Imaging prices at Community Hospital East
Indianapolis, IN · every code in this section with a posted price and a Medicare benchmark.
405 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) | $10,986 | $18,310 | 7.5× |
| Abdomen 1 View (74018) | $205.80 | $343 | 2.2× |
| Abdomen 2 views (74019) | $247.20 | $412 | 2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,502.40 | $2,504 | 3.6× |
| Angio internal mammary (75756) | $2,791.80 | $4,653 | 0.8× |
| Angio pulmonary bilat (75743) | $3,907.80 | $6,513 | 1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,930.60 | $6,551 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$15,168.88–$15,230.72 | $25,281.46–$25,384.54 | varies |
| Angiography extremity unilateral rs&i (75710) | $12,127.50 | $20,212.50 | 3.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,819 | $6,365 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,819 | $6,365 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$184.20–$314.40 | $307–$524 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,183 | $5,305 | 0.5× |
| Artery X-Rays Abdomen (75726) | $27,643.25 | $46,072.08 | 4.7× |
| Artery X-Rays Adrenal Gland (75731) | $3,930.60 | $6,551 | 1.2× |
| Artery X-Rays Pelvis (75736) | $3,919.80 | $6,533 | 0.7× |
| Artery X-Rays Spine (75705) | $3,930.60 | $6,551 | 0.7× |
| Arthrogram ankle (73615) | $508.20 | $847 | 1.4× |
| Arthrogram hip (73525) | $402 | $670 | 1.1× |
| Arthrogram Wrist (73115) | $488.40 | $814 | 1.3× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$465–$629.40 | $775–$1,049 | varies |
| Bone age studies (77072) | $196.20 | $327 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,814.40 | $3,024 | 4.3× |
| Bone Imaging Limited Area (78300) | $1,087.80 | $1,813 | 2.6× |
| Bone Imaging Multiple Areas (78305) | $1,774.20 | $2,957 | 4.2× |
| Bone Imaging Whole Body (78306) | $1,774.20 | $2,957 | 4.2× |
| Bone marrow imaging limited area (78102) | $679.80 | $1,133 | 1.6× |
| Bone marrow imaging; multiple areas (78103) | $1,222.20 | $2,037 | 2.9× |
| Bone marrow imaging; whole body (78104) | $1,222.20 | $2,037 | 2.9× |
| Bone survey infant (77076) | $333.60 | $556 | 3.0× |
| Brachytx isodose complex (77318) | $2,505 | $4,175 | 6.3× |
| Brachytx isodose intermed (77317) | $2,115 | $3,525 | 5.3× |
| Brachytx Isodose Plan Simple (77316) | $1,644 | $2,740 | 4.1× |
| Brain Image W/Flow < 4 Views (78601) | $1,025.40 | $1,709 | 2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,125.60 | $6,876 | 2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,968.80 | $4,948 | 8.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,734.40 | $6,224 | 4.5× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$270.60–$787.20 | $451–$1,312 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,527 | $2,545 | 2.7× |
| Cerebrospinal Fluid Scan (78630) | $1,544.40 | $2,574 | 2.7× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$646.80–$17,600.79 | $1,078–$29,334.65 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$180–$487.20 | $300–$812 | varies |
| Chest 3 views (71047) | $219 | $365 | 2.4× |
| Chest 4 or more views (71048) | $223.20 | $372 | 2.0× |
| Clavicle complete (73000) | $178.20 | $297 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $155.40 | $259 | 1.4× |
| Continuing medical physics consltj pr wk (77336) range across 6 matching MRF lines |
$6,071.40–$20,553 | $10,119–$34,255 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$14,628.55–$15,030.18 | $24,380.91–$25,050.30 | varies |
| Contrast X-Ray Bladder (74430) | $482.40 | $804 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $434.40 | $724 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $477.60 | $796 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,280 | $3,800 | 6.2× |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$1,080–$1,975.80 | $1,800–$3,293 | varies |
| CT abdomen w contrast (74160) | $1,248 | $2,080 | 6.7× |
| CT abdomen w wo contrast (74170) | $1,546.80 | $2,578 | 8.3× |
| CT abdomen w/o contrast (74150) | $1,122 | $1,870 | 10.1× |
