Imaging prices at CommonSpirit Saint Joseph Medical Center - East Lexington
Lexington, KY · every code in this section with a posted price and a Medicare benchmark.
395 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $3,775.75 | $9,400 | 2.8× |
| Abdomen 1 View (74018) | $185.18 | $461 | 2.2× |
| Abdomen 2 views (74019) | $203.65 | $507 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $401.68 | $1,000 | 1.0× |
| Angio internal mammary (75756) | $1,360.88 | $3,388 | 0.4× |
| Angio pulmonary bilat (75743) | $1,504.68 | $3,746 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,605.10 | $3,996 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $2,373.10 | $5,908 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $1,695.07 | $4,220 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,294.20 | $3,222 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,294.20 | $3,222 | 0.4× |
| Ankle 2 views (73600) | $265.11 | $660 | 3.1× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,360.88 | $3,388 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,360.88 | $3,388 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,854.54 | $4,617 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $1,458.89 | $3,632 | 0.5× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,360.88 | $3,388 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,360.88 | $3,388 | 0.3× |
| Arthrogram ankle (73615) | $375.57 | $935 | 1.1× |
| Arthrogram hip (73525) | $422.57 | $1,052 | 1.2× |
| Arthrogram Wrist (73115) | $375.57 | $935 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $453.90 | $1,130 | 3.5× |
| Bone age studies (77072) | $110.87 | $276 | 1.1× |
| Bone Imaging 3 Phase (78315) | $1,026.69 | $2,556 | 2.6× |
| Bone Imaging Limited Area (78300) | $738.28 | $1,838 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $641.88 | $1,598 | 1.6× |
| Bone Imaging Whole Body (78306) | $1,604.29 | $3,994 | 4.1× |
| Bone marrow imaging; whole body (78104) | $478 | $1,190 | 1.2× |
| Bone survey infant (77076) | $191.60 | $477 | 1.9× |
| Brachytx isodose complex (77318) | $921.45 | $2,294 | 2.5× |
| Brachytx isodose intermed (77317) | $921.45 | $2,294 | 2.5× |
| Brachytx Isodose Plan Simple (77316) | $345.04 | $859 | 0.9× |
| Brain Flow Imaging Only (78610) | $605.73 | $1,508 | 1.1× |
| Brain Image W/Flow < 4 Views (78601) | $503.71 | $1,254 | 1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $614.17 | $1,529 | 1.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $393.24 | $979 | 0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,722.79 | $4,289 | 1.2× |
| Cardiac Shunt Detection (78428) | $362.32 | $902 | 0.9× |
| Cat Scan Follow-Up Study (76380) | $384.41 | $957 | 4.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $463.94 | $1,155 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $605.73 | $1,508 | 1.1× |
| Chest 1 view (71045) | $185.18 | $461 | 2.2× |
| Chest 2 views (71046) | $253.86 | $632 | 3.0× |
| Chest 3 views (71047) | $151.84 | $378 | 1.8× |
| Chest 4 or more views (71048) | $361.11 | $899 | 3.5× |
| Cholecystography Oral Contrast (74290) | $203.25 | $506 | 1.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $646.70 | $1,610 | 6.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$218.92–$367.54 | $545–$915 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $740.29 | $1,843 | 7.3× |
| Continuing medical physics consltj pr wk (77336) | $455.50 | $1,134 | 3.5× |
| Contrast Exam Abdominl Aorta (75625) | $2,202.79 | $5,484 | 0.7× |
| Contrast X-Ray Bladder (74430) | $302.87 | $754 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $460.32 | $1,146 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $521.38 | $1,298 | 1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $197.23 | $491 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,606.70 | $4,000 | 4.7× |
| CT abdomen and pelvis without contrast (74176) | $1,429.97 | $3,560 | 6.1× |
| CT abdomen w contrast (74160) | $789.70 | $1,966 | 4.6× |
| CT abdomen w wo contrast (74170) | $1,144.78 | $2,850 | 6.7× |
| CT abdomen w/o contrast (74150) | $742.30 | $1,848 | 7.3× |
| CT Angio Abdomen and Pelvis (74174) | $853.16 | $2,124 | 2.5× |
| CT Angio Chest (71275) | $1,153.21 | $2,871 | 6.7× |
| CT Angio Head (70496) | $1,121.48 | $2,792 | 6.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $855.17 | $2,129 | 5.0× |
| CT Angio Neck (70498) | $1,078.90 | $2,686 | 6.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $715.39 | $1,781 | 4.2× |
