Imaging prices at Franciscan Health Mooresville
Mooresville, IN · every code in this section with a posted price and a Medicare benchmark.
396 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) | $6,664.20 | $26,237 | 4.6× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$55.12–$95.25 | $217–$375 | varies |
| Abdomen 2 views (74019) | $204.47 | $805 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $777.75 | $3,062 | 1.8× |
| Angio internal mammary (75756) | $2,553.72 | $10,054 | 0.8× |
| Angio pulmonary bilat (75743) | $2,860.04 | $11,260 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $3,745.74 | $14,747 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $2,553.72 | $10,054 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,907.03 | $7,508 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $749.05 | $2,949 | 0.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$163.58–$327.15 | $644–$1,288 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,553.72 | $10,054 | 0.4× |
| Artery X-Rays Abdomen (75726) | $3,745.74 | $14,747 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $885.95 | $3,488 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,860.04 | $11,260 | 0.5× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,860.04 | $11,260 | 0.5× |
| Arthrogram ankle (73615) | $436.37 | $1,718 | 1.2× |
| Arthrogram hip (73525) | $255.27 | $1,005 | 0.7× |
| Arthrogram Wrist (73115) | $289.56 | $1,140 | 0.8× |
| Basic radiation dosimetry calculation (77300) | $481.33 | $1,895 | 3.4× |
| Bone age studies (77072) | $88.90 | $350 | 0.8× |
| Bone Imaging 3 Phase (78315) | $1,444.50 | $5,687 | 3.4× |
| Bone Imaging Limited Area (78300) | $555.50 | $2,187 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $481.33 | $1,895 | 1.1× |
| Bone Imaging Whole Body (78306) | $1,185.16 | $4,666 | 2.8× |
| Bone marrow imaging limited area (78102) | $351.79 | $1,385 | 0.8× |
| Bone survey infant (77076) | $259.33 | $1,021 | 2.3× |
| Brachytx isodose complex (77318) | $1,406.91 | $5,539 | 3.6× |
| Brachytx isodose intermed (77317) | $999.74 | $3,936 | 2.5× |
| Brachytx Isodose Plan Simple (77316) | $999.74 | $3,936 | 2.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $555.50 | $2,187 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,884.43 | $7,419 | 1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $951.99 | $3,748 | 2.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $951.99 | $3,748 | 1.1× |
| Cardiac Shunt Detection (78428) | $481.33 | $1,895 | 1.1× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$327.15–$357.38 | $1,288–$1,407 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $407.16 | $1,603 | 0.7× |
| Cerebrospinal Fluid Scan (78630) | $888.75 | $3,499 | 1.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$55.12–$126.75 | $217–$499 | varies |
| Chest 2 views (71046) | $146.81 | $578 | 1.6× |
| Chest 3 views (71047) | $201.17 | $792 | 2.2× |
| Chest 4 or more views (71048) | $374.40 | $1,474 | 3.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$156.97–$313.94 | $618–$1,236 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $12.45 | $49 | 0.1× |
| Continuing medical physics consltj pr wk (77336) | $740.66 | $2,916 | 5.2× |
| Contrast Exam Abdominl Aorta (75625) | $2,553.72 | $10,054 | 0.8× |
| Contrast X-Ray Bladder (74430) | $477.01 | $1,878 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $392.94 | $1,547 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $635 | $2,500 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $989.33 | $3,895 | 2.7× |
| CT abdomen and pelvis without contrast (74176) | $695.45 | $2,738 | 2.8× |
| CT abdomen w contrast (74160) | $565.40 | $2,226 | 3.0× |
| CT abdomen w wo contrast (74170) | $684.78 | $2,696 | 3.7× |
| CT abdomen w/o contrast (74150) | $446.28 | $1,757 | 4.0× |
| CT Angio Abdomen and Pelvis (74174) | $684.78 | $2,696 | 1.9× |
| CT Angio Chest (71275) | $981.71 | $3,865 | 5.3× |
| CT Angio Head (70496) | $981.71 | $3,865 | 5.3× |
| CT angio hrt w/3d image (75574) | $282.96 | $1,114 | 0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$684.78–$1,369.57 | $2,696–$5,392 | varies |
| CT Angio Neck (70498) | $981.71 | $3,865 | 5.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $684.78 | $2,696 | 3.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,160.27 | $4,568 | 6.3× |
| CT cervical spine w/ contrast (72126) | $565.40 | $2,226 | 1.5× |
| CT cervical spine w/o contrast (72125) | $446.28 | $1,757 | 4.0× |
| CT cervical spine w/wo cont (72127) | $684.78 | $2,696 | 3.7× |
| CT chest w contrast (71260) | $565.40 | $2,226 | 3.0× |
