Imaging prices at East Carroll Parish Hospital
Lake Providence, LA · every code in this section with a posted price and a Medicare benchmark.
484 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) | $358.50 | $478 | 0.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$120–$140.18 | $160–$186.90 | varies |
| Abdomen 2 views (74019) | $253.15 | $337.53 | 2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $260.25 | $347 | 0.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $239.25 | $319 | 0.2× |
| Adrenal Cortex & Medulla Img (78075) | $335.25 | $447 | 0.3× |
| Angio internal mammary (75756) | $123.75 | $165 | 0.0× |
| Angio pulmonary bilat (75743) | $126 | $168 | 0.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $134.25 | $179 | 0.0× |
| Angiography extremity bilateral rs&i (75716) | $136.50 | $182 | 0.0× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$117.75–$122.25 | $157–$163 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $111.75 | $149 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $112.50 | $150 | 0.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$20.25–$140.18 | $27–$186.90 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$102 | $136 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $144 | $192 | 0.1× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$110.25 | $147 | 0.0× |
| Artery X-Rays Adrenal Gland (75731) | $125.25 | $167 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$118.50 | $158 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$174.75 | $233 | 0.0× |
| Arthrogram ankle (73615) | $72 | $96 | 0.2× |
| Arthrogram hip (73525) | $74.25 | $99 | 0.2× |
| Arthrogram Wrist (73115) | $78 | $104 | 0.2× |
| Basic radiation dosimetry calculation (77300) | $46.50 | $62 | 0.4× |
| Bone age studies (77072) | $17.25 | $23 | 0.2× |
| Bone Imaging 3 Phase (78315) | $258.75 | $345 | 0.7× |
| Bone Imaging Limited Area (78300) | $135 | $180 | 0.4× |
| Bone Imaging Multiple Areas (78305) | $172.50 | $230 | 0.5× |
| Bone Imaging Whole Body (78306) | $188.25 | $251 | 0.5× |
| Bone marrow imaging limited area (78102) | $126.75 | $169 | 0.3× |
| Bone marrow imaging; multiple areas (78103) | $165 | $220 | 0.5× |
| Bone marrow imaging; whole body (78104) | $183 | $244 | 0.5× |
| Bone survey infant (77076) | $69.75 | $93 | 0.7× |
| Brachytx isodose complex (77318) | $258 | $344 | 0.8× |
| Brachytx isodose intermed (77317) | $178.50 | $238 | 0.5× |
| Brachytx Isodose Plan Simple (77316) | $136.50 | $182 | 0.4× |
| Brain Flow Imaging Only (78610) | $129 | $172 | 0.3× |
| Brain Image W/Flow < 4 Views (78601) | $159.75 | $213 | 0.4× |
| Brain imaging < 4 static views (78600) | $137.25 | $183 | 0.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $247.50 | $330 | 0.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $147.75 | $197 | 0.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $57 | $76 | 0.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $168 | $224 | 0.5× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $179.25 | $239 | 0.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $309 | $412 | 1.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $366.75 | $489 | 0.5× |
| Cardiac Shunt Detection (78428) | $135 | $180 | 0.4× |
| Cat Scan Follow-Up Study (76380) | $107.25 | $143 | 1.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $240.75 | $321 | 0.5× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $252.75 | $337 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $252.75 | $337 | 0.5× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$20.25–$120 | $27–$160 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$21.30–$144 | $28.40–$192 | varies |
| Chest 3 views (71047) | $25.50 | $34 | 0.3× |
| Chest 4 or more views (71048) | $30.75 | $41 | 0.3× |
| Cholecystography Oral Contrast (74290) | $51 | $68 | 0.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $66 | $88 | 0.7× |
| Cisternography Positive Contrast Rs&I (70015) | $113.25 | $151 | 0.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$120–$140.18 | $160–$186.90 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $569.25 | $759 | 6.0× |
| Continuing medical physics consltj pr wk (77336) | $54.75 | $73 | 0.4× |
| Contrast Exam Abdominl Aorta (75625) | $102 | $136 | 0.0× |
| Contrast X-Ray Bladder (74430) | $27.75 | $37 | 0.1× |
| Contrast X-Ray Of Elbow (73085) | $72 | $96 | 0.2× |
| Contrast X-Ray Of Knee Joint (73580) | $83.25 | $111 | 0.3× |
| Contrast Xray Throat/Cerv Esopha (74210) | $56.25 | $75 | 0.4× |
