Imaging prices at Halifax Health | UF Health Medical Center of Deltona
Deltona, FL · every code in this section with a posted price and a Medicare benchmark.
420 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$2,756–$8,180 | $3,445–$10,225 | varies |
| Abdomen 1 View (74018) | $556 | $695 | 6.1× |
| Abdomen 2 views (74019) | $788 | $985 | 7.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,288 | $1,610 | 3.1× |
| Angio internal mammary (75756) | $1,460 | $1,825 | 0.4× |
| Angio pulmonary bilat (75743) | $3,096 | $3,870 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,312 | $2,890 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $4,284 | $5,355 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $5,380 | $6,725 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,336 | $2,920 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,368 | $2,960 | 0.7× |
| Ankle 2 views (73600) | $528 | $660 | 5.8× |
| Aortography thoracic serialography rs&i (75605) | $4,592 | $5,740 | 0.8× |
| Artery X-Rays Abdomen (75726) | $3,852 | $4,815 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $1,860 | $2,325 | 0.6× |
| Artery X-Rays Pelvis (75736) | $5,620 | $7,025 | 1.0× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,192 | $2,740 | 0.4× |
| Arthrogram ankle (73615) | $760 | $950 | 2.1× |
| Arthrogram hip (73525) | $596 | $745 | 1.6× |
| Arthrogram Wrist (73115) | $668 | $835 | 1.8× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$584–$704 | $730–$880 | varies |
| Bone age studies (77072) | $236.80 | $296 | 2.2× |
| Bone Imaging 3 Phase (78315) | $2,080 | $2,600 | 5.0× |
| Bone Imaging Limited Area (78300) | $1,072 | $1,340 | 2.6× |
| Bone Imaging Whole Body (78306) | $3,612 | $4,515 | 8.7× |
| Bone marrow imaging limited area (78102) | $904 | $1,130 | 2.2× |
| Bone marrow imaging; multiple areas (78103) | $968 | $1,210 | 2.3× |
| Bone marrow imaging; whole body (78104) | $968 | $1,210 | 2.3× |
| Bone survey infant (77076) | $315.20 | $394 | 2.9× |
| Brachytx isodose complex (77318) | $2,176 | $2,720 | 5.6× |
| Brachytx isodose intermed (77317) | $880 | $1,100 | 2.3× |
| Brachytx Isodose Plan Simple (77316) | $556 | $695 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,380 | $1,725 | 2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,332 | $7,915 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,524 | $4,405 | 9.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,480 | $3,100 | 3.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,172 | $1,465 | 2.1× |
| Cerebrospinal Fluid Scan (78630) | $1,984 | $2,480 | 3.5× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$79.20–$540 | $99–$675 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$83.20–$784 | $104–$980 | varies |
| Chest 3 views (71047) | $335.20 | $419 | 3.7× |
| Chest 4 or more views (71048) | $336.80 | $421 | 3.1× |
| Cholecystography Oral Contrast (74290) | $340 | $425 | 1.9× |
| Clavicle complete (73000) | $544 | $680 | 6.0× |
| Continuing medical physics consltj pr wk (77336) | $992 | $1,240 | 7.1× |
| Contrast Exam Abdominl Aorta (75625) | $4,584 | $5,730 | 1.4× |
| Contrast X-Ray Bladder (74430) | $448 | $560 | 1.2× |
| Contrast X-Ray Of Elbow (73085) | $984 | $1,230 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $592 | $740 | 1.6× |
| Corpora cavernosography (74445) | $373.60 | $467 | 3.4× |
| CT abdomen and pelvis without and with contrast (74178) | $8,156 | $10,195 | 22.4× |
| CT abdomen and pelvis without contrast (74176) | $6,120 | $7,650 | 24.6× |
| CT abdomen w contrast (74160) | $3,984 | $4,980 | 21.8× |
| CT abdomen w wo contrast (74170) | $3,592 | $4,490 | 19.6× |
| CT abdomen w/o contrast (74150) | $2,600 | $3,250 | 23.8× |
| CT Angio Abdomen and Pelvis (74174) | $7,212 | $9,015 | 19.8× |
| CT Angio Chest (71275) | $4,600 | $5,750 | 25.1× |
| CT Angio Head (70496) | $4,480 | $5,600 | 24.5× |
| CT angio hrt w/3d image (75574) | $1,712 | $2,140 | 4.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,340 | $2,925 | 12.8× |