| CT chest w/wo contrast (71270) | $684.78 | $2,696 | 3.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $199.90 | $787 | 1.8× |
| CT head/brain with contrast (70460) | $665.73 | $2,621 | 3.6× |
| CT head/brain without and with contrast (70470) | $493.27 | $1,942 | 2.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $282.96 | $1,114 | 0.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $12.45 | $49 | 0.1× |
| CT hrt w/3d image congen (75573) | $282.96 | $1,114 | 0.8× |
| CT iac w contrast (70481) | $565.40 | $2,226 | 3.0× |
| CT l-spine w&w/o contrast (72133) | $684.78 | $2,696 | 3.7× |
| CT lower ext w/o (73700) | $446.28 | $1,757 | 4.0× |
| CT lower extremity w/contrast material (73701) | $565.40 | $2,226 | 3.0× |
| CT lumbar spine w contrast (72132) | $565.40 | $2,226 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $446.28 | $1,757 | 4.0× |
| CT maxillofacial w contrast (70487) | $565.40 | $2,226 | 3.0× |
| CT maxillofacial wo contrast (70486) | $446.28 | $1,757 | 4.0× |
| CT neck tissue combo (70492) | $684.78 | $2,696 | 3.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $684.78 | $2,696 | 3.7× |
| CT orbits w/o contrast (70480) | $446.28 | $1,757 | 4.0× |
| CT pelvis w&w/o contrast (72194) | $805.94 | $3,173 | 4.3× |
| CT pelvis w/o contrast (72192) | $346.46 | $1,364 | 3.1× |
| CT scan of leg combo (73702) | $684.78 | $2,696 | 3.7× |
| CT scans face/jaw combo (70488) | $684.78 | $2,696 | 3.7× |
| CT soft tissue neck w contrast (70491) | $565.40 | $2,226 | 3.0× |
| CT soft tissue neck w/o contrast (70490) | $446.28 | $1,757 | 4.0× |
| CT thoracic spine w contrast (72129) | $565.40 | $2,226 | 3.0× |
| CT thoracic spine w/o contrast (72128) | $446.28 | $1,757 | 4.0× |
| CT thoracic spine w/wo cont (72130) | $714.25 | $2,812 | 3.8× |
| CT thorax w/o contrast (71250) | $446.28 | $1,757 | 4.0× |
| CT unlisted procedure (76497) | $357.38 | $1,407 | 3.9× |
| CT upper ext wo (73200) | $446.28 | $1,757 | 4.0× |
| CT upper extremity w/o & w/contrast material (73202) | $714.25 | $2,812 | 3.8× |
| CT upper extremity with contrast (73201) | $565.40 | $2,226 | 1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $981.71 | $3,865 | 5.3× |
| Cta Abdomen (74175) | $684.78 | $2,696 | 3.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,963.42 | $7,730 | 5.3× |
| CTA pelvis (72191) | $684.78 | $2,696 | 3.7× |
| Dilation ureters/urethra rs&i (74485) | $749.05 | $2,949 | 0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $82.55 | $325 | 0.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $82.55 | $325 | 0.7× |
| Dxa Bone Density Axial (77080) | $163.58 | $644 | 1.5× |
| Dxa bone density study (77085) | $116.08 | $457 | 1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $61.72 | $243 | 0.7× |
| Echo exam of fetal heart (76825) | $661.42 | $2,604 | 1.1× |
| Echo exam uterus (76831) | $330.71 | $1,302 | 1.3× |
| Echo Guide For Artery Repair (76936) | $826.52 | $3,254 | 3.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $496.06 | $1,953 | 2.0× |
| Esophagram (74220) | $320.55 | $1,262 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $363.47 | $1,431 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $198.63 | $782 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $374.40 | $1,474 | 1.5× |
| Follow-Up Angiography (75898) | $544.83 | $2,145 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$173.74–$347.47 | $684–$1,368 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$177.55–$355.09 | $699–$1,398 | varies |
| Gastric emptying imaging study (78264) | $925.58 | $3,644 | 2.2× |
| Gastroesophageal Reflux Exam (78262) | $444.75 | $1,751 | 1.1× |
| Gated Heart Planar Single (78472) | $1,148.08 | $4,520 | 2.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $420.62 | $1,656 | 0.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$167.39–$334.77 | $659–$1,318 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,517.39 | $13,848 | 4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,813.30 | $18,950 | 6.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,073.66 | $8,164 | 2.8× |
| Heart Image (Pet) Multiple (78492) | $1,194.56 | $4,703 | 0.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,281.68 | $8,983 | 0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,281.68 | $8,983 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $962.66 | $3,790 | 1.7× |
| Hepatobiliary System Imaging (78226) | $1,148.08 | $4,520 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $2,221.48 | $8,746 | 1.6× |
| Hysterosalpingogram (74740) | $646.94 | $2,547 | 2.6× |
