Imaging prices at Grady Memorial Hospital
Delaware, OH · every code in this section with a posted price and a Medicare benchmark.
434 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) | $5,933.85 | $9,129 | 4.4× |
| Abdomen 1 View (74018) | $159.90 | $246 | 1.9× |
| Abdomen 2 views (74019) | $247 | $380 | 2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,363.40 | $3,636 | 6.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,499.55 | $2,307 | 1.2× |
| Angio internal mammary (75756) | $1,294.15 | $1,991 | 0.4× |
| Angio pulmonary bilat (75743) | $2,447.90 | $3,766 | 0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,414.75 | $3,715 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $2,470.65 | $3,801 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,414.75 | $3,715 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,414.75 | $3,715 | 0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,257.45 | $3,473 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$209.30–$418.60 | $322–$644 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,086.55 | $6,287 | 0.8× |
| Artery X-Rays Abdomen (75726) | $4,004.65 | $6,161 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $1,593.80 | $2,452 | 0.5× |
| Artery X-Rays Pelvis (75736) | $4,004.65 | $6,161 | 0.7× |
| Artery X-Rays Spine (75705) | $4,004.65 | $6,161 | 0.7× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$488.80–$977.60 | $752–$1,504 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$406.90–$813.80 | $626–$1,252 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$512.20–$1,024.40 | $788–$1,576 | varies |
| Basic radiation dosimetry calculation (77300) | $1,567.15 | $2,411 | 12.1× |
| Bone age studies (77072) | $196.30 | $302 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,517.10 | $2,334 | 3.9× |
| Bone Imaging Limited Area (78300) | $1,037.40 | $1,596 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $1,306.50 | $2,010 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,504.10 | $2,314 | 3.9× |
| Bone marrow imaging limited area (78102) | $1,037.40 | $1,596 | 2.7× |
| Bone marrow imaging; multiple areas (78103) | $1,092 | $1,680 | 2.8× |
| Bone marrow imaging; whole body (78104) | $1,297.40 | $1,996 | 3.4× |
| Bone survey infant (77076) | $272.35 | $419 | 2.7× |
| Brachytx isodose complex (77318) | $6,466.85 | $9,949 | 17.9× |
| Brachytx isodose intermed (77317) | $6,466.85 | $9,949 | 17.9× |
| Brachytx Isodose Plan Simple (77316) | $3,708.25 | $5,705 | 10.3× |
| Brain Flow Imaging Only (78610) | $607.75 | $935 | 1.2× |
| Brain Image W/Flow < 4 Views (78601) | $739.70 | $1,138 | 1.9× |
| Brain imaging < 4 static views (78600) | $739.70 | $1,138 | 1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $954.20 | $1,468 | 1.8× |
| Brain Imaging Minimum 4 Static Views (78605) | $954.20 | $1,468 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,202.60 | $8,004 | 3.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,131 | $1,740 | 2.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,299.35 | $1,999 | 3.9× |
| Cardiac Shunt Detection (78428) | $1,131 | $1,740 | 2.9× |
| Cat Scan Follow-Up Study (76380) | $441.35 | $679 | 5.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $607.75 | $935 | 1.2× |
| Cerebrospinal Fluid Scan (78630) | $663.65 | $1,021 | 1.3× |
| Chest 1 view (71045) | $238.55 | $367 | 2.8× |
| Chest 2 views (71046) | $279.50 | $430 | 3.3× |
| Chest 3 views (71047) | $320.45 | $493 | 3.8× |
| Chest 4 or more views (71048) | $364 | $560 | 3.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$184.60–$369.20 | $284–$568 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $362.70 | $558 | 3.6× |
| Continuing medical physics consltj pr wk (77336) | $1,718.60 | $2,644 | 13.3× |
| Contrast Exam Abdominl Aorta (75625) | $2,414.75 | $3,715 | 0.8× |
| Contrast X-Ray Bladder (74430) | $586.95 | $903 | 1.7× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$477.10–$954.20 | $734–$1,468 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$488.80–$977.60 | $752–$1,504 | varies |
| Corpora cavernosography (74445) | $553.80 | $852 | 5.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,589.90 | $2,446 | 4.7× |
| CT abdomen and pelvis without contrast (74176) | $1,339.65 | $2,061 | 5.8× |