| CT cervical spine w/ contrast (72126) | $1,448.85 | $3,607 | 4.3× |
| CT cervical spine w/o contrast (72125) | $1,366.50 | $3,402 | 13.4× |
| CT cervical spine w/wo cont (72127) | $1,462.50 | $3,641 | 8.5× |
| CT chest w contrast (71260) | $931.49 | $2,319 | 5.4× |
| CT chest w/wo contrast (71270) | $1,058.82 | $2,636 | 6.2× |
| CT head/brain with contrast (70460) | $674.82 | $1,680 | 3.9× |
| CT head/brain without and with contrast (70470) | $990.94 | $2,467 | 5.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $214.10 | $533 | 0.6× |
| CT iac w contrast (70481) | $634.65 | $1,580 | 3.7× |
| CT l-spine w&w/o contrast (72133) | $1,562.52 | $3,890 | 9.1× |
| CT lower ext w/o (73700) | $796.93 | $1,984 | 7.8× |
| CT lower extremity w/contrast material (73701) | $814.20 | $2,027 | 4.8× |
| CT lumbar spine w contrast (72132) | $1,496.24 | $3,725 | 4.4× |
| CT lumbar spine w/o contrast (72131) | $1,324.33 | $3,297 | 13.0× |
| CT maxillofacial w contrast (70487) | $786.48 | $1,958 | 4.6× |
| CT maxillofacial wo contrast (70486) | $819.02 | $2,039 | 8.0× |
| CT neck tissue combo (70492) | $1,435.59 | $3,574 | 8.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $826.25 | $2,057 | 4.8× |
| CT orbits w/o contrast (70480) | $598.90 | $1,491 | 5.9× |
| CT pelvis w&w/o contrast (72194) | $994.55 | $2,476 | 5.8× |
| CT pelvis w/o contrast (72192) | $709.36 | $1,766 | 6.9× |
| CT scan of leg combo (73702) | $1,065.25 | $2,652 | 6.2× |
| CT scans face/jaw combo (70488) | $892.93 | $2,223 | 5.2× |
| CT soft tissue neck w contrast (70491) | $1,305.05 | $3,249 | 7.6× |
| CT soft tissue neck w/o contrast (70490) | $1,057.21 | $2,632 | 10.4× |
| CT thoracic spine w contrast (72129) | $1,190.17 | $2,963 | 6.9× |
| CT thoracic spine w/o contrast (72128) | $1,060.83 | $2,641 | 10.4× |
| CT thoracic spine w/wo cont (72130) | $1,164.06 | $2,898 | 6.8× |
| CT thorax w/o contrast (71250) | $796.12 | $1,982 | 7.8× |
| CT upper ext wo (73200) | $739.89 | $1,842 | 7.2× |
| CT upper extremity w/o & w/contrast material (73202) | $938.32 | $2,336 | 5.5× |
| CT upper extremity with contrast (73201) | $749.13 | $1,865 | 2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,133.53 | $2,822 | 6.6× |
| Cta Abdomen (74175) | $1,109.03 | $2,761 | 6.5× |
| CTA pelvis (72191) | $850.75 | $2,118 | 5.0× |
| Dilation ureters/urethra rs&i (74485) | $753.95 | $1,877 | 0.4× |
| Discography Cerv/Thor Spine (72285) | $1,360.88 | $3,388 | 0.7× |
| Diskography lumbar (72295) | $1,360.88 | $3,388 | 0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $106.85 | $266 | 1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $205.66 | $512 | 2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $110.47 | $275 | 1.1× |
| Dxa Bone Density Axial (77080) | $299.65 | $746 | 2.9× |
| Dxa bone density study (77085) | $155.85 | $388 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $260.69 | $649 | 3.1× |
| Echo exam of fetal heart (76825) | $439.44 | $1,094 | 0.8× |
| Echo Guide For Artery Repair (76936) | $318.93 | $794 | 1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $228.96 | $570 | 1.0× |
| Esophagram (74220) | $380.79 | $948 | 2.2× |
| Fetal Biophys Profile W/Nst (76818) | $237.39 | $591 | 2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $162.68 | $405 | 1.6× |
| Fluoroscopy up to 1 hr (76000) | $256.68 | $639 | 1.1× |
| Follow-Up Angiography (75898) | $495.67 | $1,234 | 0.2× |
| Foot 2 views (73620) | $292.83 | $729 | 3.4× |
| Forearm 2 views (73090) | $277.16 | $690 | 3.3× |
| Gastric emptying imaging study (78264) | $1,352.04 | $3,366 | 3.5× |
| Gated Heart Planar Single (78472) | $758.77 | $1,889 | 1.9× |
| Hand 2 views (73120) | $228.96 | $570 | 2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,360.88 | $3,388 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,552.08 | $3,864 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $966.03 | $2,405 | 1.8× |
| Hepatobiliary System Imaging (78226) | $589.26 | $1,467 | 1.5× |
| Ht Musc Image Planar Mult (78454) | $1,166.47 | $2,904 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $1,353.25 | $3,369 | 1.1× |
| Hysterosalpingogram (74740) | $374.37 | $932 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $153.85 | $383 | 1.8× |
| Infant hip ultrasound, limited static exam (76886) | $124.52 | $310 | 1.5× |
| Infusion Ivp (74410) | $265.11 | $660 | 1.5× |
