Imaging prices at CommonSpirit - Memorial Hospital - Chattanooga
Chattanooga, TN · every code in this section with a posted price and a Medicare benchmark.
326 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) | $3,686.03 | $8,714 | 2.9× |
| Abdomen 1 View (74018) | $321.91 | $761 | 4.0× |
| Abdomen 2 views (74019) | $366.75 | $867 | 3.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $820.20 | $1,939 | 2.2× |
| Angio internal mammary (75756) | $1,285.92 | $3,040 | 0.4× |
| Angio pulmonary bilat (75743) | $2,299.43 | $5,436 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $3,502.44 | $8,280 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $2,084.55 | $4,928 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,609.52 | $3,805 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,368.38 | $5,599 | 0.8× |
| Ankle 2 views (73600) | $257.61 | $609 | 3.2× |
| Aortography thoracic serialography rs&i (75605) | $3,976.20 | $9,400 | 0.8× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,239.79 | $5,295 | 0.4× |
| Artery X-Rays Pelvis (75736) | $7,880.07 | $18,629 | 1.5× |
| Artery X-Rays Spine (75705) | $7,894.88 | $18,664 | 1.5× |
| Basic radiation dosimetry calculation (77300) | $275.80 | $652 | 2.2× |
| Bone age studies (77072) | $71.49 | $169 | 0.7× |
| Bone Imaging 3 Phase (78315) | $2,079.05 | $4,915 | 5.6× |
| Bone Imaging Multiple Areas (78305) | $538.06 | $1,272 | 1.5× |
| Bone Imaging Whole Body (78306) | $1,453.86 | $3,437 | 3.9× |
| Brachytx isodose complex (77318) | $880.69 | $2,082 | 2.5× |
| Brachytx isodose intermed (77317) | $602.36 | $1,424 | 1.7× |
| Brachytx Isodose Plan Simple (77316) | $327.41 | $774 | 0.9× |
| Brain Image W/Flow < 4 Views (78601) | $720.80 | $1,704 | 2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,994.45 | $4,715 | 1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $784.67 | $1,855 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $387.47 | $916 | 4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $431.04 | $1,019 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $825.70 | $1,952 | 1.6× |
| Chest 1 view (71045) | $193.74 | $458 | 2.4× |
| Chest 2 views (71046) | $290.61 | $687 | 3.6× |
| Chest 3 views (71047) | $141.71 | $335 | 1.8× |
| Chest 4 or more views (71048) | $166.67 | $394 | 1.7× |
| Clavicle complete (73000) | $353.21 | $835 | 4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $253.80 | $600 | 2.6× |
| Continuing medical physics consltj pr wk (77336) | $293.99 | $695 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) | $2,521.93 | $5,962 | 0.9× |
| Contrast X-Ray Bladder (74430) | $379.01 | $896 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,153.53 | $2,727 | 3.6× |
| CT abdomen and pelvis without contrast (74176) | $868 | $2,052 | 3.9× |
| CT abdomen w contrast (74160) | $1,134.91 | $2,683 | 7.0× |
| CT abdomen w wo contrast (74170) | $1,194.56 | $2,824 | 7.4× |
| CT abdomen w/o contrast (74150) | $895.92 | $2,118 | 9.3× |
| CT Angio Abdomen and Pelvis (74174) | $3,649.23 | $8,627 | 11.3× |
| CT Angio Chest (71275) | $2,370.92 | $5,605 | 14.6× |
| CT Angio Head (70496) | $1,865.01 | $4,409 | 11.5× |
| CT angio hrt w/3d image (75574) | $1,232.63 | $2,914 | 3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,103.61 | $2,609 | 6.8× |
| CT Angio Neck (70498) | $1,789.72 | $4,231 | 11.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,107.42–$1,661.13 | $2,618–$3,927 | varies |
| CT cervical spine w/ contrast (72126) | $2,186.49 | $5,169 | 6.8× |
| CT cervical spine w/o contrast (72125) | $1,669.16 | $3,946 | 17.3× |
| CT cervical spine w/wo cont (72127) | $2,370.07 | $5,603 | 14.6× |
| CT chest w contrast (71260) | $2,015.18 | $4,764 | 12.5× |
| CT chest w/wo contrast (71270) | $2,293.51 | $5,422 | 14.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $527.06 | $1,246 | 5.5× |
| CT head/brain with contrast (70460) | $1,458.51 | $3,448 | 9.0× |
| CT head/brain without and with contrast (70470) | $1,657.32 | $3,918 | 10.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $838.39 | $1,982 | 2.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $29.19 | $69 | 0.4× |
| CT hrt w/3d image congen (75573) | $690.34 | $1,632 | 2.1× |
| CT iac w contrast (70481) | $1,223.74 | $2,893 | 7.6× |
| CT l-spine w&w/o contrast (72133) | $1,795.22 | $4,244 | 11.1× |
| CT lower ext w/o (73700) | $992.79 | $2,347 | 10.3× |
| CT lower extremity w/contrast material (73701) | $1,419.59 | $3,356 | 8.8× |
