Imaging prices at Fairview Hospital
Great Barrington, MA · every code in this section with a posted price and a Medicare benchmark.
313 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) | $4,310.25 | $4,537.10 | 2.6× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$258.45–$585.68 | $272.05–$616.50 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$476.19–$566.89 | $501.25–$596.73 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,860.46 | $1,958.38 | 3.9× |
| Adrenal Cortex & Medulla Img (78075) | $4,584.14 | $4,825.41 | 3.0× |
| Angiography extremity bilateral rs&i (75716) | $10,386.58 | $10,933.24 | 2.7× |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$4,414.77–$5,082.85 | $4,647.13–$5,350.37 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $10,386.58 | $10,933.24 | 2.7× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$253–$291.31 | $266.32–$306.64 | varies |
| Artery X-Rays Abdomen (75726) | $17,314.37 | $18,225.65 | 2.6× |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$1,092.35–$1,300.45 | $1,149.84–$1,368.89 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$1,209.23–$1,439.54 | $1,272.87–$1,515.30 | varies |
| Basic radiation dosimetry calculation (77300) | $407.83 | $429.29 | 2.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$306.10–$376.84 | $322.21–$396.67 | varies |
| Bone Imaging 3 Phase (78315) | $2,002.36 | $2,107.75 | 4.2× |
| Bone Imaging Limited Area (78300) | $1,321.63 | $1,391.19 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $1,323.76 | $1,393.43 | 2.8× |
| Bone Imaging Whole Body (78306) | $2,002.36 | $2,107.75 | 4.2× |
| Bone marrow imaging limited area (78102) | $1,384.52 | $1,457.39 | 2.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,454.02 | $1,530.55 | 2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$1,841.54–$2,072.98 | $1,938.46–$2,182.08 | varies |
| Cat Scan Follow-Up Study (76380) | $646.67 | $680.70 | 6.2× |
| Cerebrospinal Fluid Scan (78630) | $1,440.07 | $1,515.86 | 2.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$249.95–$307.68 | $263.11–$323.87 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$249.95–$307.68 | $263.11–$323.87 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$249.95–$307.68 | $263.11–$323.87 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$460.55–$566.89 | $484.79–$596.73 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$491.51–$565.88 | $517.38–$595.66 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$298.17–$367.03 | $313.86–$386.35 | varies |
| Continuing medical physics consltj pr wk (77336) | $508.06 | $534.80 | 3.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$333.61–$397.15 | $351.17–$418.05 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$1,081.75–$1,236.31 | $1,138.68–$1,301.38 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$993.04–$1,222.40 | $1,045.31–$1,286.74 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,492.48–$5,035.07 | $3,676.29–$5,300.07 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,405.51–$3,353.98 | $2,532.12–$3,530.50 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,544.19–$2,259.75 | $1,625.46–$2,378.68 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,802.37–$2,637.56 | $1,897.23–$2,776.38 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,279.74–$1,872.74 | $1,347.09–$1,971.31 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,978.86–$4,358.78 | $3,135.64–$4,588.19 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,574.96–$2,270.59 | $1,657.85–$2,390.09 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,785.53–$2,574.19 | $1,879.51–$2,709.67 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$636.69–$931.70 | $670.20–$980.74 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,263.09–$1,787.63 | $1,329.57–$1,881.72 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,064.27–$3,020.81 | $2,172.92–$3,179.80 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,378.40–$1,950.77 | $1,450.95–$2,053.44 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,535.77–$2,247.38 | $1,616.60–$2,365.66 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,377.96–$1,979.30 | $1,450.48–$2,083.47 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,795.04–$2,626.82 | $1,889.52–$2,765.07 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,544.19–$2,259.75 | $1,625.46–$2,378.68 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,852.88–$2,711.48 | $1,950.40–$2,854.19 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$634.47–$928.44 | $667.86–$977.31 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$656.03–$928.44 | $690.56–$977.31 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,358.15–$2,017.38 | $1,429.63–$2,123.56 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,726.84–$2,271.87 | $1,817.73–$2,391.44 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$982.29–$1,209.16 | $1,033.99–$1,272.80 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$176.46–$234.60 | $185.75–$246.95 | varies |
