Imaging prices at Emanate Health Foothill Presbyterian Hospital
Glendora, CA · every code in this section with a posted price and a Medicare benchmark.
402 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) | $6,963 | $6,963 | 3.9× |
| Abdomen 1 View (74018) | $473 | $473 | 4.2× |
| Abdomen 2 views (74019) | $710 | $710 | 5.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,507 | $1,507 | 2.9× |
| Angio pulmonary bilat (75743) | $7,670 | $7,670 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $7,734 | $7,734 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $6,472 | $6,472 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,411 | $6,411 | 1.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$473–$948 | $473–$948 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,166 | $9,166 | 1.3× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$11,302–$21,384 | $11,302–$21,384 | varies |
| Artery X-Rays Adrenal Gland (75731) | $6,472 | $6,472 | 1.6× |
| Artery X-Rays Pelvis (75736) | $8,730 | $8,730 | 1.2× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$8,730–$9,699 | $8,730–$9,699 | varies |
| Arthrogram ankle (73615) | $1,818 | $1,818 | 4.1× |
| Arthrogram hip (73525) | $1,747 | $1,747 | 3.9× |
| Arthrogram Wrist (73115) | $1,454 | $1,454 | 3.2× |
| Basic radiation dosimetry calculation (77300) | $1,274 | $1,274 | 7.4× |
| Bone age studies (77072) | $739 | $739 | 5.5× |
| Bone Imaging 3 Phase (78315) | $2,490 | $2,490 | 4.8× |
| Bone Imaging Limited Area (78300) | $1,135 | $1,135 | 2.2× |
| Bone Imaging Multiple Areas (78305) | $2,058 | $2,058 | 4.0× |
| Bone Imaging Whole Body (78306) | $2,263 | $2,263 | 4.4× |
| Bone marrow imaging limited area (78102) | $1,135 | $1,135 | 2.2× |
| Bone marrow imaging; whole body (78104) | $1,757 | $1,757 | 3.4× |
| Bone survey infant (77076) | $2,507 | $2,507 | 18.6× |
| Brachytx isodose complex (77318) | $9,376 | $9,376 | 19.5× |
| Brachytx isodose intermed (77317) | $9,289 | $9,289 | 19.3× |
| Brachytx Isodose Plan Simple (77316) | $8,546 | $8,546 | 17.7× |
| Brain Flow Imaging Only (78610) | $994 | $994 | 1.4× |
| Brain Image W/Flow < 4 Views (78601) | $925 | $925 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,635 | $1,635 | 2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,632 | $2,632 | 5.9× |
| Cardiovasc nucl exam unlisted (78499) | $1,507 | $1,507 | 2.9× |
| Cat Scan Follow-Up Study (76380) | $1,509 | $1,509 | 13.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,054 | $2,054 | 2.9× |
| Cerebrospinal Fluid Scan (78630) | $2,054 | $2,054 | 2.9× |
| Chest 1 view (71045) | $718 | $718 | 6.4× |
| Chest 2 views (71046) | $2,080 | $2,080 | 18.6× |
| Chest 3 views (71047) | $2,184 | $2,184 | 19.5× |
| Chest 4 or more views (71048) | $2,292 | $2,292 | 17.0× |
| Cholecystography Oral Contrast (74290) | $830 | $830 | 3.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$278–$1,103 | $278–$1,103 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $3,283 | $3,283 | 24.4× |
| Continuing medical physics consltj pr wk (77336) | $952 | $952 | 5.5× |
| Contrast Exam Abdominl Aorta (75625) | $12,903 | $12,903 | 3.2× |
| Contrast X-Ray Bladder (74430) | $749 | $749 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $1,747 | $1,747 | 3.9× |
| Contrast X-Ray Of Knee Joint (73580) | $1,454 | $1,454 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $8,394 | $8,394 | 18.7× |
| CT abdomen and pelvis without contrast (74176) | $7,382 | $7,382 | 24.1× |
| CT abdomen w contrast (74160) | $3,460 | $3,460 | 15.3× |
| CT abdomen w wo contrast (74170) | $3,633 | $3,633 | 16.1× |
| CT abdomen w/o contrast (74150) | $3,287 | $3,287 | 24.4× |
| CT Angio Abdomen and Pelvis (74174) | $8,518 | $8,518 | 19.0× |
| CT Angio Chest (71275) | $3,504 | $3,504 | 15.5× |
| CT Angio Head (70496) | $4,302 | $4,302 | 19.1× |
| CT angio hrt w/3d image (75574) | $4,633 | $4,633 | 10.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,504 | $3,504 | 15.5× |
