Imaging prices at Covenant HealthCare
Saginaw, MI · every code in this section with a posted price and a Medicare benchmark.
350 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) | $2,867.20 | $4,096 | 2.1× |
| Abdomen 1 View (74018) | $147.70 | $211 | 1.7× |
| Abdomen 2 views (74019) | $224 | $320 | 2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $743.40 | $1,062 | 1.9× |
| Adrenal Cortex & Medulla Img (78075) | $536.90 | $767 | 0.4× |
| Angio internal mammary (75756) | $1,730.40 | $2,472 | 0.6× |
| Angio pulmonary bilat (75743) | $3,034.50 | $4,335 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,286.90 | $3,267 | 0.7× |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$2,247–$2,422 | $3,210–$3,460 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,107.40 | $1,582 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,835.40 | $2,622 | 0.6× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$175.70–$310.10 | $251–$443 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,938.30 | $2,769 | 0.3× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$2,282.70–$3,729.60 | $3,261–$5,328 | varies |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,469.30 | $2,099 | 0.3× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,407.30 | $3,439 | 0.4× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$224–$255.50 | $320–$365 | varies |
| Bone age studies (77072) | $167.30 | $239 | 1.6× |
| Bone Imaging 3 Phase (78315) | $1,295 | $1,850 | 3.3× |
| Bone Imaging Limited Area (78300) | $858.20 | $1,226 | 2.2× |
| Bone Imaging Whole Body (78306) | $1,117.90 | $1,597 | 2.8× |
| Bone marrow imaging limited area (78102) | $581 | $830 | 1.5× |
| Bone survey infant (77076) | $158.90 | $227 | 1.5× |
| Brachytx isodose complex (77318) | $3,592.40 | $5,132 | 9.6× |
| Brachytx isodose intermed (77317) | $2,127.30 | $3,039 | 5.7× |
| Brachytx Isodose Plan Simple (77316) | $240.80 | $344 | 0.6× |
| Brain Flow Imaging Only (78610) | $620.90 | $887 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,281.90 | $6,117 | 3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,286.90 | $3,267 | 6.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,405.60 | $2,008 | 1.8× |
| Cardiac Shunt Detection (78428) | $711.20 | $1,016 | 1.8× |
| Cat Scan Follow-Up Study (76380) | $793.10 | $1,133 | 9.1× |
| Cerebrospinal Fluid Scan (78630) | $670.60 | $958 | 1.2× |
| Chest 1 view (71045) | $147.70 | $211 | 1.7× |
| Chest 2 views (71046) | $147.70 | $211 | 1.7× |
| Chest 3 views (71047) | $259.70 | $371 | 3.0× |
| Chest 4 or more views (71048) | $259.70 | $371 | 2.5× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$157.50–$242.90 | $225–$347 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $143.50 | $205 | 1.4× |
| Continuing medical physics consltj pr wk (77336) | $255.50 | $365 | 1.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,366.70 | $3,381 | 0.8× |
| Contrast X-Ray Bladder (74430) | $336 | $480 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$4,173.40–$4,200 | $5,962–$6,000 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,660.70 | $3,801 | 11.2× |
| CT abdomen w contrast (74160) | $1,523.90 | $2,177 | 8.7× |
| CT abdomen w wo contrast (74170) | $1,971.20 | $2,816 | 11.3× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$875.70–$1,356.60 | $1,251–$1,938 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,221.40 | $4,602 | 9.3× |
| CT Angio Chest (71275) | $1,470.70 | $2,101 | 8.4× |
| CT Angio Head (70496) | $1,588.30 | $2,269 | 9.1× |
| CT angio hrt w/3d image (75574) | $1,334.20 | $1,906 | 3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,600.20 | $2,286 | 9.2× |
| CT Angio Neck (70498) | $1,588.30 | $2,269 | 9.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,806 | $2,580 | 10.3× |
| CT cervical spine w/ contrast (72126) | $1,698.20 | $2,426 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,565.90 | $2,237 | 15.0× |
| CT cervical spine w/wo cont (72127) | $1,984.50 | $2,835 | 11.4× |
| CT chest w contrast (71260) | $1,667.40 | $2,382 | 9.5× |
| CT chest w/wo contrast (71270) | $1,749.30 | $2,499 | 10.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $781.20 | $1,116 | 4.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $489.30 | $699 | 4.7× |
| CT head/brain with contrast (70460) | $1,414 | $2,020 | 8.1× |
| CT head/brain without and with contrast (70470) | $1,694 | $2,420 | 9.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,049.30 | $1,499 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $171.50 | $245 | 2.0× |
| CT hrt w/3d image congen (75573) | $782.60 | $1,118 | 2.3× |
| CT iac w contrast (70481) | $1,610.70 | $2,301 | 9.2× |
| CT l-spine w&w/o contrast (72133) | $1,813.70 | $2,591 | 10.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,453.90–$2,249.10 | $2,077–$3,213 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,577.10–$2,377.90 | $2,253–$3,397 | varies |
