Imaging prices at Franklin Woods Community Hospital
Johnson City, TN · every code in this section with a posted price and a Medicare benchmark.
382 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) | $1,404.15 | $9,361 | 1.1× |
| Abdomen 1 View (74018) | $65.85 | $439 | 0.8× |
| Abdomen 2 views (74019) | $69.30 | $462 | 0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $452.25 | $3,015 | 1.2× |
| Angio internal mammary (75756) | $452.10 | $3,014 | 0.2× |
| Angio pulmonary bilat (75743) | $1,357.80 | $9,052 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $1,425.75 | $9,505 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,357.80 | $9,052 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,357.80 | $9,052 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $492.60 | $3,284 | 0.2× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$62.55–$69.30 | $417–$462 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,357.80 | $9,052 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,357.80 | $9,052 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $1,357.80 | $9,052 | 0.5× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,357.80 | $9,052 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,357.80 | $9,052 | 0.3× |
| Arthrogram hip (73525) | $182.55 | $1,217 | 0.6× |
| Arthrogram Wrist (73115) | $182.55 | $1,217 | 0.6× |
| Basic radiation dosimetry calculation (77300) | $116.55 | $777 | 1.0× |
| Bone age studies (77072) | $69.30 | $462 | 0.7× |
| Bone Imaging 3 Phase (78315) | $452.25 | $3,015 | 1.2× |
| Bone Imaging Limited Area (78300) | $452.25 | $3,015 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $452.25 | $3,015 | 1.2× |
| Bone Imaging Whole Body (78306) | $452.25 | $3,015 | 1.2× |
| Bone marrow imaging limited area (78102) | $452.25 | $3,015 | 1.2× |
| Bone marrow imaging; multiple areas (78103) | $474.90 | $3,166 | 1.3× |
| Bone survey infant (77076) | $69.30 | $462 | 0.7× |
| Brachytx isodose intermed (77317) | $192.90 | $1,286 | 0.6× |
| Brachytx Isodose Plan Simple (77316) | $147.90 | $986 | 0.4× |
| Brain Flow Imaging Only (78610) | $452.25 | $3,015 | 0.9× |
| Brain Image W/Flow < 4 Views (78601) | $452.25 | $3,015 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $452.25 | $3,015 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,529.85 | $10,199 | 1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $668.55 | $4,457 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $559.65 | $3,731 | 7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $452.25 | $3,015 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $452.25 | $3,015 | 0.9× |
| Chest 1 view (71045) | $65.85 | $439 | 0.8× |
| Chest 2 views (71046) | $69.30 | $462 | 0.9× |
| Chest 3 views (71047) | $72.75 | $485 | 0.9× |
| Chest 4 or more views (71048) | $76.35 | $509 | 0.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $101.55 | $677 | 1.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$65.85–$69.30 | $439–$462 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $91.05 | $607 | 1.0× |
| Continuing medical physics consltj pr wk (77336) | $149.70 | $998 | 1.2× |
| Contrast Exam Abdominl Aorta (75625) | $1,357.80 | $9,052 | 0.5× |
| Contrast X-Ray Bladder (74430) | $119.55 | $797 | 0.4× |
| Contrast X-Ray Of Elbow (73085) | $182.55 | $1,217 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $182.55 | $1,217 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $587.70 | $3,918 | 1.9× |
| CT abdomen and pelvis without contrast (74176) | $531.75 | $3,545 | 2.5× |
| CT abdomen w contrast (74160) | $587.70 | $3,918 | 3.7× |
| CT abdomen w wo contrast (74170) | $617.10 | $4,114 | 3.9× |
| CT abdomen w/o contrast (74150) | $559.65 | $3,731 | 5.9× |
| CT Angio Abdomen and Pelvis (74174) | $559.65 | $3,731 | 1.8× |
| CT Angio Chest (71275) | $587.70 | $3,918 | 3.7× |
| CT Angio Head (70496) | $559.65 | $3,731 | 3.5× |
| CT angio hrt w/3d image (75574) | $559.65 | $3,731 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$559.65–$587.70 | $3,731–$3,918 | varies |
| CT Angio Neck (70498) | $559.65 | $3,731 | 3.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$559.65–$587.70 | $3,731–$3,918 | varies |
| CT cervical spine w/ contrast (72126) | $559.65 | $3,731 | 1.8× |
| CT cervical spine w/o contrast (72125) | $531.75 | $3,545 | 5.6× |
| CT cervical spine w/wo cont (72127) | $587.70 | $3,918 | 3.7× |
