
| Follow-Up Angiography (75898) | $1,361.01 | $1,944.29 | 0.4× |
| Foot 2 views (73620) | $373.10 | $532.99 | 4.2× |
| Forearm 2 views (73090) | $440.54 | $629.33 | 5.0× |
| Gastric emptying imaging study (78264) | $2,283.26 | $3,261.79 | 5.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,576.90 | $2,252.71 | 3.9× |
| Gated Heart Planar Single (78472) | $1,941.26 | $2,773.22 | 4.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,092.24 | $2,988.91 | 3.8× |
| Hand 2 views (73120) | $409.71 | $585.29 | 3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,824.10 | $6,891.56 | 6.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,225.86 | $7,465.51 | 7.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,227.32 | $7,467.59 | 7.3× |
| Hepatobil Syst Image W/Drug (78227) | $2,581.46 | $3,687.80 | 4.7× |
| Hepatobiliary System Imaging (78226) | $2,247.42 | $3,210.60 | 5.5× |
| Ht Muscle Image Spect Sing (78451) | $3,686.84 | $5,266.91 | 2.8× |
| Hysterosalpingogram (74740) | $1,062.82 | $1,518.31 | 4.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $652.75 | $932.49 | 7.3× |
| Infant hip ultrasound, limited static exam (76886) | $1,305.89 | $1,865.55 | 14.7× |
| Interstitial radiation source applic complex (77778) | $5,978.82 | $8,541.17 | 8.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,293.49 | $3,276.41 | 3.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,615.49 | $2,307.84 | 2.9× |
| Intracavitary radiation source applic simple (77761) | $1,089.49 | $1,556.41 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $2,180.38 | $3,114.82 | 3.9× |
| K Flow/Funct Image W/Drug (78708) | $2,346.50 | $3,352.13 | 4.2× |
| K Flow/Funct Image W/O Drug (78707) | $2,052.62 | $2,932.31 | 3.7× |
| Kidney Imaging Morphol (78700) | $1,603.29 | $2,290.41 | 3.9× |
| Knee 3 Views (73562) | $496.35 | $709.06 | 5.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,728.35 | $2,469.06 | 4.2× |
| Liver imaging static only (78201) | $1,483.09 | $2,118.70 | 2.7× |
| Lung Perf&Ventilat Diferentl (78598) | $2,116.38 | $3,023.39 | 3.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,226.59 | $3,180.83 | 4.0× |
| Lung Ventilation Imaging (78579) | $1,352.72 | $1,932.45 | 3.3× |
| Lymph System Imaging (78195) | $2,079.78 | $2,971.11 | 3.7× |
| Magnetic Image Jaw Joint (70336) | $2,739.57 | $3,913.66 | 11.2× |
| Mammary ductogram or galactogram multiple (77054) | $625.69 | $893.83 | 2.6× |
| Mammary ductogram or galactogram single (77053) | $526.76 | $752.51 | 2.2× |
| Meckels Divert Exam (78290) | $1,218.81 | $1,741.15 | 3.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,224.32 | $1,749.02 | 3.2× |
| Mr safety determination physician/other qhp (76016) | $154 | $220 | 1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $55.13 | $78.75 | 1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $161 | $230 | 1.7× |
| Mr safety implt pos&/immoblj (76019) | $105 | $150 | 1.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $420 | $600 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $4,184.35 | $5,977.63 | 11.7× |
| MRA head w/o contrast (70544) | $3,017.66 | $4,310.94 | 12.4× |
| MRA head with contrast (70545) | $3,264.05 | $4,662.92 | 9.2× |
| MRA neck w contrast (70548) | $3,333.80 | $4,762.57 | 9.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,007.22 | $5,724.59 | 11.2× |
| MRA neck w/o contrast (70547) | $3,010.41 | $4,300.58 | 12.3× |
| MRI abdomen w contrast (74182) | $3,529.15 | $5,041.64 | 9.9× |
| MRI abdomen w/o contrast (74181) | $3,321.42 | $4,744.88 | 13.6× |
| MRI any jt lower extrem w/contrast material (73722) | $3,488.57 | $4,983.66 | 4.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,479.40 | $6,399.13 | 12.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,316.83 | $4,738.32 | 4.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $768.58 | $1,097.96 | 3.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $768.58 | $1,097.96 | 3.2× |