| CT Angio Neck (70498) | $4,112 | $5,140 | 22.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,296 | $5,370 | 23.5× |
| CT cervical spine w/ contrast (72126) | $3,784 | $4,730 | 10.4× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$3,940–$4,024 | $4,925–$5,030 | varies |
| CT cervical spine w/wo cont (72127) | $2,856 | $3,570 | 15.6× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$4,088–$4,392 | $5,110–$5,490 | varies |
| CT chest w/wo contrast (71270) | $2,544 | $3,180 | 13.9× |
| CT colonography screening (74263) | $2,820 | $3,525 | 11.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,396 | $2,995 | 13.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,396 | $2,995 | 21.9× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$3,048–$3,049.60 | $3,810–$3,812 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$3,952–$4,248 | $4,940–$5,310 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,856 | $2,320 | 5.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $752 | $940 | 8.3× |
| CT hrt w/3d image congen (75573) | $1,044 | $1,305 | 2.9× |
| CT iac w contrast (70481) | $1,980 | $2,475 | 10.8× |
| CT l-spine w&w/o contrast (72133) | $2,720 | $3,400 | 14.8× |
| CT lower ext w/o (73700) range across 22 matching MRF lines |
$748–$2,528 | $935–$3,160 | varies |
| CT lower extremity w/contrast material (73701) | $2,640 | $3,300 | 14.4× |
| CT lumbar spine w contrast (72132) | $3,308 | $4,135 | 9.1× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$3,628–$3,896 | $4,535–$4,870 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$960–$3,292 | $1,200–$4,115 | varies |
| CT maxillofacial wo contrast (70486) range across 11 matching MRF lines |
$704–$2,924 | $880–$3,655 | varies |
| CT neck tissue combo (70492) | $2,952 | $3,690 | 16.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,164 | $1,455 | 6.4× |
| CT orbits w/o contrast (70480) | $2,068 | $2,585 | 18.9× |
| CT pelvis w&w/o contrast (72194) | $4,284 | $5,355 | 23.4× |
| CT pelvis w/o contrast (72192) | $3,512 | $4,390 | 32.2× |
| CT scan of leg combo (73702) | $2,816 | $3,520 | 15.4× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$1,124–$2,616 | $1,405–$3,270 | varies |
| CT soft tissue neck w contrast (70491) | $2,892 | $3,615 | 15.8× |
| CT soft tissue neck w/o contrast (70490) | $2,996 | $3,745 | 27.4× |
| CT thoracic spine w contrast (72129) | $3,188 | $3,985 | 17.4× |
| CT thoracic spine w/o contrast (72128) | $3,952 | $4,940 | 36.2× |
| CT thoracic spine w/wo cont (72130) | $2,556 | $3,195 | 14.0× |
| CT thorax w/o contrast (71250) | $3,060 | $3,825 | 28.0× |
| CT unlisted procedure (76497) | $668 | $835 | 7.4× |
| CT upper ext wo (73200) | $2,324 | $2,905 | 21.3× |
| CT upper extremity w/o & w/contrast material (73202) | $2,912 | $3,640 | 15.9× |
| CT upper extremity with contrast (73201) | $2,284 | $2,855 | 6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,720 | $5,900 | 25.8× |
| Cta Abdomen (74175) | $4,620 | $5,775 | 25.2× |
| CTA pelvis (72191) | $1,576 | $1,970 | 8.6× |
| Dilation ureters/urethra rs&i (74485) | $1,172 | $1,465 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $2,864 | $3,580 | 1.4× |
| Diskography lumbar (72295) | $2,100 | $2,625 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $244 | $305 | 2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $844 | $1,055 | 7.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $732 | $915 | 6.7× |
| Echo exam of fetal heart (76825) | $1,624 | $2,030 | 2.8× |
| Echo Guide For Artery Repair (76936) | $780 | $975 | 3.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $584 | $730 | 2.3× |
| Echograp Trans R Pros Study (76873) | $388.80 | $486 | 3.6× |
| Esophageal Motility Study (78258) | $1,056 | $1,320 | 2.5× |
| Esophagram (74220) | $840 | $1,050 | 4.6× |
| Fetal Biophys Profile W/Nst (76818) | $1,276 | $1,595 | 11.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $744 | $930 | 6.8× |
| Fluoroscopy up to 1 hr (76000) range across 10 matching MRF lines |
$329.60–$844 | $412–$1,055 | varies |
| Follow-Up Angiography (75898) | $1,136 | $1,420 | 0.3× |