| Image fusion (77399) | $661.42 | $2,604 | 4.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $162.56 | $640 | 1.8× |
| Infant hip ultrasound, limited static exam (76886) | $129.03 | $508 | 1.4× |
| Interstitial radiation source applic complex (77778) | $583.95 | $2,299 | 0.8× |
| Joint Survey Single View (77077) | $221.49 | $872 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $1,295.91 | $5,102 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $481.33 | $1,895 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) | $814.58 | $3,207 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$201.17–$402.34 | $792–$1,584 | varies |
| Liver & Spleen Imaging Static Only (78215) | $444.75 | $1,751 | 1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $555.50 | $2,187 | 1.3× |
| Liver imaging static only (78201) | $370.33 | $1,458 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $629.41 | $2,478 | 1.1× |
| Lung perfusion differential (78597) | $407.16 | $1,603 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,111 | $4,374 | 1.9× |
| Lung Ventilation Imaging (78579) | $555.50 | $2,187 | 1.3× |
| Lymph System Imaging (78195) | $666.50 | $2,624 | 1.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,227.07 | $4,831 | 0.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $573.02 | $2,256 | 0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,061.72 | $8,117 | 0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,441.96 | $9,614 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $951.99 | $3,748 | 3.8× |
| Mammary ductogram or galactogram single (77053) | $201.17 | $792 | 0.8× |
| Meckels Divert Exam (78290) | $777.75 | $3,062 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $3,406.65 | $13,412 | 8.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $80.77 | $318 | 2.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $101.09 | $398 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $951.99 | $3,748 | 2.6× |
| MRA head w/o contrast (70544) | $833.37 | $3,281 | 3.3× |
| MRA head with contrast (70545) | $892.30 | $3,513 | 2.4× |
| MRA neck w contrast (70548) | $892.30 | $3,513 | 2.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $951.99 | $3,748 | 2.6× |
| MRA neck w/o contrast (70547) | $833.37 | $3,281 | 3.3× |
| MRI abdomen w contrast (74182) | $892.30 | $3,513 | 2.4× |
| MRI abdomen w/o contrast (74181) | $833.37 | $3,281 | 3.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,051.31 | $4,139 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $585.47 | $2,305 | 1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $892.30 | $3,513 | 1.1× |
| MRI bone marrow blood supply (77084) | $1,190.75 | $4,688 | 4.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $208.28 | $820 | 0.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $208.28 | $820 | 0.8× |
| MRI cardiac w/o cont stress (75559) | $446.28 | $1,757 | 0.8× |
| MRI cardiac w/o contrast (75557) | $1,190.75 | $4,688 | 4.7× |
| MRI cervical spine w contrast (72142) | $892.30 | $3,513 | 2.4× |
| MRI cervical spine w/o cont (72141) | $833.37 | $3,281 | 3.3× |
| MRI chest w/o contrast (71550) | $833.37 | $3,281 | 3.3× |
| MRI chest with contrast (71551) | $892.30 | $3,513 | 1.1× |
| MRI chest wo w contrast (71552) | $951.99 | $3,748 | 2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $892.30 | $3,513 | 2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$951.99–$1,903.98 | $3,748–$7,496 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$833.37–$1,666.75 | $3,281–$6,562 | varies |
| MRI lumbar spine w contrast (72149) | $1,051.31 | $4,139 | 2.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $951.99 | $3,748 | 2.6× |
| MRI orbit face &/neck w/o contrast (70540) | $833.37 | $3,281 | 3.3× |
| MRI orbit face neck w contrast (70542) | $892.30 | $3,513 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $951.99 | $3,748 | 2.6× |
| MRI pelvis w contrast (72196) | $892.30 | $3,513 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $951.99 | $3,748 | 2.6× |
| MRI pelvis w/o contrast (72195) | $833.37 | $3,281 | 3.3× |
| MRI spectroscopy (76390) | $446.28 | $1,757 | 4.8× |
| MRI thoracic spine w/o contrast (72146) | $833.37 | $3,281 | 3.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $892.30 | $3,513 | 2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $833.37 | $3,281 | 3.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $951.99 | $3,748 | 2.6× |
| MRI, abdomen, combo (74183) | $951.99 | $3,748 | 2.6× |
| MRI, dorsal spine combo (72157) | $951.99 | $3,748 | 2.6× |