| Interstitial radiation source applic complex (77778) | $3,573.30 | $8,896 | 5.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,207.44 | $3,006 | 1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,207.44 | $3,006 | 2.2× |
| Intracavitary radiation source applic simple (77761) | $1,207.44 | $3,006 | 2.2× |
| Joint Survey Single View (77077) | $110.47 | $275 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $749.53 | $1,866 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $1,189.36 | $2,961 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,094.17 | $2,724 | 2.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $868.43 | $2,162 | 2.2× |
| Knee 3 Views (73562) | $316.93 | $789 | 3.7× |
| Leveen/Shunt Patency Exam (78291) | $362.32 | $902 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $440.64 | $1,097 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $567.97 | $1,414 | 1.1× |
| Lung perfusion differential (78597) | $437.03 | $1,088 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $662.37 | $1,649 | 1.2× |
| Lung Ventilation Imaging (78579) | $469.56 | $1,169 | 1.2× |
| Lymph System Imaging (78195) | $463.94 | $1,155 | 0.9× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $298.05 | $742 | 0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $619.79 | $1,543 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,364.49 | $3,397 | 0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $757.97 | $1,887 | 0.2× |
| Magnetic Image Jaw Joint (70336) | $561.14 | $1,397 | 2.4× |
| Mammary ductogram or galactogram multiple (77054) | $133.36 | $332 | 0.6× |
| Mammary ductogram or galactogram single (77053) | $135.77 | $338 | 0.6× |
| Meckels Divert Exam (78290) | $538.25 | $1,340 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $4,949.84 | $12,323 | 13.5× |
| Mr safety determination physician/other qhp (76016) | $89.58 | $223 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $24.91 | $62 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $93.60 | $233 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $245.83 | $612 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,484.59 | $3,696 | 4.4× |
| MRA head w/o contrast (70544) | $933.90 | $2,325 | 4.0× |
| MRA head with contrast (70545) | $1,064.44 | $2,650 | 3.1× |
| MRA neck w contrast (70548) | $841.92 | $2,096 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,041.15 | $2,592 | 3.1× |
| MRA neck w/o contrast (70547) | $1,107.82 | $2,758 | 4.8× |
| MRI abdomen w contrast (74182) | $1,085.73 | $2,703 | 3.2× |
| MRI abdomen w/o contrast (74181) | $762.38 | $1,898 | 3.3× |
| MRI any jt lower extrem w/contrast material (73722) | $993.35 | $2,473 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,079.30 | $2,687 | 3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $941.93 | $2,345 | 1.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $733.86 | $1,827 | 3.1× |
| MRI cervical spine w contrast (72142) | $940.73 | $2,342 | 2.8× |
| MRI cervical spine w/o cont (72141) | $887.71 | $2,210 | 3.8× |
| MRI chest w/o contrast (71550) | $631.84 | $1,573 | 2.7× |
| MRI chest with contrast (71551) | $695.71 | $1,732 | 0.9× |
| MRI chest wo w contrast (71552) | $799.74 | $1,991 | 2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,087.34 | $2,707 | 3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $957.20 | $2,383 | 2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $882.89 | $2,198 | 3.8× |
| MRI lumbar spine w contrast (72149) | $837.50 | $2,085 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,260.46 | $3,138 | 3.7× |
| MRI orbit face &/neck w/o contrast (70540) | $950.77 | $2,367 | 4.1× |
| MRI orbit face neck w contrast (70542) | $980.09 | $2,440 | 2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $990.13 | $2,465 | 2.9× |
| MRI pelvis w contrast (72196) | $844.73 | $2,103 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,042.75 | $2,596 | 3.1× |
| MRI pelvis w/o contrast (72195) | $771.62 | $1,921 | 3.3× |
| MRI thoracic spine w/o contrast (72146) | $1,033.51 | $2,573 | 4.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,143.57 | $2,847 | 3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,002.99 | $2,497 | 4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,083.32 | $2,697 | 3.2× |
| MRI, abdomen, combo (74183) | $1,154.82 | $2,875 | 3.4× |
| MRI, dorsal spine combo (72157) | $1,456.48 | $3,626 | 4.3× |
| MRI, dorsal spine contrast (72147) | $1,127.51 | $2,807 | 3.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$914.62–$1,271.31 | $2,277–$3,165 | varies |