| CT Angio Abdomen and Pelvis (74174) | $3,715.20 | $6,192 | 10.1× |
| CT Angio Chest (71275) | $2,037.60 | $3,396 | 11.0× |
| CT Angio Head (70496) | $1,935 | $3,225 | 10.4× |
| CT angio hrt w/3d image (75574) | $1,892.40 | $3,154 | 5.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,435.80–$1,759.80 | $2,393–$2,933 | varies |
| CT Angio Neck (70498) | $1,937.40 | $3,229 | 10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,409.40 | $2,349 | 7.6× |
| CT cervical spine w/ contrast (72126) | $1,738.80 | $2,898 | 4.7× |
| CT cervical spine w/o contrast (72125) | $742.80 | $1,238 | 6.7× |
| CT cervical spine w/wo cont (72127) | $1,930.80 | $3,218 | 10.4× |
| CT chest w contrast (71260) | $1,236.60 | $2,061 | 6.7× |
| CT chest w/wo contrast (71270) | $1,535.40 | $2,559 | 8.3× |
| CT colonography screening (74263) | $1,265.40 | $2,109 | 5.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $796.20 | $1,327 | 4.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $717 | $1,195 | 6.5× |
| CT head/brain with contrast (70460) | $1,149 | $1,915 | 6.2× |
| CT head/brain without and with contrast (70470) | $1,429.20 | $2,382 | 7.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $893.40 | $1,489 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $453 | $755 | 4.9× |
| CT hrt w/3d image congen (75573) | $681.60 | $1,136 | 1.8× |
| CT iac w contrast (70481) | $1,311.60 | $2,186 | 7.1× |
| CT l-spine w&w/o contrast (72133) | $1,931.40 | $3,219 | 10.4× |
| CT lower ext w/o (73700) | $742.80 | $1,238 | 6.7× |
| CT lower extremity w/contrast material (73701) | $1,204.20 | $2,007 | 6.5× |
| CT lumbar spine w contrast (72132) | $1,684.80 | $2,808 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,429.20 | $2,382 | 12.9× |
| CT maxillofacial w contrast (70487) | $1,492.20 | $2,487 | 8.0× |
| CT maxillofacial wo contrast (70486) | $742.80 | $1,238 | 6.7× |
| CT neck tissue combo (70492) | $1,378.20 | $2,297 | 7.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,755 | $2,925 | 9.5× |
| CT orbits w/o contrast (70480) | $1,099.20 | $1,832 | 9.9× |
| CT pelvis w&w/o contrast (72194) | $1,515 | $2,525 | 8.2× |
| CT pelvis w/o contrast (72192) | $1,121.40 | $1,869 | 10.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,305.60–$1,667.40 | $2,176–$2,779 | varies |
| CT scans face/jaw combo (70488) | $1,813.20 | $3,022 | 9.8× |
| CT soft tissue neck w contrast (70491) | $1,120.80 | $1,868 | 6.0× |
| CT soft tissue neck w/o contrast (70490) | $1,027.20 | $1,712 | 9.3× |
| CT thoracic spine w contrast (72129) | $1,586.40 | $2,644 | 8.5× |
| CT thoracic spine w/o contrast (72128) | $1,312.80 | $2,188 | 11.9× |
| CT thoracic spine w/wo cont (72130) | $1,935.60 | $3,226 | 10.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$742.80–$955.20 | $1,238–$1,592 | varies |
| CT unlisted procedure (76497) | $1,444.80 | $2,408 | 15.7× |
| CT upper ext wo (73200) | $948.60 | $1,581 | 8.6× |
| CT upper extremity w/o & w/contrast material (73202) | $2,280 | $3,800 | 12.3× |
| CT upper extremity with contrast (73201) | $1,335.60 | $2,226 | 3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,798 | $6,330 | 20.5× |
| Cta Abdomen (74175) | $1,867.80 | $3,113 | 10.1× |
| CTA pelvis (72191) | $1,876.20 | $3,127 | 10.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $230.40 | $384 | 0.9× |
| Dilation ureters/urethra rs&i (74485) | $1,746 | $2,910 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $5,173.80 | $8,623 | 2.5× |
| Diskography lumbar (72295) | $3,015.60 | $5,026 | 1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $118.80 | $198 | 1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $627 | $1,045 | 5.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $367.80 | $613 | 3.3× |
| Dxa Bone Density Axial (77080) | $342.60 | $571 | 3.1× |
| Dxa bone density study (77085) | $378.60 | $631 | 3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $106.20 | $177 | 1.2× |
| Echo exam of fetal heart (76825) | $715.20 | $1,192 | 1.2× |
