Imaging prices at Good Samaritan Medical Center
West Palm Beach, FL · every code in this section with a posted price and a Medicare benchmark.
358 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) | $17,283.75 | $23,045 | 12.0× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$630.75–$782.25 | $841–$1,043 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$997.50–$1,037.25 | $1,330–$1,383 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,905.50 | $3,874 | 7.0× |
| Angio internal mammary (75756) | $8,565.75 | $11,421 | 2.6× |
| Angio pulmonary bilat (75743) | $11,949.75 | $15,933 | 3.6× |
| Angiography extremity bilateral rs&i (75716) | $7,833 | $10,444 | 2.4× |
| Angiography extremity unilateral rs&i (75710) | $6,768 | $9,024 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$6,330–$6,801.75 | $8,440–$9,069 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$7,530.75–$7,815 | $10,041–$10,420 | varies |
| Ankle 2 views (73600) | $1,929 | $2,572 | 21.2× |
| Aortography thoracic serialography rs&i (75605) | $10,330.50 | $13,774 | 1.8× |
| Artery X-Rays Abdomen (75726) | $10,479 | $13,972 | 1.8× |
| Artery X-Rays Pelvis (75736) | $11,148.75 | $14,865 | 1.9× |
| Artery X-Rays Spine (75705) | $9,603 | $12,804 | 1.7× |
| Arthrogram ankle (73615) | $2,759.25 | $3,679 | 7.6× |
| Arthrogram hip (73525) | $5,412.75 | $7,217 | 14.9× |
| Arthrogram Wrist (73115) | $2,195.25 | $2,927 | 6.0× |
| Basic radiation dosimetry calculation (77300) | $2,840.25 | $3,787 | 20.2× |
| Bone age studies (77072) | $1,371.75 | $1,829 | 12.6× |
| Bone Imaging 3 Phase (78315) | $4,813.50 | $6,418 | 11.5× |
| Bone Imaging Limited Area (78300) | $3,594 | $4,792 | 8.6× |
| Bone Imaging Whole Body (78306) | $4,479 | $5,972 | 10.7× |
| Bone marrow imaging; whole body (78104) | $2,367.75 | $3,157 | 5.7× |
| Brachytx isodose complex (77318) | $4,275.75 | $5,701 | 10.9× |
| Brachytx isodose intermed (77317) | $3,657 | $4,876 | 9.4× |
| Brachytx Isodose Plan Simple (77316) | $2,492.25 | $3,323 | 6.4× |
| Brain Flow Imaging Only (78610) | $1,755 | $2,340 | 3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $17,917.50 | $23,890 | 12.0× |
| Cat Scan Follow-Up Study (76380) | $1,693.50 | $2,258 | 18.6× |
| Cerebrospinal Fluid Scan (78630) | $1,065.75 | $1,421 | 1.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$785.25–$888 | $1,047–$1,184 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$1,034.25–$1,038 | $1,379–$1,384 | varies |
| Chest 3 views (71047) | $720 | $960 | 7.9× |
| Chest 4 or more views (71048) | $1,005.75 | $1,341 | 9.2× |
| Clavicle complete (73000) | $1,887.75 | $2,517 | 20.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,720.50 | $2,294 | 15.8× |
| Continuing medical physics consltj pr wk (77336) | $1,471.50 | $1,962 | 10.5× |
| Contrast Exam Abdominl Aorta (75625) | $7,701.75 | $10,269 | 2.3× |
| Contrast X-Ray Bladder (74430) | $1,858.50 | $2,478 | 5.1× |
| Contrast X-Ray Of Elbow (73085) | $1,872 | $2,496 | 5.1× |
| Contrast X-Ray Of Knee Joint (73580) | $2,778 | $3,704 | 7.6× |
| CT abdomen and pelvis without and with contrast (74178) | $12,247.50 | $16,330 | 33.6× |
| CT abdomen and pelvis without contrast (74176) | $12,780 | $17,040 | 51.3× |
| CT abdomen w contrast (74160) | $8,283.75 | $11,045 | 45.2× |
| CT abdomen w wo contrast (74170) | $9,311.25 | $12,415 | 50.8× |
| CT abdomen w/o contrast (74150) | $5,940.75 | $7,921 | 54.4× |
| CT Angio Abdomen and Pelvis (74174) range across 7 matching MRF lines |
$9,989.25–$22,455.75 | $13,319–$29,941 | varies |
| CT Angio Chest (71275) range across 11 matching MRF lines |
$9,191.25–$18,420 | $12,255–$24,560 | varies |
| CT Angio Head (70496) range across 7 matching MRF lines |
