Imaging prices at Harborview Medical Center
Seattle, WA · every code in this section with a posted price and a Medicare benchmark.
449 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) | $9,897.56 | $14,139.37 | 6.2× |
| Abdomen 1 View (74018) | $387.78 | $553.97 | 3.8× |
| Abdomen 2 views (74019) | $472.40 | $674.85 | 3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,317.18 | $3,310.25 | 5.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,838.03 | $2,625.76 | 1.2× |
| Adrenal Cortex & Medulla Img (78075) | $3,484.19 | $4,977.42 | 2.3× |
| Angio internal mammary (75756) | $2,632.01 | $3,760.01 | 0.7× |
| Angio pulmonary bilat (75743) | $5,414.67 | $7,735.24 | 1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,104.24 | $5,863.20 | 1.1× |
| Angiography extremity bilateral rs&i (75716) | $11,023.36 | $15,747.65 | 3.0× |
| Angiography extremity unilateral rs&i (75710) | $7,520.06 | $10,742.94 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,342.79 | $7,632.56 | 1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,523.64 | $3,605.20 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$380.27–$570.40 | $543.24–$814.86 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,888.94 | $9,841.35 | 1.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,043.16 | $5,775.94 | 1.1× |
| Artery X-Rays Abdomen (75726) | $10,847.93 | $15,497.04 | 1.7× |
| Artery X-Rays Adrenal Gland (75731) | $3,881.32 | $5,544.75 | 1.1× |
| Artery X-Rays Pelvis (75736) | $7,531.52 | $10,759.32 | 1.2× |
| Artery X-Rays Spine (75705) | $11,931.56 | $17,045.08 | 1.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,607.53–$2,411.29 | $2,296.47–$3,444.70 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,092.55–$1,638.82 | $1,560.78–$2,341.17 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,335.30–$2,002.94 | $1,907.57–$2,861.35 | varies |
| Basic radiation dosimetry calculation (77300) | $628.08 | $897.26 | 4.0× |
| Bone age studies (77072) | $358.18 | $511.68 | 3.0× |
| Bone Imaging 3 Phase (78315) | $2,683.79 | $3,833.99 | 5.8× |
| Bone Imaging Limited Area (78300) | $1,798.74 | $2,569.63 | 3.9× |
| Bone Imaging Multiple Areas (78305) | $2,148.92 | $3,069.89 | 4.6× |
| Bone Imaging Whole Body (78306) | $2,343.13 | $3,347.33 | 5.1× |
| Bone marrow imaging limited area (78102) | $1,855.38 | $2,650.55 | 4.0× |
| Bone marrow imaging; whole body (78104) | $2,717.30 | $3,881.86 | 5.9× |
| Bone survey infant (77076) | $352.76 | $503.94 | 2.9× |
| Brachytx isodose complex (77318) | $1,973.48 | $2,819.26 | 4.6× |
| Brain Image W/Flow < 4 Views (78601) | $1,881.71 | $2,688.16 | 4.1× |
| Brain imaging < 4 static views (78600) | $1,587.70 | $2,268.15 | 3.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,943.63 | $4,205.18 | 4.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,895.65 | $4,136.64 | 4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,458.04 | $10,654.34 | 4.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,321.21 | $6,173.16 | 10.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,170.57 | $5,957.96 | 4.6× |
| Cardiac Shunt Detection (78428) | $1,343.78 | $1,919.68 | 2.9× |
| Cat Scan Follow-Up Study (76380) | $912.76 | $1,303.94 | 9.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,424.86 | $3,464.08 | 3.9× |
| Cerebrospinal Fluid Scan (78630) | $2,845.96 | $4,065.65 | 4.5× |
| Chest 1 view (71045) | $399.69 | $570.99 | 4.0× |
| Chest 2 views (71046) | $532.92 | $761.31 | 5.3× |
| Chest 3 views (71047) | $675.02 | $964.32 | 6.7× |
| Chest 4 or more views (71048) | $701.67 | $1,002.39 | 5.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $1,339.47 | $1,913.53 | 11.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $529.98 | $757.12 | 4.4× |
| Cisternography Positive Contrast Rs&I (70015) | $1,971.68 | $2,816.68 | 2.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$328.08–$492.11 | $468.68–$703.02 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $289.90 | $414.15 | 2.4× |
| Continuing medical physics consltj pr wk (77336) | $792.56 | $1,132.23 | 5.1× |
| Contrast Exam Abdominl Aorta (75625) | $8,226.64 | $11,752.34 | 2.2× |