| Corpora cavernosography (74445) | $45 | $60 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$256.50–$1,736.46 | $342–$2,315.28 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$147–$1,037.52 | $196–$1,383.36 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$167.25–$907.83 | $223–$1,210.44 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$190.50–$907.83 | $254–$1,210.44 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$110.25–$506.30 | $147–$675.06 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$282.75–$1,322.48 | $377–$1,763.30 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$218.25–$907.83 | $291–$1,210.44 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$214.50–$907.83 | $286–$1,210.44 | varies |
| CT angio hrt w/3d image (75574) | $304.50 | $406 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$255–$1,123.13 | $340–$1,497.50 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$213.75–$907.83 | $285–$1,210.44 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$237–$907.83 | $316–$1,210.44 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$81.75–$355.50 | $109–$474 | varies |
| CT cervical spine w/ contrast (72126) | $166.50 | $222 | 0.5× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$134.25–$506.30 | $179–$675.06 | varies |
| CT cervical spine w/wo cont (72127) | $195.75 | $261 | 1.2× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$166.50–$907.83 | $222–$1,210.44 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$199.50–$907.83 | $266–$1,210.44 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $393.75 | $525 | 2.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $352.50 | $470 | 3.7× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$118.50–$907.83 | $158–$1,210.44 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$140.25–$907.83 | $187–$1,210.44 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $207 | $276 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $73.50 | $98 | 0.9× |
| CT hrt w/3d image congen (75573) | $284.25 | $379 | 0.9× |
| CT iac w contrast (70481) | $200.25 | $267 | 1.3× |
| CT l-spine w&w/o contrast (72133) | $195.75 | $261 | 1.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$129.75–$506.30 | $173–$675.06 | varies |
| CT lower extremity w/contrast material (73701) | $163.50 | $218 | 1.0× |
| CT lumbar spine w contrast (72132) | $165.75 | $221 | 0.5× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$129.75–$506.30 | $173–$675.06 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$123–$907.83 | $164–$1,210.44 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$102–$506.30 | $136–$675.06 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$82.08–$907.83 | $109.44–$1,210.44 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$219–$293.49 | $292–$391.32 | varies |
| CT orbits w/o contrast (70480) | $169.50 | $226 | 1.8× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$188.25–$907.83 | $251–$1,210.44 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$107.25–$506.30 | $143–$675.06 | varies |
| CT scan of leg combo (73702) | $198 | $264 | 1.2× |
| CT scans face/jaw combo (70488) | $149.25 | $199 | 0.9× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$171.75–$907.83 | $229–$1,210.44 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$141–$506.30 | $188–$675.06 | varies |
| CT thoracic spine w contrast (72129) | $166.50 | $222 | 1.0× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$130.50–$506.30 | $174–$675.06 | varies |
| CT thoracic spine w/wo cont (72130) | $195.75 | $261 | 1.2× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$131.25–$506.30 | $175–$675.06 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$129.75–$506.30 | $173–$675.06 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$201–$800.21 | $268–$1,066.95 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$161.25–$648.07 | $215–$864.09 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$276.75–$907.83 | $369–$1,210.44 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$223.50–$1,063.54 | $298–$1,418.05 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$221.25–$907.83 | $295–$1,210.44 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $12 | $16 | 0.1× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $18 | $24 | 0.0× |
| Dilation ureters/urethra rs&i (74485) | $66.75 | $89 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $84.75 | $113 | 0.0× |
| Diskography lumbar (72295) | $72 | $96 | 0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $40.50 | $54 | 0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $56.25 | $75 | 0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $69 | $92 | 0.7× |
| Dxa Bone Density Axial (77080) | $30 | $40 | 0.3× |
| Dxa bone density study (77085) | $41.25 | $55 | 0.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $21 | $28 | 0.3× |
| Echo exam of fetal heart (76825) | $203.25 | $271 | 0.4× |
| Echo exam uterus (76831) | $87 | $116 | 0.4× |
