Imaging prices at Community Hospital Grand Junction
Grand Junction, CO · every code in this section with a posted price and a Medicare benchmark.
310 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) | $8,531.04 | $15,234 | 5.8× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$275.52–$281.68 | $492–$503 | varies |
| Abdomen 2 views (74019) | $350.56 | $626 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,976.24 | $3,529 | 4.7× |
| Angio pulmonary bilat (75743) | $13,582.80 | $24,255 | 4.1× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$9,870–$14,805.28 | $17,625–$26,438 | varies |
| Angiography extremity unilateral rs&i (75710) | $9,055.20 | $16,170 | 2.7× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$239.12–$390.88 | $427–$698 | varies |
| Aortography thoracic serialography rs&i (75605) | $12,697.44 | $22,674 | 2.2× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$12,697.44–$25,394.88 | $22,674–$45,348 | varies |
| Artery X-Rays Pelvis (75736) | $13,840.40 | $24,715 | 2.4× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$1,151.36–$4,605.44 | $2,056–$8,224 | varies |
| Bone age studies (77072) | $360.08 | $643 | 3.3× |
| Bone Imaging 3 Phase (78315) | $1,976.24 | $3,529 | 4.7× |
| Bone Imaging Limited Area (78300) | $1,237.04 | $2,209 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,677.20 | $2,995 | 4.0× |
| Brachytx isodose complex (77318) | $2,611.84 | $4,664 | 6.6× |
| Brachytx isodose intermed (77317) | $2,015.44 | $3,599 | 5.1× |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$1,197.84–$1,466.08 | $2,139–$2,618 | varies |
| Cardiac Shunt Detection (78428) | $1,687.28 | $3,013 | 4.0× |
| Cat Scan Follow-Up Study (76380) | $1,190.56 | $2,126 | 13.0× |
| Chest 1 view (71045) | $258.16 | $461 | 2.8× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$260.40–$266.56 | $465–$476 | varies |
| Chest 4 or more views (71048) | $380.24 | $679 | 3.4× |
| Cholecystography Oral Contrast (74290) | $666.40 | $1,190 | 3.6× |
| Clavicle complete (73000) | $275.52 | $492 | 3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $729.12 | $1,302 | 6.6× |
| Continuing medical physics consltj pr wk (77336) | $839.44 | $1,499 | 5.9× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,792–$8,308.72 | $3,200–$14,837 | varies |
| Contrast X-Ray Bladder (74430) | $1,184.40 | $2,115 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,596.32 | $6,422 | 9.8× |
| CT abdomen and pelvis without contrast (74176) | $2,139.20 | $3,820 | 8.5× |
| CT abdomen w contrast (74160) | $1,667.12 | $2,977 | 9.0× |
| CT abdomen w wo contrast (74170) | $1,972.88 | $3,523 | 10.7× |
| CT abdomen w/o contrast (74150) | $1,190.56 | $2,126 | 10.8× |
| CT Angio Abdomen and Pelvis (74174) | $3,496.64 | $6,244 | 9.5× |
| CT Angio Chest (71275) | $2,063.04 | $3,684 | 11.1× |
| CT Angio Head (70496) | $2,063.04 | $3,684 | 11.1× |
| CT angio hrt w/3d image (75574) | $2,577.68 | $4,603 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,223.76–$2,958.48 | $3,971–$5,283 | varies |
| CT Angio Neck (70498) | $2,063.04 | $3,684 | 11.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,335.92 | $5,957 | 18.0× |
| CT cervical spine w/ contrast (72126) | $1,678.32 | $2,997 | 4.6× |
| CT cervical spine w/o contrast (72125) | $1,197.84 | $2,139 | 10.9× |
| CT cervical spine w/wo cont (72127) | $2,150.40 | $3,840 | 11.6× |
| CT chest w contrast (71260) | $2,316.72 | $4,137 | 12.5× |
| CT chest w/wo contrast (71270) | $2,071.44 | $3,699 | 11.2× |
| CT colonography screening (74263) | $1,416.80 | $2,530 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$1,299.76–$1,416.80 | $2,321–$2,530 | varies |
| CT head/brain with contrast (70460) | $1,674.40 | $2,990 | 9.0× |
| CT head/brain without and with contrast (70470) | $1,972.88 | $3,523 | 10.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $729.12 | $1,302 | 7.9× |
| CT iac w contrast (70481) | $1,818.88 | $3,248 | 9.8× |
| CT l-spine w&w/o contrast (72133) | $2,150.40 | $3,840 | 11.6× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,190.56–$2,352 | $2,126–$4,200 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,818.88–$2,728.32 | $3,248–$4,872 | varies |
| CT lumbar spine w contrast (72132) | $1,678.32 | $2,997 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,197.84 | $2,139 | 10.9× |
| CT maxillofacial w contrast (70487) | $1,678.32 | $2,997 | 9.1× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,190.56–$1,568 | $2,126–$2,800 | varies |