| MRI, dorsal spine contrast (72147) | $892.30 | $3,513 | 2.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$833.37–$1,666.75 | $3,281–$6,562 | varies |
| MRI, joint upper extrem combo (73223) | $951.99 | $3,748 | 2.6× |
| MRI, lumbar spine combo (72158) | $857 | $3,374 | 2.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,064.51 | $4,191 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,962.15 | $11,662 | 2.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,194.56 | $4,703 | 0.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,194.56 | $4,703 | 0.8× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,205.74 | $8,684 | 0.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,563.88 | $6,157 | 0.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $1,483.87 | $5,842 | 0.9× |
| N-invas est c ffr sw aly CTA (75580) | $1,408.94 | $5,547 | 1.6× |
| Neck soft tissue (70360) | $167.39 | $659 | 1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $407.16 | $1,603 | 1.0× |
| Nm myocard infarct spect (78469) | $518.67 | $2,042 | 0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $10,737.09 | $42,272 | 7.3× |
| Nuclear Rx Intra-Arterial (79445) | $518.67 | $2,042 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $1,592.33 | $6,269 | 6.5× |
| Ob us nuchal meas 1 gest (76813) | $102.62 | $404 | 0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $99.06 | $390 | 0.9× |
| Panoramic X-ray of jaws (70355) | $180.85 | $712 | 2.0× |
| Parathyroid Planar Imaging (78070) | $370.33 | $1,458 | 0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,703.07 | $6,705 | 4.0× |
| Pelvis 1 or 2 views (72170) | $173.74 | $684 | 1.6× |
| Peritoneogram Rs&I (74190) | $374.40 | $1,474 | 0.6× |
| Pet Image W/Ct Lmtd (78814) | $3,967.23 | $15,619 | 2.6× |
| PET image w/CT, full body (78816) | $3,967.23 | $15,619 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,967.23 | $15,619 | 2.6× |
| Pet Myocardial Sngl Study (78491) | $1,194.56 | $4,703 | 0.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,553.72 | $10,054 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $629.41 | $2,478 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $249.17 | $981 | 2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $374.40 | $1,474 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$204.47–$408.94 | $805–$1,610 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$211.58–$423.16 | $833–$1,666 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$221.49–$442.98 | $872–$1,744 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $374.40 | $1,474 | 3.4× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$153.42–$306.83 | $604–$1,208 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$187.20–$374.40 | $737–$1,474 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$201.17–$402.34 | $792–$1,584 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$132.84–$265.68 | $523–$1,046 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $289.56 | $1,140 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $228.60 | $900 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $132.84 | $523 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$194.56–$389.13 | $766–$1,532 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $211.58 | $833 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $177.55 | $699 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $191.01 | $752 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $265.68 | $1,046 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $156.97 | $618 | 1.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$116.08–$232.16 | $457–$914 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$184.40–$368.81 | $726–$1,452 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $477.01 | $1,878 | 4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,775.45 | $30,612 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $1,412.75 | $5,562 | 13.1× |
| Radiation treatment delivery level 2 (77407) | $2,056.13 | $8,095 | 5.0× |
| Radiation treatment delivery level 3 (77412) | $2,569.97 | $10,118 | 4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $276.10 | $1,087 | 2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $221.49 | $872 | 2.0× |
| Radiologic exam colon double contrast study (74280) | $715.26 | $2,816 | 3.9× |
| Radiologic exam colon single contrast study (74270) | $337.31 | $1,328 | 1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $578.87 | $2,279 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$249.17–$498.35 | $981–$1,962 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $252.22 | $993 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $511.05 | $2,012 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $272.29 | $1,072 | 1.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $337.31 | $1,328 | 1.8× |