| Foot 2 views (73620) | $500 | $625 | 5.5× |
| Forearm 2 views (73090) | $536 | $670 | 5.9× |
| Gastric emptying imaging study (78264) | $3,252 | $4,065 | 7.8× |
| Gastroesophageal Reflux Exam (78262) | $732 | $915 | 1.8× |
| Gated Heart Planar Single (78472) | $1,896 | $2,370 | 4.5× |
| Gated Heart, Multiple (78473) | $1,320 | $1,650 | 3.2× |
| Hand 2 views (73120) | $528 | $660 | 4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,852 | $4,815 | 5.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,056 | $6,320 | 7.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,000 | $6,250 | 6.9× |
| Heart first pass single,planar (78481) | $1,296 | $1,620 | 2.3× |
| Heart Image (Pet) Multiple (78492) | $4,736 | $5,920 | 3.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,244 | $6,555 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,988 | $2,485 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $3,364 | $4,205 | 5.9× |
| Hepatobiliary System Imaging (78226) | $2,144 | $2,680 | 5.1× |
| Ht Musc Image Planar Mult (78454) | $3,144 | $3,930 | 2.3× |
| Ht Muscle Image Spect Sing (78451) | $3,912 | $4,890 | 2.9× |
| Hysterosalpingogram (74740) | $1,600 | $2,000 | 6.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $440 | $550 | 4.8× |
| Infusion Ivp (74410) | $868 | $1,085 | 4.7× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,564–$3,528 | $1,955–$4,410 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $1,564 | $1,955 | 2.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,312 | $1,640 | 2.3× |
| Intracavitary radiation source applic simple (77761) | $1,392 | $1,740 | 2.4× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) likely a partial charge, not the full procedure |
$544 | $680 | 0.1× |
| Intraop radiaj tx deliver xray single tx session (77424) | $7,140 | $8,925 | 0.9× |
| Joint Survey Single View (77077) | $123.20 | $154 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $1,488 | $1,860 | 2.6× |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$1,532–$2,320 | $1,915–$2,900 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,296–$2,012 | $1,620–$2,515 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $748 | $935 | 1.8× |
| Kidney Imaging Morphol (78700) | $968 | $1,210 | 2.3× |
| Knee 3 Views (73562) | $628 | $785 | 6.9× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $968 | $1,210 | 2.3× |
| Leveen/Shunt Patency Exam (78291) | $1,292 | $1,615 | 3.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,184 | $1,480 | 2.8× |
| Liver imaging static only (78201) | $1,296 | $1,620 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $2,240 | $2,800 | 4.0× |
| Lung perfusion differential (78597) | $1,128 | $1,410 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $3,240 | $4,050 | 5.7× |
| Lung Ventilation Imaging (78579) | $968 | $1,210 | 2.3× |
| Lymph System Imaging (78195) | $3,156 | $3,945 | 5.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $936 | $1,170 | 0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,320 | $1,650 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $1,440 | $1,800 | 5.8× |
| Meckels Divert Exam (78290) | $1,324 | $1,655 | 3.2× |
| Mlc imrt design & construction per imrt plan (77338) | $1,848 | $2,310 | 4.7× |
| Mra Head W/O & W/Contrast Material (70546) | $4,000 | $5,000 | 11.0× |
| MRA head w/o contrast (70544) | $3,188 | $3,985 | 12.8× |
| MRA head with contrast (70545) | $3,628 | $4,535 | 10.0× |
| MRA neck w contrast (70548) | $2,580 | $3,225 | 7.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,560 | $6,950 | 15.3× |
| MRA neck w/o contrast (70547) | $3,356 | $4,195 | 13.5× |
| MRI abdomen w contrast (74182) | $2,992 | $3,740 | 8.2× |
| MRI abdomen w/o contrast (74181) | $3,844 | $4,805 | 15.4× |
| MRI any jt lower extrem w/contrast material (73722) | $3,784 | $4,730 | 4.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,652 | $5,815 | 12.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,420 | $4,275 | 4.2× |
| MRI bone marrow blood supply (77084) | $1,764 | $2,205 | 7.1× |
