Imaging prices at CommonSpirit Saint Joseph Hospital - London
London, KY · every code in this section with a posted price and a Medicare benchmark.
332 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) | $1,677.13 | $4,700 | 1.3× |
| Abdomen 1 View (74018) | $282.26 | $791 | 3.5× |
| Abdomen 2 views (74019) | $209.11 | $586 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $559.88 | $1,569 | 1.5× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $828.22 | $2,321 | 0.7× |
| Adrenal Cortex & Medulla Img (78075) | $1,026.26 | $2,876 | 0.8× |
| Angio pulmonary bilat (75743) | $1,628.60 | $4,564 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,420.92 | $3,982 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $1,576.15 | $4,417 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,294.96 | $3,629 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,197.54 | $3,356 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,197.54 | $3,356 | 0.4× |
| Ankle 2 views (73600) | $219.10 | $614 | 2.7× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,158.50 | $6,049 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,824.86 | $5,114 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $1,214.32 | $3,403 | 0.4× |
| Arthrogram ankle (73615) | $203.76 | $571 | 0.6× |
| Arthrogram hip (73525) | $401.44 | $1,125 | 1.2× |
| Arthrogram Wrist (73115) | $307.95 | $863 | 0.9× |
| Basic radiation dosimetry calculation (77300) | $201.62 | $565 | 1.6× |
| Bone age studies (77072) | $122.76 | $344 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,780.61 | $4,990 | 4.7× |
| Bone Imaging Limited Area (78300) | $903.87 | $2,533 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $566.66 | $1,588 | 1.5× |
| Bone Imaging Whole Body (78306) | $1,348.84 | $3,780 | 3.6× |
| Bone survey infant (77076) | $156.66 | $439 | 1.6× |
| Brachytx isodose complex (77318) | $405.37 | $1,136 | 1.2× |
| Brachytx isodose intermed (77317) | $405.37 | $1,136 | 1.2× |
| Brachytx Isodose Plan Simple (77316) | $151.66 | $425 | 0.4× |
| Brain Flow Imaging Only (78610) | $221.24 | $620 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $443.19 | $1,242 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $221.24 | $620 | 0.4× |
| Cerebrospinal Fluid Scan (78630) | $724.38 | $2,030 | 1.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$128.82–$149.88 | $361–$420 | varies |
| Chest 2 views (71046) | $214.11 | $600 | 2.6× |
| Chest 3 views (71047) | $220.17 | $617 | 2.7× |
| Chest 4 or more views (71048) | $220.17 | $617 | 2.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$188.06–$353.63 | $527–$991 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,050.17 | $2,943 | 10.7× |
| Continuing medical physics consltj pr wk (77336) | $202.33 | $567 | 1.6× |
| Contrast Exam Abdominl Aorta (75625) | $1,294.96 | $3,629 | 0.4× |
| Contrast X-Ray Bladder (74430) | $108.84 | $305 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $332.58 | $932 | 1.0× |
| Contrast X-Ray Of Knee Joint (73580) | $225.52 | $632 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $3,037.74 | $8,513 | 9.3× |
| CT abdomen and pelvis without contrast (74176) | $2,476.09 | $6,939 | 11.1× |
| CT abdomen w contrast (74160) | $1,176.85 | $3,298 | 7.2× |
| CT abdomen w wo contrast (74170) | $1,307.45 | $3,664 | 7.9× |
| CT abdomen w/o contrast (74150) | $1,608.26 | $4,507 | 16.4× |
| CT Angio Abdomen and Pelvis (74174) | $950.61 | $2,664 | 2.9× |
| CT Angio Chest (71275) | $1,165.79 | $3,267 | 7.1× |
| CT Angio Head (70496) | $974.52 | $2,731 | 5.9× |
| CT angio hrt w/3d image (75574) | $147.02 | $412 | 0.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $563.45 | $1,579 | 3.4× |
| CT Angio Neck (70498) | $1,299.60 | $3,642 | 7.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$654.44–$740.08 | $1,834–$2,074 | varies |
| CT cervical spine w/ contrast (72126) | $1,359.90 | $3,811 | 4.2× |
| CT cervical spine w/o contrast (72125) | $1,359.90 | $3,811 | 13.9× |
| CT cervical spine w/wo cont (72127) | $1,414.50 | $3,964 | 8.6× |
| CT chest w contrast (71260) | $1,193.26 | $3,344 | 7.3× |
| CT chest w/wo contrast (71270) | $1,109.76 | $3,110 | 6.7× |
| CT head/brain with contrast (70460) | $1,256.42 | $3,521 | 7.6× |
| CT head/brain without and with contrast (70470) | $1,367.40 | $3,832 | 8.3× |
| CT iac w contrast (70481) | $944.19 | $2,646 | 5.7× |
| CT l-spine w&w/o contrast (72133) | $1,478.37 | $4,143 | 9.0× |
| CT lower ext w/o (73700) | $568.80 | $1,594 | 5.8× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$568.80–$660.15 | $1,594–$1,850 | varies |