| MRI cardiac w/o cont stress (75559) | $1,827.51 | $2,610.72 | 3.3× |
| MRI cardiac w/o contrast (75557) | $990.62 | $1,415.16 | 4.1× |
| MRI cervical spine w contrast (72142) | $3,432.06 | $4,902.93 | 9.6× |
| MRI cervical spine w/o cont (72141) | $3,131.05 | $4,472.92 | 12.8× |
| MRI chest w/o contrast (71550) | $2,117.97 | $3,025.66 | 8.7× |
| MRI chest with contrast (71551) | $1,960.29 | $2,800.41 | 2.4× |
| MRI chest wo w contrast (71552) | $4,892.31 | $6,989.01 | 13.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,441.79 | $4,916.83 | 9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,358.50 | $6,226.42 | 12.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,027.04 | $4,324.34 | 12.4× |
| MRI lumbar spine w contrast (72149) | $3,606.39 | $5,151.98 | 10.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,650.76 | $6,643.93 | 13.0× |
| MRI orbit face &/neck w/o contrast (70540) | $3,147.68 | $4,496.68 | 12.9× |
| MRI orbit face neck w contrast (70542) | $3,314.76 | $4,735.36 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,869.65 | $6,956.63 | 13.7× |
| MRI pelvis w contrast (72196) | $3,329.80 | $4,756.85 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $4,904.86 | $7,006.93 | 13.8× |
| MRI pelvis w/o contrast (72195) | $3,182.22 | $4,546.02 | 13.1× |
| MRI thoracic spine w/o contrast (72146) | $3,171.80 | $4,531.14 | 13.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,314.76 | $4,735.36 | 9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,757.51 | $3,939.30 | 11.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,207.05 | $6,010.07 | 11.8× |
| MRI, abdomen, combo (74183) | $4,657.17 | $6,653.09 | 13.1× |
| MRI, dorsal spine combo (72157) | $4,815.13 | $6,878.75 | 13.5× |
| MRI, dorsal spine contrast (72147) | $3,500.42 | $5,000.59 | 9.8× |
| MRI, joint upper extrem (73221) | $3,014.53 | $4,306.46 | 12.4× |
| MRI, joint upper extrem combo (73223) | $4,207 | $6,009.99 | 11.8× |
| MRI, lumbar spine combo (72158) | $4,638.03 | $6,625.75 | 13.0× |
| Myelogram cervical (72240) | $1,929.62 | $2,756.59 | 2.4× |
| Myelogram Lumbar (72265) | $1,748.56 | $2,497.94 | 2.2× |
| Myelography thoracic (72255) | $1,475.91 | $2,108.44 | 1.8× |
| Myelograpy 2/more regions rs&i (72270) | $2,126.92 | $3,038.45 | 2.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,432.63 | $7,760.89 | 4.1× |
| Myocardial Spect Multiple Studies (78452) | $5,392.42 | $7,703.45 | 4.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,175.98 | $5,965.68 | 2.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $7,717.50 | $11,025 | 3.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $5,325.08 | $7,607.25 | 2.4× |
| N-invas est c ffr sw aly CTA (75580) | $1,558.20 | $2,226 | 1.8× |
| Neck soft tissue (70360) | $424.77 | $606.81 | 4.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $559.59 | $799.41 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $640.19 | $914.55 | 6.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,353.07 | $11,932.95 | 5.9× |
| Nuclear Rx Oral Admin (79005) | $1,798.42 | $2,569.16 | 7.5× |
| Ob us nuchal meas 1 gest (76813) | $270.12 | $385.88 | 2.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $125.06 | $178.65 | 1.2× |
| Panoramic X-ray of jaws (70355) | $338.26 | $483.22 | 3.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,099.77 | $2,999.66 | 3.8× |
| Parathyroid Planar Imaging (78070) | $1,883.23 | $2,690.32 | 4.6× |
| Pelvis 1 or 2 views (72170) | $423.35 | $604.78 | 4.0× |
| Peritoneogram Rs&I (74190) | $582.45 | $832.06 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $7,420.12 | $10,600.16 | 5.1× |
| PET image w/CT, full body (78816) | $8,151.78 | $11,645.39 | 5.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,198.80 | $11,712.56 | 5.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,611.66 | $2,302.37 | 3.9× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $2,352 | $3,360 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $662.73 | $946.75 | 6.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $665.59 | $950.83 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $483.02 | $690.02 | 5.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $386.50 | $552.14 | 4.3× |
