Imaging prices at Fairbanks Memorial Hospital
Fairbanks, AK · every code in this section with a posted price and a Medicare benchmark.
368 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) | $6,816.50 | $7,175.26 | 4.4× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$208.58–$210.83 | $219.56–$221.93 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$398.76–$403.10 | $419.75–$424.32 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,867.55 | $1,965.84 | 4.2× |
| Angio internal mammary (75756) | $4,419.79 | $4,652.41 | 1.3× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$907.19–$6,482.43 | $954.94–$6,823.61 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,535.79 | $3,721.88 | 1.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,072.53–$9,366.20 | $1,128.98–$9,859.16 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$946.36–$9,366.20 | $996.17–$9,859.16 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$707.38–$4,419.79 | $744.61–$4,652.41 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,419.79 | $4,652.41 | 1.3× |
| Ankle 2 views (73600) range across 7 matching MRF lines |
$90.55–$191.97 | $95.32–$202.07 | varies |
| Aortography thoracic serialography rs&i (75605) range across 4 matching MRF lines |
$620.92–$6,589.48 | $653.60–$6,936.29 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $6,482.43 | $6,823.61 | 1.8× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$1,111.52–$6,482.43 | $1,170.02–$6,823.61 | varies |
| Artery X-Rays Adrenal Gland (75731) | $6,482.43 | $6,823.61 | 1.8× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$610.81–$6,482.43 | $642.96–$6,823.61 | varies |
| Artery X-Rays Spine (75705) | $6,589.48 | $6,936.29 | 1.1× |
| Arthrogram ankle (73615) | $1,032.97 | $1,087.34 | 2.7× |
| Arthrogram hip (73525) | $1,032.97 | $1,087.34 | 2.7× |
| Arthrogram Wrist (73115) | $1,032.97 | $1,087.34 | 2.7× |
| Basic radiation dosimetry calculation (77300) | $1,034.93 | $1,089.40 | 6.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$248.77–$248.97 | $261.86–$262.07 | varies |
| Bone Imaging 3 Phase (78315) | $1,966.65 | $2,070.16 | 4.4× |
| Bone Imaging Limited Area (78300) | $1,444.17 | $1,520.18 | 3.3× |
| Bone Imaging Whole Body (78306) | $1,832.44 | $1,928.88 | 4.1× |
| Bone marrow imaging limited area (78102) | $1,406.01 | $1,480.01 | 3.2× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$343.31–$343.60 | $361.38–$361.68 | varies |
| Brachytx isodose complex (77318) | $2,373.91 | $2,498.85 | 5.7× |
| Brachytx isodose intermed (77317) | $1,719.88 | $1,810.40 | 4.1× |
| Brachytx Isodose Plan Simple (77316) | $1,431.47 | $1,506.81 | 3.4× |
| Brain Image W/Flow < 4 Views (78601) | $1,283.24 | $1,350.78 | 2.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,180.83 | $1,242.98 | 2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,080.27 | $3,242.39 | 8.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,080.27 | $3,242.39 | 3.5× |
| Cardiac Shunt Detection (78428) | $1,180.83 | $1,242.98 | 2.7× |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$495.77–$718.09 | $521.86–$755.88 | varies |
| Cerebrospinal Fluid Scan (78630) | $2,327.42 | $2,449.92 | 3.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$208.58–$210.83 | $219.56–$221.93 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$208.58–$210.83 | $219.56–$221.93 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$208.58–$210.83 | $219.56–$221.93 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$398.76–$403.10 | $419.75–$424.32 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$221.75–$224.16 | $233.42–$235.96 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $231.35 | $243.53 | 2.0× |
| Continuing medical physics consltj pr wk (77336) | $1,856.91 | $1,954.64 | 12.4× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$777.33–$6,482.43 | $818.24–$6,823.61 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$171–$597.59 | $180–$629.04 | varies |
| Contrast X-Ray Of Elbow (73085) | $1,035.92 | $1,090.44 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $1,035.92 | $1,090.44 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 12 matching MRF lines |
$2,494.04–$3,209.83 | $2,625.31–$3,378.77 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,273.66–$2,275.63 | $2,393.33–$2,395.40 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,546.74–$1,548.03 | $1,628.15–$1,629.51 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,873.85–$1,875.44 | $1,972.47–$1,974.15 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$717.47–$1,309.93 | $755.23–$1,378.87 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,197.24 | $3,365.52 | 8.3× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,597.29–$1,598.65 | $1,681.36–$1,682.79 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,129.70–$2,131.52 | $2,241.79–$2,243.70 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$1,506.79–$2,131.52 | $1,586.09–$2,243.70 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,598.65–$2,131.52 | $1,682.79–$2,243.70 | varies |