| CT lumbar spine w contrast (72132) | $1,563.66 | $4,382 | 4.8× |
| CT lumbar spine w/o contrast (72131) | $1,421.28 | $3,983 | 14.5× |
| CT maxillofacial w contrast (70487) | $1,100.84 | $3,085 | 6.7× |
| CT maxillofacial wo contrast (70486) | $1,038.75 | $2,911 | 10.6× |
| CT neck tissue combo (70492) | $1,032.33 | $2,893 | 6.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,116.54 | $3,129 | 6.8× |
| CT orbits w/o contrast (70480) | $907.79 | $2,544 | 9.3× |
| CT pelvis w&w/o contrast (72194) | $1,160.43 | $3,252 | 7.1× |
| CT pelvis w/o contrast (72192) | $1,008.78 | $2,827 | 10.3× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$670.86–$858.91 | $1,880–$2,407 | varies |
| CT scans face/jaw combo (70488) | $1,132.24 | $3,173 | 6.9× |
| CT soft tissue neck w contrast (70491) | $1,098.34 | $3,078 | 6.7× |
| CT soft tissue neck w/o contrast (70490) | $988.44 | $2,770 | 10.1× |
| CT thoracic spine w contrast (72129) | $969.53 | $2,717 | 5.9× |
| CT thoracic spine w/o contrast (72128) | $1,020.55 | $2,860 | 10.4× |
| CT thoracic spine w/wo cont (72130) | $1,010.21 | $2,831 | 6.1× |
| CT thorax w/o contrast (71250) | $1,050.17 | $2,943 | 10.7× |
| CT upper ext wo (73200) | $965.24 | $2,705 | 9.8× |
| CT upper extremity w/o & w/contrast material (73202) | $936.34 | $2,624 | 5.7× |
| CT upper extremity with contrast (73201) | $897.80 | $2,516 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $627.68 | $1,759 | 3.8× |
| Cta Abdomen (74175) | $618.04 | $1,732 | 3.8× |
| CTA pelvis (72191) | $1,069.44 | $2,997 | 6.5× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$296.18–$509.21 | $830–$1,427 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $372.90 | $1,045 | 4.6× |
| Echo Guide For Artery Repair (76936) | $2,059.66 | $5,772 | 10.2× |
| Esophagram (74220) | $387.17 | $1,085 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $393.24 | $1,102 | 4.0× |
| Fluoroscopy up to 1 hr (76000) | $193.41 | $542 | 0.9× |
| Follow-Up Angiography (75898) | $414.65 | $1,162 | 0.1× |
| Foot 2 views (73620) | $273.70 | $767 | 3.4× |
| Forearm 2 views (73090) | $246.22 | $690 | 3.0× |
| Gastric emptying imaging study (78264) | $1,321.72 | $3,704 | 3.5× |
| Gated Heart Planar Single (78472) | $528.83 | $1,482 | 1.4× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$142.74–$182.70 | $400–$512 | varies |
| Heart first pass single,planar (78481) | $535.26 | $1,500 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $665.50 | $1,865 | 1.3× |
| Hepatobiliary System Imaging (78226) | $652.30 | $1,828 | 1.7× |
| Ht Musc Image Planar Mult (78454) | $817.87 | $2,292 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $613.40 | $1,719 | 0.5× |
| Hysterosalpingogram (74740) | $476.38 | $1,335 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $196.98 | $552 | 2.4× |
| Interstitial radiation source applic complex (77778) | $1,571.86 | $4,405 | 2.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $530.98 | $1,488 | 0.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $530.98 | $1,488 | 1.0× |
| Intracavitary radiation source applic simple (77761) | $530.98 | $1,488 | 1.0× |
| K Flow/Funct Image Multiple (78709) | $518.84 | $1,454 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $1,153.30 | $3,232 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $496.36 | $1,391 | 1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $288.68 | $809 | 0.8× |
| Knee 3 Views (73562) | $315.09 | $883 | 3.9× |
| Liver & Spleen Imaging Static Only (78215) | $117.05 | $328 | 0.3× |
| Liver imaging w/vascular flow (78202) | $481.38 | $1,349 | 0.9× |
| Lung Perf&Ventilat Diferentl (78598) | $744.72 | $2,087 | 1.5× |
| Lung perfusion differential (78597) | $224.81 | $630 | 0.6× |
| Lung Ventilat&Perfus Imaging (78582) | $642.31 | $1,800 | 1.3× |
| Lung Ventilation Imaging (78579) | $481.73 | $1,350 | 1.3× |
| Lymph System Imaging (78195) | $403.23 | $1,130 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $623.75 | $1,748 | 2.8× |
| Mammary ductogram or galactogram multiple (77054) | $251.57 | $705 | 1.1× |
| Meckels Divert Exam (78290) | $270.13 | $757 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $2,093.91 | $5,868 | 6.0× |
| Mr safety determination physician/other qhp (76016) | $81.72 | $229 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $22.84 | $64 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $85.65 | $240 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $224.81 | $630 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,101.56 | $3,087 | 3.4× |
| MRA head w/o contrast (70544) | $1,090.85 | $3,057 | 4.9× |
