Imaging prices at Franciscan Health Michigan City
Michigan City, IN · every code in this section with a posted price and a Medicare benchmark.
381 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) | $832.42 | $4,002 | 0.6× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$55.54–$120.64 | $267–$580 | varies |
| Abdomen 2 views (74019) | $175.34 | $843 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $487.97 | $2,346 | 1.2× |
| Angio internal mammary (75756) | $1,779.23 | $8,554 | 0.5× |
| Angio pulmonary bilat (75743) | $1,176.45 | $5,656 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $1,635.50 | $7,863 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,463.70 | $7,037 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $975.94 | $4,692 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,779.23 | $8,554 | 0.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$92.35–$184.70 | $444–$888 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$975.94 | $4,692 | 0.2× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,209.38 | $10,622 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $1,004.64 | $4,830 | 0.3× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$975.94 | $4,692 | 0.2× |
| Artery X-Rays Spine (75705) | $3,156.61 | $15,176 | 0.5× |
| Arthrogram ankle (73615) | $183.87 | $884 | 0.5× |
| Arthrogram hip (73525) | $198.22 | $953 | 0.5× |
| Arthrogram Wrist (73115) | $315.74 | $1,518 | 0.9× |
| Basic radiation dosimetry calculation (77300) | $212.78 | $1,023 | 1.5× |
| Bone age studies (77072) | $141.02 | $678 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,119.46 | $5,382 | 2.6× |
| Bone Imaging Limited Area (78300) | $401.86 | $1,932 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $459.06 | $2,207 | 1.1× |
| Bone Imaging Whole Body (78306) | $860.91 | $4,139 | 2.0× |
| Bone marrow imaging limited area (78102) | $215.28 | $1,035 | 0.5× |
| Bone survey infant (77076) | $129.17 | $621 | 1.2× |
| Brachytx isodose complex (77318) | $545.17 | $2,621 | 1.4× |
| Brachytx isodose intermed (77317) | $430.56 | $2,070 | 1.1× |
| Brachytx Isodose Plan Simple (77316) | $344.45 | $1,656 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $545.17 | $2,621 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,611.44 | $12,555 | 1.7× |
| Cardiac Shunt Detection (78428) | $315.74 | $1,518 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $229.42 | $1,103 | 2.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $315.74 | $1,518 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $401.86 | $1,932 | 0.7× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$55.54–$100.67 | $267–$484 | varies |
| Chest 2 views (71046) | $135.20 | $650 | 1.5× |
| Chest 3 views (71047) | $149.55 | $719 | 1.6× |
| Chest 4 or more views (71048) | $192.40 | $925 | 1.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $48.67 | $234 | 0.4× |
| Cholecystography Oral Contrast (74290) | $129.17 | $621 | 0.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$152.26–$304.51 | $732–$1,464 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $10.19 | $49 | 0.1× |
| Continuing medical physics consltj pr wk (77336) | $221.31 | $1,064 | 1.6× |
| Contrast Exam Abdominl Aorta (75625) | $1,607.01 | $7,726 | 0.5× |
| Contrast X-Ray Bladder (74430) | $118.14 | $568 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $181.17 | $871 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $192.40 | $925 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,291.47 | $6,209 | 3.5× |
| CT abdomen and pelvis without contrast (74176) | $1,004.64 | $4,830 | 4.0× |
| CT abdomen w contrast (74160) | $745.89 | $3,586 | 4.0× |
| CT abdomen w wo contrast (74170) | $860.91 | $4,139 | 4.6× |
| CT abdomen w/o contrast (74150) | $631.07 | $3,034 | 5.7× |
| CT Angio Abdomen and Pelvis (74174) | $860.91 | $4,139 | 2.3× |
| CT Angio Chest (71275) | $1,004.64 | $4,830 | 5.4× |
| CT Angio Head (70496) | $1,004.64 | $4,830 | 5.4× |
| CT angio hrt w/3d image (75574) | $286.83 | $1,379 | 0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$860.91–$1,721.82 | $4,139–$8,278 | varies |
| CT Angio Neck (70498) | $1,004.64 | $4,830 | 5.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $860.91 | $4,139 | 4.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,177.07 | $5,659 | 6.3× |
| CT cervical spine w/ contrast (72126) | $745.89 | $3,586 | 2.0× |