| CT Angio Neck (70498) | $3,504 | $3,504 | 15.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,504 | $3,504 | 15.5× |
| CT bone density (77078) | $721 | $721 | 6.4× |
| CT cervical spine w/ contrast (72126) | $3,815 | $3,815 | 8.5× |
| CT cervical spine w/o contrast (72125) | $3,633 | $3,633 | 27.0× |
| CT cervical spine w/wo cont (72127) | $4,005 | $4,005 | 17.8× |
| CT chest w contrast (71260) | $3,460 | $3,460 | 15.3× |
| CT chest w/wo contrast (71270) | $3,633 | $3,633 | 16.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,069 | $2,069 | 15.4× |
| CT head/brain with contrast (70460) | $3,805 | $3,805 | 16.9× |
| CT head/brain without and with contrast (70470) | $6,051 | $6,051 | 26.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,972 | $3,972 | 8.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $3,475 | $3,475 | 31.0× |
| CT hrt w/3d image congen (75573) | $3,972 | $3,972 | 8.9× |
| CT iac w contrast (70481) range across 10 matching MRF lines |
$1,370–$4,204 | $1,370–$4,204 | varies |
| CT l-spine w&w/o contrast (72133) | $4,005 | $4,005 | 17.8× |
| CT lower ext w/o (73700) | $2,524 | $2,524 | 18.8× |
| CT lower extremity w/contrast material (73701) | $2,594 | $2,594 | 11.5× |
| CT lumbar spine w contrast (72132) | $3,815 | $3,815 | 8.5× |
| CT lumbar spine w/o contrast (72131) | $3,633 | $3,633 | 27.0× |
| CT maxillofacial w contrast (70487) | $3,004 | $3,004 | 13.3× |
| CT maxillofacial wo contrast (70486) | $2,985 | $2,985 | 22.2× |
| CT neck tissue combo (70492) | $3,162 | $3,162 | 14.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 9 matching MRF lines |
$1,370–$5,045 | $1,370–$5,045 | varies |
| CT orbits w/o contrast (70480) range across 10 matching MRF lines |
$1,370–$3,287 | $1,370–$3,287 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,731–$4,761 | $1,731–$4,761 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,442–$4,094 | $1,442–$4,094 | varies |
| CT scan of leg combo (73702) | $2,738 | $2,738 | 12.1× |
| CT scans face/jaw combo (70488) | $5,045 | $5,045 | 22.4× |
| CT soft tissue neck w contrast (70491) | $3,064 | $3,064 | 13.6× |
| CT soft tissue neck w/o contrast (70490) | $2,883 | $2,883 | 21.4× |
| CT thoracic spine w contrast (72129) | $3,172 | $3,172 | 14.1× |
| CT thoracic spine w/o contrast (72128) | $3,028 | $3,028 | 22.5× |
| CT thoracic spine w/wo cont (72130) | $5,044 | $5,044 | 22.4× |
| CT thorax w/o contrast (71250) | $3,283 | $3,283 | 24.4× |
| CT unlisted procedure (76497) | $552 | $552 | 4.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,524–$5,046 | $2,524–$5,046 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,738 | $2,738 | 12.1× |
| CT upper extremity with contrast (73201) | $2,593 | $2,593 | 5.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,504 | $3,504 | 15.5× |
| Cta Abdomen (74175) | $4,001 | $4,001 | 17.7× |
| CTA pelvis (72191) | $5,060 | $5,060 | 22.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $967 | $967 | 3.2× |
| Dilation ureters/urethra rs&i (74485) | $2,987 | $2,987 | 1.1× |
| Discography Cerv/Thor Spine (72285) | $5,391 | $5,391 | 2.1× |
| Diskography lumbar (72295) | $5,391 | $5,391 | 2.1× |
| Dxa Bone Density Axial (77080) | $992 | $992 | 7.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $316 | $316 | 2.8× |
| Echo exam uterus (76831) | $1,873 | $1,873 | 6.1× |
| Echo Guide For Artery Repair (76936) | $979 | $979 | 3.5× |
| Echograp Trans R Pros Study (76873) | $2,184 | $2,184 | 16.2× |
| Esophagram (74220) | $830 | $830 | 3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$1,952–$2,399 | $1,952–$2,399 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,493 | $2,493 | 8.1× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$1,705–$2,520 | $1,705–$2,520 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$1,925–$2,310 | $1,925–$2,310 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$394–$947 | $394–$947 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$473–$790 | $473–$790 | varies |
