Imaging prices at CHI Health Immanuel
Omaha, NE · every code in this section with a posted price and a Medicare benchmark.
431 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) | $5,593.14 | $13,317 | 3.9× |
| Abdomen 1 View (74018) | $205.38 | $489 | 2.3× |
| Abdomen 2 views (74019) | $254.52 | $606 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $766.50 | $1,825 | 1.8× |
| Adrenal Cortex & Medulla Img (78075) | $1,204.14 | $2,867 | 0.9× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$2,040.78–$2,426.34 | $4,859–$5,777 | varies |
| Angio pulmonary bilat (75743) | $1,818.18 | $4,329 | 0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,134.04 | $7,462 | 1.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,997.10–$2,165.10 | $4,755–$5,155 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$1,387.26–$2,102.10 | $3,303–$5,005 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$1,308.72–$1,377.18 | $3,116–$3,279 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $978.18 | $2,329 | 0.3× |
| Ankle 2 views (73600) | $167.58 | $399 | 1.9× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$1,743–$1,939.98 | $4,150–$4,619 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $1,914.36 | $4,558 | 0.6× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$3,622.50–$3,937.50 | $8,625–$9,375 | varies |
| Artery X-Rays Adrenal Gland (75731) | $1,641.78 | $3,909 | 0.5× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$1,903.02–$2,212.98 | $4,531–$5,269 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$1,865.64–$2,147.88 | $4,442–$5,114 | varies |
| Arthrogram ankle (73615) | $371.70 | $885 | 1.0× |
| Arthrogram hip (73525) | $471.24 | $1,122 | 1.3× |
| Arthrogram Wrist (73115) | $395.22 | $941 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $468.30 | $1,115 | 3.4× |
| Bone age studies (77072) | $90.30 | $215 | 0.8× |
| Bone Imaging 3 Phase (78315) | $1,076.04 | $2,562 | 2.6× |
| Bone Imaging Limited Area (78300) | $489.30 | $1,165 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $645.96 | $1,538 | 1.6× |
| Bone Imaging Whole Body (78306) | $978.18 | $2,329 | 2.4× |
| Bone marrow imaging limited area (78102) | $268.80 | $640 | 0.6× |
| Bone marrow imaging; multiple areas (78103) | $320.04 | $762 | 0.8× |
| Bone marrow imaging; whole body (78104) | $191.10 | $455 | 0.5× |
| Bone survey infant (77076) | $245.70 | $585 | 2.3× |
| Brachytx isodose complex (77318) | $1,705.20 | $4,060 | 4.4× |
| Brachytx isodose intermed (77317) | $1,461.60 | $3,480 | 3.8× |
| Brachytx Isodose Plan Simple (77316) | $1,380.96 | $3,288 | 3.6× |
| Brain Flow Imaging Only (78610) | $356.58 | $849 | 0.6× |
| Brain Image W/Flow < 4 Views (78601) | $620.76 | $1,478 | 1.5× |
| Brain imaging < 4 static views (78600) | $428.82 | $1,021 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $640.08 | $1,524 | 1.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $659.40 | $1,570 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$2,316.72–$2,433.06 | $5,516–$5,793 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $511.56 | $1,218 | 1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,419.18 | $3,379 | 3.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,533 | $3,650 | 1.9× |
| Cardiac Shunt Detection (78428) | $344.40 | $820 | 0.8× |
| Cat Scan Follow-Up Study (76380) | $437.22 | $1,041 | 4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $451.08 | $1,074 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $425.88 | $1,014 | 0.8× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$137.76–$143.64 | $328–$342 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$45.36–$204.12 | $108–$486 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$182.28–$271.32 | $434–$646 | varies |
| Chest 4 or more views (71048) | $337.68 | $804 | 3.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $402.36 | $958 | 3.7× |
| Clavicle complete (73000) | $166.32 | $396 | 1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $99.96 | $238 | 0.9× |
| Continuing medical physics consltj pr wk (77336) | $610.68 | $1,454 | 4.4× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,585.92–$1,669.08 | $3,776–$3,974 | varies |
