Imaging prices at Fred Hutch Cancer Center
Seattle, WA · every code in this section with a posted price and a Medicare benchmark.
494 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) range across 2 matching MRF lines |
$7,980.89–$11,243.70 | $8,867.66–$12,493 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$367.29–$448.88 | $408.10–$498.75 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$447.43–$516.15 | $497.14–$573.50 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,802.74 | $2,003.04 | 3.9× |
| Adrenal Cortex & Medulla Img (78075) | $2,534.19 | $2,815.77 | 1.7× |
| Angio internal mammary (75756) | $3,150.54 | $3,500.60 | 0.9× |
| Angio pulmonary bilat (75743) | $8,000.90 | $8,889.89 | 2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,568.57 | $5,076.19 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $7,183.65 | $7,981.83 | 2.0× |
| Angiography extremity unilateral rs&i (75710) | $7,053.63 | $7,837.37 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,532.23 | $6,146.92 | 1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,009.40 | $3,343.78 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$263.73–$448.88 | $293.03–$498.75 | varies |
| Aortography thoracic serialography rs&i (75605) | $7,162.27 | $7,958.08 | 1.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $6,290.23 | $6,989.14 | 1.7× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$6,192.90–$8,731.37 | $6,881–$9,701.52 | varies |
| Artery X-Rays Adrenal Gland (75731) | $4,320.43 | $4,800.48 | 1.2× |
| Artery X-Rays Pelvis (75736) | $7,524.50 | $8,360.56 | 1.2× |
| Artery X-Rays Spine (75705) | $9,399.52 | $10,443.91 | 1.5× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,022.28–$1,533.43 | $1,135.87–$1,703.81 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,283.26–$1,924.88 | $1,425.84–$2,138.76 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,112.18–$1,668.28 | $1,235.76–$1,853.64 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$644.72–$937.12 | $716.35–$1,041.25 | varies |
| Bone age studies (77072) | $344.92 | $383.25 | 2.8× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$2,028.12–$2,208.15 | $2,253.47–$2,453.50 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,582.78–$1,751.18 | $1,758.64–$1,945.75 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$1,623.93–$1,803.38 | $1,804.37–$2,003.75 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,770.70–$2,104.65 | $1,967.45–$2,338.50 | varies |
| Bone marrow imaging limited area (78102) | $1,184.61 | $1,316.23 | 2.6× |
| Bone marrow imaging; whole body (78104) | $1,509.08 | $1,676.75 | 3.3× |
| Bone survey infant (77076) | $320.11 | $355.68 | 2.6× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$2,378.48–$2,537.33 | $2,642.75–$2,819.26 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$1,975.79–$2,167.65 | $2,195.32–$2,408.50 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$1,425.03–$1,962.90 | $1,583.37–$2,181 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $6,018.05 | $6,686.72 | 9.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,120.10 | $1,244.55 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$5,214.32–$7,344.22 | $5,793.69–$8,160.25 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,586.80 | $2,874.22 | 5.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,634.58 | $2,927.31 | 6.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,851.64 | $4,279.60 | 4.2× |
| Cardiac Shunt Detection (78428) | $959.88 | $1,066.53 | 2.1× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$483.61–$1,257.08 | $537.34–$1,396.75 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,846.73 | $2,051.92 | 2.9× |
| Cerebrospinal Fluid Scan (78630) | $1,736.93 | $1,929.92 | 2.8× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$445.02–$448.88 | $494.47–$498.75 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$472.50–$593.36 | $525–$659.29 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$697.50–$751.60 | $775–$835.11 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$781.26–$788.18 | $868.07–$875.75 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $1,216.70 | $1,351.89 | 10.0× |
| Cholecystography Oral Contrast (74290) | $484.64 | $538.49 | 2.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $577.86 | $642.07 | 4.8× |
| Cisternography Positive Contrast Rs&I (70015) | $2,210.32 | $2,455.91 | 2.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$286.98–$448.88 | $318.87–$498.75 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$315.81–$834.30 | $350.90–$927 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$877.03–$1,472.85 | $974.48–$1,636.50 | varies |
| Contrast Exam Abdominl Aorta (75625) | $7,033.78 | $7,815.31 | 1.9× |
| Contrast X-Ray Bladder (74430) | $779.07 | $865.63 | 1.9× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,019.55–$1,529.32 | $1,132.83–$1,699.25 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,090.47–$1,635.70 | $1,211.63–$1,817.45 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $559.52 | $621.69 | 2.7× |