| MRI, joint upper extrem combo (73223) | $969.65 | $2,414 | 2.8× |
| MRI, lumbar spine combo (72158) | $1,177.72 | $2,932 | 3.5× |
| Myelogram Lumbar (72265) | $888.51 | $2,212 | 1.2× |
| Myelography thoracic (72255) | $571.99 | $1,424 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $934.70 | $2,327 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $2,332.53 | $5,807 | 1.8× |
| N-invas est c ffr sw aly CTA (75580) | $1,000.18 | $2,490 | 1.2× |
| Neck soft tissue (70360) | $159.87 | $398 | 1.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $465.55 | $1,159 | 1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $258.28 | $643 | 0.7× |
| Nm csf leak detection (78650) | $391.24 | $974 | 0.3× |
| Nonvascular Shunt X-Ray (75809) | $156.66 | $390 | 1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,775.75 | $9,400 | 2.8× |
| Nuclear Rx Oral Admin (79005) | $514.95 | $1,282 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $208.47 | $519 | 2.0× |
| Optic foramina (70190) | $94 | $234 | 1.1× |
| Parathyroid Planar Imaging (78070) | $665.98 | $1,658 | 1.7× |
| Pelvis 1 or 2 views (72170) | $194.01 | $483 | 1.9× |
| Perineogram (74775) | $218.92 | $545 | 0.9× |
| Peritoneogram Rs&I (74190) | $557.53 | $1,388 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $1,601.48 | $3,987 | 1.1× |
| PET image w/CT, full body (78816) | $1,625.98 | $4,048 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,390.77 | $5,952 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,553.68 | $3,868 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $469.56 | $1,169 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $298.05 | $742 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $176.34 | $439 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $270.73 | $674 | 3.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $153.44 | $382 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $273.95 | $682 | 3.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $306.08 | $762 | 3.0× |
| Radex fingr minimum 2 views (73140) | $203.25 | $506 | 2.4× |
| Radex foot complete minimum 3 views (73630) | $263.91 | $657 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $259.89 | $647 | 3.1× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$130.15–$203.25 | $324–$506 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $120.51 | $300 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $327.77 | $816 | 3.9× |
| Radex Ribs Unilateral 2 Views (71100) | $262.30 | $653 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$270.73–$409.71 | $674–$1,020 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $94.80 | $236 | 1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $538.65 | $1,341 | 3.1× |
| Radex Spine 1 View Specify Level (72020) | $220.93 | $550 | 2.6× |
| Radex Sternum Minimum 2 Views (71120) | $287.60 | $716 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $194.01 | $483 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $192.01 | $478 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $138.98 | $346 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $245.03 | $610 | 2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $157.86 | $393 | 1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,665.57 | $19,084 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $323.35 | $805 | 3.2× |
| Radiation treatment delivery level 2 (77407) | $488.04 | $1,215 | 1.3× |
| Radiation treatment delivery level 3 (77412) | $632.64 | $1,575 | 1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $351.47 | $875 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $200.04 | $498 | 2.0× |
| Radiologic exam colon double contrast study (74280) | $712.58 | $1,774 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $520.17 | $1,295 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $221.33 | $551 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) | $230.16 | $573 | 2.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $198.03 | $493 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $585.25 | $1,457 | 3.4× |
| Radiologic exam swallow function contrast study (74230) | $368.74 | $918 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$302.87–$318.13 | $754–$792 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$338.62–$422.97 | $843–$1,053 | varies |