| CT abdomen w contrast (74160) | $1,111.50 | $1,710 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,326.65 | $2,041 | 7.8× |
| CT abdomen w/o contrast (74150) | $865.15 | $1,331 | 8.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,836.90 | $2,826 | 5.5× |
| CT Angio Chest (71275) | $1,482.65 | $2,281 | 8.8× |
| CT Angio Head (70496) | $1,199.90 | $1,846 | 7.1× |
| CT angio hrt w/3d image (75574) | $1,123.85 | $1,729 | 3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,406.60–$2,813.20 | $2,164–$4,328 | varies |
| CT Angio Neck (70498) | $1,198.60 | $1,844 | 7.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,264.90 | $1,946 | 7.5× |
| CT cervical spine w/ contrast (72126) | $1,185.60 | $1,824 | 3.5× |
| CT cervical spine w/o contrast (72125) | $1,125.80 | $1,732 | 11.2× |
| CT cervical spine w/wo cont (72127) | $1,248 | $1,920 | 7.4× |
| CT chest w contrast (71260) | $1,302.60 | $2,004 | 7.7× |
| CT chest w/wo contrast (71270) | $1,472.90 | $2,266 | 8.7× |
| CT colonography screening (74263) | $689 | $1,060 | 3.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $854.75 | $1,315 | 8.5× |
| CT head/brain with contrast (70460) | $876.20 | $1,348 | 5.2× |
| CT head/brain without and with contrast (70470) | $993.20 | $1,528 | 5.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $957.45 | $1,473 | 2.8× |
| CT hrt w/3d image congen (75573) | $1,218.10 | $1,874 | 3.6× |
| CT iac w contrast (70481) | $1,099.15 | $1,691 | 6.5× |
| CT l-spine w&w/o contrast (72133) | $1,183 | $1,820 | 7.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$952.90–$1,905.80 | $1,466–$2,932 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,162.20–$2,324.40 | $1,788–$3,576 | varies |
| CT lumbar spine w contrast (72132) | $1,032.20 | $1,588 | 3.1× |
| CT lumbar spine w/o contrast (72131) | $835.25 | $1,285 | 8.3× |
| CT maxillofacial w contrast (70487) | $1,101.10 | $1,694 | 6.5× |
| CT maxillofacial wo contrast (70486) | $880.10 | $1,354 | 8.7× |
| CT neck tissue combo (70492) | $1,279.85 | $1,969 | 7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,254.50 | $1,930 | 7.4× |
| CT orbits w/o contrast (70480) | $865.80 | $1,332 | 8.6× |
| CT pelvis w&w/o contrast (72194) | $1,292.85 | $1,989 | 7.6× |
| CT pelvis w/o contrast (72192) | $980.20 | $1,508 | 9.7× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,289.60–$2,579.20 | $1,984–$3,968 | varies |
| CT scans face/jaw combo (70488) | $1,266.20 | $1,948 | 7.5× |
| CT soft tissue neck w contrast (70491) | $1,188.85 | $1,829 | 7.0× |
| CT soft tissue neck w/o contrast (70490) | $1,043.90 | $1,606 | 10.4× |
| CT thoracic spine w contrast (72129) | $1,053 | $1,620 | 6.2× |
| CT thoracic spine w/o contrast (72128) | $874.25 | $1,345 | 8.7× |
| CT thoracic spine w/wo cont (72130) | $1,160.25 | $1,785 | 6.9× |
| CT thorax w/o contrast (71250) | $993.85 | $1,529 | 9.9× |
| CT unlisted procedure (76497) | $2,159.30 | $3,322 | 25.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$886.60–$1,773.20 | $1,364–$2,728 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,159.60–$2,319.20 | $1,784–$3,568 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,066.65–$2,133.30 | $1,641–$3,282 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,121.25 | $1,725 | 6.6× |
| Cta Abdomen (74175) | $1,393.60 | $2,144 | 8.2× |
| CTA pelvis (72191) | $1,300.65 | $2,001 | 7.7× |
| Dilation ureters/urethra rs&i (74485) | $2,148.90 | $3,306 | 1.1× |
| Discography Cerv/Thor Spine (72285) | $2,580.50 | $3,970 | 1.4× |
| Diskography lumbar (72295) | $1,524.90 | $2,346 | 0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $198.90 | $306 | 2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $488.15 | $751 | 4.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $211.25 | $325 | 2.1× |
| Dxa Bone Density Axial (77080) | $306.15 | $471 | 3.0× |
| Dxa bone density study (77085) | $295.10 | $454 | 2.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $194.35 | $299 | 2.3× |
| Echo exam of fetal heart (76825) | $878.15 | $1,351 | 1.7× |
| Echo exam uterus (76831) | $507.65 | $781 | 2.2× |
| Echo Guide For Artery Repair (76936) | $384.80 | $592 | 1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $351 | $540 | 1.5× |
| Echograp Trans R Pros Study (76873) | $557.05 | $857 | 5.5× |
