Imaging prices at Dignity Health St. Joseph's Hospital and Medical Center
Phoenix, AZ · every code in this section with a posted price and a Medicare benchmark.
364 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) | $2,962.80 | $7,756 | 2.0× |
| Abdomen 1 View (74018) | $170.38 | $446 | 1.8× |
| Abdomen 2 views (74019) | $326.61 | $855 | 2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,005.81 | $2,633 | 2.4× |
| Angio internal mammary (75756) | $3,433.80 | $8,989 | 1.0× |
| Angio pulmonary bilat (75743) | $8,041.10 | $21,050 | 2.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,138.82 | $5,599 | 0.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,198.95–$4,325.01 | $10,992–$11,322 | varies |
| Angiography extremity unilateral rs&i (75710) | $3,719.54 | $9,737 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,020.55 | $10,525 | 1.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,859.73 | $10,104 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$212.01–$289.56 | $555–$758 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,865.46 | $10,119 | 0.7× |
| Artery X-Rays Abdomen (75726) | $6,240.74 | $16,337 | 1.1× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$3,021.24–$6,427.92 | $7,909–$16,827 | varies |
| Artery X-Rays Spine (75705) | $8,009.78 | $20,968 | 1.3× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$579.50–$870.20 | $1,517–$2,278 | varies |
| Basic radiation dosimetry calculation (77300) | $350.30 | $917 | 2.4× |
| Bone age studies (77072) | $139.43 | $365 | 1.2× |
| Bone Imaging 3 Phase (78315) | $1,254.49 | $3,284 | 2.9× |
| Bone Imaging Limited Area (78300) | $856.45 | $2,242 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,206.36 | $3,158 | 2.8× |
| Bone marrow imaging limited area (78102) | $547.41 | $1,433 | 1.3× |
| Bone survey infant (77076) | $428.99 | $1,123 | 3.8× |
| Brachytx isodose complex (77318) | $1,975.33 | $5,171 | 4.9× |
| Brachytx isodose intermed (77317) | $1,362.98 | $3,568 | 3.4× |
| Brachytx Isodose Plan Simple (77316) | $1,047.07 | $2,741 | 2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,001.23 | $2,621 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,007.57 | $10,491 | 2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,289.64 | $3,376 | 3.5× |
| Cat Scan Follow-Up Study (76380) | $190.24 | $498 | 2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $763.62 | $1,999 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $1,099.02 | $2,877 | 1.9× |
| Chest 1 view (71045) | $215.07 | $563 | 2.3× |
| Chest 2 views (71046) | $254.03 | $665 | 2.7× |
| Chest 3 views (71047) | $294.91 | $772 | 3.2× |
| Chest 4 or more views (71048) | $333.49 | $873 | 3.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $665.45 | $1,742 | 6.0× |
| Clavicle complete (73000) | $314.77 | $824 | 3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $767.82 | $2,010 | 6.9× |
| Continuing medical physics consltj pr wk (77336) | $420.20 | $1,100 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) | $4,370.85 | $11,442 | 1.3× |
| Contrast X-Ray Bladder (74430) | $459.55 | $1,203 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $576.44 | $1,509 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $2,453.59 | $6,423 | 6.6× |
| CT abdomen and pelvis without contrast (74176) | $1,332.42 | $3,488 | 5.2× |
| CT abdomen w contrast (74160) | $1,408.44 | $3,687 | 7.5× |
| CT abdomen w wo contrast (74170) | $1,618.92 | $4,238 | 8.6× |
| CT abdomen w/o contrast (74150) | $906.49 | $2,373 | 8.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,152.96 | $5,636 | 5.8× |
| CT Angio Chest (71275) | $1,626.18 | $4,257 | 8.7× |
| CT Angio Head (70496) | $1,695.32 | $4,438 | 9.1× |
| CT angio hrt w/3d image (75574) | $1,151.35 | $3,014 | 3.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$790.74–$1,186.11 | $2,070–$3,105 | varies |
| CT Angio Neck (70498) | $1,697.23 | $4,443 | 9.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $872.49 | $2,284 | 4.7× |
| CT cervical spine w/ contrast (72126) | $2,139.59 | $5,601 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,828.64 | $4,787 | 16.4× |
| CT cervical spine w/wo cont (72127) | $2,706.47 | $7,085 | 14.5× |
| CT chest w contrast (71260) | $1,505.85 | $3,942 | 8.0× |