| CT hrt w/3d image congen (75573) | $646.01 | $680.01 | 1.5× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,250.33–$1,829.73 | $1,316.14–$1,926.03 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,618.55–$2,666.32 | $2,756.37–$2,806.65 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,046.67–$1,531.68 | $1,101.76–$1,612.29 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,339.31–$1,959.96 | $1,409.80–$2,063.12 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,535.77–$2,247.38 | $1,616.60–$2,365.66 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,352.14–$1,978.67 | $1,423.30–$2,082.81 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,357.56–$2,016.51 | $1,429.01–$2,122.64 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,020.05–$1,515.21 | $1,073.74–$1,594.96 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,822.04–$2,626.82 | $1,917.94–$2,765.07 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,473.77–$2,156.71 | $1,551.34–$2,270.22 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$963.64–$1,410.16 | $1,014.36–$1,484.38 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,728.60–$2,567.68 | $1,819.58–$2,702.82 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,046.67–$1,531.68 | $1,101.76–$1,612.29 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,458.73–$2,134.69 | $1,535.51–$2,247.04 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,529.46–$2,271.87 | $1,609.96–$2,391.44 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,757.76–$2,610.97 | $1,850.27–$2,748.39 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,567.79–$2,328.77 | $1,650.31–$2,451.34 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,535.77–$2,247.38 | $1,616.60–$2,365.66 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,352.14–$1,978.67 | $1,423.30–$2,082.81 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,856.07–$2,666.32 | $1,953.76–$2,806.65 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,352.55–$1,559.99 | $1,423.74–$1,642.09 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,046.67–$1,531.68 | $1,101.76–$1,612.29 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,591.97–$2,329.60 | $1,675.76–$2,452.21 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,339.32–$1,959.96 | $1,409.81–$2,063.12 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,482.59–$3,632.99 | $2,613.25–$3,824.20 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,532.03–$2,208.70 | $1,612.66–$2,324.95 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,519.25–$2,150.16 | $1,599.21–$2,263.33 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$727.09–$824.37 | $765.36–$867.76 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$456–$460.38 | $480–$484.61 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$41.80–$538.55 | $44–$566.89 | varies |
| Echo exam uterus (76831) | $366.90 | $386.21 | 1.3× |
| Esophagram (74220) range across 2 matching MRF lines |
$400.85–$477.20 | $421.95–$502.32 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$401.65–$1,321.52 | $422.79–$1,391.07 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $770.81 | $811.38 | 2.7× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,492.70–$1,492.71 | $1,571.26–$1,571.27 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$253.56–$291.94 | $266.91–$307.31 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$316.95–$364.93 | $333.63–$384.14 | varies |
| Gastric emptying imaging study (78264) | $1,976.23 | $2,080.24 | 4.1× |
| Gastroesophageal Reflux Exam (78262) | $1,363.27 | $1,435.02 | 2.8× |
| Gated Heart Planar Single (78472) | $3,916.16 | $4,122.27 | 8.2× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$256.05–$301.86 | $269.53–$317.75 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,422.72 | $2,550.23 | 3.7× |
| Hepatobiliary System Imaging (78226) | $2,422.72 | $2,550.23 | 5.1× |
| Ht Muscle Image Spect Sing (78451) | $4,053.34 | $4,266.67 | 2.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$911.30–$1,084.92 | $959.26–$1,142.02 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$296.78–$365.42 | $312.40–$384.65 | varies |
| Infant hip ultrasound, limited static exam (76886) | $245.78 | $258.72 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $3,481.26 | $3,664.48 | 5.3× |
| K Flow/Funct Image W/O Drug (78707) | $3,481.52 | $3,664.76 | 5.4× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$378.94–$436.30 | $398.88–$459.26 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,990.48 | $2,095.24 | 4.2× |
| Lung Perf&Ventilat Diferentl (78598) | $2,398.40 | $2,524.63 | 3.7× |
| Lung perfusion differential (78597) | $1,415.31 | $1,489.80 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,398.40 | $2,524.63 | 3.7× |
| Lung Ventilation Imaging (78579) | $1,192.90 | $1,255.68 | 2.5× |
| Lymph System Imaging (78195) | $764.98 | $805.24 | 1.2× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$2,417.55–$4,604.85 | $2,544.79–$4,847.21 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$856.68–$1,054.55 | $901.77–$1,110.05 | varies |
| Meckels Divert Exam (78290) | $1,353.37 | $1,424.60 | 2.8× |
| Mlc imrt design & construction per imrt plan (77338) | $560.56 | $590.06 | 1.2× |
| Mr safety determination physician/other qhp (76016) | $258.27 | $271.86 | 2.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $71.83 | $75.61 | 2.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $269.26 | $283.43 | 2.4× |