| MRI cardiac w/o cont stress (75559) | $2,156 | $2,695 | 3.8× |
| MRI cardiac w/o contrast (75557) | $2,416 | $3,020 | 9.7× |
| MRI cervical spine w contrast (72142) | $3,988 | $4,985 | 10.9× |
| MRI cervical spine w/o cont (72141) | $4,444 | $5,555 | 17.8× |
| MRI chest w/o contrast (71550) | $1,836 | $2,295 | 7.4× |
| MRI chest with contrast (71551) | $2,200 | $2,750 | 2.7× |
| MRI chest wo w contrast (71552) | $2,932 | $3,665 | 8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,672 | $3,340 | 7.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,736 | $5,920 | 13.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,452 | $5,565 | 17.9× |
| MRI lumbar spine w contrast (72149) | $3,680 | $4,600 | 10.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,484 | $5,605 | 12.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,084 | $2,605 | 8.4× |
| MRI orbit face neck w contrast (70542) | $2,204 | $2,755 | 6.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,660 | $4,575 | 10.0× |
| MRI pelvis w contrast (72196) | $2,200 | $2,750 | 6.0× |
| MRI pelvis w/o & w contrast (72197) | $5,152 | $6,440 | 14.1× |
| MRI pelvis w/o contrast (72195) | $3,460 | $4,325 | 13.9× |
| MRI spectroscopy (76390) | $2,056 | $2,570 | 22.6× |
| MRI thoracic spine w/o contrast (72146) | $4,488 | $5,610 | 18.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,676 | $3,345 | 7.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,852 | $4,815 | 15.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,344 | $5,430 | 11.9× |
| MRI, abdomen, combo (74183) | $4,340 | $5,425 | 11.9× |
| MRI, dorsal spine combo (72157) | $5,488 | $6,860 | 15.1× |
| MRI, dorsal spine contrast (72147) | $4,160 | $5,200 | 11.4× |
| MRI, joint upper extrem (73221) | $3,984 | $4,980 | 16.0× |
| MRI, joint upper extrem combo (73223) | $4,500 | $5,625 | 12.4× |
| MRI, lumbar spine combo (72158) | $6,140 | $7,675 | 16.9× |
| Musculoskeletal Nuclear Exam (78399) | $1,652 | $2,065 | 4.0× |
| Myelogram cervical (72240) | $1,692 | $2,115 | 2.1× |
| Myelogram Lumbar (72265) | $1,692 | $2,115 | 2.1× |
| Myelography thoracic (72255) | $1,576 | $1,970 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $1,924 | $2,405 | 2.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $832 | $1,040 | 2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,696 | $5,870 | 3.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,848 | $2,310 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $7,400 | $9,250 | 5.5× |
| Neck soft tissue (70360) | $468 | $585 | 5.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $399.20 | $499 | 1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $552 | $690 | 1.3× |
| Nm csf leak detection (78650) | $1,936 | $2,420 | 1.4× |
| Nm myocard infarct spect (78469) | $1,320 | $1,650 | 2.3× |
| Nm red cell survival study (78130) | $948 | $1,185 | 2.3× |
| Nm whole blood volume (78122) | $1,296 | $1,620 | 2.3× |
| Nonvascular Shunt X-Ray (75809) | $375.20 | $469 | 3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $14,120 | $17,650 | 9.8× |
| Nuclear medicine study of endocrine organs (78099) | $968 | $1,210 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$540–$944 | $675–$1,180 | varies |
| Nuclear Rx Oral Admin (79005) | $2,500 | $3,125 | 10.3× |
| Ob us nuchal meas 1 gest (76813) | $776 | $970 | 7.1× |
| Optic foramina (70190) | $197.60 | $247 | 2.2× |
| Panoramic X-ray of jaws (70355) | $212 | $265 | 2.3× |
| Parathyroid Planar Imaging (78070) | $1,044 | $1,305 | 2.5× |
| Pelvis 1 or 2 views (72170) | $620 | $775 | 5.7× |
| Peritoneogram Rs&I (74190) | $560 | $700 | 1.0× |
| Pet Image Skull-Thigh (78812) | $6,920 | $8,650 | 4.6× |
| Pet Image W/Ct Lmtd (78814) | $6,888 | $8,610 | 4.6× |
| PET image w/CT, full body (78816) | $7,224 | $9,030 | 4.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,516 | $8,145 | 4.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $6,332 | $7,915 | 4.7× |
| Pet Myocardial Sngl Study (78491) | $4,448 | $5,560 | 3.0× |
