Imaging prices at Franciscan Health Dyer
Dyer, IN · every code in this section with a posted price and a Medicare benchmark.
387 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) | $3,724.92 | $13,796 | 2.5× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$59.40–$141.75 | $220–$525 | varies |
| Abdomen 2 views (74019) | $194.13 | $719 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $372.33 | $1,379 | 0.9× |
| Angio internal mammary (75756) | $2,309.58 | $8,554 | 0.7× |
| Angio pulmonary bilat (75743) | $1,862.19 | $6,897 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $2,235.06 | $8,278 | 0.7× |
| Angiography extremity unilateral rs&i (75710) | $1,490.40 | $5,520 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,490.40 | $5,520 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,309.58 | $8,554 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$138.24–$276.48 | $512–$1,024 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,825.20 | $6,760 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,272.05 | $8,415 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $1,266.84 | $4,692 | 0.4× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,340.82 | $4,966 | 0.2× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,421.36 | $8,968 | 0.4× |
| Arthrogram ankle (73615) | $358.29 | $1,327 | 1.0× |
| Arthrogram hip (73525) | $409.86 | $1,518 | 1.1× |
| Arthrogram Wrist (73115) | $361.53 | $1,339 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $297.81 | $1,103 | 2.1× |
| Bone age studies (77072) | $153.36 | $568 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,229.31 | $4,553 | 2.9× |
| Bone Imaging Limited Area (78300) | $595.89 | $2,207 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $484.38 | $1,794 | 1.1× |
| Bone Imaging Whole Body (78306) | $1,005.48 | $3,724 | 2.4× |
| Bone marrow imaging limited area (78102) | $268.65 | $995 | 0.6× |
| Bone survey infant (77076) | $332.10 | $1,230 | 3.0× |
| Brachytx isodose complex (77318) | $1,043.28 | $3,864 | 2.6× |
| Brachytx isodose intermed (77317) | $819.18 | $3,034 | 2.1× |
| Brachytx Isodose Plan Simple (77316) | $558.90 | $2,070 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $707.67 | $2,621 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,389.85 | $12,555 | 2.2× |
| Cardiac Shunt Detection (78428) | $302.40 | $1,120 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $409.86 | $1,518 | 4.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $633.42 | $2,346 | 1.1× |
| Cerebrospinal Fluid Scan (78630) | $1,266.84 | $4,692 | 2.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$59.40–$97.47 | $220–$361 | varies |
| Chest 2 views (71046) | $149.31 | $553 | 1.6× |
| Chest 3 views (71047) | $178.74 | $662 | 1.9× |
| Chest 4 or more views (71048) | $204.66 | $758 | 1.9× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $63.18 | $234 | 0.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$156.60–$313.20 | $580–$1,160 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $13.23 | $49 | 0.1× |
| Continuing medical physics consltj pr wk (77336) | $372.33 | $1,379 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) | $1,862.19 | $6,897 | 0.6× |
| Contrast X-Ray Bladder (74430) | $123.12 | $456 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $372.33 | $1,379 | 1.0× |
| Contrast X-Ray Of Knee Joint (73580) | $409.86 | $1,518 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,676.43 | $6,209 | 4.5× |
| CT abdomen and pelvis without contrast (74176) | $1,304.10 | $4,830 | 5.2× |
| CT abdomen w contrast (74160) | $894.24 | $3,312 | 4.8× |
| CT abdomen w wo contrast (74170) | $1,043.28 | $3,864 | 5.6× |
| CT abdomen w/o contrast (74150) | $745.20 | $2,760 | 6.7× |
| CT Angio Abdomen and Pelvis (74174) | $1,043.28 | $3,864 | 2.8× |
| CT Angio Chest (71275) | $1,304.10 | $4,830 | 7.0× |
| CT Angio Head (70496) | $1,304.10 | $4,830 | 7.0× |
| CT angio hrt w/3d image (75574) | $1,304.10 | $4,830 | 3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,043.28–$2,086.56 | $3,864–$7,728 | varies |
| CT Angio Neck (70498) | $1,304.10 | $4,830 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,043.28 | $3,864 | 5.6× |
| CT cervical spine w/ contrast (72126) | $894.24 | $3,312 | 2.4× |
| CT cervical spine w/o contrast (72125) | $745.20 | $2,760 | 6.7× |
| CT cervical spine w/wo cont (72127) | $1,043.28 | $3,864 | 5.6× |
| CT chest w contrast (71260) | $894.24 | $3,312 | 4.8× |
