Imaging prices at Firelands Regional Medical Center (Sandusky, OH)

324 codes. Prices are the hospital's own posted facility charges.

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Procedure	Posted cash	Posted gross	× Medicare
3-D radiotherapy plan dose-volume histograms (77295)	$4,209	$4,209	3.2×
Abdomen 1 View (74018) range across 6 matching MRF lines	$79.31–$349	$79.31–$349	varies
Abdomen 2 views (74019) range across 3 matching MRF lines	$97.56–$373	$97.56–$373	varies
Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines	$1,207–$1,570	$1,207–$1,570	varies
Angio pulmonary bilat (75743)	$4,474	$4,474	1.5×
Angiography extremity bilateral rs&i (75716)	$4,032	$4,032	1.3×
Angiography extremity unilateral rs&i (75710) range across 8 matching MRF lines	$2,719.26–$9,124	$2,719.26–$9,124	varies
Angiography pulmonary unilateral slctv rs&i (75741)	$3,720	$3,720	1.2×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746)	$5,977	$5,977	2.0×
Ankle 2 views (73600) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Aortography thoracic serialography rs&i (75605)	$10,325	$10,325	2.0×
Artery X-Rays Abdomen (75726)	$5,977	$5,977	1.1×
Artery X-Rays Pelvis (75736)	$15,670	$15,670	3.0×
Arthrogram hip (73525) range across 6 matching MRF lines	$336.31–$1,317	$336.31–$1,317	varies
Arthrogram Wrist (73115) range across 6 matching MRF lines	$336.31–$1,742	$336.31–$1,742	varies
Basic radiation dosimetry calculation (77300)	$259	$259	2.0×
Bone age studies (77072) range across 3 matching MRF lines	$97.56–$349	$97.56–$349	varies
Bone Imaging 3 Phase (78315) range across 2 matching MRF lines	$1,071–$1,394	$1,071–$1,394	varies
Bone Imaging Limited Area (78300) range across 2 matching MRF lines	$1,071–$1,394	$1,071–$1,394	varies
Bone Imaging Whole Body (78306) range across 2 matching MRF lines	$1,786–$2,321	$1,786–$2,321	varies
Bone survey infant (77076) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines	$1,618–$2,101	$1,618–$2,101	varies
Brain Imaging Pet Metabolic Evaluation (78608)	$7,867	$7,867	5.8×
Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines	$1,924–$2,500	$1,924–$2,500	varies
Chest 1 view (71045) range across 6 matching MRF lines	$79.31–$298	$79.31–$298	varies
Chest 2 views (71046) range across 3 matching MRF lines	$79.31–$326	$79.31–$326	varies
Chest 3 views (71047) range across 3 matching MRF lines	$79.31–$343	$79.31–$343	varies
Chest 4 or more views (71048) range across 3 matching MRF lines	$97.56–$351	$97.56–$351	varies
Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 3 matching MRF lines	$97.56–$366	$97.56–$366	varies
Clavicle complete (73000) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines	$1,341–$1,744	$1,341–$1,744	varies
Continuing medical physics consltj pr wk (77336)	$461	$461	3.6×
Contrast Exam Abdominl Aorta (75625)	$5,977	$5,977	2.0×
Contrast X-Ray Bladder (74430) range across 2 matching MRF lines	$336.31–$1,377	$336.31–$1,377	varies
Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines	$336.31–$1,166	$336.31–$1,166	varies
Contrast X-Ray Of Knee Joint (73580) range across 6 matching MRF lines	$336.31–$1,742	$336.31–$1,742	varies
Contrast Xray Throat/Cerv Esopha (74210) range across 3 matching MRF lines	$164.62–$547	$164.62–$547	varies
CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines	$3,968–$5,159	$3,968–$5,159	varies
CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines	$2,825–$3,671	$2,825–$3,671	varies
CT abdomen w contrast (74160) range across 2 matching MRF lines	$1,526–$1,981	$1,526–$1,981	varies
CT abdomen w wo contrast (74170) range across 2 matching MRF lines	$1,981–$2,578	$1,981–$2,578	varies
CT abdomen w/o contrast (74150) range across 2 matching MRF lines	$1,412–$1,836	$1,412–$1,836	varies
CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines	$2,739–$3,561	$2,739–$3,561	varies
CT Angio Chest (71275) range across 2 matching MRF lines	$1,824–$2,372	$1,824–$2,372	varies
CT Angio Head (70496) range across 4 matching MRF lines	$1,609–$2,094	$1,609–$2,094	varies
CT angio hrt w/3d image (75574) range across 2 matching MRF lines	$2,394–$3,113	$2,394–$3,113	varies
Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines	$1,824–$3,561	$1,824–$3,561	varies
CT Angio Neck (70498) range across 2 matching MRF lines	$1,609–$2,094	$1,609–$2,094	varies
Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines	$1,824–$2,372	$1,824–$2,372	varies
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473)	$2,094	$2,094	12.6×
CT cervical spine w/ contrast (72126) range across 2 matching MRF lines	$1,347–$1,748	$1,347–$1,748	varies
CT cervical spine w/o contrast (72125) range across 4 matching MRF lines	$1,245–$1,619	$1,245–$1,619	varies
CT cervical spine w/wo cont (72127) range across 2 matching MRF lines	$1,748–$2,275	$1,748–$2,275	varies
CT chest w contrast (71260) range across 2 matching MRF lines	$1,526–$1,981	$1,526–$1,981	varies
CT chest w/wo contrast (71270) range across 2 matching MRF lines	$1,981–$2,578	$1,981–$2,578	varies
CT head/brain with contrast (70460) range across 2 matching MRF lines	$1,101–$1,433	$1,101–$1,433	varies
CT head/brain without and with contrast (70470) range across 2 matching MRF lines	$1,433–$1,863	$1,433–$1,863	varies
CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines	$1,036–$1,346	$1,036–$1,346	varies
CT heart no contrast quant eval coronry calcium (75571)	$147	$147	1.8×
CT iac w contrast (70481) range across 8 matching MRF lines	$1,020–$1,324	$1,020–$1,324	varies
CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines	$1,981–$2,578	$1,981–$2,578	varies
CT lower ext w/o (73700) range across 6 matching MRF lines	$1,168–$2,278	$1,168–$2,278	varies
CT lower extremity w/contrast material (73701) range across 6 matching MRF lines	$1,260–$2,463	$1,260–$2,463	varies
CT lumbar spine w contrast (72132) range across 2 matching MRF lines	$1,526–$1,981	$1,526–$1,981	varies
CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines	$1,410–$1,833	$1,410–$1,833	varies
CT maxillofacial w contrast (70487) range across 2 matching MRF lines	$1,101–$1,433	$1,101–$1,433	varies
CT maxillofacial wo contrast (70486) range across 4 matching MRF lines	$1,021–$1,325	$1,021–$1,325	varies
CT neck tissue combo (70492) range across 4 matching MRF lines	$1,448–$1,947	$1,448–$1,947	varies
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 8 matching MRF lines	$1,323–$1,721	$1,323–$1,721	varies
CT orbits w/o contrast (70480) range across 8 matching MRF lines	$944–$1,228	$944–$1,228	varies
CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines	$1,982–$2,579	$1,982–$2,579	varies
CT pelvis w/o contrast (72192) range across 2 matching MRF lines	$1,412–$1,836	$1,412–$1,836	varies
CT scan of leg combo (73702) range across 6 matching MRF lines	$1,639–$3,203	$1,639–$3,203	varies
CT scans face/jaw combo (70488) range across 2 matching MRF lines	$1,433–$1,863	$1,433–$1,863	varies
CT soft tissue neck w contrast (70491) range across 2 matching MRF lines	$1,115–$1,448	$1,115–$1,448	varies
CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines	$1,032–$1,344	$1,032–$1,344	varies
CT thoracic spine w contrast (72129) range across 2 matching MRF lines	$1,526–$1,981	$1,526–$1,981	varies
CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines	$1,410–$1,833	$1,410–$1,833	varies
CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines	$1,981–$2,578	$1,981–$2,578	varies
CT thorax w/o contrast (71250) range across 2 matching MRF lines	$1,412–$1,836	$1,412–$1,836	varies
CT upper ext wo (73200) range across 6 matching MRF lines	$1,168–$2,278	$1,168–$2,278	varies
CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines	$1,639–$3,203	$1,639–$3,203	varies
CT upper extremity with contrast (73201) range across 6 matching MRF lines	$1,260–$2,463	$1,260–$2,463	varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines	$1,824–$2,372	$1,824–$2,372	varies
Cta Abdomen (74175) range across 2 matching MRF lines	$1,824–$2,372	$1,824–$2,372	varies
CTA head&neck c+ w/noncontrast img&post-pxessing (70471)	$2,094	$2,094	6.3×
CTA pelvis (72191) range across 2 matching MRF lines	$1,824–$2,372	$1,824–$2,372	varies