| Radiologic examination knee 1/2 views (73560) | $298.85 | $744 | 3.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $259.49 | $646 | 2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $78.73 | $196 | 0.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $338.62 | $843 | 4.0× |
| Radiopharm Dacryocystography (78660) | $364.73 | $908 | 0.9× |
| Ribs bilateral 3 views (71110) | $314.52 | $783 | 3.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $837.10 | $2,084 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,243.99 | $3,097 | 3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,035.69 | $5,068 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,922.42 | $4,786 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $753.95 | $1,877 | 1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$686.07–$1,982.67 | $1,708–$4,936 | varies |
| Rp Therapy Intravenous Administration (79101) | $297.24 | $740 | 1.3× |
| Salivary Gland Imaging (78230) | $418.95 | $1,043 | 1.1× |
| Scapula (73010) | $238.20 | $593 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $35.75 | $89 | 1.5× |
| Sella turcica (70240) | $77.93 | $194 | 0.9× |
| Shoulder 1 view (73020) | $247.03 | $615 | 2.9× |
| Shoulder Arthrography (73040) | $445.86 | $1,110 | 1.3× |
| Skull less than 4 views (70250) | $266.32 | $663 | 2.6× |
| Special dosimetry (77331) | $398.47 | $992 | 3.0× |
| Special Physics Consult (77370) | $446.67 | $1,112 | 3.4× |
| Special teletherapy port plan (77321) | $1,045.97 | $2,604 | 2.9× |
| Special treatment procedure (77470) | $1,605.50 | $3,997 | 3.0× |
| Spleen Imaging (78185) | $271.14 | $675 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $2,706.89 | $6,739 | 1.6× |
| Sternoclavicular joints (71130) | $106.45 | $265 | 1.3× |
| Superior sagittal sinus venogram (75870) | $735.07 | $1,830 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $986.52 | $2,456 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $385.21 | $959 | 1.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $418.15 | $1,041 | 1.8× |
| Testicular Imaging W/Flow (78761) | $362.32 | $902 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,154.82 | $2,875 | 3.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,097.38 | $2,732 | 3.0× |
| Ther rad simulaj-aided field setting simple (77280) | $461.93 | $1,150 | 3.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $302.06 | $752 | 1.8× |
| Thoracic spine 2 views (72070) | $284.39 | $708 | 2.8× |
| Thoracic spine 3 views (72072) | $304.47 | $758 | 3.0× |
| Thoracolumbar 2 views (72080) | $177.55 | $442 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $600.91 | $1,496 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,254.44 | $3,123 | 2.4× |
| Thyroid Uptake Measurement (78012) | $500.49 | $1,246 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $362.32 | $902 | 0.9× |
| Tx Devices Design & Construction Complex (77334) | $833.48 | $2,075 | 2.3× |
| Tx devices design & construction intermediate (77333) | $741.90 | $1,847 | 5.7× |
| Tx devices design & construction simple (77332) | $808.58 | $2,013 | 6.2× |
| Ultrasound Breast Limited (76642) | $283.19 | $705 | 3.3× |
| Ultrasound Elastography Parenchyma (76981) | $97.61 | $243 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) | $165.49 | $412 | 1.6× |
| Ultrasound, abdomen limited (76705) | $737.48 | $1,836 | 7.2× |
| Umbilical-artery Doppler (OB) (76820) | $110.47 | $275 | 1.1× |
| Unlisted Dx Radiographic Procedure (76499) | $451.09 | $1,123 | 5.3× |
| Unlisted us procedure (76999) | $166.70 | $415 | 2.0× |
| Upper gi w/o kub (74240) | $521.38 | $1,298 | 3.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $300.06 | $747 | 27.1× |
| Ureteral Reflux Study (78740) | $377.58 | $940 | 1.0× |
| Urethrocystogram voiding (74455) | $394.45 | $982 | 1.7× |
| Urethrocystography retrograde (74450) | $394.45 | $982 | 1.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$283.19–$353.88 | $705–$881 | varies |
| Us chest (76604) | $363.92 | $906 | 3.6× |
| Us complete joint (76881) | $565.16 | $1,407 | 5.5× |
| Us exam, pelvic, limited (76857) | $210.88 | $525 | 2.1× |
| Us head (76506) | $399.67 | $995 | 3.9× |
| Us kidney transplant (76776) | $483.22 | $1,203 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$279.57–$307.29 | $696–$765 | varies |
| Us ob detailed single fetus (76811) | $229.36 | $571 | 1.0× |
| Us ob limited 1 or more fetuses (76815) | $288.41 | $718 | 2.8× |
| Us ob transvaginal (76817) | $313.31 | $780 | 3.1× |