| Gastric emptying imaging study (78264) | $1,256 | $1,256 | 2.4× |
| Gated Heart Planar Single (78472) | $2,847 | $2,847 | 5.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$473–$948 | $473–$948 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $10,145 | $10,145 | 11.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,763 | $6,763 | 7.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,381 | $3,381 | 3.8× |
| Heart first pass single,planar (78481) | $828 | $828 | 1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $11,700 | $11,700 | 2.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,472 | $6,472 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,744 | $1,744 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,742 | $1,742 | 3.4× |
| Ht Musc Image Planar Mult (78454) | $1,456 | $1,456 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $3,264 | $3,264 | 2.0× |
| Hysterosalpingogram (74740) | $1,250 | $1,250 | 4.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,646 | $1,646 | 14.7× |
| Infant hip ultrasound, limited static exam (76886) | $1,646 | $1,646 | 14.7× |
| Interstitial radiation source applic complex (77778) | $6,831 | $6,831 | 7.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,673 | $2,673 | 3.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,120 | $2,120 | 3.0× |
| Intracavitary radiation source applic simple (77761) | $2,120 | $2,120 | 3.0× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $15,484 | $15,484 | 1.6× |
| Intraop radiaj tx deliver xray single tx session (77424) | $15,205 | $15,205 | 1.6× |
| Joint Survey Single View (77077) | $1,463 | $1,463 | 10.9× |
| K Flow/Funct Image Multiple (78709) | $4,268 | $4,268 | 6.1× |
| K Flow/Funct Image W/Drug (78708) | $3,452 | $3,452 | 4.9× |
| K Flow/Funct Image W/O Drug (78707) | $2,762 | $2,762 | 4.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,012 | $1,012 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,728 | $1,728 | 3.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$593–$1,186 | $593–$1,186 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,347 | $1,347 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,471 | $1,471 | 2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,070 | $2,070 | 4.0× |
| Liver imaging w/vascular flow (78202) | $1,471 | $1,471 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $4,069 | $4,069 | 5.8× |
| Lung perfusion differential (78597) | $1,801 | $1,801 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $3,675 | $3,675 | 5.3× |
| Lung Ventilation Imaging (78579) | $1,879 | $1,879 | 3.7× |
| Lymph System Imaging (78195) | $1,131 | $1,131 | 1.6× |
| Lymphangiography extremity only unilateral rs&i (75801) | $6,483 | $6,483 | 8.0× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$3,977–$6,531 | $3,977–$6,531 | varies |
| Mammary ductogram or galactogram multiple (77054) | $3,321 | $3,321 | 10.8× |
| Mammary ductogram or galactogram single (77053) | $2,467 | $2,467 | 8.0× |
| Meckels Divert Exam (78290) | $1,374 | $1,374 | 2.7× |
| Mlc imrt design & construction per imrt plan (77338) | $1,469 | $1,469 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $5,839 | $5,839 | 13.0× |
| MRA head w/o contrast (70544) | $3,828 | $3,828 | 12.5× |
| MRA head with contrast (70545) | $4,398 | $4,398 | 9.8× |
| MRA neck w contrast (70548) | $4,398 | $4,398 | 9.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,839 | $5,839 | 13.0× |
| MRA neck w/o contrast (70547) | $3,828 | $3,828 | 12.5× |
| MRI abdomen w contrast (74182) | $8,229 | $8,229 | 18.3× |
| MRI abdomen w/o contrast (74181) | $7,837 | $7,837 | 25.5× |
| MRI any jt lower extrem w/contrast material (73722) | $7,694 | $7,694 | 7.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$10,597–$13,776 | $10,597–$13,776 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $7,694 | $7,694 | 7.6× |