| CT chest w/wo contrast (71270) | $1,043.28 | $3,864 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $474.39 | $1,757 | 4.3× |
| CT head/brain with contrast (70460) | $894.24 | $3,312 | 4.8× |
| CT head/brain without and with contrast (70470) | $1,043.28 | $3,864 | 5.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $558.90 | $2,070 | 1.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $13.23 | $49 | 0.1× |
| CT hrt w/3d image congen (75573) | $558.90 | $2,070 | 1.5× |
| CT iac w contrast (70481) | $894.24 | $3,312 | 4.8× |
| CT l-spine w&w/o contrast (72133) | $1,043.28 | $3,864 | 5.6× |
| CT lower ext w/o (73700) | $745.20 | $2,760 | 6.7× |
| CT lower extremity w/contrast material (73701) | $894.24 | $3,312 | 4.8× |
| CT lumbar spine w contrast (72132) | $894.24 | $3,312 | 2.4× |
| CT lumbar spine w/o contrast (72131) | $745.20 | $2,760 | 6.7× |
| CT maxillofacial w contrast (70487) | $894.24 | $3,312 | 4.8× |
| CT maxillofacial wo contrast (70486) | $745.20 | $2,760 | 6.7× |
| CT neck tissue combo (70492) | $1,043.28 | $3,864 | 5.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,043.28 | $3,864 | 5.6× |
| CT orbits w/o contrast (70480) | $745.20 | $2,760 | 6.7× |
| CT pelvis w&w/o contrast (72194) | $1,043.28 | $3,864 | 5.6× |
| CT pelvis w/o contrast (72192) | $745.20 | $2,760 | 6.7× |
| CT scan of leg combo (73702) | $1,043.28 | $3,864 | 5.6× |
| CT scans face/jaw combo (70488) | $1,043.28 | $3,864 | 5.6× |
| CT soft tissue neck w contrast (70491) | $894.24 | $3,312 | 4.8× |
| CT soft tissue neck w/o contrast (70490) | $745.20 | $2,760 | 6.7× |
| CT thoracic spine w contrast (72129) | $894.24 | $3,312 | 4.8× |
| CT thoracic spine w/o contrast (72128) | $745.20 | $2,760 | 6.7× |
| CT thoracic spine w/wo cont (72130) | $1,043.28 | $3,864 | 5.6× |
| CT thorax w/o contrast (71250) | $745.20 | $2,760 | 6.7× |
| CT unlisted procedure (76497) | $68.31 | $253 | 0.7× |
| CT upper ext wo (73200) | $745.20 | $2,760 | 6.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,043.28 | $3,864 | 5.6× |
| CT upper extremity with contrast (73201) | $894.24 | $3,312 | 2.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,304.10 | $4,830 | 7.0× |
| Cta Abdomen (74175) | $1,043.28 | $3,864 | 5.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,532.06 | $9,378 | 6.9× |
| CTA pelvis (72191) | $1,043.28 | $3,864 | 5.6× |
| Diskography lumbar (72295) | $1,378.35 | $5,105 | 0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $166.32 | $616 | 1.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $240.57 | $891 | 2.2× |
| Dxa Bone Density Axial (77080) | $183.06 | $678 | 1.7× |
| Dxa bone density study (77085) | $287.28 | $1,064 | 2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $63.72 | $236 | 0.7× |
| Echo exam of fetal heart (76825) | $745.20 | $2,760 | 1.3× |
| Echo exam uterus (76831) | $447.12 | $1,656 | 1.8× |
| Echo Guide For Artery Repair (76936) | $745.20 | $2,760 | 3.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $316.71 | $1,173 | 1.3× |
| Esophagram (74220) | $223.83 | $829 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) | $338.85 | $1,255 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $332.10 | $1,230 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $287.28 | $1,064 | 1.1× |
| Follow-Up Angiography (75898) | $894.24 | $3,312 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$134.19–$268.38 | $497–$994 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$153.36–$306.72 | $568–$1,136 | varies |
| Gastric emptying imaging study (78264) | $670.41 | $2,483 | 1.6× |
| Gastroesophageal Reflux Exam (78262) | $335.34 | $1,242 | 0.8× |
| Gated Heart Planar Single (78472) | $1,005.48 | $3,724 | 2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $968.22 | $3,586 | 1.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$115.56–$231.12 | $428–$856 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,235.06 | $8,278 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,198.07 | $8,141 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,340.82 | $4,966 | 1.8× |
| Heart Image (Pet) Multiple (78492) | $3,389.85 | $12,555 | 2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,266.84 | $4,692 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,266.84 | $4,692 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,155.06 | $4,278 | 2.0× |
| Hepatobiliary System Imaging (78226) | $1,043.28 | $3,864 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $1,490.40 | $5,520 | 1.1× |
