Imaging prices at CommonSpirit - Memorial Hospital - North Georgia
Ringgold, GA · 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) | $2,579.35 | $8,714 | 2.0× |
| Abdomen 1 View (74018) | $225.26 | $761 | 2.8× |
| Abdomen 2 views (74019) | $256.64 | $867 | 2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $573.95 | $1,939 | 1.6× |
| Angio internal mammary (75756) | $899.84 | $3,040 | 0.3× |
| Angio pulmonary bilat (75743) | $1,609.06 | $5,436 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $2,450.88 | $8,280 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $1,458.69 | $4,928 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,126.28 | $3,805 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,657.31 | $5,599 | 0.6× |
| Ankle 2 views (73600) | $180.27 | $609 | 2.2× |
| Aortography thoracic serialography rs&i (75605) | $2,782.40 | $9,400 | 0.5× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,567.32 | $5,295 | 0.3× |
| Artery X-Rays Pelvis (75736) | $5,514.19 | $18,629 | 1.1× |
| Artery X-Rays Spine (75705) | $5,524.55 | $18,664 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $193 | $652 | 1.6× |
| Bone age studies (77072) | $50.03 | $169 | 0.5× |
| Bone Imaging 3 Phase (78315) | $1,454.84 | $4,915 | 3.9× |
| Bone Imaging Multiple Areas (78305) | $376.52 | $1,272 | 1.0× |
| Bone Imaging Whole Body (78306) | $1,017.36 | $3,437 | 2.8× |
| Brachytx isodose complex (77318) | $616.28 | $2,082 | 1.8× |
| Brachytx isodose intermed (77317) | $421.51 | $1,424 | 1.2× |
| Brachytx Isodose Plan Simple (77316) | $229.11 | $774 | 0.7× |
| Brain Image W/Flow < 4 Views (78601) | $504.39 | $1,704 | 1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,395.64 | $4,715 | 1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $549.08 | $1,855 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $271.14 | $916 | 3.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $301.63 | $1,019 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $577.80 | $1,952 | 1.2× |
| Chest 1 view (71045) | $135.57 | $458 | 1.7× |
| Chest 2 views (71046) | $203.36 | $687 | 2.5× |
| Chest 3 views (71047) | $99.16 | $335 | 1.2× |
| Chest 4 or more views (71048) | $116.63 | $394 | 1.2× |
| Clavicle complete (73000) | $247.16 | $835 | 3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $177.60 | $600 | 1.8× |
| Continuing medical physics consltj pr wk (77336) | $205.72 | $695 | 1.7× |
| Contrast Exam Abdominl Aorta (75625) | $1,764.76 | $5,962 | 0.6× |
| Contrast X-Ray Bladder (74430) | $265.22 | $896 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $807.20 | $2,727 | 2.5× |
| CT abdomen and pelvis without contrast (74176) | $607.40 | $2,052 | 2.8× |
| CT abdomen w contrast (74160) | $794.17 | $2,683 | 4.9× |
| CT abdomen w wo contrast (74170) | $835.91 | $2,824 | 5.2× |
| CT abdomen w/o contrast (74150) | $626.93 | $2,118 | 6.5× |
| CT Angio Abdomen and Pelvis (74174) | $2,553.60 | $8,627 | 7.9× |
| CT Angio Chest (71275) | $1,659.08 | $5,605 | 10.3× |
| CT Angio Head (70496) | $1,305.07 | $4,409 | 8.1× |
| CT angio hrt w/3d image (75574) | $862.55 | $2,914 | 2.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $772.27 | $2,609 | 4.8× |
| CT Angio Neck (70498) | $1,252.38 | $4,231 | 7.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$774.93–$1,162.40 | $2,618–$3,927 | varies |
| CT cervical spine w/ contrast (72126) | $1,530.03 | $5,169 | 4.8× |
| CT cervical spine w/o contrast (72125) | $1,168.02 | $3,946 | 12.1× |
| CT cervical spine w/wo cont (72127) | $1,658.49 | $5,603 | 10.2× |
| CT chest w contrast (71260) | $1,410.15 | $4,764 | 8.7× |
| CT chest w/wo contrast (71270) | $1,604.92 | $5,422 | 9.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $368.82 | $1,246 | 3.8× |
| CT head/brain with contrast (70460) | $1,020.61 | $3,448 | 6.3× |
| CT head/brain without and with contrast (70470) | $1,159.73 | $3,918 | 7.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $586.68 | $1,982 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $20.43 | $69 | 0.3× |
| CT hrt w/3d image congen (75573) | $483.08 | $1,632 | 1.5× |
| CT iac w contrast (70481) | $856.33 | $2,893 | 5.3× |
| CT l-spine w&w/o contrast (72133) | $1,256.23 | $4,244 | 7.8× |
| CT lower ext w/o (73700) | $694.72 | $2,347 | 7.2× |
| CT lower extremity w/contrast material (73701) | $993.38 | $3,356 | 6.1× |
| CT lumbar spine w contrast (72132) | $1,158.84 | $3,915 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $884.75 | $2,989 | 9.2× |