$9,561.75–$16,662 | $12,749–$22,216 | varies |
| CT angio hrt w/3d image (75574) | $10,522.50 | $14,030 | 28.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 5 matching MRF lines |
$10,380–$14,681.25 | $13,840–$19,575 | varies |
| CT Angio Neck (70498) range across 9 matching MRF lines |
$8,333.25–$16,662 | $11,111–$22,216 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$10,081.50–$12,665.25 | $13,442–$16,887 | varies |
| CT cervical spine w/ contrast (72126) | $5,041.50 | $6,722 | 13.8× |
| CT cervical spine w/o contrast (72125) | $5,784 | $7,712 | 53.0× |
| CT cervical spine w/wo cont (72127) | $5,007.75 | $6,677 | 27.3× |
| CT chest w contrast (71260) | $10,278.75 | $13,705 | 56.1× |
| CT chest w/wo contrast (71270) | $6,810 | $9,080 | 37.2× |
| CT head/brain with contrast (70460) | $4,579.50 | $6,106 | 25.0× |
| CT head/brain without and with contrast (70470) | $4,669.50 | $6,226 | 25.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $657 | $876 | 7.2× |
| CT hrt w/3d image congen (75573) | $2,725.50 | $3,634 | 7.5× |
| CT iac w contrast (70481) | $7,469.25 | $9,959 | 40.8× |
| CT l-spine w&w/o contrast (72133) | $5,007 | $6,676 | 27.3× |
| CT lower ext w/o (73700) | $9,623.25 | $12,831 | 88.1× |
| CT lower extremity w/contrast material (73701) | $7,215.75 | $9,621 | 39.4× |
| CT lumbar spine w contrast (72132) | $5,831.25 | $7,775 | 16.0× |
| CT lumbar spine w/o contrast (72131) | $6,210 | $8,280 | 56.9× |
| CT maxillofacial w contrast (70487) | $9,458.25 | $12,611 | 51.6× |
| CT maxillofacial wo contrast (70486) | $8,750.25 | $11,667 | 80.2× |
| CT neck tissue combo (70492) | $9,950.25 | $13,267 | 54.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $8,771.25 | $11,695 | 47.9× |
| CT orbits w/o contrast (70480) | $8,712.75 | $11,617 | 79.8× |
| CT pelvis w&w/o contrast (72194) | $8,345.25 | $11,127 | 45.6× |
| CT pelvis w/o contrast (72192) | $8,426.25 | $11,235 | 77.2× |
| CT scan of leg combo (73702) | $7,723.50 | $10,298 | 42.2× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$3,634.50–$8,771.25 | $4,846–$11,695 | varies |
| CT soft tissue neck w contrast (70491) | $12,218.25 | $16,291 | 66.7× |
| CT soft tissue neck w/o contrast (70490) | $10,156.50 | $13,542 | 93.0× |
| CT thoracic spine w contrast (72129) | $5,307.75 | $7,077 | 29.0× |
| CT thoracic spine w/o contrast (72128) | $6,177.75 | $8,237 | 56.6× |
| CT thoracic spine w/wo cont (72130) | $3,872.25 | $5,163 | 21.1× |
| CT thorax w/o contrast (71250) | $6,675.75 | $8,901 | 61.2× |
| CT upper ext wo (73200) | $7,937.25 | $10,583 | 72.7× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$8,056.50–$8,781.75 | $10,742–$11,709 | varies |
| CT upper extremity with contrast (73201) | $11,394 | $15,192 | 31.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $10,683 | $14,244 | 58.3× |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$9,379.50–$17,406 | $12,506–$23,208 | varies |
| CTA pelvis (72191) range across 4 matching MRF lines |
$7,908.75–$13,700.25 | $10,545–$18,267 | varies |
| Dilation ureters/urethra rs&i (74485) | $2,900.25 | $3,867 | 1.3× |
| Diskography lumbar (72295) | $7,012.50 | $9,350 | 3.4× |
| Dxa Bone Density Axial (77080) | $2,324.25 | $3,099 | 21.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $623.25 | $831 | 6.9× |
| Echo exam uterus (76831) | $1,835.25 | $2,447 | 7.4× |
| Echo Guide For Artery Repair (76936) | $290.25 | $387 | 1.3× |
| Echograp Trans R Pros Study (76873) | $1,518 | $2,024 | 13.9× |
| Esophagram (74220) | $2,432.25 | $3,243 | 13.3× |
| Fetal Biophys Profile W/Nst (76818) | $1,161.75 | $1,549 | 10.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,300.50 | $1,734 | 11.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,025.25–$1,833 | $1,367–$2,444 | varies |