| CT lumbar spine w contrast (72132) | $1,656.05 | $3,915 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,264.35 | $2,989 | 13.1× |
| CT maxillofacial w contrast (70487) | $1,258.85 | $2,976 | 7.8× |
| CT maxillofacial wo contrast (70486) | $953.45 | $2,254 | 9.9× |
| CT neck tissue combo (70492) | $1,831.17 | $4,329 | 11.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,492.35 | $3,528 | 9.2× |
| CT orbits w/o contrast (70480) | $1,073.58 | $2,538 | 11.1× |
| CT pelvis w&w/o contrast (72194) | $1,038.47 | $2,455 | 6.4× |
| CT pelvis w/o contrast (72192) | $716.14 | $1,693 | 7.4× |
| CT scan of leg combo (73702) | $1,280.43 | $3,027 | 7.9× |
| CT scans face/jaw combo (70488) | $1,392.10 | $3,291 | 8.6× |
| CT soft tissue neck w contrast (70491) | $1,744.03 | $4,123 | 10.8× |
| CT soft tissue neck w/o contrast (70490) | $1,447.51 | $3,422 | 15.0× |
| CT thoracic spine w contrast (72129) | $1,987.68 | $4,699 | 12.3× |
| CT thoracic spine w/o contrast (72128) | $1,517.31 | $3,587 | 15.7× |
| CT thoracic spine w/wo cont (72130) | $2,154.77 | $5,094 | 13.3× |
| CT thorax w/o contrast (71250) | $1,737.27 | $4,107 | 18.0× |
| CT upper ext wo (73200) | $992.79 | $2,347 | 10.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,469.08 | $3,473 | 9.1× |
| CT upper extremity with contrast (73201) | $1,469.08 | $3,473 | 4.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,200.03 | $5,201 | 13.6× |
| Cta Abdomen (74175) | $2,444.94 | $5,780 | 15.1× |
| CTA pelvis (72191) | $1,506.31 | $3,561 | 9.3× |
| Dilation ureters/urethra rs&i (74485) | $544.83 | $1,288 | 0.3× |
| Diskography lumbar (72295) | $899.73 | $2,127 | 0.5× |
| Dxa Bone Density Axial (77080) | $173.43 | $410 | 1.8× |
| Dxa bone density study (77085) | $218.27 | $516 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $121.41 | $287 | 1.5× |
| Echo Guide For Artery Repair (76936) | $574.44 | $1,358 | 2.9× |
| Echograp Trans R Pros Study (76873) | $194.58 | $460 | 2.0× |
| Esophagram (74220) | $557.52 | $1,318 | 3.4× |
| Fluoroscopy up to 1 hr (76000) | $426.39 | $1,008 | 1.9× |
| Follow-Up Angiography (75898) | $873.50 | $2,065 | 0.3× |
| Foot 2 views (73620) | $259.30 | $613 | 3.2× |
| Forearm 2 views (73090) | $335.44 | $793 | 4.2× |
| Gastric emptying imaging study (78264) | $1,284.23 | $3,036 | 3.5× |
| Gastroesophageal Reflux Exam (78262) | $796.09 | $1,882 | 2.2× |
| Gated Heart Planar Single (78472) | $735.60 | $1,739 | 2.0× |
| Hand 2 views (73120) | $79.11 | $187 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,211.05 | $2,863 | 1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,090.08 | $2,577 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $931.45 | $2,202 | 1.4× |
| Heart Image (Pet) Multiple (78492) | $1,823.98 | $4,312 | 1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,352.73 | $5,562 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,839.55 | $11,441 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,434.82 | $3,392 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,176.37 | $2,781 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $1,956.80 | $4,626 | 1.6× |
| Hysterosalpingogram (74740) | $324.02 | $766 | 1.5× |
| Interstitial radiation source applic complex (77778) | $1,306.23 | $3,088 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $1,299.04 | $3,071 | 2.6× |
| K Flow/Funct Image W/O Drug (78707) | $649.73 | $1,536 | 1.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$103.64–$174.70 | $245–$413 | varies |
| Liver & Spleen Imaging Static Only (78215) | $729.26 | $1,724 | 2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $685.26 | $1,620 | 1.9× |
| Liver imaging static only (78201) | $463.61 | $1,096 | 0.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,343.88 | $3,177 | 2.7× |
| Lung perfusion differential (78597) | $493.22 | $1,166 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,139.14 | $2,693 | 2.3× |
| Lung Ventilation Imaging (78579) | $660.73 | $1,562 | 1.8× |
| Lymph System Imaging (78195) | $1,164.52 | $2,753 | 2.3× |
| Magnetic Image Jaw Joint (70336) | $1,736.84 | $4,106 | 7.9× |
| Meckels Divert Exam (78290) | $604.47 | $1,429 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $255.07 | $603 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,482.17 | $5,868 | 7.7× |
| MRA head w/o contrast (70544) | $1,825.25 | $4,315 | 8.3× |
| MRA head with contrast (70545) | $2,080.74 | $4,919 | 6.5× |
| MRA neck w contrast (70548) | $1,634.05 | $3,863 | 5.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,222.02 | $5,253 | 6.9× |