| CT chest w/wo contrast (71270) | $1,686.53 | $4,415 | 9.0× |
| CT colonography screening (74263) | $591.34 | $1,548 | 2.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,052.03 | $2,754 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $591.34 | $1,548 | 5.3× |
| CT head/brain with contrast (70460) | $1,699.90 | $4,450 | 9.1× |
| CT head/brain without and with contrast (70470) | $2,004.36 | $5,247 | 10.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,151.35 | $3,014 | 3.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $840.40 | $2,200 | 9.1× |
| CT hrt w/3d image congen (75573) | $1,151.35 | $3,014 | 3.1× |
| CT iac w contrast (70481) | $1,557.42 | $4,077 | 8.3× |
| CT l-spine w&w/o contrast (72133) | $2,646.88 | $6,929 | 14.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$904.20–$1,808.39 | $2,367–$4,734 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,130.34–$2,260.68 | $2,959–$5,918 | varies |
| CT lumbar spine w contrast (72132) | $2,274.43 | $5,954 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $1,960.81 | $5,133 | 17.6× |
| CT maxillofacial w contrast (70487) | $1,070.37 | $2,802 | 5.7× |
| CT maxillofacial wo contrast (70486) | $884.33 | $2,315 | 7.9× |
| CT neck tissue combo (70492) | $1,697.99 | $4,445 | 9.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,681.95 | $4,403 | 9.0× |
| CT orbits w/o contrast (70480) | $1,323.63 | $3,465 | 11.9× |
| CT pelvis w&w/o contrast (72194) | $1,791.20 | $4,689 | 9.6× |
| CT pelvis w/o contrast (72192) | $1,367.18 | $3,579 | 12.3× |
| CT scan of leg combo (73702) | $1,383.61 | $3,622 | 7.4× |
| CT scans face/jaw combo (70488) | $1,300.33 | $3,404 | 6.9× |
| CT soft tissue neck w contrast (70491) | $1,391.63 | $3,643 | 7.4× |
| CT soft tissue neck w/o contrast (70490) | $1,016.12 | $2,660 | 9.1× |
| CT thoracic spine w contrast (72129) | $2,787.08 | $7,296 | 14.9× |
| CT thoracic spine w/o contrast (72128) | $1,858.05 | $4,864 | 16.7× |
| CT thoracic spine w/wo cont (72130) | $2,750.02 | $7,199 | 14.7× |
| CT thorax w/o contrast (71250) | $903.43 | $2,365 | 8.1× |
| CT unlisted procedure (76497) | $112.31 | $294 | 1.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$899.23–$1,798.46 | $2,354–$4,708 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,402.71 | $3,672 | 7.5× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,105.89–$2,212.17 | $2,895–$5,791 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,014.60 | $2,656 | 5.4× |
| Cta Abdomen (74175) | $1,701.05 | $4,453 | 9.1× |
| CTA pelvis (72191) | $498.13 | $1,304 | 2.7× |
| Dilation ureters/urethra rs&i (74485) | $2,000.16 | $5,236 | 0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $475.59 | $1,245 | 4.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $166.17 | $435 | 1.5× |
| Dxa Bone Density Axial (77080) | $229.97 | $602 | 2.1× |
| Dxa bone density study (77085) | $229.97 | $602 | 2.1× |
| Echo exam of fetal heart (76825) | $843.84 | $2,209 | 1.4× |
| Echograp Trans R Pros Study (76873) | $238.37 | $624 | 2.1× |
| Esophagram (74220) range across 2 matching MRF lines |
$374.36–$420.59 | $980–$1,101 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $291.47 | $763 | 2.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $350.68 | $918 | 1.4× |
| Fluoroscopy up to 1 hr (76000) | $411.04 | $1,076 | 1.6× |
| Follow-Up Angiography (75898) | $3,800.90 | $9,950 | 1.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$274.28–$283.83 | $718–$743 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$289.18–$348.77 | $757–$913 | varies |
| Gastric emptying imaging study (78264) | $1,245.32 | $3,260 | 2.9× |
| Gated Heart Planar Single (78472) | $1,446.64 | $3,787 | 3.4× |
| Gated Heart, Multiple (78473) | $1,432.12 | $3,749 | 3.4× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$251.74–$313.63 | $659–$821 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $917.95 | $2,403 | 1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $917.95 | $2,403 | 1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $917.95 | $2,403 | 1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,728.32 | $9,760 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,691.88 | $4,429 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,235.01 | $3,233 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $2,601.04 | $6,809 | 1.9× |
