Imaging prices at Cleveland Clinic Martin North Hospital

Stuart, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $7,670.65 $11,801 5.3×
Abdomen 2 views (74019) $596.70 $918 5.5×
Acute gi blood loss imaging (78278) $2,252.90 $3,466 5.4×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $7,319 $11,260 5.4×
Angiography extremity bilateral rs&i (75716) $17,646.20 $27,148 5.4×
Angiography extremity unilateral rs&i (75710) $17,646.20 $27,148 5.4×
Angiography internal mammary rs&i (75756) $17,646.20 $27,148 5.4×
Angiography pelvic slctv/supraslctv rs&i (75736) $30,305.60 $46,624 5.2×
Angiography pulmonary bilateral slctv rs&i (75743) $17,646.20 $27,148 5.4×
Angiography pulmonary unilateral slctv rs&i (75741) $17,646.20 $27,148 5.4×
Angiography Spinal Selective Rs&I (75705) $30,305.60 $46,624 5.2×
Angiography visceral slctv/supraslctv rs&i (75726) $30,305.60 $46,624 5.2×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $17,646.20 $27,148 5.4×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $17,646.20 $27,148 5.4×
Ankle 2 views (73600) $494 $760 5.4×
Aortogram thoracic (75605) $30,305.60 $46,624 5.2×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $17,646.20 $27,148 5.4×
Aortography abdominal serialography rs&i (75625) $17,646.20 $27,148 5.4×
Aortography Thoracic W/O Serialography Rs&I (75600) $17,646.20 $27,148 5.4×
Arthrogram ankle (73615) $2,002 $3,080 5.5×
Arthrogram elbow (73085) $2,002 $3,080 5.5×
Arthrogram hip (73525) $2,002 $3,080 5.5×
Arthrogram knee (73580) $1,965.92 $3,024.50 5.4×
Arthrogram shoulder (73040) $2,002 $3,080 5.5×
Arthrogram wrist (73115) $2,002 $3,080 5.5×
Basic dosimetry (77300) $744.25 $1,145 5.3×
Bone &/Joint Imaging Limited Area (78300) $2,252.90 $3,466 5.4×
Bone &/joint imaging whole body (78306) $2,252.90 $3,466 5.4×
Bone age studies (77072) $596.70 $918 5.5×
Bone Imaging 3 Phase (78315) $2,252.90 $3,466 5.4×
Bone Marrow Imaging Limited Area (78102) $2,252.90 $3,466 5.4×
Bone survey complete (77075) $596.70 $918 5.5×
Bone survey infant (77076) $596.70 $918 5.5×
Bowel imaging (78290) $2,252.90 $3,466 5.4×
Brachytx isodose complex (77318) $2,052.70 $3,158 5.2×
Brachytx isodose intermed (77317) $2,052.70 $3,158 5.2×
Brachytx isodose pln smpl w/dosimetry cal (77316) $2,052.70 $3,158 5.2×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $2,252.90 $3,466 5.4×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $3,017.95 $4,643 5.3×
Brain Imaging Pet Metabolic Evaluation (78608) $8,177 $12,580 5.5×
Brain Imaging Vascular Flow Only (78610) $3,017.95 $4,643 5.3×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $2,252.90 $3,466 5.4×
Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) $3,017.95 $4,643 5.3×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $4,429.10 $6,814 5.4×
Cardiac MRI w/w/o contrast & further seq (75561) $2,002 $3,080 5.5×
Cardiac shunt detection (78428) $2,252.90 $3,466 5.4×
Cephalogram, orthodontic Non-Facility (70350) $494 $760 5.4×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $3,017.95 $4,643 5.3×
Cervical spine 2 or 3 views (72040) $494 $760 5.4×
Chest 1 view (71045) $494 $760 5.4×
Chest xray 3 views (71047) $494 $760 5.4×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $997.75 $1,535 5.4×
Clavicle complete (73000) $494 $760 5.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $596.70 $918 5.5×
Continuing medical physics consltj pr wk (77336) $744.25 $1,145 5.3×
Contrast Xray Throat/Cerv Esopha (74210) $997.75 $1,535 5.4×
CT abdomen and pelvis without and with contrast (74178) $2,002 $3,080 5.5×
CT abdomen and pelvis without contrast (74176) $1,355.25 $2,085 5.4×
CT abdomen w contrast (74160) $997.75 $1,535 5.4×
CT abdomen w wo contrast (74170) $997.75 $1,535 5.4×
CT abdomen w/o contrast (74150) $596.70 $918 5.5×
CT angio hrt w/3d image (75574) $2,002 $3,080 5.5×
CT angio lwr extr w/o&w/dye (73706) $997.75 $1,535 5.4×
CT angiography upper extremity lt (73206) $997.75 $1,535 5.4×