| Contrast X-Ray Bladder (74430) | $843.24 | $1,204.63 | 2.1× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$666.75–$1,000.12 | $952.50–$1,428.75 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,839.26–$2,758.88 | $2,627.51–$3,941.26 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $482.66 | $689.52 | 2.4× |
| Corpora cavernosography (74445) | $875.01 | $1,250.01 | 7.2× |
| CT abdomen and pelvis without and with contrast (74178) | $4,069.40 | $5,813.43 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $2,567.81 | $3,668.30 | 9.3× |
| CT abdomen w contrast (74160) | $2,108.22 | $3,011.74 | 10.4× |
| CT abdomen w wo contrast (74170) | $2,395.32 | $3,421.89 | 11.8× |
| CT abdomen w/o contrast (74150) | $1,470.90 | $2,101.28 | 12.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,754.93 | $5,364.18 | 9.3× |
| CT Angio Chest (71275) | $3,095.34 | $4,421.92 | 15.2× |
| CT Angio Head (70496) | $3,455.97 | $4,937.10 | 17.0× |
| CT angio hrt w/3d image (75574) | $2,133.86 | $3,048.37 | 5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,732.18–$4,098.28 | $3,903.12–$5,854.68 | varies |
| CT Angio Neck (70498) | $3,429.09 | $4,898.70 | 16.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,100.28 | $3,000.40 | 10.3× |
| CT cervical spine w/ contrast (72126) | $2,478.41 | $3,540.59 | 6.1× |
| CT cervical spine w/o contrast (72125) | $1,944.50 | $2,777.86 | 16.1× |
| CT cervical spine w/wo cont (72127) | $3,078.25 | $4,397.50 | 15.2× |
| CT chest w contrast (71260) | $2,003.50 | $2,862.15 | 9.9× |
| CT chest w/wo contrast (71270) | $2,448.14 | $3,497.34 | 12.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,334.27 | $1,906.10 | 6.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,157.52 | $1,653.60 | 9.6× |
| CT head/brain with contrast (70460) | $1,470.64 | $2,100.92 | 7.2× |
| CT head/brain without and with contrast (70470) | $1,594 | $2,277.14 | 7.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,623.86 | $2,319.80 | 4.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $227.58 | $325.11 | 2.3× |
| CT hrt w/3d image congen (75573) | $1,723.18 | $2,461.68 | 4.3× |
| CT iac w contrast (70481) | $2,096.99 | $2,995.70 | 10.3× |
| CT l-spine w&w/o contrast (72133) | $2,655.34 | $3,793.34 | 13.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,637.11–$2,455.67 | $2,338.73–$3,508.10 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,721.92–$2,582.87 | $2,459.88–$3,689.82 | varies |
| CT lumbar spine w contrast (72132) | $2,152.82 | $3,075.45 | 5.3× |
| CT lumbar spine w/o contrast (72131) | $1,673.15 | $2,390.21 | 13.8× |
| CT maxillofacial w contrast (70487) | $1,835.43 | $2,622.04 | 9.0× |
| CT maxillofacial wo contrast (70486) | $1,597.81 | $2,282.58 | 13.2× |
| CT neck tissue combo (70492) | $2,526.17 | $3,608.81 | 12.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,312.06 | $3,302.94 | 11.4× |
| CT orbits w/o contrast (70480) | $1,711.65 | $2,445.21 | 14.1× |
| CT pelvis w&w/o contrast (72194) | $1,850.78 | $2,643.97 | 9.1× |
| CT pelvis w/o contrast (72192) | $1,405.13 | $2,007.33 | 11.6× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,188.64–$3,282.96 | $3,126.63–$4,689.94 | varies |
| CT scans face/jaw combo (70488) | $2,328.43 | $3,326.33 | 11.5× |
| CT soft tissue neck w contrast (70491) | $2,061.84 | $2,945.49 | 10.2× |
| CT soft tissue neck w/o contrast (70490) | $1,547.77 | $2,211.10 | 12.8× |
| CT thoracic spine w contrast (72129) | $2,148.48 | $3,069.26 | 10.6× |
| CT thoracic spine w/o contrast (72128) | $1,667.90 | $2,382.71 | 13.8× |
| CT thoracic spine w/wo cont (72130) | $2,646.02 | $3,780.03 | 13.0× |
| CT thorax w/o contrast (71250) | $1,465.74 | $2,093.92 | 12.1× |
| CT unlisted procedure (76497) range across 8 matching MRF lines |
$160.30–$6,546.77 | $229–$9,352.53 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,647.39–$2,471.08 | $2,353.41–$3,530.12 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,777.68–$4,166.51 | $3,968.11–$5,952.16 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,109.58–$3,164.36 | $3,013.68–$4,520.52 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,995.60 | $4,279.43 | 14.7× |
| Cta Abdomen (74175) | $3,118.56 | $4,455.08 | 15.4× |