| Echo exam uterus (76831) | $380.40 | $634 | 1.5× |
| Echo Guide For Artery Repair (76936) | $1,345.80 | $2,243 | 5.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $202.20 | $337 | 0.8× |
| Esophagram (74220) | $407.40 | $679 | 2.2× |
| Fetal Biophys Profile W/Nst (76818) | $599.40 | $999 | 5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $502.80 | $838 | 4.5× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$2,525.38–$17,329.18 | $4,208.97–$28,881.97 | varies |
| Follow-Up Angiography (75898) | $2,791.80 | $4,653 | 0.8× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$162.60–$318.60 | $271–$531 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$204.60–$339 | $341–$565 | varies |
| Gastric emptying imaging study (78264) | $1,372.20 | $2,287 | 3.2× |
| Gastroesophageal Reflux Exam (78262) | $1,057.20 | $1,762 | 2.5× |
| Gated Heart Planar Single (78472) | $2,023.20 | $3,372 | 4.8× |
| Gated Heart, Multiple (78473) | $1,014.60 | $1,691 | 2.4× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$192.60–$379.80 | $321–$633 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,462.20 | $12,437 | 10.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $7,390.80 | $12,318 | 10.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,040.80 | $10,068 | 8.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,399 | $5,665 | 1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,090.40 | $3,484 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,048.40 | $3,414 | 3.6× |
| Hepatobiliary System Imaging (78226) | $2,161.20 | $3,602 | 5.1× |
| Ht Muscle Image Spect Sing (78451) | $3,720 | $6,200 | 2.7× |
| Hyperthermia external generated superficial (77600) | $787.80 | $1,313 | 1.9× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $872.40 | $1,454 | 1.5× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $1,144.20 | $1,907 | 2.0× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $966.60 | $1,611 | 1.7× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $872.40 | $1,454 | 1.2× |
| Hysterosalpingogram (74740) | $335.40 | $559 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $441.60 | $736 | 4.8× |
| Infant hip ultrasound, limited static exam (76886) | $366 | $610 | 4.0× |
| Infusion Ivp (74410) | $743.40 | $1,239 | 4.0× |
| Interstitial radiation source applic complex (77778) | $17,233.93 | $28,723.21 | 23.4× |
| Intraop radiaj tx deliver xray single tx session (77424) | $10,760.40 | $17,934 | 1.4× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$140.40–$278.40 | $234–$464 | varies |
| K Flow/Funct Image Multiple (78709) | $2,459.40 | $4,099 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $1,632.60 | $2,721 | 2.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,303.20 | $2,172 | 2.3× |
| Kidney Imaging Morphol (78700) | $505.20 | $842 | 1.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$213–$397.20 | $355–$662 | varies |
| Leveen/Shunt Patency Exam (78291) | $948 | $1,580 | 2.2× |
| Liver & Spleen Imaging Static Only (78215) | $562.80 | $938 | 1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $888 | $1,480 | 2.1× |
| Liver imaging w/vascular flow (78202) | $888 | $1,480 | 1.5× |
| Lung Perf&Ventilat Diferentl (78598) | $1,216.20 | $2,027 | 2.1× |
| Lung perfusion differential (78597) | $1,648.20 | $2,747 | 3.9× |
| Lung Ventilat&Perfus Imaging (78582) | $2,284.80 | $3,808 | 4.0× |
| Lung Ventilation Imaging (78579) | $2,106 | $3,510 | 5.0× |
| Lymph System Imaging (78195) | $1,069.80 | $1,783 | 1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,844.80 | $6,408 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,923.60 | $3,206 | 7.6× |
| Mammary ductogram or galactogram multiple (77054) | $384 | $640 | 1.5× |
| Mammary ductogram or galactogram single (77053) | $273.60 | $456 | 1.1× |
| Meckels Divert Exam (78290) | $1,105.80 | $1,843 | 2.6× |
| Mlc imrt design & construction per imrt plan (77338) | $9,775.80 | $16,293 | 24.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,449.20 | $4,082 | 6.6× |
