Imaging prices at Falmouth Hospital
Falmouth, MA · every code in this section with a posted price and a Medicare benchmark.
354 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) | $3,801.78 | $8,945.37 | 2.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$298.60–$307.56 | $702.59–$723.67 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$867.61–$893.63 | $2,041.43–$2,102.67 | varies |
| Angio internal mammary (75756) | $4,022.80 | $9,465.40 | 1.1× |
| Angio pulmonary bilat (75743) | $7,110.99 | $16,731.73 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $7,111.03 | $16,731.84 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $7,111.03 | $16,731.84 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,967.05 | $16,393.07 | 1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,236.20 | $5,261.64 | 0.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$153.66–$316.54 | $361.55–$744.79 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,583.50 | $15,490.58 | 1.0× |
| Artery X-Rays Abdomen (75726) | $12,457.66 | $29,312.15 | 1.9× |
| Artery X-Rays Adrenal Gland (75731) | $7,111.03 | $16,731.84 | 1.9× |
| Artery X-Rays Pelvis (75736) | $7,111.03 | $16,731.84 | 1.1× |
| Artery X-Rays Spine (75705) | $12,457.66 | $29,312.15 | 1.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| Basic radiation dosimetry calculation (77300) | $420.56 | $989.55 | 2.6× |
| Bone age studies (77072) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$868.05–$894.09 | $2,042.47–$2,103.74 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$868.05–$894.09 | $2,042.47–$2,103.74 | varies |
| Bone survey infant (77076) | $249.77 | $587.70 | 2.0× |
| Brachytx isodose complex (77318) | $822.83 | $1,936.06 | 1.8× |
| Brain Flow Imaging Only (78610) | $1,441.79 | $3,392.45 | 2.2× |
| Brain Image W/Flow < 4 Views (78601) | $793.94 | $1,868.10 | 1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,240.59 | $2,919.03 | 2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,639.75 | $3,858.24 | 3.9× |
| Cat Scan Follow-Up Study (76380) | $279.58 | $657.83 | 2.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,471.58 | $3,462.54 | 2.3× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Chest 4 or more views (71048) | $323.09 | $760.21 | 2.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$153.66–$307.32 | $361.55–$723.10 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$261.36–$269.20 | $614.96–$633.41 | varies |
| Continuing medical physics consltj pr wk (77336) | $420.56 | $989.55 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) | $7,111.03 | $16,731.84 | 1.9× |
| Contrast X-Ray Bladder (74430) | $710.97 | $1,672.88 | 1.7× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,214.93–$1,251.37 | $2,858.65–$2,944.41 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$840.20–$865.41 | $1,976.95–$2,036.26 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,214.93–$1,251.37 | $2,858.65–$2,944.41 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$909.23–$936.51 | $2,139.37–$2,203.55 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$909.23–$936.51 | $2,139.37–$2,203.55 | varies |
| CT angio hrt w/3d image (75574) | $1,330.49 | $3,130.56 | 3.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$909.23–$936.51 | $2,139.37–$2,203.55 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$909.23–$936.51 | $2,139.37–$2,203.55 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$914.42–$941.85 | $2,151.57–$2,216.12 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,308.56 | $3,078.96 | 6.2× |
| CT cervical spine w/ contrast (72126) | $798.69 | $1,879.27 | 1.9× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $712.11 | $1,675.56 | 1.7× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$70.89–$73.02 | $166.80–$171.80 | varies |
| CT hrt w/3d image congen (75573) | $1,330.49 | $3,130.56 | 3.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT l-spine w&w/o contrast (72133) | $899.42 | $2,116.29 | 4.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$476.53–$953.06 | $1,121.25–$2,242.50 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$511.22–$526.56 | $1,202.87–$1,238.96 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$902.74–$929.82 | $2,124.10–$2,187.82 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$476.53–$490.83 | $1,121.25–$1,154.89 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$476.53–$953.06 | $1,121.25–$2,242.50 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$873.23–$899.42 | $2,054.65–$2,116.29 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$775.43–$798.69 | $1,824.53–$1,879.27 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$931.32–$959.26 | $2,191.35–$2,257.09 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$909.23–$936.51 | $2,139.37–$2,203.55 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,251.38 | $2,944.43 | 3.0× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$909.22–$936.50 | $2,139.34–$2,203.52 | varies |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $390.06 | $917.79 | 0.6× |
| Dilation ureters/urethra rs&i (74485) | $3,325.28 | $7,824.18 | 1.3× |