| Corpora cavernosography (74445) | $831.30 | $923.67 | 6.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,697.61–$6,221.02 | $4,108.46–$6,912.25 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,534.83–$4,048.42 | $2,816.48–$4,498.25 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,270.86–$3,043.35 | $1,412.07–$3,381.50 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,149.38–$3,356.10 | $2,388.20–$3,729 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,612.04–$2,587.95 | $1,791.15–$2,875.50 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$4,124.86–$6,804.68 | $4,583.18–$7,560.75 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,398.57–$2,810.48 | $2,665.08–$3,122.75 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,500.89–$2,531.70 | $2,778.77–$2,813 | varies |
| CT angio hrt w/3d image (75574) | $1,829.05 | $2,032.28 | 4.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,499.54–$4,222.80 | $2,777.27–$4,692 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,232.94–$2,444.62 | $2,481.04–$2,716.25 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$2,669.18–$3,854.48 | $2,965.75–$4,282.75 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,629.02–$2,932.65 | $1,810.02–$3,258.50 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,725.41–$2,241.22 | $1,917.12–$2,490.25 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$2,023.26–$3,635.78 | $2,248.07–$4,039.75 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,820.68–$2,926.12 | $2,022.98–$3,251.25 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,224.73–$3,048.75 | $2,471.92–$3,387.50 | varies |
| CT colonography screening (74263) | $1,550.95 | $1,723.28 | 5.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,621.89 | $1,802.10 | 8.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,437.70 | $1,597.44 | 11.8× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,649.60–$2,387.25 | $1,832.89–$2,652.50 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,787.98–$3,149.55 | $1,986.64–$3,499.50 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,022.11 | $1,135.68 | 2.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $126.17 | $140.19 | 1.2× |
| CT hrt w/3d image congen (75573) | $1,547.38 | $1,719.31 | 3.8× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,315.03–$2,952.45 | $1,461.14–$3,280.50 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,851.34–$3,969.90 | $2,057.05–$4,411 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,385.30–$2,077.95 | $1,539.22–$2,308.83 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,330.83–$2,625.08 | $1,478.70–$2,916.75 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,500.98–$3,220.42 | $1,667.75–$3,578.25 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,574.84–$2,570.85 | $1,749.82–$2,856.50 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,625.08–$3,151.58 | $2,916.75–$3,501.76 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$993.98–$2,484.94 | $1,104.42–$2,761.04 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,970.24–$2,506.50 | $2,189.16–$2,785 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,449.91–$3,584.48 | $1,611.01–$3,982.75 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,385.28–$1,710.22 | $1,539.20–$1,900.25 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$3,514.28–$3,625.51 | $3,904.75–$4,028.34 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,798.51–$2,317.72 | $1,998.34–$2,575.25 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,691.56–$3,249.22 | $1,879.51–$3,610.25 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,859.98–$3,914.50 | $3,177.75–$4,349.45 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,608.10–$2,811.82 | $1,786.78–$3,124.25 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,629.66–$2,014.42 | $1,810.73–$2,238.25 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,519.57–$2,500.88 | $1,688.41–$2,778.75 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,592.55–$1,920.82 | $1,769.50–$2,134.25 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,871.47–$3,969.90 | $2,079.41–$4,411 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,064.85–$2,341.58 | $1,183.17–$2,601.75 | varies |
| CT unlisted procedure (76497) range across 8 matching MRF lines |
$193.96–$7,575.55 | $215.51–$8,417.28 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,391.49–$2,087.24 | $1,546.10–$2,319.15 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,737.93–$3,460.05 | $1,931.03–$3,844.50 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,319.91–$2,625.08 | $1,466.57–$2,916.75 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,333.92–$2,679.30 | $2,593.24–$2,977 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$3,489.52–$3,830.18 | $3,877.24–$4,255.75 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,790.96–$3,830.18 | $1,989.95–$4,255.75 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,391.32 | $1,545.91 | 5.0× |
| Dilation ureters/urethra rs&i (74485) | $4,618.19 | $5,131.32 | 1.9× |
| Discography Cerv/Thor Spine (72285) | $2,404.77 | $2,671.97 | 1.1× |