| CT cervical spine w/o contrast (72125) | $631.07 | $3,034 | 5.7× |
| CT cervical spine w/wo cont (72127) | $860.91 | $4,139 | 4.6× |
| CT chest w contrast (71260) | $745.89 | $3,586 | 4.0× |
| CT chest w/wo contrast (71270) | $860.91 | $4,139 | 4.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $286.83 | $1,379 | 2.6× |
| CT head/brain with contrast (70460) | $745.89 | $3,586 | 4.0× |
| CT head/brain without and with contrast (70470) | $860.91 | $4,139 | 4.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $286.83 | $1,379 | 0.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $10.19 | $49 | 0.1× |
| CT hrt w/3d image congen (75573) | $401.86 | $1,932 | 1.1× |
| CT iac w contrast (70481) | $745.89 | $3,586 | 4.0× |
| CT l-spine w&w/o contrast (72133) | $860.91 | $4,139 | 4.6× |
| CT lower ext w/o (73700) | $631.07 | $3,034 | 5.7× |
| CT lower extremity w/contrast material (73701) | $745.89 | $3,586 | 4.0× |
| CT lumbar spine w contrast (72132) | $745.89 | $3,586 | 2.0× |
| CT lumbar spine w/o contrast (72131) | $631.07 | $3,034 | 5.7× |
| CT maxillofacial w contrast (70487) | $745.89 | $3,586 | 4.0× |
| CT maxillofacial wo contrast (70486) | $631.07 | $3,034 | 5.7× |
| CT neck tissue combo (70492) | $860.91 | $4,139 | 4.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $860.91 | $4,139 | 4.6× |
| CT orbits w/o contrast (70480) | $631.07 | $3,034 | 5.7× |
| CT pelvis w&w/o contrast (72194) | $1,032.93 | $4,966 | 5.6× |
| CT pelvis w/o contrast (72192) | $631.07 | $3,034 | 5.7× |
| CT scan of leg combo (73702) | $860.91 | $4,139 | 4.6× |
| CT scans face/jaw combo (70488) | $860.91 | $4,139 | 4.6× |
| CT soft tissue neck w contrast (70491) | $745.89 | $3,586 | 4.0× |
| CT soft tissue neck w/o contrast (70490) | $631.07 | $3,034 | 5.7× |
| CT thoracic spine w contrast (72129) | $745.89 | $3,586 | 4.0× |
| CT thoracic spine w/o contrast (72128) | $631.07 | $3,034 | 5.7× |
| CT thoracic spine w/wo cont (72130) | $860.91 | $4,139 | 4.6× |
| CT thorax w/o contrast (71250) | $631.07 | $3,034 | 5.7× |
| CT unlisted procedure (76497) | $143.73 | $691 | 1.6× |
| CT upper ext wo (73200) | $631.07 | $3,034 | 5.7× |
| CT upper extremity w/o & w/contrast material (73202) | $860.91 | $4,139 | 4.6× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$745.89–$1,491.78 | $3,586–$7,172 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,004.64 | $4,830 | 5.4× |
| Cta Abdomen (74175) | $860.91 | $4,139 | 4.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,950.62 | $9,378 | 5.3× |
| CTA pelvis (72191) | $860.91 | $4,139 | 4.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $185.33 | $891 | 1.7× |
| Dxa Bone Density Axial (77080) | $160.99 | $774 | 1.5× |
| Dxa bone density study (77085) | $221.31 | $1,064 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $88.19 | $424 | 1.0× |
| Echo exam uterus (76831) | $373.15 | $1,794 | 1.5× |
| Echo Guide For Artery Repair (76936) | $574.08 | $2,760 | 2.5× |
| Esophagram (74220) | $221.31 | $1,064 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) | $344.45 | $1,656 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $315.74 | $1,518 | 2.9× |
| Fluoroscopy up to 1 hr (76000) | $143.73 | $691 | 0.6× |
| Follow-Up Angiography (75898) | $602.78 | $2,898 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$86.11–$172.22 | $414–$828 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$143.73–$287.46 | $691–$1,382 | varies |
| Gastric emptying imaging study (78264) | $516.46 | $2,483 | 1.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $459.06 | $2,207 | 1.1× |
| Gastroesophageal Reflux Exam (78262) | $745.89 | $3,586 | 1.8× |
| Gated Heart Planar Single (78472) | $717.81 | $3,451 | 1.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $574.08 | $2,760 | 1.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$100.67–$201.34 | $484–$968 | varies |
| Heart Image (Pet) Multiple (78492) | $2,611.44 | $12,555 | 1.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,319.97 | $6,346 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $975.94 | $4,692 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $918.53 | $4,416 | 1.6× |
| Hepatobiliary System Imaging (78226) | $832.42 | $4,002 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $516.46 | $2,483 | 0.4× |
| Hysterosalpingogram (74740) | $252.30 | $1,213 | 1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $212.78 | $1,023 | 2.3× |
