Imaging prices at Glens Falls Hospital
Glens Falls, NY · every code in this section with a posted price and a Medicare benchmark.
359 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) | $1,364.50 | $2,729 | 0.8× |
| Abdomen 1 View (74018) | $114.50 | $229 | 1.1× |
| Abdomen 2 views (74019) | $131.50 | $263 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $615.50 | $1,231 | 1.2× |
| Angio internal mammary (75756) | $2,492.50 | $4,985 | 0.6× |
| Angio pulmonary bilat (75743) | $2,492.50 | $4,985 | 0.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,492.50–$2,866.50 | $4,985–$5,733 | varies |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$2,492.50–$3,426 | $4,985–$6,852 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,367 | $4,734 | 0.6× |
| Ankle 2 views (73600) | $114.50 | $229 | 1.1× |
| Aortography thoracic serialography rs&i (75605) | $4,049.50 | $8,099 | 0.6× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$4,265–$4,905 | $8,530–$9,810 | varies |
| Artery X-Rays Pelvis (75736) | $4,265 | $8,530 | 0.6× |
| Arthrogram ankle (73615) | $355 | $710 | 0.8× |
| Arthrogram hip (73525) | $301.50 | $603 | 0.7× |
| Arthrogram Wrist (73115) | $355 | $710 | 0.8× |
| Basic radiation dosimetry calculation (77300) | $137 | $274 | 0.8× |
| Bone age studies (77072) | $114.50 | $229 | 0.9× |
| Bone Imaging 3 Phase (78315) | $647.50 | $1,295 | 1.3× |
| Bone Imaging Limited Area (78300) | $1,202.50 | $2,405 | 2.4× |
| Bone Imaging Whole Body (78306) | $1,266 | $2,532 | 2.5× |
| Bone survey infant (77076) | $148.50 | $297 | 1.1× |
| Brachytx isodose intermed (77317) | $371.50 | $743 | 0.8× |
| Brachytx Isodose Plan Simple (77316) | $360 | $720 | 0.8× |
| Cat Scan Follow-Up Study (76380) | $112.50 | $225 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $945.50 | $1,891 | 1.4× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$109.50–$114.50 | $219–$229 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$99.50–$114.50 | $199–$229 | varies |
| Chest 3 views (71047) | $104.50 | $209 | 1.0× |
| Chest 4 or more views (71048) | $114.50 | $229 | 0.9× |
| Clavicle complete (73000) | $114.50 | $229 | 1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $128 | $256 | 1.0× |
| Continuing medical physics consltj pr wk (77336) | $181 | $362 | 1.1× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,492.50–$2,866.50 | $4,985–$5,733 | varies |
| Contrast X-Ray Bladder (74430) | $348.50 | $697 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $355 | $710 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $355 | $710 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $771.50 | $1,543 | 1.8× |
| CT abdomen and pelvis without contrast (74176) | $598.50 | $1,197 | 2.0× |
| CT abdomen w contrast (74160) | $702.50 | $1,405 | 3.2× |
| CT abdomen w wo contrast (74170) | $799.50 | $1,599 | 3.7× |
| CT abdomen w/o contrast (74150) | $620 | $1,240 | 4.8× |
| CT Angio Abdomen and Pelvis (74174) | $432.50 | $865 | 1.0× |
| CT Angio Chest (71275) | $511 | $1,022 | 2.3× |
| CT Angio Head (70496) | $511 | $1,022 | 2.3× |
| CT angio hrt w/3d image (75574) | $533 | $1,066 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $623 | $1,246 | 2.8× |
| CT Angio Neck (70498) | $716.50 | $1,433 | 3.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $623 | $1,246 | 2.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $818.50 | $1,637 | 3.7× |
| CT cervical spine w/ contrast (72126) | $634 | $1,268 | 1.5× |
| CT cervical spine w/o contrast (72125) | $620 | $1,240 | 4.8× |
| CT cervical spine w/wo cont (72127) | $602 | $1,204 | 2.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$611–$702.50 | $1,222–$1,405 | varies |
| CT chest w/wo contrast (71270) | $695 | $1,390 | 3.2× |
| CT head/brain with contrast (70460) | $604 | $1,208 | 2.8× |
| CT head/brain without and with contrast (70470) | $799.50 | $1,599 | 3.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $276 | $552 | 0.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $93 | $186 | 0.9× |
| CT hrt w/3d image congen (75573) | $533 | $1,066 | 1.2× |