| CT maxillofacial w contrast (70487) | $880.90 | $2,976 | 5.4× |
| CT maxillofacial wo contrast (70486) | $667.19 | $2,254 | 6.9× |
| CT neck tissue combo (70492) | $1,281.39 | $4,329 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,044.29 | $3,528 | 6.5× |
| CT orbits w/o contrast (70480) | $751.25 | $2,538 | 7.8× |
| CT pelvis w&w/o contrast (72194) | $726.68 | $2,455 | 4.5× |
| CT pelvis w/o contrast (72192) | $501.13 | $1,693 | 5.2× |
| CT scan of leg combo (73702) | $896 | $3,027 | 5.5× |
| CT scans face/jaw combo (70488) | $974.14 | $3,291 | 6.0× |
| CT soft tissue neck w contrast (70491) | $1,220.41 | $4,123 | 7.5× |
| CT soft tissue neck w/o contrast (70490) | $1,012.92 | $3,422 | 10.5× |
| CT thoracic spine w contrast (72129) | $1,390.91 | $4,699 | 8.6× |
| CT thoracic spine w/o contrast (72128) | $1,061.76 | $3,587 | 11.0× |
| CT thoracic spine w/wo cont (72130) | $1,507.83 | $5,094 | 9.3× |
| CT thorax w/o contrast (71250) | $1,215.68 | $4,107 | 12.6× |
| CT upper ext wo (73200) | $694.72 | $2,347 | 7.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,028.01 | $3,473 | 6.4× |
| CT upper extremity with contrast (73201) | $1,028.01 | $3,473 | 3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,539.50 | $5,201 | 9.5× |
| Cta Abdomen (74175) | $1,710.88 | $5,780 | 10.6× |
| CTA pelvis (72191) | $1,054.06 | $3,561 | 6.5× |
| Dilation ureters/urethra rs&i (74485) | $381.25 | $1,288 | 0.2× |
| Diskography lumbar (72295) | $629.60 | $2,127 | 0.3× |
| Dxa Bone Density Axial (77080) | $121.36 | $410 | 1.3× |
| Dxa bone density study (77085) | $152.74 | $516 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $84.96 | $287 | 1.1× |
| Echo Guide For Artery Repair (76936) | $401.97 | $1,358 | 2.0× |
| Echograp Trans R Pros Study (76873) | $136.16 | $460 | 1.4× |
| Esophagram (74220) | $390.13 | $1,318 | 2.4× |
| Fluoroscopy up to 1 hr (76000) | $298.37 | $1,008 | 1.4× |
| Follow-Up Angiography (75898) | $611.24 | $2,065 | 0.2× |
| Foot 2 views (73620) | $181.45 | $613 | 2.3× |
| Forearm 2 views (73090) | $234.73 | $793 | 2.9× |
| Gastric emptying imaging study (78264) | $898.66 | $3,036 | 2.4× |
| Gastroesophageal Reflux Exam (78262) | $557.08 | $1,882 | 1.5× |
| Gated Heart Planar Single (78472) | $514.75 | $1,739 | 1.4× |
| Hand 2 views (73120) | $55.36 | $187 | 0.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $847.45 | $2,863 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $762.80 | $2,577 | 1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $651.80 | $2,202 | 1.0× |
| Heart Image (Pet) Multiple (78492) | $1,276.36 | $4,312 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,646.36 | $5,562 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,386.54 | $11,441 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,004.04 | $3,392 | 2.0× |
| Hepatobiliary System Imaging (78226) | $823.18 | $2,781 | 2.2× |
| Ht Muscle Image Spect Sing (78451) | $1,369.30 | $4,626 | 1.1× |
| Hysterosalpingogram (74740) | $226.74 | $766 | 1.0× |
| Interstitial radiation source applic complex (77778) | $914.05 | $3,088 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $909.02 | $3,071 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $454.66 | $1,536 | 0.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$72.52–$122.25 | $245–$413 | varies |
| Liver & Spleen Imaging Static Only (78215) | $510.31 | $1,724 | 1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $479.52 | $1,620 | 1.3× |
| Liver imaging static only (78201) | $324.42 | $1,096 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $940.40 | $3,177 | 1.9× |
| Lung perfusion differential (78597) | $345.14 | $1,166 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) | $797.13 | $2,693 | 1.6× |
| Lung Ventilation Imaging (78579) | $462.36 | $1,562 | 1.3× |
| Lymph System Imaging (78195) | $814.89 | $2,753 | 1.6× |
| Magnetic Image Jaw Joint (70336) | $1,215.38 | $4,106 | 5.5× |
| Meckels Divert Exam (78290) | $422.99 | $1,429 | 1.1× |
| Mlc imrt design & construction per imrt plan (77338) | $178.49 | $603 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) | $1,736.93 | $5,868 | 5.4× |
| MRA head w/o contrast (70544) | $1,277.24 | $4,315 | 5.8× |
| MRA head with contrast (70545) | $1,456.03 | $4,919 | 4.5× |
| MRA neck w contrast (70548) | $1,143.45 | $3,863 | 3.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,554.89 | $5,253 | 4.8× |
