Imaging prices at Covenant Medical Center
Lubbock, TX · every code in this section with a posted price and a Medicare benchmark.
367 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) | $10,805.34 | $25,727 | 7.8× |
| Abdomen 1 View (74018) | $167.16 | $398 | 1.9× |
| Abdomen 2 views (74019) | $225.54 | $537 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,666.14 | $3,967 | 4.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,661.52 | $3,956 | 1.3× |
| Angio internal mammary (75756) | $2,917.74 | $6,947 | 0.9× |
| Angio pulmonary bilat (75743) | $6,538.14 | $15,567 | 2.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $9,476.04 | $22,562 | 3.0× |
| Angiography extremity bilateral rs&i (75716) | $2,917.74 | $6,947 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $2,917.74 | $6,947 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,917.74 | $6,947 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,660.70 | $6,335 | 0.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$213.36–$284.76 | $508–$678 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,864.02 | $11,581 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,395.70 | $8,085 | 1.1× |
| Artery X-Rays Abdomen (75726) | $4,864.02 | $11,581 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $2,917.74 | $6,947 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,864.02 | $11,581 | 0.9× |
| Artery X-Rays Spine (75705) | $4,864.02 | $11,581 | 0.9× |
| Arthrogram hip (73525) | $375.48 | $894 | 1.1× |
| Arthrogram Wrist (73115) | $968.52 | $2,306 | 2.8× |
| Basic radiation dosimetry calculation (77300) | $959.70 | $2,285 | 7.1× |
| Bone age studies (77072) | $383.46 | $913 | 3.7× |
| Bone Imaging 3 Phase (78315) | $1,666.14 | $3,967 | 4.1× |
| Bone Imaging Limited Area (78300) | $458.22 | $1,091 | 1.1× |
| Bone Imaging Whole Body (78306) | $596.82 | $1,421 | 1.5× |
| Bone marrow imaging limited area (78102) | $485.10 | $1,155 | 1.2× |
| Bone marrow imaging; whole body (78104) | $1,666.14 | $3,967 | 4.1× |
| Bone survey infant (77076) | $383.46 | $913 | 3.7× |
| Brachytx isodose complex (77318) | $3,112.62 | $7,411 | 8.3× |
| Brachytx isodose intermed (77317) | $2,023.98 | $4,819 | 5.4× |
| Brachytx Isodose Plan Simple (77316) | $1,530.90 | $3,645 | 4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,162.04 | $5,147.71 | 4.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,121.94 | $16,957 | 5.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,198.68 | $2,854 | 3.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,645.58 | $6,299 | 3.4× |
| Cardiac Shunt Detection (78428) | $489.72 | $1,166 | 1.2× |
| Cat Scan Follow-Up Study (76380) | $341.04 | $812 | 3.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,162.16 | $5,148 | 4.0× |
| Cerebrospinal Fluid Scan (78630) | $2,162.04 | $5,147.71 | 4.0× |
| Chest 1 view (71045) | $177.66 | $423 | 2.0× |
| Chest 2 views (71046) | $177.66 | $423 | 2.0× |
| Chest 3 views (71047) | $177.66 | $423 | 2.0× |
| Chest 4 or more views (71048) | $239.40 | $570 | 2.3× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $459.06 | $1,093 | 4.4× |
| Cholecystography Oral Contrast (74290) | $271.74 | $647 | 1.5× |
| Clavicle complete (73000) | $284.76 | $678 | 3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $341.04 | $812 | 3.2× |
| Continuing medical physics consltj pr wk (77336) | $1,311.66 | $3,123 | 9.7× |
| Contrast Exam Abdominl Aorta (75625) | $2,917.74 | $6,947 | 0.9× |
| Contrast X-Ray Bladder (74430) | $991.62 | $2,361 | 2.8× |
| Contrast X-Ray Of Elbow (73085) | $375.48 | $894 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,294.86 | $3,083 | 3.7× |
| CT abdomen and pelvis without and with contrast (74178) | $460 | $3,794 | 1.3× |
| CT abdomen and pelvis without contrast (74176) | $310 | $2,309 | 1.3× |
| CT abdomen w contrast (74160) | $668.64 | $1,592 | 3.8× |
| CT abdomen w wo contrast (74170) | $794.64 | $1,892 | 4.5× |
| CT abdomen w/o contrast (74150) | $459.06 | $1,093 | 4.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,551.48 | $3,694 | 4.4× |
| CT Angio Chest (71275) | $230 | $1,792 | 1.3× |
| CT Angio Head (70496) | $230 | $1,629 | 1.3× |
