Imaging prices at Danbury Hospital

Danbury, CT · every code in this section with a posted price and a Medicare benchmark.

399 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,753 $5,753 3.5×
Abdomen 1 View (74018) $336 $336 3.2×
Abdomen 2 views (74019) $405 $405 3.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,379 $1,379 2.9×
Adrenal Cortex & Medulla Img (78075) $4,750 $4,750 3.1×
Angio internal mammary (75756) $8,459 $8,459 2.2×
Angio pulmonary bilat (75743) $8,459 $8,459 2.2×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $8,459 $8,459 2.2×
Angiography extremity bilateral rs&i (75716) $8,459 $8,459 2.2×
Angiography extremity unilateral rs&i (75710)
range across 3 matching MRF lines		 $6,916–$8,459 $6,916–$8,459 varies
Angiography pulmonary unilateral slctv rs&i (75741) $8,459 $8,459 2.2×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $8,459 $8,459 2.2×
Ankle 2 views (73600) $385 $385 3.7×
Aortography thoracic serialography rs&i (75605) $14,583 $14,583 2.2×
Artery X-Rays Abdomen (75726) $14,583 $14,583 2.2×
Artery X-Rays Adrenal Gland (75731) $8,459 $8,459 2.2×
Artery X-Rays Pelvis (75736) $14,583 $14,583 2.2×
Artery X-Rays Spine (75705) $14,583 $14,583 2.2×
Arthrogram ankle (73615) $1,631 $1,631 3.9×
Arthrogram hip (73525) $2,153 $2,153 5.1×
Basic radiation dosimetry calculation (77300) $632 $632 3.9×
Bone age studies (77072) $466 $466 3.7×
Bone Imaging 3 Phase (78315) $1,379 $1,379 2.9×
Bone Imaging Limited Area (78300) $1,379 $1,379 2.9×
Bone Imaging Multiple Areas (78305) $1,379 $1,379 2.9×
Bone Imaging Whole Body (78306) $1,379 $1,379 2.9×
Bone marrow imaging limited area (78102) $1,379 $1,379 2.9×
Bone marrow imaging; multiple areas (78103) $1,379 $1,379 2.9×
Bone marrow imaging; whole body (78104) $1,379 $1,379 2.9×
Bone survey infant (77076) $466 $466 3.7×
Brachytx isodose complex (77318) $988 $988 2.2×
Brachytx isodose intermed (77317) $809 $809 1.8×
Brachytx Isodose Plan Simple (77316) $559 $559 1.2×
Brain Flow Imaging Only (78610) $1,808 $1,808 2.8×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,808 $1,808 2.8×
Brain Imaging Pet Metabolic Evaluation (78608) $5,234 $5,234 3.1×
Cardiac MRI w/w/o contrast & further seq (75561) $1,930 $1,930 4.6×
Cat Scan Follow-Up Study (76380) $1,140 $1,140 10.9×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,808 $1,808 2.8×
Cerebrospinal Fluid Scan (78630) $1,808 $1,808 2.8×
Chest 1 view (71045) $374 $374 3.6×
Chest 2 views (71046) $374 $374 3.6×
Chest 3 views (71047) $374 $374 3.6×
Chest 4 or more views (71048) $454 $454 3.6×
Clavicle complete (73000)
range across 3 matching MRF lines		 $385–$419 $385–$419 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $306 $306 2.4×
Continuing medical physics consltj pr wk (77336) $1,521 $1,521 9.4×
Contrast Exam Abdominl Aorta (75625) $8,459 $8,459 2.2×
Contrast X-Ray Bladder (74430) $1,420 $1,420 3.4×
Contrast X-Ray Of Knee Joint (73580) $1,293 $1,293 3.1×
CT abdomen and pelvis without and with contrast (74178) $4,829 $4,829 11.5×
CT abdomen and pelvis without contrast (74176) $3,076 $3,076 10.8×
CT abdomen w contrast (74160) $2,307 $2,307 11.0×
CT abdomen w wo contrast (74170) $2,307 $2,307 11.0×
CT abdomen w/o contrast (74150) $1,380 $1,380 11.0×
CT Angio Abdomen and Pelvis (74174) $4,829 $4,829 11.5×
CT Angio Chest (71275) $2,307 $2,307 11.0×
CT Angio Head (70496) $2,621 $2,621 12.5×
CT angio hrt w/3d image (75574) $2,307 $2,307 5.5×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines		 $2,307–$2,385 $2,307–$2,385 varies