| Us pelvic non ob complete (76856) | $659.15 | $1,641 | 6.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $224.54 | $559 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $187.99 | $468 | 1.8× |
| Us retroperitoneal complete (76770) | $2,398.81 | $5,972 | 23.5× |
| Us retroperitoneal limited (76775) | $438.63 | $1,092 | 4.3× |
| Us scrotum and contents (76870) | $561.55 | $1,398 | 5.5× |
| Us spinal canal and contents (76800) | $230.16 | $573 | 2.3× |
| Us thyroid (76536) | $486.03 | $1,210 | 4.8× |
| Us transrectal (76872) | $1,621.97 | $4,038 | 15.9× |
| Vascular Flow Imaging (78445) | $212.49 | $529 | 0.5× |
| Vein X-Ray Chest (75827) | $1,682.22 | $4,188 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,227.92 | $3,057 | 0.4× |
| Venogram Sinus/Jugular (75860) | $1,360.88 | $3,388 | 0.4× |
| Venography Adrenal Unilateral (75840) | $1,360.88 | $3,388 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,615.14 | $4,021 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $906.58 | $2,257 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $953.98 | $2,375 | 0.6× |
| Venography Renal Bilateral (75833) | $1,360.88 | $3,388 | 0.4× |
| Venography Renal Unilateral (75831) | $1,360.88 | $3,388 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,360.88 | $3,388 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $388.83 | $968 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $78.73 | $196 | 0.9× |
| Wrist 2 views (73100) | $166.70 | $415 | 2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $150.23 | $374 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $318.13 | $792 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $1,696.28 | $4,223 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $360.71 | $898 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $263.10 | $655 | 3.1× |
| X-Ray Exam Breast Specimen (76098) | $264.31 | $658 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $152.24 | $379 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $146.21 | $364 | 1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $265.11 | $660 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $157.06 | $391 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $196.42 | $489 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $159.07 | $396 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$261.09–$286.80 | $650–$714 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $331.79 | $826 | 3.2× |
| X-Ray Exam L-S Spine Bending (72114) | $550.70 | $1,371 | 5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $297.24 | $740 | 3.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$383.20–$430.60 | $954–$1,072 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $275.96 | $687 | 2.7× |
| X-ray eye for foreign body (70030) | $151.03 | $376 | 1.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$271.54–$410.11 | $676–$1,021 | varies |
| X-ray IV pyelogram (ivp) (74400) | $530.62 | $1,321 | 3.1× |
| X-ray IV pyelogram+tomography (74415) | $626.22 | $1,559 | 3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $277.96 | $692 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $224.14 | $558 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $327.77 | $816 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $132.56 | $330 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $388.83 | $968 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $250.65 | $624 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $175.54 | $437 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $208.07 | $518 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $394.45 | $982 | 4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$399.27–$439.04 | $994–$1,093 | varies |
| X-Ray Stress View (77071) | $78.73 | $196 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $423.77 | $1,055 | 4.2× |
| X-Ray Tmj Unilat (70328) | $157.06 | $391 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $408.51 | $1,017 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $563.55 | $1,403 | 5.5× |
| Xr c-spine 4 or 5 views (72050) | $433.81 | $1,080 | 4.2× |
| Xr facial bones less than 3 views (70140) | $257.48 | $641 | 3.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $187.59 | $467 | 1.8× |
| Xr orbits complete 4 views (70200) | $167.91 | $418 | 1.6× |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$331.79–$637.86 | $826–$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.