CT c-spine w/contrast (72126) $2,002 $3,080 5.5×
CT c-spine w/o contrast (72125) $596.70 $918 5.5×
CT cere prfu aly c+wo CT/CTA (70473) $1,004.25 $1,545 5.5×
CT cervical spine w&w/o contrast (72127) $997.75 $1,535 5.4×
CT chest w contrast (71260) $997.75 $1,535 5.4×
CT chest w/wo contrast (71270) $997.75 $1,535 5.4×
CT colonography w/dye (74262) $997.75 $1,535 5.4×
CT colonography w/o cntrst (74261) $596.70 $918 5.5×
CT head/brain with contrast (70460) $997.75 $1,535 5.4×
CT head/brain without and with contrast (70470) $997.75 $1,535 5.4×
CT heart contrast eval cardiac structure&morph (75572) $2,002 $3,080 5.5×
CT heart w/o contrast quant eval coronary calcium (75571) $494 $760 5.4×
CT iac w contrast (70481) $997.75 $1,535 5.4×
CT limited/localized follow up study (76380) $494 $760 5.4×
CT lower ext w/o (73700) $596.70 $918 5.5×
CT lower extremity w wo contrast (73702) $997.75 $1,535 5.4×
CT lower extremity w/contrast material (73701) $997.75 $1,535 5.4×
CT lumbar spine w & w/o contrast (72133) $997.75 $1,535 5.4×
CT lumbar spine w/contrast (72132) $2,002 $3,080 5.5×
CT lumbar spine w/o contrast (72131) $596.70 $918 5.5×
CT maxillofacial w contrast (70487) $997.75 $1,535 5.4×
CT maxillofacial w/wo contrast (70488) $997.75 $1,535 5.4×
CT maxillofacial wo contrast (70486) $596.70 $918 5.5×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $997.75 $1,535 5.4×
CT orbits w/o contrast (70480) $596.70 $918 5.5×
CT pelvis w/o contrast (72192) $596.70 $918 5.5×
CT pelvis w/wo contrast (72194) $997.75 $1,535 5.4×
CT scan of arm combo (73202) $997.75 $1,535 5.4×
CT soft tissue neck w contrast (70491) $997.75 $1,535 5.4×
CT soft tissue neck w/o & w/contrast material (70492) $997.75 $1,535 5.4×
CT soft tissue neck w/o contrast (70490) $596.70 $918 5.5×
CT thoracic spine w/contrast (72129) $997.75 $1,535 5.4×
CT thoracic spine w/o contrast (72128) $596.70 $918 5.5×
CT thoracic spine w/wo contrast (72130) $997.75 $1,535 5.4×
CT thorax w/o contrast (71250) $596.70 $918 5.5×
CT unlisted procedure (76497) $4,109.62 $6,322.50 45.2×
CT upper ext wo (73200) $596.70 $918 5.5×
CT upper extremity with contrast (73201) $2,002 $3,080 5.5×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $997.75 $1,535 5.4×
Cta Abdomen (74175) $997.75 $1,535 5.4×
CTA abdomen pelvis (74174) $2,002 $3,080 5.5×
CTA chest (71275) $997.75 $1,535 5.4×
Cta Head (70496) $997.75 $1,535 5.4×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,998.10 $3,074 5.5×
Cta Neck (70498) $997.75 $1,535 5.4×
Cta Pelvis (72191) $997.75 $1,535 5.4×
Cystography minimum 3 views rs&i (74430) $2,002 $3,080 5.5×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $11,484.85 $17,669 5.3×
Diskography lumbar (72295) $10,947.95 $16,843 5.4×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $596.70 $918 5.5×
Doppler Echo Fetal Spectral Display Complete (76827) $596.70 $918 5.5×
Doppler Fetal Mid Cerebral Artery (76821) $596.70 $918 5.5×
Dxa bone density study 1/> sites axial skel (77080) $596.70 $918 5.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $494 $760 5.4×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,355.25 $2,085 5.4×
Esophagus (74220) $997.75 $1,535 5.4×
Facial bones min 3 views (70150) $596.70 $918 5.5×
Fetal biophysical profile non-stress testing (76818) $596.70 $918 5.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $596.70 $918 5.5×
Fetal Echo (76825) $3,073.85 $4,729 5.4×
Fluoroscopy up to 1 hr (76000) $1,355.25 $2,085 5.4×
Foot 2 views (73620) $494 $760 5.4×
Forearm 2 views (73090) $494 $760 5.4×
Functional MRI brain by phys/psych (70555) $1,355.25 $2,085 5.4×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $2,252.90 $3,466 5.4×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $3,017.95 $4,643 5.3×
Hand 2 views (73120) $596.70 $918 5.5×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $3,889.60 $5,984 5.3×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $3,889.60 $5,984 5.3×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $3,889.60 $5,984 5.3×