| Esophagram (74220) | $346.45 | $533 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $336.05 | $517 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $305.50 | $470 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $328.25 | $505 | 1.4× |
| Follow-Up Angiography (75898) | $1,422.20 | $2,188 | 0.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$194.35–$388.70 | $299–$598 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$206.70–$413.40 | $318–$636 | varies |
| Gastric emptying imaging study (78264) | $1,428.05 | $2,197 | 3.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,989.65 | $3,061 | 5.2× |
| Gated Heart Planar Single (78472) | $2,138.50 | $3,290 | 5.5× |
| Gated Heart, Multiple (78473) | $2,138.50 | $3,290 | 5.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,140.45 | $3,293 | 4.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$169–$338 | $260–$520 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,788.30 | $11,982 | 11.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $7,788.30 | $11,982 | 11.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $7,788.30 | $11,982 | 11.6× |
| Heart first pass single,planar (78481) | $1,267.50 | $1,950 | 2.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,414.75 | $3,715 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,414.75 | $3,715 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $3,070.60 | $4,724 | 5.9× |
| Hepatobiliary System Imaging (78226) | $1,775.80 | $2,732 | 4.6× |
| Ht Musc Image Planar Mult (78454) | $2,146.95 | $3,303 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,527.50 | $2,350 | 1.2× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $3,430.70 | $5,278 | 5.1× |
| Hysterosalpingogram (74740) | $345.80 | $532 | 1.5× |
| Interstitial radiation source applic complex (77778) | $3,754.40 | $5,776 | 5.6× |
| Joint Survey Single View (77077) | $206.70 | $318 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $1,602.90 | $2,466 | 3.1× |
| K Flow/Funct Image W/Drug (78708) | $1,335.75 | $2,055 | 2.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,265.55 | $1,947 | 2.4× |
| Kidney Imaging Morphol (78700) | $1,188.20 | $1,828 | 3.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,188.20 | $1,828 | 3.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$244.40–$488.80 | $376–$752 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $702.65 | $1,081 | 1.8× |
| Leveen/Shunt Patency Exam (78291) | $575.90 | $886 | 1.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,318.85 | $2,029 | 3.4× |
| Liver imaging static only (78201) | $1,396.20 | $2,148 | 2.7× |
| Liver imaging w/vascular flow (78202) | $1,396.20 | $2,148 | 2.7× |
| Lung perfusion differential (78597) | $1,326 | $2,040 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,221.35 | $1,879 | 2.3× |
| Lung Ventilation Imaging (78579) | $654.55 | $1,007 | 1.7× |
| Lymph System Imaging (78195) | $1,047.15 | $1,611 | 2.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,422.20 | $2,188 | 0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) | $590.20 | $908 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,414.75 | $3,715 | 0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,422.20 | $2,188 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,186.25–$2,372.50 | $1,825–$3,650 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $1,765.40 | $2,716 | 10.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $1,606.15 | $2,471 | 3.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $1,925.30 | $2,962 | 11.4× |
| Mammary ductogram or galactogram multiple (77054) | $469.30 | $722 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $469.30 | $722 | 2.0× |
| Meckels Divert Exam (78290) | $1,819.35 | $2,799 | 4.7× |
| Medical physics dose eval radiation expos w/rprt (76145) | $2,275 | $3,500 | 6.3× |
| Mlc imrt design & construction per imrt plan (77338) | $1,296.75 | $1,995 | 3.6× |
| Mr safety determination physician/other qhp (76016) | $172.25 | $265 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $48.75 | $75 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $178.75 | $275 | 1.9× |
| Mr safety implt pos&/immoblj (76019) | $117 | $180 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,400.10 | $2,154 | 4.2× |
| MRA head w/o contrast (70544) | $1,053.65 | $1,621 | 4.6× |
| MRA head with contrast (70545) | $1,225.90 | $1,886 | 3.6× |