| Follow-Up Angiography (75898) | $2,645.25 | $3,527 | 0.8× |
| Foot 2 views (73620) | $1,455 | $1,940 | 16.0× |
| Forearm 2 views (73090) | $1,246.50 | $1,662 | 13.7× |
| Gastric emptying imaging study (78264) | $3,564.75 | $4,753 | 8.5× |
| Gated Heart Planar Single (78472) | $4,377 | $5,836 | 10.5× |
| Hand 2 views (73120) | $1,542.75 | $2,057 | 14.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,807 | $9,076 | 9.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $11,884.50 | $15,846 | 3.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,698.25 | $4,931 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $5,248.50 | $6,998 | 9.3× |
| Hepatobiliary System Imaging (78226) | $4,645.50 | $6,194 | 11.1× |
| Ht Muscle Image Spect Sing (78451) | $6,882.75 | $9,177 | 5.1× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$2,561.25–$3,679.50 | $3,415–$4,906 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,614.75 | $2,153 | 17.8× |
| Infusion Ivp (74410) | $3,357 | $4,476 | 18.3× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $6,486 | $8,648 | 0.8× |
| Intraop radiaj tx deliver xray single tx session (77424) | $8,185.50 | $10,914 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $4,243.50 | $5,658 | 7.5× |
| K Flow/Funct Image W/Drug (78708) | $3,393.75 | $4,525 | 6.0× |
| K Flow/Funct Image W/O Drug (78707) | $3,521.25 | $4,695 | 6.2× |
| Knee 3 Views (73562) | $2,671.50 | $3,562 | 29.4× |
| Liver & Spleen Imaging Static Only (78215) | $3,609.75 | $4,813 | 8.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $4,266 | $5,688 | 10.2× |
| Liver imaging static only (78201) | $4,342.50 | $5,790 | 7.7× |
| Lung perfusion differential (78597) | $2,781.75 | $3,709 | 6.7× |
| Lung Ventilat&Perfus Imaging (78582) | $4,267.50 | $5,690 | 7.5× |
| Lymph System Imaging (78195) | $4,350 | $5,800 | 7.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,411.50 | $5,882 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $8,236.50 | $10,982 | 33.1× |
| Mammary ductogram or galactogram single (77053) | $2,824.50 | $3,766 | 11.3× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$4,788–$5,583.75 | $6,384–$7,445 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $2,610 | $3,480 | 6.7× |
| Mr safety determination physician/other qhp (76016) | $360 | $480 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $99.75 | $133 | 3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $375 | $500 | 3.8× |
| Mr safety implt pos&/immoblj (76019) | $243 | $324 | 3.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $987.75 | $1,317 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$9,683.25–$10,151.25 | $12,911–$13,535 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$10,818–$11,038.50 | $14,424–$14,718 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$8,785.50–$9,552.75 | $11,714–$12,737 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$8,883–$9,658.50 | $11,844–$12,878 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$9,683.25–$10,151.25 | $12,911–$13,535 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$10,818–$11,038.50 | $14,424–$14,718 | varies |
| MRI abdomen w contrast (74182) | $10,085.25 | $13,447 | 27.7× |
| MRI abdomen w/o contrast (74181) | $8,789.25 | $11,719 | 35.3× |
| MRI any jt lower extrem w/contrast material (73722) | $8,808.75 | $11,745 | 10.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $9,616.50 | $12,822 | 26.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,155.50 | $10,874 | 10.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $13,632 | $18,176 | 54.7× |
| MRI cervical spine w contrast (72142) | $12,172.50 | $16,230 | 33.4× |
| MRI cervical spine w/o cont (72141) | $15,358.50 | $20,478 | 61.6× |