| CT neck tissue combo (70492) | $2,042.32 | $3,647 | 11.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,329.60 | $4,160 | 12.6× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$1,566.32–$2,349.76 | $2,797–$4,196 | varies |
| CT pelvis w&w/o contrast (72194) | $2,472.96 | $4,416 | 13.4× |
| CT pelvis w/o contrast (72192) | $1,197.84 | $2,139 | 10.9× |
| CT scan of leg combo (73702) | $2,039.52 | $3,642 | 11.0× |
| CT scans face/jaw combo (70488) | $1,972.88 | $3,523 | 10.7× |
| CT soft tissue neck w contrast (70491) | $2,316.72 | $4,137 | 12.5× |
| CT soft tissue neck w/o contrast (70490) | $1,190.56 | $2,126 | 10.8× |
| CT thoracic spine w contrast (72129) | $1,678.32 | $2,997 | 9.1× |
| CT thoracic spine w/o contrast (72128) | $1,190.56 | $2,126 | 10.8× |
| CT thoracic spine w/wo cont (72130) | $2,150.40 | $3,840 | 11.6× |
| CT thorax w/o contrast (71250) | $1,197.84 | $2,139 | 10.9× |
| CT unlisted procedure (76497) | $2,427.60 | $4,335 | 26.4× |
| CT upper ext wo (73200) | $1,595.44 | $2,849 | 14.5× |
| CT upper extremity w/o & w/contrast material (73202) | $2,226 | $3,975 | 12.0× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,818.88–$2,973.60 | $3,248–$5,310 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,663.36 | $4,756 | 14.4× |
| Cta Abdomen (74175) | $1,972.32 | $3,522 | 10.7× |
| CTA pelvis (72191) | $1,975.12 | $3,527 | 10.7× |
| Diskography lumbar (72295) | $5,645.92 | $10,082 | 2.7× |
| Dxa Bone Density Axial (77080) | $72.24 | $129 | 0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $59.92 | $107 | 0.7× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$994.56–$1,084.16 | $1,776–$1,936 | varies |
| Echo Guide For Artery Repair (76936) | $1,120 | $2,000 | 4.9× |
| Echograp Trans R Pros Study (76873) | $946.40 | $1,690 | 8.6× |
| Esophagram (74220) | $687.12 | $1,227 | 3.7× |
| Fetal Biophys Profile W/Nst (76818) | $753.20 | $1,345 | 6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $691.04 | $1,234 | 6.3× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$740.32–$806.96 | $1,322–$1,441 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$239.12–$390.88 | $427–$698 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$275.52–$281.68 | $492–$503 | varies |
| Gastric emptying imaging study (78264) | $1,976.24 | $3,529 | 4.7× |
| Gated Heart Planar Single (78472) | $1,976.24 | $3,529 | 4.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$304.64–$456.96 | $544–$816 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,926.08 | $12,368 | 9.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,480.16 | $9,786 | 7.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,946.72 | $5,262 | 4.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $9,055.20 | $16,170 | 2.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $8,531.60 | $15,235 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,976.24 | $3,529 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,976.24 | $3,529 | 4.7× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,540.32–$4,052.16 | $6,322–$7,236 | varies |
| Hysterosalpingogram (74740) | $1,196.72 | $2,137 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $747.04 | $1,334 | 8.1× |
| Interstitial radiation source applic complex (77778) | $2,234.96 | $3,991 | 3.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,530.80 | $6,305 | 4.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,825.20 | $5,045 | 4.8× |
| Intracavitary radiation source applic simple (77761) | $2,825.20 | $5,045 | 4.8× |
| K Flow/Funct Image W/Drug (78708) | $2,653.84 | $4,739 | 4.6× |
| K Flow/Funct Image W/O Drug (78707) | $2,892.96 | $5,166 | 5.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$260.40–$390.32 | $465–$697 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,263.52 | $4,042 | 5.4× |
| Liver imaging static only (78201) | $2,154.32 | $3,847 | 3.8× |
| Liver imaging w/vascular flow (78202) | $2,154.32 | $3,847 | 3.8× |
| Lung perfusion differential (78597) | $2,318.40 | $4,140 | 5.5× |
| Lung Ventilat&Perfus Imaging (78582) | $4,249.84 | $7,589 | 7.4× |
| Lymph System Imaging (78195) | $1,968.40 | $3,515 | 3.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $8,342.32 | $14,897 | 2.5× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$3,379.60–$3,683.68 | $6,035–$6,578 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$1,060.08–$2,009.28 | $1,893–$3,588 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,976.24–$2,154.32 | $3,529–$3,847 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $3,229.52 | $5,767 | 8.2× |