| CTA pelvis (72191) | $2,398.66 | $3,426.66 | 11.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,241.11 | $1,773.01 | 4.5× |
| Dilation ureters/urethra rs&i (74485) | $4,119.60 | $5,885.14 | 1.7× |
| Discography Cerv/Thor Spine (72285) | $2,667.23 | $3,810.33 | 1.2× |
| Diskography lumbar (72295) | $3,937.98 | $5,625.68 | 1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $388.02 | $554.32 | 3.2× |
| Dxa Bone Density Axial (77080) | $462.60 | $660.85 | 3.8× |
| Dxa bone density study (77085) | $398 | $568.57 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $235.42 | $336.31 | 2.3× |
| Echo exam uterus (76831) | $827.74 | $1,182.48 | 3.0× |
| Echo Guide For Artery Repair (76936) | $899.07 | $1,284.38 | 3.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,048.31 | $1,497.59 | 3.8× |
| Echograp Trans R Pros Study (76873) | $697.38 | $996.25 | 5.8× |
| Esophagram (74220) | $493.34 | $704.77 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $1,016.60 | $1,452.28 | 8.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $749.94 | $1,071.35 | 6.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,148.91 | $3,069.87 | 7.8× |
| Fluoroscopy up to 1 hr (76000) | $771.09 | $1,101.56 | 2.8× |
| Follow-Up Angiography (75898) | $2,344.20 | $3,348.85 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$392.21–$588.32 | $560.30–$840.45 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$412.59–$618.89 | $589.42–$884.13 | varies |
| Gastric emptying imaging study (78264) | $2,288.87 | $3,269.81 | 4.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,688.13 | $3,840.18 | 5.8× |
| Gastroesophageal Reflux Exam (78262) | $1,839.89 | $2,628.42 | 4.0× |
| Gated Heart Planar Single (78472) | $2,673.70 | $3,819.57 | 5.8× |
| GI Endoscopic US S&I (76975) | $640.83 | $915.47 | 2.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,967.06 | $4,238.65 | 4.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$558.89–$838.33 | $798.41–$1,197.62 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,787.92 | $8,268.45 | 7.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,930.23 | $5,614.61 | 4.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,683.58 | $9,547.97 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,596.41 | $9,423.44 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $3,706.55 | $5,295.07 | 5.9× |
| Hepatobiliary System Imaging (78226) | $2,712.89 | $3,875.56 | 5.9× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $792.06 | $1,131.51 | 1.2× |
| Ht Musc Image Planar Mult (78454) | $5,815.21 | $8,307.44 | 3.9× |
| Ht Muscle Image Spect Sing (78451) | $5,184.29 | $7,406.13 | 3.5× |
| Hysterosalpingogram (74740) | $829.49 | $1,184.98 | 3.0× |
| Infusion Ivp (74410) | $1,026.78 | $1,466.83 | 5.1× |
| Interstitial radiation source applic complex (77778) | $4,305.39 | $6,150.56 | 5.3× |
| K Flow/Funct Image Multiple (78709) | $2,981.78 | $4,259.69 | 4.7× |
| K Flow/Funct Image W/Drug (78708) | $1,948.20 | $2,783.14 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,847.86 | $2,639.80 | 2.9× |
| Kidney Imaging Morphol (78700) | $1,483.90 | $2,119.86 | 3.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$501.06–$751.60 | $715.80–$1,073.71 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,153.64 | $1,648.06 | 2.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,645.60 | $2,350.85 | 3.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,786.60 | $3,980.86 | 6.0× |
| Liver imaging static only (78201) | $3,482.98 | $4,975.68 | 5.5× |
| Liver imaging w/vascular flow (78202) | $3,729.17 | $5,327.38 | 5.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,953.89 | $2,791.27 | 3.1× |
| Lung perfusion differential (78597) | $1,636.39 | $2,337.70 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $3,132.58 | $4,475.12 | 5.0× |
| Lung Ventilation Imaging (78579) | $2,334.24 | $3,334.63 | 5.0× |
| Lymph System Imaging (78195) | $2,511.24 | $3,587.49 | 4.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,527.78 | $2,182.54 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,434.89 | $2,049.84 | 2.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,354.27 | $4,791.82 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,256.53 | $1,795.04 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $2,683.34 | $3,833.35 | 9.7× |
