Imaging prices at Childrens Hospital of Wisconsin
Milwaukee, WI · every code in this section with a posted price and a Medicare benchmark.
381 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) | $6,071.45 | $11,039 | 4.4× |
| Abdomen 1 View (74018) | $237.60 | $432 | 2.7× |
| Abdomen 2 views (74019) | $303.46 | $551.75 | 2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $975.56 | $1,773.75 | 2.4× |
| Angio internal mammary (75756) | $3,588.34 | $6,524.25 | 1.1× |
| Angio pulmonary bilat (75743) | $3,588.34 | $6,524.25 | 1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,320.25 | $7,855 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $3,588.34 | $6,524.25 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,588.34 | $6,524.25 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,588.34 | $6,524.25 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,588.34 | $6,524.25 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$191.26–$196.90 | $347.75–$358 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,233.90 | $7,698 | 0.8× |
| Artery X-Rays Abdomen (75726) | $3,652.69 | $6,641.25 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $4,043.46 | $7,351.75 | 1.3× |
| Artery X-Rays Pelvis (75736) | $3,588.34 | $6,524.25 | 0.6× |
| Artery X-Rays Spine (75705) | $3,652.69 | $6,641.25 | 0.7× |
| Arthrogram ankle (73615) | $599.64 | $1,090.25 | 1.7× |
| Arthrogram hip (73525) | $599.64 | $1,090.25 | 1.7× |
| Arthrogram Wrist (73115) | $452.93 | $823.50 | 1.3× |
| Basic radiation dosimetry calculation (77300) | $640.06 | $1,163.75 | 4.8× |
| Bone age studies (77072) | $159.23 | $289.50 | 1.5× |
| Bone Imaging 3 Phase (78315) | $998.25 | $1,815 | 2.5× |
| Bone Imaging Limited Area (78300) | $802.45 | $1,459 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $822.25 | $1,495 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,594.73 | $2,899.50 | 4.0× |
| Bone marrow imaging limited area (78102) | $679.53 | $1,235.50 | 1.7× |
| Bone marrow imaging; multiple areas (78103) | $801.63 | $1,457.50 | 2.0× |
| Bone marrow imaging; whole body (78104) | $1,553.34 | $2,824.25 | 3.9× |
| Bone survey infant (77076) range across 3 matching MRF lines |
$124.71–$715.41 | $226.75–$1,300.75 | varies |
| Brachytx isodose complex (77318) | $3,010.15 | $5,473 | 8.1× |
| Brachytx isodose intermed (77317) | $2,708.06 | $4,923.75 | 7.3× |
| Brachytx Isodose Plan Simple (77316) | $2,348.09 | $4,269.25 | 6.3× |
| Brain Image W/Flow < 4 Views (78601) | $661.51 | $1,202.75 | 1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,139.05 | $2,071 | 2.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $867.76 | $1,577.75 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,611.61 | $8,384.75 | 3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,353.35 | $6,097 | 9.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,590.54 | $6,528.25 | 4.6× |
| Cardiac Shunt Detection (78428) range across 2 matching MRF lines |
$618.06–$1,053.25 | $1,123.75–$1,915 | varies |
| Cat Scan Follow-Up Study (76380) range across 6 matching MRF lines |
$201.71–$1,079.51 | $366.75–$1,962.75 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $575.03 | $1,045.50 | 1.1× |
| Chest 1 view (71045) | $129.80 | $236 | 1.5× |
| Chest 2 views (71046) | $238.56 | $433.75 | 2.8× |
| Chest 3 views (71047) | $275 | $500 | 3.2× |
| Chest 4 or more views (71048) | $317.90 | $578 | 3.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $233.61 | $424.75 | 2.2× |
| Clavicle complete (73000) | $229.76 | $417.75 | 2.7× |
| Continuing medical physics consltj pr wk (77336) | $2,046.69 | $3,721.25 | 15.3× |
| Contrast Exam Abdominl Aorta (75625) | $4,233.90 | $7,698 | 1.3× |
| Contrast X-Ray Bladder (74430) | $380.88 | $692.50 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $599.64 | $1,090.25 | 1.7× |