| Mr safety determination physician/other qhp (76016) | $62.16 | $111 | 0.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $170.24 | $304 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $3,861.76 | $6,896 | 10.5× |
| MRA head w/o contrast (70544) | $2,352.56 | $4,201 | 9.3× |
| MRA neck w contrast (70548) | $2,924.32 | $5,222 | 7.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,416.56 | $6,101 | 9.3× |
| MRA neck w/o contrast (70547) | $2,450.56 | $4,376 | 9.7× |
| MRI abdomen w contrast (74182) | $3,198.72 | $5,712 | 8.7× |
| MRI abdomen w/o contrast (74181) | $2,352.56 | $4,201 | 9.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,573.20–$3,860.08 | $4,595–$6,893 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,416.56–$5,586.56 | $6,101–$9,976 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,532.32 | $4,522 | 3.1× |
| MRI bone marrow blood supply (77084) | $3,416 | $6,100 | 13.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,667.28 | $4,763 | 10.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,182.88 | $3,898 | 8.7× |
| MRI cervical spine w contrast (72142) | $2,805.04 | $5,009 | 7.6× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,044.56–$2,228.80 | $3,651–$3,980 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,747.36–$2,994.88 | $4,906–$5,348 | varies |
| MRI chest with contrast (71551) | $3,377.92 | $6,032 | 4.1× |
| MRI chest wo w contrast (71552) | $4,158.56 | $7,426 | 11.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,805.04 | $5,009 | 7.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,416.56 | $6,101 | 9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,352.56 | $4,201 | 9.3× |
| MRI lumbar spine w contrast (72149) | $2,805.04 | $5,009 | 7.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,831.92 | $5,057 | 7.7× |
| MRI orbit face &/neck w/o contrast (70540) | $2,352.56 | $4,201 | 9.3× |
| MRI orbit face neck w contrast (70542) | $2,760.24 | $4,929 | 7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,416.56 | $6,101 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $3,416.56 | $6,101 | 9.3× |
| MRI pelvis w/o contrast (72195) | $2,352.56 | $4,201 | 9.3× |
| MRI thoracic spine w/o contrast (72146) | $2,352.56 | $4,201 | 9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,352.56–$3,846.64 | $4,201–$6,869 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,416.56–$5,586.56 | $6,101–$9,976 | varies |
| MRI, abdomen, combo (74183) | $3,416.56 | $6,101 | 9.3× |
| MRI, dorsal spine combo (72157) | $3,416.56 | $6,101 | 9.3× |
| MRI, dorsal spine contrast (72147) | $2,805.04 | $5,009 | 7.6× |
| MRI, joint upper extrem (73221) | $2,352.56 | $4,201 | 9.3× |
| MRI, joint upper extrem combo (73223) | $3,416.56 | $6,101 | 9.3× |
| MRI, lumbar spine combo (72158) | $3,416.56 | $6,101 | 9.3× |
| Myelogram Lumbar (72265) | $2,408 | $4,300 | 2.9× |
| Myelography thoracic (72255) | $2,408 | $4,300 | 2.9× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$923.44–$4,108.72 | $1,649–$7,337 | varies |
| Neck soft tissue (70360) | $322.56 | $576 | 3.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $614.32 | $1,097 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $673.68 | $1,203 | 6.1× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$6,673.52–$6,753.60 | $11,917–$12,060 | varies |
| Nuclear Rx Intra-Arterial (79445) | $1,778.56 | $3,176 | 7.2× |
| Nuclear Rx Oral Admin (79005) | $2,150.40 | $3,840 | 8.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,630.88 | $4,698 | 4.6× |
| Parathyroid Planar Imaging (78070) | $1,976.24 | $3,529 | 4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,984.64 | $3,544 | 4.7× |
| Pelvis 1 or 2 views (72170) | $304.64 | $544 | 2.8× |
| Pet Image W/Ct Lmtd (78814) | $3,625.44 | $6,474 | 2.4× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$8,207.36–$8,370.88 | $14,656–$14,948 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$7,664.16–$7,817.04 | $13,686–$13,959 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,011.52 | $3,592 | 4.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $472.08 | $843 | 4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,354.64–$1,476.72 | $2,419–$2,637 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$260.40–$422.80 | $465–$755 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$275.52–$450.24 | $492–$804 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$275.52–$413.28 | $492–$738 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $362.32 | $647 | 3.3× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$275.52–$281.68 | $492–$503 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$260.40–$390.32 | $465–$697 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$295.68–$515.76 | $528–$921 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $341.60 | $610 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $355.04 | $634 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$275.52–$422.80 | $492–$755 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $351.68 | $628 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $362.32 | $647 | 3.9× |