| MRI bone marrow blood supply (77084) | $5,185 | $5,185 | 16.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,593 | $4,593 | 15.0× |
| MRI cardiac w/o contrast (75557) | $6,531 | $6,531 | 21.3× |
| MRI cervical spine w contrast (72142) | $5,430 | $5,430 | 12.1× |
| MRI cervical spine w/o cont (72141) | $5,172 | $5,172 | 16.9× |
| MRI chest w/o contrast (71550) | $7,113 | $7,113 | 23.2× |
| MRI chest with contrast (71551) | $8,274 | $8,274 | 8.2× |
| MRI chest wo w contrast (71552) | $11,178 | $11,178 | 24.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $7,694 | $7,694 | 17.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,597 | $10,597 | 23.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,531 | $6,531 | 21.3× |
| MRI lumbar spine w contrast (72149) | $9,493 | $9,493 | 21.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $6,155 | $6,155 | 13.7× |
| MRI orbit face &/neck w/o contrast (70540) | $3,533 | $3,533 | 11.5× |
| MRI orbit face neck w contrast (70542) | $4,109 | $4,109 | 9.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,551 | $5,551 | 12.4× |
| MRI pelvis w contrast (72196) | $7,694 | $7,694 | 17.1× |
| MRI pelvis w/o & w contrast (72197) | $10,597 | $10,597 | 23.6× |
| MRI pelvis w/o contrast (72195) | $6,411 | $6,411 | 20.9× |
| MRI spectroscopy (76390) | $6,097 | $6,097 | 54.5× |
| MRI thoracic spine w/o contrast (72146) | $8,332 | $8,332 | 27.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $7,694 | $7,694 | 17.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,531 | $6,531 | 21.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $10,597 | $10,597 | 23.6× |
| MRI, abdomen, combo (74183) | $10,597 | $10,597 | 23.6× |
| MRI, dorsal spine combo (72157) | $12,396 | $12,396 | 27.6× |
| MRI, dorsal spine contrast (72147) | $9,493 | $9,493 | 21.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$6,531–$13,065 | $6,531–$13,065 | varies |
| MRI, joint upper extrem combo (73223) | $10,597 | $10,597 | 23.6× |
| MRI, lumbar spine combo (72158) | $12,396 | $12,396 | 27.6× |
| Myelogram cervical (72240) | $3,696 | $3,696 | 3.7× |
| Myelogram Lumbar (72265) | $3,977 | $3,977 | 3.9× |
| Myelography thoracic (72255) | $4,045 | $4,045 | 4.0× |
| Myelograpy 2/more regions rs&i (72270) | $5,732 | $5,732 | 5.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,456 | $1,456 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $4,771 | $4,771 | 2.9× |
| Neck soft tissue (70360) | $504 | $504 | 4.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $974 | $974 | 2.0× |
| Nm csf leak detection (78650) | $1,802 | $1,802 | 1.1× |
| Nonvascular Shunt X-Ray (75809) | $1,243 | $1,243 | 9.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $13,572 | $13,572 | 7.6× |
| Nuclear Rx Intra-Arterial (79445) | $1,554 | $1,554 | 5.2× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$720–$806 | $720–$806 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $473 | $473 | 3.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $435 | $435 | 2.5× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $662 | $662 | 5.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $473 | $473 | 3.5× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $108 | $108 | 2.9× |
| Ophthalmic us dx quantitative a-scan only (76511) | $473 | $473 | 3.5× |
| Optic foramina (70190) | $455 | $455 | 4.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $5,045 | $5,045 | 7.2× |
| Parathyroid Planar Imaging (78070) | $1,716 | $1,716 | 3.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $4,520 | $4,520 | 8.8× |