| Diskography lumbar (72295) | $4,118.67 | $4,576.30 | 1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $278.99 | $309.99 | 2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $569.23 | $632.48 | 4.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $418.78 | $465.31 | 3.4× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$523.60–$770.85 | $581.78–$856.50 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$361.62–$1,022.18 | $401.80–$1,135.75 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$112.79–$317.25 | $125.32–$352.50 | varies |
| Echo exam of fetal heart (76825) | $1,434.89 | $1,594.32 | 2.3× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$614.56–$978.30 | $682.84–$1,087 | varies |
| Echo Guide For Artery Repair (76936) | $1,263.63 | $1,404.03 | 5.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,035.28 | $1,150.31 | 3.7× |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$690.95–$1,342.58 | $767.72–$1,491.75 | varies |
| Esophageal Motility Study (78258) | $772.48 | $858.31 | 1.7× |
| Esophagram (74220) | $571.88 | $635.42 | 2.8× |
| Fetal Biophys Profile W/Nst (76818) | $869.63 | $966.26 | 7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $608.40 | $676 | 5.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,321.72 | $1,468.58 | 4.8× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$838.87–$877.50 | $932.08–$975 | varies |
| Follow-Up Angiography (75898) | $2,328.07 | $2,586.74 | 0.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$271.44–$510.30 | $301.60–$567 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$313.55–$470.33 | $348.39–$522.59 | varies |
| Gastric emptying imaging study (78264) | $1,802.48 | $2,002.75 | 3.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,568.05 | $1,742.28 | 3.4× |
| Gastroesophageal Reflux Exam (78262) | $1,518.70 | $1,687.45 | 3.3× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$2,134.62–$2,716.65 | $2,371.80–$3,018.50 | varies |
| Gated Heart, Multiple (78473) | $1,918.48 | $2,131.64 | 4.1× |
| GI Endoscopic US S&I (76975) | $671.64 | $746.27 | 2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,730.77 | $1,923.08 | 2.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$389.73–$584.60 | $433.03–$649.55 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$7,363.60–$14,017.05 | $8,181.78–$15,574.50 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$4,739.51–$8,984.70 | $5,266.12–$9,983 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$2,764.01–$6,642 | $3,071.12–$7,380 | varies |
| Heart first pass single,planar (78481) | $1,123.24 | $1,248.05 | 1.8× |
| Heart Image (Pet) Multiple (78492) | $5,640.29 | $6,266.99 | 3.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,605.35 | $7,339.28 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,519.20 | $7,243.55 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,684.35 | $1,871.50 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,534.44 | $1,704.93 | 3.3× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $2,612.25 | $2,902.50 | 4.1× |
| Ht Musc Image Planar Mult (78454) | $5,206.97 | $5,785.52 | 3.5× |
| Ht Muscle Image Spect Sing (78451) | $2,997.73 | $3,330.81 | 2.0× |
| Hysterosalpingogram (74740) | $1,066.48 | $1,184.98 | 3.8× |
| Image fusion (77399) | $902.25 | $1,002.50 | 5.8× |
| Infusion Ivp (74410) | $174.38 | $193.75 | 0.9× |
| Interstitial radiation source applic complex (77778) | $5,535.50 | $6,150.56 | 6.8× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $8,853.57 | $9,837.30 | 1.0× |
| Joint Survey Single View (77077) | $401.24 | $445.82 | 3.3× |
| K Flow/Funct Image Multiple (78709) | $2,195.26 | $2,439.18 | 3.5× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,629.32–$2,093.40 | $1,810.35–$2,326 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,346.46–$3,228.30 | $1,496.07–$3,587 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,181.97 | $1,313.30 | 2.5× |
| Kidney Imaging Morphol (78700) | $1,081.08 | $1,201.20 | 2.3× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$297.07–$448.88 | $330.08–$498.75 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,362.02 | $1,513.36 | 2.9× |
| Leveen/Shunt Patency Exam (78291) | $952.25 | $1,058.06 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,049.45 | $1,166.06 | 2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,316.39 | $1,462.66 | 2.8× |
| Liver imaging static only (78201) | $2,832.38 | $3,147.09 | 4.5× |
| Liver imaging w/vascular flow (78202) | $3,369.55 | $3,743.94 | 5.3× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,896.98–$1,989.03 | $2,107.75–$2,210.03 | varies |
| Lung perfusion differential (78597) | $1,633.55 | $1,815.06 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$2,042.50–$2,254.72 | $2,269.44–$2,505.25 | varies |
| Lung Ventilation Imaging (78579) | $1,441.78 | $1,601.98 | 3.1× |
| Lymph System Imaging (78195) | $1,744.01 | $1,937.79 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,509.61 | $1,677.34 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,229.90 | $1,366.56 | 1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,016.33 | $3,351.48 | 0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,453.99 | $1,615.54 | 0.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,915.47–$3,924 | $2,128.30–$4,360 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $1,674.88 | $1,860.98 | 8.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $1,488.52 | $1,653.91 | 2.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $3,457.42 | $3,841.58 | 17.0× |