Diskography lumbar (72295) range across 2 matching MRF lines	$1,640.81–$2,386	$1,640.81–$2,386	varies
Dxa Bone Density Axial (77080) range across 3 matching MRF lines	$97.56–$424	$97.56–$424	varies
Dxa bone density study 1/>sites appendiclr skel (77081) range across 3 matching MRF lines	$79.31–$189	$79.31–$189	varies
Esophagram (74220) range across 3 matching MRF lines	$164.62–$641	$164.62–$641	varies
Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines	$468–$606	$468–$606	varies
Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines	$468–$606	$468–$606	varies
Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines	$213.16–$826	$213.16–$826	varies
Foot 2 views (73620) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Forearm 2 views (73090) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Gastric emptying imaging study (78264) range across 2 matching MRF lines	$1,397–$1,814	$1,397–$1,814	varies
Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines	$990–$1,284	$990–$1,284	varies
Gated Heart Planar Single (78472) range across 2 matching MRF lines	$1,886–$2,452	$1,886–$2,452	varies
Hand 2 views (73120) range across 9 matching MRF lines	$97.56–$464	$97.56–$464	varies
Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines	$1,588–$2,066	$1,588–$2,066	varies
Hepatobiliary System Imaging (78226) range across 2 matching MRF lines	$1,588–$2,066	$1,588–$2,066	varies
Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines	$4,780–$6,213	$4,780–$6,213	varies
Hysterosalpingogram (74740) range across 3 matching MRF lines	$213.16–$2,209	$213.16–$2,209	varies
Image fusion (77399)	$202	$202	1.6×
K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines	$4,359–$5,669	$4,359–$5,669	varies
K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines	$3,063–$3,974	$3,063–$3,974	varies
K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines	$1,651–$2,149	$1,651–$2,149	varies
Kidney Imaging Morphol (78700) range across 2 matching MRF lines	$1,315–$1,706	$1,315–$1,706	varies
Knee 3 Views (73562) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines	$1,315–$1,706	$1,315–$1,706	varies
Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines	$1,315–$1,706	$1,315–$1,706	varies
Liver imaging static only (78201) range across 2 matching MRF lines	$1,315–$1,706	$1,315–$1,706	varies
Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines	$1,786–$2,321	$1,786–$2,321	varies
Lung perfusion differential (78597) range across 2 matching MRF lines	$1,531–$1,991	$1,531–$1,991	varies
Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines	$1,786–$2,321	$1,786–$2,321	varies
Lung Ventilation Imaging (78579) range across 2 matching MRF lines	$1,071–$1,394	$1,071–$1,394	varies
Lymph System Imaging (78195) range across 2 matching MRF lines	$1,608–$2,091	$1,608–$2,091	varies
Magnetic Image Jaw Joint (70336) range across 4 matching MRF lines	$2,580–$4,712	$2,580–$4,712	varies
Mammary ductogram or galactogram multiple (77054)	$890	$890	3.9×
Mammary ductogram or galactogram single (77053)	$786	$786	3.5×
Meckels Divert Exam (78290) range across 2 matching MRF lines	$1,165–$1,513	$1,165–$1,513	varies
Medical physics dose eval radiation expos w/rprt (76145)	$1,538	$1,538	4.4×
Mlc imrt design & construction per imrt plan (77338)	$1,081	$1,081	3.1×
Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines	$3,106–$4,038	$3,106–$4,038	varies
MRA head w/o contrast (70544) range across 2 matching MRF lines	$2,212–$2,877	$2,212–$2,877	varies
MRA head with contrast (70545) range across 2 matching MRF lines	$2,390–$3,106	$2,390–$3,106	varies
MRA neck w contrast (70548) range across 2 matching MRF lines	$2,390–$3,106	$2,390–$3,106	varies
Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines	$3,106–$4,038	$3,106–$4,038	varies
MRA neck w/o contrast (70547) range across 2 matching MRF lines	$2,212–$2,877	$2,212–$2,877	varies
MRI abdomen w contrast (74182) range across 2 matching MRF lines	$2,996–$3,896	$2,996–$3,896	varies
MRI abdomen w/o contrast (74181) range across 2 matching MRF lines	$2,774–$3,606	$2,774–$3,606	varies
MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines	$2,830–$5,521	$2,830–$5,521	varies
MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines	$3,683–$7,176	$3,683–$7,176	varies
MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines	$2,830–$5,521	$2,830–$5,521	varies
MRI bone marrow blood supply (77084) range across 2 matching MRF lines	$2,286–$2,972	$2,286–$2,972	varies
MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines	$1,598–$2,077	$1,598–$2,077	varies
MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines	$1,523–$1,979	$1,523–$1,979	varies
MRI cervical spine w contrast (72142) range across 2 matching MRF lines	$3,294–$4,283	$3,294–$4,283	varies
MRI cervical spine w/o cont (72141) range across 2 matching MRF lines	$3,049–$3,965	$3,049–$3,965	varies
MRI chest w/o contrast (71550) range across 2 matching MRF lines	$2,268–$2,946	$2,268–$2,946	varies
MRI chest with contrast (71551) range across 2 matching MRF lines	$2,451–$3,185	$2,451–$3,185	varies
MRI chest wo w contrast (71552) range across 2 matching MRF lines	$3,185–$4,139	$3,185–$4,139	varies
MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 6 matching MRF lines	$2,830–$5,521	$2,830–$5,521	varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines	$3,683–$7,176	$3,683–$7,176	varies
MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines	$2,620–$3,408	$2,620–$3,408	varies
MRI lumbar spine w contrast (72149) range across 2 matching MRF lines	$3,313–$4,307	$3,313–$4,307	varies
Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines	$4,283–$5,566	$4,283–$5,566	varies
MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines	$2,088–$2,715	$2,088–$2,715	varies
MRI orbit face neck w contrast (70542) range across 4 matching MRF lines	$2,255–$2,930	$2,255–$2,930	varies
Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines	$2,930–$3,810	$2,930–$3,810	varies
MRI pelvis w contrast (72196) range across 4 matching MRF lines	$2,998–$3,897	$2,998–$3,897	varies
MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines	$3,897–$5,064	$3,897–$5,064	varies
MRI pelvis w/o contrast (72195) range across 4 matching MRF lines	$2,774–$3,606	$2,774–$3,606	varies
MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines	$3,067–$3,988	$3,067–$3,988	varies
MRI upper extremity oth than jt w/contr matrl (73219) range across 6 matching MRF lines	$2,830–$5,521	$2,830–$5,521	varies
MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines	$2,620–$3,408	$2,620–$3,408	varies
Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines	$3,683–$7,176	$3,683–$7,176	varies
MRI, abdomen, combo (74183) range across 2 matching MRF lines	$3,896–$5,063	$3,896–$5,063	varies
MRI, dorsal spine combo (72157) range across 2 matching MRF lines	$4,307–$5,597	$4,307–$5,597	varies
MRI, dorsal spine contrast (72147) range across 2 matching MRF lines	$3,313–$4,307	$3,313–$4,307	varies
MRI, joint upper extrem (73221) range across 4 matching MRF lines	$2,620–$3,408	$2,620–$3,408	varies
MRI, joint upper extrem combo (73223) range across 6 matching MRF lines	$3,683–$7,176	$3,683–$7,176	varies
MRI, lumbar spine combo (72158) range across 2 matching MRF lines	$4,307–$5,597	$4,307–$5,597	varies
Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines	$4,465–$8,176	$4,465–$8,176	varies
Neck soft tissue (70360) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
Nm myocard infarct spect (78469) range across 2 matching MRF lines	$1,251–$1,627	$1,251–$1,627	varies
Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Ntsty modul radthx pln dose-vol histos (77301)	$4,078	$4,078	3.1×
Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines	$1,005–$1,306	$1,005–$1,306	varies
Panoramic X-ray of jaws (70355) range across 3 matching MRF lines	$79.31–$232	$79.31–$232	varies
Parathyroid Planar Imaging (78070) range across 2 matching MRF lines	$1,165–$1,513	$1,165–$1,513	varies
Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines	$3,280–$4,265	$3,280–$4,265	varies
Pelvis 1 or 2 views (72170) range across 3 matching MRF lines	$97.56–$373	$97.56–$373	varies