| MRI chest w/o contrast (71550) | $8,637 | $11,516 | 34.7× |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$9,624.75–$10,491 | $12,833–$13,988 | varies |
| MRI chest wo w contrast (71552) | $11,165.25 | $14,887 | 30.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $8,155.50 | $10,874 | 22.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $9,616.50 | $12,822 | 26.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $8,749.50 | $11,666 | 35.1× |
| MRI lumbar spine w contrast (72149) | $5,865.75 | $7,821 | 16.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $9,458.25 | $12,611 | 26.0× |
| MRI orbit face &/neck w/o contrast (70540) | $6,861.75 | $9,149 | 27.5× |
| MRI orbit face neck w contrast (70542) | $8,711.25 | $11,615 | 23.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $10,013.25 | $13,351 | 27.5× |
| MRI pelvis w contrast (72196) | $10,085.25 | $13,447 | 27.7× |
| MRI pelvis w/o & w contrast (72197) | $13,590.75 | $18,121 | 37.3× |
| MRI pelvis w/o contrast (72195) | $8,789.25 | $11,719 | 35.3× |
| MRI thoracic spine w/o contrast (72146) | $8,800.50 | $11,734 | 35.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $8,155.50 | $10,874 | 22.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,781.50 | $9,042 | 27.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $9,270.75 | $12,361 | 25.4× |
| MRI, abdomen, combo (74183) | $13,590.75 | $18,121 | 37.3× |
| MRI, dorsal spine combo (72157) | $13,725 | $18,300 | 37.7× |
| MRI, dorsal spine contrast (72147) | $8,749.50 | $11,666 | 24.0× |
| MRI, joint upper extrem (73221) | $8,457.75 | $11,277 | 33.9× |
| MRI, joint upper extrem combo (73223) | $8,883 | $11,844 | 24.4× |
| MRI, lumbar spine combo (72158) | $11,577.75 | $15,437 | 31.8× |
| Myelogram cervical (72240) | $6,619.50 | $8,826 | 8.1× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$5,426.25–$6,619.50 | $7,235–$8,826 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$4,272.75–$4,413 | $5,697–$5,884 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$3,551.25–$6,619.50 | $4,735–$8,826 | varies |
| Myocardial Spect Multiple Studies (78452) | $13,211.25 | $17,615 | 9.8× |
| N-invas est c ffr sw aly CTA (75580) | $4,926 | $6,568 | 5.5× |
| Neck soft tissue (70360) | $2,061.75 | $2,749 | 22.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $2,134.50 | $2,846 | 5.1× |
| Nonvascular Shunt X-Ray (75809) | $1,441.50 | $1,922 | 13.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,365.75 | $9,821 | 5.1× |
| Nuclear Rx Intra-Arterial (79445) | $2,761.50 | $3,682 | 11.3× |
| Nuclear Rx Oral Admin (79005) | $3,972 | $5,296 | 16.3× |
| Optic foramina (70190) | $885 | $1,180 | 9.7× |
| Panoramic X-ray of jaws (70355) | $1,266 | $1,688 | 13.9× |
| Parathyroid Planar Imaging (78070) | $5,228.25 | $6,971 | 12.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $9,973.50 | $13,298 | 23.9× |
| Pelvis 1 or 2 views (72170) range across 8 matching MRF lines |
$1,018.50–$2,115 | $1,358–$2,820 | varies |
| Perineogram (74775) | $3,584.25 | $4,779 | 14.4× |
| Peritoneogram Rs&I (74190) | $3,432 | $4,576 | 6.0× |
| Pet Image Skull-Thigh (78812) | $16,590 | $22,120 | 11.1× |
| Pet Image W/Ct Lmtd (78814) | $16,744.50 | $22,326 | 11.2× |
| PET image w/CT, full body (78816) | $15,504.75 | $20,673 | 10.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $17,917.50 | $23,890 | 12.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $14,890.50 | $19,854 | 11.0× |
