Imaging prices at Franciscan Health Rensselaer, Inc
Rensselaer, IN · every code in this section with a posted price and a Medicare benchmark.
355 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) | $2,963.52 | $8,278 | 2.0× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$27.92–$55.85 | $78–$156 | varies |
| Abdomen 2 views (74019) | $106.33 | $297 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $133.89 | $374 | 0.3× |
| Angio internal mammary (75756) | $1,565.89 | $4,374 | 0.5× |
| Angio pulmonary bilat (75743) | $2,963.52 | $8,278 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $2,460.18 | $6,872 | 0.7× |
| Angiography extremity unilateral rs&i (75710) | $2,404.33 | $6,716 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,963.52 | $8,278 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,628.08 | $7,341 | 0.8× |
| Ankle 2 views (73600) | $80.91 | $226 | 0.9× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,683.93 | $7,497 | 0.5× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,739.42 | $7,652 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $2,124.73 | $5,935 | 0.6× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,739.42 | $7,652 | 0.5× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,180.94 | $6,092 | 0.4× |
| Arthrogram ankle (73615) | $615.04 | $1,718 | 1.7× |
| Arthrogram hip (73525) | $465.76 | $1,301 | 1.3× |
| Arthrogram Wrist (73115) | $408.12 | $1,140 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $277.09 | $774 | 1.9× |
| Bone age studies (77072) | $199.76 | $558 | 1.8× |
| Bone Imaging 3 Phase (78315) | $274.94 | $768 | 0.7× |
| Bone Imaging Limited Area (78300) | $249.88 | $698 | 0.6× |
| Bone Imaging Multiple Areas (78305) | $253.11 | $707 | 0.6× |
| Bone Imaging Whole Body (78306) | $257.04 | $718 | 0.6× |
| Bone marrow imaging limited area (78102) | $356.21 | $995 | 0.8× |
| Bone survey infant (77076) | $99.17 | $277 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,037.48 | $2,898 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,656 | $7,419 | 1.8× |
| Cardiac Shunt Detection (78428) | $543.44 | $1,518 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $501.56 | $1,401 | 5.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $309.67 | $865 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $2,358.50 | $6,588 | 4.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$27.92–$55.85 | $78–$156 | varies |
| Chest 2 views (71046) | $106.68 | $298 | 1.2× |
| Chest 3 views (71047) | $158.95 | $444 | 1.7× |
| Chest 4 or more views (71048) | $220.53 | $616 | 2.0× |
| Clavicle complete (73000) | $81.27 | $227 | 0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $17.54 | $49 | 0.2× |
| Continuing medical physics consltj pr wk (77336) | $400.96 | $1,120 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) | $2,571.87 | $7,184 | 0.8× |
| Contrast X-Ray Bladder (74430) | $119.57 | $334 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $553.83 | $1,547 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $895 | $2,500 | 2.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,435.58 | $4,010 | 3.9× |
| CT abdomen and pelvis without contrast (74176) | $1,038.92 | $2,902 | 4.1× |
| CT abdomen w contrast (74160) | $630.80 | $1,762 | 3.4× |
| CT abdomen w wo contrast (74170) | $785.45 | $2,194 | 4.2× |
| CT abdomen w/o contrast (74150) | $552.39 | $1,543 | 5.0× |
| CT Angio Abdomen and Pelvis (74174) | $894.64 | $2,499 | 2.4× |
| CT Angio Chest (71275) | $501.56 | $1,401 | 2.7× |
| CT Angio Head (70496) | $501.56 | $1,401 | 2.7× |
| CT angio hrt w/3d image (75574) | $838.44 | $2,342 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,732.36–$3,464.72 | $4,839–$9,678 | varies |
| CT Angio Neck (70498) | $501.56 | $1,401 | 2.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $501.56 | $1,401 | 2.7× |
| CT cervical spine w/ contrast (72126) | $679.48 | $1,898 | 1.8× |
| CT cervical spine w/o contrast (72125) | $591.77 | $1,653 | 5.4× |
| CT cervical spine w/wo cont (72127) | $731.04 | $2,042 | 3.9× |
| CT chest w contrast (71260) | $630.80 | $1,762 | 3.4× |
| CT chest w/wo contrast (71270) | $785.45 | $2,194 | 4.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $629.01 | $1,757 | 5.7× |
| CT head/brain with contrast (70460) | $575.31 | $1,607 | 3.1× |
| CT head/brain without and with contrast (70470) | $785.45 | $2,194 | 4.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $629.01 | $1,757 | 1.7× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$17.54–$17.90 | $49–$50 | varies |
| CT hrt w/3d image congen (75573) | $629.01 | $1,757 | 1.7× |
| CT iac w contrast (70481) | $607.53 | $1,697 | 3.3× |
| CT l-spine w&w/o contrast (72133) | $731.04 | $2,042 | 3.9× |
| CT lower ext w/o (73700) | $501.56 | $1,401 | 4.5× |
| CT lower extremity w/contrast material (73701) | $552.39 | $1,543 | 3.0× |