| CT iac w contrast (70481) | $604 | $1,208 | 2.8× |
| CT l-spine w&w/o contrast (72133) | $602 | $1,204 | 2.7× |
| CT lower ext w/o (73700) | $620 | $1,240 | 4.8× |
| CT lower extremity w/contrast material (73701) | $611 | $1,222 | 2.8× |
| CT lumbar spine w contrast (72132) | $670 | $1,340 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $620 | $1,240 | 4.8× |
| CT maxillofacial w contrast (70487) | $604 | $1,208 | 2.8× |
| CT maxillofacial wo contrast (70486) | $620 | $1,240 | 4.8× |
| CT neck tissue combo (70492) | $695 | $1,390 | 3.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $695 | $1,390 | 3.2× |
| CT orbits w/o contrast (70480) | $620 | $1,240 | 4.8× |
| CT pelvis w&w/o contrast (72194) | $695 | $1,390 | 3.2× |
| CT pelvis w/o contrast (72192) | $620 | $1,240 | 4.8× |
| CT scan of leg combo (73702) | $664.50 | $1,329 | 3.0× |
| CT scans face/jaw combo (70488) | $664.50 | $1,329 | 3.0× |
| CT soft tissue neck w contrast (70491) | $702.50 | $1,405 | 3.2× |
| CT soft tissue neck w/o contrast (70490) | $539 | $1,078 | 4.1× |
| CT thoracic spine w contrast (72129) | $638.50 | $1,277 | 2.9× |
| CT thoracic spine w/o contrast (72128) | $620 | $1,240 | 4.8× |
| CT thoracic spine w/wo cont (72130) | $549.50 | $1,099 | 2.5× |
| CT thorax w/o contrast (71250) | $539 | $1,078 | 4.1× |
| CT unlisted procedure (76497) | $539 | $1,078 | 5.0× |
| CT upper ext wo (73200) | $620 | $1,240 | 4.8× |
| CT upper extremity w/o & w/contrast material (73202) | $566 | $1,132 | 2.6× |
| CT upper extremity with contrast (73201) | $634 | $1,268 | 1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $716.50 | $1,433 | 3.3× |
| Cta Abdomen (74175) | $623 | $1,246 | 2.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,067.50 | $2,135 | 2.5× |
| CTA pelvis (72191) | $605 | $1,210 | 2.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $456 | $912 | 1.5× |
| Dilation ureters/urethra rs&i (74485) | $1,695.50 | $3,391 | 0.6× |
| Discography Cerv/Thor Spine (72285) | $1,610.50 | $3,221 | 0.7× |
| Diskography lumbar (72295) | $1,610.50 | $3,221 | 0.7× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$174–$200 | $348–$400 | varies |
| Dxa bone density study (77085) | $200 | $400 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $77.50 | $155 | 0.7× |
| Echo Guide For Artery Repair (76936) | $286 | $572 | 1.1× |
| Echograp Trans R Pros Study (76873) | $131 | $262 | 1.0× |
| Esophageal Motility Study (78258) | $437 | $874 | 0.9× |
| Esophagram (74220) | $194.50 | $389 | 0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $122.50 | $245 | 0.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$255.50–$286 | $511–$572 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$983–$1,130.50 | $1,966–$2,261 | varies |
| Foot 2 views (73620) | $114.50 | $229 | 1.1× |
| Forearm 2 views (73090) | $114.50 | $229 | 1.1× |
| Gastric emptying imaging study (78264) | $540 | $1,080 | 1.1× |
| Gastroesophageal Reflux Exam (78262) | $437 | $874 | 0.9× |
| Gated Heart Planar Single (78472) range across 8 matching MRF lines |
$349.50–$713.50 | $699–$1,427 | varies |
| Hand 2 views (73120) | $131.50 | $263 | 1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $821 | $1,642 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $821 | $1,642 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $814.50 | $1,629 | 0.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,861.50 | $5,723 | 0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,492.50 | $4,985 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $826 | $1,652 | 1.2× |
| Hepatobiliary System Imaging (78226) | $610 | $1,220 | 1.2× |
| Ht Musc Image Planar Mult (78454) | $1,383 | $2,766 | 0.9× |
| Ht Muscle Image Spect Sing (78451) range across 7 matching MRF lines |
$1,202.50–$1,383 | $2,405–$2,766 | varies |
| Hysterosalpingogram (74740) | $232.50 | $465 | 0.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $156.50 | $313 | 1.4× |
| Infant hip ultrasound, limited static exam (76886) | $136.50 | $273 | 1.3× |