CT Angio Neck (70498) $2,621 $2,621 12.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,307 $2,307 11.0×
CT cervical spine w/ contrast (72126) $5,486 $5,486 13.1×
CT cervical spine w/o contrast (72125) $1,568 $1,568 12.5×
CT cervical spine w/wo cont (72127) $5,486 $5,486 26.1×
CT chest w contrast (71260) $2,307 $2,307 11.0×
CT chest w/wo contrast (71270) $2,307 $2,307 11.0×
CT colonography screening (74263) $2,490 $2,490 8.7×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $2,307 $2,307 11.0×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,380 $1,380 11.0×
CT head/brain with contrast (70460) $2,621 $2,621 12.5×
CT head/brain without and with contrast (70470) $2,621 $2,621 12.5×
CT heart contrast eval cardiac structure&morph (75572) $2,307 $2,307 5.5×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 0.9×
CT iac w contrast (70481) $2,621 $2,621 12.5×
CT l-spine w&w/o contrast (72133) $4,829 $4,829 23.0×
CT lower ext w/o (73700)
range across 3 matching MRF lines		 $1,380–$1,726 $1,380–$1,726 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines		 $1,981–$2,307 $1,981–$2,307 varies
CT lumbar spine w contrast (72132) $4,829 $4,829 11.5×
CT lumbar spine w/o contrast (72131) $1,380 $1,380 11.0×
CT maxillofacial w contrast (70487) $2,621 $2,621 12.5×
CT maxillofacial wo contrast (70486) $1,568 $1,568 12.5×
CT neck tissue combo (70492) $2,621 $2,621 12.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,621 $2,621 12.5×
CT orbits w/o contrast (70480) $1,568 $1,568 12.5×
CT pelvis w&w/o contrast (72194) $2,307 $2,307 11.0×
CT pelvis w/o contrast (72192) $1,380 $1,380 11.0×
CT scan of leg combo (73702) $2,307 $2,307 11.0×
CT scans face/jaw combo (70488) $2,621 $2,621 12.5×
CT soft tissue neck w contrast (70491) $2,621 $2,621 12.5×
CT soft tissue neck w/o contrast (70490) $1,568 $1,568 12.5×
CT thoracic spine w contrast (72129) $2,307 $2,307 11.0×
CT thoracic spine w/o contrast (72128) $1,380 $1,380 11.0×
CT thoracic spine w/wo cont (72130) $2,307 $2,307 11.0×
CT thorax w/o contrast (71250) $1,380 $1,380 11.0×
CT unlisted procedure (76497) $1,140 $1,140 10.9×
CT upper ext wo (73200)
range across 3 matching MRF lines		 $1,380–$1,726 $1,380–$1,726 varies
CT upper extremity w/o & w/contrast material (73202) $4,829 $4,829 23.0×
CT upper extremity with contrast (73201) $4,829 $4,829 11.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,307 $2,307 11.0×
Cta Abdomen (74175) $2,307 $2,307 11.0×
CTA pelvis (72191) $2,307 $2,307 11.0×
Dilation ureters/urethra rs&i (74485) $7,524 $7,524 3.0×
Discography Cerv/Thor Spine (72285) $8,190 $8,190 3.5×
Diskography lumbar (72295) $8,190 $8,190 3.5×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $627 $627 5.0×
Doppler Echo Fetal Spectral Display Complete (76827) $627 $627 5.0×
Doppler Fetal Mid Cerebral Artery (76821) $292 $292 2.3×
Dxa Bone Density Axial (77080) $466 $466 3.7×
Dxa bone density study (77085) $292 $292 2.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $385 $385 3.7×
Echo exam of fetal heart (76825) $3,146 $3,146 4.8×
Echo exam uterus (76831) $1,397 $1,397 4.9×
Echo Guide For Artery Repair (76936) $832 $832 3.2×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,397 $1,397 4.9×
Echograp Trans R Pros Study (76873) $627 $627 5.0×
Esophagram (74220) $678 $678 3.2×
Fetal Biophys Profile W/Nst (76818) $627 $627 5.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $627–$1,233 $627–$1,233 varies