| CT lumbar spine w contrast (72132) | $679.48 | $1,898 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $591.77 | $1,653 | 5.4× |
| CT maxillofacial w contrast (70487) | $583.18 | $1,629 | 3.1× |
| CT maxillofacial wo contrast (70486) | $552.39 | $1,543 | 5.0× |
| CT neck tissue combo (70492) | $711.70 | $1,988 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $649.77 | $1,815 | 3.5× |
| CT orbits w/o contrast (70480) | $552.39 | $1,543 | 5.0× |
| CT pelvis w&w/o contrast (72194) | $674.47 | $1,884 | 3.6× |
| CT pelvis w/o contrast (72192) | $552.39 | $1,543 | 5.0× |
| CT scan of leg combo (73702) | $616.83 | $1,723 | 3.3× |
| CT scans face/jaw combo (70488) | $645.83 | $1,804 | 3.5× |
| CT soft tissue neck w contrast (70491) | $575.31 | $1,607 | 3.1× |
| CT soft tissue neck w/o contrast (70490) | $552.39 | $1,543 | 5.0× |
| CT thoracic spine w contrast (72129) | $679.48 | $1,898 | 3.7× |
| CT thoracic spine w/o contrast (72128) | $552.39 | $1,543 | 5.0× |
| CT thoracic spine w/wo cont (72130) | $731.04 | $2,042 | 3.9× |
| CT thorax w/o contrast (71250) | $552.39 | $1,543 | 5.0× |
| CT unlisted procedure (76497) | $90.57 | $253 | 1.0× |
| CT upper ext wo (73200) | $622.20 | $1,738 | 5.6× |
| CT upper extremity w/o & w/contrast material (73202) | $552.39 | $1,543 | 3.0× |
| CT upper extremity with contrast (73201) | $627.93 | $1,754 | 1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $501.56 | $1,401 | 2.7× |
| Cta Abdomen (74175) | $501.56 | $1,401 | 2.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,003.12 | $2,802 | 2.7× |
| CTA pelvis (72191) | $501.56 | $1,401 | 2.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $318.98 | $891 | 2.9× |
| Dxa Bone Density Axial (77080) | $180.79 | $505 | 1.6× |
| Dxa bone density study (77085) | $169.69 | $474 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $180.79 | $505 | 2.0× |
| Echo exam uterus (76831) | $1,505.03 | $4,204 | 6.0× |
| Echo Guide For Artery Repair (76936) | $752.52 | $2,102 | 3.3× |
| Esophagram (74220) | $118.86 | $332 | 0.6× |
| Fetal Biophys Profile W/Nst (76818) | $620.06 | $1,732 | 5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $160.03 | $447 | 1.4× |
| Fluoroscopy up to 1 hr (76000) | $734.97 | $2,053 | 2.9× |
| Follow-Up Angiography (75898) | $251.32 | $702 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$76.25–$152.51 | $213–$426 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$106.33–$212.65 | $297–$594 | varies |
| Gastric emptying imaging study (78264) | $309.67 | $865 | 0.7× |
| Gastroesophageal Reflux Exam (78262) | $1,283.79 | $3,586 | 3.0× |
| Gated Heart Planar Single (78472) | $328.64 | $918 | 0.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $592.85 | $1,656 | 1.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$81.62–$163.25 | $228–$456 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,516.38 | $7,029 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,404.33 | $6,716 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $343.68 | $960 | 0.6× |
| Hepatobiliary System Imaging (78226) | $155.01 | $433 | 0.4× |
| Ht Muscle Image Spect Sing (78451) | $944.05 | $2,637 | 0.7× |
| Hysterosalpingogram (74740) | $516.95 | $1,444 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $664.09 | $1,855 | 7.2× |
| Infant hip ultrasound, limited static exam (76886) | $129.24 | $361 | 1.4× |
| Joint Survey Single View (77077) | $144.27 | $403 | 1.3× |
| K Flow/Funct Image Multiple (78709) | $388.07 | $1,084 | 0.7× |
| K Flow/Funct Image W/Drug (78708) | $328.64 | $918 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) | $298.93 | $835 | 0.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$97.38–$194.75 | $272–$544 | varies |
| Liver & Spleen Imaging Static Only (78215) | $321.48 | $898 | 0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,196.79 | $3,343 | 2.8× |
| Liver imaging static only (78201) | $390.94 | $1,092 | 0.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,037.48 | $2,898 | 1.8× |
| Lung perfusion differential (78597) | $180.07 | $503 | 0.4× |
| Lung Ventilat&Perfus Imaging (78582) | $180.07 | $503 | 0.3× |
| Lung Ventilation Imaging (78579) | $394.87 | $1,103 | 0.9× |
| Lymph System Imaging (78195) | $357.64 | $999 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $1,531.52 | $4,278 | 6.1× |
| Mammary ductogram or galactogram single (77053) | $447.14 | $1,249 | 1.8× |
| Meckels Divert Exam (78290) | $309.67 | $865 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $385.57 | $1,077 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $27.57 | $77 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $89.86 | $251 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,163.86 | $3,251 | 3.2× |
| MRA head w/o contrast (70544) | $927.22 | $2,590 | 3.7× |