| Mr safety implt pos&/immoblj (76019) | $174.23 | $183.40 | 2.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $709.04 | $746.36 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,391.07–$3,384 | $2,516.92–$3,562.11 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$2,391.07–$3,384 | $2,516.92–$3,562.11 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,890.51–$4,229.92 | $3,042.64–$4,452.55 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,312.66–$3,384.29 | $2,434.38–$3,562.41 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$2,890.51–$4,229.92 | $3,042.64–$4,452.55 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,996.49 | $2,101.57 | 7.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,996.49 | $2,101.57 | 7.0× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$1,091.83–$1,229.05 | $1,149.29–$1,293.74 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,391.07–$3,384 | $2,516.92–$3,562.11 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$3,090.42–$4,229.92 | $3,253.07–$4,452.55 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,312.47–$3,384 | $2,434.18–$3,562.11 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$3,158.25–$4,621.73 | $3,324.47–$4,864.98 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,391.07–$3,384 | $2,516.92–$3,562.11 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,391.07–$3,384 | $2,516.92–$3,562.11 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,265.63–$3,555.17 | $3,437.51–$3,742.28 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,629.77–$3,848.35 | $2,768.18–$4,050.89 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,890.51–$3,253.77 | $3,042.64–$3,425.02 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,391.07–$3,384.01 | $2,516.92–$3,562.12 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$2,988.79–$4,621.73 | $3,146.09–$4,864.98 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,312.47–$3,384 | $2,434.18–$3,562.11 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$2,988.79–$4,229.92 | $3,146.09–$4,452.55 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$2,312.47–$3,384 | $2,434.18–$3,562.11 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$3,158.25–$4,621.73 | $3,324.47–$4,864.98 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$3,615.65–$4,621.73 | $3,805.95–$4,864.98 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$3,158.25–$4,621.73 | $3,324.47–$4,864.98 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$2,312.47–$3,384 | $2,434.18–$3,562.11 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$3,265.63–$4,621.73 | $3,437.51–$4,864.98 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$3,158.25–$4,621.73 | $3,324.47–$4,864.98 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,829.49 | $1,925.78 | 3.8× |
| Myocardial Spect Multiple Studies (78452) | $4,954.99 | $5,215.78 | 3.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$410.22–$509.88 | $431.81–$536.72 | varies |
| Nervous system nuclear exam (78699) | $1,363.27 | $1,435.02 | 2.8× |
| Nm myocard infarct spect (78469) | $1,717.90 | $1,808.32 | 2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,734.40 | $3,930.95 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $1,692.62 | $1,781.71 | 6.1× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$625.98–$632.03 | $658.93–$665.29 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$234.43–$393.74 | $246.77–$414.46 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$217.31–$267.79 | $228.75–$281.88 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,847.39 | $1,944.62 | 2.8× |
| Parathyroid Planar Imaging (78070) | $2,061.40 | $2,169.89 | 4.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$270.17–$321.60 | $284.39–$338.53 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,458.72 | $1,535.49 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$763.10–$908.49 | $803.26–$956.30 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,075.69 | $1,132.30 | 1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$334.36–$384.94 | $351.96–$405.20 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$349.55–$402.46 | $367.95–$423.64 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$323.36–$401.94 | $340.38–$423.09 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$382.67–$455.56 | $402.81–$479.54 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$349.55–$402.46 | $367.95–$423.64 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$334.36–$384.94 | $351.96–$405.20 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$334.36–$384.94 | $351.96–$405.20 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$320.05–$377.34 | $336.89–$397.20 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$373.70–$444.92 | $393.37–$468.34 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$320.05–$381.03 | $336.89–$401.08 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$239.99–$285.69 | $252.62–$300.73 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$378.94–$436.30 | $398.88–$459.26 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$758.01–$911.24 | $797.90–$959.20 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$244.94–$291.56 | $257.83–$306.90 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$248.70–$298.92 | $261.79–$314.65 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$303.17–$364.46 | $319.13–$383.64 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$366.48–$455.56 | $385.77–$479.54 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$352.94–$420.19 | $371.52–$442.31 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$276.37–$318.22 | $290.92–$334.97 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$601.90–$716.52 | $633.58–$754.23 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$877.13–$1,044.21 | $923.29–$1,099.17 | varies |