| CT angio hrt w/3d image (75574) | $752.64 | $1,792 | 2.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $752.64 | $1,792 | 4.3× |
| CT Angio Neck (70498) | $230 | $1,629 | 1.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $752.64 | $1,792 | 4.3× |
| CT cervical spine w/ contrast (72126) | $1,410.36 | $3,358 | 4.0× |
| CT cervical spine w/o contrast (72125) | $417.48 | $994 | 4.0× |
| CT cervical spine w/wo cont (72127) | $1,452.36 | $3,458 | 8.2× |
| CT chest w contrast (71260) | $752.64 | $1,792 | 4.3× |
| CT chest w/wo contrast (71270) | $794.64 | $1,892 | 4.5× |
| CT head/brain with contrast (70460) | $684.18 | $1,629 | 3.9× |
| CT head/brain without and with contrast (70470) | $726.18 | $1,729 | 4.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $752.64 | $1,792 | 2.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $110 | $812 | 1.3× |
| CT hrt w/3d image congen (75573) | $752.64 | $1,792 | 2.1× |
| CT iac w contrast (70481) | $684.18 | $1,629 | 3.9× |
| CT l-spine w&w/o contrast (72133) | $1,593.48 | $3,794 | 9.0× |
| CT lower ext w/o (73700) | $459.06 | $1,093 | 4.4× |
| CT lower extremity w/contrast material (73701) | $752.64 | $1,792 | 4.3× |
| CT lumbar spine w contrast (72132) | $1,551.48 | $3,694 | 4.4× |
| CT lumbar spine w/o contrast (72131) | $459.06 | $1,093 | 4.4× |
| CT maxillofacial w contrast (70487) | $684.18 | $1,629 | 3.9× |
| CT maxillofacial wo contrast (70486) | $417.48 | $994 | 4.0× |
| CT neck tissue combo (70492) | $726.18 | $1,729 | 4.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $726.18 | $1,729 | 4.1× |
| CT orbits w/o contrast (70480) | $417.48 | $994 | 4.0× |
| CT pelvis w&w/o contrast (72194) | $794.64 | $1,892 | 4.5× |
| CT pelvis w/o contrast (72192) | $459.06 | $1,093 | 4.4× |
| CT scan of leg combo (73702) | $794.64 | $1,892 | 4.5× |
| CT scans face/jaw combo (70488) | $726.18 | $1,729 | 4.1× |
| CT soft tissue neck w contrast (70491) | $684.18 | $1,629 | 3.9× |
| CT soft tissue neck w/o contrast (70490) | $417.48 | $994 | 4.0× |
| CT thoracic spine w contrast (72129) | $752.64 | $1,792 | 4.3× |
| CT thoracic spine w/o contrast (72128) | $459.06 | $1,093 | 4.4× |
| CT thoracic spine w/wo cont (72130) | $794.64 | $1,892 | 4.5× |
| CT thorax w/o contrast (71250) | $459.06 | $1,093 | 4.4× |
| CT upper ext wo (73200) | $459.06 | $1,093 | 4.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,593.48 | $3,794 | 9.0× |
| CT upper extremity with contrast (73201) | $1,551.48 | $3,694 | 4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $752.64 | $1,792 | 4.3× |
| Cta Abdomen (74175) | $752.64 | $1,792 | 4.3× |
| CTA pelvis (72191) | $752.64 | $1,792 | 4.3× |
| Dilation ureters/urethra rs&i (74485) | $3,708.18 | $8,829 | 1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $944.16 | $2,248 | 9.0× |
| Dxa Bone Density Axial (77080) | $383.46 | $913 | 3.7× |
| Dxa bone density study (77085) | $111.30 | $265 | 1.1× |
| Echo exam of fetal heart (76825) | $944.16 | $2,248 | 1.7× |
| Echo Guide For Artery Repair (76936) | $269.64 | $642 | 1.2× |
| Echograp Trans R Pros Study (76873) | $512.82 | $1,221 | 4.9× |
| Esophagram (74220) | $369.18 | $879 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $655.62 | $1,561 | 6.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $258.30 | $615 | 2.5× |
| Fluoroscopy up to 1 hr (76000) | $234.78 | $559 | 1.0× |
| Follow-Up Angiography (75898) | $3,514.98 | $8,369 | 1.1× |
| Foot 2 views (73620) | $284.76 | $678 | 3.3× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$172.20–$217.14 | $410–$517 | varies |
| Gastric emptying imaging study (78264) | $1,666.14 | $3,967 | 4.1× |
| Gastroesophageal Reflux Exam (78262) | $1,666.02 | $3,966.71 | 4.1× |
| Gated Heart Planar Single (78472) | $1,666.14 | $3,967 | 4.1× |
| GI Endoscopic US S&I (76975) | $323.82 | $771 | 1.4× |