| Magnetic Resonance Elastography (76391) | $1,227.41 | $1,753.44 | 4.4× |
| Meckels Divert Exam (78290) | $1,537.43 | $2,196.33 | 3.3× |
| Medical physics dose eval radiation expos w/rprt (76145) | $887.88 | $1,268.40 | 2.1× |
| Mlc imrt design & construction per imrt plan (77338) | $1,634.86 | $2,335.51 | 3.8× |
| Mr safety determination physician/other qhp (76016) | $2,066.97 | $2,952.82 | 20.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $140.80 | $201.14 | 4.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $95.44 | $136.35 | 0.9× |
| Mr safety implt pos&/immoblj (76019) | $79.06 | $112.95 | 1.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $891.10 | $1,273 | 3.2× |
| Mra Head W/O & W/Contrast Material (70546) | $7,185.04 | $10,264.34 | 17.8× |
| MRA head w/o contrast (70544) | $4,987.65 | $7,125.21 | 18.1× |
| MRA head with contrast (70545) | $5,286.12 | $7,551.60 | 13.1× |
| MRA neck w contrast (70548) | $5,483.68 | $7,833.83 | 13.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,220.61 | $11,743.73 | 20.3× |
| MRA neck w/o contrast (70547) | $5,101.08 | $7,287.26 | 18.5× |
| MRI abdomen w contrast (74182) | $4,028.92 | $5,755.60 | 10.0× |
| MRI abdomen w/o contrast (74181) | $2,539.26 | $3,627.52 | 9.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,114.84–$3,172.26 | $3,021.20–$4,531.80 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,571–$3,856.50 | $3,672.86–$5,509.29 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,326.41–$4,989.63 | $4,752.02–$7,128.04 | varies |
| MRI bone marrow blood supply (77084) | $2,994.92 | $4,278.45 | 10.8× |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$3,455.96–$5,183.93 | $4,937.08–$7,405.62 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$3,455.96–$5,183.93 | $4,937.08–$7,405.62 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $7,205.26 | $10,293.23 | 26.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,602.63 | $5,146.62 | 13.0× |
| MRI cardiac w/o cont stress (75559) | $3,219.57 | $4,599.38 | 5.1× |
| MRI cardiac w/o contrast (75557) | $3,210.30 | $4,586.14 | 11.6× |
| MRI cervical spine w contrast (72142) | $3,274.64 | $4,678.06 | 8.1× |
| MRI cervical spine w/o cont (72141) | $2,381.30 | $3,401.86 | 8.6× |
| MRI chest w/o contrast (71550) | $4,801.72 | $6,859.60 | 17.4× |
| MRI chest with contrast (71551) | $5,215.13 | $7,450.19 | 5.7× |
| MRI chest wo w contrast (71552) | $6,556 | $9,365.72 | 16.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$4,593.75–$6,890.62 | $6,562.50–$9,843.75 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$5,828.54–$8,742.80 | $8,326.48–$12,489.72 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,910.19–$5,865.28 | $5,585.98–$8,378.97 | varies |
| MRI lumbar spine w contrast (72149) | $2,629.26 | $3,756.09 | 6.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,667.77 | $5,239.67 | 9.1× |
| MRI orbit face &/neck w/o contrast (70540) | $4,251.20 | $6,073.15 | 15.4× |
| MRI orbit face neck w contrast (70542) | $5,012.02 | $7,160.03 | 12.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,204.24 | $8,863.20 | 15.4× |
| MRI pelvis w contrast (72196) | $4,999.81 | $7,142.58 | 12.4× |
| MRI pelvis w/o & w contrast (72197) | $6,285.71 | $8,979.58 | 15.6× |
| MRI pelvis w/o contrast (72195) | $3,713.35 | $5,304.79 | 13.4× |
| MRI spectroscopy (76390) | $2,245.64 | $3,208.05 | 22.3× |
| MRI thoracic spine w/o contrast (72146) | $4,752.87 | $6,789.82 | 17.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$3,826.49–$5,739.74 | $5,466.42–$8,199.63 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$3,538.62–$5,307.93 | $5,055.17–$7,582.76 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$4,610.39–$6,915.58 | $6,586.27–$9,879.40 | varies |
| MRI, abdomen, combo (74183) | $4,284.80 | $6,121.14 | 10.6× |
| MRI, dorsal spine combo (72157) | $5,446.77 | $7,781.10 | 13.5× |
| MRI, dorsal spine contrast (72147) | $5,256.55 | $7,509.36 | 13.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,685.45–$4,028.18 | $3,836.36–$5,754.54 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,912.29–$5,868.43 | $5,588.98–$8,383.47 | varies |