| Magnetic Resonance Elastography (76391) range across 2 matching MRF lines |
$791.52–$3,190.28 | $879.47–$3,544.75 | varies |
| Mammary ductogram or galactogram multiple (77054) | $801.94 | $891.05 | 2.9× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$609.93–$1,572.08 | $677.70–$1,746.75 | varies |
| Meckels Divert Exam (78290) | $1,176.74 | $1,307.49 | 2.5× |
| Medical physics dose eval radiation expos w/rprt (76145) | $626.79 | $696.43 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$7,437.38–$8,020.13 | $8,263.75–$8,911.26 | varies |
| Mr safety determination physician/other qhp (76016) | $2,657.54 | $2,952.82 | 26.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $127.62 | $141.80 | 3.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $90.90 | $101 | 0.8× |
| Mr safety implt pos&/immoblj (76019) | $86.30 | $95.89 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $864 | $960 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,969.65–$4,168.12 | $3,299.61–$4,631.25 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,217.64–$3,707.32 | $2,464.05–$4,119.25 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,959.53–$3,790.35 | $2,177.26–$4,211.50 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,955.82–$3,559.95 | $2,173.13–$3,955.50 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,931.98–$5,208.98 | $3,257.76–$5,787.75 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$2,212.56–$3,186.90 | $2,458.40–$3,541 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$3,554.22–$5,704.42 | $3,949.13–$6,338.25 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,564.60–$3,840.08 | $2,849.55–$4,266.75 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,406.53–$3,609.79 | $2,673.92–$4,010.88 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,305.63–$5,666.18 | $3,672.92–$6,295.75 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,620–$3,930 | $2,911.11–$4,366.67 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$1,428.70–$3,666.15 | $1,587.44–$4,073.50 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$1,917.19–$2,875.79 | $2,130.21–$3,195.32 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$1,874.66–$2,812 | $2,082.96–$3,124.44 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$3,361.65–$3,536.55 | $3,735.17–$3,929.50 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$2,471.20–$3,529.58 | $2,745.78–$3,921.75 | varies |
| MRI cardiac w/o cont stress (75559) | $1,635.88 | $1,817.64 | 2.6× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$1,331.26–$3,840.08 | $1,479.18–$4,266.75 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,400.02–$4,329.22 | $2,666.69–$4,810.25 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,341.25–$3,922.88 | $2,601.39–$4,358.75 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,091.49–$4,047.30 | $2,323.88–$4,497 | varies |
| MRI chest with contrast (71551) | $1,682.64 | $1,869.60 | 1.8× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,115.27–$5,335.65 | $2,350.30–$5,928.50 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,136.64–$3,204.97 | $2,374.05–$3,561.08 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,460.38–$4,808.48 | $2,733.75–$5,342.75 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,119.77–$3,411 | $2,355.30–$3,790 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,938.41–$4,574.02 | $3,264.90–$5,082.25 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,688.14–$5,269.50 | $2,986.82–$5,855 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,172.13–$3,285 | $2,413.48–$3,650 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,896.94–$5,174.78 | $2,107.71–$5,749.75 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,348.17–$5,388.52 | $2,609.08–$5,987.25 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,048.90–$4,178.02 | $2,276.55–$4,642.25 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,575.84–$5,269.50 | $2,862.05–$5,855 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,121.72–$3,411 | $2,357.47–$3,790 | varies |
| MRI spectroscopy (76390) | $1,547.38 | $1,719.31 | 15.3× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,986.07–$3,922.88 | $2,206.74–$4,358.75 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$1,668.69–$3,899.92 | $1,854.10–$4,333.25 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,083.25–$3,348.90 | $2,314.72–$3,721 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,010.54–$5,057.32 | $2,233.93–$5,619.25 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$3,779.96–$6,076.35 | $4,199.95–$6,751.50 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,617.84–$6,059.02 | $2,908.71–$6,732.25 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,311.81–$4,321.80 | $2,568.68–$4,802 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,855.31–$4,282.97 | $3,172.57–$4,758.86 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,081.46–$5,604.75 | $3,423.85–$6,227.50 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$3,351.35–$6,059.02 | $3,723.72–$6,732.25 | varies |