| Contrast X-Ray Of Knee Joint (73580) | $746.35 | $1,357 | 2.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,547.33 | $4,631.50 | 7.3× |
| CT abdomen and pelvis without contrast (74176) | $1,849.38 | $3,362.50 | 7.8× |
| CT abdomen w contrast (74160) | $1,408.28 | $2,560.50 | 8.1× |
| CT abdomen w wo contrast (74170) | $1,605.18 | $2,918.50 | 9.2× |
| CT abdomen w/o contrast (74150) | $1,309.96 | $2,381.75 | 12.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,835.19 | $8,791.25 | 13.9× |
| CT Angio Chest (71275) | $3,247.48 | $5,904.50 | 18.6× |
| CT Angio Head (70496) | $2,943.05 | $5,351 | 16.8× |
| CT angio hrt w/3d image (75574) | $3,863.06 | $7,023.75 | 11.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,892.86 | $5,259.75 | 16.6× |
| CT Angio Neck (70498) | $2,798.81 | $5,088.75 | 16.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,892.86 | $5,259.75 | 16.6× |
| CT cervical spine w/ contrast (72126) | $1,346.95 | $2,449 | 3.9× |
| CT cervical spine w/o contrast (72125) | $1,269.54 | $2,308.25 | 12.2× |
| CT cervical spine w/wo cont (72127) | $1,626.76 | $2,957.75 | 9.3× |
| CT chest w contrast (71260) | $1,481.70 | $2,694 | 8.5× |
| CT chest w/wo contrast (71270) | $1,660.73 | $3,019.50 | 9.5× |
| CT head/brain with contrast (70460) | $1,347.09 | $2,449.25 | 7.7× |
| CT head/brain without and with contrast (70470) | $1,828.06 | $3,323.75 | 10.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $4,249.58 | $7,726.50 | 12.2× |
| CT hrt w/3d image congen (75573) | $4,249.58 | $7,726.50 | 12.2× |
| CT iac w contrast (70481) | $1,341.18 | $2,438.50 | 7.7× |
| CT l-spine w&w/o contrast (72133) | $1,660.73 | $3,019.50 | 9.5× |
| CT lower ext w/o (73700) | $864.88 | $1,572.50 | 8.3× |
| CT lower extremity w/contrast material (73701) | $940.78 | $1,710.50 | 5.4× |
| CT lumbar spine w contrast (72132) | $1,346.95 | $2,449 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,269.54 | $2,308.25 | 12.2× |
| CT maxillofacial w contrast (70487) | $1,341.18 | $2,438.50 | 7.7× |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$570.90–$1,375 | $1,038–$2,500 | varies |
| CT neck tissue combo (70492) | $1,522.26 | $2,767.75 | 8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,909.60 | $3,472 | 10.9× |
| CT orbits w/o contrast (70480) | $1,250.01 | $2,272.75 | 12.0× |
| CT pelvis w&w/o contrast (72194) | $1,660.73 | $3,019.50 | 9.5× |
| CT pelvis w/o contrast (72192) | $1,396.45 | $2,539 | 13.4× |
| CT scan of leg combo (73702) | $1,014.75 | $1,845 | 5.8× |
| CT scans face/jaw combo (70488) | $1,826.83 | $3,321.50 | 10.5× |
| CT soft tissue neck w contrast (70491) | $1,135.48 | $2,064.50 | 6.5× |
| CT soft tissue neck w/o contrast (70490) | $1,116.09 | $2,029.25 | 10.7× |
| CT thoracic spine w contrast (72129) | $1,818.44 | $3,306.25 | 10.4× |
| CT thoracic spine w/o contrast (72128) | $1,523.50 | $2,770 | 14.6× |
| CT thoracic spine w/wo cont (72130) | $1,626.76 | $2,957.75 | 9.3× |
| CT thorax w/o contrast (71250) | $1,459.98 | $2,654.50 | 14.0× |
| CT upper ext wo (73200) | $864.88 | $1,572.50 | 8.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,014.75 | $1,845 | 5.8× |
| CT upper extremity with contrast (73201) | $940.78 | $1,710.50 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,723.23 | $6,769.50 | 21.3× |
| Cta Abdomen (74175) | $3,223.28 | $5,860.50 | 18.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $5,741.86 | $10,439.75 | 16.5× |
| CTA pelvis (72191) | $3,223.28 | $5,860.50 | 18.4× |
| Dilation ureters/urethra rs&i (74485) | $899.53 | $1,635.50 | 0.4× |
| Diskography lumbar (72295) | $1,160.91 | $2,110.75 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $251.90 | $458 | 2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $340.04 | $618.25 | 3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $508.06 | $923.75 | 4.9× |
| Dxa Bone Density Axial (77080) | $502.43 | $913.50 | 4.8× |
