Imaging prices at George Washington University Hospital
Washington, DC · every code in this section with a posted price and a Medicare benchmark.
436 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) | $2,354 | $5,885 | 1.4× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$315.60–$318.40 | $789–$796 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$366–$369.20 | $915–$923 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,368–$1,782.80 | $3,420–$4,457 | varies |
| Adrenal Cortex & Medulla Img (78075) | $2,002.40 | $5,006 | 1.3× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$2,269.60–$2,723.60 | $5,674–$6,809 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$4,426–$4,639.60 | $11,065–$11,599 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,742.80 | $4,357 | 0.5× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,452.40–$3,616.80 | $6,131–$9,042 | varies |
| Angiography extremity unilateral rs&i (75710) range across 12 matching MRF lines |
$1,295.20–$5,686.40 | $3,238–$14,216 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$2,132–$4,639.60 | $5,330–$11,599 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,171.60 | $5,429 | 0.6× |
| Ankle 2 views (73600) range across 14 matching MRF lines |
$290.80–$418 | $727–$1,045 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$2,406.80–$7,340.80 | $6,017–$18,352 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$2,657.60–$6,117.20 | $6,644–$15,293 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$1,997.20–$2,117.60 | $4,993–$5,294 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$2,406.80–$7,340.80 | $6,017–$18,352 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$2,138.40–$6,117.20 | $5,346–$15,293 | varies |
| Arthrogram ankle (73615) range across 5 matching MRF lines |
$466–$930.80 | $1,165–$2,327 | varies |
| Arthrogram hip (73525) range across 8 matching MRF lines |
$493.20–$930.80 | $1,233–$2,327 | varies |
| Arthrogram Wrist (73115) range across 5 matching MRF lines |
$466–$930.80 | $1,165–$2,327 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$246–$599.60 | $615–$1,499 | varies |
| Bone age studies (77072) range across 6 matching MRF lines |
$214.80–$236.40 | $537–$591 | varies |
| Bone Imaging 3 Phase (78315) | $2,816.80 | $7,042 | 6.0× |
| Bone Imaging Limited Area (78300) | $1,045.60 | $2,614 | 2.2× |
| Bone Imaging Whole Body (78306) | $2,317.20 | $5,793 | 4.9× |
| Bone marrow imaging limited area (78102) | $512.80 | $1,282 | 1.1× |
| Bone marrow imaging; whole body (78104) | $872.40 | $2,181 | 1.8× |
| Bone survey infant (77076) range across 4 matching MRF lines |
$219.60–$285.60 | $549–$714 | varies |
| Brachytx isodose complex (77318) | $1,134 | $2,835 | 2.6× |
| Brachytx isodose intermed (77317) | $832 | $2,080 | 1.9× |
| Brachytx Isodose Plan Simple (77316) | $700.40 | $1,751 | 1.6× |
| Brain Flow Imaging Only (78610) | $924 | $2,310 | 1.4× |
| Brain Image W/Flow < 4 Views (78601) | $367.60 | $919 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,106.80 | $2,767 | 1.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $811.20 | $2,028 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$4,548–$5,236.80 | $11,370–$13,092 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$1,282–$4,823.60 | $3,205–$12,059 | varies |
| Cardiac Shunt Detection (78428) | $694 | $1,735 | 1.5× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$762.40–$998.40 | $1,906–$2,496 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,084 | $2,710 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $2,670.80 | $6,677 | 4.2× |
| Chest 1 view (71045) range across 8 matching MRF lines |
$122–$242.40 | $305–$606 | varies |
| Chest 2 views (71046) range across 7 matching MRF lines |
$139.60–$516.40 | $349–$1,291 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$180.40–$457.60 | $451–$1,144 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$516.40–$567.20 | $1,291–$1,418 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $165.20 | $413 | 1.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $493.20 | $1,233 | 4.0× |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$865.20–$1,268.40 | $2,163–$3,171 | varies |
| Clavicle complete (73000) range across 7 matching MRF lines |
$275.20–$344.40 | $688–$861 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$142–$626.80 | $355–$1,567 | varies |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$246–$644.80 | $615–$1,612 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,452.40–$3,688.40 | $6,131–$9,221 | varies |
| Contrast X-Ray Bladder (74430) range across 5 matching MRF lines |
$1,073.20–$1,292.40 | $2,683–$3,231 | varies |
| Contrast X-Ray Of Elbow (73085) range across 5 matching MRF lines |