| Infant hip ultrasound, limited static exam (76886) | $75.09 | $361 | 0.8× |
| Interstitial radiation source applic complex (77778) | $947.02 | $4,553 | 1.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $889.82 | $4,278 | 1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $659.98 | $3,173 | 1.1× |
| Intracavitary radiation source applic simple (77761) | $401.86 | $1,932 | 0.7× |
| Joint Survey Single View (77077) | $146.02 | $702 | 1.3× |
| K Flow/Funct Image Multiple (78709) | $688.90 | $3,312 | 1.2× |
| K Flow/Funct Image W/Drug (78708) | $659.98 | $3,173 | 1.1× |
| K Flow/Funct Image W/O Drug (78707) | $344.45 | $1,656 | 0.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$146.22–$292.45 | $703–$1,406 | varies |
| Liver & Spleen Imaging Static Only (78215) | $430.56 | $2,070 | 1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $688.90 | $3,312 | 1.6× |
| Liver imaging static only (78201) | $344.45 | $1,656 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $401.86 | $1,932 | 0.7× |
| Lung perfusion differential (78597) | $401.86 | $1,932 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $430.56 | $2,070 | 0.7× |
| Lung Ventilation Imaging (78579) | $373.15 | $1,794 | 0.9× |
| Lymph System Imaging (78195) | $459.06 | $2,207 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $1,004.64 | $4,830 | 4.0× |
| Magnetic Resonance Elastography (76391) | $200.93 | $966 | 0.8× |
| Mammary ductogram or galactogram single (77053) | $209.66 | $1,008 | 0.8× |
| Meckels Divert Exam (78290) | $459.06 | $2,207 | 1.1× |
| Mlc imrt design & construction per imrt plan (77338) | $430.56 | $2,070 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $10.82 | $52 | 0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $105.46 | $507 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,291.47 | $6,209 | 3.5× |
| MRA head w/o contrast (70544) | $1,004.64 | $4,830 | 4.0× |
| MRA head with contrast (70545) | $1,148.16 | $5,520 | 3.1× |
| MRA neck w contrast (70548) | $1,148.16 | $5,520 | 3.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,291.47 | $6,209 | 3.5× |
| MRA neck w/o contrast (70547) | $1,004.64 | $4,830 | 4.0× |
| MRI abdomen w contrast (74182) | $1,148.16 | $5,520 | 3.1× |
| MRI abdomen w/o contrast (74181) | $1,004.64 | $4,830 | 4.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,148.16 | $5,520 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,291.47 | $6,209 | 3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,148.16 | $5,520 | 1.4× |
| MRI bone marrow blood supply (77084) | $975.10 | $4,688 | 3.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $200.93 | $966 | 0.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $200.93 | $966 | 0.8× |
| MRI cardiac w/o contrast (75557) | $365.46 | $1,757 | 1.4× |
| MRI cervical spine w contrast (72142) | $1,148.16 | $5,520 | 3.1× |
| MRI cervical spine w/o cont (72141) | $1,004.64 | $4,830 | 4.0× |
| MRI chest w/o contrast (71550) | $1,004.64 | $4,830 | 4.0× |
| MRI chest with contrast (71551) | $1,148.16 | $5,520 | 1.4× |
| MRI chest wo w contrast (71552) | $1,291.47 | $6,209 | 3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,148.16 | $5,520 | 3.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,291.47–$2,582.94 | $6,209–$12,418 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,004.64 | $4,830 | 4.0× |
| MRI lumbar spine w contrast (72149) | $1,148.16 | $5,520 | 3.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,291.47 | $6,209 | 3.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,004.64 | $4,830 | 4.0× |
| MRI orbit face neck w contrast (70542) | $1,148.16 | $5,520 | 3.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,291.47 | $6,209 | 3.5× |
| MRI pelvis w contrast (72196) | $1,148.16 | $5,520 | 3.1× |
| MRI pelvis w/o & w contrast (72197) | $1,291.47 | $6,209 | 3.5× |
| MRI pelvis w/o contrast (72195) | $1,004.64 | $4,830 | 4.0× |
| MRI thoracic spine w/o contrast (72146) | $1,004.64 | $4,830 | 4.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,004.64 | $4,830 | 2.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,004.64–$2,009.28 | $4,830–$9,660 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,291.47 | $6,209 | 3.5× |
| MRI, abdomen, combo (74183) | $1,291.47 | $6,209 | 3.5× |
| MRI, dorsal spine combo (72157) | $1,291.47 | $6,209 | 3.5× |
| MRI, dorsal spine contrast (72147) | $1,148.16 | $5,520 | 3.1× |