| PET whole body (78813) | $14,890.50 | $19,854 | 10.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $11,460 | $15,280 | 3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,269.75 | $1,693 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,617 | $2,156 | 14.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $4,042.50 | $5,390 | 7.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $2,018.25 | $2,691 | 22.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $1,478.25 | $1,971 | 16.3× |
| Radex elbow complete minimum 3 views (73080) | $1,961.25 | $2,615 | 21.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,673.25 | $2,231 | 15.3× |
| Radex fingr minimum 2 views (73140) | $973.50 | $1,298 | 10.7× |
| Radex foot complete minimum 3 views (73630) | $1,953 | $2,604 | 21.5× |
| Radex Hand Minimum 3 Views (73130) | $2,037.75 | $2,717 | 22.4× |
| Radex lower extremity infant minimum 2 views (73592) | $592.50 | $790 | 6.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$708.75–$954 | $945–$1,272 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,227.75 | $1,637 | 13.5× |
| Radex Ribs Unilateral 2 Views (71100) | $960.75 | $1,281 | 10.6× |
| Radex shoulder complete minimum 2 views (73030) | $1,929 | $2,572 | 21.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $784.50 | $1,046 | 8.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $3,100.50 | $4,134 | 16.9× |
| Radex Spine 1 View Specify Level (72020) | $1,053 | $1,404 | 11.6× |
| Radex Sternum Minimum 2 Views (71120) | $1,048.50 | $1,398 | 11.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,056 | $1,408 | 11.6× |
| Radex Toe Minimum 2 Views (73660) | $675.75 | $901 | 7.4× |
| Radex upper extremity infant minimum 2 views (73092) | $576 | $768 | 5.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $2,369.25 | $3,159 | 26.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,102.50 | $1,470 | 10.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $36,267 | $48,356 | 4.7× |
| Radiation treatment delivery level 1 (77402) | $1,152.75 | $1,537 | 10.8× |
| Radiation treatment delivery level 2 (77407) | $1,467.75 | $1,957 | 3.6× |
| Radiation treatment delivery level 3 (77412) | $3,573.75 | $4,765 | 6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,048.50 | $1,398 | 9.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$997.50–$1,037.25 | $1,330–$1,383 | varies |
| Radiologic exam colon double contrast study (74280) | $3,246.75 | $4,329 | 17.7× |
| Radiologic exam colon single contrast study (74270) | $2,913.75 | $3,885 | 15.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $2,432.25 | $3,243 | 13.3× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$1,962.75–$2,839.50 | $2,617–$3,786 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,770.75 | $2,361 | 16.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $3,763.50 | $5,018 | 20.5× |
| Radiologic exam swallow function contrast study (74230) | $1,159.50 | $1,546 | 6.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $3,865.50 | $5,154 | 21.1× |
| Radiologic examination femur 1 view (73551) | $1,356 | $1,808 | 14.9× |
| Radiologic examination femur minimum 2 views (73552) | $1,783.50 | $2,378 | 19.6× |
| Radiologic examination knee 1/2 views (73560) | $1,369.50 | $1,826 | 15.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $2,142 | $2,856 | 19.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,818 | $2,424 | 20.0× |
| Ribs bilateral 3 views (71110) | $960.75 | $1,281 | 8.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,543.25 | $3,391 | 6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,926.25 | $5,235 | 9.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,425.75 | $5,901 | 7.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,264 | $4,352 | 5.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,669.50 | $6,226 | 8.2× |
| Scapula (73010) | $1,146 | $1,528 | 10.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $528.75 | $705 | 22.6× |