$466–$930.80 | $1,165–$2,327 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$642–$930.80 | $1,605–$2,327 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $330.80 | $827 | 1.6× |
| Corpora cavernosography (74445) | $579.20 | $1,448 | 4.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$681.20–$6,194.40 | $1,703–$15,486 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$4,433.20–$4,816 | $11,083–$12,040 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$2,750–$2,987.20 | $6,875–$7,468 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$2,992.40–$3,251.20 | $7,481–$8,128 | varies |
| CT abdomen w/o contrast (74150) range across 5 matching MRF lines |
$2,560–$2,844.80 | $6,400–$7,112 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$606–$6,108.80 | $1,515–$15,272 | varies |
| CT Angio Chest (71275) range across 5 matching MRF lines |
$2,496.40–$2,711.60 | $6,241–$6,779 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$2,426–$3,765.20 | $6,065–$9,413 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$300.40–$3,883.20 | $751–$9,708 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 11 matching MRF lines |
$1,344.40–$2,793.20 | $3,361–$6,983 | varies |
| CT Angio Neck (70498) range across 5 matching MRF lines |
$2,132.80–$3,310 | $5,332–$8,275 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 6 matching MRF lines |
$1,344.40–$1,548 | $3,361–$3,870 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$2,296–$2,494 | $5,740–$6,235 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$1,903.20–$2,067.20 | $4,758–$5,168 | varies |
| CT cervical spine w/wo cont (72127) range across 4 matching MRF lines |
$2,348–$2,439.20 | $5,870–$6,098 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$330.40–$2,711.60 | $826–$6,779 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$2,974.40–$3,230.80 | $7,436–$8,077 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$1,927.60–$2,094 | $4,819–$5,235 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$2,332–$2,533.20 | $5,830–$6,333 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$2,546.40–$2,765.60 | $6,366–$6,914 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$480–$522 | $1,200–$1,305 | varies |
| CT hrt w/3d image congen (75573) | $3,883.20 | $9,708 | 9.4× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$2,059.60–$2,236.80 | $5,149–$5,592 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$2,368.40–$3,088 | $5,921–$7,720 | varies |
| CT lower ext w/o (73700) range across 12 matching MRF lines |
$1,384.80–$2,308.40 | $3,462–$5,771 | varies |
| CT lower extremity w/contrast material (73701) range across 13 matching MRF lines |
$1,074–$2,539.20 | $2,685–$6,348 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$2,280.80–$2,478 | $5,702–$6,195 | varies |
| CT lumbar spine w/o contrast (72131) range across 5 matching MRF lines |
$202–$2,264.40 | $505–$5,661 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$1,600–$1,869.20 | $4,000–$4,673 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$202–$1,671.20 | $505–$4,178 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$1,946.40–$2,114.80 | $4,866–$5,287 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$2,305.20–$3,004.40 | $5,763–$7,511 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$1,643.60–$1,785.20 | $4,109–$4,463 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$2,709.60–$3,532 | $6,774–$8,830 | varies |
| CT pelvis w/o contrast (72192) range across 5 matching MRF lines |
$1,814.40–$1,970.80 | $4,536–$4,927 | varies |
| CT scan of leg combo (73702) range across 8 matching MRF lines |
$1,344.40–$1,796 | $3,361–$4,490 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$2,308.40–$2,770 | $5,771–$6,925 | varies |
| CT soft tissue neck w contrast (70491) range across 5 matching MRF lines |
$330.40–$1,868.80 | $826–$4,672 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$1,476.80–$1,604.80 | $3,692–$4,012 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$2,157.60–$2,344 | $5,394–$5,860 | varies |
| CT thoracic spine w/o contrast (72128) range across 5 matching MRF lines |
$202–$2,178.40 | $505–$5,446 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$2,368.40–$2,842 | $5,921–$7,105 | varies |
| CT thorax w/o contrast (71250) range across 6 matching MRF lines |
$202–$2,392.40 | $505–$5,981 | varies |
| CT unlisted procedure (76497) | $1,141.20 | $2,853 | 11.1× |
| CT upper ext wo (73200) range across 11 matching MRF lines |
$1,378.40–$2,265.20 | $3,446–$5,663 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 7 matching MRF lines |
$1,344.40–$1,626.80 | $3,361–$4,067 | varies |
| CT upper extremity with contrast (73201) range across 9 matching MRF lines |