| MRI, joint upper extrem (73221) | $1,004.64 | $4,830 | 4.0× |
| MRI, joint upper extrem combo (73223) | $1,291.47 | $6,209 | 3.5× |
| MRI, lumbar spine combo (72158) | $1,291.47 | $6,209 | 3.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,611.44 | $12,555 | 1.9× |
| Myocardial Spect Multiple Studies (78452) | $1,492.40 | $7,175 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $418.70 | $2,013 | 0.5× |
| Neck soft tissue (70360) | $112.11 | $539 | 1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $149.55 | $719 | 0.4× |
| Nm csf leak detection (78650) | $681.20 | $3,275 | 0.5× |
| Nm myocard infarct spect (78469) | $276.02 | $1,327 | 0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,032.93 | $4,966 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $401.86 | $1,932 | 1.6× |
| Ob us nuchal meas 1 gest (76813) | $149.14 | $717 | 1.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $75.09 | $361 | 0.7× |
| Panoramic X-ray of jaws (70355) | $118.14 | $568 | 1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $286.83 | $1,379 | 0.5× |
| Parathyroid Planar Imaging (78070) | $688.90 | $3,312 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $774.59 | $3,724 | 1.8× |
| Pelvis 1 or 2 views (72170) | $115.02 | $553 | 1.0× |
| Peritoneogram Rs&I (74190) | $224.02 | $1,077 | 0.4× |
| Pet Image W/Ct Lmtd (78814) | $2,869.57 | $13,796 | 1.9× |
| PET image w/CT, full body (78816) | $2,209.38 | $10,622 | 1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,209.38 | $10,622 | 1.5× |
| Pet Myocardial Sngl Study (78491) | $2,611.44 | $12,555 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,344.51 | $6,464 | 0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $401.86 | $1,932 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $192.40 | $925 | 1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $344.45 | $1,656 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$146.22–$292.45 | $703–$1,406 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$109.20–$218.40 | $525–$1,050 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$149.55–$299.10 | $719–$1,438 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $166.40 | $800 | 1.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$109.20–$218.40 | $525–$1,050 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$149.55–$299.10 | $719–$1,438 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$143.73–$287.46 | $691–$1,382 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$89.02–$178.05 | $428–$856 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $112.11 | $539 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $135.20 | $650 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $115.02 | $553 | 1.2× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$152.26–$304.51 | $732–$1,464 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $92.35 | $444 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $97.76 | $470 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $135.20 | $650 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $118.14 | $568 | 1.3× |
| Radex Toe Minimum 2 Views (73660) | $106.50 | $512 | 1.2× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$132.29–$264.58 | $636–$1,272 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$146.22–$292.45 | $703–$1,406 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $430.56 | $2,070 | 3.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,738.72 | $27,590 | 0.7× |
| Radiation treatment delivery level 1 (77402) | $309.92 | $1,490 | 2.9× |
| Radiation treatment delivery level 2 (77407) | $415.58 | $1,998 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $394.78 | $1,898 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $181.17 | $871 | 1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $186.78 | $898 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $602.78 | $2,898 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $459.06 | $2,207 | 2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $254.38 | $1,223 | 1.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$160.99–$321.98 | $774–$1,548 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $137.70 | $662 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $241.49 | $1,161 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $141.02 | $678 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $373.15 | $1,794 | 2.0× |