| Hand 2 views (73120) | $224.28 | $534 | 2.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $9,548.70 | $22,735 | 13.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,914.46 | $16,463 | 9.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,837.60 | $16,280 | 9.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,538.14 | $15,567 | 2.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,917.74 | $6,947 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $2,162.04 | $5,147.71 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,666.14 | $3,967 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $2,499 | $5,950 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $341.04 | $812 | 3.9× |
| Infant hip ultrasound, limited static exam (76886) | $341.04 | $812 | 3.9× |
| Joint Survey Single View (77077) | $141.12 | $336 | 1.3× |
| K Flow/Funct Image Multiple (78709) | $907.20 | $2,160 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $743.10 | $1,769.29 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $659.10 | $1,569.29 | 1.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,666.14 | $3,967 | 4.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $611.52 | $1,456 | 1.5× |
| Knee 3 Views (73562) | $284.76 | $678 | 3.3× |
| Leveen/Shunt Patency Exam (78291) | $1,666.14 | $3,967 | 4.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,666.02 | $3,966.71 | 4.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $458.22 | $1,091 | 1.1× |
| Liver imaging static only (78201) | $2,162.04 | $5,147.71 | 4.0× |
| Lung Perf&Ventilat Diferentl (78598) | $1,833.30 | $4,365 | 3.4× |
| Lung perfusion differential (78597) | $1,666.14 | $3,967 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,997.10 | $4,755 | 3.7× |
| Lung Ventilation Imaging (78579) | $1,666.14 | $3,967 | 4.1× |
| Lymph System Imaging (78195) | $2,162.04 | $5,147.71 | 4.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,233.60 | $10,080 | 1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,966.06 | $9,443 | 1.3× |
| Meckels Divert Exam (78290) | $1,666.02 | $3,966.71 | 4.1× |
| Mlc imrt design & construction per imrt plan (77338) | $2,016 | $4,800 | 5.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,240.68 | $2,954 | 3.5× |
| MRA head w/o contrast (70544) | $749.28 | $1,784 | 3.1× |
| MRA head with contrast (70545) | $1,198.68 | $2,854 | 3.4× |
| MRA neck w contrast (70548) | $1,198.68 | $2,854 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,240.68 | $2,954 | 3.5× |
| MRA neck w/o contrast (70547) | $749.28 | $1,784 | 3.1× |
| MRI abdomen w contrast (74182) | $1,198.68 | $2,854 | 3.4× |
| MRI abdomen w/o contrast (74181) | $749.28 | $1,784 | 3.1× |
| MRI any jt lower extrem w/contrast material (73722) | $2,328.90 | $5,545 | 3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,878.68 | $6,854 | 8.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,328.90 | $5,545 | 3.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $749.28 | $1,784 | 3.1× |
| MRI cardiac w/o contrast (75557) | $749.28 | $1,784 | 3.1× |
| MRI cervical spine w contrast (72142) | $1,198.68 | $2,854 | 3.4× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$665.28–$749.28 | $1,584–$1,784 | varies |
| MRI chest w/o contrast (71550) | $749.28 | $1,784 | 3.1× |
| MRI chest wo w contrast (71552) | $1,198.68 | $2,854 | 3.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $4,307.10 | $10,255 | 12.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,198.68 | $2,854 | 3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $749.28 | $1,784 | 3.1× |
| MRI lumbar spine w contrast (72149) | $988.68 | $2,354 | 2.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,240.68 | $2,954 | 3.5× |
| MRI orbit face &/neck w/o contrast (70540) | $749.28 | $1,784 | 3.1× |
| MRI orbit face neck w contrast (70542) | $1,198.68 | $2,854 | 3.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,240.68 | $2,954 | 3.5× |
| MRI pelvis w contrast (72196) | $1,198.68 | $2,854 | 3.4× |
| MRI pelvis w/o & w contrast (72197) | $441.31 | $2,954 | 1.3× |
| MRI pelvis w/o contrast (72195) | $749.28 | $1,784 | 3.1× |
| MRI spectroscopy (76390) | $263.34 | $627 | 3.0× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$665.28–$749.28 | $1,584–$1,784 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,594.76 | $6,178 | 7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $749.28 | $1,784 | 3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,198.68 | $2,854 | 3.4× |