| Radex elbow complete minimum 3 views (73080) | $494.01 | $705.72 | 5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $563.34 | $804.77 | 5.3× |
| Radex fingr minimum 2 views (73140) | $363.01 | $518.58 | 4.1× |
| Radex foot complete minimum 3 views (73630) | $454.65 | $649.50 | 5.1× |
| Radex Hand Minimum 3 Views (73130) | $479.04 | $684.33 | 5.4× |
| Radex lower extremity infant minimum 2 views (73592) | $287.35 | $410.50 | 3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $490.73 | $701.03 | 5.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $496.47 | $709.23 | 5.6× |
| Radex Ribs Unilateral 2 Views (71100) | $449.98 | $642.82 | 5.1× |
| Radex shoulder complete minimum 2 views (73030) | $484.81 | $692.58 | 5.5× |
| Radex Sinuses Paransl < 3 Views (70210) | $323.05 | $461.49 | 3.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,467.79 | $2,096.84 | 8.2× |
| Radex Spine 1 View Specify Level (72020) | $375.15 | $535.92 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $406.47 | $580.66 | 4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $467.81 | $668.29 | 5.3× |
| Radex Toe Minimum 2 Views (73660) | $363.13 | $518.75 | 4.1× |
| Radex upper extremity infant minimum 2 views (73092) | $328.70 | $469.56 | 3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $453.99 | $648.55 | 5.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,235.96 | $1,765.65 | 11.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $19,025.71 | $27,179.58 | 2.5× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$656.72–$1,010.80 | $938.16–$1,443.99 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$1,166.26–$2,482.52 | $1,666.08–$3,546.45 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$1,582.91–$3,556.42 | $2,261.29–$5,080.59 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $344.26 | $491.79 | 3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $423.45 | $604.92 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $1,186.22 | $1,694.60 | 6.6× |
| Radiologic exam colon single contrast study (74270) | $1,071.31 | $1,530.43 | 6.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $682.11 | $974.44 | 3.8× |
| Radiologic exam knee complete 4/more views (73564) | $555.48 | $793.54 | 5.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $451.34 | $644.76 | 4.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $864.53 | $1,235.04 | 4.8× |
| Radiologic exam swallow function contrast study (74230) | $647.96 | $925.65 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$780.18–$823.33 | $1,114.53–$1,176.18 | varies |
| Radiologic examination femur 1 view (73551) | $209.73 | $299.61 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $206.60 | $295.13 | 2.3× |
| Radiologic examination knee 1/2 views (73560) | $396.92 | $567.02 | 4.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $455.91 | $651.29 | 5.1× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $952.31 | $1,360.44 | 4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $707.95 | $1,011.35 | 1.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $707.95 | $1,011.35 | 1.8× |
| Renal Cyst Study (74470) | $895.22 | $1,278.88 | 1.6× |
| Ribs bilateral 3 views (71110) | $603.38 | $861.97 | 5.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,629.49 | $2,327.83 | 4.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,988.58 | $2,840.82 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,982.36 | $5,689.08 | 7.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,501.54 | $3,573.62 | 4.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,034.16 | $4,334.51 | 5.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,501.54 | $3,573.62 | 1.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,543.63 | $3,633.75 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,254.54 | $3,220.76 | 1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,891.55 | $2,702.21 | 7.9× |
