Imaging prices at Covenant Health Fort Loudoun
Lenoir City, TN · every code in this section with a posted price and a Medicare benchmark.
409 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) | $1,039.36 | $3,248 | 0.8× |
| Abdomen 1 View (74018) | $62.72 | $196 | 0.8× |
| Abdomen 2 views (74019) | $83.20 | $260 | 0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $238.72 | $746 | 0.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $650.24 | $2,032 | 0.6× |
| Angio internal mammary (75756) | $1,510.72 | $4,721 | 0.5× |
| Angio pulmonary bilat (75743) | $1,510.72 | $4,721 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,510.72 | $4,721 | 0.5× |
| Angiography extremity bilateral rs&i (75716) range across 8 matching MRF lines |
$945.28–$1,510.72 | $2,954–$4,721 | varies |
| Angiography extremity unilateral rs&i (75710) range across 22 matching MRF lines |
$1,403.20–$1,510.72 | $4,385–$4,721 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,510.72 | $4,721 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $265.28 | $829 | 0.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$49.60–$99.20 | $155–$310 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,594.88 | $8,109 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,510.72 | $4,721 | 0.5× |
| Artery X-Rays Abdomen (75726) range across 22 matching MRF lines |
$2,467.20–$2,594.88 | $7,710–$8,109 | varies |
| Artery X-Rays Adrenal Gland (75731) | $372.48 | $1,164 | 0.1× |
| Artery X-Rays Pelvis (75736) range across 17 matching MRF lines |
$1,571.20–$2,594.88 | $4,910–$8,109 | varies |
| Artery X-Rays Spine (75705) range across 13 matching MRF lines |
$1,571.20–$2,594.88 | $4,910–$8,109 | varies |
| Arthrogram ankle (73615) range across 4 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| Arthrogram Wrist (73115) range across 5 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| Basic radiation dosimetry calculation (77300) | $64 | $200 | 0.5× |
| Bone age studies (77072) | $95.36 | $298 | 1.0× |
| Bone Imaging 3 Phase (78315) | $358.72 | $1,121 | 1.0× |
| Bone Imaging Limited Area (78300) | $241.92 | $756 | 0.7× |
| Bone Imaging Multiple Areas (78305) | $330.24 | $1,032 | 0.9× |
| Bone Imaging Whole Body (78306) | $300.16 | $938 | 0.8× |
| Bone marrow imaging limited area (78102) | $192.96 | $603 | 0.5× |
| Bone marrow imaging; whole body (78104) | $265.28 | $829 | 0.7× |
| Bone survey infant (77076) | $65.28 | $204 | 0.7× |
| Brachytx isodose complex (77318) | $426.88 | $1,334 | 1.3× |
| Brachytx isodose intermed (77317) | $205.44 | $642 | 0.6× |
| Brachytx Isodose Plan Simple (77316) | $395.52 | $1,236 | 1.2× |
| Brain Flow Imaging Only (78610) | $258.24 | $807 | 0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $258.24 | $807 | 0.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $258.24 | $807 | 0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,716.48 | $5,364 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $457.92 | $1,431 | 1.4× |
| Cat Scan Follow-Up Study (76380) | $225.92 | $706 | 2.9× |
| Cerebrospinal Fluid Scan (78630) | $303.36 | $948 | 0.6× |
| Chest 1 view (71045) | $51.84 | $162 | 0.7× |
| Chest 2 views (71046) | $79.36 | $248 | 1.0× |
| Chest 3 views (71047) | $84.80 | $265 | 1.1× |
| Chest 4 or more views (71048) | $88.64 | $277 | 0.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $53.44 | $167 | 0.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$64.32–$129.28 | $201–$404 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $508.80 | $1,590 | 5.4× |
| Continuing medical physics consltj pr wk (77336) | $108.48 | $339 | 0.9× |
| Contrast Exam Abdominl Aorta (75625) range across 11 matching MRF lines |
$1,403.20–$1,510.72 | $4,385–$4,721 | varies |
| Contrast X-Ray Bladder (74430) | $180.48 | $564 | 0.6× |
| Contrast X-Ray Of Elbow (73085) range across 5 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,266.56 | $3,958 | 4.0× |
| CT abdomen and pelvis without contrast (74176) | $844.80 | $2,640 | 3.9× |
| CT abdomen w contrast (74160) | $422.40 | $1,320 | 2.7× |
| CT abdomen w wo contrast (74170) | $633.28 | $1,979 | 4.0× |
| CT abdomen w/o contrast (74150) | $422.40 | $1,320 | 4.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,672 | $5,225 | 5.3× |
| CT Angio Chest (71275) | $836.16 | $2,613 | 5.3× |
| CT Angio Head (70496) | $836.16 | $2,613 | 5.3× |
| CT angio hrt w/3d image (75574) | $346.88 | $1,084 | 1.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$557.12–$1,114.24 | $1,741–$3,482 | varies |
| CT Angio Neck (70498) | $727.04 | $2,272 | 4.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$557.12–$1,114.24 | $1,741–$3,482 | varies |