| Contrast X-Ray Bladder (74430) | $352.38 | $839 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $229.74 | $547 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $326.34 | $777 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,933.70 | $6,985 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $1,559.04 | $3,712 | 6.3× |
| CT abdomen w contrast (74160) | $1,257.90 | $2,995 | 6.9× |
| CT abdomen w wo contrast (74170) | $1,396.08 | $3,324 | 7.7× |
| CT abdomen w/o contrast (74150) | $943.32 | $2,246 | 8.7× |
| CT Angio Abdomen and Pelvis (74174) | $1,408.26 | $3,353 | 3.9× |
| CT Angio Chest (71275) | $1,197.84 | $2,852 | 6.6× |
| CT Angio Head (70496) | $1,198.68 | $2,854 | 6.6× |
| CT angio hrt w/3d image (75574) | $1,309.56 | $3,118 | 3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,132.32 | $2,696 | 6.2× |
| CT Angio Neck (70498) | $1,260.42 | $3,001 | 6.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,288.56 | $3,068 | 7.1× |
| CT cervical spine w/ contrast (72126) | $1,153.32 | $2,746 | 3.2× |
| CT cervical spine w/o contrast (72125) | $915.18 | $2,179 | 8.4× |
| CT cervical spine w/wo cont (72127) | $1,217.16 | $2,898 | 6.7× |
| CT chest w contrast (71260) | $1,110.06 | $2,643 | 6.1× |
| CT chest w/wo contrast (71270) | $1,265.04 | $3,012 | 6.9× |
| CT colonography screening (74263) | $1,062.18 | $2,529 | 4.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,285.20 | $3,060 | 7.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,223.88 | $2,914 | 11.3× |
| CT head/brain with contrast (70460) | $916.02 | $2,181 | 5.0× |
| CT head/brain without and with contrast (70470) | $1,104.60 | $2,630 | 6.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,257.48 | $2,994 | 3.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $109.20 | $260 | 1.2× |
| CT hrt w/3d image congen (75573) | $1,204.98 | $2,869 | 3.3× |
| CT iac w contrast (70481) | $1,152.48 | $2,744 | 6.3× |
| CT l-spine w&w/o contrast (72133) | $1,150.38 | $2,739 | 6.3× |
| CT lower ext w/o (73700) | $805.98 | $1,919 | 7.4× |
| CT lower extremity w/contrast material (73701) | $1,039.92 | $2,476 | 5.7× |
| CT lumbar spine w contrast (72132) | $1,094.10 | $2,605 | 3.0× |
| CT lumbar spine w/o contrast (72131) | $935.34 | $2,227 | 8.6× |
| CT maxillofacial w contrast (70487) | $1,034.46 | $2,463 | 5.7× |
| CT maxillofacial wo contrast (70486) | $808.50 | $1,925 | 7.4× |
| CT neck tissue combo (70492) | $1,388.10 | $3,305 | 7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,368.36 | $3,258 | 7.5× |
| CT orbits w/o contrast (70480) | $1,029 | $2,450 | 9.5× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$118.86–$1,280.58 | $283–$3,049 | varies |
| CT pelvis w/o contrast (72192) | $847.98 | $2,019 | 7.8× |
| CT scan of leg combo (73702) | $1,168.86 | $2,783 | 6.4× |
| CT scans face/jaw combo (70488) | $1,050.84 | $2,502 | 5.8× |
| CT soft tissue neck w contrast (70491) | $1,128.54 | $2,687 | 6.2× |
| CT soft tissue neck w/o contrast (70490) | $1,071.84 | $2,552 | 9.9× |
| CT thoracic spine w contrast (72129) | $1,102.50 | $2,625 | 6.1× |
| CT thoracic spine w/o contrast (72128) | $958.44 | $2,282 | 8.8× |
| CT thoracic spine w/wo cont (72130) | $1,112.16 | $2,648 | 6.1× |
| CT thorax w/o contrast (71250) | $754.74 | $1,797 | 7.0× |
| CT upper ext wo (73200) | $893.34 | $2,127 | 8.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,259.58 | $2,999 | 6.9× |
| CT upper extremity with contrast (73201) | $1,045.38 | $2,489 | 2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,529.22 | $3,641 | 8.4× |
| Cta Abdomen (74175) | $1,661.52 | $3,956 | 9.1× |
| CTA pelvis (72191) | $660.24 | $1,572 | 3.6× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$666.54–$699.72 | $1,587–$1,666 | varies |
| Diskography lumbar (72295) | $2,306.22 | $5,491 | 1.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $80.22 | $191 | 0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$131.04–$146.16 | $312–$348 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $168 | $400 | 1.5× |
| Dxa Bone Density Axial (77080) | $280.14 | $667 | 2.6× |
| Dxa bone density study (77085) | $106.68 | $254 | 1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $57.96 | $138 | 0.6× |
| Echo exam of fetal heart (76825) | $437.64 | $1,042 | 0.8× |
| Echo exam uterus (76831) | $163.80 | $390 | 0.7× |