| MRI, abdomen, combo (74183) | $441.31 | $2,954 | 1.3× |
| MRI, dorsal spine combo (72157) | $1,240.68 | $2,954 | 3.5× |
| MRI, dorsal spine contrast (72147) | $1,198.68 | $2,854 | 3.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$665.28–$749.28 | $1,584–$1,784 | varies |
| MRI, joint upper extrem combo (73223) | $2,370.90 | $5,645 | 6.8× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,156.68–$1,240.68 | $2,754–$2,954 | varies |
| Myelogram Lumbar (72265) | $729.12 | $1,736 | 0.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,666.02 | $3,966.71 | 4.1× |
| Myocardial Spect Multiple Studies (78452) | $5,769.30 | $13,736.42 | 4.4× |
| Neck soft tissue (70360) | $167.16 | $398 | 1.9× |
| Nm csf leak detection (78650) | $5,769.12 | $13,736 | 4.4× |
| Nonvascular Shunt X-Ray (75809) | $225.54 | $537 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,283.64 | $17,342 | 5.2× |
| Nuclear Rx Intra-Arterial (79445) | $1,102.92 | $2,626 | 4.7× |
| Nuclear Rx Oral Admin (79005) | $1,102.92 | $2,626 | 4.7× |
| Ob us nuchal meas 1 gest (76813) | $459.06 | $1,093 | 4.4× |
| Optic foramina (70190) | $284.76 | $678 | 3.3× |
| Panoramic X-ray of jaws (70355) | $284.76 | $678 | 3.3× |
| Parathyroid Planar Imaging (78070) | $1,666.02 | $3,966.71 | 4.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,666.02 | $3,966.71 | 4.1× |
| Pelvis 1 or 2 views (72170) | $383.46 | $913 | 3.7× |
| Peritoneogram Rs&I (74190) | $690.90 | $1,645 | 1.3× |
| Pet Image Skull-Thigh (78812) | $1,520.82 | $3,621 | 1.1× |
| PET image w/CT, full body (78816) | $8,962.80 | $21,340 | 6.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,122.80 | $19,340 | 5.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,917.74 | $6,947 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,666.14 | $3,967 | 4.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $225.54 | $537 | 2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,300.32 | $3,096 | 2.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $284.76 | $678 | 3.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $284.76 | $678 | 3.3× |
| Radex elbow complete minimum 3 views (73080) | $284.76 | $678 | 3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $383.46 | $913 | 3.7× |
| Radex fingr minimum 2 views (73140) | $284.76 | $678 | 3.3× |
| Radex foot complete minimum 3 views (73630) | $284.76 | $678 | 3.3× |
| Radex Hand Minimum 3 Views (73130) | $326.76 | $778 | 3.7× |
| Radex lower extremity infant minimum 2 views (73592) | $284.76 | $678 | 3.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $383.46 | $913 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $284.76 | $678 | 3.3× |
| Radex Ribs Unilateral 2 Views (71100) | $284.76 | $678 | 3.3× |
| Radex shoulder complete minimum 2 views (73030) | $284.76 | $678 | 3.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $284.76 | $678 | 3.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $369.18 | $879 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $284.76 | $678 | 3.3× |
| Radex Sternum Minimum 2 Views (71120) | $284.76 | $678 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $284.76 | $678 | 3.3× |
| Radex Toe Minimum 2 Views (73660) | $284.76 | $678 | 3.3× |
| Radex upper extremity infant minimum 2 views (73092) | $383.46 | $913 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $284.76 | $678 | 3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $383.46 | $913 | 3.7× |
| Radiation treatment delivery level 1 (77402) | $1,021.02 | $2,431 | 10.0× |
| Radiation treatment delivery level 2 (77407) | $1,189.02 | $2,831 | 3.1× |
| Radiation treatment delivery level 3 (77412) | $2,064.30 | $4,915 | 3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $383.46 | $913 | 3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $225.54 | $537 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $369.18 | $879 | 2.1× |
| Radiologic exam colon single contrast study (74270) | $369.18 | $879 | 2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $966.42 | $2,301 | 5.5× |