| Radiologic examination femur 1 view (73551) | $187.20 | $737 | 2.0× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$204.47–$408.94 | $805–$1,610 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$180.85–$361.70 | $712–$1,424 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $224.79 | $885 | 2.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$170.43–$340.87 | $671–$1,342 | varies |
| Ribs bilateral 3 views (71110) | $252.22 | $993 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $407.16 | $1,603 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $518.67 | $2,042 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $666.50 | $2,624 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,073.91 | $4,228 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$827.28–$1,295.91 | $3,257–$5,102 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $870.20 | $3,426 | 0.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $870.20 | $3,426 | 0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $870.20 | $3,426 | 0.6× |
| Rp Therapy Intravenous Administration (79101) | $999.74 | $3,936 | 4.0× |
| Scapula (73010) range across 2 matching MRF lines |
$191.01–$382.02 | $752–$1,504 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $14.99 | $59 | 0.6× |
| Shoulder 1 view (73020) | $75.18 | $296 | 0.8× |
| Shoulder Arthrography (73040) | $340.61 | $1,341 | 0.9× |
| Sialogram (70390) | $374.40 | $1,474 | 1.5× |
| Skull less than 4 views (70250) | $252.22 | $993 | 2.3× |
| Special dosimetry (77331) | $230.12 | $906 | 1.6× |
| Special Physics Consult (77370) | $740.66 | $2,916 | 5.2× |
| Special teletherapy port plan (77321) | $962.66 | $3,790 | 2.4× |
| Special treatment procedure (77470) | $2,332.48 | $9,183 | 4.0× |
| Stereotactic Body Radiation Delivery (77373) | $3,702.30 | $14,576 | 2.0× |
| Sternoclavicular joints (71130) | $211.58 | $833 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,628.90 | $6,413 | 4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $777.75 | $3,062 | 2.0× |
| Testicular Imaging W/Flow (78761) | $385.57 | $1,518 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,962.40 | $7,726 | 5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $350.27 | $1,379 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) | $999.74 | $3,936 | 7.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $153.42 | $604 | 0.8× |
| Thoracic spine 2 views (72070) | $191.01 | $752 | 1.7× |
| Thoracic spine 3 views (72072) | $224.79 | $885 | 2.0× |
| Thoracolumbar 2 views (72080) | $82.04 | $323 | 0.9× |
| Thyroid Imaging With Vascular Flow (78013) | $344.68 | $1,357 | 0.8× |
| Thyroid Met Imaging Body (78018) | $1,740.41 | $6,852 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $962.66 | $3,790 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $999.74 | $3,936 | 2.5× |
| Tx devices design & construction intermediate (77333) | $304.29 | $1,198 | 2.1× |
| Tx devices design & construction simple (77332) | $481.33 | $1,895 | 3.4× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$155.70–$377.95 | $613–$1,488 | varies |
| Ultrasound elastography first target lesion (76982) | $112.78 | $444 | 1.0× |
| Ultrasound Elastography Parenchyma (76981) | $112.78 | $444 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$5.84–$165.35 | $23–$651 | varies |
| Ultrasound, abdomen limited (76705) | $255.02 | $1,004 | 2.3× |
| Umbilical-artery Doppler (OB) (76820) | $96.27 | $379 | 0.9× |
| Unlisted fluoroscopic procedure (76496) | $374.40 | $1,474 | 4.1× |
| Unlisted magnetic resonance procedure (76498) | $833.37 | $3,281 | 9.1× |
| Unlisted us procedure (76999) | $63.25 | $249 | 0.7× |
| Upper gi w/o kub (74240) | $320.55 | $1,262 | 1.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $192.53 | $758 | 17.4× |
| Urethrocystogram voiding (74455) | $477.01 | $1,878 | 1.9× |
| Urethrocystography retrograde (74450) | $477.01 | $1,878 | 1.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$129.03–$258.06 | $508–$1,016 | varies |
| Us chest (76604) | $363.47 | $1,431 | 3.3× |
| Us complete joint (76881) | $562.61 | $2,215 | 5.1× |
| Us exam, pelvic, limited (76857) | $297.69 | $1,172 | 2.7× |
| Us head (76506) | $694.44 | $2,734 | 6.3× |
| Us kidney transplant (76776) | $258.32 | $1,017 | 2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$304.55–$609.09 | $1,199–$2,398 | varies |