| Echo Guide For Artery Repair (76936) | $456.54 | $1,087 | 2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $416.64 | $992 | 1.7× |
| Echograp Trans R Pros Study (76873) | $287.28 | $684 | 2.6× |
| Esophagram (74220) | $358.68 | $854 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$321.72–$346.92 | $766–$826 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$229.32–$279.72 | $546–$666 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $230.58 | $549 | 0.9× |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$166.74–$433.44 | $397–$1,032 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$694.26–$2,040.78 | $1,653–$4,859 | varies |
| Foot 2 views (73620) | $157.08 | $374 | 1.7× |
| Forearm 2 views (73090) | $194.46 | $463 | 2.2× |
| Gastric emptying imaging study (78264) | $912.24 | $2,172 | 2.2× |
| Gastroesophageal Reflux Exam (78262) | $672 | $1,600 | 1.6× |
| Gated Heart Planar Single (78472) | $924.84 | $2,202 | 2.2× |
| Gated Heart, Multiple (78473) | $286.86 | $683 | 0.7× |
| Hand 2 views (73120) | $171.78 | $409 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,152.96 | $9,888 | 5.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,693.88 | $6,414 | 3.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,244.90 | $5,345 | 3.1× |
| Heart Image (Pet) Multiple (78492) | $2,677.08 | $6,374 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,417.92 | $3,376 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,843.38 | $4,389 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $951.72 | $2,266 | 1.7× |
| Hepatobiliary System Imaging (78226) | $857.64 | $2,042 | 2.1× |
| Ht Musc Image Planar Mult (78454) | $1,779.96 | $4,238 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $736.68 | $1,754 | 0.5× |
| Hysterosalpingogram (74740) | $592.62 | $1,411 | 2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $314.58 | $749 | 3.5× |
| Infant hip ultrasound, limited static exam (76886) | $292.74 | $697 | 3.2× |
| Interstitial radiation source applic complex (77778) | $3,240.30 | $7,715 | 4.5× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,247.82 | $2,971 | 1.7× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,129.80 | $2,690 | 2.0× |
| Intracavitary radiation source applic simple (77761) | $837.06 | $1,993 | 1.5× |
| Joint Survey Single View (77077) | $88.20 | $210 | 0.8× |
| K Flow/Funct Image Multiple (78709) | $1,126.86 | $2,683 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $1,063.02 | $2,531 | 1.9× |
| K Flow/Funct Image W/O Drug (78707) | $861 | $2,050 | 1.5× |
| Kidney Imaging Morphol (78700) | $382.62 | $911 | 0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $260.82 | $621 | 0.6× |
| Knee 3 Views (73562) | $264.18 | $629 | 2.9× |
| Leveen/Shunt Patency Exam (78291) | $530.04 | $1,262 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $580.86 | $1,383 | 1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $480.06 | $1,143 | 1.2× |
| Liver imaging static only (78201) | $357.42 | $851 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $1,231.02 | $2,931 | 2.2× |
| Lung perfusion differential (78597) | $591.78 | $1,409 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $714 | $1,700 | 1.3× |
| Lung Ventilation Imaging (78579) | $456.96 | $1,088 | 1.1× |
| Lymph System Imaging (78195) | $956.34 | $2,277 | 1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,097.90 | $4,995 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $1,209.18 | $2,879 | 4.9× |
| Magnetic Resonance Elastography (76391) | $194.04 | $462 | 0.8× |
| Mammary ductogram or galactogram multiple (77054) | $537.18 | $1,279 | 2.2× |
| Mammary ductogram or galactogram single (77053) | $564.48 | $1,344 | 2.3× |
| Meckels Divert Exam (78290) | $527.94 | $1,257 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) | $2,918.58 | $6,949 | 7.5× |
| Mr safety determination physician/other qhp (76016) | $63 | $150 | 0.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $18.06 | $43 | 0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $65.52 | $156 | 0.7× |
| Mr safety implt pos&/immoblj (76019) | $42.42 | $101 | 0.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $172.62 | $411 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,120.58 | $5,049 | 5.9× |