| MRA head w/o contrast (70544) | $1,077 | $1,795 | 4.3× |
| MRA head with contrast (70545) | $2,073 | $3,455 | 5.6× |
| MRA neck w contrast (70548) | $1,585.20 | $2,642 | 4.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,836.60 | $3,061 | 5.0× |
| MRA neck w/o contrast (70547) | $1,291.20 | $2,152 | 5.1× |
| MRI abdomen w contrast (74182) | $2,085 | $3,475 | 5.6× |
| MRI abdomen w/o contrast (74181) | $1,636.80 | $2,728 | 6.5× |
| MRI any jt lower extrem w/contrast material (73722) | $2,219.40 | $3,699 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,629.20 | $4,382 | 7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,781.60–$3,806.13 | $6,302.67–$6,343.55 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $3,534 | $5,890 | 14.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,728.80 | $4,548 | 10.8× |
| MRI cardiac w/o contrast (75557) | $2,311.20 | $3,852 | 9.2× |
| MRI cervical spine w contrast (72142) | $1,844.40 | $3,074 | 5.0× |
| MRI cervical spine w/o cont (72141) | $1,935.60 | $3,226 | 7.7× |
| MRI chest w/o contrast (71550) | $2,131.20 | $3,552 | 8.4× |
| MRI chest with contrast (71551) | $2,490 | $4,150 | 3.0× |
| MRI chest wo w contrast (71552) | $2,705.40 | $4,509 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,219.40 | $3,699 | 6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,628.60 | $4,381 | 7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,712.40 | $2,854 | 6.8× |
| MRI lumbar spine w contrast (72149) | $2,038.80 | $3,398 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,289.60 | $3,816 | 6.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,551 | $2,585 | 6.1× |
| MRI orbit face neck w contrast (70542) | $2,130.60 | $3,551 | 5.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,176.20 | $3,627 | 5.9× |
| MRI pelvis w contrast (72196) | $2,112.60 | $3,521 | 5.7× |
| MRI pelvis w/o & w contrast (72197) | $2,848.80 | $4,748 | 7.7× |
| MRI pelvis w/o contrast (72195) | $1,669.20 | $2,782 | 6.6× |
| MRI spectroscopy (76390) | $963.60 | $1,606 | 10.5× |
| MRI thoracic spine w/o contrast (72146) | $2,065.80 | $3,443 | 8.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,219.40 | $3,699 | 6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,712.40 | $2,854 | 6.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,421 | $4,035 | 6.6× |
| MRI, abdomen, combo (74183) | $2,172.60 | $3,621 | 5.9× |
| MRI, dorsal spine combo (72157) | $2,507.40 | $4,179 | 6.8× |
| MRI, dorsal spine contrast (72147) | $2,194.80 | $3,658 | 5.9× |
| MRI, joint upper extrem (73221) | $1,712.40 | $2,854 | 6.8× |
| MRI, joint upper extrem combo (73223) | $2,419.20 | $4,032 | 6.6× |
| MRI, lumbar spine combo (72158) | $1,310.40 | $2,184 | 3.6× |
| Myelogram cervical (72240) | $1,036.20 | $1,727 | 1.2× |
| Myelogram Lumbar (72265) | $916.20 | $1,527 | 1.1× |
| Myelography thoracic (72255) | $1,163.40 | $1,939 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $938.40 | $1,564 | 1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,125.60 | $6,876 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $4,154.40 | $6,924 | 3.0× |
| N-invas est c ffr sw aly CTA (75580) | $4,169.40 | $6,949 | 4.6× |
| Neck soft tissue (70360) | $181.80 | $303 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $327.60 | $546 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $531.60 | $886 | 4.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $20,758.20 | $34,597 | 14.2× |
| Nuclear Rx Intra-Arterial (79445) | $529.80 | $883 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $1,457.40 | $2,429 | 5.9× |
| Ob us nuchal meas 1 gest (76813) | $545.40 | $909 | 4.9× |
| Optic foramina (70190) | $210.60 | $351 | 2.3× |
| Panoramic X-ray of jaws (70355) | $187.20 | $312 | 2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $618.60 | $1,031 | 1.1× |
| Parathyroid Planar Imaging (78070) | $843 | $1,405 | 2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,816.80 | $3,028 | 4.3× |
| Pelvis 1 or 2 views (72170) | $175.80 | $293 | 1.6× |