| MRA neck w contrast (70548) | $1,231.10 | $1,894 | 3.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,407.90 | $2,166 | 4.2× |
| MRA neck w/o contrast (70547) | $1,053.65 | $1,621 | 4.6× |
| MRI abdomen w contrast (74182) | $1,631.50 | $2,510 | 4.9× |
| MRI abdomen w/o contrast (74181) | $1,287 | $1,980 | 5.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,499.55–$2,999.10 | $2,307–$4,614 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,690–$3,380 | $2,600–$5,200 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,391.65–$2,783.30 | $2,141–$4,282 | varies |
| MRI bone marrow blood supply (77084) | $1,380.60 | $2,124 | 6.0× |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$1,760.85–$3,521.70 | $2,709–$5,418 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,496.95 | $2,303 | 6.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,224.60 | $1,884 | 5.3× |
| MRI cardiac w/o contrast (75557) | $1,169.35 | $1,799 | 5.1× |
| MRI cervical spine w contrast (72142) | $1,712.10 | $2,634 | 5.1× |
| MRI cervical spine w/o cont (72141) | $1,281.80 | $1,972 | 5.6× |
| MRI chest w/o contrast (71550) | $1,339.65 | $2,061 | 5.8× |
| MRI chest with contrast (71551) | $1,447.55 | $2,227 | 1.9× |
| MRI chest wo w contrast (71552) | $1,697.15 | $2,611 | 5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,554.15–$3,108.30 | $2,391–$4,782 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,723.15–$3,446.30 | $2,651–$5,302 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,287–$2,574 | $1,980–$3,960 | varies |
| MRI lumbar spine w contrast (72149) | $1,634.75 | $2,515 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,017.60 | $3,104 | 6.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,370.20 | $2,108 | 6.0× |
| MRI orbit face neck w contrast (70542) | $1,623.70 | $2,498 | 4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,762.15 | $2,711 | 5.2× |
| MRI pelvis w contrast (72196) | $1,567.80 | $2,412 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $1,827.15 | $2,811 | 5.4× |
| MRI pelvis w/o contrast (72195) | $1,277.90 | $1,966 | 5.6× |
| MRI spectroscopy (76390) | $1,182.35 | $1,819 | 14.1× |
| MRI thoracic spine w/o contrast (72146) | $1,287.65 | $1,981 | 5.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,458.60–$2,917.20 | $2,244–$4,488 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,271.40–$2,542.80 | $1,956–$3,912 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,692.60–$3,385.20 | $2,604–$5,208 | varies |
| MRI, abdomen, combo (74183) | $1,975.35 | $3,039 | 5.9× |
| MRI, dorsal spine combo (72157) | $1,939.60 | $2,984 | 5.8× |
| MRI, dorsal spine contrast (72147) | $1,552.85 | $2,389 | 4.6× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,265.55–$2,531.10 | $1,947–$3,894 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,530.75–$3,061.50 | $2,355–$4,710 | varies |
| MRI, lumbar spine combo (72158) | $1,924.65 | $2,961 | 5.7× |
| Myelogram cervical (72240) | $667.55 | $1,027 | 0.9× |
| Myelogram Lumbar (72265) | $703.30 | $1,082 | 0.9× |
| Myelography thoracic (72255) | $815.10 | $1,254 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $856.05 | $1,317 | 1.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,111.50 | $1,710 | 2.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,111.50 | $1,710 | 2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,679.60 | $2,584 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $2,744.30 | $4,222 | 2.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,300 | $2,000 | 0.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,019.55 | $3,107 | 1.5× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,236.65 | $3,441 | 1.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,796 | $5,840 | 1.8× |
| Neck soft tissue (70360) | $198.25 | $305 | 2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $511.55 | $787 | 1.3× |
| Nm csf leak detection (78650) | $1,842.75 | $2,835 | 1.5× |
| Nm myocard infarct spect (78469) | $1,111.50 | $1,710 | 2.1× |
| Nonvascular Shunt X-Ray (75809) | $380.90 | $586 | 3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $11,338.60 | $17,444 | 8.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,454.05 | $2,237 | 6.5× |
| Nuclear Rx Oral Admin (79005) | $1,802.45 | $2,773 | 8.0× |
| Ob us nuchal meas 1 gest (76813) | $230.75 | $355 | 2.3× |
| Optic foramina (70190) range across 2 matching MRF lines |