| MRA head w/o contrast (70544) | $1,452.36 | $3,458 | 5.9× |
| MRA head with contrast (70545) | $1,496.04 | $3,562 | 4.1× |
| MRA neck w contrast (70548) | $1,434.72 | $3,416 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,839.18 | $4,379 | 5.1× |
| MRA neck w/o contrast (70547) | $1,195.74 | $2,847 | 4.8× |
| MRI abdomen w contrast (74182) | $1,604.82 | $3,821 | 4.4× |
| MRI abdomen w/o contrast (74181) | $1,406.58 | $3,349 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,546.86 | $3,683 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,647.66 | $3,923 | 4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,396.50 | $3,325 | 1.7× |
| MRI brain functional w/o physician admnistration (70554) | $1,138.62 | $2,711 | 4.6× |
| MRI brain functional w/physician admnistration (70555) | $1,186.08 | $2,824 | 4.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $201.60 | $480 | 0.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $201.60 | $480 | 0.8× |
| MRI cardiac w/o cont stress (75559) | $1,092.84 | $2,602 | 1.9× |
| MRI cardiac w/o contrast (75557) | $610.26 | $1,453 | 2.5× |
| MRI cervical spine w contrast (72142) | $1,880.76 | $4,478 | 5.2× |
| MRI cervical spine w/o cont (72141) | $1,424.64 | $3,392 | 5.8× |
| MRI chest w/o contrast (71550) | $1,755.60 | $4,180 | 7.1× |
| MRI chest with contrast (71551) | $1,922.76 | $4,578 | 2.4× |
| MRI chest wo w contrast (71552) | $2,089.92 | $4,976 | 5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,242.36 | $2,958 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,425.48 | $3,394 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,150.38 | $2,739 | 4.6× |
| MRI lumbar spine w contrast (72149) | $1,695.54 | $4,037 | 4.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,094.12 | $4,986 | 5.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,872.78 | $4,459 | 7.6× |
| MRI orbit face neck w contrast (70542) | $1,934.52 | $4,606 | 5.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,058 | $4,900 | 5.7× |
| MRI pelvis w contrast (72196) | $1,620.78 | $3,859 | 4.5× |
| MRI pelvis w/o & w contrast (72197) | $1,687.98 | $4,019 | 4.7× |
| MRI pelvis w/o contrast (72195) | $1,435.14 | $3,417 | 5.8× |
| MRI spectroscopy (76390) | $578.76 | $1,378 | 6.4× |
| MRI thoracic spine w/o contrast (72146) | $1,561.56 | $3,718 | 6.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,291.92 | $3,076 | 3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,191.54 | $2,837 | 4.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,435.56 | $3,418 | 4.0× |
| MRI, abdomen, combo (74183) | $1,803.06 | $4,293 | 5.0× |
| MRI, dorsal spine combo (72157) | $1,748.88 | $4,164 | 4.8× |
| MRI, dorsal spine contrast (72147) | $1,577.10 | $3,755 | 4.4× |
| MRI, joint upper extrem (73221) | $1,173.48 | $2,794 | 4.7× |
| MRI, joint upper extrem combo (73223) | $1,490.16 | $3,548 | 4.1× |
| MRI, lumbar spine combo (72158) | $1,966.02 | $4,681 | 5.4× |
| Myelogram cervical (72240) | $727.86 | $1,733 | 0.9× |
| Myelogram Lumbar (72265) | $727.86 | $1,733 | 0.9× |
| Myelography thoracic (72255) | $727.86 | $1,733 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $1,091.58 | $2,599 | 1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,070.18 | $4,929 | 1.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $614.04 | $1,462 | 0.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,045.82–$2,168.88 | $4,871–$5,164 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,167.18 | $2,779 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,358.28 | $3,234 | 0.6× |
| N-invas est c ffr sw aly CTA (75580) | $847.56 | $2,018 | 1.0× |
| Neck soft tissue (70360) | $186.48 | $444 | 2.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $2,288.16 | $5,448 | 5.7× |
| Nm csf leak detection (78650) | $438.48 | $1,044 | 0.3× |
| Nm whole blood volume (78122) | $481.74 | $1,147 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $276.78 | $659 | 2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,414.22 | $12,891 | 3.8× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$187.32–$292.74 | $446–$697 | varies |
| Nuclear Rx Oral Admin (79005) | $501.90 | $1,195 | 2.1× |
| Ob us nuchal meas 1 gest (76813) | $149.52 | $356 | 1.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $27.30 | $65 | 0.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $276.78 | $659 | 0.5× |