| Rp Therapy Intravenous Administration (79101) | $1,103.12 | $1,575.88 | 4.6× |
| Salivary Gland Function Study (78232) | $720.68 | $1,029.54 | 1.8× |
| Scapula (73010) | $453.93 | $648.46 | 4.2× |
| Shoulder 1 view (73020) | $342.96 | $489.94 | 3.9× |
| Shoulder Arthrography (73040) | $1,207.99 | $1,725.69 | 3.4× |
| Skull less than 4 views (70250) | $479.11 | $684.43 | 4.5× |
| Special dosimetry (77331) | $420.56 | $600.80 | 3.1× |
| Special Physics Consult (77370) | $1,336.74 | $1,909.62 | 9.7× |
| Special teletherapy port plan (77321) | $2,447.39 | $3,496.26 | 6.4× |
| Special treatment procedure (77470) | $6,506.13 | $9,294.46 | 11.5× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$9,902.25–$13,555.12 | $14,146.06–$19,364.45 | varies |
| Sternoclavicular joints (71130) | $161.70 | $231 | 1.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $137.13 | $195.90 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,784.70 | $6,835.28 | 12.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $3,046.15 | $4,351.64 | 8.0× |
| Testicular Imaging W/Flow (78761) | $1,329.30 | $1,898.99 | 3.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,880.33 | $5,543.32 | 10.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,905.30 | $5,578.99 | 10.2× |
| Ther rad simulaj-aided field setting simple (77280) | $2,695.64 | $3,850.91 | 19.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $819.55 | $1,170.78 | 4.6× |
| Thoracic spine 2 views (72070) | $457.51 | $653.58 | 4.3× |
| Thoracic spine 3 views (72072) | $510.54 | $729.34 | 4.8× |
| Thoracolumbar 2 views (72080) | $322.19 | $460.27 | 3.6× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,459.79 | $2,085.41 | 3.6× |
| Thyroid Imaging With Vascular Flow (78013) | $693.75 | $991.06 | 1.7× |
| Thyroid Met Imaging Body (78018) | $2,519.66 | $3,599.51 | 4.5× |
| Thyroid Uptake Measurement (78012) | $802.22 | $1,146.02 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,577.94 | $2,254.20 | 3.9× |
| Tx Devices Design & Construction Complex (77334) | $1,763.16 | $2,518.80 | 4.6× |
| Tx devices design & construction intermediate (77333) | $951.67 | $1,359.52 | 6.9× |
| Tx devices design & construction simple (77332) | $795.37 | $1,136.24 | 5.8× |
| Ultrasound Breast Limited (76642) | $494.73 | $706.75 | 5.6× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$119.10–$513.07 | $170.14–$732.95 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$125.06–$915.42 | $178.65–$1,307.74 | varies |
| Umbilical-artery Doppler (OB) (76820) | $423.08 | $604.40 | 4.0× |
| Unlisted magnetic resonance procedure (76498) | $2,462.02 | $3,517.17 | 27.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,359.92 | $1,942.73 | 13.0× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$953.55–$956.30 | $1,362.21–$1,366.14 | varies |
| Ureteral Reflux Study (78740) | $1,465.64 | $2,093.77 | 3.6× |
| Urethrocystogram voiding (74455) | $1,018.18 | $1,454.54 | 4.2× |
| Urethrocystography retrograde (74450) | $992.20 | $1,417.42 | 4.1× |
| Us breast unilateral complete (76641) | $596.98 | $852.82 | 5.6× |
| Us chest (76604) range across 2 matching MRF lines |
$125.06–$661.26 | $178.65–$944.65 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$125.06–$850.92 | $178.65–$1,215.60 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$125.06–$618.01 | $178.65–$882.87 | varies |
| Us head (76506) | $637.47 | $910.67 | 6.0× |
| Us kidney transplant (76776) | $940.22 | $1,343.16 | 8.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$125.06–$586.63 | $178.65–$838.03 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$125.06–$605.11 | $178.65–$864.44 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$125.06–$724 | $178.65–$1,034.28 | varies |