| PET whole body (78813) | $5,740 | $7,175 | 3.8× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $1,172 | $1,465 | 0.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,072 | $3,840 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,032 | $2,540 | 4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 5 matching MRF lines |
$444–$732 | $555–$915 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $644 | $805 | 7.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $416 | $520 | 4.6× |
| Radex elbow complete minimum 3 views (73080) | $576 | $720 | 6.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $480 | $600 | 4.4× |
| Radex fingr minimum 2 views (73140) | $373.60 | $467 | 4.1× |
| Radex foot complete minimum 3 views (73630) | $564 | $705 | 6.2× |
| Radex Hand Minimum 3 Views (73130) | $596 | $745 | 6.6× |
| Radex lower extremity infant minimum 2 views (73592) | $247.20 | $309 | 2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $440 | $550 | 4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $756 | $945 | 8.3× |
| Radex Ribs Unilateral 2 Views (71100) | $648 | $810 | 7.1× |
| Radex shoulder complete minimum 2 views (73030) | $600 | $750 | 6.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $216 | $270 | 2.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $692 | $865 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $472 | $590 | 5.2× |
| Radex Sternum Minimum 2 Views (71120) | $396 | $495 | 4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $328 | $410 | 3.6× |
| Radex Toe Minimum 2 Views (73660) | $360 | $450 | 4.0× |
| Radex upper extremity infant minimum 2 views (73092) | $214.40 | $268 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $572 | $715 | 6.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $8,336 | $10,420 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $301.60 | $377 | 2.8× |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$464–$524 | $580–$655 | varies |
| Radiation treatment delivery level 3 (77412) | $1,160 | $1,450 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $588 | $735 | 5.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $436 | $545 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $964 | $1,205 | 5.3× |
| Radiologic exam colon single contrast study (74270) | $1,184 | $1,480 | 6.5× |
| Radiologic exam knee complete 4/more views (73564) | $672 | $840 | 6.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $688 | $860 | 6.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,172 | $1,465 | 6.4× |
| Radiologic exam swallow function contrast study (74230) | $1,032 | $1,290 | 5.6× |
| Radiologic exam teeth complete full mouth (70320) | $208.80 | $261 | 0.8× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $221.60 | $277 | 0.9× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$404–$1,268 | $505–$1,585 | varies |
| Radiologic examination femur 1 view (73551) | $352.80 | $441 | 3.9× |
| Radiologic examination femur minimum 2 views (73552) | $560 | $700 | 6.2× |
| Radiologic examination knee 1/2 views (73560) | $604 | $755 | 6.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $440 | $550 | 4.0× |
| Radiologic Examination Salivary Gland Calculus (70380) | $232 | $290 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $548 | $685 | 6.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $480 | $600 | 0.8× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $210.40 | $263 | 2.3× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $1,296 | $1,620 | 2.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,204 | $1,505 | 3.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $800 | $1,000 | 2.0× |
| Ribs bilateral 3 views (71110) | $404 | $505 | 3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$1,196–$6,352 | $1,495–$7,940 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 13 matching MRF lines |
$3,452–$8,924 | $4,315–$11,155 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 15 matching MRF lines |
$2,444–$9,688 | $3,055–$12,110 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 18 matching MRF lines |