| Interstitial radiation source applic complex (77778) | $821 | $1,642 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $659 | $1,318 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $589 | $1,178 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $659 | $1,318 | 1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $547.50 | $1,095 | 1.1× |
| Knee 3 Views (73562) | $96 | $192 | 0.9× |
| Leveen/Shunt Patency Exam (78291) | $468.50 | $937 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $604.50 | $1,209 | 1.2× |
| Liver imaging static only (78201) | $732.50 | $1,465 | 1.1× |
| Liver imaging w/vascular flow (78202) | $1,202.50 | $2,405 | 1.8× |
| Lung perfusion differential (78597) | $402 | $804 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,007 | $2,014 | 1.5× |
| Lung Ventilation Imaging (78579) | $543 | $1,086 | 1.1× |
| Lymph System Imaging (78195) | $742.50 | $1,485 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $528 | $1,056 | 1.8× |
| Mammary ductogram or galactogram single (77053) | $251 | $502 | 0.8× |
| Meckels Divert Exam (78290) | $615.50 | $1,231 | 1.2× |
| Mlc imrt design & construction per imrt plan (77338) | $1,003 | $2,006 | 2.1× |
| Mr safety determination physician/other qhp (76016) | $109 | $218 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $36.50 | $73 | 1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $119 | $238 | 1.0× |
| Mr safety implt pos&/immoblj (76019) | $74 | $148 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $298 | $596 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $827.50 | $1,655 | 1.9× |
| MRA head w/o contrast (70544) | $607 | $1,214 | 2.0× |
| MRA head with contrast (70545) | $827.50 | $1,655 | 1.9× |
| MRA neck w contrast (70548) | $827.50 | $1,655 | 1.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $827.50 | $1,655 | 1.9× |
| MRA neck w/o contrast (70547) | $607 | $1,214 | 2.0× |
| MRI abdomen w contrast (74182) | $827.50 | $1,655 | 1.9× |
| MRI abdomen w/o contrast (74181) | $607 | $1,214 | 2.0× |
| MRI any jt lower extrem w/contrast material (73722) | $951.50 | $1,903 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $827.50 | $1,655 | 1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $951.50 | $1,903 | 1.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $514.50 | $1,029 | 1.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $514.50 | $1,029 | 1.7× |
| MRI cardiac w/o contrast (75557) | $2,498.50 | $4,997 | 8.4× |
| MRI cervical spine w contrast (72142) | $827.50 | $1,655 | 1.9× |
| MRI cervical spine w/o cont (72141) | $607 | $1,214 | 2.0× |
| MRI chest w/o contrast (71550) | $528 | $1,056 | 1.8× |
| MRI chest with contrast (71551) | $951.50 | $1,903 | 1.0× |
| MRI chest wo w contrast (71552) | $827.50 | $1,655 | 1.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $827.50 | $1,655 | 1.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $951.50 | $1,903 | 2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $607 | $1,214 | 2.0× |
| MRI lumbar spine w contrast (72149) | $827.50 | $1,655 | 1.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $951.50 | $1,903 | 2.2× |
| MRI orbit face &/neck w/o contrast (70540) | $528 | $1,056 | 1.8× |
| MRI orbit face neck w contrast (70542) | $827.50 | $1,655 | 1.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $951.50 | $1,903 | 2.2× |
| MRI pelvis w contrast (72196) | $827.50 | $1,655 | 1.9× |
| MRI pelvis w/o & w contrast (72197) | $990.50 | $1,981 | 2.3× |
| MRI pelvis w/o contrast (72195) | $607 | $1,214 | 2.0× |
| MRI spectroscopy (76390) | $699 | $1,398 | 6.4× |
| MRI thoracic spine w/o contrast (72146) | $607 | $1,214 | 2.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $827.50 | $1,655 | 1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $528 | $1,056 | 1.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $843 | $1,686 | 1.9× |
| MRI, abdomen, combo (74183) | $930 | $1,860 | 2.1× |
| MRI, dorsal spine combo (72157) | $951.50 | $1,903 | 2.2× |
| MRI, dorsal spine contrast (72147) | $827.50 | $1,655 | 1.9× |
| MRI, joint upper extrem (73221) | $607 | $1,214 | 2.0× |