| MRA head with contrast (70545) | $840 | $2,354 | 2.6× |
| MRA neck w contrast (70548) | $927.06 | $2,598 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,287.11 | $3,607 | 3.9× |
| MRA neck w/o contrast (70547) | $1,090.85 | $3,057 | 4.9× |
| MRI abdomen w contrast (74182) | $1,143.66 | $3,205 | 3.5× |
| MRI abdomen w/o contrast (74181) | $984.16 | $2,758 | 4.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,257.85 | $3,525 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,319.58 | $3,698 | 4.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,083.36 | $3,036 | 1.5× |
| MRI cervical spine w contrast (72142) | $1,426.63 | $3,998 | 4.4× |
| MRI cervical spine w/o cont (72141) | $1,160.08 | $3,251 | 5.2× |
| MRI chest w/o contrast (71550) | $964.53 | $2,703 | 4.3× |
| MRI chest wo w contrast (71552) | $1,190.76 | $3,337 | 3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,359.55 | $3,810 | 4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,275.33 | $3,574 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,203.25 | $3,372 | 5.4× |
| MRI lumbar spine w contrast (72149) | $1,399.87 | $3,923 | 4.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,670.35 | $4,681 | 5.1× |
| MRI orbit face &/neck w/o contrast (70540) | $885.67 | $2,482 | 4.0× |
| MRI orbit face neck w contrast (70542) | $1,038.40 | $2,910 | 3.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,526.90 | $4,279 | 4.7× |
| MRI pelvis w contrast (72196) | $1,136.88 | $3,186 | 3.5× |
| MRI pelvis w/o & w contrast (72197) | $1,227.52 | $3,440 | 3.7× |
| MRI pelvis w/o contrast (72195) | $1,136.88 | $3,186 | 5.1× |
| MRI thoracic spine w/o contrast (72146) | $1,131.53 | $3,171 | 5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,226.09 | $3,436 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,190.41 | $3,336 | 5.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,059.45 | $2,969 | 3.2× |
| MRI, abdomen, combo (74183) | $1,447.33 | $4,056 | 4.4× |
| MRI, dorsal spine combo (72157) | $1,108.69 | $3,107 | 3.4× |
| MRI, dorsal spine contrast (72147) | $1,357.76 | $3,805 | 4.1× |
| MRI, joint upper extrem (73221) | $1,128.68 | $3,163 | 5.0× |
| MRI, joint upper extrem combo (73223) | $1,218.95 | $3,416 | 3.7× |
| MRI, lumbar spine combo (72158) | $1,453.75 | $4,074 | 4.4× |
| Myelogram cervical (72240) | $588.78 | $1,650 | 0.8× |
| Myelogram Lumbar (72265) | $671.93 | $1,883 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $559.52 | $1,568 | 0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $317.23 | $889 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,271.62 | $6,366 | 1.9× |
| N-invas est c ffr sw aly CTA (75580) | $888.52 | $2,490 | 1.1× |
| Neck soft tissue (70360) | $249.79 | $700 | 3.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $204.83 | $574 | 0.6× |
| Nm myocard infarct spect (78469) | $689.05 | $1,931 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,597.20 | $4,476 | 1.2× |
| Nuclear Rx Oral Admin (79005) | $191.63 | $537 | 0.9× |
| Ob us nuchal meas 1 gest (76813) | $201.97 | $566 | 2.1× |
| Parathyroid Planar Imaging (78070) | $156.30 | $438 | 0.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $155.23 | $435 | 0.4× |
| Pelvis 1 or 2 views (72170) | $196.26 | $550 | 2.0× |
| Perineogram (74775) | $194.48 | $545 | 0.9× |
| PET image w/CT, full body (78816) | $1,444.47 | $4,048 | 1.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,123.89 | $5,952 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $244.08 | $684 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$360.05–$431.78 | $1,009–$1,210 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $195.91 | $549 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $260.49 | $730 | 3.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $187.70 | $526 | 2.3× |
| Radex elbow complete minimum 3 views (73080) | $312.59 | $876 | 3.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$271.91–$293.68 | $762–$823 | varies |
| Radex fingr minimum 2 views (73140) | $237.30 | $665 | 2.9× |
| Radex foot complete minimum 3 views (73630) | $321.87 | $902 | 3.9× |
| Radex Hand Minimum 3 Views (73130) | $210.18 | $589 | 2.6× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$64.59–$188.06 | $181–$527 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $102.77 | $288 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $310.09 | $869 | 3.8× |
| Radex Ribs Unilateral 2 Views (71100) | $64.59 | $181 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$220.89–$599.49 | $619–$1,680 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$63.52–$116.69 | $178–$327 | varies |