Heart first pass single,planar (78481) $3,017.95 $4,643 5.3×
Heart Infarct Image (78466) $2,252.90 $3,466 5.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $17,646.20 $27,148 5.4×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $17,646.20 $27,148 5.4×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $3,017.95 $4,643 5.3×
Hepatobiliary syst imaging including gallbladder (78226) $2,252.90 $3,466 5.4×
Hysterosalpingogram (74740) $1,355.25 $2,085 5.4×
Intracavitary Radiation Source Applic Simple (77761) $3,242.85 $4,989 5.6×
Intraop radiaj tx deliver xray single tx session (77424) $42,857.10 $65,934 5.6×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $596.70 $918 5.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $3,017.95 $4,643 5.3×
Kidney img morphology vascular flow 1 w/rx (78708) $3,017.95 $4,643 5.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $3,017.95 $4,643 5.3×
Knee 3 views (73562) $494 $760 5.4×
Liver & spleen imaging static only (78215) $2,252.90 $3,466 5.4×
Lung perf&ventilat diferentl (78598) $3,017.95 $4,643 5.3×
Lung perfusion differential (78597) $2,252.90 $3,466 5.4×
Lung ventilation imaging (78579) $2,252.90 $3,466 5.4×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $17,646.20 $27,148 5.4×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) $8,709.35 $13,399 5.3×
Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) $3,466.45 $5,333 5.3×
Lymphoscintigraphy (78195) $3,017.95 $4,643 5.3×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $4,429.10 $6,814 5.4×
Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70559) $997.75 $1,535 5.4×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $2,002 $3,080 5.5×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $2,002 $3,080 5.5×
Magnetic Resonance Elastography (76391) $1,355.25 $2,085 5.4×
Mammary ductogram or galactogram multiple (77054) $1,355.25 $2,085 5.4×
Mammary ductogram or galactogram single (77053) $1,355.25 $2,085 5.4×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $494 $760 5.4×
Mlc imrt design & construction per imrt plan (77338) $2,052.70 $3,158 5.2×
Mr safety determination physician/other qhp (76016) $494 $760 5.4×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $137.15 $211 4.5×
Mr safety implt electronics prepj supvj phys/qhp (76018) $514.15 $791 5.2×
Mr safety implt pos&/immoblj (76019) $333.45 $513 5.4×
Mr safety med physics xm customization plng&mntr (76017) $1,355.25 $2,085 5.4×
MRA head w & w/o contrast (70546) $2,002 $3,080 5.5×
MRA head w/o contrast (70544) $1,355.25 $2,085 5.4×
MRA head with contrast (70545) $2,002 $3,080 5.5×
MRA neck w contrast (70548) $2,002 $3,080 5.5×
Mra Neck W/O &W/Contrast Material (70549) $2,002 $3,080 5.5×
MRA neck w/o contrast (70547) $1,355.25 $2,085 5.4×
MRI abdomen w contrast (74182) $2,002 $3,080 5.5×
MRI abdomen w/o & w/contrast material (74183) $2,002 $3,080 5.5×
MRI abdomen w/o contrast (74181) $1,355.25 $2,085 5.4×
MRI any jt lower extrem w/contrast material (73722) $4,429.10 $6,814 5.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,002 $3,080 5.5×
MRI breast w/o contrast bilateral (77047) $1,355.25 $2,085 5.4×
MRI breast wo contrast unilateral (77046) $1,355.25 $2,085 5.4×
MRI c-spine with contrast (72142) $2,002 $3,080 5.5×
MRI cardiac w/o contrast (75557) $1,355.25 $2,085 5.4×
MRI cervical spine w/o contrast (72141) $1,355.25 $2,085 5.4×
MRI chest w/o & w/contrast material (71552) $2,002 $3,080 5.5×
MRI chest w/o contrast (71550) $1,355.25 $2,085 5.4×
MRI chest with contrast (71551) $4,429.10 $6,814 5.4×
MRI fetal sngl/1st gestation (74712) $1,355.25 $2,085 5.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,002 $3,080 5.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,002 $3,080 5.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,355.25 $2,085 5.4×