| CT cervical spine w/ contrast (72126) | $580.48 | $1,814 | 1.8× |
| CT cervical spine w/o contrast (72125) | $580.48 | $1,814 | 6.1× |
| CT cervical spine w/wo cont (72127) | $870.72 | $2,721 | 5.5× |
| CT chest w contrast (71260) | $597.76 | $1,868 | 3.8× |
| CT chest w/wo contrast (71270) | $762.56 | $2,383 | 4.8× |
| CT head/brain with contrast (70460) | $398.40 | $1,245 | 2.5× |
| CT head/brain without and with contrast (70470) | $616.64 | $1,927 | 3.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $346.88 | $1,084 | 1.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $38.40 | $120 | 0.5× |
| CT iac w contrast (70481) | $360 | $1,125 | 2.3× |
| CT l-spine w&w/o contrast (72133) | $870.72 | $2,721 | 5.5× |
| CT lower ext w/o (73700) range across 5 matching MRF lines |
$439.68–$879.36 | $1,374–$2,748 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$468.48–$936.96 | $1,464–$2,928 | varies |
| CT lumbar spine w contrast (72132) | $580.48 | $1,814 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $580.48 | $1,814 | 6.1× |
| CT maxillofacial w contrast (70487) | $369.60 | $1,155 | 2.3× |
| CT maxillofacial wo contrast (70486) | $369.60 | $1,155 | 3.9× |
| CT neck tissue combo (70492) | $527.04 | $1,647 | 3.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $473.92 | $1,481 | 3.0× |
| CT orbits w/o contrast (70480) | $319.36 | $998 | 3.4× |
| CT pelvis w&w/o contrast (72194) | $633.28 | $1,979 | 4.0× |
| CT pelvis w/o contrast (72192) | $422.40 | $1,320 | 4.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$600.64–$1,201.28 | $1,877–$3,754 | varies |
| CT scans face/jaw combo (70488) | $553.60 | $1,730 | 3.5× |
| CT soft tissue neck w contrast (70491) | $360 | $1,125 | 2.3× |
| CT soft tissue neck w/o contrast (70490) | $342.40 | $1,070 | 3.6× |
| CT thoracic spine w contrast (72129) | $580.48 | $1,814 | 3.6× |
| CT thoracic spine w/o contrast (72128) | $580.48 | $1,814 | 6.1× |
| CT thoracic spine w/wo cont (72130) | $870.72 | $2,721 | 5.5× |
| CT thorax w/o contrast (71250) | $508.80 | $1,590 | 5.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$351.04–$702.08 | $1,097–$2,194 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$478.40–$956.80 | $1,495–$2,990 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$418.88–$837.76 | $1,309–$2,618 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $931.20 | $2,910 | 5.9× |
| Cta Abdomen (74175) | $836.16 | $2,613 | 5.3× |
| CTA pelvis (72191) | $836.16 | $2,613 | 5.3× |
| Dilation ureters/urethra rs&i (74485) | $983.36 | $3,073 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $937.28 | $2,929 | 0.5× |
| Diskography lumbar (72295) | $937.28 | $2,929 | 0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $46.40 | $145 | 0.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$72.96–$90.56 | $228–$283 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $45.76 | $143 | 0.5× |
| Dxa Bone Density Axial (77080) | $108.16 | $338 | 1.1× |
| Dxa bone density study (77085) | $177.28 | $554 | 1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $73.28 | $229 | 0.9× |
| Echo exam of fetal heart (76825) | $180.16 | $563 | 0.4× |
| Echo exam uterus (76831) | $116.16 | $363 | 0.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $109.44 | $342 | 0.5× |
| Echograp Trans R Pros Study (76873) | $102.40 | $320 | 1.1× |
| Esophageal Motility Study (78258) | $374.08 | $1,169 | 1.0× |
| Esophagram (74220) | $104.32 | $326 | 0.7× |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$154.88–$167.68 | $484–$524 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$48.64–$53.44 | $152–$167 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $539.84 | $1,687 | 2.5× |
| Fluoroscopy up to 1 hr (76000) | $116.16 | $363 | 0.5× |
| Follow-Up Angiography (75898) | $549.12 | $1,716 | 0.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$48.32–$96.32 | $151–$301 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Gastric emptying imaging study (78264) | $309.44 | $967 | 0.9× |
| Gastroesophageal Reflux Exam (78262) | $192.96 | $603 | 0.5× |
| Gated Heart Planar Single (78472) | $312 | $975 | 0.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $423.04 | $1,322 | 0.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$59.20–$118.40 | $185–$370 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $974.08 | $3,044 | 1.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $974.08 | $3,044 | 1.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $962.56 | $3,008 | 1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,510.72 | $4,721 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,510.72 | $4,721 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $427.84 | $1,337 | 0.9× |