| CT Angio Neck (70498) | $2,131.52 | $2,243.70 | 10.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,598.65 | $1,682.79 | 8.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,806.25–$1,807.80 | $1,901.32–$1,902.95 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,703.48–$1,704.93 | $1,793.14–$1,794.66 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$836.79–$837.51 | $880.83–$881.59 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,958.65–$1,960.33 | $2,061.74–$2,063.51 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,382.88–$2,384.91 | $2,508.29–$2,510.43 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,613.71–$1,615.08 | $1,698.64–$1,700.08 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,965.66–$1,967.36 | $2,069.12–$2,070.90 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,536.63 | $1,617.51 | 4.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $119.94 | $126.25 | 1.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,711.73–$1,713.17 | $1,801.82–$1,803.34 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,689.73–$2,692.01 | $2,831.29–$2,833.69 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,448.32–$1,449.54 | $1,524.55–$1,525.83 | varies |
| CT lower extremity w/contrast material (73701) range across 5 matching MRF lines |
$1,566.34–$3,522.59 | $1,648.78–$3,707.99 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,393.56–$2,395.62 | $2,519.54–$2,521.70 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,703.48–$1,704.93 | $1,793.14–$1,794.66 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,546.07–$1,547.39 | $1,627.44–$1,628.83 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,417.36–$1,418.56 | $1,491.96–$1,493.22 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,899.35–$1,900.98 | $1,999.32–$2,001.03 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,264.52–$2,266.46 | $2,383.70–$2,385.75 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,472.61–$1,473.89 | $1,550.12–$1,551.46 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$738.06–$738.69 | $776.90–$777.57 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$680.94–$681.52 | $716.78–$717.39 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$546.92–$2,123.69 | $575.71–$2,235.46 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,867.92–$1,869.51 | $1,966.23–$1,967.90 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,706.87–$1,708.35 | $1,796.71–$1,798.26 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,373.15–$1,374.30 | $1,445.42–$1,446.63 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,896.68–$1,898.29 | $1,996.51–$1,998.20 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,675.86–$1,677.29 | $1,764.06–$1,765.57 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,634.54–$1,635.94 | $1,720.57–$1,722.04 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,353.61–$1,354.76 | $1,424.85–$1,426.06 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,102.04–$2,207.97 | $2,212.67–$2,324.18 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,566.34–$1,567.68 | $1,648.78–$1,650.19 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,598.65 | $1,682.79 | 8.2× |
| Cta Abdomen (74175) | $2,131.52 | $2,243.70 | 10.9× |
| CTA pelvis (72191) | $1,598.65 | $1,682.79 | 8.2× |
| Dilation ureters/urethra rs&i (74485) | $1,164.98 | $1,226.29 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $4,560.06 | $4,800.06 | 2.1× |
| Diskography lumbar (72295) range across 3 matching MRF lines |
$2,085.81–$5,500.19 | $2,195.59–$5,789.67 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$313.26–$368.94 | $329.75–$388.36 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$326.89–$368.94 | $344.09–$388.36 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$310.59–$310.86 | $326.94–$327.22 | varies |
| Dxa Bone Density Axial (77080) | $568.41 | $598.33 | 4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $226.89 | $238.83 | 2.3× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$933.82–$1,585.29 | $982.97–$1,668.73 | varies |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$629.85–$897.15 | $663–$944.37 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$595.90–$596.39 | $627.26–$627.78 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$464.70–$767.12 | $489.16–$807.49 | varies |
| Echograp Trans R Pros Study (76873) | $1,409.86 | $1,484.06 | 12.2× |
| Esophageal Motility Study (78258) | $1,215.65 | $1,279.63 | 2.7× |
| Esophagram (74220) | $547.38 | $576.19 | 2.8× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$1,050.15–$1,051.05 | $1,105.42–$1,106.37 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$820.19–$820.90 | $863.36–$864.10 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $737.01 | $775.80 | 2.8× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$174.46–$807.83 | $183.64–$850.35 | varies |
| Follow-Up Angiography (75898) | $1,031.36 | $1,085.64 | 0.3× |
| Foot 2 views (73620) range across 9 matching MRF lines |
$90.55–$322.44 | $95.32–$339.41 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$226.75–$229.23 | $238.68–$241.29 | varies |