MRI orbit face &/neck w/o contrast (70540) $1,355.25 $2,085 5.4×
MRI orbit face neck w contrast (70542) $2,002 $3,080 5.5×
MRI orbit/face/neck w&w/o cont (70543) $2,002 $3,080 5.5×
MRI pelvis w/contrast (72196) $2,002 $3,080 5.5×
MRI pelvis w/o & w/contrast material (72197) $2,002 $3,080 5.5×
MRI pelvis w/o contrast (72195) $1,355.25 $2,085 5.4×
MRI spectroscopy (76390) $494 $760 5.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,002 $3,080 5.5×
MRI spinal canal lumbar w/contrast material (72149) $2,002 $3,080 5.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,002 $3,080 5.5×
MRI spinal canal thoracic w/contrast matrl (72147) $2,002 $3,080 5.5×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,002 $3,080 5.5×
MRI temporomandibular joint (70336) $1,355.25 $2,085 5.4×
MRI thoracic spine w/o contrast (72146) $1,355.25 $2,085 5.4×
MRI up ext w/o contrast (73218) $1,355.25 $2,085 5.4×
MRI upper ext joint w/o contrast (73221) $1,355.25 $2,085 5.4×
MRI, joint upper extrem combo (73223) $2,002 $3,080 5.5×
Myelogram Cervical (72240) $4,429.10 $6,814 5.4×
Myelogram Lumbar (72265) $4,429.10 $6,814 5.4×
Myelogram thoracic (72255) $4,429.10 $6,814 5.4×
Myelography 2 or more regions (72270) $4,429.10 $6,814 5.4×
Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) $10,934.95 $16,823 4.8×
Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) $8,177 $12,580 5.5×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) $8,177 $12,580 5.5×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) $12,616.50 $19,410 5.5×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) $8,177 $12,580 5.5×
Myocardial infarct spect (78469) $3,017.95 $4,643 5.3×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $7,319 $11,260 5.4×
Myocardial Perfusion Planar Multiple Studies (78454) $7,319 $11,260 5.4×
Myocardial Spect Multiple Studies (78452) $7,319 $11,260 5.4×
Myocardial spect single study at rest or stress (78451) $7,319 $11,260 5.4×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $8,177 $12,580 5.5×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $10,374 $15,960 6.5×
N-invas est c ffr sw aly CTA (75580) $5,703.75 $8,775 6.4×
Neck soft tissue (70360) $494 $760 5.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $2,252.90 $3,466 5.4×
Nm adrenal scan (78075) $7,319 $11,260 5.4×
Nm bone marrow multi (78103) $2,252.90 $3,466 5.4×
Nm bone marrow wb (78104) $2,252.90 $3,466 5.4×
Nm cardiac blood pool multiple (78473) $2,252.90 $3,466 5.4×
Nm cisternogram (78630) $3,017.95 $4,643 5.3×
Nm csf leak detection (78650) $7,319 $11,260 5.4×
Nm gastric emptying study (78264) $2,252.90 $3,466 5.4×
Nm gastroesophageal reflux study (78262) $2,252.90 $3,466 5.4×
Nm peritoneal-venous shunt patency (78291) $2,252.90 $3,466 5.4×
Nonvascular shunt X-ray (75809) $596.70 $918 5.5×
Ntsty modul radthx pln dose-vol histos (77301) $7,670.65 $11,801 5.3×
Nuclear Rx Oral Admin (79005) $1,256.45 $1,933 5.2×
Ob us nuchal meas 1 gest (76813) $596.70 $918 5.5×
Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) $596.70 $918 5.5×
Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) $596.70 $918 5.5×
Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) $596.70 $918 5.5×
Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) $722.15 $1,111 5.2×
Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) $137.15 $211 4.5×
Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) $596.70 $918 5.5×
Osseous survey limited (77074) $596.70 $918 5.5×
Parathyrd planar w/spect&CT (78072) $3,017.95 $4,643 5.3×
Parathyroid Planar Imaging (78070) $2,252.90 $3,466 5.4×
Parathyroid planar imaging w/wo subtraction (78071) $2,252.90 $3,466 5.4×
Pelvis 1 or 2 views (72170) $596.70 $918 5.5×
Peritoneogram after injection (74190) $3,073.85 $4,729 5.4×
PET image w/CT, skull-thigh (78815) $8,177 $12,580 5.5×
PET imaging CT for attenuation limited area (78814) $8,177 $12,580 5.5×