| Myelogram cervical (72240) | $2,356.85 | $2,618.72 | 2.6× |
| Myelogram Lumbar (72265) | $1,781.68 | $1,979.64 | 2.0× |
| Myelography thoracic (72255) | $1,791.52 | $1,990.58 | 2.0× |
| Myelograpy 2/more regions rs&i (72270) | $1,953.78 | $2,170.87 | 2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $6,230.95 | $6,923.28 | 4.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,782.20 | $3,091.33 | 1.9× |
| Myocardial Spect Multiple Studies (78452) | $3,212.26 | $3,569.18 | 2.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $5,411.95 | $6,013.28 | 3.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,439.45 | $4,932.72 | 2.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $5,105.95 | $5,673.28 | 2.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,580.99 | $3,978.88 | 1.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,478.64 | $3,865.16 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) | $4,654.73 | $5,171.92 | 4.7× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$383.29–$475.88 | $425.88–$528.75 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $869.80 | $966.44 | 1.9× |
| Nm csf leak detection (78650) | $1,395.52 | $1,550.58 | 0.9× |
| Nm red cell survival study (78130) | $1,054.66 | $1,171.84 | 2.3× |
| Nm whole blood volume (78122) | $1,859.56 | $2,066.18 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $644.90 | $716.56 | 5.3× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$9,704.26–$16,500.82 | $10,782.51–$18,334.25 | varies |
| Nuclear Rx Intra-Arterial (79445) | $898.14 | $997.93 | 3.3× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,275.46–$1,909.80 | $1,417.18–$2,122 | varies |
| Ob us nuchal meas 1 gest (76813) | $476.49 | $529.43 | 3.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $417.02 | $463.35 | 3.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$494.59–$741.88 | $549.54–$824.31 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $370.19 | $411.32 | 3.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$322.93–$484.40 | $358.81–$538.22 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $83.63 | $92.92 | 2.5× |
| Optic foramina (70190) range across 2 matching MRF lines |
$179.12–$268.68 | $199.02–$298.53 | varies |
| Panoramic X-ray of jaws (70355) | $275.40 | $306 | 2.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,231.49 | $2,479.43 | 3.5× |
| Parathyroid Planar Imaging (78070) | $1,782.14 | $1,980.16 | 3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,782.22 | $1,980.24 | 3.8× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$426.04–$461.02 | $473.38–$512.25 | varies |
| Perineogram (74775) | $783.90 | $871 | 2.8× |
| Peritoneogram Rs&I (74190) | $1,278.58 | $1,420.64 | 2.0× |
| Pet Image Skull-Thigh (78812) range across 3 matching MRF lines |
$432.95–$8,243.10 | $481.06–$9,159 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$5,412.29–$7,945.65 | $6,013.66–$8,828.50 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$3,136.30–$9,405.90 | $3,484.78–$10,451 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,445.50–$8,954.78 | $6,050.55–$9,949.75 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$5,479.16–$7,759.80 | $6,087.95–$8,622 | varies |
| Pet Myocardial Sngl Study (78491) | $2,458.79 | $2,731.99 | 1.5× |
| PET whole body (78813) range across 3 matching MRF lines |
$2,547.64–$8,780.62 | $2,830.71–$9,756.25 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $4,531.45 | $5,034.94 | 3.0× |
| Proton trmt simple w/comp (77522) | $6,947.10 | $7,719 | 4.8× |
| Proton tx delivery complex (77525) range across 2 matching MRF lines |
$8,403.84–$9,007.88 | $9,337.60–$10,008.75 | varies |
| Proton tx delivery intermediate (77523) range across 2 matching MRF lines |
$3,779.59–$7,977.82 | $4,199.54–$8,864.25 | varies |
| Proton tx delivery simple w/o compensation (77520) | $6,947.10 | $7,719 | 10.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,035.01 | $4,483.34 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,135.51–$1,603.35 | $1,261.68–$1,781.50 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$617–$659.48 | $685.55–$732.75 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,143.79 | $1,270.88 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$265.72–$448.88 | $295.25–$498.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$206.01–$448.88 | $228.90–$498.75 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$253.23–$448.88 | $281.37–$498.75 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$368.55–$768.82 | $409.50–$854.25 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$315.32–$472.98 | $350.35–$525.53 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$294.12–$448.88 | $326.80–$498.