| Hysterosalpingogram (74740) | $719.69 | $1,884 | 2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $369.78 | $968 | 4.0× |
| Interstitial radiation source applic complex (77778) | $3,381.85 | $8,853 | 4.6× |
| K Flow/Funct Image Multiple (78709) | $2,444.04 | $6,398 | 4.2× |
| K Flow/Funct Image W/Drug (78708) | $1,175.04 | $3,076 | 2.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,574.61 | $4,122 | 2.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,456.95 | $3,814 | 3.4× |
| Knee 3 Views (73562) | $366.34 | $959 | 3.9× |
| Liver & Spleen Imaging Static Only (78215) | $560.78 | $1,468 | 1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,128.81 | $2,955 | 2.6× |
| Liver imaging w/vascular flow (78202) | $1,071.13 | $2,804 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,153.26 | $3,019 | 2.0× |
| Lung perfusion differential (78597) | $748.72 | $1,960 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,431.36 | $3,747 | 2.5× |
| Lung Ventilation Imaging (78579) | $730.77 | $1,913 | 1.7× |
| Lymph System Imaging (78195) | $1,236.16 | $3,236 | 2.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,265.57 | $3,313 | 0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $843.46 | $2,208 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $691.04 | $1,809 | 2.7× |
| Magnetic Resonance Elastography (76391) | $359.08 | $940 | 1.4× |
| Mammary ductogram or galactogram single (77053) | $362.90 | $950 | 1.4× |
| Meckels Divert Exam (78290) | $1,016.89 | $2,662 | 2.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,807.25 | $4,731 | 4.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,428.38 | $6,357 | 6.5× |
| MRA head w/o contrast (70544) | $1,167.40 | $3,056 | 4.6× |
| MRA head with contrast (70545) | $1,715.95 | $4,492 | 4.6× |
| MRA neck w contrast (70548) | $1,502.79 | $3,934 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,625.41 | $4,255 | 4.4× |
| MRA neck w/o contrast (70547) | $1,022.24 | $2,676 | 4.0× |
| MRI abdomen w contrast (74182) | $2,440.60 | $6,389 | 6.6× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$370.93–$1,719.39 | $971–$4,501 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,576.52 | $4,127 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,966.92–$3,934.22 | $5,149–$10,299 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,314.47 | $3,441 | 1.6× |
| MRI brain functional w/physician admnistration (70555) | $576.44 | $1,509 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,949.35 | $5,103 | 7.7× |
| MRI cardiac w/o contrast (75557) | $1,121.94 | $2,937 | 4.4× |
| MRI cervical spine w contrast (72142) | $1,795.02 | $4,699 | 4.8× |
| MRI cervical spine w/o cont (72141) | $1,464.97 | $3,835 | 5.8× |
| MRI chest w/o contrast (71550) | $769.35 | $2,014 | 3.0× |
| MRI chest wo w contrast (71552) | $1,282.38 | $3,357 | 3.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,630.38 | $4,268 | 4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,832.08–$3,663.77 | $4,796–$9,591 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,099.02–$2,198.41 | $2,877–$5,755 | varies |
| MRI lumbar spine w contrast (72149) | $1,917.26 | $5,019 | 5.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,063.19 | $5,401 | 5.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,273.21 | $3,333 | 5.0× |
| MRI orbit face neck w contrast (70542) | $1,740.78 | $4,557 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,598.37 | $6,802 | 7.0× |
| MRI pelvis w contrast (72196) | $1,516.93 | $3,971 | 4.1× |
| MRI pelvis w/o & w contrast (72197) | $2,106.73 | $5,515 | 5.7× |
| MRI pelvis w/o contrast (72195) | $1,306.44 | $3,420 | 5.1× |
| MRI spectroscopy (76390) | $371.31 | $972 | 4.0× |
| MRI thoracic spine w/o contrast (72146) | $1,564.68 | $4,096 | 6.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,001.23 | $2,621 | 2.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $803.73 | $2,104 | 3.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,410.35–$2,820.69 | $3,692–$7,384 | varies |
| MRI, abdomen, combo (74183) | $2,773.32 | $7,260 | 7.4× |
| MRI, dorsal spine combo (72157) | $2,203.38 | $5,768 | 5.9× |