$237.25–$474.50 | $365–$730 | varies |
| Panoramic X-ray of jaws (70355) | $163.80 | $252 | 2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,733.55 | $2,667 | 3.3× |
| Parathyroid Planar Imaging (78070) | $1,290.25 | $1,985 | 3.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,560 | $2,400 | 4.0× |
| Pelvis 1 or 2 views (72170) | $225.55 | $347 | 2.2× |
| Perineogram (74775) | $1,806.35 | $2,779 | 7.9× |
| Peritoneogram Rs&I (74190) | $729.30 | $1,122 | 1.4× |
| Pet Image W/Ct Lmtd (78814) | $4,848.35 | $7,459 | 3.5× |
| PET image w/CT, full body (78816) | $6,158.75 | $9,475 | 4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,390.45 | $8,293 | 3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,414.75 | $3,715 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $702.65 | $1,081 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $351.65 | $541 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $584.35 | $899 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$240.50–$481 | $370–$740 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$199.55–$399.10 | $307–$614 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$228.15–$456.30 | $351–$702 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $242.45 | $373 | 2.4× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$157.95–$315.90 | $243–$486 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$247–$494 | $380–$760 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$219.70–$439.40 | $338–$676 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$180.70–$361.40 | $278–$556 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$471.25–$942.50 | $725–$1,450 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $163.80 | $252 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $200.20 | $308 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$276.90–$553.80 | $426–$852 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $137.80 | $212 | 1.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $607.75 | $935 | 3.6× |
| Radex Spine 1 View Specify Level (72020) | $195.65 | $301 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) | $186.55 | $287 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $233.35 | $359 | 2.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$188.50–$377 | $290–$580 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$237.25–$474.50 | $365–$730 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$174.85–$349.70 | $269–$538 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $319.80 | $492 | 3.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,569.85 | $8,569 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $1,416.35 | $2,179 | 14.4× |
| Radiation treatment delivery level 2 (77407) | $1,416.35 | $2,179 | 3.8× |
| Radiation treatment delivery level 3 (77412) | $1,551.55 | $2,387 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $226.85 | $349 | 2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $327.60 | $504 | 3.2× |
| Radiologic exam colon double contrast study (74280) | $651.95 | $1,003 | 3.9× |
| Radiologic exam colon single contrast study (74270) | $517.40 | $796 | 3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $518.70 | $798 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$293.15–$586.30 | $451–$902 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $289.25 | $445 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $484.25 | $745 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $269.75 | $415 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $612.95 | $943 | 3.6× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$132.60–$265.20 | $204–$408 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$161.85–$323.70 | $249–$498 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$214.50–$429 | $330–$660 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $226.85 | $349 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$191.10–$382.20 | $294–$588 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,119.30 | $1,722 | 2.1× |
| Renal Cyst Study (74470) | $2,276.30 | $3,502 | 4.3× |