| MRA neck w/o contrast (70547) | $285.94 | $966 | 1.3× |
| MRI abdomen w contrast (74182) | $608.88 | $2,057 | 1.9× |
| MRI abdomen w/o contrast (74181) | $1,183.71 | $3,999 | 5.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,445.08 | $4,882 | 2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,014.88 | $6,807 | 6.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,416.96 | $4,787 | 2.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $376.81 | $1,273 | 1.7× |
| MRI cardiac w/o cont stress (75559) | $181.45 | $613 | 0.4× |
| MRI cardiac w/o contrast (75557) | $181.45 | $613 | 0.8× |
| MRI cervical spine w contrast (72142) | $1,724.20 | $5,825 | 5.4× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$862.25–$1,724.20 | $2,913–$5,825 | varies |
| MRI chest w/o contrast (71550) | $1,288.79 | $4,354 | 5.9× |
| MRI chest with contrast (71551) | $1,122.44 | $3,792 | 1.6× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$692.94–$1,385.88 | $2,341–$4,682 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,322.53 | $4,468 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,739.89 | $5,878 | 5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,322.53 | $4,468 | 6.0× |
| MRI lumbar spine w contrast (72149) | $1,565.25 | $5,288 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,637.96 | $8,912 | 8.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,160.62 | $3,921 | 5.3× |
| MRI orbit face neck w contrast (70542) | $403.75 | $1,364 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$841.24–$1,682.17 | $2,842–$5,683 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$660.38–$1,303 | $2,231–$4,402 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$868.76–$1,737.23 | $2,935–$5,869 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$695.01–$1,389.72 | $2,348–$4,695 | varies |
| MRI spectroscopy (76390) | $1,586.27 | $5,359 | 19.8× |
| MRI thoracic spine w/o contrast (72146) | $1,415.18 | $4,781 | 6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,210.35 | $4,089 | 5.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,512.86–$1,597.52 | $5,111–$5,397 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$845.68–$1,691.05 | $2,857–$5,713 | varies |
| MRI, dorsal spine combo (72157) | $2,177.08 | $7,355 | 6.8× |
| MRI, dorsal spine contrast (72147) | $1,567.62 | $5,296 | 4.9× |
| MRI, joint upper extrem (73221) | $957.27 | $3,234 | 4.3× |
| MRI, joint upper extrem combo (73223) | $1,560.52 | $5,272 | 4.8× |
| MRI, lumbar spine combo (72158) | $2,177.08 | $7,355 | 6.8× |
| Myelograpy 2/more regions rs&i (72270) | $672.52 | $2,272 | 0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,044.29 | $3,528 | 0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $785 | $2,652 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $1,669.74 | $5,641 | 1.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,721.24 | $5,815 | 1.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,670.81 | $9,023 | 1.3× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,264.29 | $11,028 | 1.6× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $2,967.40 | $10,025 | 2.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,072.12 | $3,622 | 1.4× |
| Neck soft tissue (70360) | $165.17 | $558 | 2.1× |
| Nm myocard infarct spect (78469) | $693.24 | $2,342 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,482.56 | $8,387 | 1.9× |
| Nuclear Rx Intra-Arterial (79445) | $172.28 | $582 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $537.54 | $1,816 | 2.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $186.48 | $630 | 0.4× |
| Parathyroid Planar Imaging (78070) | $290.08 | $980 | 0.8× |
| Pelvis 1 or 2 views (72170) | $80.81 | $273 | 0.8× |
| PET image w/CT, full body (78816) | $2,254.04 | $7,615 | 1.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,254.04 | $7,615 | 1.7× |
| Pet Myocardial Sngl Study (78491) | $1,276.36 | $4,312 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $326.79 | $1,104 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $267.88 | $905 | 2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $234.44 | $792 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$166.95–$250.42 | $564–$846 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $153.92 | $520 | 1.9× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$194.18–$291.27 | $656–$984 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $304 | $1,027 | 3.2× |