| MRI, lumbar spine combo (72158) | $2,630.56 | $3,757.94 | 6.5× |
| Myelogram cervical (72240) | $2,061.65 | $2,945.21 | 2.3× |
| Myelogram Lumbar (72265) | $1,549.91 | $2,214.16 | 1.7× |
| Myelography thoracic (72255) | $1,548.22 | $2,211.75 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,688.45 | $2,412.07 | 1.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,047.28 | $7,210.40 | 3.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,999 | $5,712.86 | 2.7× |
| Myocardial Spect Multiple Studies (78452) | $6,806.96 | $9,724.23 | 4.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $5,927.12 | $8,467.31 | 3.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,840.52 | $6,915.03 | 2.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $5,477.38 | $7,824.83 | 2.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $5,974.49 | $8,534.98 | 2.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $5,751.61 | $8,216.59 | 3.3× |
| N-invas est c ffr sw aly CTA (75580) | $4,962.57 | $7,089.39 | 5.0× |
| Neck soft tissue (70360) | $382.81 | $546.87 | 3.8× |
| Nm csf leak detection (78650) | $3,005.63 | $4,293.76 | 2.0× |
| Nm whole blood volume (78122) | $2,201.62 | $3,145.17 | 3.5× |
| Nonvascular Shunt X-Ray (75809) | $565.15 | $807.36 | 4.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,079.89 | $7,256.99 | 3.2× |
| Nuclear Rx Intra-Arterial (79445) | $1,450.55 | $2,072.21 | 5.4× |
| Nuclear Rx Oral Admin (79005) | $1,794.90 | $2,564.14 | 6.6× |
| Ob us nuchal meas 1 gest (76813) | $506.69 | $723.84 | 4.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $535.64 | $765.20 | 4.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$1,635.53–$2,453.29 | $2,336.47–$3,504.70 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 2 matching MRF lines |
$376.76–$565.14 | $538.23–$807.34 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $378.74 | $541.05 | 3.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$542.12–$813.18 | $774.45–$1,161.68 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $77.36 | $110.51 | 2.3× |
| Ophthalmic us dx quantitative a-scan only (76511) range across 2 matching MRF lines |
$437.59–$656.39 | $625.13–$937.70 | varies |
| Optic foramina (70190) range across 2 matching MRF lines |
$323.08–$484.62 | $461.54–$692.31 | varies |
| Panoramic X-ray of jaws (70355) | $227.14 | $324.48 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,613.88 | $5,162.69 | 5.7× |
| Parathyroid Planar Imaging (78070) | $2,515.64 | $3,593.77 | 5.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,886.30 | $4,123.29 | 6.2× |
| Pelvis 1 or 2 views (72170) | $480.43 | $686.33 | 4.0× |
| Pet Image W/Ct Lmtd (78814) | $9,107.04 | $13,010.05 | 5.5× |
| PET image w/CT, full body (78816) | $9,997.58 | $14,282.26 | 6.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $9,228.86 | $13,184.09 | 5.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $5,234.56 | $7,477.95 | 3.5× |
| Pet Myocardial Sngl Study (78491) | $4,830.31 | $6,900.44 | 2.9× |
| PET whole body (78813) | $5,543.10 | $7,918.72 | 3.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $2,930.93 | $4,187.04 | 2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,181.76 | $5,973.94 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,446.46 | $2,066.37 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $791.92 | $1,131.32 | 6.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,408.32 | $2,011.88 | 2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$417.84–$626.77 | $596.92–$895.38 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$284.21–$426.31 | $406.01–$609.02 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$489.85–$734.78 | $699.79–$1,049.69 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $554.47 | $792.10 | 4.6× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$401.39–$602.09 | $573.42–$860.13 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$466.21–$699.32 | $666.02–$999.03 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$670.66–$1,005.99 | $958.09–$1,437.13 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$242.34–$363.51 | $346.20–$519.30 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $339.68 | $485.26 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $453.95 | $648.50 | 4.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$371.96–$557.94 | $531.37–$797.06 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $288.29 | $411.84 | 2.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $3,995.60 | $5,708 | 19.7× |