Fluoroscopy up to 1 hr (76000) $650 $650 2.3×
Follow-Up Angiography (75898) $8,459 $8,459 2.2×
Foot 2 views (73620) $385 $385 3.7×
Forearm 2 views (73090)
range across 3 matching MRF lines		 $385–$441 $385–$441 varies
Gastric emptying imaging study (78264) $1,379 $1,379 2.9×
Gastroesophageal Reflux Exam (78262) $1,379 $1,379 2.9×
Gated Heart Planar Single (78472) $1,379 $1,379 2.9×
Hand 2 views (73120) $466 $466 3.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $4,947 $4,947 5.9×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,709 $4,709 5.6×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $4,319 $4,319 5.2×
Heart Image (Pet) Multiple (78492) $5,234 $5,234 3.1×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $8,459 $8,459 2.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $8,459 $8,459 2.2×
Hepatobil Syst Image W/Drug (78227) $1,808 $1,808 2.8×
Hepatobiliary System Imaging (78226) $1,379 $1,379 2.9×
Ht Muscle Image Spect Sing (78451) $4,750 $4,750 3.1×
Hysterosalpingogram (74740) $904 $904 3.2×
Infant hip ultrasound with hip movement (dynamic) (76885) $518 $518 5.0×
Interstitial radiation source applic complex (77778) $4,829 $4,829 5.8×
K Flow/Funct Image Multiple (78709) $1,808 $1,808 2.8×
K Flow/Funct Image W/Drug (78708) $1,808 $1,808 2.8×
K Flow/Funct Image W/O Drug (78707) $1,808 $1,808 2.8×
Kidney Imaging Morphol (78700) $1,379 $1,379 2.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,379 $1,379 2.9×
Knee 3 Views (73562)
range across 3 matching MRF lines		 $385–$440 $385–$440 varies
Leveen/Shunt Patency Exam (78291) $1,379 $1,379 2.9×
Liver & Spleen Imaging Static Only (78215) $1,604 $1,604 3.3×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,379 $1,379 2.9×
Liver imaging static only (78201) $1,808 $1,808 2.8×
Lung Perf&Ventilat Diferentl (78598) $1,808 $1,808 2.8×
Lung Ventilat&Perfus Imaging (78582) $1,808 $1,808 2.8×
Lymph System Imaging (78195) $1,808 $1,808 2.8×
Lymphangiography extremity only unilateral rs&i (75801) $1,666 $1,666 2.2×
Lymphangiography, pelvic/abdominal, unilateral (75805) $8,459 $8,459 2.2×
Magnetic Image Jaw Joint (70336) $1,229 $1,229 4.3×
Magnetic Resonance Elastography (76391) $1,229 $1,229 4.3×
Mammary ductogram or galactogram single (77053) $1,011 $1,011 3.5×
Meckels Divert Exam (78290) $1,379 $1,379 2.9×
Mlc imrt design & construction per imrt plan (77338) $5,317 $5,317 11.8×
Mra Head W/O & W/Contrast Material (70546) $1,755 $1,755 4.2×
MRA head w/o contrast (70544) $1,118 $1,118 3.9×
MRA head with contrast (70545) $1,755 $1,755 4.2×
MRA neck w contrast (70548) $1,755 $1,755 4.2×
Mra Neck W/O &W/Contrast Material (70549) $1,755 $1,755 4.2×
MRA neck w/o contrast (70547) $1,118 $1,118 3.9×
MRI abdomen w contrast (74182) $1,930 $1,930 4.6×
MRI abdomen w/o contrast (74181) $1,229 $1,229 4.3×
MRI any jt lower extrem w/contrast material (73722) $4,019 $4,019 4.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,019 $4,019 9.6×
MRI any jt upper extremity w/contrast matrl (73222) $4,019 $4,019 4.3×
MRI brain functional w/o physician admnistration (70554) $1,118 $1,118 3.9×
MRI Breast W/O Contrast Bilateral (77047) $1,229 $1,229 4.3×
MRI Breast Without Contrast Material Unilateral (77046) $1,229 $1,229 4.3×
MRI cardiac w/o contrast (75557) $1,229 $1,229 4.3×
MRI cervical spine w contrast (72142) $1,755 $1,755 4.2×
MRI cervical spine w/o cont (72141) $1,118 $1,118 3.9×
MRI chest w/o contrast (71550) $1,229 $1,229 4.3×
MRI chest with contrast (71551) $4,019 $4,019 4.3×