PET imaging for CT attenuation whole body (78816) $8,177 $12,580 5.5×
PET whole body (78813) $8,177 $12,580 5.5×
Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) $8,177 $12,580 5.5×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $17,646.20 $27,148 5.4×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $17,646.20 $27,148 5.4×
Pulmonary Perfusion Imaging Particulate (78580) $2,252.90 $3,466 5.4×
Pulmonary Ventilation & Perfusion Imaging (78582) $3,017.95 $4,643 5.3×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $5,328.70 $8,198 5.5×
Radex abscess/fistula/sinus tract rs&i (76080) $3,073.85 $4,729 5.4×
Radex Ankle Compl Minimum 3 Views (73610) $494 $760 5.4×
Radex Calcaneus Minimum 2 Views (73650) $494 $760 5.4×
Radex Elbw Compl Minimum 3 Views (73080) $494 $760 5.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $494 $760 5.4×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $596.70 $918 5.5×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $596.70 $918 5.5×
Radex fingr minimum 2 views (73140) $494 $760 5.4×
Radex Foot Compl Minimum 3 Views (73630) $494 $760 5.4×
Radex Hand Minimum 3 Views (73130) $494 $760 5.4×
Radex Hip Unilateral With Pelvis 1 View (73501) $494 $760 5.4×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $596.70 $918 5.5×
Radex Hips Bilateral With Pelvis 2 Views (73521) $596.70 $918 5.5×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $596.70 $918 5.5×
Radex Humerus Minimum 2 Views (73060) $494 $760 5.4×
Radex Kne 1/2 Views (73560) $494 $760 5.4×
Radex Kne Compl 4/More Views (73564) $596.70 $918 5.5×
Radex Mndbl Compl Minimum 4 Views (70110) $596.70 $918 5.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $494 $760 5.4×
Radex Pelvis Compl Minimum 3 Views (72190) $596.70 $918 5.5×
Radex Sho Compl Minimum 2 Views (73030) $494 $760 5.4×
Radex Sinuses Paransl < 3 Views (70210) $494 $760 5.4×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $596.70 $918 5.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $494 $760 5.4×
Radex Toe Minimum 2 Views (73660) $494 $760 5.4×
Radex upper extremity infant minimum 2 views (73092) $596.70 $918 5.5×
Radex Wrst Compl Minimum 3 Views (73110) $494 $760 5.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $596.70 $918 5.5×
Radiation Delivery Stereotactic Cranial Linear (77372) $42,857.10 $65,934 5.6×
Radiation treatment delivery level 1 (77402) $728.65 $1,121 6.8×
Radiation treatment delivery level 2 (77407) $2,753.40 $4,236 6.8×
Radiation treatment delivery level 3 (77412) $3,944.20 $6,068 6.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $494 $760 5.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $596.70 $918 5.5×
Radiologic exam chest 2 views (71046) $494 $760 5.4×
Radiologic exam colon single contrast study (74270) $997.75 $1,535 5.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $997.75 $1,535 5.4×
Radiologic exam upr gi trc double contrast study (74246) $997.75 $1,535 5.4×
Radiologic exam upr gi trc single contrast study (74240) $997.75 $1,535 5.4×
Radiologic examination femur 1 view (73551) $494 $760 5.4×
Radiologic examination tibia & fibula 2 views (73590) $494 $760 5.4×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $3,073.85 $4,729 5.4×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $596.70 $918 5.5×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $596.70 $918 5.5×
Radiologic examination, teeth; complete, full mouth Non-Facility (70320) $1,355.25 $2,085 5.4×
Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) $1,355.25 $2,085 5.4×
Radiological examination surgical specimen (76098) $3,073.85 $4,729 5.4×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $1,474.85 $2,269 3.7×
Ribs bilateral 3 views (71110) $596.70 $918 5.5×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $2,252.90 $3,466 5.4×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,252.90 $3,466 5.4×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $7,319 $11,260 12.9×