| Hepatobiliary System Imaging (78226) | $213.44 | $667 | 0.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$650.24 | $99.09–$2,032 | 0.6× |
| Hysterosalpingogram (74740) | $116.16 | $363 | 0.5× |
| Image fusion (77399) | $275.84 | $862 | 2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $113.92 | $356 | 1.4× |
| Infant hip ultrasound, limited static exam (76886) | $58.56 | $183 | 0.7× |
| Interstitial radiation source applic complex (77778) | $2,429.44 | $7,592 | 3.8× |
| Joint Survey Single View (77077) | $201.28 | $629 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $258.24 | $807 | 0.5× |
| K Flow/Funct Image W/Drug (78708) | $258.24 | $807 | 0.5× |
| K Flow/Funct Image W/O Drug (78707) | $319.04 | $997 | 0.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $192.96 | $603 | 0.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $217.28 | $679 | 0.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$67.20–$134.40 | $210–$420 | varies |
| Leveen/Shunt Patency Exam (78291) | $222.72 | $696 | 0.6× |
| Liver & Spleen Imaging Static Only (78215) | $247.04 | $772 | 0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $192.96 | $603 | 0.5× |
| Liver imaging static only (78201) | $488.32 | $1,526 | 1.0× |
| Liver imaging w/vascular flow (78202) | $403.84 | $1,262 | 0.8× |
| Lung Perf&Ventilat Diferentl (78598) | $563.20 | $1,760 | 1.1× |
| Lung perfusion differential (78597) | $563.20 | $1,760 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $540.48 | $1,689 | 1.1× |
| Lung Ventilation Imaging (78579) | $311.68 | $974 | 0.9× |
| Lymph System Imaging (78195) | $276.48 | $864 | 0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) | $296.64 | $927 | 0.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$1,429.76–$1,510.72 | $4,468–$4,721 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $188.80 | $590 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $580.48 | $1,814 | 2.7× |
| Magnetic Resonance Elastography (76391) | $496.96 | $1,553 | 2.3× |
| Mammary ductogram or galactogram multiple (77054) | $143.68 | $449 | 0.7× |
| Mammary ductogram or galactogram single (77053) | $116.16 | $363 | 0.5× |
| Meckels Divert Exam (78290) | $205.44 | $642 | 0.6× |
| Mlc imrt design & construction per imrt plan (77338) | $175.68 | $549 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) | $559.04 | $1,747 | 1.8× |
| MRA head w/o contrast (70544) | $342.08 | $1,069 | 1.6× |
| MRA head with contrast (70545) | $372.48 | $1,164 | 1.2× |
| MRA neck w contrast (70548) | $372.48 | $1,164 | 1.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $559.04 | $1,747 | 1.8× |
| MRA neck w/o contrast (70547) | $342.08 | $1,069 | 1.6× |
| MRI abdomen w contrast (74182) | $568.64 | $1,777 | 1.8× |
| MRI abdomen w/o contrast (74181) | $568.64 | $1,777 | 2.6× |
| MRI any jt lower extrem w/contrast material (73722) | $568.64 | $1,777 | 0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $868.80 | $2,715 | 2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $568.64 | $1,777 | 0.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $505.60 | $1,580 | 2.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $336.96 | $1,053 | 1.6× |
| MRI cardiac w/o contrast (75557) | $352.64 | $1,102 | 1.6× |
| MRI cervical spine w contrast (72142) | $752 | $2,350 | 2.4× |
| MRI cervical spine w/o cont (72141) | $752 | $2,350 | 3.5× |
| MRI chest w/o contrast (71550) | $566.08 | $1,769 | 2.6× |
| MRI chest with contrast (71551) | $568.64 | $1,777 | 0.8× |
| MRI chest wo w contrast (71552) | $808.32 | $2,526 | 2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $568.64 | $1,777 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $868.80 | $2,715 | 2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $568.64 | $1,777 | 2.6× |
| MRI lumbar spine w contrast (72149) | $752 | $2,350 | 2.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $924.80 | $2,890 | 2.9× |
| MRI orbit face &/neck w/o contrast (70540) | $566.08 | $1,769 | 2.6× |
| MRI orbit face neck w contrast (70542) | $580.48 | $1,814 | 1.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $808.32 | $2,526 | 2.6× |
| MRI pelvis w contrast (72196) | $568.64 | $1,777 | 1.8× |
| MRI pelvis w/o & w contrast (72197) | $771.52 | $2,411 | 2.4× |
| MRI pelvis w/o contrast (72195) | $539.84 | $1,687 | 2.5× |
| MRI spectroscopy (76390) | $488.96 | $1,528 | 6.2× |
| MRI thoracic spine w/o contrast (72146) | $752 | $2,350 | 3.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $568.64 | $1,777 | 1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $496.32 | $1,551 | 2.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $868.80 | $2,715 | 2.7× |