| Gastric emptying imaging study (78264) | $1,548.87 | $1,630.39 | 3.5× |
| Gastroesophageal Reflux Exam (78262) | $1,533.61 | $1,614.33 | 3.5× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$436.34–$2,520.35 | $459.30–$2,653 | varies |
| Hand 2 views (73120) range across 8 matching MRF lines |
$105.16–$337.14 | $110.69–$354.88 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,589.48 | $6,936.29 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,589.48 | $6,936.29 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,763.06 | $1,855.85 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,469.16 | $1,546.48 | 3.3× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$759.54–$1,932.65 | $799.52–$2,034.37 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$418.95–$685.32 | $441–$721.39 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$734.26–$734.87 | $772.90–$773.55 | varies |
| Interstitial radiation source applic complex (77778) | $2,391.55 | $2,517.42 | 3.1× |
| K Flow/Funct Image W/Drug (78708) | $1,732.98 | $1,824.19 | 2.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,559.88 | $1,641.98 | 2.6× |
| Kidney Imaging Morphol (78700) | $873.28 | $919.24 | 2.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$280.78–$283.85 | $295.56–$298.79 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$762.17–$826.50 | $802.28–$870 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,269.97 | $1,336.81 | 2.9× |
| Lung Perf&Ventilat Diferentl (78598) | $771.12 | $811.71 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $2,549.58 | $2,683.77 | 4.2× |
| Lung Ventilation Imaging (78579) | $656.16 | $690.69 | 1.5× |
| Lymph System Imaging (78195) | $1,564.52 | $1,646.86 | 2.6× |
| Magnetic Image Jaw Joint (70336) | $2,437.26 | $2,565.54 | 9.2× |
| Mammary ductogram or galactogram multiple (77054) | $1,204.20 | $1,267.58 | 4.5× |
| Mammary ductogram or galactogram single (77053) | $882.09 | $928.52 | 3.3× |
| Meckels Divert Exam (78290) | $1,205.37 | $1,268.81 | 2.7× |
| Mlc imrt design & construction per imrt plan (77338) | $614.91 | $647.27 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) | $3,130.66 | $3,295.43 | 8.1× |
| MRA head w/o contrast (70544) | $2,186.05 | $2,301.10 | 8.3× |
| MRA head with contrast (70545) | $2,561.01 | $2,695.80 | 6.6× |
| MRA neck w contrast (70548) | $2,313.34 | $2,435.09 | 6.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,499.34 | $4,736.15 | 11.6× |
| MRA neck w/o contrast (70547) | $2,186.05 | $2,301.10 | 8.3× |
| MRI abdomen w contrast (74182) | $2,866.88 | $3,017.77 | 7.4× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,286.10–$2,573.56 | $1,353.79–$2,709.01 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,110.53 | $2,221.61 | 2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,504.40 | $2,636.21 | 6.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,110.53 | $2,221.61 | 2.4× |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$2,924.25–$2,926.72 | $3,078.16–$3,080.76 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $688.42 | $724.65 | 2.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $688.42 | $724.65 | 2.6× |
| MRI cardiac w/o contrast (75557) | $2,705.32 | $2,847.71 | 10.2× |
| MRI cervical spine w contrast (72142) | $3,101.59 | $3,264.83 | 8.0× |
| MRI cervical spine w/o cont (72141) | $2,642.99 | $2,782.09 | 10.0× |
| MRI chest w/o contrast (71550) | $2,573.56 | $2,709.01 | 9.7× |
| MRI chest with contrast (71551) | $2,866.88 | $3,017.77 | 3.3× |
| MRI chest wo w contrast (71552) | $3,303.74 | $3,477.62 | 8.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,427.25 | $2,555 | 6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,315.25 | $2,437.11 | 6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,582.92–$2,504.40 | $1,666.23–$2,636.21 | varies |
| MRI lumbar spine w contrast (72149) | $3,121.72 | $3,286.02 | 8.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,121.72 | $3,286.02 | 8.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,504.40 | $2,636.21 | 9.5× |
| MRI orbit face neck w contrast (70542) | $2,879.94 | $3,031.52 | 7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,130.40 | $3,295.16 | 8.1× |
| MRI pelvis w contrast (72196) | $2,504.40 | $2,636.21 | 6.5× |
| MRI pelvis w/o & w contrast (72197) | $3,130.40 | $3,295.16 | 8.1× |
| MRI pelvis w/o contrast (72195) | $2,253.89 | $2,372.52 | 8.5× |
| MRI spectroscopy (76390) | $393.77 | $414.49 | 4.1× |
| MRI thoracic spine w/o contrast (72146) | $2,642.99 | $2,782.09 | 10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,650.18 | $2,789.66 | 6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,110.53 | $2,221.61 | 8.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,504.40 | $2,636.21 | 6.5× |
| MRI, abdomen, combo (74183) | $3,303.74 | $3,477.62 | 8.5× |
| MRI, dorsal spine combo (72157) | $3,061.57 | $3,222.71 | 7.9× |
| MRI, dorsal spine contrast (72147) | $3,101.59 | $3,264.83 | 8.0× |
| MRI, joint upper extrem (73221) | $2,110.53 | $2,221.61 | 8.0× |