| Radiologic examination femur 1 view (73551) | $97.76 | $470 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$146.22–$292.45 | $703–$1,406 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$129.17–$258.34 | $621–$1,242 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $69.06 | $332 | 0.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$126.88–$253.76 | $610–$1,220 | varies |
| Ribs bilateral 3 views (71110) | $143.73 | $691 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $717.81 | $3,451 | 1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,032.93 | $4,966 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $860.91 | $4,139 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $717.81 | $3,451 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$688.90–$1,061.63 | $3,312–$5,104 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $947.02 | $4,553 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $943.49 | $4,536 | 0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $574.08 | $2,760 | 0.4× |
| Rp Therapy Intravenous Administration (79101) | $267.07 | $1,284 | 1.1× |
| Scapula (73010) | $109.20 | $525 | 1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$23.09–$46.18 | $111–$222 | varies |
| Shoulder 1 view (73020) | $89.02 | $428 | 1.0× |
| Shoulder Arthrography (73040) | $344.45 | $1,656 | 0.9× |
| Sialogram (70390) | $198.22 | $953 | 0.8× |
| Skull less than 4 views (70250) | $126.88 | $610 | 1.1× |
| Special dosimetry (77331) | $181.17 | $871 | 1.3× |
| Special Physics Consult (77370) | $430.56 | $2,070 | 3.0× |
| Special teletherapy port plan (77321) | $373.15 | $1,794 | 0.9× |
| Special treatment procedure (77470) | $688.90 | $3,312 | 1.2× |
| Stereotactic Body Radiation Delivery (77373) | $717.81 | $3,451 | 0.4× |
| Sternoclavicular joints (71130) | $71.76 | $345 | 0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $430.56 | $2,070 | 1.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $401.86 | $1,932 | 1.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $114.82 | $552 | 0.5× |
| Testicular Imaging W/Flow (78761) | $459.06 | $2,207 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $516.46 | $2,483 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $459.06 | $2,207 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $315.74 | $1,518 | 2.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $281.22 | $1,352 | 1.5× |
| Thoracic spine 2 views (72070) | $94.85 | $456 | 0.9× |
| Thoracic spine 3 views (72072) | $172.43 | $829 | 1.6× |
| Thoracolumbar 2 views (72080) | $89.02 | $428 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $261.04 | $1,255 | 0.6× |
| Thyroid Met Imaging Body (78018) | $947.02 | $4,553 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $401.86 | $1,932 | 1.0× |
| Tx Devices Design & Construction Complex (77334) | $344.45 | $1,656 | 0.9× |
| Tx devices design & construction intermediate (77333) | $247.31 | $1,189 | 1.7× |
| Tx devices design & construction simple (77332) | $237.95 | $1,144 | 1.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$200.93–$401.86 | $966–$1,932 | varies |
| Ultrasound elastography first target lesion (76982) | $97.76 | $470 | 0.9× |
| Ultrasound Elastography Parenchyma (76981) | $97.76 | $470 | 0.9× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$160.99 | $23–$774 | 1.5× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$206.96–$258.34 | $995–$1,242 | varies |
| Umbilical-artery Doppler (OB) (76820) | $86.11 | $414 | 0.8× |
| Unlisted fluoroscopic procedure (76496) | $42.85 | $206 | 0.5× |
| Upper gi w/o kub (74240) | $344.45 | $1,656 | 1.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $126.88 | $610 | 11.5× |
| Urethrocystogram voiding (74455) | $430.56 | $2,070 | 1.7× |
| Urethrocystography retrograde (74450) | $243.98 | $1,173 | 1.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$430.56–$861.12 | $2,070–$4,140 | varies |
| Us chest (76604) | $118.14 | $568 | 1.1× |
| Us complete joint (76881) | $255.84 | $1,230 | 2.3× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$212.78–$232.96 | $1,023–$1,120 | varies |
| Us head (76506) | $123.55 | $594 | 1.1× |
| Us kidney transplant (76776) | $247.31 | $1,189 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$146.22–$292.45 | $703–$1,406 | varies |
| Us ob detailed single fetus (76811) | $373.15 | $1,794 | 1.5× |