| Peritoneogram Rs&I (74190) | $685.20 | $1,142 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $4,125.60 | $6,876 | 2.7× |
| PET image w/CT, full body (78816) | $4,050.60 | $6,751 | 2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,230.80 | $8,718 | 3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,895.80 | $6,493 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,329 | $2,215 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $424.80 | $708 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $633.60 | $1,056 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$232.20–$416.40 | $387–$694 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$192–$379.80 | $320–$633 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$321.60–$450.60 | $536–$751 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $276 | $460 | 2.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$166.80–$330 | $278–$550 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$204.60–$402.60 | $341–$671 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$204–$402.60 | $340–$671 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $107.40 | $179 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $306.60 | $511 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $207 | $345 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) | $206.40 | $344 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$252–$391.20 | $420–$652 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $215.40 | $359 | 2.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $773.40 | $1,289 | 4.2× |
| Radex Spine 1 View Specify Level (72020) | $210 | $350 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) | $204.60 | $341 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $327 | $545 | 3.6× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$150–$297.60 | $250–$496 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $107.40 | $179 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$205.20–$403.80 | $342–$673 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,212.20 | $18,687 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $1,224 | $2,040 | 11.3× |
| Radiation treatment delivery level 2 (77407) | $1,422 | $2,370 | 3.5× |
| Radiation treatment delivery level 3 (77412) | $1,723.20 | $2,872 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $275.40 | $459 | 2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $289.20 | $482 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $692.40 | $1,154 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $507 | $845 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $470.45 | $784.09 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$238.20–$455.40 | $397–$759 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$204–$500.40 | $340–$834 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $386.40 | $644 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $425.40 | $709 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $719.40 | $1,199 | 3.9× |
| Radiologic examination femur 1 view (73551) | $88.20 | $147 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) | $184.80 | $308 | 2.0× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$187.80–$363.60 | $313–$606 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $677.40 | $1,129 | 6.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $178.80 | $298 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$184.20–$238.20 | $307–$397 | varies |
| Renal Cyst Study (74470) | $436.20 | $727 | 0.8× |
| Ribs bilateral 3 views (71110) | $264 | $440 | 2.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $854.40 | $1,424 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,895.40 | $3,159 | 4.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,466.60 | $4,111 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,916.40 | $3,194 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,944.60 | $3,241 | 3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,681.20 | $2,802 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,790.40 | $2,984 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,625.40 | $2,709 | 1.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,199.60 | $3,666 | 8.9× |