| CT chest w contrast (71260) | $559.65 | $3,731 | 3.5× |
| CT chest w/wo contrast (71270) | $587.70 | $3,918 | 3.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $559.65 | $3,731 | 5.9× |
| CT head/brain with contrast (70460) | $559.65 | $3,731 | 3.5× |
| CT head/brain without and with contrast (70470) | $587.70 | $3,918 | 3.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $7.35 | $49 | 0.1× |
| CT iac w contrast (70481) | $559.65 | $3,731 | 3.5× |
| CT l-spine w&w/o contrast (72133) | $587.70 | $3,918 | 3.7× |
| CT lower ext w/o (73700) | $531.75 | $3,545 | 5.6× |
| CT lower extremity w/contrast material (73701) | $559.65 | $3,731 | 3.5× |
| CT lumbar spine w contrast (72132) | $559.65 | $3,731 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $531.75 | $3,545 | 5.6× |
| CT maxillofacial w contrast (70487) | $559.65 | $3,731 | 3.5× |
| CT maxillofacial wo contrast (70486) | $531.75 | $3,545 | 5.6× |
| CT neck tissue combo (70492) | $587.70 | $3,918 | 3.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $587.70 | $3,918 | 3.7× |
| CT orbits w/o contrast (70480) | $559.65 | $3,731 | 5.9× |
| CT pelvis w&w/o contrast (72194) | $648 | $4,320 | 4.1× |
| CT pelvis w/o contrast (72192) | $587.70 | $3,918 | 6.2× |
| CT scan of leg combo (73702) | $587.70 | $3,918 | 3.7× |
| CT scans face/jaw combo (70488) | $587.70 | $3,918 | 3.7× |
| CT soft tissue neck w contrast (70491) | $559.65 | $3,731 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $531.75 | $3,545 | 5.6× |
| CT thoracic spine w contrast (72129) | $559.65 | $3,731 | 3.5× |
| CT thoracic spine w/o contrast (72128) | $531.75 | $3,545 | 5.6× |
| CT thoracic spine w/wo cont (72130) | $587.70 | $3,918 | 3.7× |
| CT thorax w/o contrast (71250) | $531.75 | $3,545 | 5.6× |
| CT unlisted procedure (76497) | $559.65 | $3,731 | 7.1× |
| CT upper ext wo (73200) | $531.75 | $3,545 | 5.6× |
| CT upper extremity w/o & w/contrast material (73202) | $587.70 | $3,918 | 3.7× |
| CT upper extremity with contrast (73201) | $559.65 | $3,731 | 1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $559.65 | $3,731 | 3.5× |
| Cta Abdomen (74175) | $587.70 | $3,918 | 3.7× |
| CTA pelvis (72191) | $617.10 | $4,114 | 3.9× |
| Dilation ureters/urethra rs&i (74485) | $796.20 | $5,308 | 0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $101.55 | $677 | 1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $101.55 | $677 | 1.1× |
| Dxa Bone Density Axial (77080) | $78.75 | $525 | 0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $69.30 | $462 | 0.9× |
| Echo exam of fetal heart (76825) | $144 | $960 | 0.3× |
| Echo Guide For Artery Repair (76936) | $166.35 | $1,109 | 0.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $144 | $960 | 0.7× |
| Esophagram (74220) | $69.30 | $462 | 0.4× |
| Fetal Biophys Profile W/Nst (76818) | $101.55 | $677 | 1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $101.55 | $677 | 1.1× |
| Fluoroscopy up to 1 hr (76000) | $69.30 | $462 | 0.3× |
| Follow-Up Angiography (75898) | $492.60 | $3,284 | 0.2× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$62.55–$69.30 | $417–$462 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$65.85–$72.75 | $439–$485 | varies |
| Gastric emptying imaging study (78264) | $452.25 | $3,015 | 1.2× |
| Gastroesophageal Reflux Exam (78262) | $452.25 | $3,015 | 1.2× |
| Gated Heart Planar Single (78472) | $430.65 | $2,871 | 1.2× |
| Gated Heart, Multiple (78473) | $452.25 | $3,015 | 1.2× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$59.25–$72.75 | $395–$485 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $317.70 | $2,118 | 0.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $288.75 | $1,925 | 0.5× |
| Heart Image (Pet) Multiple (78492) | $1,282.05 | $8,547 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,357.80 | $9,052 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,293.15 | $8,621 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $452.25 | $3,015 | 0.9× |
| Hepatobiliary System Imaging (78226) | $452.25 | $3,015 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $430.65 | $2,871 | 0.4× |
| Hysterosalpingogram (74740) | $153.90 | $1,026 | 0.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $101.55 | $677 | 1.3× |
| Infant hip ultrasound, limited static exam (76886) | $96.45 | $643 | 1.2× |