| MRI, abdomen, combo (74183) | $808.32 | $2,526 | 2.6× |
| MRI, dorsal spine combo (72157) | $924.80 | $2,890 | 2.9× |
| MRI, dorsal spine contrast (72147) | $752 | $2,350 | 2.4× |
| MRI, joint upper extrem (73221) | $566.08 | $1,769 | 2.6× |
| MRI, joint upper extrem combo (73223) | $868.80 | $2,715 | 2.7× |
| MRI, lumbar spine combo (72158) | $924.80 | $2,890 | 2.9× |
| Myelogram cervical (72240) | $379.20 | $1,185 | 0.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$37.35–$722.24 | $116.72–$2,257 | varies |
| Neck soft tissue (70360) | $62.72 | $196 | 0.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $192.96 | $603 | 0.5× |
| Nm red cell survival study (78130) | $397.12 | $1,241 | 1.1× |
| Nonvascular Shunt X-Ray (75809) | $95.36 | $298 | 1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,162.24 | $3,632 | 0.9× |
| Nuclear Rx Intra-Arterial (79445) | $322.24 | $1,007 | 1.5× |
| Nuclear Rx Oral Admin (79005) | $379.52 | $1,186 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $113.92 | $356 | 1.2× |
| Optic foramina (70190) | $65.28 | $204 | 0.8× |
| Panoramic X-ray of jaws (70355) | $76.80 | $240 | 1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $258.24 | $807 | 0.5× |
| Parathyroid Planar Imaging (78070) | $192.96 | $603 | 0.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $192.96 | $603 | 0.5× |
| Pelvis 1 or 2 views (72170) | $80.96 | $253 | 0.9× |
| Perineogram (74775) | $130.24 | $407 | 0.6× |
| Peritoneogram Rs&I (74190) | $263.04 | $822 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $1,716.48 | $5,364 | 1.3× |
| PET image w/CT, full body (78816) | $1,716.48 | $5,364 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$1,577.28–$1,716.48 | $4,929–$5,364 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $918.08 | $2,869 | 0.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,510.72 | $4,721 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $228.80 | $715 | 0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $99.20 | $310 | 1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $263.04 | $822 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$59.20–$118.40 | $185–$370 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$63.68–$127.36 | $199–$398 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $96.32 | $301 | 1.0× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$70.08–$140.16 | $219–$438 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$70.08–$140.16 | $219–$438 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$61.12–$122.24 | $191–$382 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $111.04 | $347 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $66.24 | $207 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) | $46.40 | $145 | 0.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $55.68 | $174 | 0.7× |
| Radex Spine 1 View Specify Level (72020) | $58.24 | $182 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $62.08 | $194 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $88.32 | $276 | 1.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$53.44–$106.88 | $167–$334 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $82.88 | $259 | 0.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,737.92 | $36,681 | 1.8× |
| Radiation treatment delivery level 1 (77402) | $108.16 | $338 | 1.2× |
| Radiation treatment delivery level 2 (77407) | $144.32 | $451 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $152 | $475 | 0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $76.16 | $238 | 0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $99.20 | $310 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $176.64 | $552 | 1.1× |
| Radiologic exam colon single contrast study (74270) | $174.72 | $546 | 1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $104.32 | $326 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$70.08–$134.72 | $219–$421 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $80.96 | $253 | 0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $103.36 | $323 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $87.68 | $274 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $183.36 | $573 | 1.2× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$70.08–$140.16 | $219–$438 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$70.08–$140.16 | $219–$438 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$49.28–$98.56 | $154–$308 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $111.04 | $347 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $263.04 | $822 | 0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $356.16 | $1,113 | 0.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $959.36 | $2,998 | 2.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $959.36 | $2,998 | 2.7× |