| MRI, dorsal spine contrast (72147) | $1,917.26 | $5,019 | 5.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,228.52–$2,457.03 | $3,216–$6,432 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,449.31–$2,899 | $3,794–$7,589 | varies |
| MRI, lumbar spine combo (72158) | $2,203.38 | $5,768 | 5.9× |
| Myelogram cervical (72240) | $1,629.23 | $4,265 | 1.9× |
| Myelogram Lumbar (72265) | $1,629.23 | $4,265 | 1.9× |
| Myelography thoracic (72255) | $1,629.23 | $4,265 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $2,444.04 | $6,398 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $3,133.93 | $8,204 | 2.3× |
| N-invas est c ffr sw aly CTA (75580) | $1,192.23 | $3,121 | 1.3× |
| Neck soft tissue (70360) | $269.31 | $705 | 2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $361.38 | $946 | 0.8× |
| Nm csf leak detection (78650) | $991.68 | $2,596 | 0.7× |
| Nonvascular Shunt X-Ray (75809) | $177.25 | $464 | 1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,222.17 | $8,435 | 2.2× |
| Nuclear Rx Intra-Arterial (79445) | $473.68 | $1,240 | 1.9× |
| Nuclear Rx Oral Admin (79005) | $1,043.25 | $2,731 | 4.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $814.05 | $2,131 | 1.4× |
| Parathyroid Planar Imaging (78070) | $667.74 | $1,748 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $708.23 | $1,854 | 1.7× |
| Pelvis 1 or 2 views (72170) | $289.94 | $759 | 2.6× |
| Perineogram (74775) | $309.42 | $810 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $4,007.57 | $10,491 | 2.6× |
| PET image w/CT, full body (78816) | $4,083.97 | $10,691 | 2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,988.47 | $10,441 | 2.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,983.35 | $5,192 | 1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,619.84 | $9,476 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,015.36 | $2,658 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $680.73 | $1,782 | 6.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$519.91–$626.48 | $1,361–$1,640 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $336.93 | $882 | 3.6× |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$144.40–$148.60 | $378–$389 | varies |
| Radex elbow complete minimum 3 views (73080) | $317.06 | $830 | 3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $232.26 | $608 | 2.1× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$212.40–$218.89 | $556–$573 | varies |
| Radex foot complete minimum 3 views (73630) | $318.97 | $835 | 3.4× |
| Radex Hand Minimum 3 Views (73130) | $364.81 | $955 | 3.9× |
| Radex lower extremity infant minimum 2 views (73592) | $134.85 | $353 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $163.50 | $428 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $302.17 | $791 | 3.3× |
| Radex shoulder complete minimum 2 views (73030) | $323.56 | $847 | 3.5× |
| Radex Sinuses Paransl < 3 Views (70210) | $166.94 | $437 | 1.8× |
| Radex Spine 1 View Specify Level (72020) | $221.56 | $580 | 2.4× |
| Radex Sternum Minimum 2 Views (71120) | $203.61 | $533 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $160.06 | $419 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $211.63 | $554 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $136.76 | $358 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $322.41 | $844 | 3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $527.93 | $1,382 | 4.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $10,377.80 | $27,167 | 1.3× |
| Radiation treatment delivery level 1 (77402) | $361.76 | $947 | 3.3× |
| Radiation treatment delivery level 2 (77407) | $406.83 | $1,065 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $758.27 | $1,985 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $187.95 | $492 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $469.86 | $1,230 | 2.5× |
| Radiologic exam colon single contrast study (74270) | $340.37 | $891 | 1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $347.62 | $910 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) | $421.35 | $1,103 | 3.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $406.07 | $1,063 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $314.39 | $823 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $458.40 | $1,200 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $448.09 | $1,173 | 2.4× |