| Diskography lumbar (72295) | $7,620.44 | $17,930.45 | 3.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $199.20 | $468.70 | 1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$194.83–$200.68 | $458.43–$472.18 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$169.25–$174.33 | $398.23–$410.18 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$241.60–$248.85 | $568.48–$585.53 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$263.29–$271.19 | $619.50–$638.09 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$137.23–$141.35 | $322.90–$332.59 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$748.36–$770.81 | $1,760.85–$1,813.68 | varies |
| Echo exam uterus (76831) | $526.74 | $1,239.38 | 1.8× |
| Echograp Trans R Pros Study (76873) | $199.20 | $468.70 | 1.6× |
| Esophagram (74220) range across 2 matching MRF lines |
$272.89–$281.08 | $642.10–$661.36 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$419.82–$2,394.70 | $987.82–$5,634.58 | varies |
| Follow-Up Angiography (75898) | $2,282.39 | $5,370.33 | 0.6× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$867.61–$893.63 | $2,041.43–$2,102.67 | varies |
| Gated Heart, Multiple (78473) | $885.90 | $2,084.47 | 1.8× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,577.34 | $6,064.32 | 3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,553.83 | $6,009.02 | 3.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $7,111.03 | $16,731.84 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,967.05 | $16,393.07 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$998.34–$1,028.29 | $2,349.03–$2,419.50 | varies |
| Hepatobiliary System Imaging (78226) | $1,028.29 | $2,419.50 | 2.1× |
| Ht Musc Image Planar Mult (78454) | $3,700.39 | $8,706.81 | 2.4× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,592.61–$3,700.39 | $8,453.21–$8,706.81 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$851.87–$877.43 | $2,004.40–$2,064.53 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $240.30 | $565.42 | 2.3× |
| Infant hip ultrasound, limited static exam (76886) | $248.54 | $584.79 | 2.4× |
| Interstitial radiation source applic complex (77778) | $3,660.58 | $8,613.13 | 4.4× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,117.46–$1,150.99 | $2,629.32–$2,708.20 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,150.99 | $2,708.20 | 1.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$1,117.46–$1,150.99 | $2,629.32–$2,708.20 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Leveen/Shunt Patency Exam (78291) | $893.63 | $2,102.67 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,028.29 | $2,419.50 | 2.1× |
| Liver imaging static only (78201) | $1,795.47 | $4,224.64 | 2.8× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,154.56–$1,189.19 | $2,716.60–$2,798.10 | varies |
| Lung perfusion differential (78597) | $844.61 | $1,987.31 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,154.56–$1,189.19 | $2,716.60–$2,798.10 | varies |
| Lung Ventilation Imaging (78579) | $844.61 | $1,987.31 | 1.8× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$928.06–$955.91 | $2,183.68–$2,249.19 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| Mammary ductogram or galactogram multiple (77054) | $859.67 | $2,022.76 | 3.0× |
| Mammary ductogram or galactogram single (77053) | $877.43 | $2,064.53 | 3.1× |
| Meckels Divert Exam (78290) | $893.63 | $2,102.67 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,142.20 | $2,687.53 | 2.5× |
| Mr safety determination physician/other qhp (76016) | $114.43 | $269.24 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $31.82 | $74.88 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $119.30 | $280.71 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,639.29–$1,688.47 | $3,857.15–$3,972.86 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRA head with contrast (70545) | $1,839.03 | $4,327.14 | 4.4× |
| MRA neck w contrast (70548) | $1,368.02 | $3,218.87 | 3.3× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI abdomen w contrast (74182) | $1,368.02 | $3,218.87 | 3.3× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,328.18–$1,368.02 | $3,125.12–$3,218.87 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,328.18–$1,368.02 | $3,125.12–$3,218.87 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,384.64–$1,426.18 | $3,257.97–$3,355.71 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,432.70 | $3,371.07 | 5.0× |
| MRI cardiac w/o cont stress (75559) | $926.11 | $2,179.08 | 1.4× |
| MRI cardiac w/o contrast (75557) | $1,493.96 | $3,515.21 | 5.2× |
| MRI cervical spine w contrast (72142) | $1,368.02 | $3,218.87 | 3.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI chest with contrast (71551) | $1,877.25 | $4,417.05 | 2.0× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,708.90 | $4,020.93 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$918–$1,836 | $2,160–$4,320 | varies |