| Renal Cyst Study (74470) | $263.04 | $822 | 0.5× |
| Ribs bilateral 3 views (71110) | $123.20 | $385 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $192.96 | $603 | 0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $256 | $800 | 0.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $650.24 | $2,032 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $650.24 | $2,032 | 1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $650.24 | $2,032 | 1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $650.24 | $2,032 | 0.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $725.44 | $2,267 | 0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $650.24 | $2,032 | 0.6× |
| Rp Therapy Intravenous Administration (79101) | $379.52 | $1,186 | 1.8× |
| Salivary Gland Imaging (78230) | $192.96 | $603 | 0.5× |
| Scapula (73010) range across 3 matching MRF lines |
$59.20–$118.40 | $185–$370 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $11.20 | $35 | 0.5× |
| Sella turcica (70240) | $52.80 | $165 | 0.7× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$42.24–$84.80 | $132–$265 | varies |
| Shoulder Arthrography (73040) range across 5 matching MRF lines |
$180.48–$360.96 | $564–$1,128 | varies |
| Sialogram (70390) | $120.64 | $377 | 0.6× |
| Skull less than 4 views (70250) | $61.12 | $191 | 0.6× |
| Special dosimetry (77331) | $71.68 | $224 | 0.6× |
| Special Physics Consult (77370) | $176.96 | $553 | 1.5× |
| Special teletherapy port plan (77321) | $212.16 | $663 | 0.6× |
| Special treatment procedure (77470) | $415.04 | $1,297 | 0.8× |
| Srs Multisource (77371) | $14,080 | $44,000 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $1,638.08 | $5,119 | 1.0× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$64–$128 | $200–$400 | varies |
| Superior sagittal sinus venogram (75870) | $440.64 | $1,377 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $461.76 | $1,443 | 1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $249.60 | $780 | 0.7× |
| Testicular Imaging W/Flow (78761) | $192.96 | $603 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $226.56 | $708 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $183.36 | $573 | 0.5× |
| Ther rad simulaj-aided field setting simple (77280) | $136.32 | $426 | 1.1× |
| Thoracic spine 2 views (72070) | $67.84 | $212 | 0.7× |
| Thoracic spine 3 views (72072) | $88.32 | $276 | 0.9× |
| Thoracolumbar 2 views (72080) | $72.96 | $228 | 0.9× |
| Thyroid Imaging With Vascular Flow (78013) | $192.96 | $603 | 0.5× |
| Thyroid Met Imaging Body (78018) | $310.08 | $969 | 0.6× |
| Thyroid Uptake Measurement (78012) | $192.96 | $603 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $208.96 | $653 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $175.68 | $549 | 0.5× |
| Tx devices design & construction intermediate (77333) | $105.28 | $329 | 0.9× |
| Tx devices design & construction simple (77332) | $87.36 | $273 | 0.7× |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$101.12–$202.24 | $316–$632 | varies |
| Ultrasound elastography first target lesion (76982) | $105.60 | $330 | 1.1× |
| Ultrasound Elastography Parenchyma (76981) | $118.72 | $371 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $53.44 | $167 | 0.6× |
| Ultrasound, abdomen limited (76705) | $155.84 | $487 | 1.6× |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$46.40–$53.44 | $145–$167 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 17 matching MRF lines |
$48–$96 | $150–$300 | varies |
| Unlisted magnetic resonance procedure (76498) range across 12 matching MRF lines |
$539.84–$924.80 | $1,687–$2,890 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,393.92 | $4,356 | 3.8× |
| Unlisted us procedure (76999) | $153.92 | $481 | 1.9× |
| Upper gi w/o kub (74240) | $162.56 | $508 | 1.0× |
| Ureteral Reflux Study (78740) | $192.96 | $603 | 0.5× |
| Urethrocystogram voiding (74455) | $152.32 | $476 | 0.7× |
| Urethrocystography retrograde (74450) | $138.24 | $432 | 0.6× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$151.68–$303.36 | $474–$948 | varies |
| Us chest (76604) | $128 | $400 | 1.3× |
| Us exam, pelvic, limited (76857) | $74.24 | $232 | 0.8× |
| Us head (76506) | $140.16 | $438 | 1.5× |
| Us kidney transplant (76776) | $173.44 | $542 | 1.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 9 matching MRF lines |
$81.92–$164.48 | $256–$514 | varies |
| Us ob detailed single fetus (76811) | $96.32 | $301 | 0.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$84.80–$96 | $265–$300 | varies |