| Radex Sternum Minimum 2 Views (71120) | $313.04 | $559 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $492.80 | $880 | 5.4× |
| Radex Toe Minimum 2 Views (73660) | $275.52 | $492 | 3.0× |
| Radex upper extremity infant minimum 2 views (73092) | $540.40 | $965 | 4.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$260.40–$422.80 | $465–$755 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,708.80 | $36,980 | 2.7× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$839.44–$1,350.72 | $1,499–$2,412 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$926.80–$4,682.16 | $1,655–$8,361 | varies |
| Radiation treatment delivery level 3 (77412) range across 4 matching MRF lines |
$978.88–$4,738.16 | $1,748–$8,461 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $413.28 | $738 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $823.20 | $1,470 | 4.4× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$350.56–$525.28 | $626–$938 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $386.96 | $691 | 3.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $827.68 | $1,478 | 4.5× |
| Radiologic exam swallow function contrast study (74230) | $554.96 | $991 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $858.48 | $1,533 | 4.6× |
| Radiologic examination femur 1 view (73551) | $275.52 | $492 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$260.40–$425.60 | $465–$760 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$275.52–$413.28 | $492–$738 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$568.96–$619.92 | $1,016–$1,107 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$275.52–$413.28 | $492–$738 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,137.44 | $9,174 | 9.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,175.36 | $7,456 | 7.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,966.48 | $7,083 | 6.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 3 matching MRF lines |
$3,479.84–$4,175.36 | $6,214–$7,456 | varies |
| Rp Therapy Intravenous Administration (79101) | $8,328.32 | $14,872 | 33.8× |
| Scapula (73010) | $350.56 | $626 | 3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $183.68 | $328 | 7.9× |
| Shoulder 1 view (73020) | $275.52 | $492 | 3.0× |
| Skull less than 4 views (70250) | $389.76 | $696 | 3.5× |
| Special dosimetry (77331) | $839.44 | $1,499 | 5.9× |
| Special Physics Consult (77370) | $839.44 | $1,499 | 5.9× |
| Special teletherapy port plan (77321) | $1,658.72 | $2,962 | 4.2× |
| Special treatment procedure (77470) | $2,712.64 | $4,844 | 4.7× |
| Spleen Imaging (78185) | $2,263.52 | $4,042 | 5.4× |
| Stereotactic Body Radiation Delivery (77373) | $16,564.24 | $29,579 | 8.8× |
| Sternoclavicular joints (71130) | $347.20 | $620 | 3.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,310.16 | $5,911 | 8.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $3,147.76 | $5,621 | 8.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,701.60 | $6,610 | 9.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,058 | $3,675 | 5.2× |
| Ther rad simulaj-aided field setting simple (77280) | $964.32 | $1,722 | 6.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,140.72 | $2,037 | 6.2× |
| Thoracic spine 2 views (72070) | $304.64 | $544 | 2.8× |
| Thoracic spine 3 views (72072) | $433.44 | $774 | 3.9× |
| Thoracolumbar 2 views (72080) | $355.04 | $634 | 3.9× |
| Thyroid Imaging With Vascular Flow (78013) | $2,154.32 | $3,847 | 5.1× |
| Thyroid Met Imaging Body (78018) | $2,286.48 | $4,083 | 4.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,976.24 | $3,529 | 4.7× |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$1,595.44–$3,206.56 | $2,849–$5,726 | varies |
| Tx devices design & construction intermediate (77333) | $1,090.32 | $1,947 | 7.7× |
