Imaging prices at Children's Hospital of Michigan
Detroit, MI · every code in this section with a posted price and a Medicare benchmark.
319 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $235.50 | $314 | 2.7× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$271.50–$292.50 | $362–$390 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,444.50 | $1,926 | 3.6× |
| Angio internal mammary (75756) | $6,294.75 | $8,393 | 2.0× |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$1,209.75–$6,194.25 | $1,613–$8,259 | varies |
| Angiography extremity bilateral rs&i (75716) | $6,873 | $9,164 | 2.2× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$6,146.25–$12,865.50 | $8,195–$17,154 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$3,699–$12,865.50 | $4,932–$17,154 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,798 | $5,064 | 1.2× |
| Ankle 2 views (73600) | $229.50 | $306 | 2.6× |
| Aortography thoracic serialography rs&i (75605) | $22,096.50 | $29,462 | 4.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $12,865.50 | $17,154 | 4.1× |
| Artery X-Rays Abdomen (75726) | $4,804.50 | $6,406 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,718.25 | $6,291 | 0.9× |
| Artery X-Rays Spine (75705) | $22,096.50 | $29,462 | 4.0× |
| Arthrogram ankle (73615) | $1,598.25 | $2,131 | 4.6× |
| Arthrogram hip (73525) | $2,440.50 | $3,254 | 7.0× |
| Arthrogram Wrist (73115) | $1,598.25 | $2,131 | 4.6× |
| Basic radiation dosimetry calculation (77300) | $801.75 | $1,069 | 6.0× |
| Bone age studies (77072) | $360.75 | $481 | 3.5× |
| Bone Imaging 3 Phase (78315) | $1,224 | $1,632 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,959.75 | $2,613 | 4.9× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$327.75–$354.75 | $437–$473 | varies |
| Brain Flow Imaging Only (78610) | $1,381.50 | $1,842 | 2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,986.50 | $7,982 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $6,664.50 | $8,886 | 19.2× |
| Cerebrospinal Fluid Scan (78630) | $1,671 | $2,228 | 3.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$248.25–$263.25 | $331–$351 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$332.25–$505.50 | $443–$674 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$418.50–$505.50 | $558–$674 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$454.50–$488.25 | $606–$651 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $270.75 | $361 | 2.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$359.25–$446.25 | $479–$595 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $112.50 | $150 | 1.1× |
| Continuing medical physics consltj pr wk (77336) | $1,098.75 | $1,465 | 8.2× |
| Contrast Exam Abdominl Aorta (75625) | $4,248.75 | $5,665 | 1.4× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$1,019.25–$1,106.25 | $1,359–$1,475 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,463.25–$1,587 | $1,951–$2,116 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,892.25–$2,052.75 | $2,523–$2,737 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $530.25 | $707 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $5,938.50 | $7,918 | 17.1× |
| CT abdomen and pelvis without contrast (74176) | $3,912.75 | $5,217 | 16.5× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$4,420.50–$4,795.50 | $5,894–$6,394 | varies |
| CT abdomen w wo contrast (74170) | $5,077.50 | $6,770 | 29.1× |
| CT abdomen w/o contrast (74150) | $3,907.50 | $5,210 | 37.5× |
| CT Angio Abdomen and Pelvis (74174) | $6,885.75 | $9,181 | 19.8× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$8,490.75–$9,212.25 | $11,321–$12,283 | varies |
| CT Angio Head (70496) | $7,440.75 | $9,921 | 42.6× |
| CT angio hrt w/3d image (75574) | $2,538 | $3,384 | 7.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,571 | $7,428 | 31.9× |
| CT Angio Neck (70498) | $4,941.75 | $6,589 | 28.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $7,596.75 | $10,129 | 43.5× |
| CT cervical spine w/ contrast (72126) | $3,189 | $4,252 | 9.2× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,904.75–$3,151.50 | $3,873–$4,202 | varies |
| CT cervical spine w/wo cont (72127) | $3,954 | $5,272 | 22.6× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$3,950.25–$4,285.50 | $5,267–$5,714 | varies |
| CT chest w/wo contrast (71270) | $4,659 | $6,212 | 26.7× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$3,435–$3,724.50 | $4,580–$4,966 | varies |
| CT head/brain without and with contrast (70470) | $4,352.25 | $5,803 | 24.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,538 | $3,384 | 7.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $128.25 | $171 | 1.5× |
| CT hrt w/3d image congen (75573) | $1,987.50 | $2,650 | 5.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$3,732–$4,050.75 | $4,976–$5,401 | varies |