| MRI lumbar spine w contrast (72149) | $1,368.02 | $3,218.87 | 3.3× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI orbit face neck w contrast (70542) | $1,368.02 | $3,218.87 | 3.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI pelvis w contrast (72196) | $1,839.03 | $4,327.14 | 4.4× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,408.74 | $3,314.68 | 3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$918–$945.54 | $2,160–$2,224.80 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI, dorsal spine contrast (72147) | $1,368.02 | $3,218.87 | 3.3× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$918–$1,891.08 | $2,160–$4,449.61 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,535.07–$1,581.12 | $3,611.92–$3,720.28 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,700.39 | $8,706.81 | 2.4× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$3,592.61–$3,700.39 | $8,453.21–$8,706.81 | varies |
| N-invas est c ffr sw aly CTA (75580) | $3,804.21 | $8,951.08 | 3.7× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $705.32 | $1,659.57 | 1.5× |
| Nm myocard infarct spect (78469) | $1,228.86 | $2,891.43 | 1.9× |
| Nonvascular Shunt X-Ray (75809) | $249.33 | $586.67 | 2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,801.78 | $8,945.37 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $356.32 | $838.41 | 1.3× |
| Nuclear Rx Oral Admin (79005) | $706.04 | $1,661.26 | 2.5× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$150.37–$300.75 | $353.82–$707.64 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $685.23 | $1,612.30 | 1.1× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$768.88–$791.95 | $1,809.13–$1,863.40 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$501.23–$516.26 | $1,179.36–$1,214.74 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,092.79 | $9,630.10 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$820.01–$844.61 | $1,929.43–$1,987.31 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $877.43 | $2,064.53 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$153.66–$307.32 | $361.55–$723.10 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$153.66–$316.54 | $361.55–$744.79 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$153.66–$307.32 | $361.55–$723.10 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$153.66–$307.32 | $361.55–$723.10 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,175.18 | $31,000.43 | 1.5× |
| Radiation treatment delivery level 1 (77402) | $130.28 | $306.54 | 1.1× |
| Radiation treatment delivery level 2 (77407) | $492.28 | $1,158.31 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $705.32 | $1,659.57 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$405.23–$417.39 | $953.49–$982.09 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$405.23–$417.39 | $953.49–$982.09 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $309.50 | $728.24 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$194.48–$316.55 | $457.60–$744.82 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$272.89–$281.08 | $642.10–$661.36 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$272.89–$281.08 | $642.10–$661.36 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$405.23–$417.39 | $953.49–$982.09 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$153.66–$316.53 | $361.55–$744.78 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$153.66–$316.54 | $361.55–$744.80 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| Ribs bilateral 3 views (71110) | $250.87 | $590.28 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $477.85 | $1,124.36 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,194.50 | $7,516.47 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,849.34–$1,904.82 | $4,351.38–$4,481.92 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,852.69–$1,908.27 | $4,359.26–$4,490.04 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 2 matching MRF lines |
$955.77–$984.44 | $2,248.87–$2,316.34 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$685.47–$706.04 | $1,612.87–$1,661.26 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$67.26–$69.28 | $158.27–$163.02 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$153.66–$316.53 | $361.55–$744.78 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$909.27–$936.55 | $2,139.47–$2,203.65 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$408.31–$420.56 | $960.73–$989.55 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$408.31–$420.56 | $960.73–$989.55 | varies |
| Special teletherapy port plan (77321) | $1,142.20 | $2,687.53 | 2.5× |
| Special treatment procedure (77470) | $1,515.81 | $3,566.62 | 2.3× |
| Stereotactic Body Radiation Delivery (77373) | $13,175.18 | $31,000.43 | 6.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $1,034.46 | $2,434.02 | 8.5× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $1,025.05 | $2,411.89 | 8.4× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $341.68 | $803.96 | 7.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $551.43 | $1,297.48 | 1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $310.28 | $730.08 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,142.20 | $2,687.53 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,142.20 | $2,687.53 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $420.56 | $989.55 | 2.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$242.50–$249.77 | $570.58–$587.70 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $547.71 | $1,288.72 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $506.18 | $1,191.01 | 1.1× |