| MRI, joint upper extrem combo (73223) | $827.50 | $1,655 | 1.9× |
| MRI, lumbar spine combo (72158) | $951.50 | $1,903 | 2.2× |
| Myelograpy 2/more regions rs&i (72270) | $862.50 | $1,725 | 0.9× |
| Myocardial Spect Multiple Studies (78452) range across 8 matching MRF lines |
$1,327.27–$1,593 | $2,654.54–$3,186 | varies |
| Neck soft tissue (70360) | $99.50 | $199 | 0.9× |
| Nm csf leak detection (78650) | $1,383 | $2,766 | 0.9× |
| Nm unlisted gi procedure (78299) | $402 | $804 | 0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,002 | $6,004 | 1.7× |
| Nuclear Rx Intra-Arterial (79445) | $238.50 | $477 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $274.50 | $549 | 0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 5 matching MRF lines |
$115–$132.50 | $230–$265 | varies |
| Panoramic X-ray of jaws (70355) | $99.50 | $199 | 0.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $677 | $1,354 | 1.0× |
| Parathyroid Planar Imaging (78070) | $774 | $1,548 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $774.50 | $1,549 | 1.6× |
| Pelvis 1 or 2 views (72170) | $131.50 | $263 | 1.0× |
| Peritoneogram Rs&I (74190) | $486.50 | $973 | 0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,492.50 | $4,985 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $575 | $1,150 | 1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$232.31–$267 | $464.62–$534 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $114.50 | $229 | 1.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $114.50 | $229 | 1.1× |
| Radex elbow complete minimum 3 views (73080) | $114.50 | $229 | 1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $125.50 | $251 | 1.0× |
| Radex fingr minimum 2 views (73140) | $114.50 | $229 | 1.1× |
| Radex foot complete minimum 3 views (73630) | $114.50 | $229 | 1.1× |
| Radex Hand Minimum 3 Views (73130) | $114.50 | $229 | 1.1× |
| Radex lower extremity infant minimum 2 views (73592) | $99.50 | $199 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $129.50 | $259 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $99.50 | $199 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) | $103.50 | $207 | 1.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$104.50–$114.50 | $209–$229 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $99.50 | $199 | 0.9× |
| Radex Spine 1 View Specify Level (72020) | $114.50 | $229 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $99.50 | $199 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $99.50 | $199 | 0.9× |
| Radex Toe Minimum 2 Views (73660) | $114.50 | $229 | 1.1× |
| Radex upper extremity infant minimum 2 views (73092) | $114.50 | $229 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $114.50 | $229 | 1.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,565.50 | $15,131 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $429 | $858 | 3.4× |
| Radiation treatment delivery level 2 (77407) | $429 | $858 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $429 | $858 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $122 | $244 | 0.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $131.50 | $263 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $313 | $626 | 1.4× |
| Radiologic exam colon single contrast study (74270) | $252.50 | $505 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $169.50 | $339 | 0.8× |
| Radiologic exam knee complete 4/more views (73564) | $131.50 | $263 | 1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $117.50 | $235 | 0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $230 | $460 | 1.1× |
| Radiologic exam swallow function contrast study (74230) | $195.50 | $391 | 0.9× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $232.50 | $465 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $360 | $720 | 1.6× |
| Radiologic examination femur 1 view (73551) | $98 | $196 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) | $114.50 | $229 | 1.1× |