$1,485.20–$2,420 | $3,713–$6,050 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$3,025.20–$3,286 | $7,563–$8,215 | varies |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$606–$3,251.20 | $1,515–$8,128 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$2,709.60–$3,532 | $6,774–$8,830 | varies |
| Discography Cerv/Thor Spine (72285) | $1,699.60 | $4,249 | 0.7× |
| Diskography lumbar (72295) range across 5 matching MRF lines |
$1,184.80–$2,288.40 | $2,962–$5,721 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) | $199.20 | $498 | 1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $456.40 | $1,141 | 3.7× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$376.40–$388.80 | $941–$972 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $206 | $515 | 2.0× |
| Echo exam of fetal heart (76825) | $955.20 | $2,388 | 1.5× |
| Echo exam uterus (76831) | $981.20 | $2,453 | 3.5× |
| Echo Guide For Artery Repair (76936) | $1,968 | $4,920 | 7.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $955.20 | $2,388 | 3.4× |
| Echograp Trans R Pros Study (76873) | $1,015.60 | $2,539 | 8.2× |
| Esophagram (74220) range across 4 matching MRF lines |
$422.80–$459.20 | $1,057–$1,148 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 8 matching MRF lines |
$470–$598 | $1,175–$1,495 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 10 matching MRF lines |
$232.40–$598 | $581–$1,495 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $628 | $1,570 | 2.2× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$575.60–$1,073.60 | $1,439–$2,684 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$1,145.20–$2,215.60 | $2,863–$5,539 | varies |
| Foot 2 views (73620) range across 13 matching MRF lines |
$290.80–$418 | $727–$1,045 | varies |
| Forearm 2 views (73090) range across 14 matching MRF lines |
$309.20–$444.40 | $773–$1,111 | varies |
| Gastric emptying imaging study (78264) | $2,060 | $5,150 | 4.4× |
| Gastroesophageal Reflux Exam (78262) | $961.60 | $2,404 | 2.0× |
| Gated Heart Planar Single (78472) | $1,916.80 | $4,792 | 4.1× |
| Gated Heart, Multiple (78473) | $1,808.40 | $4,521 | 3.8× |
| Hand 2 views (73120) range across 14 matching MRF lines |
$290.80–$472 | $727–$1,180 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,766 | $4,415 | 2.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,302 | $5,755 | 2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,918.40 | $4,796 | 2.3× |
| Heart first pass single,planar (78481) | $1,013.20 | $2,533 | 1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$2,358.40–$2,774.40 | $5,896–$6,936 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$1,635.60–$4,426 | $4,089–$11,065 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$835.20–$1,450 | $2,088–$3,625 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$835.20–$1,450 | $2,088–$3,625 | varies |
| Ht Musc Image Planar Mult (78454) | $2,653.60 | $6,634 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,852 | $4,630 | 1.2× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$594.80–$858.80 | $1,487–$2,147 | varies |
| Image fusion (77399) | $819.20 | $2,048 | 5.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $936.80 | $2,342 | 9.1× |
| Infant hip ultrasound, limited static exam (76886) | $808.40 | $2,021 | 7.9× |
| Infusion Ivp (74410) | $545.20 | $1,363 | 2.6× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,684–$1,935.60 | $4,210–$4,839 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $1,778.80 | $4,447 | 2.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,410.40 | $3,526 | 2.2× |
| Intracavitary radiation source applic simple (77761) | $903.60 | $2,259 | 1.4× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $17,322.80 | $43,307 | 2.0× |
| Intraop radiaj tx deliver xray single tx session (77424) | $17,322.80 | $43,307 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $1,646 | $4,115 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $1,321.20 | $3,303 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,347.20 | $3,368 | 2.1× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $313.20 | $783 | 0.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $696.40 | $1,741 | 1.5× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$517.20–$707.60 | $1,293–$1,769 | varies |
| Leveen/Shunt Patency Exam (78291) | $783.60 | $1,959 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,339.20 | $3,348 | 2.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,072.40 | $5,181 | 4.4× |
| Liver imaging static only (78201) | $1,939.20 | $4,848 | 3.0× |
| Liver imaging w/vascular flow (78202) | $1,503.60 | $3,759 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $2,728 | $6,820 | 4.3× |
| Lung Ventilat&Perfus Imaging (78582) | $2,963.60 | $7,409 | 4.6× |
| Lymph System Imaging (78195) | $2,431.60 | $6,079 | 3.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 2 matching MRF lines |