| Us ob limited 1 or more fetuses (76815) | $221.31 | $1,064 | 2.0× |
| Us ob transvaginal (76817) | $198.22 | $953 | 1.8× |
| Us pelvic non ob complete (76856) | $344.45 | $1,656 | 3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$278.51–$315.74 | $1,339–$1,518 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $224.02 | $1,077 | 2.0× |
| Us retroperitoneal complete (76770) | $315.74 | $1,518 | 2.9× |
| Us retroperitoneal limited (76775) | $141.02 | $678 | 1.3× |
| Us scrotum and contents (76870) | $315.74 | $1,518 | 2.9× |
| Us spinal canal and contents (76800) | $195.52 | $940 | 1.8× |
| Us thyroid (76536) | $286.83 | $1,379 | 2.6× |
| Us transrectal (76872) | $252.30 | $1,213 | 2.3× |
| Vein X-Ray Chest (75827) | $745.89 | $3,586 | 0.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $545.17 | $2,621 | 0.2× |
| Venogram Sinus/Jugular (75860) | $1,779.23 | $8,554 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,004.64 | $4,830 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $373.15 | $1,794 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $602.78 | $2,898 | 0.4× |
| Venography Renal Bilateral (75833) | $975.94 | $4,692 | 0.3× |
| Venography Renal Unilateral (75831) | $975.94 | $4,692 | 0.3× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$1,779.23 | $8,554 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $218.40 | $1,050 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $69.06 | $332 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$123.55–$247.10 | $594–$1,188 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $186.78 | $898 | 2.0× |
| X-ray antegrade pyelogram tube (74425) | $164.11 | $789 | 0.4× |
| X-Ray Aorta Leg Arteries (75630) | $1,521.10 | $7,313 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $209.66 | $1,008 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$106.50–$212.99 | $512–$1,024 | varies |
| X-Ray Exam Breast Specimen (76098) | $135.20 | $650 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $135.20 | $650 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $209.66 | $1,008 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $401.86 | $1,932 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $200.93 | $966 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $258.34 | $1,242 | 2.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $344.45 | $1,656 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $315.74 | $1,518 | 2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $401.86 | $1,932 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $487.97 | $2,346 | 4.4× |
| X-Ray Exam L-S Spine Bending (72114) | $200.93 | $966 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $112.11 | $539 | 1.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $258.34 | $1,242 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $143.73 | $691 | 1.3× |
| X-ray eye for foreign body (70030) | $78.42 | $377 | 0.9× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$120.64–$241.28 | $580–$1,160 | varies |
| X-ray IV pyelogram (ivp) (74400) | $255.84 | $1,230 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $135.20 | $650 | 1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $57.62 | $277 | 0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $155.17 | $746 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $126.88 | $610 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $200.93 | $966 | 1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $115.02 | $553 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $92.35 | $444 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $115.02 | $553 | 1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $181.17 | $871 | 2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $224.02 | $1,077 | 2.0× |
| X-Ray Stress View (77071) | $49.09 | $236 | 0.5× |
| X-ray thoracic spine 4 vw (72074) | $218.40 | $1,050 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $344.45 | $1,656 | 0.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$137.70–$275.39 | $662–$1,324 | varies |
| X-Rays Bone Survey Complete (77075) | $267.07 | $1,284 | 2.4× |
| Xr c-spine 4 or 5 views (72050) | $198.22 | $953 | 1.8× |
| Xr facial bones less than 3 views (70140) | $92.35 | $444 | 1.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $84.86 | $408 | 0.8× |
| Xr orbits complete 4 views (70200) | $164.11 | $789 | 1.5× |
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.