| Radiation treatment delivery level 1 (77402) | $584.95 | $615.74 | 4.8× |
| Radiation treatment delivery level 2 (77407) | $741.71 | $780.75 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $919.16 | $967.54 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$591.06–$710.57 | $622.17–$747.97 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,391.07–$1,656.03 | $1,464.28–$1,743.19 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,208.28–$1,438.39 | $1,271.87–$1,514.09 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$403.19–$464.20 | $424.41–$488.63 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$378.94–$451.13 | $398.88–$474.87 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$758.01–$902.39 | $797.90–$949.88 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$664.34–$790.86 | $699.30–$832.48 | varies |
| Radiologic exam teeth complete full mouth (70320) range across 2 matching MRF lines |
$85.05–$87.54 | $89.53–$92.15 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$277.78–$319.85 | $292.40–$336.68 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$277.78–$319.85 | $292.40–$336.68 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$334.36–$384.94 | $351.96–$405.20 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$696.89–$829.66 | $733.57–$873.33 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$316.95–$364.93 | $333.63–$384.14 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$758.01–$911.24 | $797.90–$959.20 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,363.27 | $1,435.02 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,198.24 | $1,261.30 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,725.99 | $4,974.73 | 7.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,895.99 | $1,995.78 | 2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $5,470.49 | $5,758.41 | 3.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,822.64 | $5,076.46 | 3.1× |
| Rp Therapy Intravenous Administration (79101) | $663.74 | $698.67 | 2.4× |
| Scapula (73010) range across 4 matching MRF lines |
$585.73–$674.41 | $616.56–$709.91 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $333.79 | $351.36 | 14.3× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$267.55–$307.99 | $281.63–$324.20 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$1,614.22–$1,660.99 | $1,699.18–$1,748.41 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$1,011.76–$1,204.47 | $1,065.01–$1,267.86 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$280.32–$333.69 | $295.07–$351.25 | varies |
| Special dosimetry (77331) | $479.07 | $504.28 | 3.0× |
| Special Physics Consult (77370) | $950.67 | $1,000.70 | 5.9× |
| Special treatment procedure (77470) | $1,625.47 | $1,711.02 | 2.5× |
| Stereotactic Body Radiation Delivery (77373) | $9,002.26 | $9,476.06 | 4.2× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$1,087.28–$1,251.82 | $1,144.51–$1,317.70 | varies |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $292.52 | $307.92 | 2.8× |
| Tbs technical calculation only (77091) | $292.52 | $307.92 | 2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $522.22 | $549.70 | 1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $522.22 | $549.70 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,143.83 | $2,256.66 | 4.8× |
| Ther rad simulaj-aided field setting simple (77280) | $1,081.82 | $1,138.76 | 6.7× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$459.18–$546.66 | $483.35–$575.43 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$277.78–$330.70 | $292.40–$348.11 | varies |
| Thyroid Met Imaging Body (78018) | $1,873.32 | $1,971.92 | 2.9× |
| Thyroid Uptake Measurement (78012) | $2,566.41 | $2,701.48 | 5.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,566.43 | $2,701.51 | 5.4× |
| Tx Devices Design & Construction Complex (77334) | $1,031.86 | $1,086.17 | 2.3× |
| Tx devices design & construction intermediate (77333) | $805.55 | $847.95 | 5.0× |
| Tx devices design & construction simple (77332) | $551.50 | $580.53 | 3.4× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$288.54–$444.25 | $303.73–$467.63 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$462.19–$469.34 | $486.52–$494.04 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$251.83–$885.99 | $265.08–$932.62 | varies |
| Umbilical-artery Doppler (OB) (76820) | $300.77 | $316.60 | 2.4× |
| Unlisted Dx Radiographic Procedure (76499) range across 8 matching MRF lines |
$307.15–$365.66 | $323.32–$384.90 | varies |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$289.87–$356.83 | $305.13–$375.61 | varies |
| Unlisted genitourinary px dx nuclear medicine (78799) | $1,323.76 | $1,393.43 | 2.8× |