| Parathyroid Planar Imaging (78070) | $754.74 | $1,797 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $503.58 | $1,199 | 1.2× |
| Pelvis 1 or 2 views (72170) | $168.42 | $401 | 1.6× |
| Peritoneogram Rs&I (74190) | $647.22 | $1,541 | 1.1× |
| Pet Image W/Ct Lmtd (78814) | $2,802.24 | $6,672 | 1.9× |
| PET image w/CT, full body (78816) | $3,092.04 | $7,362 | 2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,220.98 | $7,669 | 2.2× |
| Pet Myocardial Sngl Study (78491) | $2,679.18 | $6,379 | 1.8× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $909.30 | $2,165 | 0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$1,739.22–$1,843.38 | $4,141–$4,389 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $614.04 | $1,462 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $348.60 | $830 | 3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $636.30 | $1,515 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $229.32 | $546 | 2.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $145.32 | $346 | 1.6× |
| Radex elbow complete minimum 3 views (73080) | $205.80 | $490 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $259.56 | $618 | 2.4× |
| Radex fingr minimum 2 views (73140) | $141.54 | $337 | 1.6× |
| Radex foot complete minimum 3 views (73630) | $189 | $450 | 2.1× |
| Radex Hand Minimum 3 Views (73130) | $223.02 | $531 | 2.5× |
| Radex lower extremity infant minimum 2 views (73592) | $105.84 | $252 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $204.96 | $488 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $169.26 | $403 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $214.62 | $511 | 2.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $207.48 | $494 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $170.94 | $407 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $110.46 | $263 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $209.16 | $498 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $146.58 | $349 | 1.6× |
| Radex upper extremity infant minimum 2 views (73092) | $81.06 | $193 | 0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $217.14 | $517 | 2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $178.50 | $425 | 1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$10,181.22–$10,717.14 | $24,241–$25,517 | varies |
| Radiation treatment delivery level 1 (77402) | $385.56 | $918 | 3.6× |
| Radiation treatment delivery level 2 (77407) | $472.08 | $1,124 | 1.2× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$718.20–$797.58 | $1,710–$1,899 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $218.40 | $520 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $71.82 | $171 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $564.06 | $1,343 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $417.48 | $994 | 2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $171.78 | $409 | 0.9× |
| Radiologic exam knee complete 4/more views (73564) | $268.80 | $640 | 2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $261.24 | $622 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $402.36 | $958 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $317.94 | $757 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$381.36–$465.36 | $908–$1,108 | varies |
| Radiologic examination femur 1 view (73551) | $65.52 | $156 | 0.7× |
| Radiologic examination femur minimum 2 views (73552) | $65.52 | $156 | 0.7× |
| Radiologic examination knee 1/2 views (73560) | $231.84 | $552 | 2.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $177.66 | $423 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $214.20 | $510 | 2.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $346.08 | $824 | 0.6× |
| Renal Cyst Study (74470) | $810.18 | $1,929 | 1.4× |
| Ribs bilateral 3 views (71110) | $235.62 | $561 | 2.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $763.98 | $1,819 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $935.76 | $2,228 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,418.76 | $3,378 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,216.32 | $2,896 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$1,044.54–$1,559.04 | $2,487–$3,712 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $770.70 | $1,835 | 3.2× |