| MRA neck w contrast (70548) | $1,008.13 | $2,816 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,112.66 | $3,108 | 3.0× |
| MRA neck w/o contrast (70547) | $927.22 | $2,590 | 3.7× |
| MRI abdomen w contrast (74182) | $784.02 | $2,190 | 2.1× |
| MRI abdomen w/o contrast (74181) | $703.11 | $1,964 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) | $784.02 | $2,190 | 0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,048.94 | $2,930 | 2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $784.02 | $2,190 | 0.9× |
| MRI bone marrow blood supply (77084) | $1,678.30 | $4,688 | 6.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $197.97 | $553 | 0.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $197.97 | $553 | 0.8× |
| MRI cardiac w/o contrast (75557) | $629.01 | $1,757 | 2.5× |
| MRI cervical spine w contrast (72142) | $784.02 | $2,190 | 2.1× |
| MRI cervical spine w/o cont (72141) | $703.11 | $1,964 | 2.8× |
| MRI chest w/o contrast (71550) | $830.56 | $2,320 | 3.3× |
| MRI chest with contrast (71551) | $869.58 | $2,429 | 1.0× |
| MRI chest wo w contrast (71552) | $887.12 | $2,478 | 2.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $820.18 | $2,291 | 2.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $887.12 | $2,478 | 2.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $703.11 | $1,964 | 2.8× |
| MRI lumbar spine w contrast (72149) | $783.66 | $2,189 | 2.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $887.12 | $2,478 | 2.4× |
| MRI orbit face &/neck w/o contrast (70540) | $887.12 | $2,478 | 3.5× |
| MRI orbit face neck w contrast (70542) | $886.77 | $2,477 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $887.12 | $2,478 | 2.4× |
| MRI pelvis w contrast (72196) | $783.66 | $2,189 | 2.1× |
| MRI pelvis w/o & w contrast (72197) | $887.12 | $2,478 | 2.4× |
| MRI pelvis w/o contrast (72195) | $703.11 | $1,964 | 2.8× |
| MRI thoracic spine w/o contrast (72146) | $703.11 | $1,964 | 2.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $784.02 | $2,190 | 2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $703.11 | $1,964 | 2.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $886.77 | $2,477 | 2.4× |
| MRI, abdomen, combo (74183) | $887.12 | $2,478 | 2.4× |
| MRI, dorsal spine combo (72157) | $887.12 | $2,478 | 2.4× |
| MRI, dorsal spine contrast (72147) | $784.02 | $2,190 | 2.1× |
| MRI, joint upper extrem (73221) | $703.11 | $1,964 | 2.8× |
| MRI, joint upper extrem combo (73223) | $1,048.94 | $2,930 | 2.8× |
| MRI, lumbar spine combo (72158) | $887.12 | $2,478 | 2.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,982.86 | $8,332 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $965.53 | $2,697 | 0.7× |
| Neck soft tissue (70360) | $66.95 | $187 | 0.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $351.56 | $982 | 0.8× |
| Nm myocard infarct spect (78469) | $1,827.23 | $5,104 | 3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,407.44 | $9,518 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $642.25 | $1,794 | 2.6× |
| Ob us nuchal meas 1 gest (76813) | $256.69 | $717 | 2.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $114.92 | $321 | 1.0× |
| Parathyroid Planar Imaging (78070) | $298.93 | $835 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $408.84 | $1,142 | 1.0× |
| Pelvis 1 or 2 views (72170) | $123.51 | $345 | 1.1× |
| Peritoneogram Rs&I (74190) | $431.03 | $1,204 | 0.7× |
| PET image w/CT, full body (78816) | $2,003.73 | $5,597 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,003.73 | $5,597 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,628.08 | $7,341 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $136.04 | $380 | 0.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $78.76 | $220 | 0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $298.93 | $835 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$87.71–$175.42 | $245–$490 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$94.51–$189.02 | $264–$528 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$95.59–$191.17 | $267–$534 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $48.69 | $136 | 0.4× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$83.41–$166.83 | $233–$466 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$85.56–$171.12 | $239–$478 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$90.22–$180.43 | $252–$504 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $112.77 | $315 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $247.02 | $690 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $46.54 | $130 | 0.5× |
| Radex Ribs Unilateral 2 Views (71100) | $104.89 | $293 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$108.47–$216.95 | $303–$606 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $53.70 | $150 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $64.08 | $179 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $108.47 | $303 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $56.21 | $157 | 0.6× |