| Radiologic exam knee complete 4/more views (73564) | $383.46 | $913 | 3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $383.46 | $913 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $369.18 | $879 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $369.18 | $879 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $369.18 | $879 | 2.1× |
| Radiologic examination femur 1 view (73551) | $284.76 | $678 | 3.3× |
| Radiologic examination femur minimum 2 views (73552) | $284.76 | $678 | 3.3× |
| Radiologic examination knee 1/2 views (73560) | $284.76 | $678 | 3.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $383.46 | $913 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$213.36–$284.76 | $508–$678 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,102.92 | $2,626 | 4.7× |
| Ribs bilateral 3 views (71110) | $383.46 | $913 | 3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,666.02 | $3,966.71 | 4.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,389.84 | $10,452 | 8.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,769.30 | $13,736.42 | 10.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,039.56 | $9,618 | 7.4× |
| Rp Therapy Intravenous Administration (79101) | $1,102.92 | $2,626 | 4.7× |
| Scapula (73010) | $383.46 | $913 | 3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $52.92 | $126 | 2.3× |
| Shoulder 1 view (73020) | $284.76 | $678 | 3.3× |
| Shoulder Arthrography (73040) | $375.48 | $894 | 1.1× |
| Sialogram (70390) | $475.86 | $1,133 | 2.0× |
| Skull less than 4 views (70250) | $383.46 | $913 | 3.7× |
| Special dosimetry (77331) | $661.50 | $1,575 | 4.9× |
| Special Physics Consult (77370) | $2,694.72 | $6,416 | 20.0× |
| Special teletherapy port plan (77321) | $2,038.68 | $4,854 | 5.4× |
| Special treatment procedure (77470) | $4,605.30 | $10,965 | 8.3× |
| Srs Multisource (77371) | $50,984.64 | $121,392 | 6.9× |
| Stereotactic Body Radiation Delivery (77373) | $3,435.60 | $8,180 | 1.9× |
| Sternoclavicular joints (71130) | $284.76 | $678 | 3.3× |
| Superior sagittal sinus venogram (75870) | $2,917.74 | $6,947 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,409.54 | $5,737 | 6.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,623.76 | $8,628 | 9.6× |
| Ther rad simulaj-aided field setting simple (77280) | $1,578.36 | $3,758 | 11.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $181.86 | $433 | 1.0× |
| Thoracic spine 2 views (72070) | $383.46 | $913 | 3.7× |
| Thoracic spine 3 views (72072) | $383.46 | $913 | 3.7× |
| Thoracolumbar 2 views (72080) | $284.76 | $678 | 3.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,666.02 | $3,966.71 | 4.1× |
| Thyroid Met Imaging Body (78018) | $2,162.16 | $5,148 | 4.0× |
| Thyroid Uptake Measurement (78012) | $1,666.02 | $3,966.71 | 4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,451.52 | $3,456 | 3.6× |
| Tx Devices Design & Construction Complex (77334) | $1,713.60 | $4,080 | 4.6× |
| Tx devices design & construction intermediate (77333) | $1,390.62 | $3,311 | 10.3× |
| Tx devices design & construction simple (77332) | $695.52 | $1,656 | 5.2× |
| Ultrasound Breast Limited (76642) | $341.04 | $812 | 3.9× |
| Ultrasound Exam Aaa Screen (76706) | $468.72 | $1,116 | 4.5× |
| Ultrasound, abdomen limited (76705) | $459.06 | $1,093 | 4.4× |
| Umbilical-artery Doppler (OB) (76820) | $140.28 | $334 | 1.3× |
| Unlisted us procedure (76999) | $341.04 | $812 | 3.9× |
| Upper gi w/o kub (74240) | $369.18 | $879 | 2.1× |
| Ureteral Reflux Study (78740) | $1,666.14 | $3,967 | 4.1× |
| Urethrocystogram voiding (74455) | $475.86 | $1,133 | 2.0× |
| Urethrocystography retrograde (74450) | $475.86 | $1,133 | 2.0× |
| Us breast unilateral complete (76641) | $459.06 | $1,093 | 4.4× |
| Us chest (76604) | $459.06 | $1,093 | 4.4× |
| Us complete joint (76881) | $459.06 | $1,093 | 4.4× |
| Us exam, pelvic, limited (76857) | $459.06 | $1,093 | 4.4× |
| Us head (76506) | $459.06 | $1,093 | 4.4× |
| Us kidney transplant (76776) | $459.06 | $1,093 | 4.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $459.06 | $1,093 | 4.4× |
| Us ob detailed single fetus (76811) | $591.36 | $1,408 | 2.5× |
| Us ob limited 1 or more fetuses (76815) | $512.82 | $1,221 | 4.9× |