Pet Image W/Ct Lmtd (78814)	$6,498	$6,498	4.8×
PET image w/CT, full body (78816)	$6,498	$6,498	4.8×
PET imaging CT attenuation skull base mid-thigh (78815)	$6,498	$6,498	4.8×
Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines	$1,071–$1,394	$1,071–$1,394	varies
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines	$97.56–$524	$97.56–$524	varies
Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines	$459.27–$2,209	$459.27–$2,209	varies
Radex Ankle Complete Minimum 3 Views (73610) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Radex elbow complete minimum 3 views (73080) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Radex fingr minimum 2 views (73140) range across 30 matching MRF lines	$79.31–$373	$79.31–$373	varies
Radex foot complete minimum 3 views (73630) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radex lower extremity infant minimum 2 views (73592) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines	$97.56–$393	$97.56–$393	varies
Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines	$79.31–$393	$79.31–$393	varies
Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines	$79.31–$419	$79.31–$419	varies
Radex shoulder complete minimum 2 views (73030) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines	$79.31–$349	$79.31–$349	varies
Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
Radex Toe Minimum 2 Views (73660) range across 30 matching MRF lines	$79.31–$373	$79.31–$373	varies
Radex upper extremity infant minimum 2 views (73092) range across 9 matching MRF lines	$97.56–$464	$97.56–$464	varies
Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines	$79.31–$511	$79.31–$511	varies
Radiation Delivery Stereotactic Cranial Linear (77372)	$22,637	$22,637	3.2×
Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines	$426–$997	$426–$997	varies
Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines	$612–$1,675	$612–$1,675	varies
Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines	$713–$2,000	$713–$2,000	varies
Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines	$164.62–$1,742	$164.62–$1,742	varies
Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines	$164.62–$1,301	$164.62–$1,301	varies
Radiologic exam knee complete 4/more views (73564) range across 9 matching MRF lines	$97.56–$559	$97.56–$559	varies
Radiologic exam pelvis compl minimum 3 views (72190) range across 6 matching MRF lines	$97.56–$419	$97.56–$419	varies
Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines	$164.62–$698	$164.62–$698	varies
Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines	$164.62–$641	$164.62–$641	varies
Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines	$164.62–$1,384	$164.62–$1,384	varies
Radiologic examination femur minimum 2 views (73552) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Radiologic Examination Salivary Gland Calculus (70380) range across 3 matching MRF lines	$79.31–$393	$79.31–$393	varies
Radiologic examination tibia & fibula 2 views (73590) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Radiologic examination, teeth; single view Non-Facility (70300) range across 3 matching MRF lines	$79.31–$349	$79.31–$349	varies
Ribs bilateral 3 views (71110) range across 3 matching MRF lines	$97.56–$603	$97.56–$603	varies
Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines	$1,114–$2,143	$1,114–$2,143	varies
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines	$1,197–$1,555	$1,197–$1,555	varies
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines	$4,465–$5,806	$4,465–$5,806	varies
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 4 matching MRF lines	$2,478–$4,186	$2,478–$4,186	varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 14 matching MRF lines	$1,651–$4,409	$1,651–$4,409	varies
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403)	$1,484	$1,484	6.7×
Rp Therapy Intravenous Administration (79101)	$701	$701	3.2×
Scapula (73010) range across 9 matching MRF lines	$97.56–$464	$97.56–$464	varies
Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines	$22.25–$39	$22.25–$39	varies