| Dxa bone density study (77085) | $703.86 | $1,279.75 | 6.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $436.70 | $794 | 5.0× |
| Echo exam of fetal heart (76825) | $991.10 | $1,802 | 1.8× |
| Echo Guide For Artery Repair (76936) | $1,904.10 | $3,462 | 8.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $524.29 | $953.25 | 2.2× |
| Esophageal Motility Study (78258) | $819.64 | $1,490.25 | 2.1× |
| Esophagram (74220) | $463.65 | $843 | 2.7× |
| Fetal Biophys Profile W/Nst (76818) | $613.66 | $1,115.75 | 5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $534.19 | $971.25 | 5.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $3,094.58 | $5,626.50 | 13.0× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$460.08–$483.73 | $836.50–$879.50 | varies |
| Follow-Up Angiography (75898) | $303.05 | $551 | 0.1× |
| Foot 2 views (73620) | $192.36 | $349.75 | 2.2× |
| Forearm 2 views (73090) | $191.26 | $347.75 | 2.2× |
| Gastric emptying imaging study (78264) | $1,034.69 | $1,881.25 | 2.6× |
| Gastroesophageal Reflux Exam (78262) | $819.64 | $1,490.25 | 2.1× |
| Gated Heart Planar Single (78472) | $1,565.30 | $2,846 | 3.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $740.58 | $1,346.50 | 1.4× |
| Hand 2 views (73120) | $191.26 | $347.75 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,929.13 | $3,507.50 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,588.34 | $6,524.25 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $634.84 | $1,154.25 | 1.2× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$485.24–$634.84 | $882.25–$1,154.25 | varies |
| Ht Muscle Image Spect Sing (78451) | $963.74 | $1,752.25 | 0.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $537.08 | $976.50 | 6.2× |
| Infant hip ultrasound, limited static exam (76886) | $512.19 | $931.25 | 5.9× |
| K Flow/Funct Image W/Drug (78708) | $1,674.89 | $3,045.25 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,027.68 | $1,868.50 | 1.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $216.01 | $392.75 | 0.5× |
| Kidney Imaging Morphol (78700) | $706.34 | $1,284.25 | 1.8× |
| Knee 3 Views (73562) | $358.88 | $652.50 | 4.1× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,186.08 | $2,156.50 | 3.0× |
| Leveen/Shunt Patency Exam (78291) | $500.09 | $909.25 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,118.01 | $2,032.75 | 2.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $575.30 | $1,046 | 1.4× |
| Liver imaging static only (78201) | $574.48 | $1,044.50 | 1.1× |
| Liver imaging w/vascular flow (78202) | $867.76 | $1,577.75 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $261.25 | $475 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,717.10 | $3,122 | 3.2× |
| Lung Ventilation Imaging (78579) | $923.45 | $1,679 | 2.3× |
| Lymph System Imaging (78195) | $803.28 | $1,460.50 | 1.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,738.96 | $3,161.75 | 1.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,738.96 | $3,161.75 | 2.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,739.10 | $3,162 | 0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,738.96 | $3,161.75 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $2,516.94 | $4,576.25 | 10.6× |
| Meckels Divert Exam (78290) | $867.08 | $1,576.50 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) | $1,739.10 | $3,162 | 4.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $16.50 | $30 | 0.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,356.06 | $4,283.75 | 6.8× |
| MRA head w/o contrast (70544) | $2,611.81 | $4,748.75 | 11.0× |
| MRA head with contrast (70545) | $2,611.81 | $4,748.75 | 7.5× |
| MRA neck w contrast (70548) | $2,611.81 | $4,748.75 | 7.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,356.06 | $4,283.75 | 6.8× |
| MRA neck w/o contrast (70547) | $2,611.81 | $4,748.75 | 11.0× |
| MRI abdomen w contrast (74182) | $2,516.94 | $4,576.25 | 7.2× |