| Radex Toe Minimum 2 Views (73660) | $88.78 | $248 | 1.0× |
| Radex upper extremity infant minimum 2 views (73092) | $123.51 | $345 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$81.98–$163.96 | $229–$458 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $269.93 | $754 | 2.4× |
| Radiation treatment delivery level 1 (77402) | $192.96 | $539 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $71.60 | $200 | 0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $158.95 | $444 | 1.4× |
| Radiologic exam colon double contrast study (74280) | $147.85 | $413 | 0.8× |
| Radiologic exam colon single contrast study (74270) | $94.15 | $263 | 0.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $229.84 | $642 | 1.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$112.41–$224.82 | $314–$628 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $312.18 | $872 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $94.15 | $263 | 0.5× |
| Radiologic exam swallow function contrast study (74230) | $51.19 | $143 | 0.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $229.84 | $642 | 1.2× |
| Radiologic examination femur 1 view (73551) | $87.71 | $245 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$87.71–$175.42 | $245–$490 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$81.98–$163.96 | $229–$458 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $153.22 | $428 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$103.82–$207.64 | $290–$580 | varies |
| Ribs bilateral 3 views (71110) | $144.27 | $403 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $380.91 | $1,064 | 0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,235.46 | $3,451 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,404.58 | $9,510 | 5.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $630.80 | $1,762 | 1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,495.37–$1,631.05 | $4,177–$4,556 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,631.05 | $4,556 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,863.75 | $5,206 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,456.70 | $4,069 | 1.1× |
| Rp Therapy Intravenous Administration (79101) | $741.06 | $2,070 | 3.0× |
| Scapula (73010) | $129.24 | $361 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $35.80 | $100 | 1.5× |
| Shoulder 1 view (73020) | $78.04 | $218 | 0.8× |
| Shoulder Arthrography (73040) | $465.76 | $1,301 | 1.3× |
| Sialogram (70390) | $543.09 | $1,517 | 2.2× |
| Skull less than 4 views (70250) | $56.21 | $157 | 0.5× |
| Special dosimetry (77331) | $257.40 | $719 | 1.8× |
| Special Physics Consult (77370) | $282.46 | $789 | 2.0× |
| Special teletherapy port plan (77321) | $345.83 | $966 | 0.9× |
| Special treatment procedure (77470) | $888.91 | $2,483 | 1.5× |
| Sternoclavicular joints (71130) | $112.77 | $315 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $543.44 | $1,518 | 1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $409.55 | $1,144 | 1.0× |
| Testicular Imaging W/Flow (78761) | $416.71 | $1,164 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $888.91 | $2,483 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $493.68 | $1,379 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $409.55 | $1,144 | 2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $368.74 | $1,030 | 2.0× |
| Thoracic spine 2 views (72070) | $144.27 | $403 | 1.3× |
| Thoracic spine 3 views (72072) | $144.27 | $403 | 1.3× |
| Thoracolumbar 2 views (72080) | $132.46 | $370 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $200.12 | $559 | 0.5× |
| Thyroid Met Imaging Body (78018) | $1,283.79 | $3,586 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $286.04 | $799 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $592.85 | $1,656 | 1.5× |
| Tx devices design & construction intermediate (77333) | $311.82 | $871 | 2.2× |
| Tx devices design & construction simple (77332) | $405.61 | $1,133 | 2.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$132.46–$264.92 | $370–$740 | varies |
| Ultrasound elastography first target lesion (76982) | $151.08 | $422 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $151.08 | $422 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) range across 6 matching MRF lines |
$8.23–$566.36 | $23–$1,582 | varies |
| Ultrasound, abdomen limited (76705) | $156.45 | $437 | 1.4× |
| Umbilical-artery Doppler (OB) (76820) | $128.52 | $359 | 1.2× |
| Upper gi w/o kub (74240) | $118.86 | $332 | 0.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $271.36 | $758 | 24.5× |
| Urethrocystogram voiding (74455) | $116.35 | $325 | 0.5× |
| Urethrocystography retrograde (74450) | $543.09 | $1,517 | 2.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$132.46–$264.92 | $370–$740 | varies |