$836.80–$1,544.40 | $2,092–$3,861 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,029.60 | $2,574 | 1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$1,206.40–$1,864.40 | $3,016–$4,661 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 2 matching MRF lines |
$1,035.60–$1,242.80 | $2,589–$3,107 | varies |
| Magnetic Image Jaw Joint (70336) range across 17 matching MRF lines |
$2,057.20–$3,331.20 | $5,143–$8,328 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $928.40 | $2,321 | 1.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $267.60 | $669 | 1.3× |
| Mammary ductogram or galactogram multiple (77054) | $928.80 | $2,322 | 3.3× |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$275.20–$287.20 | $688–$718 | varies |
| Meckels Divert Exam (78290) | $2,134.40 | $5,336 | 4.5× |
| Mlc imrt design & construction per imrt plan (77338) | $6,492.40 | $16,231 | 14.7× |
| Mr safety determination physician/other qhp (76016) | $40 | $100 | 0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $40 | $100 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $40 | $100 | 0.4× |
| Mr safety implt pos&/immoblj (76019) | $40 | $100 | 0.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $40 | $100 | 0.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$5,318–$5,570.80 | $13,295–$13,927 | varies |
| MRA head w/o contrast (70544) range across 8 matching MRF lines |
$2,792.80–$3,178 | $6,982–$7,945 | varies |
| MRA head with contrast (70545) range across 7 matching MRF lines |
$526.40–$3,356 | $1,316–$8,390 | varies |
| MRA neck w contrast (70548) range across 7 matching MRF lines |
$2,796.80–$3,356 | $6,992–$8,390 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 7 matching MRF lines |
$681.20–$4,043.20 | $1,703–$10,108 | varies |
| MRA neck w/o contrast (70547) range across 8 matching MRF lines |
$2,792.80–$3,178 | $6,982–$7,945 | varies |
| MRI abdomen w contrast (74182) range across 11 matching MRF lines |
$906–$3,161.60 | $2,265–$7,904 | varies |
| MRI abdomen w/o contrast (74181) range across 11 matching MRF lines |
$2,442.80–$2,874 | $6,107–$7,185 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 8 matching MRF lines |
$2,458–$3,204 | $6,145–$8,010 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 10 matching MRF lines |
$4,938.40–$6,507.60 | $12,346–$16,269 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 8 matching MRF lines |
$2,458–$3,116.80 | $6,145–$7,792 | varies |
| MRI bone marrow blood supply (77084) | $2,450 | $6,125 | 8.7× |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$2,586–$3,370.40 | $6,465–$8,426 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$4,440–$5,053.60 | $11,100–$12,634 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines |
$3,164.40–$4,322 | $7,911–$10,805 | varies |
| MRI cardiac w/o contrast (75557) range across 4 matching MRF lines |
$2,167.20–$2,354 | $5,418–$5,885 | varies |
| MRI cervical spine w contrast (72142) range across 6 matching MRF lines |
$1,779.20–$3,342.40 | $4,448–$8,356 | varies |
| MRI cervical spine w/o cont (72141) range across 5 matching MRF lines |
$2,797.20–$3,038.80 | $6,993–$7,597 | varies |
| MRI chest w/o contrast (71550) range across 7 matching MRF lines |
$2,597.20–$2,821.20 | $6,493–$7,053 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$2,796.80–$2,929.60 | $6,992–$7,324 | varies |
| MRI chest wo w contrast (71552) range across 4 matching MRF lines |
$5,318–$5,776.80 | $13,295–$14,442 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 10 matching MRF lines |
$2,796.80–$3,544.80 | $6,992–$8,862 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 11 matching MRF lines |
$2,743.60–$3,902.40 | $6,859–$9,756 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 16 matching MRF lines |
$2,450–$3,484.40 | $6,125–$8,711 | varies |
| MRI lumbar spine w contrast (72149) range across 7 matching MRF lines |
$2,796.80–$3,646 | $6,992–$9,115 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$949.20–$6,051.20 | $2,373–$15,128 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 8 matching MRF lines |
$2,572.80–$3,513.20 | $6,432–$8,783 | varies |
| MRI orbit face neck w contrast (70542) range across 7 matching MRF lines |
$2,487.20–$3,626 | $6,218–$9,065 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 8 matching MRF lines |
$2,675.60–$3,956 | $6,689–$9,890 | varies |
| MRI pelvis w contrast (72196) range across 7 matching MRF lines |
$906–$2,642.80 | $2,265–$6,607 | varies |
| MRI pelvis w/o & w contrast (72197) range across 7 matching MRF lines |
$5,318–$5,776.80 | $13,295–$14,442 | varies |
| MRI pelvis w/o contrast (72195) range across 7 matching MRF lines |
$2,306.80–$2,714 | $5,767–$6,785 | varies |
| MRI spectroscopy (76390) range across 4 matching MRF lines |
$2,621.60–$2,847.20 | $6,554–$7,118 | varies |
| MRI thoracic spine w/o contrast (72146) range across 6 matching MRF lines |