| Us ob transvaginal (76817) | $203.84 | $637 | 2.1× |
| Us pelvic non ob complete (76856) | $116.48 | $364 | 1.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $211.84 | $662 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$36.16–$48.64 | $113–$152 | varies |
| Us retroperitoneal complete (76770) | $92.80 | $290 | 1.0× |
| Us retroperitoneal limited (76775) | $71.04 | $222 | 0.7× |
| Us scrotum and contents (76870) | $110.40 | $345 | 1.2× |
| Us spinal canal and contents (76800) | $58.56 | $183 | 0.6× |
| Us thyroid (76536) | $147.20 | $460 | 1.6× |
| Us transrectal (76872) | $203.84 | $637 | 2.1× |
| Vascular Flow Imaging (78445) | $192.96 | $603 | 0.5× |
| Vein X-Ray Chest (75827) | $745.60 | $2,330 | 0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $675.20 | $2,110 | 0.2× |
| Vein X-Ray Skull Epidural (75872) | $577.28 | $1,804 | 1.0× |
| Vein X-Ray Spleen/Liver (75810) | $586.56 | $1,833 | 0.2× |
| Venogram Sinus/Jugular (75860) range across 18 matching MRF lines |
$945.28–$1,510.72 | $2,954–$4,721 | varies |
| Venography Adrenal Unilateral (75840) | $1,510.72 | $4,721 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,510.72 | $4,721 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $299.20 | $935 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $745.60 | $2,330 | 0.5× |
| Venography Orbital Rs&I (75880) | $577.28 | $1,804 | 1.0× |
| Venography Renal Bilateral (75833) | $1,510.72 | $4,721 | 0.5× |
| Venography Renal Unilateral (75831) | $1,510.72 | $4,721 | 0.5× |
| Venous sampling by catheter (75893) | $2,594.88 | $8,109 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $73.28 | $229 | 0.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$42.24–$84.48 | $132–$264 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$59.20–$117.44 | $185–$367 | varies |
| X-ray antegrade pyelogram tube (74425) | $180.48 | $564 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $1,510.72 | $4,721 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $171.20 | $535 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$42.24–$84.48 | $132–$264 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$252.48–$263.04 | $789–$822 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $42.24 | $132 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $53.44 | $167 | 0.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $82.88 | $259 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $142.40 | $445 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $144.96 | $453 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $144.96 | $453 | 1.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $206.40 | $645 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $206.40 | $645 | 2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $206.40 | $645 | 2.2× |
| X-Ray Exam L-S Spine Bending (72114) | $171.20 | $535 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $61.12 | $191 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $129.28 | $404 | 1.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $77.12 | $241 | 0.8× |
| X-ray eye for foreign body (70030) | $125.44 | $392 | 1.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$70.08–$139.84 | $219–$437 | varies |
| X-ray IV pyelogram (ivp) (74400) | $203.20 | $635 | 1.3× |
| X-ray IV pyelogram+tomography (74415) | $203.20 | $635 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $55.36 | $173 | 0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $75.84 | $237 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $80.32 | $251 | 0.8× |
| X-ray nose-rectum child f.b. (76010) | $55.04 | $172 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $123.20 | $385 | 1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $59.20 | $185 | 0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $61.76 | $193 | 0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $77.12 | $241 | 1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $83.84 | $262 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $117.44 | $367 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $96.96 | $303 | 1.0× |
| X-Ray Tmj Unilat (70328) | $50.56 | $158 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $180.48 | $564 | 0.6× |
| X-Rays Bone Length Studies (77073) | $65.28 | $204 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $201.28 | $629 | 2.1× |
| Xr c-spine 4 or 5 views (72050) | $123.52 | $386 | 1.3× |
| Xr facial bones less than 3 views (70140) | $51.84 | $162 | 0.7× |
| Xr orbits complete 4 views (70200) | $83.84 | $262 | 0.9× |
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.