| Us ob transvaginal (76817) | $512.82 | $1,221 | 4.9× |
| Us pelvic non ob complete (76856) | $459.06 | $1,093 | 4.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $512.82 | $1,221 | 4.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $512.82 | $1,221 | 4.9× |
| Us retroperitoneal complete (76770) | $459.06 | $1,093 | 4.4× |
| Us retroperitoneal limited (76775) | $459.06 | $1,093 | 4.4× |
| Us scrotum and contents (76870) | $459.06 | $1,093 | 4.4× |
| Us spinal canal and contents (76800) | $459.06 | $1,093 | 4.4× |
| Us thyroid (76536) | $459.06 | $1,093 | 4.4× |
| Vascular Flow Imaging (78445) | $1,666.02 | $3,966.71 | 4.1× |
| Vein X-Ray Chest (75827) | $1,433.88 | $3,414 | 0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,917.74 | $6,947 | 0.9× |
| Vein X-Ray Spleen/Liver (75810) | $4,522.14 | $10,767 | 1.4× |
| Venogram Sinus/Jugular (75860) | $3,514.98 | $8,369 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $2,917.74 | $6,947 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,433.88 | $3,414 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,433.88 | $3,414 | 0.9× |
| Venography Renal Bilateral (75833) | $4,361.28 | $10,384 | 1.4× |
| Venography Renal Unilateral (75831) | $2,917.74 | $6,947 | 0.9× |
| Venous sampling by catheter (75893) | $4,864.02 | $11,581 | 0.9× |
| Wrist 2 views (73100) | $224.28 | $534 | 2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $284.76 | $678 | 3.3× |
| X-ray antegrade pyelogram tube (74425) | $660.24 | $1,572 | 1.9× |
| X-Ray Aorta Leg Arteries (75630) | $2,917.74 | $6,947 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $383.46 | $913 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $224.28 | $534 | 2.6× |
| X-Ray Exam Breast Specimen (76098) | $1,060.92 | $2,526 | 1.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $284.76 | $678 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $383.46 | $913 | 3.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $383.46 | $913 | 3.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $284.76 | $678 | 3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $284.76 | $678 | 3.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $383.46 | $913 | 3.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $383.46 | $913 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $383.46 | $913 | 3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $383.46 | $913 | 3.7× |
| X-Ray Exam L-S Spine Bending (72114) | $383.46 | $913 | 3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $284.76 | $678 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $383.46 | $913 | 3.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $383.46 | $913 | 3.7× |
| X-ray eye for foreign body (70030) | $167.16 | $398 | 1.9× |
| X-ray humerus (73060) | $224.28 | $534 | 2.6× |
| X-ray IV pyelogram (ivp) (74400) | $369.18 | $879 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $284.76 | $678 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $284.76 | $678 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $246.96 | $588 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $167.16 | $398 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $383.46 | $913 | 3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $383.46 | $913 | 3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $383.46 | $913 | 3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $284.76 | $678 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $284.76 | $678 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $383.46 | $913 | 3.7× |
| X-Ray Stress View (77071) | $284.76 | $678 | 3.3× |
| X-ray thoracic spine 4 vw (72074) | $383.46 | $913 | 3.7× |
| X-Ray Tmj Unilat (70328) | $284.76 | $678 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $761.46 | $1,813 | 2.2× |
| X-Rays Bone Length Studies (77073) | $383.46 | $913 | 3.7× |
| X-Rays Bone Survey Complete (77075) | $383.46 | $913 | 3.7× |
| Xr c-spine 4 or 5 views (72050) | $383.46 | $913 | 3.7× |
| Xr facial bones less than 3 views (70140) | $284.76 | $678 | 3.3× |
| Xr orbits complete 4 views (70200) | $383.46 | $913 | 3.7× |
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.