| Radex fingr minimum 2 views (73140) | $205.43 | $694 | 2.6× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$188.85–$283.28 | $638–$957 | varies |
| Radex Hand Minimum 3 Views (73130) | $212.53 | $718 | 2.6× |
| Radex lower extremity infant minimum 2 views (73592) | $118.11 | $399 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $216.97 | $733 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $241.54 | $816 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) | $268.77 | $908 | 3.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $139.42 | $471 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $95.32 | $322 | 1.2× |
| Radex Sternum Minimum 2 Views (71120) | $212.24 | $717 | 2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $128.47 | $434 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $156.88 | $530 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) | $54.76 | $185 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$214.90–$320.57 | $726–$1,083 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $4,013.47 | $13,559 | 0.6× |
| Radiation treatment delivery level 1 (77402) | $205.13 | $693 | 2.2× |
| Radiation treatment delivery level 2 (77407) | $237.99 | $804 | 0.7× |
| Radiation treatment delivery level 3 (77412) | $280.61 | $948 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $182.04 | $615 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $338.92 | $1,145 | 2.1× |
| Radiologic exam colon single contrast study (74270) | $338.92 | $1,145 | 2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $342.77 | $1,158 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $122.25 | $413 | 1.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $188.26 | $636 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $307.55 | $1,039 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $485.15 | $1,639 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $412.92 | $1,395 | 2.6× |
| Radiologic examination femur minimum 2 views (73552) | $99.46 | $336 | 1.2× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$177.01–$265.52 | $598–$897 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $227.04 | $767 | 2.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $222.60 | $752 | 0.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $198.62 | $671 | 0.6× |
| Ribs bilateral 3 views (71110) | $422.40 | $1,427 | 4.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $425.06 | $1,436 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $850.12 | $2,872 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,509.60 | $5,100 | 3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,465.50 | $4,951 | 2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,509.60 | $5,100 | 1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,714.73 | $5,793 | 1.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,509.60 | $5,100 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $468.57 | $1,583 | 2.2× |
| Scapula (73010) | $147.71 | $499 | 1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16.58 | $56 | 0.7× |
| Shoulder 1 view (73020) | $206.91 | $699 | 2.6× |
| Skull less than 4 views (70250) | $148 | $500 | 1.5× |
| Special dosimetry (77331) | $249.83 | $844 | 2.0× |
| Special Physics Consult (77370) | $228.52 | $772 | 1.8× |
| Special teletherapy port plan (77321) | $759.54 | $2,566 | 2.2× |
| Special treatment procedure (77470) | $358.76 | $1,212 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $2,306.73 | $7,793 | 1.4× |
| Sternoclavicular joints (71130) | $137.94 | $466 | 1.7× |
| Superior sagittal sinus venogram (75870) | $3,412.88 | $11,530 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $894.52 | $3,022 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $456.44 | $1,542 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $918.20 | $3,102 | 2.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $771.08 | $2,605 | 2.2× |
| Ther rad simulaj-aided field setting simple (77280) | $468.28 | $1,582 | 3.8× |
| Thoracic spine 3 views (72072) | $139.12 | $470 | 1.4× |
| Thoracolumbar 2 views (72080) | $152.74 | $516 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $333.30 | $1,126 | 0.9× |
| Thyroid Met Imaging Body (78018) | $522.15 | $1,764 | 1.0× |
| Thyroid Uptake Measurement (78012) | $134.09 | $453 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $432.76 | $1,462 | 1.2× |
| Tx Devices Design & Construction Complex (77334) | $541.68 | $1,830 | 1.6× |