| Shoulder 1 view (73020) | $1,354.50 | $1,806 | 14.9× |
| Shoulder Arthrography (73040) | $4,641.75 | $6,189 | 12.7× |
| Skull less than 4 views (70250) | $1,327.50 | $1,770 | 12.2× |
| Special dosimetry (77331) | $2,847 | $3,796 | 20.3× |
| Special Physics Consult (77370) | $1,471.50 | $1,962 | 10.5× |
| Special teletherapy port plan (77321) | $2,658 | $3,544 | 6.8× |
| Special treatment procedure (77470) | $2,431.50 | $3,242 | 4.2× |
| Srs Multisource (77371) | $73,029 | $97,372 | 9.5× |
| Stereotactic Body Radiation Delivery (77373) | $18,864.75 | $25,153 | 10.1× |
| Sternoclavicular joints (71130) | $581.25 | $775 | 6.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $7,068.75 | $9,425 | 18.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,769.75 | $3,693 | 7.1× |
| Testicular Imaging W/Flow (78761) | $2,723.25 | $3,631 | 6.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,558 | $4,744 | 9.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,198 | $4,264 | 8.2× |
| Ther rad simulaj-aided field setting simple (77280) | $2,175 | $2,900 | 15.5× |
| Thoracic spine 2 views (72070) | $966.75 | $1,289 | 8.9× |
| Thoracic spine 3 views (72072) | $1,194 | $1,592 | 10.9× |
| Thoracolumbar 2 views (72080) | $483.75 | $645 | 5.3× |
| Thyroid Imaging With Vascular Flow (78013) | $2,598 | $3,464 | 6.2× |
| Thyroid Met Imaging Body (78018) | $6,363.75 | $8,485 | 11.2× |
| Thyroid Uptake Measurement (78012) | $2,536.50 | $3,382 | 6.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $5,772 | $7,696 | 13.8× |
| Tx Devices Design & Construction Complex (77334) | $3,450 | $4,600 | 8.8× |
| Tx devices design & construction intermediate (77333) | $1,560.75 | $2,081 | 11.1× |
| Tx devices design & construction simple (77332) | $1,350.75 | $1,801 | 9.6× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$1,080–$1,268.25 | $1,440–$1,691 | varies |
| Ultrasound Elastography Parenchyma (76981) | $669.75 | $893 | 6.1× |
| Ultrasound Exam Aaa Screen (76706) | $806.25 | $1,075 | 7.4× |
| Ultrasound, abdomen limited (76705) | $3,048 | $4,064 | 27.9× |
| Umbilical-artery Doppler (OB) (76820) | $1,188.75 | $1,585 | 10.9× |
| Unlisted Dx Radiographic Procedure (76499) | $696.75 | $929 | 7.7× |
| Unlisted magnetic resonance procedure (76498) | $6,567 | $8,756 | 72.3× |
| Unlisted us procedure (76999) | $648 | $864 | 7.1× |
| Upper gi w/o kub (74240) | $4,614 | $6,152 | 25.2× |
| Urethrocystogram voiding (74455) | $2,541 | $3,388 | 10.2× |
| Urethrocystography retrograde (74450) | $2,541 | $3,388 | 10.2× |
| Us breast unilateral complete (76641) | $1,698.75 | $2,265 | 15.6× |
| Us chest (76604) range across 5 matching MRF lines |
$1,059.75–$1,928.25 | $1,413–$2,571 | varies |
| Us complete joint (76881) | $1,061.25 | $1,415 | 9.7× |
| Us exam, pelvic, limited (76857) | $957.75 | $1,277 | 8.8× |
| Us head (76506) | $1,188.75 | $1,585 | 10.9× |
| Us kidney transplant (76776) | $2,277 | $3,036 | 20.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,140.75 | $1,521 | 10.4× |
| Us ob detailed single fetus (76811) | $2,307 | $3,076 | 9.3× |
| Us ob limited 1 or more fetuses (76815) | $1,552.50 | $2,070 | 14.2× |
| Us ob transvaginal (76817) | $3,606.75 | $4,809 | 33.0× |
| Us pelvic non ob complete (76856) | $2,948.25 | $3,931 | 27.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,796 | $3,728 | 25.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,755 | $2,340 | 16.1× |
| Us retroperitoneal complete (76770) | $3,488.25 | $4,651 | 32.0× |
| Us retroperitoneal limited (76775) | $2,760 | $3,680 | 25.3× |
| Us scrotum and contents (76870) | $3,090 | $4,120 | 28.3× |
| Us spinal canal and contents (76800) | $1,059.75 | $1,413 | 9.7× |
| Us thyroid (76536) | $3,440.25 | $4,587 | 31.5× |