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$346.42–$519.63 | $384.91–$577.37 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$256.65–$384.98 | $285.17–$427.76 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$410.71–$616.06 | $456.34–$684.51 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$369.35–$665.55 | $410.39–$739.50 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$302.92–$516.15 | $336.58–$573.50 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$253.25–$448.88 | $281.39–$498.75 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$295.42–$443.48 | $328.25–$492.75 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,865.52 | $2,072.80 | 9.2× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$243.58–$436.95 | $270.65–$485.50 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$317.09–$496.12 | $352.32–$551.25 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $304.20 | $338 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$276.35–$434.92 | $307.06–$483.25 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$252.94–$379.40 | $281.04–$421.56 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$335.67–$503.51 | $372.97–$559.46 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$539.30–$1,118.92 | $599.22–$1,243.25 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $28,080 | $31,200 | 3.3× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$647.81–$1,106.78 | $719.79–$1,229.75 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$753.74–$1,351.35 | $837.49–$1,501.50 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$1,204.96–$1,679.18 | $1,338.85–$1,865.75 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$273.96–$606.82 | $304.40–$674.25 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$520.87–$664.65 | $578.74–$738.50 | varies |
| Radiologic exam colon double contrast study (74280) | $1,548.12 | $1,720.13 | 7.6× |
| Radiologic exam colon single contrast study (74270) | $994.97 | $1,105.52 | 4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $799.82 | $888.69 | 3.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$326.05–$736.42 | $362.28–$818.25 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$450–$498.38 | $500–$553.75 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $892.94 | $992.16 | 4.4× |
| Radiologic exam swallow function contrast study (74230) | $890.29 | $989.21 | 4.4× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $116.32 | $129.25 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $881 | $978.89 | 4.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$261.74–$400.05 | $290.82–$444.50 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$238.10–$516.15 | $264.55–$573.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$337.46–$517.95 | $374.96–$575.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$407.44–$582.98 | $452.71–$647.75 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $181.35 | $201.50 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$314.44–$517.95 | $349.38–$575.50 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $116.32 | $129.25 | 1.2× |
| Radiopharm Dacryocystography (78660) | $828.92 | $921.02 | 1.8× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $1,619.96 | $1,799.95 | 6.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,619.96 | $1,799.95 | 6.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $4,045.42 | $4,494.91 | 6.4× |
| Renal Cyst Study (74470) | $964.58 | $1,071.76 | 1.5× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$369.35–$709.42 | $410.39–$788.25 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,241.80–$2,089.35 | $1,379.78–$2,321.50 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$1,355.22–$4,389.08 | $1,505.80–$4,876.75 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$5,011.42–$9,833.85 | $5,568.25–$10,926.50 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,497.46–$4,423.05 | $1,663.85–$4,914.50 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$3,653.55–$3,791.45 | $4,059.50–$4,212.72 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$4,399.65–$6,330.31 | $4,888.50–$7,033.68 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$5,266.80–$8,367.98 | $5,852–$9,297.75 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$3,066.98–$4,963.53 | $3,407.75–$5,515.03 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 2 matching MRF lines |
$726.86–$2,505.60 | $807.62–$2,784 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$994.68–$1,655.32 | $1,105.20–$1,839.25 | varies |
| Salivary Gland Function Study (78232) | $1,151.40 | $1,279.33 | 2.5× |
| Salivary Gland Imaging Serial Images (78231) | $759.84 | $844.27 | 1.6× |
| Scapula (73010) range across 3 matching MRF lines |
$344.45–$517.95 | $382.72–$575.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$71.08–$96.75 | $78.98–$107.50 | varies |
| Sella turcica (70240) | $220.63 | $245.14 | 2.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$303.81–$516.15 | $337.57–$573.50 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,297.83–$1,946.74 | $1,442.03–$2,163.05 | varies |
| Sialogram (70390) | $728.32 | $809.25 | 2.6× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$471.74–$479.02 | $524.16–$532.25 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$547.85–$900.90 | $608.72–$1,001 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$1,235.18–$1,825.20 | $1,372.42–$2,028 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,685.74–$2,072.92 | $1,873.04–$2,303.25 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$3,780.50–$4,075.42 | $4,200.56–$4,528.25 | varies |