| CT l-spine w&w/o contrast (72133) | $3,664.50 | $4,886 | 21.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,756.50–$1,907.25 | $2,342–$2,543 | varies |
| CT lower extremity w/contrast material (73701) | $2,608.50 | $3,478 | 14.9× |
| CT lumbar spine w contrast (72132) | $2,608.50 | $3,478 | 7.5× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$2,268.75–$2,445.75 | $3,025–$3,261 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$3,270.75–$3,549.75 | $4,361–$4,733 | varies |
| CT maxillofacial wo contrast (70486) | $2,978.25 | $3,971 | 28.6× |
| CT neck tissue combo (70492) | $3,384.75 | $4,513 | 19.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,091.75 | $6,789 | 29.1× |
| CT orbits w/o contrast (70480) | $2,721.75 | $3,629 | 26.1× |
| CT pelvis w&w/o contrast (72194) | $5,091.75 | $6,789 | 29.1× |
| CT pelvis w/o contrast (72192) | $2,904.75 | $3,873 | 27.9× |
| CT scan of leg combo (73702) | $3,561.75 | $4,749 | 20.4× |
| CT scans face/jaw combo (70488) | $4,693.50 | $6,258 | 26.9× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,863.50–$3,107.25 | $3,818–$4,143 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,116.50–$2,295.75 | $2,822–$3,061 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$2,127–$2,295.75 | $2,836–$3,061 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$2,091.75–$2,268.75 | $2,789–$3,025 | varies |
| CT thoracic spine w/wo cont (72130) | $3,664.50 | $4,886 | 21.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$606.75–$3,373.50 | $809–$4,498 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,849.25–$3,091.50 | $3,799–$4,122 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $4,854 | $6,472 | 27.8× |
| CT upper extremity with contrast (73201) | $3,131.25 | $4,175 | 9.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,619.75 | $7,493 | 32.2× |
| Cta Abdomen (74175) | $7,695.75 | $10,261 | 44.0× |
| CTA pelvis (72191) | $5,882.25 | $7,843 | 33.7× |
| Dilation ureters/urethra rs&i (74485) | $8,373.75 | $11,165 | 4.0× |
| Diskography lumbar (72295) | $7,982.25 | $10,643 | 4.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,614 | $2,152 | 15.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $3,045.75 | $4,061 | 29.2× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$529.33–$1,109.25 | $705.77–$1,479 | varies |
| Dxa Bone Density Axial (77080) | $512.25 | $683 | 4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $426 | $568 | 4.9× |
| Echo exam of fetal heart (76825) | $4,521.75 | $6,029 | 8.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$2,536.50–$2,595 | $3,382–$3,460 | varies |
| Esophagram (74220) | $792 | $1,056 | 4.5× |
| Fetal Biophys Profile W/Nst (76818) | $1,102.50 | $1,470 | 10.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $872.25 | $1,163 | 8.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,117.50 | $5,490 | 17.3× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$246–$1,206 | $328–$1,608 | varies |
| Follow-Up Angiography (75898) | $12,865.50 | $17,154 | 4.1× |
| Foot 2 views (73620) | $229.50 | $306 | 2.6× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$299.25–$365.25 | $399–$487 | varies |
| Gastric emptying imaging study (78264) | $1,183.50 | $1,578 | 3.0× |
| Gastroesophageal Reflux Exam (78262) | $1,183.50 | $1,578 | 3.0× |
| Hand 2 views (73120) | $270.75 | $361 | 2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $12,865.50 | $17,154 | 4.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,040.75 | $2,721 | 3.8× |
| Hepatobiliary System Imaging (78226) | $2,040.75 | $2,721 | 5.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$1,467.75–$1,581.75 | $1,957–$2,109 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$1,467.75–$1,581.75 | $1,957–$2,109 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,821.75 | $2,429 | 3.4× |
| K Flow/Funct Image W/O Drug (78707) | $2,133 | $2,844 | 3.9× |
| Kidney Imaging Morphol (78700) | $1,914.75 | $2,553 | 4.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$296.25–$384 | $395–$512 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,824.75 | $2,433 | 4.6× |
| Lung perfusion differential (78597) | $3,150.75 | $4,201 | 7.9× |
| Lung Ventilat&Perfus Imaging (78582) | $8,453.25 | $11,271 | 15.6× |
| Lymph System Imaging (78195) | $1,401 | $1,868 | 2.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $12,865.50 | $17,154 | 4.1× |
| Magnetic Image Jaw Joint (70336) | $4,251 | $5,668 | 17.9× |
| Meckels Divert Exam (78290) | $1,824.75 | $2,433 | 4.6× |
| Mr safety determination physician/other qhp (76016) | $1,541.25 | $2,055 | 17.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $234.75 | $313 | 8.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $2,439.75 | $3,253 | 25.8× |