$2,474–$2,844.80 | $6,185–$7,112 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 9 matching MRF lines |
$2,796.80–$3,544.80 | $6,992–$8,862 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 16 matching MRF lines |
$483.20–$3,220 | $1,208–$8,050 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 9 matching MRF lines |
$2,720.80–$3,105.60 | $6,802–$7,764 | varies |
| MRI, abdomen, combo (74183) range across 10 matching MRF lines |
$2,597.20–$5,019.60 | $6,493–$12,549 | varies |
| MRI, dorsal spine combo (72157) range across 6 matching MRF lines |
$5,318–$6,051.20 | $13,295–$15,128 | varies |
| MRI, dorsal spine contrast (72147) range across 7 matching MRF lines |
$2,964.80–$3,220.40 | $7,412–$8,051 | varies |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$2,415.20–$2,835.20 | $6,038–$7,088 | varies |
| MRI, joint upper extrem combo (73223) range across 11 matching MRF lines |
$3,270–$5,921.20 | $8,175–$14,803 | varies |
| MRI, lumbar spine combo (72158) range across 6 matching MRF lines |
$5,318–$6,051.20 | $13,295–$15,128 | varies |
| Myelogram cervical (72240) range across 3 matching MRF lines |
$949.60–$1,429.60 | $2,374–$3,574 | varies |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$1,310–$2,142.40 | $3,275–$5,356 | varies |
| Myelography thoracic (72255) | $1,190.80 | $2,977 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $2,498.80 | $6,247 | 2.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $624.40 | $1,561 | 1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $8,134.40 | $20,336 | 5.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,321.60 | $5,804 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $4,205.20 | $10,513 | 2.7× |
| N-invas est c ffr sw aly CTA (75580) | $1,428 | $3,570 | 1.4× |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$225.20–$246.80 | $563–$617 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $484.80 | $1,212 | 1.1× |
| Nm csf leak detection (78650) | $1,097.20 | $2,743 | 0.7× |
| Nm myocard infarct spect (78469) | $888.40 | $2,221 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,313.60 | $23,284 | 5.7× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$622.80–$690.40 | $1,557–$1,726 | varies |
| Nuclear Rx Oral Admin (79005) | $2,181.60 | $5,454 | 7.9× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $282.40 | $706 | 2.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$208.40–$522.80 | $521–$1,307 | varies |
| Panoramic X-ray of jaws (70355) | $458 | $1,145 | 4.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,215.20 | $8,038 | 5.0× |
| Parathyroid Planar Imaging (78070) | $2,304.80 | $5,762 | 4.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,215.20 | $8,038 | 6.8× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$388.80–$393.20 | $972–$983 | varies |
| Peritoneogram Rs&I (74190) | $260.40 | $651 | 0.4× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$2,632.40–$3,158.80 | $6,581–$7,897 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$4,865.60–$5,285.20 | $12,164–$13,213 | varies |
| PET image w/CT, full body (78816) | $8,258.40 | $20,646 | 4.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,598 | $18,995 | 4.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,321.60 | $5,804 | 1.5× |
| PET whole body (78813) range across 2 matching MRF lines |
$2,632.40–$6,994 | $6,581–$17,485 | varies |
| Proton tx delivery simple w/o compensation (77520) | $785.60 | $1,964 | 1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,426 | $11,065 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,332–$1,446.80 | $3,330–$3,617 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 5 matching MRF lines |
$590.40–$648 | $1,476–$1,620 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$382–$640.80 | $955–$1,602 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 9 matching MRF lines |
$372–$489.20 | $930–$1,223 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 17 matching MRF lines |
$309.20–$474 | $773–$1,185 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$336.80–$444.40 | $842–$1,111 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$547.20–$600 | $1,368–$1,500 | varies |
| Radex fingr minimum 2 views (73140) range across 45 matching MRF lines |
$202.80–$430.40 | $507–$1,076 | varies |
| Radex foot complete minimum 3 views (73630) range across 9 matching MRF lines |
$403.20–$502 | $1,008–$1,255 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$307.60–$383.20 | $769–$958 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 9 matching MRF lines |
$233.60–$391.20 | $584–$978 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $429.60 | $1,074 | 3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 6 matching MRF lines |