| MRA neck w/o contrast (70547) | $408.62 | $966 | 1.9× |
| MRI abdomen w contrast (74182) | $870.12 | $2,057 | 2.7× |
| MRI abdomen w/o contrast (74181) | $1,691.58 | $3,999 | 7.7× |
| MRI any jt lower extrem w/contrast material (73722) | $2,065.09 | $4,882 | 2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,879.37 | $6,807 | 8.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,024.91 | $4,787 | 2.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $538.48 | $1,273 | 2.4× |
| MRI cardiac w/o cont stress (75559) | $259.30 | $613 | 0.5× |
| MRI cardiac w/o contrast (75557) | $259.30 | $613 | 1.2× |
| MRI cervical spine w contrast (72142) | $2,463.98 | $5,825 | 7.7× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,232.20–$2,463.98 | $2,913–$5,825 | varies |
| MRI chest w/o contrast (71550) | $1,841.75 | $4,354 | 8.4× |
| MRI chest with contrast (71551) | $1,604.02 | $3,792 | 2.2× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$990.25–$1,980.49 | $2,341–$4,682 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,889.97 | $4,468 | 5.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,486.40 | $5,878 | 7.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,889.97 | $4,468 | 8.6× |
| MRI lumbar spine w contrast (72149) | $2,236.83 | $5,288 | 6.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,769.78 | $8,912 | 11.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,658.59 | $3,921 | 7.5× |
| MRI orbit face neck w contrast (70542) | $576.98 | $1,364 | 1.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,202.17–$2,403.91 | $2,842–$5,683 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$943.72–$1,862.05 | $2,231–$4,402 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,241.51–$2,482.59 | $2,935–$5,869 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$993.21–$1,985.99 | $2,348–$4,695 | varies |
| MRI spectroscopy (76390) | $2,266.86 | $5,359 | 28.2× |
| MRI thoracic spine w/o contrast (72146) | $2,022.37 | $4,781 | 9.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,729.65 | $4,089 | 7.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,161.96–$2,282.94 | $5,111–$5,397 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,208.52–$2,416.60 | $2,857–$5,713 | varies |
| MRI, dorsal spine combo (72157) | $3,111.17 | $7,355 | 9.7× |
| MRI, dorsal spine contrast (72147) | $2,240.21 | $5,296 | 7.0× |
| MRI, joint upper extrem (73221) | $1,367.99 | $3,234 | 6.2× |
| MRI, joint upper extrem combo (73223) | $2,230.06 | $5,272 | 6.9× |
| MRI, lumbar spine combo (72158) | $3,111.17 | $7,355 | 9.7× |
| Myelograpy 2/more regions rs&i (72270) | $961.06 | $2,272 | 1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,492.35 | $3,528 | 1.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,121.80 | $2,652 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $2,386.15 | $5,641 | 2.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,459.75 | $5,815 | 1.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,816.73 | $9,023 | 1.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,664.85 | $11,028 | 2.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $4,240.58 | $10,025 | 3.0× |
| N-invas est c ffr sw aly CTA (75580) | $1,532.11 | $3,622 | 1.9× |
| Neck soft tissue (70360) | $236.04 | $558 | 2.9× |
| Nm myocard infarct spect (78469) | $990.67 | $2,342 | 2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,547.71 | $8,387 | 2.8× |
| Nuclear Rx Intra-Arterial (79445) | $246.19 | $582 | 1.1× |
| Nuclear Rx Oral Admin (79005) | $768.17 | $1,816 | 3.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $266.49 | $630 | 0.5× |
| Parathyroid Planar Imaging (78070) | $414.54 | $980 | 1.1× |
| Pelvis 1 or 2 views (72170) | $115.48 | $273 | 1.2× |
| PET image w/CT, full body (78816) | $3,221.15 | $7,615 | 2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,221.15 | $7,615 | 2.4× |
| Pet Myocardial Sngl Study (78491) | $1,823.98 | $4,312 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $467 | $1,104 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $382.82 | $905 | 4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $335.02 | $792 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$238.58–$357.86 | $564–$846 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $219.96 | $520 | 2.7× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$277.49–$416.24 | $656–$984 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $434.43 | $1,027 | 4.5× |