| Mr safety implt pos&/immoblj (76019) | $3,198.75 | $4,265 | 54.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $4,828.50 | $6,438 | 20.3× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$8,485.50–$9,164.25 | $11,314–$12,219 | varies |
| MRA head w/o contrast (70544) | $5,793.75 | $7,725 | 24.4× |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$7,579.50–$8,226.75 | $10,106–$10,969 | varies |
| MRA neck w contrast (70548) | $8,226.75 | $10,969 | 23.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $9,164.25 | $12,219 | 26.4× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$5,380.50–$5,793.75 | $7,174–$7,725 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$6,963–$6,995.25 | $9,284–$9,327 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$5,080.50–$5,679 | $6,774–$7,572 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $6,875.25 | $9,167 | 8.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$7,917.75–$8,530.50 | $10,557–$11,374 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$6,095.25–$6,876 | $8,127–$9,168 | varies |
| MRI brain functional w/o physician admnistration (70554) | $4,370.25 | $5,827 | 18.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,973.75 | $3,965 | 12.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,973.75 | $3,965 | 12.5× |
| MRI cardiac w/o contrast (75557) | $5,983.50 | $7,978 | 25.2× |
| MRI cervical spine w contrast (72142) | $7,640.25 | $10,187 | 22.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$5,241–$5,685 | $6,988–$7,580 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$5,249.25–$6,114 | $6,999–$8,152 | varies |
| MRI chest with contrast (71551) | $6,985.50 | $9,314 | 8.9× |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$8,529–$8,985 | $11,372–$11,980 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$7,917.75–$8,590.50 | $10,557–$11,454 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$5,012.25–$5,670 | $6,683–$7,560 | varies |
| MRI lumbar spine w contrast (72149) | $6,879 | $9,172 | 19.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,421 | $11,228 | 24.2× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$5,228.25–$5,505.75 | $6,971–$7,341 | varies |
| MRI orbit face neck w contrast (70542) | $7,545 | $10,060 | 21.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $9,191.25 | $12,255 | 26.4× |
| MRI pelvis w contrast (72196) | $7,564.50 | $10,086 | 21.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$8,300.25–$9,275.25 | $11,067–$12,367 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$5,235.75–$5,682 | $6,981–$7,576 | varies |
| MRI spectroscopy (76390) | $3,385.50 | $4,514 | 39.0× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$5,241–$5,685 | $6,988–$7,580 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$4,557–$5,154 | $6,076–$6,872 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $7,810.50 | $10,414 | 22.5× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$8,293.50–$9,270 | $11,058–$12,360 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$6,712.50–$8,985 | $8,950–$11,980 | varies |
| MRI, dorsal spine contrast (72147) | $7,640.25 | $10,187 | 22.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$4,410.75–$4,783.50 | $5,881–$6,378 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$7,810.50–$8,475 | $10,414–$11,300 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$10,763.25–$11,598.75 | $14,351–$15,465 | varies |
| Myelogram Lumbar (72265) | $2,231.25 | $2,975 | 2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,535.25 | $6,047 | 3.5× |
| Neck soft tissue (70360) | $246.75 | $329 | 2.8× |
| Nm csf leak detection (78650) | $1,580.25 | $2,107 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $140.25 | $187 | 1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,669.25 | $7,559 | 4.1× |
| Nuclear Rx Oral Admin (79005) | $817.50 | $1,090 | 3.5× |
| Ob us nuchal meas 1 gest (76813) | $747.75 | $997 | 7.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $947.25 | $1,263 | 9.1× |
| Parathyroid Planar Imaging (78070) | $2,081.25 | $2,775 | 5.2× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$248.25–$426 | $331–$568 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,928.50 | $9,238 | 4.9× |
| PET image w/CT, full body (78816) | $6,459.75 | $8,613 | 4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,385.50 | $8,514 | 4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,778.50 | $9,038 | 2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $765.75 | $1,021 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$439.50–$497.25 | $586–$663 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,241.75 | $2,989 | 4.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $262.50 | $350 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$190.50–$241.50 | $254–$322 | varies |
| Radex elbow complete minimum 3 views (73080) | $369 | $492 | 4.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $530.25 | $707 | 5.1× |