$320.80–$417.60 | $802–$1,044 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $211.20 | $528 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$408–$412.40 | $1,020–$1,031 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$459.20–$606 | $1,148–$1,515 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$184–$202 | $460–$505 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $260.40 | $651 | 1.3× |
| Radex Spine 1 View Specify Level (72020) range across 7 matching MRF lines |
$353.60–$387.60 | $884–$969 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 5 matching MRF lines |
$275.20–$301.60 | $688–$754 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 5 matching MRF lines |
$475.60–$620.80 | $1,189–$1,552 | varies |
| Radex Toe Minimum 2 Views (73660) range across 47 matching MRF lines |
$190.40–$380.80 | $476–$952 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 8 matching MRF lines |
$256.40–$342 | $641–$855 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$336.80–$436 | $842–$1,090 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$692–$759.60 | $1,730–$1,899 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $19,176 | $47,940 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $944 | $2,360 | 7.8× |
| Radiation treatment delivery level 2 (77407) | $985.60 | $2,464 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $1,358 | $3,395 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 4 matching MRF lines |
$504–$656.80 | $1,260–$1,642 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 4 matching MRF lines |
$331.60–$406.40 | $829–$1,016 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$792.80–$861.60 | $1,982–$2,154 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$407.60–$457.20 | $1,019–$1,143 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $422.80 | $1,057 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 9 matching MRF lines |
$470.40–$574.80 | $1,176–$1,437 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$449.20–$454 | $1,123–$1,135 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$312.80–$407.20 | $782–$1,018 | varies |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$504.40–$593.20 | $1,261–$1,483 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 15 matching MRF lines |
$1,048–$1,417.20 | $2,620–$3,543 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 9 matching MRF lines |
$388.80–$466 | $972–$1,165 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$378.40–$475.60 | $946–$1,189 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$438.40–$480.80 | $1,096–$1,202 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 17 matching MRF lines |
$334.40–$507.20 | $836–$1,268 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $3,233.60 | $8,084 | 11.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $526 | $1,315 | 1.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $526 | $1,315 | 1.2× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$680.80–$893.20 | $1,702–$2,233 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$470–$516 | $1,175–$1,290 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $600.40 | $1,501 | 1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $778 | $1,945 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,616 | $4,040 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,616 | $4,040 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 7 matching MRF lines |
$1,179.60–$2,116 | $2,949–$5,290 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,067.60 | $2,669 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,067.60 | $2,669 | 0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,175.60 | $2,939 | 0.8× |
| Rp Therapy Intravenous Administration (79101) | $629.20 | $1,573 | 2.3× |
| Scapula (73010) range across 9 matching MRF lines |
$246.40–$322.40 | $616–$806 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
$44–$69.60 | $110–$174 | varies |
| Sella turcica (70240) | $168 | $420 | 1.6× |
| Shoulder 1 view (73020) range across 8 matching MRF lines |
$143.60–$176 | $359–$440 | varies |
| Shoulder Arthrography (73040) range across 8 matching MRF lines |
$734.40–$1,442 | $1,836–$3,605 | varies |
| Sialogram (70390) | $376.40 | $941 | 1.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$445.60–$450 | $1,114–$1,125 | varies |
| Special dosimetry (77331) | $1,176 | $2,940 | 7.4× |
| Special Physics Consult (77370) range across 4 matching MRF lines |
$382–$963.20 | $955–$2,408 | varies |
| Special teletherapy port plan (77321) | $3,291.60 | $8,229 | 7.4× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,177.60–$2,976 | $2,944–$7,440 | varies |
| Speech evaluation, complex (70371) | $850.80 | $2,127 | 3.0× |
| Stereotactic Body Radiation Delivery (77373) | $6,544.40 | $16,361 | 3.1× |
| Sternoclavicular joints (71130) range across 7 matching MRF lines |