| Tx devices design & construction intermediate (77333) | $254.56 | $860 | 2.1× |
| Tx devices design & construction simple (77332) | $167.84 | $567 | 1.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$266.11–$332.71 | $899–$1,124 | varies |
| Ultrasound Exam Aaa Screen (76706) | $230.29 | $778 | 2.4× |
| Ultrasound, abdomen limited (76705) | $281.50 | $951 | 2.9× |
| Upper gi w/o kub (74240) | $273.51 | $924 | 1.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $134.09 | $453 | 12.1× |
| Urethrocystogram voiding (74455) | $317.02 | $1,071 | 1.4× |
| Urethrocystography retrograde (74450) | $249.53 | $843 | 1.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$798.32–$997.23 | $2,697–$3,369 | varies |
| Us chest (76604) | $260.48 | $880 | 2.7× |
| Us exam, pelvic, limited (76857) | $64.24 | $217 | 0.7× |
| Us kidney transplant (76776) | $337.74 | $1,141 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $195.36 | $660 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $153.63 | $519 | 1.6× |
| Us ob transvaginal (76817) | $255.75 | $864 | 2.7× |
| Us pelvic non ob complete (76856) | $583.12 | $1,970 | 6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $165.76 | $560 | 1.7× |
| Us retroperitoneal complete (76770) | $253.38 | $856 | 2.6× |
| Us retroperitoneal limited (76775) | $253.38 | $856 | 2.6× |
| Us scrotum and contents (76870) | $488.11 | $1,649 | 5.1× |
| Us thyroid (76536) | $374.74 | $1,266 | 3.9× |
| Us transrectal (76872) | $289.20 | $977 | 3.0× |
| Vein X-Ray Chest (75827) | $1,287.31 | $4,349 | 0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,993.27 | $6,734 | 0.7× |
| Venogram Sinus/Jugular (75860) | $612.72 | $2,070 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $1,287.31 | $4,349 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $574.84 | $1,942 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $542.28 | $1,832 | 0.4× |
| Venography Renal Bilateral (75833) | $3,386.54 | $11,441 | 1.2× |
| Venography Renal Unilateral (75831) | $3,386.54 | $11,441 | 1.2× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$869.06 | $2,936 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $92.95 | $314 | 1.2× |
| Wrist 2 views (73100) | $105.97 | $358 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $171.09 | $578 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $300.44 | $1,015 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $1,835.50 | $6,201 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $186.48 | $630 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $103.01 | $348 | 1.3× |
| X-Ray Exam Breast Specimen (76098) | $565.36 | $1,910 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $123.44 | $417 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $65.42 | $221 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $79.63 | $269 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $108.93 | $368 | 1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $325.90 | $1,101 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $365.27 | $1,234 | 3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $101.53 | $343 | 1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $429.80 | $1,452 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $354.91 | $1,199 | 3.7× |
| X-ray eye for foreign body (70030) | $115.74 | $391 | 1.4× |
| X-ray humerus (73060) | $199.80 | $675 | 2.5× |
| X-ray IV pyelogram (ivp) (74400) | $523.63 | $1,769 | 3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $282.98 | $956 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $248.35 | $839 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $472.12 | $1,595 | 4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $160.73 | $543 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $220.23 | $744 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $297.19 | $1,004 | 3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $315.24 | $1,065 | 3.3× |
| X-ray thoracic spine 4 vw (72074) | $134.98 | $456 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $429.20 | $1,450 | 1.3× |
| X-Rays Bone Length Studies (77073) | $146.23 | $494 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $547.01 | $1,848 | 5.7× |
| Xr c-spine 4 or 5 views (72050) | $338.33 | $1,143 | 3.5× |
| Xr facial bones less than 3 views (70140) | $243.02 | $821 | 3.0× |
| Xr orbits complete 4 views (70200) | $76.96 | $260 | 0.8× |
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.