| Hysterosalpingogram (74740) | $372.33 | $1,379 | 1.5× |
| Image fusion (77399) | $104.49 | $387 | 0.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $343.17 | $1,271 | 3.7× |
| Infant hip ultrasound, limited static exam (76886) | $324.54 | $1,202 | 3.5× |
| Interstitial radiation source applic complex (77778) | $1,340.82 | $4,966 | 1.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,155.06 | $4,278 | 1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $856.71 | $3,173 | 1.5× |
| Intracavitary radiation source applic simple (77761) | $521.64 | $1,932 | 0.9× |
| Joint Survey Single View (77077) | $189.54 | $702 | 1.7× |
| K Flow/Funct Image Multiple (78709) | $1,490.40 | $5,520 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $782.46 | $2,898 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $819.18 | $3,034 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$160.38–$320.76 | $594–$1,188 | varies |
| Liver & Spleen Imaging Static Only (78215) | $745.20 | $2,760 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $782.46 | $2,898 | 1.8× |
| Liver imaging static only (78201) | $294.84 | $1,092 | 0.5× |
| Lung Perf&Ventilat Diferentl (78598) | $338.85 | $1,255 | 0.6× |
| Lung perfusion differential (78597) | $633.42 | $2,346 | 1.5× |
| Lung Ventilat&Perfus Imaging (78582) | $931.77 | $3,451 | 1.6× |
| Lung Ventilation Imaging (78579) | $745.20 | $2,760 | 1.8× |
| Lymph System Imaging (78195) | $670.41 | $2,483 | 1.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,309.58 | $8,554 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,490.40 | $5,520 | 5.9× |
| Magnetic Resonance Elastography (76391) | $260.82 | $966 | 1.0× |
| Mammary ductogram or galactogram single (77053) | $242.46 | $898 | 1.0× |
| Meckels Divert Exam (78290) | $372.33 | $1,379 | 0.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,490.40 | $5,520 | 3.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $14.04 | $52 | 0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $136.89 | $507 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,676.43 | $6,209 | 4.5× |
| MRA head w/o contrast (70544) | $1,304.10 | $4,830 | 5.2× |
| MRA head with contrast (70545) | $1,490.40 | $5,520 | 4.0× |
| MRA neck w contrast (70548) | $1,490.40 | $5,520 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,676.43 | $6,209 | 4.5× |
| MRA neck w/o contrast (70547) | $1,304.10 | $4,830 | 5.2× |
| MRI abdomen w contrast (74182) | $1,490.40 | $5,520 | 4.0× |
| MRI abdomen w/o contrast (74181) | $1,304.10 | $4,830 | 5.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,490.40 | $5,520 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,676.43–$3,352.86 | $6,209–$12,418 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,490.40 | $5,520 | 1.8× |
| MRI bone marrow blood supply (77084) | $1,265.76 | $4,688 | 5.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $260.82 | $966 | 1.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $260.82 | $966 | 1.0× |
| MRI cardiac w/o contrast (75557) | $474.39 | $1,757 | 1.9× |
| MRI cervical spine w contrast (72142) | $1,490.40 | $5,520 | 4.0× |
| MRI cervical spine w/o cont (72141) | $1,304.10 | $4,830 | 5.2× |
| MRI chest w/o contrast (71550) | $1,304.10 | $4,830 | 5.2× |
| MRI chest with contrast (71551) | $1,490.40 | $5,520 | 1.8× |
| MRI chest wo w contrast (71552) | $1,676.43 | $6,209 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,490.40 | $5,520 | 4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,676.43 | $6,209 | 4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,304.10 | $4,830 | 5.2× |
| MRI lumbar spine w contrast (72149) | $1,490.40 | $5,520 | 4.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,676.43 | $6,209 | 4.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,304.10 | $4,830 | 5.2× |
| MRI orbit face neck w contrast (70542) | $1,490.40 | $5,520 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,676.43 | $6,209 | 4.5× |
| MRI pelvis w contrast (72196) | $1,490.40 | $5,520 | 4.0× |
| MRI pelvis w/o & w contrast (72197) | $1,676.43 | $6,209 | 4.5× |
| MRI pelvis w/o contrast (72195) | $1,304.10 | $4,830 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $1,304.10 | $4,830 | 5.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,490.40 | $5,520 | 4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,304.10 | $4,830 | 5.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,676.43 | $6,209 | 4.5× |
| MRI, abdomen, combo (74183) | $1,676.43 | $6,209 | 4.5× |