| Radex Spine 1 View Specify Level (72020) | $313.88 | $448.40 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $328.71 | $469.59 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $511.44 | $730.63 | 5.1× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$360.47–$540.70 | $514.96–$772.43 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$392.97–$589.45 | $561.38–$842.07 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$403.02–$604.53 | $575.74–$863.61 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $745.88 | $1,065.54 | 6.2× |
| Radiation treatment delivery level 1 (77402) | $495.77 | $708.24 | 4.2× |
| Radiation treatment delivery level 3 (77412) | $1,050.83 | $1,501.18 | 1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $323.34 | $461.91 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $549.94 | $785.63 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $1,565.98 | $2,237.11 | 7.7× |
| Radiologic exam colon single contrast study (74270) | $1,006.45 | $1,437.79 | 5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,323.18 | $1,890.26 | 6.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$549.95–$824.92 | $785.64–$1,178.46 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $573.66 | $819.51 | 4.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $928.44 | $1,326.35 | 4.6× |
| Radiologic exam swallow function contrast study (74230) | $768.01 | $1,097.16 | 3.8× |
| Radiologic exam teeth complete full mouth (70320) | $165.66 | $236.66 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $964.53 | $1,377.90 | 4.7× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$299.21–$448.81 | $427.44–$641.16 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$367.45–$551.18 | $524.93–$787.40 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$421.63–$632.44 | $602.33–$903.49 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $536.02 | $765.74 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$420.34–$630.50 | $600.48–$900.72 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $119.70 | $171 | 1.2× |
| Radiopharm Dacryocystography (78660) | $1,004.23 | $1,434.62 | 2.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $2,484.29 | $3,548.99 | 4.0× |
| Renal Cyst Study (74470) | $1,465.49 | $2,093.56 | 2.3× |
| Ribs bilateral 3 views (71110) | $431.70 | $616.72 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,983.23 | $2,833.19 | 4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,164.38 | $3,091.97 | 4.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,335.72 | $7,622.45 | 8.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,391.54 | $3,416.48 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,222.42 | $4,603.46 | 5.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $6,574.72 | $9,392.46 | 4.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,691.06 | $12,415.80 | 5.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,432.49 | $6,332.13 | 3.0× |
| Rp Therapy Intravenous Administration (79101) | $1,350.20 | $1,928.86 | 5.0× |
| Salivary Gland Imaging Serial Images (78231) | $920.54 | $1,315.06 | 2.0× |
| Scapula (73010) range across 2 matching MRF lines |
$348.48–$522.72 | $497.83–$746.74 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $85.44 | $122.06 | 3.7× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$345.88–$518.81 | $494.11–$741.16 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,122.88–$1,684.31 | $1,604.11–$2,406.16 | varies |
| Sialogram (70390) | $649.68 | $928.12 | 2.4× |
| Skull less than 4 views (70250) | $386.07 | $551.53 | 3.2× |
| Special dosimetry (77331) | $451.41 | $644.87 | 2.9× |
| Special Physics Consult (77370) | $653.02 | $932.88 | 4.2× |
| Special treatment procedure (77470) | $2,941.92 | $4,202.74 | 4.6× |
| Speech evaluation, complex (70371) | $680.62 | $972.32 | 2.5× |
| Srs Multisource (77371) | $83,512.30 | $119,303.29 | 9.8× |