| Interstitial radiation source applic complex (77778) | $501.75 | $3,345 | 0.8× |
| Joint Survey Single View (77077) | $69.30 | $462 | 0.7× |
| K Flow/Funct Image Multiple (78709) | $452.25 | $3,015 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $452.25 | $3,015 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $452.25 | $3,015 | 0.9× |
| Kidney Imaging Morphol (78700) | $452.25 | $3,015 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $418.80 | $2,792 | 1.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$69.30–$72.75 | $462–$485 | varies |
| Leveen/Shunt Patency Exam (78291) | $452.25 | $3,015 | 1.2× |
| Liver & Spleen Imaging Static Only (78215) | $474.90 | $3,166 | 1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $498.60 | $3,324 | 1.4× |
| Liver imaging static only (78201) | $452.25 | $3,015 | 0.9× |
| Liver imaging w/vascular flow (78202) | $474.90 | $3,166 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $452.25 | $3,015 | 0.9× |
| Lung perfusion differential (78597) | $452.25 | $3,015 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $452.25 | $3,015 | 0.9× |
| Lung Ventilation Imaging (78579) | $452.25 | $3,015 | 1.2× |
| Lymph System Imaging (78195) | $452.25 | $3,015 | 0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $492.60 | $3,284 | 0.2× |
| Magnetic Image Jaw Joint (70336) | $636.75 | $4,245 | 2.9× |
| Mammary ductogram or galactogram multiple (77054) | $161.55 | $1,077 | 0.7× |
| Mammary ductogram or galactogram single (77053) | $153.90 | $1,026 | 0.7× |
| Meckels Divert Exam (78290) | $452.25 | $3,015 | 1.2× |
| Mlc imrt design & construction per imrt plan (77338) | $391.95 | $2,613 | 1.2× |
| Mr safety determination physician/other qhp (76016) | $39.90 | $266 | 0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $11.10 | $74 | 0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $39.45 | $263 | 0.5× |
| Mr safety implt pos&/immoblj (76019) | $25.65 | $171 | 0.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $104.10 | $694 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) | $668.55 | $4,457 | 2.1× |
| MRA head w/o contrast (70544) | $604.95 | $4,033 | 2.8× |
| MRA head with contrast (70545) | $636.75 | $4,245 | 2.0× |
| MRA neck w contrast (70548) | $636.75 | $4,245 | 2.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $668.55 | $4,457 | 2.1× |
| MRA neck w/o contrast (70547) | $604.95 | $4,033 | 2.8× |
| MRI abdomen w contrast (74182) | $636.75 | $4,245 | 2.0× |
| MRI abdomen w/o contrast (74181) | $604.95 | $4,033 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) | $636.75 | $4,245 | 0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$647.40–$668.55 | $4,316–$4,457 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $636.75 | $4,245 | 0.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $668.55 | $4,457 | 3.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $636.75 | $4,245 | 2.9× |
| MRI cardiac w/o contrast (75557) | $636.75 | $4,245 | 2.9× |
| MRI cervical spine w contrast (72142) | $636.75 | $4,245 | 2.0× |
| MRI cervical spine w/o cont (72141) | $604.95 | $4,033 | 2.8× |
| MRI chest w/o contrast (71550) | $604.95 | $4,033 | 2.8× |
| MRI chest with contrast (71551) | $636.75 | $4,245 | 0.9× |
| MRI chest wo w contrast (71552) | $668.55 | $4,457 | 2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $636.75 | $4,245 | 2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$647.40–$668.55 | $4,316–$4,457 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$604.95–$679.80 | $4,033–$4,532 | varies |
| MRI lumbar spine w contrast (72149) | $636.75 | $4,245 | 2.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $668.55 | $4,457 | 2.1× |
| MRI orbit face &/neck w/o contrast (70540) | $604.95 | $4,033 | 2.8× |
| MRI orbit face neck w contrast (70542) | $636.75 | $4,245 | 2.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $668.55 | $4,457 | 2.1× |
| MRI pelvis w contrast (72196) | $636.75 | $4,245 | 2.0× |
| MRI pelvis w/o & w contrast (72197) | $668.55 | $4,457 | 2.1× |
| MRI pelvis w/o contrast (72195) | $604.95 | $4,033 | 2.8× |
| MRI spectroscopy (76390) | $537.15 | $3,581 | 6.8× |
| MRI thoracic spine w/o contrast (72146) | $604.95 | $4,033 | 2.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $636.75 | $4,245 | 2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$604.95–$636.75 | $4,033–$4,245 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $668.55 | $4,457 | 2.1× |