| Rp Therapy Intravenous Administration (79101) | $1,416 | $2,360 | 5.7× |
| Scapula (73010) range across 2 matching MRF lines |
$178.20–$351.60 | $297–$586 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $379.20 | $632 | 16.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$190.20–$227.40 | $317–$379 | varies |
| Shoulder Arthrography (73040) | $434.40 | $724 | 1.2× |
| Sialogram (70390) | $495.60 | $826 | 2.0× |
| Skull less than 4 views (70250) | $253.80 | $423 | 2.3× |
| Special dosimetry (77331) | $318.60 | $531 | 2.2× |
| Special Physics Consult (77370) | $877.20 | $1,462 | 6.2× |
| Special teletherapy port plan (77321) | $1,600.80 | $2,668 | 4.0× |
| Special treatment procedure (77470) | $4,329 | $7,215 | 7.4× |
| Stereotactic Body Radiation Delivery (77373) | $9,612 | $16,020 | 5.1× |
| Sternoclavicular joints (71130) | $208.20 | $347 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,204.80 | $7,008 | 10.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,841.40 | $3,069 | 4.6× |
| Testicular Imaging W/Flow (78761) | $1,636.20 | $2,727 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,603.60 | $6,006 | 9.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,264 | $5,440 | 8.2× |
| Ther rad simulaj-aided field setting simple (77280) | $1,862.40 | $3,104 | 13.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $765 | $1,275 | 4.1× |
| Thoracic spine 2 views (72070) | $249 | $415 | 2.3× |
| Thoracic spine 3 views (72072) | $309 | $515 | 2.8× |
| Thoracolumbar 2 views (72080) | $412.20 | $687 | 4.5× |
| Thyroid Imaging With Vascular Flow (78013) | $336.60 | $561 | 0.8× |
| Thyroid Met Imaging Body (78018) | $1,774.20 | $2,957 | 3.1× |
| Thyroid Uptake Measurement (78012) | $349.20 | $582 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $525.60 | $876 | 1.2× |
| Tx Devices Design & Construction Complex (77334) | $1,296 | $2,160 | 3.3× |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$7,071.60–$36,078.60 | $11,786–$60,131 | varies |
| Tx devices design & construction simple (77332) | $594 | $990 | 4.2× |
| Ultrasound Breast Limited (76642) | $293.40 | $489 | 3.2× |
| Ultrasound elastography first target lesion (76982) | $88.20 | $147 | 0.8× |
| Ultrasound Elastography Parenchyma (76981) | $584.40 | $974 | 5.3× |
| Ultrasound Exam Aaa Screen (76706) | $201 | $335 | 1.8× |
| Ultrasound, abdomen limited (76705) | $584.40 | $974 | 5.3× |
| Umbilical-artery Doppler (OB) (76820) | $402 | $670 | 3.6× |
| Unlisted fluoroscopic procedure (76496) | $510 | $850 | 5.5× |
| Unlisted magnetic resonance procedure (76498) | $6,039.60 | $10,066 | 65.6× |
| Upper gi w/o kub (74240) | $450 | $750 | 2.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $169.20 | $282 | 15.3× |
| Urea breath test c-14 isotopic analysis (78268) | $247.20 | $412 | 2.6× |
| Urethrocystogram voiding (74455) | $366 | $610 | 1.4× |
| Urethrocystography retrograde (74450) | $448.80 | $748 | 1.8× |
| Us breast unilateral complete (76641) | $325.20 | $542 | 2.9× |
| Us chest (76604) | $310.80 | $518 | 2.8× |
| Us complete joint (76881) | $741 | $1,235 | 6.7× |
| Us exam, pelvic, limited (76857) | $320.40 | $534 | 2.9× |
| Us head (76506) | $324 | $540 | 2.9× |
| Us kidney transplant (76776) | $253.20 | $422 | 2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $339 | $565 | 3.1× |
| Us ob detailed single fetus (76811) | $1,145.40 | $1,909 | 4.5× |
| Us ob limited 1 or more fetuses (76815) | $301.80 | $503 | 2.7× |
| Us ob transvaginal (76817) | $420 | $700 | 3.8× |
| Us pelvic non ob complete (76856) | $502.80 | $838 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $567.60 | $946 | 5.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $420.60 | $701 | 3.8× |
| Us retroperitoneal complete (76770) | $582 | $970 | 5.3× |