| MRI, dorsal spine combo (72157) | $1,676.43 | $6,209 | 4.5× |
| MRI, dorsal spine contrast (72147) | $1,490.40 | $5,520 | 4.0× |
| MRI, joint upper extrem (73221) | $1,304.10 | $4,830 | 5.2× |
| MRI, joint upper extrem combo (73223) | $1,676.43 | $6,209 | 4.5× |
| MRI, lumbar spine combo (72158) | $1,676.43 | $6,209 | 4.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,389.85 | $12,555 | 2.5× |
| Myocardial Spect Multiple Studies (78452) | $1,974.51 | $7,313 | 1.4× |
| Neck soft tissue (70360) | $119.88 | $444 | 1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $189.81 | $703 | 0.4× |
| Nm myocard infarct spect (78469) | $782.46 | $2,898 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,607.39 | $9,657 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $931.77 | $3,451 | 3.8× |
| Ob us nuchal meas 1 gest (76813) | $193.59 | $717 | 1.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $97.47 | $361 | 0.9× |
| Parathyroid Planar Imaging (78070) | $745.20 | $2,760 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,005.48 | $3,724 | 2.4× |
| Pelvis 1 or 2 views (72170) | $134.19 | $497 | 1.2× |
| Peritoneogram Rs&I (74190) | $290.79 | $1,077 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $3,389.85 | $12,555 | 2.2× |
| PET image w/CT, full body (78816) | $2,756.43 | $10,209 | 1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,756.43 | $10,209 | 1.8× |
| Pet Myocardial Sngl Study (78491) | $3,389.85 | $12,555 | 2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,309.58 | $8,554 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $633.42 | $2,346 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $216 | $800 | 2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $372.33 | $1,379 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$160.38–$320.76 | $594–$1,188 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$126.90–$253.80 | $470–$940 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$178.74–$357.48 | $662–$1,324 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $204.66 | $758 | 1.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$119.88–$239.76 | $444–$888 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$171.72–$343.44 | $636–$1,272 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$160.38–$320.76 | $594–$1,188 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$130.68–$261.36 | $484–$968 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $189.81 | $703 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $183.06 | $678 | 2.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $153.36 | $568 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) | $167.67 | $621 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$175.50–$351 | $650–$1,300 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $141.75 | $525 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $134.19 | $497 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $183.06 | $678 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $246.24 | $912 | 2.7× |
| Radex Toe Minimum 2 Views (73660) | $119.88 | $444 | 1.3× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$123.12–$246.24 | $456–$912 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$160.38–$320.76 | $594–$1,188 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $558.90 | $2,070 | 5.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $6,332.31 | $23,453 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $297.81 | $1,103 | 2.8× |
| Radiation treatment delivery level 2 (77407) | $372.33 | $1,379 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $484.38 | $1,794 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $287.28 | $1,064 | 2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $223.83 | $829 | 2.0× |
| Radiologic exam colon double contrast study (74280) | $372.33 | $1,379 | 2.0× |
| Radiologic exam colon single contrast study (74270) | $223.83 | $829 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $285.93 | $1,059 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$204.66–$409.32 | $758–$1,516 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $246.24 | $912 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $223.83 | $829 | 1.2× |
| Radiologic exam swallow function contrast study (74230) | $186.57 | $691 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $409.86 | $1,518 | 2.2× |