| Radex fingr minimum 2 views (73140) | $293.57 | $694 | 3.7× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$269.88–$404.82 | $638–$957 | varies |
| Radex Hand Minimum 3 Views (73130) | $303.72 | $718 | 3.8× |
| Radex lower extremity infant minimum 2 views (73592) | $168.78 | $399 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $310.06 | $733 | 3.9× |
| Radex Ribs Unilateral 2 Views (71100) | $345.17 | $816 | 4.3× |
| Radex shoulder complete minimum 2 views (73030) | $384.09 | $908 | 4.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $199.24 | $471 | 2.5× |
| Radex Spine 1 View Specify Level (72020) | $136.21 | $322 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $303.30 | $717 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $183.59 | $434 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $224.19 | $530 | 2.8× |
| Radex upper extremity infant minimum 2 views (73092) | $78.26 | $185 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$307.10–$458.11 | $726–$1,083 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,735.46 | $13,559 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $293.14 | $693 | 3.1× |
| Radiation treatment delivery level 2 (77407) | $340.10 | $804 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $401.01 | $948 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $260.15 | $615 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $484.34 | $1,145 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $484.34 | $1,145 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $489.84 | $1,158 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) | $174.70 | $413 | 1.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $269.03 | $636 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $439.50 | $1,039 | 2.7× |
| Radiologic exam swallow function contrast study (74230) | $693.30 | $1,639 | 4.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $590.09 | $1,395 | 3.6× |
| Radiologic examination femur minimum 2 views (73552) | $142.13 | $336 | 1.8× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$252.96–$379.44 | $598–$897 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $324.45 | $767 | 4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $318.10 | $752 | 0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $283.84 | $671 | 0.8× |
| Ribs bilateral 3 views (71110) | $603.63 | $1,427 | 6.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $607.43 | $1,436 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,214.86 | $2,872 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,157.30 | $5,100 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,094.28 | $4,951 | 4.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,157.30 | $5,100 | 1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,450.44 | $5,793 | 1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,157.30 | $5,100 | 1.8× |
| Rp Therapy Intravenous Administration (79101) | $669.61 | $1,583 | 3.1× |
| Scapula (73010) | $211.08 | $499 | 2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $23.69 | $56 | 1.0× |
| Shoulder 1 view (73020) | $295.68 | $699 | 3.7× |
| Skull less than 4 views (70250) | $211.50 | $500 | 2.2× |
| Special dosimetry (77331) | $357.02 | $844 | 2.9× |
| Special Physics Consult (77370) | $326.56 | $772 | 2.6× |
| Special teletherapy port plan (77321) | $1,085.42 | $2,566 | 3.1× |
| Special treatment procedure (77470) | $512.68 | $1,212 | 1.0× |
| Stereotactic Body Radiation Delivery (77373) | $3,296.44 | $7,793 | 2.0× |
| Sternoclavicular joints (71130) | $197.12 | $466 | 2.5× |
| Superior sagittal sinus venogram (75870) | $4,877.19 | $11,530 | 1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,278.31 | $3,022 | 3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $652.27 | $1,542 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,312.15 | $3,102 | 3.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,101.92 | $2,605 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $669.19 | $1,582 | 5.4× |
| Thoracic spine 3 views (72072) | $198.81 | $470 | 2.1× |
| Thoracolumbar 2 views (72080) | $218.27 | $516 | 2.7× |
| Thyroid Imaging With Vascular Flow (78013) | $476.30 | $1,126 | 1.3× |
| Thyroid Met Imaging Body (78018) | $746.18 | $1,764 | 1.5× |
| Thyroid Uptake Measurement (78012) | $191.62 | $453 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $618.43 | $1,462 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $774.09 | $1,830 | 2.2× |