| Pelvis 1 or 2 views (72170) | $521 | $521 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,801 | $1,801 | 3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,051 | $1,051 | 7.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,421 | $1,421 | 2.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$592–$1,184 | $592–$1,184 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$568–$1,138 | $568–$1,138 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$616–$1,231 | $616–$1,231 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,073 | $1,073 | 8.0× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$418–$1,001 | $418–$1,001 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$589–$1,177 | $589–$1,177 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$592–$1,421 | $592–$1,421 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $473 | $473 | 4.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,421 | $1,421 | 10.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $616 | $616 | 5.5× |
| Radex Ribs Unilateral 2 Views (71100) | $710 | $710 | 6.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$595–$1,190 | $595–$1,190 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$342–$710 | $342–$710 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,552 | $1,552 | 6.9× |
| Radex Spine 1 View Specify Level (72020) | $569 | $569 | 5.1× |
| Radex Sternum Minimum 2 Views (71120) | $852 | $852 | 7.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,138 | $1,138 | 10.2× |
| Radex Toe Minimum 2 Views (73660) | $379 | $379 | 3.4× |
| Radex upper extremity infant minimum 2 views (73092) | $490 | $490 | 3.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$592–$1,184 | $592–$1,184 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $18,112 | $18,112 | 1.9× |
| Radiation treatment delivery level 1 (77402) | $1,441 | $1,441 | 11.0× |
| Radiation treatment delivery level 2 (77407) | $2,277 | $2,277 | 4.6× |
| Radiation treatment delivery level 3 (77412) | $2,691 | $2,691 | 3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $995 | $995 | 7.4× |
| Radiologic exam colon double contrast study (74280) | $2,030 | $2,030 | 9.0× |
| Radiologic exam colon single contrast study (74270) | $1,118 | $1,118 | 5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $995 | $995 | 4.4× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$758–$1,516 | $758–$1,516 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $656 | $656 | 4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,231 | $1,231 | 5.5× |
| Radiologic exam swallow function contrast study (74230) | $770 | $770 | 3.4× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$2,276–$2,732 | $2,276–$2,732 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$679–$1,359 | $679–$1,359 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$749–$1,418 | $749–$1,418 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$186.36–$948 | $186.36–$948 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $2,501 | $2,501 | 18.6× |
| Radiologic Examination Salivary Gland Calculus (70380) | $379 | $379 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$592–$1,184 | $592–$1,184 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $3,312 | $3,312 | 6.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $2,174 | $2,174 | 4.4× |
| Renal Cyst Study (74470) | $990 | $990 | 1.4× |
| Ribs bilateral 3 views (71110) | $904 | $904 | 6.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,416 | $1,416 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,752 | $1,752 | 3.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 3 matching MRF lines |
$3,766–$4,085 | $3,766–$4,085 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,259 | $2,259 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,520 | $4,520 | 6.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $6,778 | $6,778 | 4.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $7,566 | $7,566 | 4.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,045 | $5,045 | 3.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $925 | $925 | 3.1× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$720–$806 | $720–$806 | varies |
| Salivary Gland Imaging Serial Images (78231) | $1,374 | $1,374 | 2.7× |
| Scapula (73010) range across 3 matching MRF lines |
$711–$1,424 | $711–$1,424 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $225 | $225 | 9.6× |