| Radiologic examination femur 1 view (73551) | $126.90 | $470 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$189.81–$379.62 | $703–$1,406 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$130.68–$261.36 | $484–$968 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $153.36 | $568 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$149.31–$298.62 | $553–$1,106 | varies |
| Ribs bilateral 3 views (71110) | $279.45 | $1,035 | 2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $558.90 | $2,070 | 1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $447.12 | $1,656 | 1.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,043.28 | $3,864 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,080.54 | $4,002 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$782.46–$856.71 | $2,898–$3,173 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,080.54 | $4,002 | 0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $353.97 | $1,311 | 0.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $707.67 | $2,621 | 0.5× |
| Rp Therapy Intravenous Administration (79101) | $279.45 | $1,035 | 1.1× |
| Scapula (73010) range across 2 matching MRF lines |
$183.06–$366.12 | $678–$1,356 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$37.53–$75.06 | $139–$278 | varies |
| Shoulder 1 view (73020) | $119.88 | $444 | 1.3× |
| Shoulder Arthrography (73040) | $409.86 | $1,518 | 1.1× |
| Sialogram (70390) | $260.82 | $966 | 1.0× |
| Skull less than 4 views (70250) | $201.42 | $746 | 1.8× |
| Special dosimetry (77331) | $186.57 | $691 | 1.3× |
| Special Physics Consult (77370) | $558.90 | $2,070 | 3.9× |
| Special teletherapy port plan (77321) | $521.64 | $1,932 | 1.3× |
| Special treatment procedure (77470) | $931.77 | $3,451 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $1,005.48 | $3,724 | 0.5× |
| Sternoclavicular joints (71130) | $164.70 | $610 | 1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,117.53 | $4,139 | 2.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $447.12 | $1,656 | 1.1× |
| Testicular Imaging W/Flow (78761) | $521.64 | $1,932 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,304.10 | $4,830 | 3.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $745.20 | $2,760 | 1.9× |
| Ther rad simulaj-aided field setting simple (77280) | $558.90 | $2,070 | 3.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $361.53 | $1,339 | 1.9× |
| Thoracic spine 2 views (72070) | $104.49 | $387 | 0.9× |
| Thoracic spine 3 views (72072) | $197.64 | $732 | 1.8× |
| Thoracolumbar 2 views (72080) | $167.67 | $621 | 1.8× |
| Thyroid Imaging With Vascular Flow (78013) | $338.85 | $1,255 | 0.8× |
| Thyroid Met Imaging Body (78018) | $931.77 | $3,451 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $521.64 | $1,932 | 1.2× |
| Tx Devices Design & Construction Complex (77334) | $633.42 | $2,346 | 1.6× |
| Tx devices design & construction intermediate (77333) | $297.81 | $1,103 | 2.1× |
| Tx devices design & construction simple (77332) | $335.34 | $1,242 | 2.4× |
| Ultrasound Breast Limited (76642) | $227.61 | $843 | 2.5× |
| Ultrasound elastography first target lesion (76982) | $126.90 | $470 | 1.1× |
| Ultrasound Elastography Parenchyma (76981) | $126.90 | $470 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$6.21–$220.05 | $23–$815 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $223.83 | $829 | 0.6× |
| Ultrasound, abdomen limited (76705) | $327.51 | $1,213 | 3.0× |
| Umbilical-artery Doppler (OB) (76820) | $153.36 | $568 | 1.4× |
| Unlisted fluoroscopic procedure (76496) | $931.77 | $3,451 | 10.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $745.20 | $2,760 | 6.9× |
| Unlisted us procedure (76999) | $78.30 | $290 | 0.9× |
| Upper gi w/o kub (74240) | $484.38 | $1,794 | 2.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $204.66 | $758 | 18.5× |
| Urethrocystogram voiding (74455) | $346.68 | $1,284 | 1.4× |
| Urethrocystography retrograde (74450) | $316.71 | $1,173 | 1.3× |
| Us breast unilateral complete (76641) | $308.88 | $1,144 | 2.8× |
| Us chest (76604) | $283.50 | $1,050 | 2.6× |
| Us complete joint (76881) range across 2 matching MRF lines |
$343.17–$686.34 | $1,271–$2,542 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$257.31–$294.84 | $953–$1,092 | varies |
| Us head (76506) | $260.82 | $966 | 2.4× |
| Us kidney transplant (76776) | $484.38 | $1,794 | 4.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$178.74–$357.48 | $662–$1,324 | varies |
| Us ob detailed single fetus (76811) | $305.91 | $1,133 | 1.2× |
| Us ob limited 1 or more fetuses (76815) | $353.97 | $1,311 | 3.2× |