| Us ob detailed single fetus (76811) | $694.44 | $2,734 | 2.8× |
| Us ob limited 1 or more fetuses (76815) | $496.06 | $1,953 | 4.5× |
| Us ob transvaginal (76817) | $162.56 | $640 | 1.5× |
| Us pelvic non ob complete (76856) | $274.83 | $1,082 | 2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $661.42 | $2,604 | 6.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $191.77 | $755 | 1.7× |
| Us retroperitoneal complete (76770) | $311.15 | $1,225 | 2.8× |
| Us retroperitoneal limited (76775) | $363.47 | $1,431 | 3.3× |
| Us scrotum and contents (76870) | $429.77 | $1,692 | 3.9× |
| Us spinal canal and contents (76800) | $152.15 | $599 | 1.4× |
| Us thyroid (76536) | $268.22 | $1,056 | 2.4× |
| Us transrectal (76872) | $496.06 | $1,953 | 4.5× |
| Vein X-Ray Chest (75827) | $1,395.98 | $5,496 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $919.23 | $3,619 | 0.3× |
| Venogram Sinus/Jugular (75860) | $2,996.69 | $11,798 | 0.9× |
| Venography Adrenal Unilateral (75840) | $2,553.72 | $10,054 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $2,179.57 | $8,581 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,362.20 | $5,363 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,225.55 | $4,825 | 0.7× |
| Venography Renal Bilateral (75833) | $2,485.90 | $9,787 | 0.7× |
| Venography Renal Unilateral (75831) | $2,860.04 | $11,260 | 0.9× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,042.92 | $8,043 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $525.78 | $2,070 | 1.2× |
| Vertebral fracture assessment via dxa (77086) | $71.88 | $283 | 0.8× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$170.43–$340.87 | $671–$1,342 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $228.60 | $900 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $214.88 | $846 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $3,745.74 | $14,747 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $184.40 | $726 | 1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$170.43–$340.87 | $671–$1,342 | varies |
| X-Ray Exam Breast Specimen (76098) | $885.95 | $3,488 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $191.01 | $752 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $286.26 | $1,127 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $408.43 | $1,608 | 3.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $95.25 | $375 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $160.27 | $631 | 1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $180.85 | $712 | 1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $204.47 | $805 | 1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $238.76 | $940 | 2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $272.29 | $1,072 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $332.99 | $1,311 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $259.33 | $1,021 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $306.58 | $1,207 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $184.40 | $726 | 1.7× |
| X-ray eye for foreign body (70030) | $116.08 | $457 | 1.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$173.74–$347.47 | $684–$1,368 | varies |
| X-ray IV pyelogram (ivp) (74400) | $646.94 | $2,547 | 3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $58.17 | $229 | 0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $228.60 | $900 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $153.67 | $605 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $51.31 | $202 | 0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $249.17 | $981 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$170.43–$340.87 | $671–$1,342 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $71.88 | $283 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $170.43 | $671 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $204.47 | $805 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $228.60 | $900 | 2.1× |
| X-Ray Stress View (77071) | $194.56 | $766 | 2.1× |
| X-ray thoracic spine 4 vw (72074) | $323.60 | $1,274 | 2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $578.87 | $2,279 | 1.6× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$259.33–$518.67 | $1,021–$2,042 | varies |
| X-Rays Bone Survey Complete (77075) | $337.31 | $1,328 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $276.10 | $1,087 | 2.5× |
| Xr facial bones less than 3 views (70140) | $211.58 | $833 | 2.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $103.63 | $408 | 0.9× |
| Xr orbits complete 4 views (70200) | $276.10 | $1,087 | 2.5× |
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.