| Unlisted respiratory px dx nuclear medicine (78599) | $1,323.76 | $1,393.43 | 2.8× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$78.98–$174.11 | $83.14–$183.27 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$1,114.70–$1,327 | $1,173.37–$1,396.84 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$911.30–$1,084.92 | $959.26–$1,142.02 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,181.95–$1,293.72 | $1,244.16–$1,361.81 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$437.48–$444.25 | $460.51–$467.63 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$204.73–$808.33 | $215.51–$850.87 | varies |
| Us complete joint (76881) | $73.15 | $77 | 0.6× |
| Us exam, pelvic, limited (76857) range across 7 matching MRF lines |
$110.20–$741.10 | $116–$780.11 | varies |
| Us head (76506) range across 2 matching MRF lines |
$1,500.87–$1,728.03 | $1,579.86–$1,818.98 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$1,067.45–$1,228.77 | $1,123.63–$1,293.44 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$39.90–$353.41 | $42–$372.01 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$115.90–$537.24 | $122–$565.52 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$124.45–$790.82 | $131–$832.44 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$122.55–$938.05 | $129–$987.42 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$171.95–$1,081.09 | $181–$1,137.99 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$202.26–$942.33 | $212.90–$991.93 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$815.16–$970.43 | $858.06–$1,021.51 | varies |
| Us retroperitoneal limited (76775) range across 7 matching MRF lines |
$123.50–$1,211.64 | $130–$1,275.41 | varies |
| Us scrotum and contents (76870) range across 7 matching MRF lines |
$138.70–$668.30 | $146–$703.47 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$238.25–$296.21 | $250.79–$311.80 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$318.77–$416.83 | $335.55–$438.77 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$159.60–$456 | $168–$480 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$3,471.88–$4,133.19 | $3,654.61–$4,350.73 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$2,170.38–$2,583.79 | $2,284.61–$2,719.78 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$5,358.86–$6,379.60 | $5,640.91–$6,715.37 | varies |
| Venography extremity unilateral rs&i (75820) | $5,103.69 | $5,372.30 | 2.7× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$287.64–$342.45 | $302.78–$360.47 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$337.63–$384.94 | $355.40–$405.20 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$316.51–$364.40 | $333.17–$383.58 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$642.79–$765.23 | $676.62–$805.51 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$429.43–$647.99 | $452.03–$682.09 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$276.37–$332.24 | $290.92–$349.73 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$192.19–$236.60 | $202.31–$249.05 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$277.78–$330.70 | $292.40–$348.11 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$277.78–$319.85 | $292.40–$336.68 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$277.78–$330.70 | $292.40–$348.11 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$460.08–$547.68 | $484.29–$576.50 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$327.54–$389.31 | $344.78–$409.80 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$562.81–$670.03 | $592.43–$705.29 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$427.66–$509.17 | $450.17–$535.97 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$531.26–$632.48 | $559.22–$665.77 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$104.82–$120.72 | $110.34–$127.07 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$383.18–$476.29 | $403.35–$501.36 | varies |
| X-ray IV pyelogram (ivp) (74400) | $658.10 | $692.74 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$378.94–$455.56 | $398.88–$479.54 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$606.33–$728.91 | $638.24–$767.27 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$450.19–$535.91 | $473.88–$564.12 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$295.68–$352.03 | $311.24–$370.56 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$415.30–$494.42 | $437.16–$520.44 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$1,131.13–$1,302.30 | $1,190.66–$1,370.84 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$396.21–$476.29 | $417.06–$501.36 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$366.48–$455.56 | $385.77–$479.54 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$468.23–$557.45 | $492.87–$586.79 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$547.78–$652.15 | $576.61–$686.47 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$267.61–$348.96 | $281.69–$367.33 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$530.56–$637.82 | $558.48–$671.39 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$454.67–$541.29 | $478.60–$569.78 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$754.09–$868.22 | $793.78–$913.92 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$396.21–$476.29 | $417.06–$501.36 | 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.