| Radex Spine 1 View Specify Level (72020) | $144.17 | $404 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$183.06–$223.03 | $513–$625 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $204.83 | $574 | 2.5× |
| Radex Toe Minimum 2 Views (73660) | $168.79 | $473 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $123.47 | $346 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $282.26 | $791 | 3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $138.81 | $389 | 1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) unusually low: confirm this is the full procedure |
$3,372.10 | $9,450 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $142.38 | $399 | 1.5× |
| Radiation treatment delivery level 2 (77407) | $214.82 | $602 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $281.19 | $788 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$180.21–$286.19 | $505–$802 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $160.94 | $451 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $670.86 | $1,880 | 4.1× |
| Radiologic exam colon single contrast study (74270) | $366.83 | $1,028 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $287.97 | $807 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) | $361.84 | $1,014 | 3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $15.71 | $44 | 0.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$416.07–$519.91 | $1,166–$1,457 | varies |
| Radiologic exam swallow function contrast study (74230) | $333.29 | $934 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$235.87–$346.85 | $661–$972 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$274.05–$349.70 | $768–$980 | varies |
| Radiologic examination knee 1/2 views (73560) | $286.19 | $802 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $285.47 | $800 | 3.5× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$278.69–$466.39 | $781–$1,307 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $155.23 | $435 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,010.92 | $2,833 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,404.15 | $3,935 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $527.05 | $1,477 | 1.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$783.26–$918.50 | $2,195–$2,574 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$474.95–$558.45 | $1,331–$1,565 | varies |
| Scapula (73010) | $184.85 | $518 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $31.41 | $88 | 1.3× |
| Shoulder 1 view (73020) | $192.70 | $540 | 2.4× |
| Shoulder Arthrography (73040) | $390.74 | $1,095 | 1.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$159.87–$216.60 | $448–$607 | varies |
| Special dosimetry (77331) | $175.21 | $491 | 1.4× |
| Special Physics Consult (77370) | $198.41 | $556 | 1.6× |
| Special teletherapy port plan (77321) | $433.92 | $1,216 | 1.2× |
| Special treatment procedure (77470) | $634.10 | $1,777 | 1.2× |
| Stereotactic Body Radiation Delivery (77373) | $1,069.44 | $2,997 | 0.6× |
| Sternoclavicular joints (71130) | $129.54 | $363 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $433.92 | $1,216 | 1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $169.50 | $475 | 0.5× |
| Testicular Imaging W/Flow (78761) | $439.98 | $1,233 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $513.13 | $1,438 | 1.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $487.44 | $1,366 | 1.4× |
| Ther rad simulaj-aided field setting simple (77280) | $205.19 | $575 | 1.6× |
| Thoracic spine 2 views (72070) | $253.71 | $711 | 2.6× |
| Thoracic spine 3 views (72072) | $78.87 | $221 | 0.8× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$156.30–$314.02 | $438–$880 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $474.60 | $1,330 | 1.3× |
| Thyroid Met Imaging Body (78018) | $508.85 | $1,426 | 1.0× |
| Thyroid Uptake Measurement (78012) | $759.35 | $2,128 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $318.66 | $893 | 0.8× |
| Tx Devices Design & Construction Complex (77334) | $370.40 | $1,038 | 1.1× |
| Tx devices design & construction intermediate (77333) | $329.72 | $924 | 2.6× |
| Tx devices design & construction simple (77332) | $359.34 | $1,007 | 2.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$191.27–$658.72 | $536–$1,846 | varies |
| Ultrasound Exam Aaa Screen (76706) | $364.33 | $1,021 | 3.7× |
| Ultrasound, abdomen limited (76705) | $841.78 | $2,359 | 8.6× |
| Unlisted magnetic resonance procedure (76498) | $76.01 | $213 | 0.9× |