| MRI, joint upper extrem combo (73223) | $2,722.02 | $2,865.28 | 7.0× |
| MRI, lumbar spine combo (72158) | $3,121.72 | $3,286.02 | 8.1× |
| Myelogram cervical (72240) | $3,073.95 | $3,235.74 | 3.5× |
| Myelogram Lumbar (72265) | $3,506.32 | $3,690.86 | 4.0× |
| Myelography thoracic (72255) | $3,669.38 | $3,862.51 | 4.2× |
| Myelograpy 2/more regions rs&i (72270) | $4,468.70 | $4,703.89 | 5.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,084.69 | $2,194.41 | 4.7× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$894.74–$4,179.53 | $941.83–$4,399.50 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$133.15–$134.60 | $140.16–$141.68 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,180.83 | $1,242.98 | 2.7× |
| Nm csf leak detection (78650) | $2,036.69 | $2,143.88 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $210.27 | $221.34 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,522.62 | $8,971.18 | 5.5× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,670.96–$1,673.31 | $1,758.90–$1,761.38 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$377.31–$377.64 | $397.17–$397.52 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) | $303.09 | $319.04 | 2.6× |
| Panoramic X-ray of jaws (70355) | $374 | $393.68 | 3.9× |
| Parathyroid Planar Imaging (78070) | $1,359.71 | $1,431.27 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,296.98 | $1,365.24 | 2.9× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$226.75–$229.23 | $238.68–$241.29 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,589.48 | $6,936.29 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,339.44 | $1,409.94 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$364.44–$368.40 | $383.62–$387.79 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$737.01–$781.91 | $775.80–$823.06 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$266.05–$268.92 | $280.05–$283.07 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$206.94–$209.18 | $217.83–$220.19 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$251.43–$254.18 | $264.66–$267.56 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$433.25–$437.99 | $456.05–$461.04 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$177.50–$179.44 | $186.84–$188.88 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$241.34–$243.96 | $254.04–$256.80 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$256.33–$259.12 | $269.82–$272.76 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$213.72–$251.49 | $224.97–$264.73 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$517.30–$522.93 | $544.53–$550.45 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$374.62–$378.71 | $394.34–$398.64 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$257.46–$260.27 | $271.01–$273.97 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$251.43–$254.18 | $264.66–$267.56 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$256.33–$259.12 | $269.82–$272.76 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$192.11–$194.18 | $202.22–$204.40 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$285.51–$288.62 | $300.54–$303.81 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$374.62–$378.71 | $394.34–$398.64 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$177.50–$179.44 | $186.84–$188.88 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 7 matching MRF lines |
$192.29–$403.10 | $202.41–$424.32 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$251.43–$254.18 | $264.66–$267.56 | varies |
| Radiation treatment delivery level 1 (77402) | $1,024.95 | $1,078.89 | 9.1× |
| Radiation treatment delivery level 2 (77407) | $1,341.76 | $1,412.38 | 3.1× |
| Radiation treatment delivery level 3 (77412) | $1,689.64 | $1,778.57 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$433.25–$437.99 | $456.05–$461.04 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$398.76–$403.10 | $419.75–$424.32 | varies |
| Radiologic exam colon double contrast study (74280) | $1,140.30 | $1,200.32 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $836.74 | $880.78 | 4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $547.38 | $576.19 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$290.66–$293.82 | $305.96–$309.28 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$408.87–$413.34 | $430.39–$435.09 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $547.38 | $576.19 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $722.38 | $760.40 | 3.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $547.38 | $576.19 | 2.8× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$251.43–$508.35 | $264.66–$535.10 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$279.46–$565 | $294.17–$594.74 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$226.75–$229.23 | $238.68–$241.29 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$226.75–$229.23 | $238.68–$241.29 | varies |
| Radiopharm Dacryocystography (78660) | $871.39 | $917.25 | 2.0× |