| Us chest (76604) | $199.05 | $556 | 1.8× |
| Us complete joint (76881) range across 2 matching MRF lines |
$119.57–$239.14 | $334–$668 | varies |
| Us exam, pelvic, limited (76857) | $157.88 | $441 | 1.4× |
| Us head (76506) | $350.84 | $980 | 3.2× |
| Us kidney transplant (76776) | $531.63 | $1,485 | 4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$80.55–$161.10 | $225–$450 | varies |
| Us ob detailed single fetus (76811) | $315.04 | $880 | 1.2× |
| Us ob limited 1 or more fetuses (76815) | $81.98 | $229 | 0.7× |
| Us ob transvaginal (76817) | $60.86 | $170 | 0.6× |
| Us pelvic non ob complete (76856) | $187.95 | $525 | 1.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $209.43 | $585 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $64.08 | $179 | 0.6× |
| Us retroperitoneal complete (76770) | $241.65 | $675 | 2.2× |
| Us retroperitoneal limited (76775) | $180.79 | $505 | 1.6× |
| Us scrotum and contents (76870) | $188.31 | $526 | 1.7× |
| Us spinal canal and contents (76800) | $296.78 | $829 | 2.7× |
| Us thyroid (76536) | $209.43 | $585 | 1.9× |
| Us transrectal (76872) | $139.62 | $390 | 1.3× |
| Vein X-Ray Chest (75827) | $1,845.49 | $5,155 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,516.38 | $7,029 | 0.8× |
| Venogram Sinus/Jugular (75860) | $1,229.73 | $3,435 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,068.88 | $5,779 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $1,093.33 | $3,054 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $783.30 | $2,188 | 0.5× |
| Venography Renal Bilateral (75833) | $2,628.08 | $7,341 | 0.8× |
| Venography Renal Unilateral (75831) | $1,677.95 | $4,687 | 0.5× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$783.30 | $2,188 | 0.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $741.06 | $2,070 | 1.8× |
| Vertebral fracture assessment via dxa (77086) | $87.71 | $245 | 1.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$80.91–$161.82 | $226–$452 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $100.60 | $281 | 1.1× |
| X-ray antegrade pyelogram tube (74425) | $139.62 | $390 | 0.4× |
| X-Ray Aorta Leg Arteries (75630) | $3,522.72 | $9,840 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $116.35 | $325 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $81.62 | $228 | 0.9× |
| X-Ray Exam Breast Specimen (76098) | $378.05 | $1,056 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $87.35 | $244 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $144.27 | $403 | 1.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $324.35 | $906 | 2.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $87.71 | $245 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $87.71 | $245 | 1.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $144.27 | $403 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $144.27 | $403 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $144.27 | $403 | 1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $273.51 | $764 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $165.04 | $461 | 1.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $103.82 | $290 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $171.84 | $480 | 1.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $240.58 | $672 | 2.2× |
| X-ray eye for foreign body (70030) | $134.97 | $377 | 1.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$102.39–$204.78 | $286–$572 | varies |
| X-ray IV pyelogram (ivp) (74400) | $559.55 | $1,563 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $78.04 | $218 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $48.69 | $136 | 0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $106.68 | $298 | 1.0× |
| X-ray nose-rectum child f.b. (76010) | $60.86 | $170 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $126.73 | $354 | 1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $166.11 | $464 | 1.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $52.27 | $146 | 0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $166.11 | $464 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $60.86 | $170 | 0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $89.86 | $251 | 0.8× |
| X-Ray Stress View (77071) | $60.86 | $170 | 0.7× |
| X-ray thoracic spine 4 vw (72074) | $157.88 | $441 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $116.35 | $325 | 0.3× |
| X-Rays Bone Length Studies (77073) | $291.41 | $814 | 2.6× |
| X-Rays Bone Survey Complete (77075) | $249.53 | $697 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $146.06 | $408 | 1.3× |
| Xr facial bones less than 3 views (70140) | $83.77 | $234 | 0.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $146.06 | $408 | 1.3× |
| Xr orbits complete 4 views (70200) | $68.02 | $190 | 0.6× |
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.