| Thyroid Uptake Measurement (78012) | $547.71 | $1,288.72 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$768.88–$791.95 | $1,809.13–$1,863.40 | varies |
| Tx Devices Design & Construction Complex (77334) | $783.15 | $1,842.70 | 1.7× |
| Tx devices design & construction intermediate (77333) | $783.15 | $1,842.70 | 4.9× |
| Tx devices design & construction simple (77332) | $783.15 | $1,842.70 | 4.9× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$203.89–$420.01 | $479.74–$988.27 | varies |
| Ultrasound elastography first target lesion (76982) | $177.02 | $416.51 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $161.61 | $380.25 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$309.37–$318.66 | $727.94–$749.78 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $350.46 | $824.62 | 0.8× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$360.60–$721.20 | $848.47–$1,696.94 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$233.24–$240.24 | $548.81–$565.27 | varies |
| Unlisted fluoroscopic procedure (76496) | $86.67 | $203.92 | 0.8× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$405.23–$417.39 | $953.49–$982.09 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$690.27–$710.97 | $1,624.16–$1,672.88 | varies |
| Urethrocystography retrograde (74450) | $346.83 | $816.08 | 1.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$210.01–$591.47 | $494.13–$1,391.69 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us complete joint (76881) | $371.42 | $873.92 | 3.0× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$241.30–$248.54 | $567.76–$584.79 | varies |
| Us head (76506) | $371.41 | $873.91 | 3.0× |
| Us kidney transplant (76776) | $371.42 | $873.92 | 3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$241.30–$299.34 | $567.76–$704.33 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$511.39–$526.74 | $1,203.28–$1,239.38 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$241.30–$248.54 | $567.76–$584.79 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Us spinal canal and contents (76800) | $280.85 | $660.82 | 2.2× |
| Us thyroid (76536) range across 2 matching MRF lines |
$360.60–$371.42 | $848.47–$873.92 | varies |
| Vein X-Ray Chest (75827) | $2,282.39 | $5,370.33 | 1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,645.13 | $3,870.89 | 0.4× |
| Venogram Sinus/Jugular (75860) | $2,236.20 | $5,261.64 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $7,111.03 | $16,731.84 | 1.9× |
| Venography extremity bilateral rs&i (75822) | $2,282.39 | $5,370.33 | 1.2× |
| Venography extremity unilateral rs&i (75820) | $2,282.39 | $5,370.33 | 1.2× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$3,530.48–$7,111.03 | $8,307.01–$16,731.84 | varies |
| Venography Renal Unilateral (75831) | $7,111.03 | $16,731.84 | 1.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$153.66–$316.53 | $361.55–$744.78 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-ray antegrade pyelogram tube (74425) | $710.97 | $1,672.88 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $7,111.03 | $16,731.84 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$798.23–$877.43 | $1,878.19–$2,064.53 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $169.25 | $398.23 | 1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $287.90 | $677.42 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$307.32–$316.54 | $723.11–$744.80 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$307.32–$614.64 | $723.11–$1,446.22 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $386.04 | $908.33 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$397.22–$409.14 | $934.64–$962.68 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $514.18 | $1,209.83 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $250.87 | $590.28 | 2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$76.83–$158.27 | $180.77–$372.40 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$153.66–$316.55 | $361.55–$744.82 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$194.48–$200.32 | $457.60–$471.33 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| X-Ray Stress View (77071) | $85.90 | $202.11 | 0.8× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$153.66–$158.27 | $361.55–$372.40 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $710.97 | $1,672.88 | 1.7× |
| X-Rays Bone Length Studies (77073) | $200.32 | $471.33 | 1.6× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$243.56–$250.87 | $573.09–$590.28 | varies |
| Xr facial bones less than 3 views (70140) | $158.27 | $372.40 | 1.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $164.32 | $386.63 | 1.3× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$194.48–$200.32 | $457.60–$471.33 | 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.