Rp loclzj tum plnr whole body single day imaging (78802) $7,319 $11,260 12.9×
Rp loclzj tum spect 1 area single day imaging (78803) $7,319 $11,260 12.9×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $8,177 $12,580 5.5×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $7,319 $11,260 5.4×
Rp therapy intra-arterial particulate admn (79445) $1,256.45 $1,933 5.2×
Rp Therapy Intravenous Administration (79101) $1,256.45 $1,933 5.2×
Sacroiliac Joints < 3 Views (72200) $596.70 $918 5.5×
Saline Infus Sonohysterography W/Color Doppler (76831) $1,355.25 $2,085 5.4×
Salivary gland function study (78232) $2,252.90 $3,466 5.4×
Salivary gland imaging (78230) $2,252.90 $3,466 5.4×
Salivary gland imaging; with serial images Non-Facility (78231) $2,252.90 $3,466 5.4×
Scapula (73010) $596.70 $918 5.5×
Screening Digital Breast Tomosynthesis Bi (77063) $113.75 $175 4.9×
Shoulder 1 view (73020) $494 $760 5.4×
Simulation intermediate (77285) $2,052.70 $3,158 5.2×
Small bowel series (74250) $997.75 $1,535 5.4×
Spec telethx port pln parts hemibdy tot bdy (77321) $2,052.70 $3,158 5.2×
Special dosimetry (77331) $744.25 $1,145 5.3×
Special Physics Consult (77370) $744.25 $1,145 5.3×
Special treatment procedure (77470) $3,242.85 $4,989 5.6×
Spine thoracic 3 views (72072) $596.70 $918 5.5×
Splenoportograpy rs&i (75810) $17,646.20 $27,148 5.4×
Stereotactic Body Radiation Delivery (77373) $9,844.25 $15,145 5.3×
Superior sagittal sinus venogram (75870) $17,646.20 $27,148 5.4×
Tbs technical calculation only (77091) $494 $760 5.4×
Telethx isodose pln cplx w/basic dosimetry (77307) $2,052.70 $3,158 5.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $2,052.70 $3,158 5.2×
Testicular Imaging With Vascular Flow (78761) $2,252.90 $3,466 5.4×
Ther rad simulaj-aided field setting complex (77290) $2,052.70 $3,158 5.2×
Ther rad simulaj-aided field setting simple (77280) $744.25 $1,145 5.3×
Thoracolumbar 2 views (72080) $494 $760 5.4×
Thyroid carcinoma metastases img whole body (78018) $3,017.95 $4,643 5.3×
Thyroid imaging w/blood flow (78013) $2,252.90 $3,466 5.4×
Thyroid uptake measurement (78012) $2,252.90 $3,466 5.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,252.90 $3,466 5.4×
Tomogram (76100) $596.70 $918 5.5×
Treatment device complex (77334) $2,052.70 $3,158 5.2×
Treatment device intermediate (77333) $744.25 $1,145 5.3×
Treatment devices simple (77332) $744.25 $1,145 5.3×
Ultrasound breast complete (76641) $596.70 $918 5.5×
Ultrasound Exam Aaa Screen (76706) $596.70 $918 5.5×
Ultrasound, abdomen limited (76705) $596.70 $918 5.5×
Umbilical-artery Doppler (OB) (76820) $596.70 $918 5.5×
Unlisted Diagnostic Radiographic Procedure (76499) $881.72 $1,356.50 9.7×
Unlisted fluoroscopic procedure (76496) $17,646.20 $27,148 194.2×
Unlisted magnetic resonance procedure (76498) $1,595.75 $2,455 17.6×
Unlisted miscellaneous px dx nuclear medicine (78999) $340.60 $524 0.8×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $1,379.95 $2,123 124.8×
Urea breath test, C-14 (isotopic); analysis Facility (78268) $2,252.90 $3,466 23.9×
Ureteral reflux study (78740) $2,252.90 $3,466 5.4×
Urethrocystogram voiding (74455) $1,355.25 $2,085 5.4×
Urethrocystography retrograde rs&i (74450) $1,355.25 $2,085 5.4×
Us breast unilateral limited (76642) $494 $760 5.4×
Us chest (76604) $596.70 $918 5.5×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $1,745.90 $2,686 7.7×
Us compl joint r-t w/image documentation (76881) $596.70 $918 5.5×
Us encephalogram (76506) $596.70 $918 5.5×
Us hips infant static (76886) $494 $760 5.4×
Us infant hips w manipulation (76885) $494 $760 5.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $596.70 $918 5.5×
Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $596.70 $918 5.5×
Us ob detailed single fetus (76811) $1,355.25 $2,085 5.4×
Us ob limited (76815) $596.70 $918 5.5×
Us ob transvaginal (76817) $596.70 $918 5.5×