| Radiologic examination knee 1/2 views (73560) | $114.50 | $229 | 1.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $73.50 | $147 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $114.50 | $229 | 1.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $62 | $124 | 0.6× |
| Ribs bilateral 3 views (71110) | $125.50 | $251 | 1.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $632.50 | $1,265 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,716.50 | $3,433 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,383 | $2,766 | 2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,535 | $3,070 | 2.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,359 | $2,718 | 0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,541.50 | $3,083 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,359 | $2,718 | 0.8× |
| Rp Therapy Intravenous Administration (79101) | $290.50 | $581 | 1.0× |
| Scapula (73010) | $114.50 | $229 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$22–$91.50 | $44–$183 | varies |
| Shoulder 1 view (73020) | $87.50 | $175 | 0.8× |
| Shoulder Arthrography (73040) | $355 | $710 | 0.8× |
| Sialogram (70390) | $232.50 | $465 | 0.8× |
| Skull less than 4 views (70250) | $114.50 | $229 | 0.9× |
| Special dosimetry (77331) | $137 | $274 | 0.8× |
| Special Physics Consult (77370) | $228 | $456 | 1.4× |
| Special teletherapy port plan (77321) | $371.50 | $743 | 0.8× |
| Special treatment procedure (77470) | $575 | $1,150 | 0.8× |
| Stereotactic Body Radiation Delivery (77373) | $2,642 | $5,284 | 1.2× |
| Sternoclavicular joints (71130) | $99.50 | $199 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $412.50 | $825 | 0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $412.50 | $825 | 0.9× |
| Testicular Imaging W/Flow (78761) | $402 | $804 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $847 | $1,694 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $371.50 | $743 | 0.8× |
| Ther rad simulaj-aided field setting simple (77280) | $137 | $274 | 0.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $290.50 | $581 | 1.3× |
| Thoracic spine 2 views (72070) | $131.50 | $263 | 1.0× |
| Thoracic spine 3 views (72072) | $114.50 | $229 | 0.9× |
| Thoracolumbar 2 views (72080) | $112.50 | $225 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $402 | $804 | 0.8× |
| Thyroid Uptake Measurement (78012) | $402 | $804 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $452 | $904 | 0.9× |
| Tx Devices Design & Construction Complex (77334) range across 6 matching MRF lines |
$137–$353 | $274–$706 | varies |
| Tx devices design & construction intermediate (77333) | $137 | $274 | 0.8× |
| Tx devices design & construction simple (77332) | $144.50 | $289 | 0.9× |
| Ultrasound Breast Limited (76642) | $329 | $658 | 3.0× |
| Ultrasound elastography first target lesion (76982) | $304.50 | $609 | 2.3× |
| Ultrasound Elastography Parenchyma (76981) | $350.50 | $701 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$104–$127.50 | $208–$255 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$302.50–$318 | $605–$636 | varies |
| Upper gi w/o kub (74240) | $360 | $720 | 1.6× |
| Ureteral Reflux Study (78740) | $402 | $804 | 0.8× |
| Urethrocystogram voiding (74455) | $348.50 | $697 | 1.2× |
| Urethrocystography retrograde (74450) | $355.50 | $711 | 1.2× |
| Us breast unilateral complete (76641) | $219 | $438 | 1.7× |
| Us chest (76604) range across 2 matching MRF lines |
$114.50–$171 | $229–$342 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$114.50–$192 | $229–$384 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$284.50–$327.50 | $569–$655 | varies |
| Us head (76506) | $143 | $286 | 1.1× |
| Us kidney transplant (76776) | $346 | $692 | 2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$114.50–$192 | $229–$384 | varies |
| Us ob detailed single fetus (76811) | $275 | $550 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $114.50 | $229 | 0.9× |