| Speech evaluation, complex (70371) | $657.24 | $730.27 | 2.4× |
| Srs Multisource (77371) | $107,372.96 | $119,303.29 | 12.6× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$12,564.10–$13,268.48 | $13,960.11–$14,742.75 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$350.50–$631.80 | $389.45–$702 | varies |
| Superior sagittal sinus venogram (75870) | $3,029.65 | $3,366.28 | 0.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $211.54 | $235.04 | 2.1× |
| Tbs technical calculation only (77091) | $241.49 | $268.32 | 2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$2,572.75–$4,497.52 | $2,858.61–$4,997.25 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$1,425.53–$3,725.78 | $1,583.92–$4,139.75 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$670.24–$1,005.36 | $744.71–$1,117.07 | varies |
| Testicular Imaging W/Flow (78761) | $1,181.89 | $1,313.21 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,301.86–$3,073.28 | $2,557.62–$3,414.75 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$2,106.93–$2,430 | $2,341.03–$2,700 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$1,331.93–$1,571.40 | $1,479.92–$1,746 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$342.77–$478.58 | $380.86–$531.75 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$318.46–$524.02 | $353.85–$582.25 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$361.38–$483.08 | $401.53–$536.75 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,318.06 | $1,464.51 | 2.8× |
| Thyroid Imaging With Vascular Flow (78013) | $1,060.49 | $1,178.32 | 2.3× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,875.34–$2,072.25 | $2,083.71–$2,302.50 | varies |
| Thyroid Uptake Measurement (78012) | $548.27 | $609.19 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,078.82 | $1,198.69 | 2.3× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,886.28–$2,137.72 | $2,095.87–$2,375.25 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$1,244.12–$1,298.70 | $1,382.36–$1,443 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$833.04–$1,171.35 | $925.60–$1,301.50 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$465.56–$728.78 | $517.29–$809.75 | varies |
| Ultrasound elastography first target lesion (76982) | $189.14 | $210.16 | 1.6× |
| Ultrasound Elastography Parenchyma (76981) | $402.36 | $447.07 | 3.3× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$459.50–$962.55 | $510.56–$1,069.50 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $629.26 | $699.18 | 1.6× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$754.32–$962.55 | $838.13–$1,069.50 | varies |
| Umbilical-artery Doppler (OB) (76820) | $449.05 | $498.94 | 3.7× |
| Unlis px ther radiol clinical tx planning (77299) | $347 | $385.55 | 2.2× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$513.81–$713.70 | $570.90–$793 | varies |
| Unlisted fluoroscopic procedure (76496) range across 3 matching MRF lines |
$3,052.62–$6,698.86 | $3,391.80–$7,443.18 | varies |
| Unlisted magnetic resonance procedure (76498) range across 6 matching MRF lines |
$659.45–$7,893.98 | $732.72–$8,771.09 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 4 matching MRF lines |
$193.96–$485.03 | $215.51–$538.92 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $323.50 | $359.45 | 2.7× |
| Unlisted us procedure (76999) range across 5 matching MRF lines |
$183.60–$640.16 | $204–$711.29 | varies |
| Upper gi w/o kub (74240) | $824.99 | $916.66 | 4.1× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $192.40 | $213.78 | 17.4× |
| Urea breath test c-14 isotopic analysis (78268) | $234.15 | $260.17 | 2.5× |
| Ureteral Reflux Study (78740) | $1,029.63 | $1,144.03 | 2.2× |
| Urethrocystogram voiding (74455) | $1,046.45 | $1,162.72 | 3.8× |
| Urethrocystography retrograde (74450) | $1,012.75 | $1,125.28 | 3.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$455.23–$944.32 | $505.81–$1,049.25 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$540.07–$920.02 | $600.08–$1,022.25 | varies |
| Us complete joint (76881) | $532.01 | $591.12 | 4.4× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$632.66–$759.60 | $702.96–$844 | varies |
| Us head (76506) | $682.85 | $758.72 | 5.6× |
| Us kidney transplant (76776) | $749.05 | $832.28 | 6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$479.42–$674.10 | $532.69–$749 | varies |
| Us ob detailed single fetus (76811) | $971.57 | $1,079.52 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $578.96 | $643.29 | 4.8× |
| Us ob transvaginal (76817) | $692.64 | $769.60 | 5.7× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$711.76–$1,017.22 | $790.85–$1,130.25 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $775.58 | $861.75 | 6.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $518.36 | $575.95 | 4.3× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$799.78–$1,198.58 | $888.65–$1,331.75 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$637.59–$778.05 | $708.43–$864.50 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$813.76–$978.75 | $904.18–$1,087.50 | varies |