| Echo Guide For Artery Repair (76936) | $200.25 | $267 | 1.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $120.75 | $161 | 0.6× |
| Echograp Trans R Pros Study (76873) | $123.75 | $165 | 1.3× |
| Esophageal Motility Study (78258) | $164.25 | $219 | 0.5× |
| Esophagram (74220) | $64.50 | $86 | 0.4× |
| Fetal Biophys Profile W/Nst (76818) | $90 | $120 | 0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $66 | $88 | 0.7× |
| Fluoroscopy up to 1 hr (76000) | $34.50 | $46 | 0.2× |
| Follow-Up Angiography (75898) | $65.25 | $87 | 0.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$18.75–$140.18 | $25–$186.90 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$120–$140.18 | $160–$186.90 | varies |
| Gastric emptying imaging study (78264) | $216 | $288 | 0.6× |
| Gastric Mucosa Imaging (78261) | $188.25 | $251 | 0.5× |
| Gastroesophageal Reflux Exam (78262) | $181.50 | $242 | 0.5× |
| Gastrointestinal Protein Loss (78282) | $15 | $20 | 0.0× |
| Gated Heart Planar Single (78472) | $172.50 | $230 | 0.5× |
| Gated Heart, Multiple (78473) | $216.75 | $289 | 0.6× |
| GI Endoscopic US S&I (76975) | $33.75 | $45 | 0.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$19.50–$253.15 | $26–$337.53 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $567.75 | $757 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $357 | $476 | 0.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $174 | $232 | 0.3× |
| Heart first pass single,planar (78481) | $131.25 | $175 | 0.3× |
| Heart Image (Pet) Multiple (78492) | $70.50 | $94 | 0.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $106.50 | $142 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $107.25 | $143 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) | $333.75 | $445 | 0.7× |
| Hepatobiliary System Imaging (78226) | $246.75 | $329 | 0.7× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) range across 2 matching MRF lines |
$24–$46.50 | $32–$62 | varies |
| Ht Musc Image Planar Mult (78454) | $324.75 | $433 | 0.3× |
| Ht Muscle Image Spect Sing (78451) | $255 | $340 | 0.2× |
| Hyperthermia external generated superficial (77600) | $291 | $388 | 0.8× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $737.25 | $983 | 1.5× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $725.25 | $967 | 1.4× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $333.75 | $445 | 0.7× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $549 | $732 | 0.9× |
| Hysterosalpingogram (74740) | $54.75 | $73 | 0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $105.75 | $141 | 1.3× |
| Infant hip ultrasound, limited static exam (76886) | $78 | $104 | 1.0× |
| Infusion Ivp (74410) | $77.25 | $103 | 0.5× |
| Interstitial radiation source applic complex (77778) | $648 | $864 | 1.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $541.50 | $722 | 0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) | $398.25 | $531 | 0.8× |
| Intracavitary radiation source applic simple (77761) | $285.75 | $381 | 0.6× |
| Joint Survey Single View (77077) | $27.75 | $37 | 0.3× |
| K Flow/Funct Image Multiple (78709) | $270 | $360 | 0.5× |
| K Flow/Funct Image W/Drug (78708) | $131.25 | $175 | 0.3× |
| K Flow/Funct Image W/O Drug (78707) | $174 | $232 | 0.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $81 | $108 | 0.2× |
| Kidney Imaging Morphol (78700) | $127.50 | $170 | 0.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $156.75 | $209 | 0.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$24.75–$140.18 | $33–$186.90 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $102 | $136 | 0.3× |
| Leveen/Shunt Patency Exam (78291) | $186 | $248 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $144.75 | $193 | 0.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $93.75 | $125 | 0.3× |
| Liver imaging static only (78201) | $140.25 | $187 | 0.3× |
| Liver imaging w/vascular flow (78202) | $149.25 | $199 | 0.3× |
| Lung Perf&Ventilat Diferentl (78598) | $228 | $304 | 0.5× |
| Lung perfusion differential (78597) | $150.75 | $201 | 0.4× |
| Lung Ventilat&Perfus Imaging (78582) | $249.75 | $333 | 0.5× |
| Lung Ventilation Imaging (78579) | $137.25 | $183 | 0.4× |
| Lymph System Imaging (78195) | $265.50 | $354 | 0.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $46.50 | $62 | 0.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $33.75 | $45 | 0.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $46.50 | $62 | 0.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $32.25 | $43 | 0.0× |
| Magnetic Image Jaw Joint (70336) | $231.75 | $309 | 1.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $127.50 | $170 | 0.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $115.50 | $154 | 0.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $127.50 | $170 | 0.8× |