| Tx devices design & construction intermediate (77333) | $363.78 | $860 | 2.9× |
| Tx devices design & construction simple (77332) | $239.85 | $567 | 1.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$380.28–$475.46 | $899–$1,124 | varies |
| Ultrasound Exam Aaa Screen (76706) | $329.10 | $778 | 3.4× |
| Ultrasound, abdomen limited (76705) | $402.28 | $951 | 4.2× |
| Upper gi w/o kub (74240) | $390.86 | $924 | 2.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $191.62 | $453 | 17.3× |
| Urethrocystogram voiding (74455) | $453.04 | $1,071 | 2.1× |
| Urethrocystography retrograde (74450) | $356.59 | $843 | 1.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$1,140.84–$1,425.09 | $2,697–$3,369 | varies |
| Us chest (76604) | $372.24 | $880 | 3.9× |
| Us exam, pelvic, limited (76857) | $91.80 | $217 | 1.0× |
| Us kidney transplant (76776) | $482.65 | $1,141 | 5.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $279.18 | $660 | 2.9× |
| Us ob limited 1 or more fetuses (76815) | $219.54 | $519 | 2.3× |
| Us ob transvaginal (76817) | $365.48 | $864 | 3.8× |
| Us pelvic non ob complete (76856) | $833.31 | $1,970 | 8.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $236.88 | $560 | 2.5× |
| Us retroperitoneal complete (76770) | $362.09 | $856 | 3.8× |
| Us retroperitoneal limited (76775) | $362.09 | $856 | 3.8× |
| Us scrotum and contents (76870) | $697.53 | $1,649 | 7.2× |
| Us thyroid (76536) | $535.52 | $1,266 | 5.6× |
| Us transrectal (76872) | $413.28 | $977 | 4.3× |
| Vein X-Ray Chest (75827) | $1,839.63 | $4,349 | 1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,848.49 | $6,734 | 1.0× |
| Venogram Sinus/Jugular (75860) | $875.61 | $2,070 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,839.63 | $4,349 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $821.47 | $1,942 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $774.94 | $1,832 | 0.5× |
| Venography Renal Bilateral (75833) | $4,839.55 | $11,441 | 1.7× |
| Venography Renal Unilateral (75831) | $4,839.55 | $11,441 | 1.7× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,241.93 | $2,936 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $132.83 | $314 | 1.7× |
| Wrist 2 views (73100) | $151.44 | $358 | 1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $244.50 | $578 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $429.35 | $1,015 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $2,623.03 | $6,201 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $266.49 | $630 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $147.21 | $348 | 1.8× |
| X-Ray Exam Breast Specimen (76098) | $807.93 | $1,910 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $176.40 | $417 | 1.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $93.49 | $221 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $113.79 | $269 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $155.67 | $368 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $465.73 | $1,101 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $521.99 | $1,234 | 5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $145.09 | $343 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $614.20 | $1,452 | 6.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $507.18 | $1,199 | 5.3× |
| X-ray eye for foreign body (70030) | $165.40 | $391 | 2.1× |
| X-ray humerus (73060) | $285.53 | $675 | 3.6× |
| X-ray IV pyelogram (ivp) (74400) | $748.29 | $1,769 | 4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $404.39 | $956 | 5.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $354.90 | $839 | 3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $674.69 | $1,595 | 7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $229.69 | $543 | 2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $314.72 | $744 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $424.70 | $1,004 | 5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $450.50 | $1,065 | 4.7× |
| X-ray thoracic spine 4 vw (72074) | $192.89 | $456 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $613.35 | $1,450 | 1.9× |
| X-Rays Bone Length Studies (77073) | $208.97 | $494 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $781.71 | $1,848 | 8.1× |
| Xr c-spine 4 or 5 views (72050) | $483.49 | $1,143 | 5.0× |
| Xr facial bones less than 3 views (70140) | $347.29 | $821 | 4.3× |
| Xr orbits complete 4 views (70200) | $109.98 | $260 | 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.