| Us pelvic non ob complete (76856) | $1,028.45 | $1,469.21 | 9.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $823.32 | $1,176.17 | 7.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $560.56 | $800.79 | 5.2× |
| Us retroperitoneal complete (76770) | $1,026.53 | $1,466.46 | 9.6× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$125.06–$559.20 | $178.65–$798.85 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$125.06–$948.04 | $178.65–$1,354.33 | varies |
| Us spinal canal and contents (76800) | $668.63 | $955.18 | 6.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$125.06–$897.66 | $178.65–$1,282.37 | varies |
| Us transrectal (76872) | $835.92 | $1,194.17 | 7.8× |
| Vein X-Ray Chest (75827) | $3,144.31 | $4,491.87 | 2.0× |
| Vein X-Ray Skull Epidural (75872) | $1,015.35 | $1,450.50 | 1.6× |
| Venogram Sinus/Jugular (75860) | $2,006.90 | $2,866.99 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $3,396.45 | $4,852.06 | 1.1× |
| Venography extremity bilateral rs&i (75822) | $2,407.38 | $3,439.11 | 1.5× |
| Venography extremity unilateral rs&i (75820) | $2,024.59 | $2,892.26 | 1.3× |
| Venography Renal Bilateral (75833) | $3,500.22 | $5,000.31 | 1.1× |
| Venography Renal Unilateral (75831) | $3,617.70 | $5,168.14 | 1.1× |
| Wrist 2 views (73100) | $392 | $560 | 4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $393.35 | $561.92 | 4.4× |
| X-ray antegrade pyelogram tube (74425) | $1,014.40 | $1,449.14 | 2.8× |
| X-Ray Aorta Leg Arteries (75630) | $5,814.13 | $8,305.89 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $403.82 | $576.88 | 4.5× |
| X-Ray Exam Breast Specimen (76098) | $611.50 | $873.57 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $432.35 | $617.64 | 4.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $761.80 | $1,088.28 | 7.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,235.96 | $1,765.65 | 11.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $226.50 | $323.56 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $277.93 | $397.03 | 3.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $276.17 | $394.52 | 2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $320.23 | $457.47 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $291.58 | $416.54 | 2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $564.60 | $806.56 | 5.3× |
| X-Ray Exam L-S Spine Bending (72114) | $867.53 | $1,239.32 | 8.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $510.53 | $729.32 | 5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $780.24 | $1,114.62 | 7.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $574.03 | $820.04 | 5.4× |
| X-ray eye for foreign body (70030) | $341.86 | $488.36 | 3.8× |
| X-ray humerus (73060) | $339.97 | $485.66 | 3.8× |
| X-ray IV pyelogram (ivp) (74400) | $1,254.36 | $1,791.93 | 7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $421.65 | $602.35 | 4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $276.15 | $394.50 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $523.62 | $748.02 | 4.9× |
| X-ray nose-rectum child f.b. (76010) | $256.22 | $366.02 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $761.88 | $1,088.40 | 7.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $450.13 | $643.04 | 4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $456.54 | $652.19 | 5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $589.35 | $841.92 | 6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $689.99 | $985.69 | 6.5× |
| X-ray thoracic spine 4 vw (72074) | $444.13 | $634.46 | 4.2× |
| X-Ray Tmj Unilat (70328) | $307.10 | $438.71 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $987.14 | $1,410.19 | 2.8× |
| X-Rays Bone Length Studies (77073) | $539.37 | $770.52 | 5.0× |
| X-Rays Bone Survey Complete (77075) | $1,049.12 | $1,498.74 | 9.8× |
| Xr c-spine 4 or 5 views (72050) | $702.06 | $1,002.93 | 6.6× |
| Xr facial bones less than 3 views (70140) | $373.78 | $533.96 | 4.2× |
| Xr orbits complete 4 views (70200) | $504.03 | $720.03 | 4.7× |
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.