| Mammary ductogram or galactogram multiple (77054) | $55.50 | $74 | 0.3× |
| Mammary ductogram or galactogram single (77053) | $42.75 | $57 | 0.2× |
| Meckels Divert Exam (78290) | $247.50 | $330 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $369.75 | $493 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $432 | $576 | 1.4× |
| MRA head w/o contrast (70544) | $1,048.50 | $1,398 | 4.8× |
| MRA head with contrast (70545) | $278.25 | $371 | 0.9× |
| MRA neck w contrast (70548) | $297.75 | $397 | 0.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $434.25 | $579 | 1.4× |
| MRA neck w/o contrast (70547) | $283.50 | $378 | 1.3× |
| MRI abdomen w contrast (74182) | $328.50 | $438 | 1.0× |
| MRI abdomen w/o contrast (74181) | $240.75 | $321 | 1.1× |
| MRI any jt lower extrem w/contrast material (73722) | $276 | $368 | 0.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $341.25 | $455 | 1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $273.75 | $365 | 0.4× |
| MRI bone marrow blood supply (77084) | $282.75 | $377 | 1.3× |
| MRI brain functional w/o physician admnistration (70554) | $326.25 | $435 | 1.5× |
| MRI brain functional w/physician admnistration (70555) | $100.50 | $134 | 0.5× |
| MRI cardiac w/o cont stress (75559) | $316.50 | $422 | 0.6× |
| MRI cardiac w/o contrast (75557) | $232.50 | $310 | 1.1× |
| MRI cervical spine w contrast (72142) | $234.75 | $313 | 0.7× |
| MRI cervical spine w/o cont (72141) | $162.75 | $217 | 0.7× |
| MRI chest w/o contrast (71550) | $299.25 | $399 | 1.4× |
| MRI chest with contrast (71551) | $330.75 | $441 | 0.5× |
| MRI chest wo w contrast (71552) | $419.25 | $559 | 1.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $292.50 | $390 | 0.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $363.75 | $485 | 1.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $263.25 | $351 | 1.2× |
| MRI lumbar spine w contrast (72149) | $232.50 | $310 | 0.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $276 | $368 | 0.9× |
| MRI orbit face &/neck w/o contrast (70540) | $258.75 | $345 | 1.2× |
| MRI orbit face neck w contrast (70542) | $291 | $388 | 0.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $356.25 | $475 | 1.1× |
| MRI pelvis w contrast (72196) | $297.75 | $397 | 0.9× |
| MRI pelvis w/o & w contrast (72197) | $366 | $488 | 1.2× |
| MRI pelvis w/o contrast (72195) | $271.50 | $362 | 1.2× |
| MRI thoracic spine w/o contrast (72146) | $162.75 | $217 | 0.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $291.75 | $389 | 0.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $262.50 | $350 | 1.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $361.50 | $482 | 1.1× |
| MRI, abdomen, combo (74183) | $366.75 | $489 | 1.2× |
| MRI, dorsal spine combo (72157) | $276.75 | $369 | 0.9× |
| MRI, dorsal spine contrast (72147) | $233.25 | $311 | 0.7× |
| MRI, joint upper extrem (73221) | $171 | $228 | 0.8× |
| MRI, joint upper extrem combo (73223) | $339.75 | $453 | 1.1× |
| MRI, lumbar spine combo (72158) | $275.25 | $367 | 0.9× |
| Myelogram cervical (72240) | $72.75 | $97 | 0.1× |
| Myelogram Lumbar (72265) | $67.50 | $90 | 0.1× |
| Myelography thoracic (72255) | $72 | $96 | 0.1× |
| Myelograpy 2/more regions rs&i (72270) | $94.50 | $126 | 0.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $145.50 | $194 | 0.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $56.25 | $75 | 0.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $144.75 | $193 | 0.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $227.25 | $303 | 0.2× |
| Myocardial Spect Multiple Studies (78452) | $352.50 | $470 | 0.3× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$20.25–$140.18 | $27–$186.90 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $276 | $368 | 0.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $33 | $44 | 0.1× |
| Nm csf leak detection (78650) | $248.25 | $331 | 0.2× |
| Nm myocard infarct spect (78469) | $170.25 | $227 | 0.3× |
| Nm red cell survival study (78130) | $117.75 | $157 | 0.3× |
| Nm whole blood volume (78122) | $72 | $96 | 0.1× |
| Nonvascular Shunt X-Ray (75809) | $72 | $96 | 0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,398 | $1,864 | 1.1× |
| Nuclear Rx Intra-Arterial (79445) | $91.50 | $122 | 0.4× |
| Nuclear Rx Oral Admin (79005) | $102.75 | $137 | 0.5× |
| Ob us nuchal meas 1 gest (76813) | $90.75 | $121 | 1.0× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $62.25 | $83 | 0.7× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $71.25 | $95 | 0.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $126.75 | $169 | 1.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $58.50 | $78 | 0.6× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $59.25 | $79 | 0.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $69.75 | $93 | 0.7× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $12 | $16 | 0.5× |