| Upper gi w/o kub (74240) | $158.08 | $443 | 1.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$376.47–$730.80 | $1,055–$2,048 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$598.77–$1,197.54 | $1,678–$3,356 | varies |
| Us chest (76604) | $178.07 | $499 | 1.8× |
| Us complete joint (76881) | $394.31 | $1,105 | 4.0× |
| Us exam, pelvic, limited (76857) | $497.43 | $1,394 | 5.1× |
| Us head (76506) | $382.89 | $1,073 | 3.9× |
| Us kidney transplant (76776) | $355.41 | $996 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$64.24–$226.95 | $180–$636 | varies |
| Us ob limited 1 or more fetuses (76815) | $523.48 | $1,467 | 5.3× |
| Us ob transvaginal (76817) | $428.92 | $1,202 | 4.4× |
| Us pelvic non ob complete (76856) | $720.46 | $2,019 | 7.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $602.34 | $1,688 | 6.1× |
| Us retroperitoneal complete (76770) | $1,773.48 | $4,970 | 18.1× |
| Us retroperitoneal limited (76775) | $555.95 | $1,558 | 5.7× |
| Us scrotum and contents (76870) | $592.35 | $1,660 | 6.0× |
| Us spinal canal and contents (76800) | $246.58 | $691 | 2.5× |
| Us thyroid (76536) | $462.11 | $1,295 | 4.7× |
| Us transrectal (76872) | $1,632.53 | $4,575 | 16.6× |
| Vein X-Ray Chest (75827) | $1,153.30 | $3,232 | 0.8× |
| Venogram Sinus/Jugular (75860) | $1,200.40 | $3,364 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,281.76 | $3,592 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $1,398.80 | $3,920 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $508.85 | $1,426 | 0.3× |
| Wrist 2 views (73100) | $256.93 | $720 | 3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $190.91 | $535 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $193.05 | $541 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $1,294.96 | $3,629 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $75.65 | $212 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $256.57 | $719 | 3.1× |
| X-Ray Exam Breast Specimen (76098) | $155.23 | $435 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $121.33 | $340 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $348.28 | $976 | 3.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $233.38 | $654 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $65.31 | $183 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$158.44–$282.26 | $444–$791 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $141.31 | $396 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $115.98 | $325 | 1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $294.75 | $826 | 3.0× |
| X-Ray Exam L-S Spine Bending (72114) | $327.94 | $919 | 3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $224.81 | $630 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $263.35 | $738 | 2.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $293.32 | $822 | 3.0× |
| X-ray eye for foreign body (70030) | $99.92 | $280 | 1.2× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$235.87–$304.39 | $661–$853 | varies |
| X-ray IV pyelogram (ivp) (74400) | $332.58 | $932 | 2.0× |
| X-ray IV pyelogram+tomography (74415) | $695.12 | $1,948 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $226.24 | $634 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$180.92–$199.12 | $507–$558 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$290.11–$330.79 | $813–$927 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$346.14–$466.39 | $970–$1,307 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $313.66 | $879 | 3.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $142.38 | $399 | 1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $241.23 | $676 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$260.14–$265.49 | $729–$744 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$280.12–$354.70 | $785–$994 | varies |
| X-Ray Stress View (77071) | $69.23 | $194 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $284.05 | $796 | 2.9× |
| X-Ray Tmj Unilat (70328) | $137.03 | $384 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $89.93 | $252 | 0.3× |
| X-Rays Bone Length Studies (77073) | $149.88 | $420 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $504.93 | $1,415 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $350.77 | $983 | 3.6× |
| Xr facial bones less than 3 views (70140) | $223.03 | $625 | 2.7× |
| XR Mastoids < 3 Views Bilateral (70120) | $179.49 | $503 | 1.8× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$147.73–$219.46 | $414–$615 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$291.90–$566.66 | $818–$1,588 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.