| Stereotactic Body Radiation Delivery (77373) | $8,576.02 | $12,251.45 | 4.1× |
| Sternoclavicular joints (71130) | $328.44 | $469.20 | 3.3× |
| Superior sagittal sinus venogram (75870) | $2,774.41 | $3,963.44 | 0.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $223.15 | $318.79 | 2.2× |
| Tbs technical calculation only (77091) | $228.53 | $326.47 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,160.32 | $1,657.60 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $609.40 | $870.57 | 1.4× |
| Testicular Imaging W/Flow (78761) | $1,431.85 | $2,045.50 | 3.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,369.72 | $1,956.74 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $792.56 | $1,132.23 | 5.1× |
| Thoracic spine 2 views (72070) | $439.92 | $628.45 | 3.6× |
| Thoracic spine 3 views (72072) | $551.77 | $788.24 | 4.6× |
| Thoracolumbar 2 views (72080) | $342.71 | $489.58 | 3.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,533.27 | $2,190.39 | 3.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,267.53 | $1,810.76 | 2.7× |
| Thyroid Met Imaging Body (78018) | $2,181.54 | $3,116.49 | 3.5× |
| Thyroid Uptake Measurement (78012) | $869.96 | $1,242.80 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,597.71 | $2,282.44 | 3.5× |
| Tx Devices Design & Construction Complex (77334) | $1,074.77 | $1,535.38 | 2.5× |
| Tx devices design & construction intermediate (77333) | $874.51 | $1,249.30 | 5.6× |
| Tx devices design & construction simple (77332) | $813.18 | $1,161.68 | 5.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$475.02–$712.53 | $678.60–$1,017.90 | varies |
| Ultrasound elastography first target lesion (76982) | $173.41 | $247.73 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $624.89 | $892.70 | 5.2× |
| Ultrasound Exam Aaa Screen (76706) | $504 | $720 | 4.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $647.92 | $925.60 | 1.6× |
| Ultrasound, abdomen limited (76705) | $544.78 | $778.26 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) | $399.85 | $571.22 | 3.3× |
| Unlis px ther radiol clinical tx planning (77299) | $437.87 | $625.53 | 2.8× |
| Unlisted Dx Radiographic Procedure (76499) | $630.45 | $900.64 | 6.3× |
| Unlisted fluoroscopic procedure (76496) range across 3 matching MRF lines |
$3,296.91–$5,789.14 | $4,709.87–$8,270.20 | varies |
| Unlisted magnetic resonance procedure (76498) range across 7 matching MRF lines |
$1,820.07–$9,595.89 | $2,600.10–$13,708.42 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 4 matching MRF lines |
$335.71–$839.46 | $479.59–$1,199.23 | varies |
| Unlisted us procedure (76999) range across 5 matching MRF lines |
$241.89–$941.32 | $345.56–$1,344.74 | varies |
| Upper gi w/o kub (74240) | $808.88 | $1,155.55 | 4.0× |
| Ureteral Reflux Study (78740) | $1,247.39 | $1,781.98 | 2.7× |
| Urethrocystogram voiding (74455) | $908.31 | $1,297.59 | 3.3× |
| Urethrocystography retrograde (74450) | $873.21 | $1,247.44 | 3.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$627.02–$940.53 | $895.75–$1,343.62 | varies |
| Us chest (76604) | $590.28 | $843.26 | 4.9× |
| Us complete joint (76881) | $1,077.61 | $1,539.44 | 8.9× |
| Us exam, pelvic, limited (76857) | $523.09 | $747.27 | 4.3× |
| Us head (76506) | $674.98 | $964.26 | 5.6× |
| Us kidney transplant (76776) | $929.78 | $1,328.25 | 7.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $458.61 | $655.16 | 3.8× |
| Us ob detailed single fetus (76811) | $1,153.26 | $1,647.52 | 4.2× |
| Us ob limited 1 or more fetuses (76815) | $581.33 | $830.47 | 4.8× |
| Us ob transvaginal (76817) | $722.71 | $1,032.44 | 6.0× |
| Us pelvic non ob complete (76856) | $1,672.26 | $2,388.94 | 13.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $913.80 | $1,305.43 | 7.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $581.33 | $830.47 | 4.8× |
| Us retroperitoneal complete (76770) | $1,347.42 | $1,924.88 | 11.1× |
| Us retroperitoneal limited (76775) | $522.60 | $746.57 | 4.3× |
| Us scrotum and contents (76870) | $769.50 | $1,099.29 | 6.4× |
| Us spinal canal and contents (76800) | $430.77 | $615.38 | 3.6× |
| Us thyroid (76536) | $762.05 | $1,088.64 | 6.3× |
| Us transrectal (76872) | $372.01 | $531.44 | 3.1× |