| MRI abdomen w/o contrast (74181) | $2,516.94 | $4,576.25 | 10.6× |
| MRI any jt lower extrem w/contrast material (73722) | $2,516.94 | $4,576.25 | 3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,424.03 | $6,225.50 | 9.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,516.94 | $4,576.25 | 3.2× |
| MRI bone marrow blood supply (77084) | $3,146.14 | $5,720.25 | 13.2× |
| MRI brain functional w/physician admnistration (70555) | $5,222.53 | $9,495.50 | 22.0× |
| MRI cardiac w/o contrast (75557) | $2,611.81 | $4,748.75 | 11.0× |
| MRI cervical spine w contrast (72142) | $2,783.96 | $5,061.75 | 8.0× |
| MRI cervical spine w/o cont (72141) | $2,783.96 | $5,061.75 | 11.7× |
| MRI chest w/o contrast (71550) | $2,611.81 | $4,748.75 | 11.0× |
| MRI chest with contrast (71551) | $2,188.73 | $3,979.50 | 2.8× |
| MRI chest wo w contrast (71552) | $2,536.33 | $4,611.50 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,516.94 | $4,576.25 | 7.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,397.90 | $6,178 | 9.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,322.41 | $6,040.75 | 14.0× |
| MRI lumbar spine w contrast (72149) | $2,783.96 | $5,061.75 | 8.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,856.60 | $7,012 | 11.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,516.94 | $4,576.25 | 10.6× |
| MRI orbit face neck w contrast (70542) | $2,188.73 | $3,979.50 | 6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,184.50 | $5,790 | 9.2× |
| MRI pelvis w contrast (72196) | $2,633.40 | $4,788 | 7.6× |
| MRI pelvis w/o & w contrast (72197) | $3,346.75 | $6,085 | 9.6× |
| MRI pelvis w/o contrast (72195) | $2,640.28 | $4,800.50 | 11.1× |
| MRI spectroscopy (76390) | $471.90 | $858 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $2,709.03 | $4,925.50 | 11.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,516.94 | $4,576.25 | 7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,640.28 | $4,800.50 | 11.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,516.94 | $4,576.25 | 7.2× |
| MRI, abdomen, combo (74183) | $3,184.50 | $5,790 | 9.2× |
| MRI, dorsal spine combo (72157) | $3,789.91 | $6,890.75 | 10.9× |
| MRI, dorsal spine contrast (72147) | $2,709.03 | $4,925.50 | 7.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$744.70–$2,516.94 | $1,354–$4,576.25 | varies |
| MRI, joint upper extrem combo (73223) | $3,424.03 | $6,225.50 | 9.9× |
| MRI, lumbar spine combo (72158) | $3,539.39 | $6,435.25 | 10.2× |
| Myelogram cervical (72240) | $1,353.83 | $2,461.50 | 1.7× |
| Myelogram Lumbar (72265) | $1,161.60 | $2,112 | 1.5× |
| Myelography thoracic (72255) | $1,233.51 | $2,242.75 | 1.6× |
| Myelograpy 2/more regions rs&i (72270) | $1,739.10 | $3,162 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $963.74 | $1,752.25 | 0.7× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$235.40–$260.43 | $428–$473.50 | varies |
| Nonvascular Shunt X-Ray (75809) | $213.68 | $388.50 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,509.50 | $17,290 | 6.9× |
| Nuclear Rx Oral Admin (79005) | $703.73 | $1,279.50 | 3.0× |
| Ob us nuchal meas 1 gest (76813) | $403.98 | $734.50 | 3.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$71.50–$157.85 | $130–$287 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $62.84 | $114.25 | 2.2× |
| Panoramic X-ray of jaws (70355) | $161.01 | $292.75 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,090.10 | $1,982 | 2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,361.56 | $4,293.75 | 5.9× |
| Pelvis 1 or 2 views (72170) | $203.50 | $370 | 2.0× |
| Perineogram (74775) | $355.85 | $647 | 1.5× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$6,036.11–$7,193.45 | $10,974.75–$13,079 | varies |
| PET image w/CT, full body (78816) | $7,260.96 | $13,201.75 | 5.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $4,949.86 | $8,999.75 | 3.8× |
| PET whole body (78813) | $6,284.16 | $11,425.75 | 4.4× |