| Ribs bilateral 3 views (71110) | $339.95 | $523 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,643.85 | $2,529 | 4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,818.70 | $2,798 | 4.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,249 | $3,460 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,909.05 | $2,937 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,340.65 | $3,601 | 4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,845.05 | $4,377 | 2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,136.90 | $4,826 | 2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,580.50 | $3,970 | 2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,810.95 | $5,863 | 16.9× |
| Rp Therapy Intravenous Administration (79101) | $1,796.60 | $2,764 | 8.0× |
| Salivary Gland Imaging (78230) | $1,337.05 | $2,057 | 3.5× |
| Scapula (73010) range across 2 matching MRF lines |
$214.50–$429 | $330–$660 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $55.25 | $85 | 2.4× |
| Sella turcica (70240) | $170.95 | $263 | 2.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$183.95–$367.90 | $283–$566 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$384.15–$768.30 | $591–$1,182 | varies |
| Sialogram (70390) | $468.65 | $721 | 2.0× |
| Skull less than 4 views (70250) | $223.60 | $344 | 2.2× |
| Special dosimetry (77331) | $822.90 | $1,266 | 6.3× |
| Special Physics Consult (77370) | $1,827.80 | $2,812 | 14.1× |
| Special teletherapy port plan (77321) | $5,878.60 | $9,044 | 16.3× |
| Special treatment procedure (77470) | $2,568.15 | $3,951 | 4.8× |
| Stereotactic Body Radiation Delivery (77373) | $3,820.05 | $5,877 | 2.2× |
| Sternoclavicular joints (71130) | $222.30 | $342 | 2.6× |
| Superior sagittal sinus venogram (75870) | $1,522.95 | $2,343 | 0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $10,010.65 | $15,401 | 27.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $4,524 | $6,960 | 12.5× |
| Testicular Imaging W/Flow (78761) | $952.25 | $1,465 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,546.75 | $6,995 | 12.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,237.95 | $3,443 | 6.2× |
| Ther rad simulaj-aided field setting simple (77280) | $1,227.85 | $1,889 | 9.5× |
| Thoracic spine 2 views (72070) | $207.35 | $319 | 2.1× |
| Thoracic spine 3 views (72072) | $248.95 | $383 | 2.5× |
| Thoracolumbar 2 views (72080) | $215.15 | $331 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $642.20 | $988 | 1.7× |
| Thyroid Met Imaging Body (78018) | $1,627.60 | $2,504 | 3.1× |
| Thyroid Uptake Measurement (78012) | $953.55 | $1,467 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,410.50 | $2,170 | 3.7× |
| Tx Devices Design & Construction Complex (77334) | $1,338.35 | $2,059 | 3.7× |
| Tx devices design & construction intermediate (77333) | $1,338.35 | $2,059 | 10.3× |
| Tx devices design & construction simple (77332) | $1,338.35 | $2,059 | 10.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$514.80–$1,029.60 | $792–$1,584 | varies |
| Ultrasound Elastography Parenchyma (76981) | $393.25 | $605 | 3.9× |
| Ultrasound Exam Aaa Screen (76706) | $235.30 | $362 | 2.3× |
| Ultrasound, abdomen limited (76705) | $345.80 | $532 | 3.4× |
| Umbilical-artery Doppler (OB) (76820) | $191.75 | $295 | 1.9× |
| Unlisted fluoroscopic procedure (76496) | $193.70 | $298 | 2.3× |
| Unlisted magnetic resonance procedure (76498) | $373.75 | $575 | 4.5× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,235 | $1,900 | 12.6× |
| Unlisted us procedure (76999) | $555.10 | $854 | 6.6× |
| Upper gi w/o kub (74240) | $525.20 | $808 | 3.1× |
| Ureteral Reflux Study (78740) | $1,777.10 | $2,734 | 4.6× |
| Urethrocystogram voiding (74455) | $648.05 | $997 | 2.8× |
| Urethrocystography retrograde (74450) | $601.25 | $925 | 2.6× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$146.25–$1,372.80 | $225–$2,112 | varies |
| Us chest (76604) | $340.60 | $524 | 3.4× |
| Us complete joint (76881) | $542.10 | $834 | 5.4× |
| Us exam, pelvic, limited (76857) | $240.50 | $370 | 2.4× |
| Us head (76506) | $352.30 | $542 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $366.60 | $564 | 3.6× |
| Us ob detailed single fetus (76811) | $559 | $860 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $214.50 | $330 | 2.1× |
| Us ob transvaginal (76817) | $350.35 | $539 | 3.5× |
| Us pelvic non ob complete (76856) | $295.75 | $455 | 2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $376.35 | $579 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $332.15 | $511 | 3.3× |