| Vein X-Ray Chest (75827) | $7,275.75 | $9,701 | 4.4× |
| Venogram Sinus/Jugular (75860) | $7,645.50 | $10,194 | 2.3× |
| Venography caval inferior serialography rs&i (75825) | $11,914.50 | $15,886 | 3.6× |
| Venography extremity bilateral rs&i (75822) | $7,698.75 | $10,265 | 4.7× |
| Venography extremity unilateral rs&i (75820) | $7,698.75 | $10,265 | 4.7× |
| Venography Renal Bilateral (75833) | $12,032.25 | $16,043 | 3.6× |
| Venography Renal Unilateral (75831) | $10,527 | $14,036 | 3.2× |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$5,631.75–$8,661.75 | $7,509–$11,549 | varies |
| Wrist 2 views (73100) | $1,073.25 | $1,431 | 11.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,731 | $2,308 | 19.0× |
| X-ray antegrade pyelogram tube (74425) | $3,258 | $4,344 | 8.9× |
| X-Ray Aorta Leg Arteries (75630) | $9,026.25 | $12,035 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $2,478.75 | $3,305 | 22.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,605 | $2,140 | 17.7× |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$2,166–$2,439.75 | $2,888–$3,253 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $741 | $988 | 8.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,018.50 | $1,358 | 9.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,189.50 | $1,586 | 10.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $1,356 | $1,808 | 14.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 9 matching MRF lines |
$1,518–$4,088.25 | $2,024–$5,451 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,953.75 | $2,605 | 17.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $927 | $1,236 | 8.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,091 | $2,788 | 19.2× |
| X-Ray Exam L-S Spine Bending (72114) | $2,383.50 | $3,178 | 21.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $2,018.25 | $2,691 | 22.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $2,482.50 | $3,310 | 22.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,961.25 | $2,615 | 18.0× |
| X-ray eye for foreign body (70030) | $533.25 | $711 | 5.9× |
| X-ray humerus (73060) | $2,178.75 | $2,905 | 24.0× |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$2,136.75–$4,299 | $2,849–$5,732 | varies |
| X-ray IV pyelogram+tomography (74415) | $3,343.50 | $4,458 | 18.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,098.75 | $1,465 | 12.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$665.25–$870.75 | $887–$1,161 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $2,216.25 | $2,955 | 20.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,453.25 | $3,271 | 22.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,082.25 | $1,443 | 9.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $1,051.50 | $1,402 | 9.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,347 | $1,796 | 14.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,940.25 | $2,587 | 21.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,432.25 | $3,243 | 22.3× |
| X-ray thoracic spine 4 vw (72074) | $572.25 | $763 | 5.2× |
| X-Ray Tmj Unilat (70328) | $528.75 | $705 | 5.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,641.25 | $4,855 | 10.0× |
| X-Rays Bone Length Studies (77073) | $597 | $796 | 5.5× |
| X-Rays Bone Survey Complete (77075) | $2,471.25 | $3,295 | 22.6× |
| Xr c-spine 4 or 5 views (72050) | $2,365.50 | $3,154 | 21.7× |
| Xr facial bones less than 3 views (70140) | $1,470.75 | $1,961 | 16.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $609.75 | $813 | 5.6× |
| Xr orbits complete 4 views (70200) | $1,673.25 | $2,231 | 15.3× |
| Xr Tomogram Single Plane (76100) | $1,533 | $2,044 | 14.0× |
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.