| Platelet survival study Non-Facility (78191) | $683.51 | $1,242.75 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,588.34 | $6,524.25 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,168.48 | $2,124.50 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $343.06 | $623.75 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $303.05 | $551 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $235.40 | $428 | 2.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $231.41 | $420.75 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $235.40 | $428 | 2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $297.55 | $541 | 2.9× |
| Radex fingr minimum 2 views (73140) | $191.26 | $347.75 | 2.2× |
| Radex foot complete minimum 3 views (73630) | $235.40 | $428 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $235.40 | $428 | 2.7× |
| Radex lower extremity infant minimum 2 views (73592) | $150.29 | $273.25 | 1.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $249.56 | $453.75 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $211.20 | $384 | 2.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $297.55 | $541 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $174.35 | $317 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) | $235.40 | $428 | 2.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $172.56 | $313.75 | 2.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,269.40 | $2,308 | 7.3× |
| Radex Spine 1 View Specify Level (72020) | $159.23 | $289.50 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $174.35 | $317 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $249.56 | $453.75 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $191.26 | $347.75 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $150.29 | $273.25 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $235.40 | $428 | 2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $768.90 | $1,398 | 7.4× |
| Radiation treatment delivery level 1 (77402) | $830.23 | $1,509.50 | 8.2× |
| Radiation treatment delivery level 2 (77407) | $1,067.96 | $1,941.75 | 2.8× |
| Radiation treatment delivery level 3 (77412) | $1,972.85 | $3,587 | 3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $297.55 | $541 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $274.18 | $498.50 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $355.85 | $647 | 2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $452.93 | $823.50 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) | $402.46 | $731.75 | 3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $237.46 | $431.75 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $355.85 | $647 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $493.90 | $898 | 2.8× |
| Radiologic examination femur 1 view (73551) | $190.44 | $346.25 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) | $258.36 | $469.75 | 3.0× |
| Radiologic examination knee 1/2 views (73560) | $159.23 | $289.50 | 1.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $359.01 | $652.75 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$202.95–$268.40 | $369–$488 | varies |
| Radiopharm Dacryocystography (78660) | $357.23 | $649.50 | 0.9× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $612.01 | $1,112.75 | 2.6× |
| Renal Cyst Study (74470) | $355.99 | $647.25 | 0.7× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$230.86–$297.55 | $419.75–$541 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,569.43 | $2,853.50 | 3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,086.53 | $1,975.50 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,221.66 | $7,675.75 | 7.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,270.68 | $4,128.50 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,108.11 | $2,014.75 | 2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,316.54 | $7,848.25 | 3.3× |