| Us retroperitoneal limited (76775) | $323.40 | $539 | 2.9× |
| Us scrotum and contents (76870) | $499.80 | $833 | 4.5× |
| Us spinal canal and contents (76800) | $430.80 | $718 | 3.9× |
| Us thyroid (76536) | $507 | $845 | 4.6× |
| Us transrectal (76872) range across 2 matching MRF lines |
$960–$985.80 | $1,600–$1,643 | varies |
| Vein X-Ray Chest (75827) | $1,413 | $2,355 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,791.80 | $4,653 | 0.8× |
| Vein X-Ray Spleen/Liver (75810) | $4,171.80 | $6,953 | 1.2× |
| Venogram Sinus/Jugular (75860) | $2,791.80 | $4,653 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $3,876.60 | $6,461 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,539.60 | $2,566 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,400.40 | $2,334 | 0.8× |
| Venography Renal Bilateral (75833) | $2,378.40 | $3,964 | 0.7× |
| Venography Renal Unilateral (75831) | $3,795.60 | $6,326 | 1.1× |
| Venous sampling by catheter (75893) | $3,126.60 | $5,211 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $172.20 | $287 | 1.9× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$183.60–$363.60 | $306–$606 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $214.20 | $357 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $342 | $570 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $3,881.40 | $6,469 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $253.20 | $422 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$184.20–$338.40 | $307–$564 | varies |
| X-Ray Exam Breast Specimen (76098) | $633.60 | $1,056 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $202.80 | $338 | 2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $415.20 | $692 | 3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $487.20 | $812 | 4.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $100.80 | $168 | 1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $226.20 | $377 | 2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $379.20 | $632 | 3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $286.80 | $478 | 2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $459.60 | $766 | 4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $363.60 | $606 | 3.3× |
| X-Ray Exam L-S Spine Bending (72114) | $441.60 | $736 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $249 | $415 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $441.60 | $736 | 4.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $215.40 | $359 | 1.9× |
| X-ray eye for foreign body (70030) | $136.20 | $227 | 1.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$204.60–$376.20 | $341–$627 | varies |
| X-ray IV pyelogram (ivp) (74400) | $634.20 | $1,057 | 3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $122.40 | $204 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$209.40–$407.40 | $349–$679 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $252 | $420 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $174.60 | $291 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $270.60 | $451 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $240.60 | $401 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $216.60 | $361 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $219.60 | $366 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $300.60 | $501 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $411 | $685 | 3.7× |
| X-ray thoracic spine 4 vw (72074) | $355.20 | $592 | 3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $765.60 | $1,276 | 2.1× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$159.60–$505.20 | $266–$842 | varies |
| X-Rays Bone Survey Complete (77075) | $682.80 | $1,138 | 6.2× |
| Xr c-spine 4 or 5 views (72050) | $300 | $500 | 2.7× |
| Xr facial bones less than 3 views (70140) | $214.20 | $357 | 2.3× |
| Xr myelogram posterior fossa (70010) | $574.20 | $957 | 1.6× |
| Xr orbits complete 4 views (70200) | $300.60 | $501 | 2.7× |
| Xr Tomogram Single Plane (76100) | $663 | $1,105 | 6.0× |
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.