| MRI, abdomen, combo (74183) | $668.55 | $4,457 | 2.1× |
| MRI, dorsal spine combo (72157) | $668.55 | $4,457 | 2.1× |
| MRI, dorsal spine contrast (72147) | $636.75 | $4,245 | 2.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$604.95–$636.75 | $4,033–$4,245 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$647.40–$668.55 | $4,316–$4,457 | varies |
| MRI, lumbar spine combo (72158) | $668.55 | $4,457 | 2.1× |
| Myocardial Spect Multiple Studies (78452) | $452.25 | $3,015 | 0.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $582.30 | $3,882 | 0.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,410.90 | $9,406 | 0.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,164.50 | $14,430 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,372.35 | $9,149 | 1.8× |
| Neck soft tissue (70360) | $69.30 | $462 | 0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $452.25 | $3,015 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $69.30 | $462 | 0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,739.10 | $11,594 | 1.4× |
| Nuclear Rx Intra-Arterial (79445) | $452.25 | $3,015 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $452.25 | $3,015 | 2.1× |
| Ob us nuchal meas 1 gest (76813) | $126.15 | $841 | 1.3× |
| Optic foramina (70190) | $69.30 | $462 | 0.9× |
| Panoramic X-ray of jaws (70355) | $65.85 | $439 | 0.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $452.25 | $3,015 | 0.9× |
| Parathyroid Planar Imaging (78070) | $452.25 | $3,015 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $452.25 | $3,015 | 1.2× |
| Pelvis 1 or 2 views (72170) | $65.85 | $439 | 0.7× |
| Pet Image W/Ct Lmtd (78814) | $1,405.50 | $9,370 | 1.1× |
| PET image w/CT, full body (78816) | $1,614 | $10,760 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,537.20 | $10,248 | 1.2× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $582.45 | $3,883 | 0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,357.80 | $9,052 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $452.25 | $3,015 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $69.30 | $462 | 0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $153.90 | $1,026 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$72.75–$76.35 | $485–$509 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$69.30–$72.75 | $462–$485 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$72.75–$76.35 | $485–$509 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $69.30 | $462 | 0.7× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$69.30–$72.75 | $462–$485 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$72.75–$76.35 | $485–$509 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$76.35–$80.10 | $509–$534 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$66–$69.30 | $440–$462 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $69.30 | $462 | 0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $69.30 | $462 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) | $65.85 | $439 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$72.75–$76.35 | $485–$509 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $34.80 | $232 | 0.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $263.10 | $1,754 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $65.85 | $439 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $65.85 | $439 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $69.30 | $462 | 0.9× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$65.85–$72.75 | $439–$485 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$69.30–$96.15 | $462–$641 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$72.75–$76.35 | $485–$509 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $85.20 | $568 | 0.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $4,102.20 | $27,348 | 0.6× |
| Radiation treatment delivery level 1 (77402) | $157.80 | $1,052 | 1.7× |
| Radiation treatment delivery level 2 (77407) | $173.40 | $1,156 | 0.5× |
| Radiation treatment delivery level 3 (77412) | $190.95 | $1,273 | 0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $69.30 | $462 | 0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $72.75 | $485 | 0.8× |
| Radiologic exam colon double contrast study (74280) | $118.80 | $792 | 0.7× |