| Renal Cyst Study (74470) | $593.95 | $625.21 | 1.0× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$449.55–$454.42 | $473.21–$478.34 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines |
$172.81–$1,312.97 | $181.91–$1,382.07 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,105.85 | $1,164.05 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,821.57 | $4,022.70 | 6.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,982.04–$3,821.57 | $2,086.36–$4,022.70 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$594.66–$3,821.57 | $625.96–$4,022.70 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,821.57 | $4,022.70 | 2.7× |
| Rp Therapy Intravenous Administration (79101) | $1,217.82 | $1,281.92 | 4.7× |
| Scapula (73010) range across 3 matching MRF lines |
$251.43–$254.18 | $264.66–$267.56 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $127.70 | $134.42 | 5.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$157.03–$158.72 | $165.29–$167.07 | varies |
| Shoulder Arthrography (73040) | $1,015.94 | $1,069.41 | 2.6× |
| Sialogram (70390) | $677.70 | $713.37 | 2.6× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$300.77–$304.04 | $316.60–$320.04 | varies |
| Special dosimetry (77331) | $1,756.26 | $1,848.69 | 11.8× |
| Special Physics Consult (77370) | $2,301.89 | $2,423.04 | 15.4× |
| Special teletherapy port plan (77321) | $2,301.89 | $2,423.04 | 5.5× |
| Special treatment procedure (77470) | $3,986.16 | $4,195.96 | 6.5× |
| Stereotactic Body Radiation Delivery (77373) | $5,139.88 | $5,410.40 | 2.6× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$285.51–$288.62 | $300.54–$303.81 | varies |
| Superior sagittal sinus venogram (75870) | $2,125.46 | $2,237.33 | 0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,847.37 | $2,997.23 | 6.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,733.06 | $1,824.27 | 4.2× |
| Testicular Imaging W/Flow (78761) | $1,259.76 | $1,326.06 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,342.42 | $3,518.34 | 8.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,723.49 | $2,866.83 | 6.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$325.74–$1,980.71 | $342.88–$2,084.96 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $215.67 | $227.02 | 1.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$300.77–$304.04 | $316.60–$320.04 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$345.68–$349.44 | $363.87–$367.83 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$417.87–$422.39 | $439.86–$444.62 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $727.82 | $766.13 | 1.6× |
| Thyroid Met Imaging Body (78018) | $2,235.83 | $2,353.50 | 3.7× |
| Thyroid Uptake Measurement (78012) | $516.21 | $543.38 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,010.99 | $1,064.20 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $1,949.75 | $2,052.37 | 4.7× |
| Tx devices design & construction intermediate (77333) | $1,755.08 | $1,847.45 | 11.8× |
| Tx devices design & construction simple (77332) | $1,755.08 | $1,847.45 | 11.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$333.98–$667.96 | $351.56–$703.12 | varies |
| Ultrasound elastography first target lesion (76982) | $332.62 | $350.13 | 2.9× |
| Ultrasound Elastography Parenchyma (76981) | $332.62 | $350.13 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$313.35–$432.41 | $329.84–$455.17 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$472.15–$1,058.64 | $497–$1,114.36 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$310.59–$310.86 | $326.94–$327.22 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $71.96 | $75.75 | 0.7× |
| Unlisted magnetic resonance procedure (76498) | $212.24 | $223.41 | 2.2× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$608.11–$693.27 | $640.12–$729.76 | varies |
| Upper gi w/o kub (74240) | $547.38 | $576.19 | 2.8× |
| Ureteral Reflux Study (78740) | $1,386.45 | $1,459.42 | 3.1× |
| Urethrocystogram voiding (74455) | $802.01 | $844.22 | 3.0× |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$76.95–$874 | $81–$920 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$333.98–$667.96 | $351.56–$703.12 | varies |
| Us chest (76604) range across 5 matching MRF lines |
$239.40–$734.87 | $252–$773.55 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$429.74–$734.87 | $452.36–$773.55 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$228.95–$734.87 | $241–$773.55 | varies |
| Us head (76506) range across 2 matching MRF lines |
$701.20–$701.77 | $738.10–$738.70 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$896.41–$897.15 | $943.59–$944.37 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$234.65–$430.08 | $247–$452.72 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,317.33–$1,318.45 | $1,386.66–$1,387.84 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$342.95–$706.34 | $361–$743.52 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$330.57–$531.03 | $347.97–$558.98 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$810.79–$811.48 | $853.46–$854.19 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$496.85–$706.34 | $523–$743.52 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$459.80–$706.34 | $484–$743.52 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,010.89–$1,011.74 | $1,064.09–$1,064.99 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$118.75–$1,060.08 | $125–$1,115.87 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$734.26–$734.87 | $772.90–$773.55 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$734.26–$734.87 | $772.90–$773.55 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$442.70–$734.87 | $466–$773.55 | varies |