Sella turcica (70240) range across 3 matching MRF lines	$79.31–$393	$79.31–$393	varies
Shoulder 1 view (73020) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
Shoulder Arthrography (73040) range across 6 matching MRF lines	$336.31–$1,317	$336.31–$1,317	varies
Skull less than 4 views (70250) range across 3 matching MRF lines	$97.56–$393	$97.56–$393	varies
Special dosimetry (77331)	$722	$722	5.7×
Special Physics Consult (77370)	$414	$414	3.3×
Special teletherapy port plan (77321)	$979	$979	2.8×
Special treatment procedure (77470)	$706	$706	1.4×
Spleen Imaging (78185) range across 2 matching MRF lines	$1,427–$1,858	$1,427–$1,858	varies
Stereotactic Body Radiation Delivery (77373)	$5,048	$5,048	3.0×
Sternoclavicular joints (71130) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
Telethx isodose pln cplx w/basic dosimetry (77307)	$1,836	$1,836	5.2×
Telethx isodose pln smpl w/dosimetry calculation (77306)	$787	$787	2.2×
Testicular Imaging W/Flow (78761) range across 2 matching MRF lines	$1,251–$1,627	$1,251–$1,627	varies
Ther Rad Simulaj-Aided Field Setting Complex (77290)	$1,287	$1,287	3.6×
Ther Rad Simulaj-Aided Field Setting Intermed (77285)	$1,076	$1,076	3.0×
Ther rad simulaj-aided field setting simple (77280)	$739	$739	5.8×
Thoracic spine 2 views (72070) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Thoracic spine 3 views (72072) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
Thoracolumbar 2 views (72080) range across 3 matching MRF lines	$79.31–$464	$79.31–$464	varies
Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines	$983–$1,276	$983–$1,276	varies
Thyroid Met Imaging Body (78018) range across 2 matching MRF lines	$1,264–$1,641	$1,264–$1,641	varies
Thyroid Uptake Measurement (78012) range across 2 matching MRF lines	$716–$930	$716–$930	varies
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines	$1,194–$1,553	$1,194–$1,553	varies
Tx Devices Design & Construction Complex (77334)	$632	$632	1.8×
Tx devices design & construction intermediate (77333)	$466	$466	3.7×
Tx devices design & construction simple (77332)	$429	$429	3.4×
Ultrasound Breast Limited (76642) range across 2 matching MRF lines	$619–$925	$619–$925	varies
Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines	$346–$447	$346–$447	varies
Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines	$346–$447	$346–$447	varies
Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines	$578–$751	$578–$751	varies
Ultrasound, abdomen limited (76705) range across 13 matching MRF lines	$157–$990	$157–$990	varies
Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines	$79.31–$298	$79.31–$298	varies
Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines	$249–$324	$249–$324	varies
Unlisted us procedure (76999) range across 2 matching MRF lines	$424–$551	$424–$551	varies
Upper gi w/o kub (74240) range across 3 matching MRF lines	$164.62–$1,384	$164.62–$1,384	varies
Urethrocystogram voiding (74455) range across 3 matching MRF lines	$213.16–$1,627	$213.16–$1,627	varies
Us breast unilateral complete (76641) range across 2 matching MRF lines	$648–$961	$648–$961	varies
Us chest (76604) range across 5 matching MRF lines	$157–$551	$157–$551	varies
Us exam, pelvic, limited (76857) range across 2 matching MRF lines	$359–$469	$359–$469	varies
Us head (76506) range across 2 matching MRF lines	$468–$606	$468–$606	varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines	$468–$606	$468–$606	varies
Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines	$468–$606	$468–$606	varies
Us ob transvaginal (76817) range across 2 matching MRF lines	$807–$1,047	$807–$1,047	varies
Us pelvic non ob complete (76856) range across 2 matching MRF lines	$718–$938	$718–$938	varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines	$807–$1,047	$807–$1,047	varies
Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines	$339–$439	$339–$439	varies
Us retroperitoneal limited (76775) range across 6 matching MRF lines	$531–$1,213	$531–$1,213	varies
Us scrotum and contents (76870) range across 2 matching MRF lines	$678–$880	$678–$880	varies