| Radiologic exam colon single contrast study (74270) | $85.50 | $570 | 0.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $73.50 | $490 | 0.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$76.35–$80.10 | $509–$534 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $69.30 | $462 | 0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $69.30 | $462 | 0.4× |
| Radiologic exam swallow function contrast study (74230) | $69.30 | $462 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $65.70 | $438 | 0.4× |
| Radiologic examination femur 1 view (73551) | $65.85 | $439 | 0.8× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$69.30–$72.75 | $462–$485 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$62.55–$65.85 | $417–$439 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $69.30 | $462 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$65.85–$72.75 | $439–$485 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $221.70 | $1,478 | 0.4× |
| Ribs bilateral 3 views (71110) | $72.75 | $485 | 0.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $452.25 | $3,015 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $474.90 | $3,166 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $640.50 | $4,270 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $452.25 | $3,015 | 0.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $452.25 | $3,015 | 0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $582.30 | $3,882 | 0.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $513.30 | $3,422 | 0.4× |
| Rp Therapy Intravenous Administration (79101) | $452.25 | $3,015 | 2.1× |
| Scapula (73010) | $69.30 | $462 | 0.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$70.35–$74.10 | $469–$494 | varies |
| Sella turcica (70240) | $69.30 | $462 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$65.85–$69.30 | $439–$462 | varies |
| Shoulder Arthrography (73040) | $182.55 | $1,217 | 0.6× |
| Skull less than 4 views (70250) | $65.85 | $439 | 0.7× |
| Special dosimetry (77331) | $116.55 | $777 | 1.0× |
| Special Physics Consult (77370) | $175.05 | $1,167 | 1.4× |
| Special teletherapy port plan (77321) | $285.90 | $1,906 | 0.8× |
| Special treatment procedure (77470) | $560.40 | $3,736 | 1.1× |
| Srs Multisource (77371) unusually low: confirm this is the full procedure |
$3,100.20 | $20,668 | 0.5× |
| Stereotactic Body Radiation Delivery (77373) | $2,930.25 | $19,535 | 1.8× |
| Sternoclavicular joints (71130) | $69.30 | $462 | 0.9× |
| Superior sagittal sinus venogram (75870) | $492.60 | $3,284 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $174.30 | $1,162 | 0.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $107.70 | $718 | 0.3× |
| Testicular Imaging W/Flow (78761) | $452.25 | $3,015 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $480.60 | $3,204 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $415.65 | $2,771 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $265.20 | $1,768 | 2.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $72.45 | $483 | 0.5× |
| Thoracic spine 2 views (72070) | $65.85 | $439 | 0.7× |
| Thoracic spine 3 views (72072) | $69.30 | $462 | 0.7× |
| Thoracolumbar 2 views (72080) | $76.35 | $509 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $452.25 | $3,015 | 1.2× |
| Thyroid Met Imaging Body (78018) | $452.25 | $3,015 | 0.9× |
| Thyroid Uptake Measurement (78012) | $452.25 | $3,015 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $452.25 | $3,015 | 1.2× |
| Tx Devices Design & Construction Complex (77334) | $262.50 | $1,750 | 0.8× |
| Tx devices design & construction intermediate (77333) | $238.65 | $1,591 | 2.0× |
| Tx devices design & construction simple (77332) | $217.05 | $1,447 | 1.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$91.80–$96.45 | $612–$643 | varies |
| Ultrasound Elastography Parenchyma (76981) | $101.55 | $677 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $101.55 | $677 | 1.1× |
| Ultrasound, abdomen limited (76705) | $96.45 | $643 | 1.0× |
| Umbilical-artery Doppler (OB) (76820) | $101.55 | $677 | 1.1× |
| Upper gi w/o kub (74240) | $69.30 | $462 | 0.4× |
| Ureteral Reflux Study (78740) | $182.70 | $1,218 | 0.5× |
| Urethrocystogram voiding (74455) | $119.55 | $797 | 0.6× |
| Urethrocystography retrograde (74450) | $119.55 | $797 | 0.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$96.75–$101.55 | $645–$677 | varies |