| Ophthalmic us dx quantitative a-scan only (76511) | $76.50 | $102 | 0.8× |
| Optic foramina (70190) | $25.50 | $34 | 0.3× |
| Panoramic X-ray of jaws (70355) | $15 | $20 | 0.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $306 | $408 | 0.6× |
| Parathyroid Planar Imaging (78070) | $223.50 | $298 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $267 | $356 | 0.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$120–$253.15 | $160–$337.53 | varies |
| Perineogram (74775) | $24.75 | $33 | 0.1× |
| Peritoneogram Rs&I (74190) | $18.75 | $25 | 0.0× |
| Pet Image Skull-Thigh (78812) | $74.25 | $99 | 0.1× |
| Pet Image W/Ct Lmtd (78814) | $86.25 | $115 | 0.1× |
| PET image w/CT, full body (78816) | $95.25 | $127 | 0.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $94.50 | $126 | 0.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $60.75 | $81 | 0.1× |
| Pet Myocardial Sngl Study (78491) | $56.25 | $75 | 0.0× |
| PET whole body (78813) | $77.25 | $103 | 0.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $72 | $96 | 0.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $76.50 | $102 | 0.1× |
| Platelet survival study Non-Facility (78191) range across 2 matching MRF lines |
$124.50–$292.50 | $166–$390 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $117 | $156 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $177.75 | $237 | 0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$32.25–$253.15 | $43–$337.53 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $41.25 | $55 | 0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$19.50–$140.18 | $26–$186.90 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$120–$140.18 | $160–$186.90 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$143.25–$253.15 | $191–$337.53 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$8.72–$140.18 | $11.63–$186.90 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $20.25 | $27 | 0.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $39.75 | $53 | 0.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$140.18–$143.25 | $186.90–$191 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $58.50 | $78 | 0.7× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$68.25–$143.25 | $91–$191 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $128.25 | $171 | 1.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$250.50–$300 | $334–$400 | varies |
| Radex Spine 1 View Specify Level (72020) | $16.50 | $22 | 0.2× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $34.50 | $46 | 0.4× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$6.89–$140.18 | $9.18–$186.90 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $20.25 | $27 | 0.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$128.25–$140.18 | $171–$186.90 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$756 | $1,008 | 0.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$27.75–$253.15 | $37–$337.53 | varies |
| Radiologic exam colon double contrast study (74280) | $153.75 | $205 | 1.0× |
| Radiologic exam colon single contrast study (74270) | $108.75 | $145 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$144.75–$253.15 | $193–$337.53 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $27.75 | $37 | 0.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $75.75 | $101 | 0.5× |
| Radiologic exam swallow function contrast study (74230) | $93 | $124 | 0.6× |
| Radiologic exam teeth complete full mouth (70320) | $39 | $52 | 0.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $28.50 | $38 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$93–$102 | $124–$136 | varies |
| Radiologic examination femur minimum 2 views (73552) | $140.18 | $186.90 | 1.8× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$8.68–$140.18 | $11.57–$186.90 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $47.25 | $63 | 0.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $26.25 | $35 | 0.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$120–$140.18 | $160–$186.90 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $37.50 | $50 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $11.25 | $15 | 0.1× |
| Radiopharm Dacryocystography (78660) | $131.25 | $175 | 0.4× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $56.25 | $75 | 0.3× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $97.50 | $130 | 0.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $102.75 | $137 | 0.5× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $69.75 | $93 | 0.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $78.75 | $105 | 0.2× |
| Renal Cyst Study (74470) | $20.25 | $27 | 0.0× |