Us spinal canal and contents (76800) range across 2 matching MRF lines	$578–$751	$578–$751	varies
Us thyroid (76536) range across 2 matching MRF lines	$678–$880	$678–$880	varies
Us transrectal (76872) range across 2 matching MRF lines	$620–$807	$620–$807	varies
Vein X-Ray Chest (75827)	$2,826	$2,826	1.9×
Venography caval inferior serialography rs&i (75825)	$5,977	$5,977	2.0×
Venography extremity bilateral rs&i (75822)	$3,753	$3,753	2.5×
Venography extremity unilateral rs&i (75820)	$2,826	$2,826	1.9×
Venography Renal Bilateral (75833)	$4,032	$4,032	1.3×
Venography Renal Unilateral (75831)	$9,124	$9,124	3.1×
Vertebral fracture assessment via dxa (77086) range across 6 matching MRF lines	$79.31–$218	$79.31–$218	varies
Wrist 2 views (73100) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines	$79.31–$349	$79.31–$349	varies
X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines	$336.31–$1,377	$336.31–$1,377	varies
X-Ray Aorta Leg Arteries (75630)	$5,977	$5,977	2.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 9 matching MRF lines	$79.31–$464	$79.31–$464	varies
X-Ray Exam Breast Specimen (76098)	$792	$792	1.5×
X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines	$79.31–$414	$79.31–$414	varies
X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines	$97.56–$511	$97.56–$511	varies
X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines	$79.31–$373	$79.31–$373	varies
X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines	$79.31–$431	$79.31–$431	varies
X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines	$97.56–$373	$97.56–$373	varies
X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines	$97.56–$515	$97.56–$515	varies
X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines	$97.56–$559	$97.56–$559	varies
X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines	$97.56–$756	$97.56–$756	varies
X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines	$79.31–$464	$79.31–$464	varies
X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines	$97.56–$756	$97.56–$756	varies
X-Ray Exam Unilat Ribs/Chest (71101) range across 6 matching MRF lines	$97.56–$603	$97.56–$603	varies
X-ray eye for foreign body (70030) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
X-ray humerus (73060) range across 6 matching MRF lines	$79.31–$373	$79.31–$373	varies
X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines	$164.62–$1,627	$164.62–$1,627	varies
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines	$79.31–$393	$79.31–$393	varies
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 9 matching MRF lines	$97.56–$464	$97.56–$464	varies
X-ray nose-rectum child f.b. (76010) range across 6 matching MRF lines	$79.31–$373	$79.31–$373	varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 6 matching MRF lines	$97.56–$603	$97.56–$603	varies
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines	$97.56–$442	$97.56–$442	varies
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines	$97.56–$349	$97.56–$349	varies
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines	$79.31–$393	$79.31–$393	varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines	$79.31–$442	$79.31–$442	varies
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines	$97.56–$491	$97.56–$491	varies
X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines	$97.56–$464	$97.56–$464	varies
X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines	$336.31–$1,377	$336.31–$1,377	varies
X-Rays Bone Length Studies (77073) range across 5 matching MRF lines	$97.56–$373	$97.56–$373	varies
X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines	$97.56–$764	$97.56–$764	varies
Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines	$97.56–$756	$97.56–$756	varies
Xr facial bones less than 3 views (70140) range across 3 matching MRF lines	$79.31–$373	$79.31–$373	varies
XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines	$97.56–$349	$97.56–$349	varies
Xr orbits complete 4 views (70200) range across 3 matching MRF lines	$97.56–$442	$97.56–$442	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.