| Radiologic examination femur 1 view (73551) | $137.52 | $360 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$183.36–$366.34 | $480–$959 | varies |
| Radiologic examination knee 1/2 views (73560) | $311.33 | $815 | 3.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $287.27 | $752 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$344.19–$354.50 | $901–$928 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $280.01 | $733 | 0.7× |
| Ribs bilateral 3 views (71110) | $359.47 | $941 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $969.52 | $2,538 | 2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,309.50 | $3,428 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,840.17 | $7,435 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,275.50 | $3,339 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,700.67 | $4,452 | 2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,125.83 | $5,565 | 1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,363.82 | $6,188 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,125.83 | $5,565 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $471.77 | $1,235 | 1.9× |
| Scapula (73010) | $226.15 | $592 | 2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$54.25–$81.37 | $142–$213 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$250.98–$258.62 | $657–$677 | varies |
| Skull less than 4 views (70250) | $226.53 | $593 | 2.0× |
| Special dosimetry (77331) | $241.05 | $631 | 1.7× |
| Special Physics Consult (77370) | $731.15 | $1,914 | 5.1× |
| Special teletherapy port plan (77321) | $1,093.67 | $2,863 | 2.7× |
| Special treatment procedure (77470) | $2,936.44 | $7,687 | 5.0× |
| Srs Multisource (77371) | $30,508.82 | $79,866 | 3.9× |
| Stereotactic Body Radiation Delivery (77373) | $16,915.73 | $44,282 | 8.9× |
| Sternoclavicular joints (71130) | $233.02 | $610 | 2.5× |
| Superior sagittal sinus venogram (75870) | $1,239.21 | $3,244 | 0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,688.83 | $4,421 | 4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $861.03 | $2,254 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,273.97 | $3,335 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $471.39 | $1,234 | 3.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $529.46 | $1,386 | 2.8× |
| Thoracic spine 2 views (72070) | $361.38 | $946 | 3.2× |
| Thoracic spine 3 views (72072) | $388.88 | $1,018 | 3.5× |
| Thoracolumbar 2 views (72080) | $226.15 | $592 | 2.4× |
| Thyroid Met Imaging Body (78018) | $1,054.71 | $2,761 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $558.49 | $1,462 | 1.3× |
| Tx Devices Design & Construction Complex (77334) | $794.56 | $2,080 | 2.0× |
| Tx devices design & construction intermediate (77333) | $357.56 | $936 | 2.5× |
| Tx devices design & construction simple (77332) | $278.10 | $728 | 1.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$178.40–$269.31 | $467–$705 | varies |
| Ultrasound Elastography Parenchyma (76981) | $254.03 | $665 | 2.3× |
| Ultrasound Exam Aaa Screen (76706) | $205.90 | $539 | 1.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $393.85 | $1,031 | 1.1× |
| Ultrasound, abdomen limited (76705) | $691.04 | $1,809 | 6.2× |
| Umbilical-artery Doppler (OB) (76820) | $137.14 | $359 | 1.2× |
| Unlisted Dx Radiographic Procedure (76499) | $119.57 | $313 | 1.3× |
| Unlisted fluoroscopic procedure (76496) | $676.91 | $1,772 | 7.3× |
| Unlisted magnetic resonance procedure (76498) | $594.78 | $1,557 | 6.4× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $472.16 | $1,236 | 1.1× |
| Upper gi w/o kub (74240) | $441.60 | $1,156 | 2.4× |
| Urethrocystogram voiding (74455) | $367.87 | $963 | 1.4× |
| Urethrocystography retrograde (74450) | $367.87 | $963 | 1.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$198.26–$396.14 | $519–$1,037 | varies |
| Us chest (76604) | $408.74 | $1,070 | 3.7× |
| Us complete joint (76881) | $339.22 | $888 | 3.0× |
| Us exam, pelvic, limited (76857) | $354.88 | $929 | 3.2× |
| Us head (76506) | $301.02 | $788 | 2.7× |
| Us kidney transplant (76776) | $391.17 | $1,024 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $145.93 | $382 | 1.3× |