| Sella turcica (70240) | $626 | $626 | 5.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$554–$583 | $554–$583 | varies |
| Shoulder Arthrography (73040) | $2,184 | $2,184 | 4.9× |
| Sialogram (70390) | $1,184 | $1,184 | 3.9× |
| Skull less than 4 views (70250) | $706 | $706 | 5.3× |
| Special dosimetry (77331) | $287 | $287 | 1.7× |
| Special Physics Consult (77370) | $673 | $673 | 3.9× |
| Special teletherapy port plan (77321) | $1,946 | $1,946 | 4.0× |
| Special treatment procedure (77470) | $2,413 | $2,413 | 3.4× |
| Stereotactic Body Radiation Delivery (77373) | $7,038 | $7,038 | 3.1× |
| Sternoclavicular joints (71130) | $593 | $593 | 5.3× |
| Superior sagittal sinus venogram (75870) | $5,203 | $5,203 | 1.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $765 | $765 | 5.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $9,056 | $9,056 | 18.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $8,189 | $8,189 | 17.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $3,350 | $3,350 | 10.9× |
| Testicular Imaging W/Flow (78761) | $1,243 | $1,243 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,648 | $2,648 | 5.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,085 | $1,085 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $1,026 | $1,026 | 5.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,454 | $2,454 | 10.9× |
| Thoracic spine 2 views (72070) | $558 | $558 | 4.1× |
| Thoracic spine 3 views (72072) | $356 | $356 | 2.6× |
| Thoracolumbar 2 views (72080) | $482 | $482 | 4.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,243 | $1,243 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $1,067 | $1,067 | 2.1× |
| Thyroid Met Imaging Body (78018) | $1,884 | $1,884 | 2.7× |
| Thyroid Uptake Measurement (78012) | $450 | $450 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,095 | $1,095 | 2.1× |
| Tx Devices Design & Construction Complex (77334) | $1,886 | $1,886 | 3.9× |
| Tx devices design & construction intermediate (77333) | $793 | $793 | 4.6× |
| Tx devices design & construction simple (77332) | $673 | $673 | 3.9× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$716–$1,074 | $716–$1,074 | varies |
| Ultrasound, abdomen limited (76705) | $2,246 | $2,246 | 16.7× |
| Unlisted Dx Radiographic Procedure (76499) range across 7 matching MRF lines |
$1,137–$7,564 | $1,137–$7,564 | varies |
| Unlisted fluoroscopic procedure (76496) | $1,678 | $1,678 | 15.0× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $3,641 | $3,641 | 7.1× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,347 | $1,347 | 2.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,297 | $1,297 | 9.9× |
| Unlisted us procedure (76999) range across 4 matching MRF lines |
$807–$2,305 | $807–$2,305 | varies |
| Upper gi w/o kub (74240) | $852 | $852 | 3.8× |
| Ureteral Reflux Study (78740) | $871 | $871 | 1.7× |
| Urethrocystogram voiding (74455) | $1,398 | $1,398 | 4.6× |
| Urethrocystography retrograde (74450) | $1,224 | $1,224 | 4.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,433–$1,888 | $1,433–$1,888 | varies |
| Us chest (76604) | $1,497 | $1,497 | 11.1× |
| Us complete joint (76881) | $1,891 | $1,891 | 14.1× |
| Us exam, pelvic, limited (76857) | $1,092 | $1,092 | 8.1× |
| Us head (76506) | $1,796 | $1,796 | 13.4× |
| Us kidney transplant (76776) | $1,534 | $1,534 | 11.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,719 | $1,719 | 12.8× |
| Us ob detailed single fetus (76811) | $1,104 | $1,104 | 3.6× |
| Us ob limited 1 or more fetuses (76815) | $1,497 | $1,497 | 11.1× |
| Us ob transvaginal (76817) | $1,719 | $1,719 | 12.8× |
| Us pelvic non ob complete (76856) | $2,264 | $2,264 | 16.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,995 | $2,995 | 22.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,873 | $1,873 | 13.9× |
| Us retroperitoneal complete (76770) | $2,493 | $2,493 | 18.5× |
| Us retroperitoneal limited (76775) | $1,832 | $1,832 | 13.6× |
| Us scrotum and contents (76870) | $2,148 | $2,148 | 16.0× |