| Us transrectal (76872) range across 5 matching MRF lines |
$542.45–$809.04 | $571–$851.62 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$619.48–$4,419.79 | $652.08–$4,652.41 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,125.46 | $2,237.33 | 0.6× |
| Vein X-Ray Skull Epidural (75872) | $2,125.46 | $2,237.33 | 3.1× |
| Vein X-Ray Spleen/Liver (75810) | $6,589.48 | $6,936.29 | 1.9× |
| Venogram Sinus/Jugular (75860) | $2,125.46 | $2,237.33 | 0.6× |
| Venography Adrenal Unilateral (75840) | $6,589.48 | $6,936.29 | 1.9× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$619.75–$4,419.79 | $652.37–$4,652.41 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$904.87–$3,535.79 | $952.49–$3,721.88 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$572.91–$3,535.79 | $603.06–$3,721.88 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$806.65–$4,419.79 | $849.11–$4,652.41 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$607.66–$4,419.79 | $639.64–$4,652.41 | varies |
| Venous sampling by catheter (75893) | $6,589.48 | $6,936.29 | 1.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,829.99 | $1,926.31 | 4.1× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$157.76–$212.66 | $166.06–$223.85 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$295.71–$298.94 | $311.27–$314.67 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$548.22–$1,147.05 | $577.07–$1,207.42 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$448.42–$6,482.43 | $472.02–$6,823.61 | varies |
| X-Ray Bend Only L-S Spine (72120) | $588.20 | $619.16 | 5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$90.55–$219.25 | $95.32–$230.79 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$124.53–$538.65 | $131.08–$567 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$298.28–$301.51 | $313.98–$317.38 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$342.35–$346.08 | $360.37–$364.29 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$234.14–$236.68 | $246.46–$249.14 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$325.63–$329.16 | $342.77–$346.48 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$342.35–$346.08 | $360.37–$364.29 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$353.66–$357.49 | $372.27–$376.31 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$689.75–$697.24 | $726.05–$733.94 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$225.53–$268.92 | $237.40–$283.07 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$491.32–$496.68 | $517.18–$522.82 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$325.14–$328.69 | $342.25–$345.99 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$172.99–$184.17 | $182.09–$193.86 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$241.34–$243.96 | $254.04–$256.80 | varies |
| X-ray IV pyelogram (ivp) (74400) | $687.17 | $723.34 | 3.5× |
| X-ray IV pyelogram+tomography (74415) | $881.69 | $928.09 | 4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$213.66–$215.97 | $224.91–$227.34 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$436.39–$441.13 | $459.36–$464.35 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$336.12–$339.78 | $353.81–$357.66 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$433.25–$437.99 | $456.05–$461.04 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$334.93–$338.56 | $352.56–$356.38 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 6 matching MRF lines |
$250–$273.87 | $263.16–$288.28 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$359.37–$363.29 | $378.28–$382.41 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$492.77–$512.30 | $518.70–$539.26 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$183.14–$183.30 | $192.78–$192.95 | varies |
| X-ray thoracic spine 4 vw (72074) | $588.20 | $619.16 | 5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$312.55–$742.18 | $329–$781.24 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$432.89–$433.29 | $455.67–$456.09 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$691.54–$692.12 | $727.94–$728.55 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$404.01–$408.40 | $425.27–$429.89 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$359.37–$363.29 | $378.28–$382.41 | varies |
| Xr orbits complete 4 views (70200) range across 5 matching MRF lines |
$358.26–$363.16 | $377.12–$382.27 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$1,224.08–$1,225.13 | $1,288.51–$1,289.61 | varies |
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.