MRI chest wo w contrast (71552) $4,019 $4,019 9.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,930 $1,930 4.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,930 $1,930 4.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,229 $1,229 4.3×
MRI lumbar spine w contrast (72149) $1,930 $1,930 4.6×
Mri Neck Spine W/O & W/Dye (72156) $1,755 $1,755 4.2×
MRI orbit face &/neck w/o contrast (70540) $1,118 $1,118 3.9×
MRI orbit face neck w contrast (70542) $1,755 $1,755 4.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,755 $1,755 4.2×
MRI pelvis w contrast (72196) $1,930 $1,930 4.6×
MRI pelvis w/o & w contrast (72197) $1,930 $1,930 4.6×
MRI pelvis w/o contrast (72195) $1,229 $1,229 4.3×
MRI spectroscopy (76390) $456 $456 4.4×
MRI thoracic spine w/o contrast (72146) $1,229 $1,229 4.3×
MRI upper extremity oth than jt w/contr matrl (73219) $1,930 $1,930 4.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,229 $1,229 4.3×
Mri Uppr Extremity W/O&W/Dye (73220) $1,930 $1,930 4.6×
MRI, abdomen, combo (74183) $1,930 $1,930 4.6×
MRI, dorsal spine combo (72157) $1,930 $1,930 4.6×
MRI, dorsal spine contrast (72147) $1,930 $1,930 4.6×
MRI, joint upper extrem (73221) $1,229 $1,229 4.3×
MRI, joint upper extrem combo (73223) $4,019 $4,019 9.6×
MRI, lumbar spine combo (72158) $1,930 $1,930 4.6×
Myelogram cervical (72240) $2,124 $2,124 2.3×
Myelogram Lumbar (72265) $2,124 $2,124 2.3×
Myelography thoracic (72255) $2,124 $2,124 2.3×
Myelograpy 2/more regions rs&i (72270) $2,124 $2,124 2.3×
Myocardial Imaging Pet Metabolic Evaluation (78459) $4,750 $4,750 3.1×
Myocardial Spect Multiple Studies (78452) $4,750 $4,750 3.1×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $5,234 $5,234 3.1×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $5,234 $5,234 3.1×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $7,902 $7,902 3.0×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $6,848 $6,848 2.6×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $6,498 $6,498 3.6×
N-invas est c ffr sw aly CTA (75580) $13,129 $13,129 12.8×
Neck soft tissue (70360) $336 $336 3.2×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $531 $531 1.1×
Nm csf leak detection (78650) $4,750 $4,750 3.1×
Nonvascular Shunt X-Ray (75809) $405 $405 3.2×
Ntsty modul radthx pln dose-vol histos (77301) $8,080 $8,080 4.9×
Nuclear Rx Intra-Arterial (79445) $831 $831 3.0×
Nuclear Rx Oral Admin (79005) $831 $831 3.0×
Ob us nuchal meas 1 gest (76813) $627 $627 5.0×
Ophthalmic Ultrasonic Foreign Body Localization (76529)
range across 2 matching MRF lines		 $123–$518 $123–$518 varies
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 2 matching MRF lines		 $117–$627 $117–$627 varies
Ophthalmic us dx quantitative a-scan only (76511)
range across 2 matching MRF lines		 $137–$669 $137–$669 varies
Panoramic X-ray of jaws (70355) $385 $385 3.7×
Parathyroid Planar Imaging (78070) $1,379 $1,379 2.9×
Parathyroid planar imaging w/wo subtraction (78071) $1,379 $1,379 2.9×
Pelvis 1 or 2 views (72170) $466 $466 3.7×
Pet Image W/Ct Lmtd (78814) $5,234 $5,234 3.1×
PET image w/CT, full body (78816) $5,234 $5,234 3.1×
PET imaging CT attenuation skull base mid-thigh (78815) $5,234 $5,234 3.1×
Pet Myocardial Sngl Study (78491) $5,234 $5,234 3.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $8,459 $8,459 2.2×
Pulmonary Perfusion Imaging Particulate (78580) $1,379 $1,379 2.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $405 $405 3.2×