| CT lumbar spine w contrast (72132) | $1,698.20 | $2,426 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,565.90 | $2,237 | 15.0× |
| CT maxillofacial w contrast (70487) | $1,453.20 | $2,076 | 8.3× |
| CT maxillofacial wo contrast (70486) | $1,464.40 | $2,092 | 14.1× |
| CT neck tissue combo (70492) | $1,603 | $2,290 | 9.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,815.80–$1,840.30 | $2,594–$2,629 | varies |
| CT orbits w/o contrast (70480) | $1,280.30 | $1,829 | 12.3× |
| CT pelvis w&w/o contrast (72194) | $1,683.50 | $2,405 | 9.6× |
| CT pelvis w/o contrast (72192) | $1,306.90 | $1,867 | 12.5× |
| CT scan of leg combo (73702) | $1,767.50 | $2,525 | 10.1× |
| CT scans face/jaw combo (70488) | $2,054.50 | $2,935 | 11.8× |
| CT soft tissue neck w contrast (70491) | $1,610.70 | $2,301 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,476.30 | $2,109 | 14.2× |
| CT thoracic spine w contrast (72129) | $1,698.20 | $2,426 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,565.90 | $2,237 | 15.0× |
| CT thoracic spine w/wo cont (72130) | $1,749.30 | $2,499 | 10.0× |
| CT thorax w/o contrast (71250) | $1,331.40 | $1,902 | 12.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,453.90–$2,249.10 | $2,077–$3,213 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,042.60 | $2,918 | 11.7× |
| CT upper extremity with contrast (73201) | $1,414 | $2,020 | 4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,415.70 | $3,451 | 13.8× |
| Cta Abdomen (74175) | $1,647.10 | $2,353 | 9.4× |
| CTA pelvis (72191) | $1,554 | $2,220 | 8.9× |
| Dilation ureters/urethra rs&i (74485) | $828.80 | $1,184 | 0.4× |
| Diskography lumbar (72295) | $2,346.40 | $3,352 | 1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $156.80 | $224 | 1.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $156.80 | $224 | 1.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $156.80 | $224 | 1.5× |
| Dxa Bone Density Axial (77080) | $345.80 | $494 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $88.20 | $126 | 1.0× |
| Echo exam of fetal heart (76825) | $1,565.90 | $2,237 | 2.9× |
| Echo Guide For Artery Repair (76936) | $507.50 | $725 | 2.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,128.40 | $1,612 | 4.7× |
| Esophagram (74220) | $333.20 | $476 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,125.60 | $1,608 | 10.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $721.70 | $1,031 | 6.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $582.40 | $832 | 2.4× |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$252.70–$270.20 | $361–$386 | varies |
| Foot 2 views (73620) range across 5 matching MRF lines |
$172.20–$294.70 | $246–$421 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$158.20–$308.70 | $226–$441 | varies |
| Gastric emptying imaging study (78264) | $1,025.50 | $1,465 | 2.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,025.50 | $1,465 | 2.6× |
| Gated Heart Planar Single (78472) | $1,246.70 | $1,781 | 3.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,025.50 | $1,465 | 1.9× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$142.80–$166.60 | $204–$238 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,531.60 | $2,188 | 2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,191.40 | $1,702 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $851.20 | $1,216 | 1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,541.60 | $6,488 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,173.20 | $1,676 | 2.2× |
| Hepatobiliary System Imaging (78226) | $935.20 | $1,336 | 2.3× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,517.60–$1,911 | $2,168–$2,730 | varies |
| Hysterosalpingogram (74740) | $379.40 | $542 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $419.30 | $599 | 4.8× |
| Interstitial radiation source applic complex (77778) | $1,290.80 | $1,844 | 1.9× |
| Joint Survey Single View (77077) | $128.80 | $184 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $676.20 | $966 | 1.2× |
| K Flow/Funct Image W/Drug (78708) | $998.20 | $1,426 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $899.50 | $1,285 | 1.7× |
| Kidney Imaging Morphol (78700) | $614.60 | $878 | 1.5× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$230.30–$448.70 | $329–$641 | varies |
| Liver & Spleen Imaging Static Only (78215) | $699.30 | $999 | 1.8× |
| Liver imaging w/vascular flow (78202) | $696.50 | $995 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) | $1,048.60 | $1,498 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $999.60 | $1,428 | 1.8× |
| Lung Ventilation Imaging (78579) | $999.60 | $1,428 | 2.5× |
| Lymph System Imaging (78195) | $623.70 | $891 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,945.30 | $2,779 | 8.2× |
| Mammary ductogram or galactogram multiple (77054) | $546 | $780 | 2.3× |
| Mammary ductogram or galactogram single (77053) | $263.90 | $377 | 1.1× |