| Radex fingr minimum 2 views (73140) | $292.50 | $390 | 3.4× |
| Radex foot complete minimum 3 views (73630) | $299.25 | $399 | 3.5× |
| Radex Hand Minimum 3 Views (73130) | $456 | $608 | 5.3× |
| Radex lower extremity infant minimum 2 views (73592) | $327.75 | $437 | 3.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $497.25 | $663 | 4.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$282.75–$303.75 | $377–$405 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$663.75–$777 | $885–$1,036 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$300–$378 | $400–$504 | varies |
| Radex shoulder complete minimum 2 views (73030) | $378 | $504 | 4.4× |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$302.25–$328.50 | $403–$438 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$300.75–$380.25 | $401–$507 | varies |
| Radex Sternum Minimum 2 Views (71120) | $282.75 | $377 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $528.75 | $705 | 6.1× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$213–$286.50 | $284–$382 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$327.75–$408.75 | $437–$545 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $328.50 | $438 | 3.8× |
| Radiation treatment delivery level 3 (77412) | $2,637 | $3,516 | 4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$528.75–$570.75 | $705–$761 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$458.25–$620.25 | $611–$827 | varies |
| Radiologic exam colon double contrast study (74280) | $1,227.75 | $1,637 | 7.0× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$735.75–$792.75 | $981–$1,057 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,082.25 | $1,443 | 6.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$369–$384 | $492–$512 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$392.25–$423.75 | $523–$565 | varies |
| Radiologic exam swallow function contrast study (74230) | $723.75 | $965 | 4.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$144–$154.50 | $192–$206 | varies |
| Radiologic examination femur minimum 2 views (73552) | $250.50 | $334 | 2.9× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$286.50–$366 | $382–$488 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $830.25 | $1,107 | 8.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $258 | $344 | 3.0× |
| Ribs bilateral 3 views (71110) | $490.50 | $654 | 4.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,842.50 | $3,790 | 5.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,167.50 | $2,890 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,653.50 | $3,538 | 4.9× |
| Scapula (73010) range across 2 matching MRF lines |
$300–$326.25 | $400–$435 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$343.50–$375 | $458–$500 | varies |
| Shoulder Arthrography (73040) | $1,322.25 | $1,763 | 3.8× |
| Sialogram (70390) | $1,622.25 | $2,163 | 6.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$541.50–$629.25 | $722–$839 | varies |
| Special treatment procedure (77470) | $3,886.50 | $5,182 | 7.1× |
| Sternoclavicular joints (71130) | $392.25 | $523 | 4.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,887.75 | $2,517 | 5.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,959.75 | $2,613 | 14.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $969 | $1,292 | 5.5× |
| Thoracic spine 2 views (72070) | $366 | $488 | 3.5× |
| Thoracic spine 3 views (72072) | $296.25 | $395 | 2.8× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$316.50–$342.75 | $422–$457 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $2,014.50 | $2,686 | 5.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,596.50 | $3,462 | 6.5× |
| Tx Devices Design & Construction Complex (77334) | $1,417.50 | $1,890 | 3.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$144.75–$171 | $193–$228 | varies |
| Ultrasound elastography first target lesion (76982) | $734.25 | $979 | 7.0× |
| Ultrasound Elastography Parenchyma (76981) | $734.25 | $979 | 7.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $734.25 | $979 | 2.1× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$931.50–$1,074 | $1,242–$1,432 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$531.76–$855.75 | $709.01–$1,141 | varies |
| Upper gi w/o kub (74240) | $663.75 | $885 | 3.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $531 | $708 | 48.0× |
| Urea breath test c-14 isotopic analysis (78268) | $738.75 | $985 | 7.8× |
| Urethrocystogram voiding (74455) | $1,215.75 | $1,621 | 5.1× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$837–$907.50 | $1,116–$1,210 | varies |
| Us breast unilateral complete (76641) | $235.50 | $314 | 2.3× |
| Us chest (76604) range across 3 matching MRF lines |
$806.25–$1,190.25 | $1,075–$1,587 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$424.50–$492 | $566–$656 | varies |