Us pelvic non ob complete (76856) $596.70 $918 5.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $596.70 $918 5.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $596.70 $918 5.5×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $596.70 $918 5.5×
Us retroperitoneal complete (76770) $596.70 $918 5.5×
Us retroperitoneal limited (76775) $596.70 $918 5.5×
Us scrotum and contents (76870) $596.70 $918 5.5×
Us soft tissue head/neck (76536) $596.70 $918 5.5×
Us spinal canal and contents (76800) $596.70 $918 5.5×
Us transrectal (76872) $596.70 $918 5.5×
Us transrectal prostate volume (76873) $596.70 $918 5.5×
Us, eye b-scan (76512) $596.70 $918 5.5×
Us,transplanted kidney, real time/ doppler (76776) $596.70 $918 5.5×
Venogram extremity bilateral (75822) $8,709.35 $13,399 5.3×
Venogram Extremity Unilateral (75820) $8,709.35 $13,399 5.3×
Venography caval inferior serialography rs&i (75825) $17,646.20 $27,148 5.4×
Venography caval superior serialography rs&i (75827) $8,709.35 $13,399 5.3×
Venography Renal Bilateral (75833) $17,646.20 $27,148 5.4×
Venography renal unilateral selective rs&i (75831) $17,646.20 $27,148 5.4×
Venography venous sinus/jugular cath rs&i (75860) $17,646.20 $27,148 5.4×
Venous sampling by catheter (75893) $30,305.60 $46,624 5.2×
Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) $3,017.95 $4,643 5.3×
Vertebral fracture assessment via dxa (77086) $494 $760 5.4×
Whole blood volume determination, including separate measurement of plasma volume and red cell volume… (78122) $3,017.95 $4,643 5.3×
Wrist 2 views (73100) $494 $760 5.4×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $596.70 $918 5.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $494 $760 5.4×
X-ray b.e. reductn intuss (74283) $997.75 $1,535 5.4×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $997.75 $1,535 5.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $494 $760 5.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $494 $760 5.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $596.70 $918 5.5×
X-ray exam of femur 2/> (73552) $494 $760 5.4×
X-ray eye for foreign body (70030) $494 $760 5.4×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $494 $760 5.4×
X-ray IV pyelogram (ivp) (74400) $997.75 $1,535 5.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $494 $760 5.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $494 $760 5.4×
X-ray leg, infant (73592) $494 $760 5.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $596.70 $918 5.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $596.70 $918 5.5×
X-ray nose-rectum child f.b. (76010) $494 $760 5.4×
X-ray optic foramen (70190) $494 $760 5.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $596.70 $918 5.5×
X-ray retrograde pyelogram (74420) $2,002 $3,080 5.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $494 $760 5.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $596.70 $918 5.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $596.70 $918 5.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $596.70 $918 5.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $494 $760 5.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $494 $760 5.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $596.70 $918 5.5×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $596.70 $918 5.5×
X-Ray Spine One View - Xr Spine (72020) $494 $760 5.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $494 $760 5.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $494 $760 5.4×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $596.70 $918 5.5×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $596.70 $918 5.5×
Xr bone length studies (77073) $596.70 $918 5.5×
Xr c-spine 4 or 5 views (72050) $596.70 $918 5.5×
Xr c-spine 6 or more views (72052) $596.70 $918 5.5×
Xr chest 4+ views (71048) $596.70 $918 5.5×
Xr urogram antegrade (74425) $2,002 $3,080 5.5×