| Us ob transvaginal (76817) | $194.13 | $719 | 1.8× |
| Us pelvic non ob complete (76856) | $350.46 | $1,298 | 3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$242.46–$409.86 | $898–$1,518 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $134.19 | $497 | 1.2× |
| Us retroperitoneal complete (76770) | $372.33 | $1,379 | 3.4× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$335.34–$358.29 | $1,242–$1,327 | varies |
| Us scrotum and contents (76870) | $308.88 | $1,144 | 2.8× |
| Us spinal canal and contents (76800) | $126.90 | $470 | 1.1× |
| Us thyroid (76536) | $343.17 | $1,271 | 3.1× |
| Us transrectal (76872) | $447.12 | $1,656 | 4.0× |
| Vein X-Ray Chest (75827) | $1,117.53 | $4,139 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $819.18 | $3,034 | 0.2× |
| Venogram Sinus/Jugular (75860) | $2,309.58 | $8,554 | 0.7× |
| Venography Adrenal Unilateral (75840) | $1,848.96 | $6,848 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $1,490.40 | $5,520 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $1,304.10 | $4,830 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $856.71 | $3,173 | 0.5× |
| Venography Renal Bilateral (75833) | $1,266.84 | $4,692 | 0.4× |
| Venography Renal Unilateral (75831) | $1,266.84 | $4,692 | 0.4× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,309.58 | $8,554 | 0.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $447.12 | $1,656 | 1.1× |
| Vertebral fracture assessment via dxa (77086) | $89.64 | $332 | 1.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$160.38–$320.76 | $594–$1,188 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $189.81 | $703 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $409.86 | $1,518 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,569.86 | $9,518 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $227.61 | $843 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$111.78–$223.56 | $414–$828 | varies |
| X-Ray Exam Breast Specimen (76098) | $290.79 | $1,077 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $175.50 | $650 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $268.65 | $995 | 2.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $521.64 | $1,932 | 4.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $260.82 | $966 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $335.34 | $1,242 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $447.12 | $1,656 | 4.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $409.86 | $1,518 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $521.64 | $1,932 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $670.41 | $2,483 | 6.1× |
| X-Ray Exam L-S Spine Bending (72114) | $208.98 | $774 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $156.60 | $580 | 1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $220.05 | $815 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $186.57 | $691 | 1.7× |
| X-ray eye for foreign body (70030) | $101.79 | $377 | 1.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$138.24–$276.48 | $512–$1,024 | varies |
| X-ray IV pyelogram (ivp) (74400) | $409.86 | $1,518 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $160.38 | $594 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $149.31 | $553 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$197.64–$395.28 | $732–$1,464 | varies |
| X-ray nose-rectum child f.b. (76010) | $164.70 | $610 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $297.81 | $1,103 | 2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $189.81 | $703 | 1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $119.88 | $444 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $160.38 | $594 | 1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $194.13 | $719 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $272.16 | $1,008 | 2.5× |
| X-Ray Stress View (77071) | $80.46 | $298 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $297.81 | $1,103 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $213.03 | $789 | 0.6× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$208.98–$417.96 | $774–$1,548 | varies |
| X-Rays Bone Survey Complete (77075) | $324.54 | $1,202 | 2.9× |
| Xr c-spine 4 or 5 views (72050) | $265.14 | $982 | 2.4× |
| Xr facial bones less than 3 views (70140) | $167.67 | $621 | 1.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $145.53 | $539 | 1.3× |
| Xr orbits complete 4 views (70200) | $260.82 | $966 | 2.4× |
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.