| Meckels Divert Exam (78290) | $893.90 | $1,277 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) | $691.60 | $988 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,772.70 | $3,961 | 8.0× |
| MRA head w/o contrast (70544) | $1,680.70 | $2,401 | 7.1× |
| MRA head with contrast (70545) | $1,461.60 | $2,088 | 4.2× |
| MRA neck w contrast (70548) | $1,461.60 | $2,088 | 4.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,772.70 | $3,961 | 8.0× |
| MRA neck w/o contrast (70547) | $1,680.70 | $2,401 | 7.1× |
| MRI abdomen w contrast (74182) | $1,765.40 | $2,522 | 5.1× |
| MRI abdomen w/o contrast (74181) | $1,688.40 | $2,412 | 7.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,392.30 | $1,989 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,676.10 | $3,823 | 7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,821.40 | $2,602 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,902.60 | $2,718 | 8.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,261.40 | $1,802 | 5.3× |
| MRI cardiac w/o contrast (75557) | $1,381.80 | $1,974 | 5.8× |
| MRI cervical spine w contrast (72142) | $2,086 | $2,980 | 6.0× |
| MRI cervical spine w/o cont (72141) | $1,839.60 | $2,628 | 7.7× |
| MRI chest w/o contrast (71550) | $2,097.90 | $2,997 | 8.8× |
| MRI chest with contrast (71551) | $1,392.30 | $1,989 | 1.8× |
| MRI chest wo w contrast (71552) | $2,805.60 | $4,008 | 8.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,707.60 | $3,868 | 7.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,890 | $2,700 | 7.9× |
| MRI lumbar spine w contrast (72149) | $2,097.90 | $2,997 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,674.70 | $3,821 | 7.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,694 | $2,420 | 7.1× |
| MRI orbit face neck w contrast (70542) | $2,294.60 | $3,278 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,413.60 | $3,448 | 6.9× |
| MRI pelvis w contrast (72196) | $1,392.30 | $1,989 | 4.0× |
| MRI pelvis w/o & w contrast (72197) | $2,707.60 | $3,868 | 7.8× |
| MRI pelvis w/o contrast (72195) | $1,867.60 | $2,668 | 7.9× |
| MRI spectroscopy (76390) | $1,570.10 | $2,243 | 18.1× |
| MRI thoracic spine w/o contrast (72146) | $1,867.60 | $2,668 | 7.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,873.20 | $2,676 | 7.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,445.10–$3,357.20 | $3,493–$4,796 | varies |
| MRI, abdomen, combo (74183) | $2,389.80 | $3,414 | 6.9× |
| MRI, dorsal spine combo (72157) | $2,381.40 | $3,402 | 6.9× |
| MRI, dorsal spine contrast (72147) | $2,382.80 | $3,404 | 6.9× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,868.30–$2,654.40 | $2,669–$3,792 | varies |
| MRI, joint upper extrem combo (73223) | $2,707.60 | $3,868 | 7.8× |
| MRI, lumbar spine combo (72158) | $2,685.20 | $3,836 | 7.7× |
| Myelogram cervical (72240) | $1,055.60 | $1,508 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $2,495.50 | $3,565 | 1.9× |
| Neck soft tissue (70360) | $177.80 | $254 | 2.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $427 | $610 | 1.1× |
| Nonvascular Shunt X-Ray (75809) | $224 | $320 | 2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,565.80 | $5,094 | 2.6× |
| Nuclear Rx Intra-Arterial (79445) | $417.90 | $597 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $891.80 | $1,274 | 3.8× |
| Ob us nuchal meas 1 gest (76813) | $156.80 | $224 | 1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $210 | $300 | 2.0× |
| Panoramic X-ray of jaws (70355) | $270.20 | $386 | 3.1× |
| Parathyroid Planar Imaging (78070) | $581 | $830 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $711.20 | $1,016 | 1.8× |
| Pelvis 1 or 2 views (72170) | $176.40 | $252 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $5,254.20 | $7,506 | 3.7× |
| PET image w/CT, full body (78816) | $4,526.20 | $6,466 | 3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,570.30 | $6,529 | 3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $621.60 | $888 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $306.60 | $438 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$442.40–$507.50 | $632–$725 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$213.50–$410.20 | $305–$586 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$156.80–$221.90 | $224–$317 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$191.10–$328.30 | $273–$469 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $320.60 | $458 | 3.1× |
| Radex fingr minimum 2 views (73140) | $128.10 | $183 | 1.5× |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$211.40–$409.50 | $302–$585 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$184.10–$279.30 | $263–$399 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$119–$235.20 | $170–$336 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $222.60 | $318 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $175 | $250 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $210.70 | $301 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$242.90–$469.70 | $347–$671 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $197.40 | $282 | 2.3× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$193.90–$233.80 | $277–$334 | varies |