| Rp Therapy Intravenous Administration (79101) | $521.22 | $1,241 | 2.2× |
| Scapula (73010) | $203.70 | $485 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42 | $100 | 1.8× |
| Shoulder 1 view (73020) | $163.38 | $389 | 1.8× |
| Shoulder Arthrography (73040) | $504.42 | $1,201 | 1.4× |
| Sialogram (70390) | $297.36 | $708 | 1.2× |
| Skull less than 4 views (70250) | $143.64 | $342 | 1.3× |
| Special dosimetry (77331) | $362.46 | $863 | 2.6× |
| Special Physics Consult (77370) | $702.24 | $1,672 | 5.0× |
| Special teletherapy port plan (77321) | $1,107.12 | $2,636 | 2.8× |
| Special treatment procedure (77470) | $1,855.14 | $4,417 | 3.2× |
| Speech evaluation, complex (70371) | $240.66 | $573 | 1.0× |
| Srs Multisource (77371) | $8,909.88 | $21,214 | 1.2× |
| Stereotactic Body Radiation Delivery (77373) | $6,487.32 | $15,446 | 3.5× |
| Sternoclavicular joints (71130) | $84 | $200 | 0.9× |
| Superior sagittal sinus venogram (75870) | $2,040.78 | $4,859 | 0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $396.48 | $944 | 3.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,922.34 | $4,577 | 4.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,191.96 | $2,838 | 3.1× |
| Testicular Imaging W/Flow (78761) | $732.06 | $1,743 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,534.26 | $3,653 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,196.58 | $2,849 | 3.1× |
| Ther rad simulaj-aided field setting simple (77280) | $798 | $1,900 | 5.7× |
| Thoracic spine 2 views (72070) | $183.96 | $438 | 1.7× |
| Thoracic spine 3 views (72072) | $230.16 | $548 | 2.1× |
| Thoracolumbar 2 views (72080) | $197.82 | $471 | 2.2× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $393.12 | $936 | 0.9× |
| Thyroid Imaging With Vascular Flow (78013) | $228.48 | $544 | 0.6× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$904.26–$982.80 | $2,153–$2,340 | varies |
| Thyroid Uptake Measurement (78012) | $343.14 | $817 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $438.90 | $1,045 | 1.1× |
| Tx Devices Design & Construction Complex (77334) | $918.96 | $2,188 | 2.4× |
| Tx devices design & construction intermediate (77333) | $615.72 | $1,466 | 4.4× |
| Tx devices design & construction simple (77332) | $248.22 | $591 | 1.8× |
| Ultrasound Breast Limited (76642) | $139.02 | $331 | 1.5× |
| Ultrasound elastography first target lesion (76982) | $113.82 | $271 | 1.0× |
| Ultrasound Elastography Parenchyma (76981) | $119.70 | $285 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $199.50 | $475 | 1.8× |
| Ultrasound, abdomen limited (76705) | $320.04 | $762 | 2.9× |
| Umbilical-artery Doppler (OB) (76820) | $143.64 | $342 | 1.3× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$22.68–$45.36 | $54–$108 | varies |
| Unlisted fluoroscopic procedure (76496) | $285.60 | $680 | 3.2× |
| Unlisted magnetic resonance procedure (76498) | $67.20 | $160 | 0.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$1,199.94–$2,212.98 | $2,857–$5,269 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$137.76–$189.42 | $328–$451 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$279.72–$325.08 | $666–$774 | varies |
| Urethrocystogram voiding (74455) | $471.66 | $1,123 | 1.9× |
| Urethrocystography retrograde (74450) | $476.70 | $1,135 | 1.9× |
| Us breast unilateral complete (76641) | $139.02 | $331 | 1.3× |
| Us chest (76604) | $171.78 | $409 | 1.6× |
| Us complete joint (76881) | $380.10 | $905 | 3.5× |
| Us exam, pelvic, limited (76857) | $231.42 | $551 | 2.1× |
| Us head (76506) | $385.14 | $917 | 3.5× |
| Us kidney transplant (76776) | $60.48 | $144 | 0.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $316.68 | $754 | 2.9× |
| Us ob detailed single fetus (76811) | $490.98 | $1,169 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $251.16 | $598 | 2.3× |
| Us ob transvaginal (76817) | $398.58 | $949 | 3.7× |
| Us pelvic non ob complete (76856) | $471.66 | $1,123 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $444.36 | $1,058 | 4.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $251.16 | $598 | 2.3× |
| Us retroperitoneal complete (76770) | $488.04 | $1,162 | 4.5× |