| Us spinal canal and contents (76800) | $1,713 | $1,713 | 12.7× |
| Us thyroid (76536) range across 3 matching MRF lines |
$546–$2,184 | $546–$2,184 | varies |
| Us transrectal (76872) | $2,184 | $2,184 | 16.2× |
| Vascular Flow Imaging (78445) | $993 | $993 | 1.9× |
| Vasogram (74440) | $782 | $782 | 2.5× |
| Vein X-Ray Chest (75827) | $7,707 | $7,707 | 3.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,905 | $5,905 | 1.5× |
| Vein X-Ray Skull Epidural (75872) | $5,186 | $5,186 | 6.4× |
| Venogram Sinus/Jugular (75860) | $6,472 | $6,472 | 1.6× |
| Venography Adrenal Unilateral (75840) | $6,472 | $6,472 | 1.6× |
| Venography caval inferior serialography rs&i (75825) | $6,472 | $6,472 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $5,370 | $5,370 | 2.7× |
| Venography extremity unilateral rs&i (75820) range across 11 matching MRF lines |
$2,842–$4,806 | $2,842–$4,806 | varies |
| Venography Orbital Rs&I (75880) | $6,472 | $6,472 | 8.0× |
| Venography Renal Bilateral (75833) | $6,951 | $6,951 | 1.7× |
| Venography Renal Unilateral (75831) | $6,472 | $6,472 | 1.6× |
| Venous sampling by catheter (75893) | $8,730 | $8,730 | 1.2× |
| Venous thrombosis imaging (78457) | $1,004 | $1,004 | 1.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,330 | $1,330 | 2.6× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$473–$1,138 | $473–$1,138 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $724 | $724 | 6.5× |
| X-ray antegrade pyelogram tube (74425) | $1,171 | $1,171 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $13,548 | $13,548 | 3.3× |
| X-Ray Bend Only L-S Spine (72120) | $709 | $709 | 5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$473–$947 | $473–$947 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,598 | $1,598 | 2.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $369 | $369 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $739 | $739 | 5.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $473 | $473 | 4.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$1,047–$1,256 | $1,047–$1,256 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,231 | $1,231 | 9.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $343.38 | $343.38 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $1,342 | $1,342 | 10.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $640 | $640 | 5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,278 | $1,278 | 9.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $194 | $194 | 1.4× |
| X-ray eye for foreign body (70030) | $626 | $626 | 5.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$473–$948 | $473–$948 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,421 | $1,421 | 6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $316 | $316 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $616 | $616 | 4.6× |
| X-ray nose-rectum child f.b. (76010) | $238 | $238 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $830 | $830 | 6.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $745 | $745 | 5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $473 | $473 | 4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $900 | $900 | 8.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,113 | $1,113 | 8.3× |
| X-ray thoracic spine 4 vw (72074) | $912 | $912 | 6.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,224 | $1,224 | 2.7× |
| X-Rays Bone Length Studies (77073) | $1,009 | $1,009 | 7.5× |
| X-Rays Bone Survey Complete (77075) | $2,507 | $2,507 | 18.6× |
| Xr c-spine 4 or 5 views (72050) | $948 | $948 | 7.1× |
| Xr facial bones less than 3 views (70140) | $630 | $630 | 5.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $662 | $662 | 4.9× |
| Xr myelogram posterior fossa (70010) | $3,979 | $3,979 | 8.9× |
| Xr orbits complete 4 views (70200) | $995 | $995 | 7.4× |
| Xr Tomogram Single Plane (76100) | $1,226 | $1,226 | 9.1× |
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.