| Us ob transvaginal (76817) | $127.50 | $255 | 1.0× |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$172–$198 | $344–$396 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $189 | $378 | 1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $131.50 | $263 | 1.0× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$286–$329 | $572–$658 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$172–$180.50 | $344–$361 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$172–$198 | $344–$396 | varies |
| Us spinal canal and contents (76800) | $197 | $394 | 1.5× |
| Us thyroid (76536) | $167 | $334 | 1.3× |
| Us transrectal (76872) range across 4 matching MRF lines |
$104–$119.50 | $208–$239 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$684.13–$689.50 | $1,368.26–$1,379 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,130.50 | $2,261 | 0.3× |
| Venogram Sinus/Jugular (75860) | $2,492.50 | $4,985 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $2,492.50 | $4,985 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $983 | $1,966 | 0.5× |
| Venography extremity unilateral rs&i (75820) range across 9 matching MRF lines |
$684.13–$689.50 | $1,368.26–$1,379 | varies |
| Venography Renal Bilateral (75833) | $2,492.50 | $4,985 | 0.6× |
| Venography Renal Unilateral (75831) | $2,492.50 | $4,985 | 0.6× |
| Venous sampling by catheter (75893) | $4,265 | $8,530 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $78.50 | $157 | 0.7× |
| Wrist 2 views (73100) | $114.50 | $229 | 1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $99.50 | $199 | 0.9× |
| X-ray antegrade pyelogram tube (74425) | $240 | $480 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$2,492.57–$2,866.50 | $4,985.14–$5,733 | varies |
| X-Ray Bend Only L-S Spine (72120) | $133.50 | $267 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $114.50 | $229 | 1.1× |
| X-Ray Exam Breast Specimen (76098) | $559.50 | $1,119 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $99.50 | $199 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $205.50 | $411 | 1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $126 | $252 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $99.50 | $199 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$99.50–$133.50 | $199–$267 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $118.50 | $237 | 0.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $131.50 | $263 | 1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $131.50 | $263 | 1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $260 | $520 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $136 | $272 | 1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $114.50 | $229 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $136 | $272 | 1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $136 | $272 | 1.0× |
| X-ray eye for foreign body (70030) | $96.50 | $193 | 0.9× |
| X-ray humerus (73060) | $114.50 | $229 | 1.1× |
| X-ray IV pyelogram (ivp) (74400) | $401 | $802 | 1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $83.50 | $167 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $99.50 | $199 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$114.50–$131.50 | $229–$263 | varies |
| X-ray nose-rectum child f.b. (76010) | $99.50 | $199 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $118.50 | $237 | 0.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $131.50 | $263 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $118.50 | $237 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $114.50 | $229 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $125.50 | $251 | 1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $169.50 | $339 | 1.3× |
| X-Ray Tmj Unilat (70328) | $76 | $152 | 0.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $525 | $1,050 | 1.2× |
| X-Rays Bone Length Studies (77073) | $125 | $250 | 1.0× |
| X-Rays Bone Survey Complete (77075) | $195 | $390 | 1.5× |
| Xr c-spine 4 or 5 views (72050) | $195 | $390 | 1.5× |
| Xr facial bones less than 3 views (70140) | $99.50 | $199 | 0.9× |
| Xr orbits complete 4 views (70200) | $125.50 | $251 | 1.0× |
| Xr Tomogram Single Plane (76100) | $164.50 | $329 | 1.3× |
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.