$1,380–$4,044 | $1,725–$5,055 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,144 | $3,930 | 2.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,360 | $1,700 | 5.6× |
| Rp Therapy Intravenous Administration (79101) | $760 | $950 | 3.1× |
| Scapula (73010) | $556 | $695 | 5.1× |
| Sella turcica (70240) | $186.40 | $233 | 2.1× |
| Shoulder 1 view (73020) | $588 | $735 | 6.5× |
| Shoulder Arthrography (73040) | $528 | $660 | 1.4× |
| Sialogram (70390) | $476 | $595 | 1.9× |
| Skull less than 4 views (70250) | $524 | $655 | 4.8× |
| Special dosimetry (77331) | $452 | $565 | 3.2× |
| Special Physics Consult (77370) | $1,036 | $1,295 | 7.4× |
| Special teletherapy port plan (77321) | $476 | $595 | 1.2× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,900–$2,192 | $2,375–$2,740 | varies |
| Spleen Imaging (78185) | $904 | $1,130 | 2.2× |
| Stereotactic Body Radiation Delivery (77373) | $13,604 | $17,005 | 7.3× |
| Sternoclavicular joints (71130) | $224.80 | $281 | 2.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $272 | $340 | 2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,352 | $4,190 | 8.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $656 | $820 | 1.7× |
| Temporomandble Jt Arthrography Rs&I (70332) | $408 | $510 | 1.6× |
| Testicular Imaging W/Flow (78761) | $968 | $1,210 | 2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,144 | $3,930 | 8.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $952 | $1,190 | 2.4× |
| Ther rad simulaj-aided field setting simple (77280) | $1,620 | $2,025 | 11.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $700 | $875 | 3.8× |
| Thoracic spine 2 views (72070) | $576 | $720 | 5.3× |
| Thoracic spine 3 views (72072) | $668 | $835 | 6.1× |
| Thyroid Met Imaging Body (78018) | $1,684 | $2,105 | 3.0× |
| Thyroid Uptake Measurement (78012) range across 5 matching MRF lines |
$524–$1,400 | $655–$1,750 | varies |
| Tx Devices Design & Construction Complex (77334) | $2,084 | $2,605 | 5.3× |
| Tx devices design & construction intermediate (77333) | $552 | $690 | 3.9× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$612–$712 | $765–$890 | varies |
| Ultrasound Breast Limited (76642) | $369.60 | $462 | 4.1× |
| Ultrasound, abdomen limited (76705) | $1,392 | $1,740 | 12.8× |
| Umbilical-artery Doppler (OB) (76820) | $476 | $595 | 4.4× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$250.40–$289.60 | $313–$362 | varies |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$315.20–$444 | $394–$555 | varies |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$1,800–$4,044 | $2,250–$5,055 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,284 | $1,605 | 3.1× |
| Unlisted us procedure (76999) | $920 | $1,150 | 10.1× |
| Upper gi w/o kub (74240) | $1,088 | $1,360 | 5.9× |
| Ureteral Reflux Study (78740) | $1,132 | $1,415 | 2.7× |
| Urethrocystogram voiding (74455) | $376.80 | $471 | 1.5× |
| Urethrocystography retrograde (74450) | $420 | $525 | 1.7× |
| Us breast unilateral complete (76641) | $371.20 | $464 | 3.4× |
| Us chest (76604) | $872 | $1,090 | 8.0× |
| Us complete joint (76881) | $568 | $710 | 5.2× |
| Us exam, pelvic, limited (76857) | $1,256 | $1,570 | 11.5× |
| Us head (76506) | $792 | $990 | 7.3× |
| Us kidney transplant (76776) | $996 | $1,245 | 9.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $732 | $915 | 6.7× |
| Us ob detailed single fetus (76811) | $1,184 | $1,480 | 4.8× |
| Us ob limited 1 or more fetuses (76815) | $752 | $940 | 6.9× |
| Us ob transvaginal (76817) | $852 | $1,065 | 7.8× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$1,460–$1,592 | $1,825–$1,990 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,340 | $1,675 | 12.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $640 | $800 | 5.9× |
| Us retroperitoneal complete (76770) | $1,124 | $1,405 | 10.3× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$89.60–$1,080 | $112–$1,350 | varies |
| Us scrotum and contents (76870) | $1,156 | $1,445 | 10.6× |
| Us spinal canal and contents (76800) | $716 | $895 | 6.6× |
| Us thyroid (76536) | $1,064 | $1,330 | 9.7× |