Radex abscess/fistula/sinus tract rs&i (76080) $2,038 $2,038 3.1×
Radex Ankle Complete Minimum 3 Views (73610) $385 $385 3.7×
Radex Calcaneus Minimum 2 Views (73650)
range across 4 matching MRF lines		 $385–$418 $385–$418 varies
Radex elbow complete minimum 3 views (73080) $385 $385 3.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $466 $466 3.7×
Radex fingr minimum 2 views (73140)
range across 13 matching MRF lines		 $369–$385 $369–$385 varies
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines		 $385–$616 $385–$616 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $385–$578 $385–$578 varies
Radex lower extremity infant minimum 2 views (73592) $385 $385 3.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $466 $466 3.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $385 $385 3.7×
Radex Ribs Unilateral 2 Views (71100) $385 $385 3.7×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $385–$665 $385–$665 varies
Radex Sinuses Paransl < 3 Views (70210) $385 $385 3.7×
Radex Spine 1 View Specify Level (72020) $385 $385 3.7×
Radex Sternum Minimum 2 Views (71120) $385 $385 3.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $385 $385 3.7×
Radex Toe Minimum 2 Views (73660)
range across 12 matching MRF lines		 $369–$385 $369–$385 varies
Radex upper extremity infant minimum 2 views (73092) $466 $466 3.7×
Radex Wrist Complete Minimum 3 Views (73110) $385 $385 3.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $466 $466 3.7×
Radiation treatment delivery level 1 (77402) $1,509 $1,509 12.3×
Radiation treatment delivery level 2 (77407) $1,831 $1,831 4.0×
Radiation treatment delivery level 3 (77412) $2,153 $2,153 3.3×
Radiolog exam mandible compl minimum 4 views (70110) $466 $466 3.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $405 $405 3.2×
Radiologic exam colon double contrast study (74280) $678 $678 3.2×
Radiologic exam colon single contrast study (74270) $678 $678 3.2×
Radiologic Exam Esophagus Double Contrast Study (74221) $678 $678 3.2×
Radiologic exam knee complete 4/more views (73564) $466 $466 3.7×
Radiologic exam pelvis compl minimum 3 views (72190) $466 $466 3.7×
Radiologic Exam Small Int Single Contrast Study (74250) $678 $678 3.2×
Radiologic exam swallow function contrast study (74230) $678 $678 3.2×
Radiologic exam upr gi trc double contrast study (74246) $678 $678 3.2×
Radiologic examination femur 1 view (73551) $385 $385 3.7×
Radiologic examination femur minimum 2 views (73552) $385 $385 3.7×
Radiologic examination knee 1/2 views (73560) $385 $385 3.7×
Radiologic Examination Osseous Survey Limited (77074) $466 $466 3.7×
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines		 $385–$699 $385–$699 varies
Radiopharm Dacryocystography (78660) $1,379 $1,379 2.9×
Ribs bilateral 3 views (71110) $466 $466 3.7×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,379 $1,379 2.9×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,379 $1,379 2.9×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,750 $4,750 7.3×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $4,750 $4,750 7.3×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,750 $4,750 7.3×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $4,750 $4,750 3.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $5,234 $5,234 3.1×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $4,750 $4,750 3.1×
Rp Therapy Intravenous Administration (79101) $831 $831 3.0×
Scapula (73010) $466 $466 3.7×
Screening Digital Breast Tomosynthesis Bi (77063) $92 $92 3.9×