| Radex Sternum Minimum 2 Views (71120) | $274.40 | $392 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $239.40 | $342 | 2.8× |
| Radex Toe Minimum 2 Views (73660) range across 10 matching MRF lines |
$109.20–$120.40 | $156–$172 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$112–$208.60 | $160–$298 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$182–$347.90 | $260–$497 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,969.50 | $11,385 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $409.50 | $585 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $301.70 | $431 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $171.50 | $245 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $648.90 | $927 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $518 | $740 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $334.60 | $478 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$279.30–$548.10 | $399–$783 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $207.20 | $296 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $327.60 | $468 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $343.70 | $491 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$466.20–$476.70 | $666–$681 | varies |
| Radiologic examination femur 1 view (73551) | $129.50 | $185 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $289.10 | $413 | 3.3× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$189–$365.40 | $270–$522 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $317.10 | $453 | 3.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$181.30–$347.90 | $259–$497 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $680.40 | $972 | 1.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $425.60 | $608 | 1.1× |
| Ribs bilateral 3 views (71110) | $224 | $320 | 2.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$868–$2,198 | $1,240–$3,140 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,251.20 | $3,216 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $967.40 | $1,382 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,311.40 | $3,302 | 4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,337.30 | $3,339 | 1.8× |
| Rp Therapy Intravenous Administration (79101) | $1,204 | $1,720 | 5.2× |
| Scapula (73010) | $184.80 | $264 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $45.50 | $65 | 1.9× |
| Shoulder 1 view (73020) range across 5 matching MRF lines |
$152.60–$256.20 | $218–$366 | varies |
| Shoulder Arthrography (73040) | $420 | $600 | 1.2× |
| Skull less than 4 views (70250) | $275.80 | $394 | 2.6× |
| Special dosimetry (77331) | $255.50 | $365 | 1.9× |
| Special Physics Consult (77370) | $244.30 | $349 | 1.8× |
| Special teletherapy port plan (77321) | $691.60 | $988 | 1.9× |
| Special treatment procedure (77470) | $1,081.50 | $1,545 | 2.0× |
| Stereotactic Body Radiation Delivery (77373) | $4,263 | $6,090 | 2.4× |
| Sternoclavicular joints (71130) | $189.70 | $271 | 2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,220.80 | $1,744 | 3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $732.20 | $1,046 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $691.60 | $988 | 1.9× |
| Ther rad simulaj-aided field setting simple (77280) | $334.60 | $478 | 2.5× |
| Thoracic spine 2 views (72070) | $196 | $280 | 1.9× |
| Thoracic spine 3 views (72072) | $273 | $390 | 2.6× |
| Thoracolumbar 2 views (72080) | $249.90 | $357 | 2.9× |
| Thyroid Imaging With Vascular Flow (78013) | $353.50 | $505 | 0.9× |
| Thyroid Met Imaging Body (78018) | $1,341.20 | $1,916 | 2.5× |
| Thyroid Uptake Measurement (78012) | $353.50 | $505 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $765.80 | $1,094 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $473.90 | $677 | 1.3× |
| Tx devices design & construction simple (77332) | $473.90 | $677 | 3.5× |
| Ultrasound Breast Limited (76642) | $194.60 | $278 | 2.2× |
| Ultrasound Elastography Parenchyma (76981) | $203.70 | $291 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $320.60 | $458 | 3.1× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$210–$798.70 | $300–$1,141 | varies |
| Umbilical-artery Doppler (OB) (76820) | $156.80 | $224 | 1.5× |
| Unlisted Dx Radiographic Procedure (76499) | $151.90 | $217 | 1.8× |
| Unlisted us procedure (76999) | $133.70 | $191 | 1.5× |
| Upper gi w/o kub (74240) | $490 | $700 | 2.8× |
| Ureteral Reflux Study (78740) | $645.40 | $922 | 1.6× |
| Urethrocystogram voiding (74455) | $520.80 | $744 | 2.2× |
| Urethrocystography retrograde (74450) | $198.80 | $284 | 0.8× |
| Us breast unilateral complete (76641) | $389.90 | $557 | 3.7× |