| Us transrectal (76872) | $432 | $540 | 4.0× |
| Vascular Flow Imaging (78445) | $1,232 | $1,540 | 3.0× |
| Vein X-Ray Chest (75827) | $1,836 | $2,295 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,028 | $2,535 | 0.6× |
| Vein X-Ray Skull Epidural (75872) | $1,280 | $1,600 | 2.0× |
| Vein X-Ray Spleen/Liver (75810) | $1,896 | $2,370 | 0.6× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,464–$1,856 | $1,830–$2,320 | varies |
| Venography Adrenal Unilateral (75840) | $3,032 | $3,790 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,268 | $2,835 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,708 | $2,135 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $2,164 | $2,705 | 1.3× |
| Venography Orbital Rs&I (75880) | $1,280 | $1,600 | 2.0× |
| Venography Renal Bilateral (75833) | $1,948 | $2,435 | 0.6× |
| Venography Renal Unilateral (75831) | $2,488 | $3,110 | 0.8× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,700 | $3,375 | 0.5× |
| Venous thrombosis imaging (78457) | $972 | $1,215 | 1.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $764 | $955 | 1.8× |
| Wrist 2 views (73100) | $532 | $665 | 5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $269.60 | $337 | 3.0× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$668–$932 | $835–$1,165 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,712 | $4,640 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $456 | $570 | 4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $488 | $610 | 5.4× |
| X-Ray Exam Breast Specimen (76098) | $356 | $445 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $364 | $455 | 4.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $309.60 | $387 | 2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $333.60 | $417 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $524 | $655 | 5.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $708 | $885 | 7.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $576 | $720 | 5.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $720 | $900 | 6.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $568 | $710 | 5.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $588 | $735 | 5.4× |
| X-Ray Exam L-S Spine Bending (72114) | $588 | $735 | 5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $668 | $835 | 7.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $616 | $770 | 5.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $740 | $925 | 6.8× |
| X-ray eye for foreign body (70030) | $400 | $500 | 4.4× |
| X-ray humerus (73060) | $532 | $665 | 5.9× |
| X-ray IV pyelogram+tomography (74415) | $1,100 | $1,375 | 6.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $440 | $550 | 4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $127.20 | $159 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $804 | $1,005 | 7.4× |
| X-ray nose-rectum child f.b. (76010) | $404 | $505 | 4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $492 | $615 | 4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $496 | $620 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $397.60 | $497 | 3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $632 | $790 | 7.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $280 | $350 | 3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $784 | $980 | 7.2× |
| X-Ray Stress View (77071) | $122.40 | $153 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $316 | $395 | 2.9× |
| X-Ray Tmj Unilat (70328) | $208.80 | $261 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,288 | $1,610 | 3.5× |
| X-Rays Bone Length Studies (77073) | $256.80 | $321 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $1,440 | $1,800 | 13.2× |
| Xr c-spine 4 or 5 views (72050) | $1,012 | $1,265 | 9.3× |
| Xr facial bones less than 3 views (70140) | $285.60 | $357 | 3.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $253.60 | $317 | 2.3× |
| Xr orbits complete 4 views (70200) | $377.60 | $472 | 3.5× |
| Xr Tomogram Single Plane (76100) | $326.40 | $408 | 3.0× |
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.