| Vascular Flow Imaging (78445) | $1,140.99 | $1,629.98 | 2.5× |
| Vein X-Ray Chest (75827) | $3,117.42 | $4,453.46 | 1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,179.18 | $4,541.68 | 0.9× |
| Vein X-Ray Skull Epidural (75872) | $3,669.12 | $5,241.60 | 5.1× |
| Venogram Sinus/Jugular (75860) | $3,730.27 | $5,328.96 | 1.0× |
| Venography Adrenal Unilateral (75840) | $3,050.36 | $4,357.65 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $6,596.41 | $9,423.44 | 1.8× |
| Venography extremity bilateral rs&i (75822) | $2,458.97 | $3,512.82 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $2,423.51 | $3,462.16 | 1.3× |
| Venography Orbital Rs&I (75880) | $2,165.64 | $3,093.77 | 3.0× |
| Venography Renal Bilateral (75833) | $5,328.57 | $7,612.24 | 1.5× |
| Venography Renal Unilateral (75831) | $4,833.92 | $6,905.60 | 1.3× |
| Venous sampling by catheter (75893) | $9,450.53 | $13,500.76 | 1.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $2,030.78 | $2,901.11 | 4.4× |
| Vertebral fracture assessment via dxa (77086) | $203.84 | $291.20 | 2.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$399.77–$599.65 | $571.10–$856.64 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $367.64 | $525.20 | 3.6× |
| X-ray antegrade pyelogram tube (74425) | $1,112.39 | $1,589.13 | 2.8× |
| X-Ray Aorta Leg Arteries (75630) | $8,697.96 | $12,425.65 | 2.4× |
| X-Ray Bend Only L-S Spine (72120) | $453.01 | $647.16 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$441.67–$662.51 | $630.96–$946.44 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $288.01 | $411.44 | 2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $528.02 | $754.31 | 4.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $620.33 | $886.19 | 5.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $382.33 | $546.19 | 3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $394.13 | $563.04 | 3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $490.56 | $700.80 | 4.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $421.18 | $601.68 | 3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $549.14 | $784.48 | 4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $639.76 | $913.95 | 5.3× |
| X-Ray Exam L-S Spine Bending (72114) | $546.08 | $780.12 | 4.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $412.05 | $588.64 | 4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $684.91 | $978.44 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $514.93 | $735.62 | 4.3× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$385.84–$578.76 | $551.20–$826.80 | varies |
| X-ray head for orthodontia (70350) | $187.82 | $268.32 | 1.9× |
| X-ray humerus (73060) | $425.93 | $608.47 | 4.2× |
| X-ray IV pyelogram (ivp) (74400) | $1,510.72 | $2,158.17 | 7.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $299.68 | $428.11 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $273 | $390 | 2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $365.04 | $521.49 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $332.23 | $474.62 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $536.86 | $766.95 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $343.43 | $490.62 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $301.10 | $430.14 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $310.60 | $443.71 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $330.82 | $472.60 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $492.51 | $703.58 | 4.1× |
| X-Ray Stress View (77071) | $193.65 | $276.64 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $633.78 | $905.40 | 5.2× |
| X-Ray Tmj Unilat (70328) | $314.38 | $449.11 | 3.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,442.15 | $2,060.21 | 3.6× |
| X-Rays Bone Length Studies (77073) | $399.67 | $570.96 | 3.3× |
| X-Rays Bone Survey Complete (77075) | $883.95 | $1,262.79 | 7.3× |
| Xr c-spine 4 or 5 views (72050) | $567.97 | $811.38 | 4.7× |
| Xr facial bones less than 3 views (70140) | $357.32 | $510.46 | 3.5× |
| Xr orbits complete 4 views (70200) | $387.70 | $553.86 | 3.2× |
| Xr Tomogram Single Plane (76100) | $617.38 | $881.97 | 5.1× |
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.