| Tx devices design & construction simple (77332) | $839.44 | $1,499 | 5.9× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$302.40–$485.52 | $540–$867 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 3 matching MRF lines |
$379.68–$413.84 | $678–$739 | varies |
| Ultrasound Exam Aaa Screen (76706) | $606.48 | $1,083 | 5.5× |
| Ultrasound, abdomen limited (76705) | $535.92 | $957 | 4.9× |
| Unlisted Dx Radiographic Procedure (76499) | $1,135.68 | $2,028 | 12.4× |
| Unlisted us procedure (76999) | $340.48 | $608 | 3.7× |
| Upper gi w/o kub (74240) | $858.48 | $1,533 | 4.6× |
| Urethrocystogram voiding (74455) | $1,056.72 | $1,887 | 4.2× |
| Urethrocystography retrograde (74450) | $980.56 | $1,751 | 3.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$374.08–$611.52 | $668–$1,092 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$108.64–$427.28 | $194–$763 | varies |
| Us complete joint (76881) | $921.76 | $1,646 | 8.4× |
| Us exam, pelvic, limited (76857) | $374.08 | $668 | 3.4× |
| Us head (76506) | $761.04 | $1,359 | 6.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$312.48–$323.68 | $558–$578 | varies |
| Us ob detailed single fetus (76811) | $847.28 | $1,513 | 3.4× |
| Us ob limited 1 or more fetuses (76815) | $374.08 | $668 | 3.4× |
| Us ob transvaginal (76817) | $575.68 | $1,028 | 5.2× |
| Us pelvic non ob complete (76856) | $575.68 | $1,028 | 5.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $575.68 | $1,028 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $449.12 | $802 | 4.1× |
| Us retroperitoneal complete (76770) | $681.52 | $1,217 | 6.2× |
| Us retroperitoneal limited (76775) | $575.68 | $1,028 | 5.2× |
| Us scrotum and contents (76870) | $696.64 | $1,244 | 6.3× |
| Us spinal canal and contents (76800) | $725.20 | $1,295 | 6.6× |
| Us thyroid (76536) | $627.76 | $1,121 | 5.7× |
| Us transrectal (76872) | $425.04 | $759 | 3.9× |
| Vein X-Ray Chest (75827) | $4,081.84 | $7,289 | 2.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,097.84 | $10,889 | 1.8× |
| Venogram Sinus/Jugular (75860) | $9,870 | $17,625 | 3.0× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$9,055.20–$9,870 | $16,170–$17,625 | varies |
| Venography extremity bilateral rs&i (75822) | $4,089.68 | $7,303 | 2.5× |
| Venography extremity unilateral rs&i (75820) | $3,744.72 | $6,687 | 2.3× |
| Venography Renal Unilateral (75831) | $9,870 | $17,625 | 3.0× |
| Wrist 2 views (73100) | $275.52 | $492 | 3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$275.52–$413.28 | $492–$738 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,290.80 | $2,305 | 3.5× |
| X-Ray Aorta Leg Arteries (75630) | $8,342.32 | $14,897 | 2.5× |
| X-Ray Bend Only L-S Spine (72120) | $324.80 | $580 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $275.52 | $492 | 3.0× |
| X-Ray Exam Breast Specimen (76098) | $1,286.88 | $2,298 | 2.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $256.48 | $458 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$260.40–$384.72 | $465–$687 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $489.44 | $874 | 4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $535.92 | $957 | 4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$434.56–$473.76 | $776–$846 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $522.48 | $933 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $304.64 | $544 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $599.20 | $1,070 | 5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $304.64 | $544 | 2.8× |
| X-ray eye for foreign body (70030) | $275.52 | $492 | 3.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$275.52–$551.04 | $492–$984 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$301.28–$328.16 | $538–$586 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $308.56 | $551 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $282.24 | $504 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $540.96 | $966 | 4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$292.88–$529.20 | $523–$945 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $390.88 | $698 | 4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $362.32 | $647 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $646.80 | $1,155 | 5.9× |
| X-Ray Tmj Unilat (70328) | $316.40 | $565 | 3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,090.32 | $1,947 | 3.0× |
| X-Rays Bone Length Studies (77073) | $333.76 | $596 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $621.04 | $1,109 | 5.6× |
| Xr c-spine 4 or 5 views (72050) | $472.08 | $843 | 4.3× |
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.