| Us ob limited 1 or more fetuses (76815) | $347.62 | $910 | 3.1× |
| Us ob transvaginal (76817) | $469.86 | $1,230 | 4.2× |
| Us pelvic non ob complete (76856) | $521.82 | $1,366 | 4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $581.03 | $1,521 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $399.19 | $1,045 | 3.6× |
| Us retroperitoneal complete (76770) | $418.68 | $1,096 | 3.8× |
| Us retroperitoneal limited (76775) | $359.85 | $942 | 3.2× |
| Us scrotum and contents (76870) | $511.12 | $1,338 | 4.6× |
| Us spinal canal and contents (76800) | $222.33 | $582 | 2.0× |
| Us thyroid (76536) | $336.16 | $880 | 3.0× |
| Us transrectal (76872) | $313.63 | $821 | 2.8× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$977.54–$1,809.92 | $2,559–$4,738 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,619.84 | $9,476 | 1.1× |
| Venogram Sinus/Jugular (75860) | $3,349.38 | $8,768 | 1.0× |
| Venography Adrenal Unilateral (75840) | $4,075.18 | $10,668 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $3,619.84 | $9,476 | 1.1× |
| Venography extremity bilateral rs&i (75822) | $3,182.83 | $8,332 | 1.9× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,036.75–$1,818.71 | $2,714–$4,761 | varies |
| Venography Renal Bilateral (75833) | $6,112.77 | $16,002 | 1.8× |
| Venography Renal Unilateral (75831) | $4,075.18 | $10,668 | 1.2× |
| Venous sampling by catheter (75893) | $5,748.72 | $15,049 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $101.23 | $265 | 1.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$260.91–$267.40 | $683–$700 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $197.50 | $517 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $473.68 | $1,240 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $4,370.85 | $11,442 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $335.78 | $879 | 3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$225–$279.25 | $589–$731 | varies |
| X-Ray Exam Breast Specimen (76098) | $715.87 | $1,874 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $139.05 | $364 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $262.82 | $688 | 2.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $506.92 | $1,327 | 4.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $219.27 | $574 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $327.38 | $857 | 3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$356.79–$392.70 | $934–$1,028 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $543.21 | $1,422 | 4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $654.75 | $1,714 | 5.9× |
| X-Ray Exam L-S Spine Bending (72114) | $527.16 | $1,380 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $333.11 | $872 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $526.40 | $1,378 | 4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $359.47 | $941 | 3.2× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$184.89–$276.19 | $484–$723 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$263.97–$325.85 | $691–$853 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $125.68 | $329 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $340.75 | $892 | 3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $335.78 | $879 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $442.36 | $1,158 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $305.99 | $801 | 2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$242.19–$266.64 | $634–$698 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $263.97 | $691 | 2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $208.58 | $546 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $285.74 | $748 | 2.6× |
| X-ray thoracic spine 4 vw (72074) | $435.48 | $1,140 | 3.9× |
| X-Ray Tmj Unilat (70328) | $106.58 | $279 | 1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $473.68 | $1,240 | 1.3× |
| X-Rays Bone Length Studies (77073) | $131.03 | $343 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $393.46 | $1,030 | 3.5× |
| Xr c-spine 4 or 5 views (72050) | $436.63 | $1,143 | 3.9× |
| Xr facial bones less than 3 views (70140) | $167.32 | $438 | 1.8× |
| Xr orbits complete 4 views (70200) | $227.29 | $595 | 2.0× |
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.