Shoulder 1 view (73020) $385 $385 3.7×
Shoulder Arthrography (73040)
range across 3 matching MRF lines		 $1,020–$2,516 $1,020–$2,516 varies
Skull less than 4 views (70250) $466 $466 3.7×
Special dosimetry (77331) $246 $246 1.5×
Special Physics Consult (77370) $887 $887 5.5×
Special teletherapy port plan (77321) $1,352 $1,352 3.0×
Special treatment procedure (77470) $1,812 $1,812 2.7×
Stereotactic Body Radiation Delivery (77373) $6,836 $6,836 3.2×
Sternoclavicular joints (71130) $385 $385 3.7×
Superior sagittal sinus venogram (75870) $8,459 $8,459 2.2×
Tbs technical calculation only (77091) $130 $130 1.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,252 $1,252 2.8×
Telethx isodose pln smpl w/dosimetry calculation (77306) $547 $547 1.2×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,953 $2,953 6.6×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,110 $1,110 2.5×
Ther rad simulaj-aided field setting simple (77280) $771 $771 4.8×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $343 $343 1.6×
Thoracic spine 2 views (72070) $466 $466 3.7×
Thoracic spine 3 views (72072) $466 $466 3.7×
Thoracolumbar 2 views (72080) $385 $385 3.7×
Thyroid Imaging With Vascular Flow (78013) $1,379 $1,379 2.9×
Thyroid Met Imaging Body (78018) $1,808 $1,808 2.8×
Thyroid Uptake Measurement (78012) $1,379 $1,379 2.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,379 $1,379 2.9×
Tx Devices Design & Construction Complex (77334) $1,114 $1,114 2.5×
Tx devices design & construction intermediate (77333) $634 $634 3.9×
Tx devices design & construction simple (77332) $559 $559 3.5×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $126–$553 $126–$553 varies
Ultrasound Elastography Parenchyma (76981) $627 $627 5.0×
Ultrasound Exam Aaa Screen (76706) $627 $627 5.0×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines		 $99–$627 $99–$627 varies
Umbilical-artery Doppler (OB) (76820) $292 $292 2.3×
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines		 $241–$582 $241–$582 varies
Unlisted fluoroscopic procedure (76496) $241 $241 2.3×
Unlisted us procedure (76999)
range across 3 matching MRF lines		 $297–$518 $297–$518 varies
Upper gi w/o kub (74240) $678 $678 3.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $32 $32 2.9×
Urea breath test c-14 isotopic analysis (78268) $276 $276 2.9×
Urethrocystogram voiding (74455) $904 $904 3.2×
Urethrocystography retrograde (74450) $904 $904 3.2×
Us breast unilateral complete (76641) $627 $627 5.0×
Us chest (76604)
range across 3 matching MRF lines		 $96–$627 $96–$627 varies
Us complete joint (76881) $627 $627 5.0×
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines		 $81–$627 $81–$627 varies
Us head (76506) $627 $627 5.0×
Us kidney transplant (76776) $627 $627 5.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 5 matching MRF lines		 $127–$627 $127–$627 varies
Us ob detailed single fetus (76811) $1,397 $1,397 4.9×
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines		 $153–$627 $153–$627 varies
Us ob transvaginal (76817)
range across 3 matching MRF lines		 $138–$669 $138–$669 varies
Us pelvic non ob complete (76856) $627 $627 5.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $627 $627 5.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $627 $627 5.0×
Us retroperitoneal complete (76770) $627 $627 5.0×
Us retroperitoneal limited (76775)
range across 3 matching MRF lines		 $96–$627 $96–$627 varies
Us scrotum and contents (76870) $627 $627 5.0×