| Us chest (76604) | $101.55 | $677 | 1.1× |
| Us complete joint (76881) | $101.55 | $677 | 1.1× |
| Us exam, pelvic, limited (76857) | $101.55 | $677 | 1.1× |
| Us head (76506) | $101.55 | $677 | 1.1× |
| Us kidney transplant (76776) | $101.55 | $677 | 1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$96.45–$101.55 | $643–$677 | varies |
| Us ob detailed single fetus (76811) | $101.55 | $677 | 0.5× |
| Us ob limited 1 or more fetuses (76815) | $101.55 | $677 | 1.1× |
| Us ob transvaginal (76817) | $101.55 | $677 | 1.1× |
| Us pelvic non ob complete (76856) | $101.55 | $677 | 1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $101.55 | $677 | 1.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $101.55 | $677 | 1.1× |
| Us retroperitoneal complete (76770) | $101.55 | $677 | 1.1× |
| Us retroperitoneal limited (76775) | $96.45 | $643 | 1.0× |
| Us scrotum and contents (76870) | $101.55 | $677 | 1.1× |
| Us spinal canal and contents (76800) | $101.55 | $677 | 1.1× |
| Us thyroid (76536) | $101.55 | $677 | 1.1× |
| Us transrectal (76872) | $101.55 | $677 | 1.1× |
| Vein X-Ray Chest (75827) | $429.15 | $2,861 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,357.80 | $9,052 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $450.60 | $3,004 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $429.15 | $2,861 | 0.3× |
| Venography Renal Bilateral (75833) | $1,357.80 | $9,052 | 0.5× |
| Venography Renal Unilateral (75831) | $1,293.15 | $8,621 | 0.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$62.55–$69.30 | $417–$462 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $69.30 | $462 | 0.9× |
| X-ray antegrade pyelogram tube (74425) | $119.55 | $797 | 0.4× |
| X-Ray Aorta Leg Arteries (75630) | $1,357.80 | $9,052 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $62.55 | $417 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$62.55–$69.30 | $417–$462 | varies |
| X-Ray Exam Breast Specimen (76098) | $276.60 | $1,844 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $65.85 | $439 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $69.30 | $462 | 0.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $72.75 | $485 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $65.85 | $439 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $69.30 | $462 | 0.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $72.75 | $485 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $65.85 | $439 | 0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $69.30 | $462 | 0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $72.75 | $485 | 0.8× |
| X-Ray Exam L-S Spine Bending (72114) | $72.75 | $485 | 0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $69.30 | $462 | 0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $76.35 | $509 | 0.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $69.30 | $462 | 0.7× |
| X-ray eye for foreign body (70030) | $69.30 | $462 | 0.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$65.85–$72.75 | $439–$485 | varies |
| X-ray IV pyelogram (ivp) (74400) | $119.55 | $797 | 0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $65.85 | $439 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $69.30 | $462 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $65.85 | $439 | 0.7× |
| X-ray nose-rectum child f.b. (76010) | $69.30 | $462 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $76.35 | $509 | 0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $69.30 | $462 | 0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $65.85 | $439 | 0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $69.30 | $462 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $69.30 | $462 | 0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $69.30 | $462 | 0.7× |
| X-ray thoracic spine 4 vw (72074) | $72.75 | $485 | 0.8× |
| X-Ray Tmj Unilat (70328) | $66 | $440 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $119.55 | $797 | 0.4× |
| X-Rays Bone Length Studies (77073) | $69.30 | $462 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $72.75 | $485 | 0.8× |
| Xr c-spine 4 or 5 views (72050) | $72.75 | $485 | 0.8× |
| Xr facial bones less than 3 views (70140) | $65.85 | $439 | 0.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $66 | $440 | 0.7× |
| Xr orbits complete 4 views (70200) | $69.30 | $462 | 0.7× |
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.