| Us retroperitoneal limited (76775) | $317.52 | $756 | 2.9× |
| Us scrotum and contents (76870) | $416.22 | $991 | 3.8× |
| Us spinal canal and contents (76800) | $290.64 | $692 | 2.7× |
| Us thyroid (76536) | $367.92 | $876 | 3.4× |
| Us transrectal (76872) | $302.40 | $720 | 2.8× |
| Vascular Flow Imaging (78445) | $487.62 | $1,161 | 1.2× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$845.88–$981.12 | $2,014–$2,336 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$1,268.82–$2,186.52 | $3,021–$5,206 | varies |
| Vein X-Ray Spleen/Liver (75810) | $970.20 | $2,310 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,055.88 | $2,514 | 0.3× |
| Venography Adrenal Unilateral (75840) | $1,631.70 | $3,885 | 0.5× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$1,471.68–$1,691.76 | $3,504–$4,028 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,260.42–$1,357.02 | $3,001–$3,231 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$693.42–$745.92 | $1,651–$1,776 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$1,880.76–$2,093.28 | $4,478–$4,984 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$1,312.92–$1,391.88 | $3,126–$3,314 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$1,905.54–$2,000.88 | $4,537–$4,764 | varies |
| Venous thrombosis imaging (78457) | $566.16 | $1,348 | 1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $628.74 | $1,497 | 1.5× |
| Wrist 2 views (73100) | $145.32 | $346 | 1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $204.54 | $487 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $485.94 | $1,157 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$1,619.10–$1,702.68 | $3,855–$4,054 | varies |
| X-Ray Bend Only L-S Spine (72120) | $519.54 | $1,237 | 4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $164.64 | $392 | 1.8× |
| X-Ray Exam Breast Specimen (76098) | $277.20 | $660 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $57.54 | $137 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $301.98 | $719 | 2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $178.50 | $425 | 1.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $79.80 | $190 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $65.52 | $156 | 0.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $108.78 | $259 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $108.78 | $259 | 1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $108.78 | $259 | 1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $207.48 | $494 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $429.24 | $1,022 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $211.68 | $504 | 2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $472.08 | $1,124 | 4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $228.90 | $545 | 2.1× |
| X-ray eye for foreign body (70030) | $86.94 | $207 | 1.0× |
| X-ray humerus (73060) | $204.12 | $486 | 2.3× |
| X-ray IV pyelogram (ivp) (74400) | $338.52 | $806 | 1.9× |
| X-ray IV pyelogram+tomography (74415) | $757.68 | $1,804 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $87.36 | $208 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $120.54 | $287 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $311.22 | $741 | 2.9× |
| X-ray nose-rectum child f.b. (76010) | $186.06 | $443 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $322.56 | $768 | 3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $236.88 | $564 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $205.38 | $489 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $102.06 | $243 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $242.76 | $578 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $243.18 | $579 | 2.2× |
| X-Ray Stress View (77071) | $73.50 | $175 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $476.70 | $1,135 | 1.3× |
| X-Rays Bone Length Studies (77073) | $153.30 | $365 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $522.48 | $1,244 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $338.52 | $806 | 3.1× |
| Xr facial bones less than 3 views (70140) | $75.18 | $179 | 0.8× |
| Xr orbits complete 4 views (70200) | $247.38 | $589 | 2.3× |
| Xr Tomogram Single Plane (76100) | $119.28 | $284 | 1.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.