| Salivary Gland Imaging (78230) | $509.58 | $926.50 | 1.3× |
| Scapula (73010) | $267.85 | $487 | 2.6× |
| Shoulder 1 view (73020) | $143.14 | $260.25 | 1.7× |
| Shoulder Arthrography (73040) | $599.64 | $1,090.25 | 1.7× |
| Sialogram (70390) | $519.20 | $944 | 2.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$117.98–$174.35 | $214.50–$317 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$577.91–$1,202.16 | $1,050.75–$2,185.75 | varies |
| Special Physics Consult (77370) | $941.46 | $1,711.75 | 7.0× |
| Special teletherapy port plan (77321) | $1,572.04 | $2,858.25 | 4.2× |
| Special treatment procedure (77470) | $2,699.95 | $4,909 | 4.9× |
| Speech evaluation, complex (70371) | $377.44 | $686.25 | 1.6× |
| Spleen Imaging (78185) | $575.30 | $1,046 | 1.4× |
| Sternoclavicular joints (71130) | $174.35 | $317 | 2.0× |
| Superior sagittal sinus venogram (75870) | $3,588.34 | $6,524.25 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,041.64 | $5,530.25 | 8.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,619.51 | $4,762.75 | 7.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $599.64 | $1,090.25 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,292.44 | $5,986.25 | 8.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $832.43 | $1,513.50 | 2.2× |
| Ther rad simulaj-aided field setting simple (77280) | $1,462.31 | $2,658.75 | 10.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$444.81–$600.46 | $808.75–$1,091.75 | varies |
| Thoracic spine 2 views (72070) | $174.35 | $317 | 1.7× |
| Thoracic spine 3 views (72072) | $249.56 | $453.75 | 2.4× |
| Thoracolumbar 2 views (72080) | $297.55 | $541 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $786.36 | $1,429.75 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,679.43 | $3,053.50 | 3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,650.83 | $3,001.50 | 4.1× |
| Tx Devices Design & Construction Complex (77334) | $1,516.35 | $2,757 | 4.1× |
| Tx devices design & construction intermediate (77333) | $484.96 | $881.75 | 3.6× |
| Tx devices design & construction simple (77332) | $431.61 | $784.75 | 3.2× |
| Ultrasound Breast Limited (76642) | $324.78 | $590.50 | 3.7× |
| Ultrasound Elastography Parenchyma (76981) | $556.74 | $1,012.25 | 5.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $849.75 | $1,545 | 2.4× |
| Ultrasound, abdomen limited (76705) range across 9 matching MRF lines |
$116.88–$441.65 | $212.50–$803 | varies |
| Umbilical-artery Doppler (OB) (76820) | $199.79 | $363.25 | 1.9× |
| Unlisted fluoroscopic procedure (76496) | $272.94 | $496.25 | 3.1× |
| Unlisted magnetic resonance procedure (76498) | $4,303.89 | $7,825.25 | 49.7× |
| Upper gi w/o kub (74240) | $600.46 | $1,091.75 | 3.4× |
| Urethrocystogram voiding (74455) | $615.59 | $1,119.25 | 2.6× |
| Urethrocystography retrograde (74450) | $70.54 | $128.25 | 0.3× |
| Us chest (76604) range across 3 matching MRF lines |
$116.88–$324.78 | $212.50–$590.50 | varies |
| Us complete joint (76881) | $588.78 | $1,070.50 | 5.7× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$116.88–$386.38 | $212.50–$702.50 | varies |
| Us head (76506) | $431.34 | $784.25 | 4.1× |
| Us kidney transplant (76776) | $817.44 | $1,486.25 | 7.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$157.85–$481.39 | $287–$875.25 | varies |
| Us ob detailed single fetus (76811) | $811.25 | $1,475 | 3.4× |
| Us ob limited 1 or more fetuses (76815) | $375.93 | $683.50 | 3.6× |
| Us ob transvaginal (76817) | $389.95 | $709 | 3.7× |
| Us pelvic non ob complete (76856) | $492.39 | $895.25 | 4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$484.96–$671.14 | $881.75–$1,220.25 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $555.91 | $1,010.75 | 5.3× |
| Us retroperitoneal complete (76770) | $899.39 | $1,635.25 | 8.6× |
| Us retroperitoneal limited (76775) | $570.35 | $1,037 | 5.5× |