| Us retroperitoneal complete (76770) | $549.25 | $845 | 5.4× |
| Us retroperitoneal limited (76775) | $442 | $680 | 4.4× |
| Us scrotum and contents (76870) | $449.80 | $692 | 4.5× |
| Us spinal canal and contents (76800) | $504.40 | $776 | 5.0× |
| Us thyroid (76536) | $598.65 | $921 | 5.9× |
| Us transrectal (76872) | $597.35 | $919 | 5.9× |
| Vascular Flow Imaging (78445) | $1,188.20 | $1,828 | 3.1× |
| Vein X-Ray Chest (75827) | $628.55 | $967 | 0.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,414.75 | $3,715 | 0.8× |
| Vein X-Ray Skull Epidural (75872) | $2,237.30 | $3,442 | 3.7× |
| Vein X-Ray Spleen/Liver (75810) | $3,153.15 | $4,851 | 1.0× |
| Venogram Sinus/Jugular (75860) | $2,414.75 | $3,715 | 0.8× |
| Venography Adrenal Unilateral (75840) | $2,414.75 | $3,715 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $2,414.75 | $3,715 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $964.60 | $1,484 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $549.90 | $846 | 0.4× |
| Venography Renal Bilateral (75833) | $2,672.15 | $4,111 | 0.9× |
| Venography Renal Unilateral (75831) | $2,414.75 | $3,715 | 0.8× |
| Venous sampling by catheter (75893) | $4,004.65 | $6,161 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,188.20 | $1,828 | 3.1× |
| Vertebral fracture assessment via dxa (77086) | $84.50 | $130 | 1.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$141.70–$283.40 | $218–$436 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $206.05 | $317 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $499.85 | $769 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $2,552.55 | $3,927 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $198.25 | $305 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$195.65–$391.30 | $301–$602 | varies |
| X-Ray Exam Breast Specimen (76098) | $691.60 | $1,064 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $124.80 | $192 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $228.15 | $351 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $273 | $420 | 2.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $198.90 | $306 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $226.20 | $348 | 2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $253.50 | $390 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $218.40 | $336 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $279.50 | $430 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $340.60 | $524 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $352.30 | $542 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $226.85 | $349 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $347.10 | $534 | 3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $315.25 | $485 | 3.1× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$174.85–$349.70 | $269–$538 | varies |
| X-ray humerus (73060) | $208 | $320 | 2.5× |
| X-ray IV pyelogram (ivp) (74400) | $718.25 | $1,105 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $132.60 | $204 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $214.50 | $330 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $245.05 | $377 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $605.80 | $932 | 7.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $403 | $620 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $226.20 | $348 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $166.40 | $256 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $214.50 | $330 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $248.95 | $383 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $324.35 | $499 | 3.2× |
| X-Ray Stress View (77071) | $149.50 | $230 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $308.10 | $474 | 3.1× |
| X-Ray Tmj Unilat (70328) | $141.70 | $218 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $954.20 | $1,468 | 2.8× |
| X-Rays Bone Length Studies (77073) | $198.25 | $305 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $412.10 | $634 | 4.1× |
| Xr c-spine 4 or 5 views (72050) | $288.60 | $444 | 2.9× |
| Xr facial bones less than 3 views (70140) | $128.05 | $197 | 1.5× |
| Xr orbits complete 4 views (70200) | $267.15 | $411 | 2.7× |
| Xr Tomogram Single Plane (76100) | $481 | $740 | 4.8× |
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.