Us spinal canal and contents (76800) $627 $627 5.0×
Us thyroid (76536)
range across 3 matching MRF lines		 $105–$627 $105–$627 varies
Us transrectal (76872) $627 $627 5.0×
Vein X-Ray Chest (75827) $4,249 $4,249 2.3×
Vein X-Ray Liver W/O Hemodyn (75887) $8,459 $8,459 2.2×
Venogram Sinus/Jugular (75860) $8,459 $8,459 2.2×
Venography Adrenal Unilateral (75840) $8,459 $8,459 2.2×
Venography caval inferior serialography rs&i (75825) $8,459 $8,459 2.2×
Venography extremity bilateral rs&i (75822) $4,249 $4,249 2.3×
Venography extremity unilateral rs&i (75820)
range across 3 matching MRF lines		 $2,137–$4,249 $2,137–$4,249 varies
Venography Orbital Rs&I (75880) $1,666 $1,666 2.2×
Venography Renal Bilateral (75833) $8,459 $8,459 2.2×
Venography Renal Unilateral (75831) $8,459 $8,459 2.2×
Venous sampling by catheter (75893) $14,583 $14,583 2.2×
Vertebral fracture assessment via dxa (77086)
range across 2 matching MRF lines		 $241–$633 $241–$633 varies
Wrist 2 views (73100) $385 $385 3.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $385 $385 3.7×
X-ray antegrade pyelogram tube (74425)
range across 3 matching MRF lines		 $528–$1,420 $528–$1,420 varies
X-Ray Aorta Leg Arteries (75630) $8,459 $8,459 2.2×
X-Ray Bend Only L-S Spine (72120) $466 $466 3.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $385 $385 3.7×
X-Ray Exam Breast Specimen (76098)
range across 3 matching MRF lines		 $1,745–$2,277 $1,745–$2,277 varies
X-Ray Exam Entire Spi 1 Vw (72081) $385 $385 3.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $466 $466 3.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $466 $466 3.7×
X-Ray Exam Hip Uni 1 View (73501) $385 $385 3.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $385 $385 3.7×
X-Ray Exam Hip Uni 4/> Views (73503) $466 $466 3.7×
X-Ray Exam Hips Bi 2 Views (73521) $466 $466 3.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $466 $466 3.7×
X-Ray Exam Hips Bi 5/> Views (73523) $466 $466 3.7×
X-Ray Exam L-S Spine Bending (72114) $466 $466 3.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $385 $385 3.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $466 $466 3.7×
X-Ray Exam Unilat Ribs/Chest (71101) $466 $466 3.7×
X-ray eye for foreign body (70030) $336 $336 3.2×
X-ray humerus (73060)
range across 3 matching MRF lines		 $385–$499 $385–$499 varies
X-ray IV pyelogram (ivp) (74400) $678 $678 3.2×
X-ray IV pyelogram+tomography (74415) $678 $678 3.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $385 $385 3.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $385 $385 3.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $466 $466 3.7×
X-ray nose-rectum child f.b. (76010) $336 $336 3.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $466 $466 3.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $466 $466 3.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $466 $466 3.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $385 $385 3.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $385 $385 3.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $466 $466 3.7×
X-ray thoracic spine 4 vw (72074) $466 $466 3.7×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,420 $1,420 3.4×
X-Rays Bone Length Studies (77073) $466 $466 3.7×
X-Rays Bone Survey Complete (77075) $466 $466 3.7×
Xr c-spine 4 or 5 views (72050) $466 $466 3.7×
Xr facial bones less than 3 views (70140) $385 $385 3.7×
Xr orbits complete 4 views (70200) $466 $466 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.