| Us scrotum and contents (76870) | $425.70 | $774 | 4.1× |
| Us spinal canal and contents (76800) | $405.76 | $737.75 | 3.9× |
| Us thyroid (76536) range across 2 matching MRF lines |
$116.88–$438.49 | $212.50–$797.25 | varies |
| Vascular Flow Imaging (78445) | $456.50 | $830 | 1.1× |
| Vein X-Ray Chest (75827) | $4,253.01 | $7,732.75 | 2.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,588.34 | $6,524.25 | 1.1× |
| Vein X-Ray Spleen/Liver (75810) | $3,588.34 | $6,524.25 | 1.1× |
| Venogram Sinus/Jugular (75860) | $4,310.21 | $7,836.75 | 1.4× |
| Venography Adrenal Unilateral (75840) | $3,588.34 | $6,524.25 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $4,233.90 | $7,698 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $1,559.94 | $2,836.25 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,559.94 | $2,836.25 | 1.0× |
| Venography Orbital Rs&I (75880) | $3,588.34 | $6,524.25 | 5.7× |
| Venography Renal Bilateral (75833) | $3,588.34 | $6,524.25 | 1.1× |
| Venography Renal Unilateral (75831) | $3,588.34 | $6,524.25 | 1.1× |
| Venous sampling by catheter (75893) | $3,588.34 | $6,524.25 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $470.80 | $856 | 5.4× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$141.63–$191.26 | $257.50–$347.75 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $150.29 | $273.25 | 1.7× |
| X-ray antegrade pyelogram tube (74425) | $371.80 | $676 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $3,740.41 | $6,800.75 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $306.90 | $558 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $191.26 | $347.75 | 2.2× |
| X-Ray Exam Breast Specimen (76098) | $84.15 | $153 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $326.70 | $594 | 3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $430.93 | $783.50 | 4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $767.80 | $1,396 | 7.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $117.98 | $214.50 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $182.05 | $331 | 2.1× |
| X-Ray Exam L-S Spine Bending (72114) | $639.93 | $1,163.50 | 6.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $174.35 | $317 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $291.91 | $530.75 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $247.91 | $450.75 | 2.4× |
| X-ray eye for foreign body (70030) | $187.14 | $340.25 | 2.2× |
| X-ray humerus (73060) | $202.95 | $369 | 2.3× |
| X-ray IV pyelogram (ivp) (74400) | $409.34 | $744.25 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $172.56 | $313.75 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $143.14 | $260.25 | 1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $235.40 | $428 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $198.83 | $361.50 | 2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $340.31 | $618.75 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $183.84 | $334.25 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $159.23 | $289.50 | 1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $174.35 | $317 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $359.84 | $654.25 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $401.64 | $730.25 | 3.9× |
| X-ray thoracic spine 4 vw (72074) | $253.69 | $461.25 | 2.4× |
| X-Ray Tmj Unilat (70328) | $172.56 | $313.75 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $297.55 | $541 | 0.9× |
| X-Rays Bone Length Studies (77073) | $348.15 | $633 | 3.3× |
| X-Rays Bone Survey Complete (77075) | $491.98 | $894.50 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $320.51 | $582.75 | 3.1× |
| Xr facial bones less than 3 views (70140) | $252.18 | $458.50 | 2.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $181.50 | $330 | 1.7× |
| Xr orbits complete 4 views (70200) | $297.55 | $541 | 2.9× |
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.