| Ribs bilateral 3 views (71110) | $27.75 | $37 | 0.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $141.75 | $189 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $194.25 | $259 | 0.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $423 | $564 | 0.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $241.50 | $322 | 0.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 7 matching MRF lines |
$147.75–$263.25 | $197–$351 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $142.50 | $190 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $108 | $144 | 0.5× |
| Salivary Gland Function Study (78232) | $74.25 | $99 | 0.2× |
| Salivary Gland Imaging (78230) | $129 | $172 | 0.4× |
| Salivary Gland Imaging Serial Images (78231) | $96.75 | $129 | 0.3× |
| Scapula (73010) range across 2 matching MRF lines |
$107.25–$253.15 | $143–$337.53 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42 | $56 | 1.8× |
| Sella turcica (70240) | $21.75 | $29 | 0.3× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$7.97–$74.06 | $10.62–$98.75 | varies |
| Shoulder Arthrography (73040) | $73.50 | $98 | 0.2× |
| Sialogram (70390) | $68.25 | $91 | 0.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$128.25–$253.15 | $171–$337.53 | varies |
| Special dosimetry (77331) | $48 | $64 | 0.4× |
| Special Physics Consult (77370) | $83.25 | $111 | 0.7× |
| Special teletherapy port plan (77321) | $68.25 | $91 | 0.2× |
| Special treatment procedure (77470) | $116.25 | $155 | 0.2× |
| Speech evaluation, complex (70371) | $66.75 | $89 | 0.3× |
| Spleen Imaging (78185) | $157.50 | $210 | 0.4× |
| Stereotactic Body Radiation Delivery (77373) | $960 | $1,280 | 0.6× |
| Sternoclavicular joints (71130) | $26.25 | $35 | 0.3× |
| Superior sagittal sinus venogram (75870) | $109.50 | $146 | 0.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $87.75 | $117 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $210 | $280 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $107.25 | $143 | 0.3× |
| Temporomandble Jt Arthrography Rs&I (70332) | $60 | $80 | 0.3× |
| Testicular Imaging W/Flow (78761) | $157.50 | $210 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $367.50 | $490 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $306.75 | $409 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) | $195 | $260 | 1.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $152.25 | $203 | 1.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$128.25–$253.15 | $171–$337.53 | varies |
| Thoracic spine 3 views (72072) | $25.50 | $34 | 0.3× |
| Thoracolumbar 2 views (72080) | $24.75 | $33 | 0.3× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $210.75 | $281 | 0.6× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $164.25 | $219 | 0.5× |
| Thyroid Imaging With Vascular Flow (78013) | $141 | $188 | 0.4× |
| Thyroid Met Imaging Body (78018) | $232.50 | $310 | 0.5× |
| Thyroid Uptake Measurement (78012) | $59.25 | $79 | 0.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $179.25 | $239 | 0.5× |
| Tx Devices Design & Construction Complex (77334) | $111.75 | $149 | 0.3× |
| Tx devices design & construction intermediate (77333) | $39.75 | $53 | 0.3× |
| Tx devices design & construction simple (77332) | $60.75 | $81 | 0.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$66–$307.46 | $88–$409.95 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$84.75–$354.71 | $113–$472.95 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$67.50–$296.70 | $90–$395.60 | varies |
| Umbilical-artery Doppler (OB) (76820) | $35.25 | $47 | 0.4× |
| Unlisted Dx Radiographic Procedure (76499) | $55.50 | $74 | 0.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$345–$435.75 | $460–$581 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$83.25–$85.50 | $111–$114 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$162.75–$413 | $217–$550.66 | varies |
| Urethrocystogram voiding (74455) | $59.25 | $79 | 0.3× |
| Urethrocystography retrograde (74450) | $12.75 | $17 | 0.1× |
| Us bone density measurement (76977) | $5.25 | $7 | 0.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$79.50–$378.75 | $106–$505 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$65.25–$296.70 | $87–$395.60 | varies |
| Us complete joint (76881) | $85.50 | $114 | 0.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$35.25–$393 | $47–$524 | varies |
| Us head (76506) | $87 | $116 | 0.9× |
| Us kidney transplant (76776) | $114.75 | $153 | 1.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$27–$253.15 | $36–$337.53 | varies |
| Us ob detailed single fetus (76811) | $135.75 | $181 | 0.6× |