| Us spinal canal and contents (76800) | $425.41 | $472.68 | 3.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$787.71–$991.12 | $875.23–$1,101.25 | varies |
| Us transrectal (76872) | $394.61 | $438.46 | 3.3× |
| Vascular Flow Imaging (78445) | $941.80 | $1,046.45 | 2.0× |
| Vein X-Ray Chest (75827) | $3,296.59 | $3,662.88 | 1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$3,319.99–$5,503.50 | $3,688.88–$6,115 | varies |
| Vein X-Ray Skull Epidural (75872) | $4,245.70 | $4,717.44 | 5.8× |
| Vein X-Ray Spleen/Liver (75810) | $3,348.26 | $3,720.29 | 0.9× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$3,212.48–$6,369.08 | $3,569.42–$7,076.75 | varies |
| Venography Adrenal Unilateral (75840) | $6,209.91 | $6,899.90 | 1.7× |
| Venography caval inferior serialography rs&i (75825) | $5,565.60 | $6,184 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $2,302.39 | $2,558.21 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $2,269.18 | $2,521.31 | 1.2× |
| Venography Orbital Rs&I (75880) | $1,868.56 | $2,076.18 | 2.6× |
| Venography Renal Bilateral (75833) | $4,982.69 | $5,536.32 | 1.4× |
| Venography Renal Unilateral (75831) | $4,520.15 | $5,022.39 | 1.2× |
| Venous sampling by catheter (75893) | $7,390.66 | $8,211.84 | 1.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,441.61 | $1,601.79 | 3.1× |
| Vertebral fracture assessment via dxa (77086) | $262.08 | $291.20 | 2.6× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$365.81–$548.72 | $406.46–$609.69 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$344.02–$375.97 | $382.25–$417.74 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,023.15 | $1,136.83 | 2.5× |
| X-Ray Aorta Leg Arteries (75630) | $7,436.76 | $8,263.07 | 2.0× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$432.43–$736.42 | $480.48–$818.25 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$308.23–$462.35 | $342.48–$513.72 | varies |
| X-Ray Exam Breast Specimen (76098) | $815.75 | $906.39 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $281.12 | $312.36 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$381.78–$731.48 | $424.20–$812.75 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$448.52–$903.82 | $498.36–$1,004.25 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$308.23–$455.18 | $342.48–$505.75 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$351.85–$447.30 | $390.94–$497 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$437.93–$512.10 | $486.59–$569 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$348.98–$992.02 | $387.76–$1,102.25 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$337.04–$1,042.42 | $374.49–$1,158.25 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$392.66–$1,181.48 | $436.29–$1,312.75 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$699.06–$945.22 | $776.73–$1,050.25 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$361.38–$518.85 | $401.53–$576.50 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$444.95–$841.95 | $494.39–$935.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$254.54–$504.68 | $282.82–$560.75 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$483.06–$724.59 | $536.73–$805.10 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$329.50–$448.88 | $366.11–$498.75 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,645.31 | $1,828.12 | 8.1× |
| X-ray IV pyelogram+tomography (74415) | $1,027.73 | $1,141.92 | 5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$342.77–$520.65 | $380.86–$578.50 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$144.68–$502.20 | $160.75–$558 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$420.58–$541.35 | $467.31–$601.50 | varies |
| X-ray nose-rectum child f.b. (76010) | $372.45 | $413.83 | 3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$340.24–$625.50 | $378.05–$695 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$274.65–$475.42 | $305.17–$528.25 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$325.06–$439.42 | $361.18–$488.25 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$304.70–$448.88 | $338.55–$498.75 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$251.14–$499.05 | $279.04–$554.50 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$417.56–$549.22 | $463.95–$610.25 | varies |
| X-Ray Stress View (77071) | $166.08 | $184.53 | 1.6× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$365.80–$565.20 | $406.45–$628 | varies |
| X-Ray Tmj Unilat (70328) | $252.44 | $280.49 | 2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,567.80 | $1,742 | 3.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$334.81–$424.80 | $372.01–$472 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$497.72–$968.62 | $553.02–$1,076.25 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$368.98–$696.38 | $409.98–$773.75 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$320.64–$455.18 | $356.27–$505.75 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$264.51–$396.76 | $293.90–$440.85 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$290.17–$657.22 | $322.41–$730.25 | varies |
| Xr Tomogram Single Plane (76100) | $622.89 | $692.10 | 5.1× |
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.