$159.20–$174.40 | $398–$436 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$1,997.20–$2,171.60 | $4,993–$5,429 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $174.40 | $436 | 1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,429.20 | $3,573 | 3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $510.80 | $1,277 | 1.2× |
| Testicular Imaging W/Flow (78761) | $900.80 | $2,252 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$601.20–$2,630 | $1,503–$6,575 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$601.20–$2,307.20 | $1,503–$5,768 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 4 matching MRF lines |
$232–$1,637.60 | $580–$4,094 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$451.60–$456.80 | $1,129–$1,142 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$313.20–$343.60 | $783–$859 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$187.60–$205.20 | $469–$513 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $788.40 | $1,971 | 1.7× |
| Thyroid Met Imaging Body (78018) | $2,147.60 | $5,369 | 3.3× |
| Thyroid Uptake Measurement (78012) range across 3 matching MRF lines |
$172.80–$705.20 | $432–$1,763 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$516.40–$843.20 | $1,291–$2,108 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$669.20–$1,497.20 | $1,673–$3,743 | varies |
| Tx devices design & construction intermediate (77333) | $616.40 | $1,541 | 3.9× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$246–$437.20 | $615–$1,093 | varies |
| Ultrasound Breast Limited (76642) range across 8 matching MRF lines |
$148.80–$1,075.20 | $372–$2,688 | varies |
| Ultrasound elastography first target lesion (76982) | $211.60 | $529 | 1.7× |
| Ultrasound Elastography Parenchyma (76981) | $272.40 | $681 | 2.2× |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$193.60–$256.80 | $484–$642 | varies |
| Ultrasound, abdomen limited (76705) range across 15 matching MRF lines |
$281.60–$695.60 | $704–$1,739 | varies |
| Umbilical-artery Doppler (OB) (76820) | $547.60 | $1,369 | 4.4× |
| Unlis px ther radiol clinical tx planning (77299) | $2,425.20 | $6,063 | 15.3× |
| Unlisted Dx Radiographic Procedure (76499) | $132.40 | $331 | 1.3× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$2,237.60–$2,344 | $5,594–$5,860 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $229.20 | $573 | 1.9× |
| Upper gi w/o kub (74240) range across 16 matching MRF lines |
$1,048–$1,138.40 | $2,620–$2,846 | varies |
| Ureteral Reflux Study (78740) | $1,422.80 | $3,557 | 3.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$378.80–$494.40 | $947–$1,236 | varies |
| Urethrocystography retrograde (74450) range across 4 matching MRF lines |
$384–$501.60 | $960–$1,254 | varies |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$629.60–$1,075.20 | $1,574–$2,688 | varies |
| Us chest (76604) range across 6 matching MRF lines |
$1,019.20–$1,211.20 | $2,548–$3,028 | varies |
| Us complete joint (76881) range across 8 matching MRF lines |
$766.40–$780.40 | $1,916–$1,951 | varies |
| Us exam, pelvic, limited (76857) range across 9 matching MRF lines |
$80.02–$605.20 | $200.05–$1,513 | varies |
| Us head (76506) range across 5 matching MRF lines |
$884–$1,151.60 | $2,210–$2,879 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$1,761.20–$1,780 | $4,403–$4,450 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 10 matching MRF lines |
$165.20–$245.20 | $413–$613 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$910.80–$920.40 | $2,277–$2,301 | varies |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$599.60–$628.40 | $1,499–$1,571 | varies |
| Us ob transvaginal (76817) range across 5 matching MRF lines |
$672–$678.80 | $1,680–$1,697 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$510–$1,483.60 | $1,275–$3,709 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$910.80–$920.40 | $2,277–$2,301 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$376.40–$412.80 | $941–$1,032 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,078.80–$1,184.40 | $2,697–$2,961 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$444.40–$1,082 | $1,111–$2,705 | varies |
| Us scrotum and contents (76870) range across 5 matching MRF lines |
$620–$735.60 | $1,550–$1,839 | varies |
| Us spinal canal and contents (76800) | $444.40 | $1,111 | 3.6× |
| Us thyroid (76536) range across 10 matching MRF lines |
$80.02–$1,000 | $200.05–$2,500 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$883.60–$925.20 | $2,209–$2,313 | varies |
| Vascular Flow Imaging (78445) | $408 | $1,020 | 0.9× |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,975.20–$3,137.20 | $4,938–$7,843 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,492 | $3,730 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$2,606–$4,641.20 | $6,515–$11,603 | varies |