| Us chest (76604) range across 3 matching MRF lines |
$210–$452.20 | $300–$646 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$695.10–$1,208.90 | $993–$1,727 | varies |
| Us exam, pelvic, limited (76857) | $499.80 | $714 | 4.8× |
| Us head (76506) | $291.20 | $416 | 2.8× |
| Us kidney transplant (76776) | $572.60 | $818 | 5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$691.60–$1,204.70 | $988–$1,721 | varies |
| Us ob detailed single fetus (76811) | $407.40 | $582 | 1.7× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$519.40–$566.30 | $742–$809 | varies |
| Us ob transvaginal (76817) | $483.70 | $691 | 4.6× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$851.20–$932.40 | $1,216–$1,332 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$364–$498.40 | $520–$712 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$255.50–$615.30 | $365–$879 | varies |
| Us retroperitoneal complete (76770) | $670.60 | $958 | 6.4× |
| Us retroperitoneal limited (76775) | $511.70 | $731 | 4.9× |
| Us scrotum and contents (76870) | $901.60 | $1,288 | 8.7× |
| Us spinal canal and contents (76800) | $541.10 | $773 | 5.2× |
| Us thyroid (76536) range across 2 matching MRF lines |
$445.90–$892.50 | $637–$1,275 | varies |
| Us transrectal (76872) | $472.50 | $675 | 4.5× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,420.30–$2,498.30 | $2,029–$3,569 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,997.40 | $4,282 | 1.0× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,810.20–$2,102.80 | $2,586–$3,004 | varies |
| Venography caval inferior serialography rs&i (75825) | $2,230.90 | $3,187 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,214.50 | $1,735 | 0.8× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$538.30–$1,078 | $769–$1,540 | varies |
| Venography Renal Bilateral (75833) | $1,841.70 | $2,631 | 0.6× |
| Venography Renal Unilateral (75831) | $1,915.90 | $2,737 | 0.6× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,437.10 | $2,053 | 0.3× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$166.60–$242.90 | $238–$347 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $170.80 | $244 | 2.0× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$450.10–$609.70 | $643–$871 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,448.90 | $4,927 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $141.40 | $202 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$168–$294 | $240–$420 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$113.40–$503.30 | $162–$719 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $123.20 | $176 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $214.90 | $307 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $408.10 | $583 | 3.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $214.90 | $307 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $290.50 | $415 | 3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $290.50 | $415 | 2.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $256.20 | $366 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $256.20 | $366 | 2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $497.70 | $711 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $412.30 | $589 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $240.80 | $344 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $373.80 | $534 | 3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $239.40 | $342 | 2.3× |
| X-ray eye for foreign body (70030) | $221.90 | $317 | 2.6× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$182–$347.90 | $260–$497 | varies |
| X-ray IV pyelogram (ivp) (74400) | $645.40 | $922 | 3.7× |
| X-ray IV pyelogram+tomography (74415) | $780.50 | $1,115 | 4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $128.80 | $184 | 1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $158.90 | $227 | 1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $280.70 | $401 | 2.7× |
| X-ray nose-rectum child f.b. (76010) | $91 | $130 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $288.40 | $412 | 2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $165.20 | $236 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $193.20 | $276 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $259 | $370 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $293.30 | $419 | 2.8× |
| X-ray thoracic spine 4 vw (72074) | $205.80 | $294 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $408.10 | $583 | 1.2× |
| X-Rays Bone Length Studies (77073) | $221.20 | $316 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $308 | $440 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $333.20 | $476 | 3.2× |
| Xr facial bones less than 3 views (70140) | $245 | $350 | 2.8× |
| Xr orbits complete 4 views (70200) | $239.40 | $342 | 2.3× |
| Xr Tomogram Single Plane (76100) | $755.30 | $1,079 | 7.3× |
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.