| Us exam, pelvic, limited (76857) | $969 | $1,292 | 9.3× |
| Us head (76506) | $1,471.50 | $1,962 | 14.1× |
| Us kidney transplant (76776) | $1,496.25 | $1,995 | 14.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$282–$679.50 | $376–$906 | varies |
| Us ob detailed single fetus (76811) | $1,329 | $1,772 | 5.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$779.25–$793.50 | $1,039–$1,058 | varies |
| Us ob transvaginal (76817) | $945.75 | $1,261 | 9.1× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$1,033.50–$1,290.75 | $1,378–$1,721 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,041 | $1,388 | 10.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $717.75 | $957 | 6.9× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$855–$931.50 | $1,140–$1,242 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$687.75–$1,122.75 | $917–$1,497 | varies |
| Us scrotum and contents (76870) | $1,122.75 | $1,497 | 10.8× |
| Us spinal canal and contents (76800) | $969.75 | $1,293 | 9.3× |
| Us thyroid (76536) range across 3 matching MRF lines |
$858–$1,320 | $1,144–$1,760 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$3,914.25–$4,248.75 | $5,219–$5,665 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,268 | $7,024 | 1.7× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$3,355.50–$12,865.50 | $4,474–$17,154 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$4,248.75–$4,484.25 | $5,665–$5,979 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$3,603–$6,676.50 | $4,804–$8,902 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,818.50–$2,842.50 | $3,758–$3,790 | varies |
| Venography Renal Bilateral (75833) | $4,223.25 | $5,631 | 1.3× |
| Venography Renal Unilateral (75831) | $4,004.25 | $5,339 | 1.3× |
| Venous sampling by catheter (75893) | $22,096.50 | $29,462 | 4.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$262.50–$385.50 | $350–$514 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$359.25–$387.75 | $479–$517 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,636.50–$1,701.75 | $2,182–$2,269 | varies |
| X-Ray Aorta Leg Arteries (75630) | $12,865.50 | $17,154 | 4.1× |
| X-Ray Bend Only L-S Spine (72120) | $324.75 | $433 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$365.25–$426 | $487–$568 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,241.75 | $2,989 | 4.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$144–$169.50 | $192–$226 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$270.75–$284.25 | $361–$379 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$393–$426 | $524–$568 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$144–$282 | $192–$376 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $214.50 | $286 | 2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $310.50 | $414 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $445.50 | $594 | 4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $430.50 | $574 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $501 | $668 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $663.75 | $885 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$354.75–$437.25 | $473–$583 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$489–$530.25 | $652–$707 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$681–$741.75 | $908–$989 | varies |
| X-ray eye for foreign body (70030) | $207 | $276 | 2.4× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$271.50–$437.25 | $362–$583 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$297.75–$324 | $397–$432 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$260.25–$411 | $347–$548 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$405.75–$520.50 | $541–$694 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$864.75–$936.75 | $1,153–$1,249 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $389.25 | $519 | 3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$248.25–$389.25 | $331–$519 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$324.75–$380.25 | $433–$507 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$453.75–$566.25 | $605–$755 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $457.50 | $610 | 4.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$465.75–$507.75 | $621–$677 | varies |
| X-Ray Tmj Unilat (70328) | $324 | $432 | 3.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,001.25 | $1,335 | 2.9× |
| X-Rays Bone Length Studies (77073) | $610.50 | $814 | 5.9× |
| X-Rays Bone Survey Complete (77075) | $830.25 | $1,107 | 8.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$418.50–$520.50 | $558–$694 | varies |
| Xr facial bones less than 3 views (70140) | $296.25 | $395 | 3.4× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$488.25–$522.75 | $651–$697 | varies |
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.