| Venogram Sinus/Jugular (75860) range across 5 matching MRF lines |
$2,269.60–$5,164 | $5,674–$12,910 | varies |
| Venography Adrenal Unilateral (75840) | $2,428.80 | $6,072 | 0.7× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$1,975.20–$3,688.40 | $4,938–$9,221 | varies |
| Venography extremity bilateral rs&i (75822) range across 5 matching MRF lines |
$821.20–$2,171.60 | $2,053–$5,429 | varies |
| Venography extremity unilateral rs&i (75820) range across 12 matching MRF lines |
$598–$1,113.20 | $1,495–$2,783 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$2,269.60–$3,688.40 | $5,674–$9,221 | varies |
| Venography Renal Unilateral (75831) range across 3 matching MRF lines |
$2,406.80–$3,137.20 | $6,017–$7,843 | varies |
| Venous sampling by catheter (75893) | $6,117.20 | $15,293 | 0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,065.20 | $2,663 | 2.3× |
| Vertebral fracture assessment via dxa (77086) range across 3 matching MRF lines |
$133.20–$170 | $333–$425 | varies |
| Wrist 2 views (73100) range across 13 matching MRF lines |
$284.80–$406.40 | $712–$1,016 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 6 matching MRF lines |
$268.80–$295.20 | $672–$738 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$690–$1,643.60 | $1,725–$4,109 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$3,128–$3,326.80 | $7,820–$8,317 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$328.80–$333.20 | $822–$833 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 15 matching MRF lines |
$290.80–$410 | $727–$1,025 | varies |
| X-Ray Exam Breast Specimen (76098) range across 6 matching MRF lines |
$130.40–$611.60 | $326–$1,529 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$269.60–$275.20 | $674–$688 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 6 matching MRF lines |
$439.20–$482.40 | $1,098–$1,206 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$166.40–$168.80 | $416–$422 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 8 matching MRF lines |
$394.80–$439.20 | $987–$1,098 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$160–$176 | $400–$440 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$232–$449.20 | $580–$1,123 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $439.20 | $1,098 | 3.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$330.80–$363.20 | $827–$908 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$400.80–$439.60 | $1,002–$1,099 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$588.40–$706 | $1,471–$1,765 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$202–$224.40 | $505–$561 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$118.80–$143.20 | $297–$358 | varies |
| X-ray humerus (73060) range across 11 matching MRF lines |
$357.20–$436 | $893–$1,090 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 5 matching MRF lines |
$530.80–$682.80 | $1,327–$1,707 | varies |
| X-ray IV pyelogram+tomography (74415) | $942 | $2,355 | 4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$146–$160.80 | $365–$402 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$313.60–$316.40 | $784–$791 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$609.60–$615.60 | $1,524–$1,539 | varies |
| X-ray nose-rectum child f.b. (76010) | $422 | $1,055 | 4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$595.60–$601.60 | $1,489–$1,504 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$222.80–$244.80 | $557–$612 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$168.80–$202.40 | $422–$506 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 5 matching MRF lines |
$378.80–$416 | $947–$1,040 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 4 matching MRF lines |
$541.20–$706 | $1,353–$1,765 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$541.20–$594 | $1,353–$1,485 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$256.40–$281.60 | $641–$704 | varies |
| X-Ray Tmj Unilat (70328) range across 5 matching MRF lines |
$417.60–$544.80 | $1,044–$1,362 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$560–$1,118.40 | $1,400–$2,796 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$446.80–$490 | $1,117–$1,225 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$1,903.20–$2,089.60 | $4,758–$5,224 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$561.20–$567.20 | $1,403–$1,418 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$199.60–$239.60 | $499–$599 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $174 | $435 | 1.4× |
| Xr orbits complete 4 views (70200) range across 5 matching MRF lines |
$510.80–$666.40 | $1,277–$1,666 | varies |
| Xr Tomogram Single Plane (76100) | $489.60 | $1,224 | 4.0× |
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.