| Us ob limited 1 or more fetuses (76815) | $63 | $84 | 0.7× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$72–$253.15 | $96–$337.53 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$81–$253.15 | $108–$337.53 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $92.25 | $123 | 1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $84.75 | $113 | 0.9× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$83.25–$253.15 | $111–$337.53 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$29.42–$253.15 | $39.23–$337.53 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$49.50–$253.15 | $66–$337.53 | varies |
| Us spinal canal and contents (76800) | $102 | $136 | 1.1× |
| Us thyroid (76536) range across 3 matching MRF lines |
$84.75–$296.70 | $113–$395.60 | varies |
| Us transrectal (76872) | $69 | $92 | 0.7× |
| Vascular Flow Imaging (78445) | $133.50 | $178 | 0.4× |
| Vasogram (74440) | $57.75 | $77 | 0.3× |
| Vein X-Ray Chest (75827) | $101.25 | $135 | 0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $118.50 | $158 | 0.0× |
| Vein X-Ray Skull Epidural (75872) | $109.50 | $146 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $45.75 | $61 | 0.0× |
| Venogram Sinus/Jugular (75860) | $105.75 | $141 | 0.0× |
| Venography Adrenal Unilateral (75840) | $109.50 | $146 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $100.50 | $134 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $101.25 | $135 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $84 | $112 | 0.1× |
| Venography Orbital Rs&I (75880) | $106.50 | $142 | 0.2× |
| Venography Renal Bilateral (75833) | $123 | $164 | 0.0× |
| Venography Renal Unilateral (75831) | $103.50 | $138 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$86.25 | $115 | 0.0× |
| Venous thrombosis imaging (78457) | $131.25 | $175 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $153.75 | $205 | 0.4× |
| Vertebral fracture assessment via dxa (77086) | $26.25 | $35 | 0.3× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$8.68–$114.79 | $11.57–$153.05 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$140.18–$255.75 | $186.90–$341 | varies |
| X-ray antegrade pyelogram tube (74425) | $14.25 | $19 | 0.0× |
| X-Ray Aorta Leg Arteries (75630) | $126.75 | $169 | 0.0× |
| X-Ray Bend Only L-S Spine (72120) | $29.25 | $39 | 0.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$20.25–$140.18 | $27–$186.90 | varies |
| X-Ray Exam Breast Specimen (76098) | $12 | $16 | 0.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $163.50 | $218 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $19.50 | $26 | 0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $140.18 | $186.90 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $253.15 | $337.53 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$45.75–$117.82 | $61–$157.09 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$134.25–$140.18 | $179–$186.90 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $41.25 | $55 | 0.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $27 | $36 | 0.3× |
| X-ray eye for foreign body (70030) | $20.25 | $27 | 0.3× |
| X-ray head for orthodontia (70350) | $14.25 | $19 | 0.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$46.73–$140.18 | $62.30–$186.90 | varies |
| X-ray IV pyelogram (ivp) (74400) | $79.50 | $106 | 0.5× |
| X-ray IV pyelogram+tomography (74415) | $99 | $132 | 0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $128.25 | $171 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $24 | $32 | 0.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$24.41–$253.15 | $32.55–$337.53 | varies |
| X-ray nose-rectum child f.b. (76010) | $19.50 | $26 | 0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $34.50 | $46 | 0.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$24–$253.15 | $32–$337.53 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $21 | $28 | 0.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$19.74–$140.18 | $26.32–$186.90 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$140.18–$143.25 | $186.90–$191 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$33–$253.15 | $44–$337.53 | varies |
| X-Ray Stress View (77071) | $35.25 | $47 | 0.4× |
| X-ray thoracic spine 4 vw (72074) | $28.50 | $38 | 0.3× |
| X-Ray Tmj Unilat (70328) | $22.50 | $30 | 0.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $14.25 | $19 | 0.0× |
| X-Rays Bone Length Studies (77073) | $27 | $36 | 0.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$63.75–$123.75 | $85–$165 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$33–$253.15 | $44–$337.53 | varies |
| Xr facial bones less than 3 views (70140) | $128.25 | $171 | 1.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $24.75 | $33 | 0.3× |
| Xr myelogram posterior fossa (70010) | $54 | $72 | 0.2× |
| Xr orbits complete 4 views (70200) | $30.75 | $41 | 0.3× |
| Xr Tomogram Single Plane (76100) | $67.50 | $90 | 0.7× |
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.