Imaging prices at DMC Harper University Hospital
Detroit, MI · every code in this section with a posted price and a Medicare benchmark.
359 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) range across 3 matching MRF lines |
$6,267–$11,832.75 | $8,356–$15,777 | varies |
| Abdomen 1 View (74018) | $213 | $284 | 2.5× |
| Abdomen 2 views (74019) | $627.75 | $837 | 6.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,781.25 | $2,375 | 4.5× |
| Angio internal mammary (75756) | $6,746.25 | $8,995 | 2.1× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,678.25–$6,231 | $7,571–$8,308 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$5,344.50–$7,512 | $7,126–$10,016 | varies |
| Angiography extremity unilateral rs&i (75710) | $9,417 | $12,556 | 3.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$5,299.50–$7,201.50 | $7,066–$9,602 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,769.50 | $5,026 | 1.2× |
| Ankle 2 views (73600) | $354.75 | $473 | 4.1× |
| Aortography thoracic serialography rs&i (75605) | $8,961.75 | $11,949 | 1.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $8,973.75 | $11,965 | 2.9× |
| Artery X-Rays Abdomen (75726) | $11,508 | $15,344 | 2.1× |
| Artery X-Rays Adrenal Gland (75731) | $6,051.75 | $8,069 | 1.9× |
| Artery X-Rays Pelvis (75736) | $9,648 | $12,864 | 1.7× |
| Artery X-Rays Spine (75705) | $11,716.50 | $15,622 | 2.1× |
| Arthrogram ankle (73615) | $1,634.25 | $2,179 | 4.7× |
| Arthrogram hip (73525) | $1,919.25 | $2,559 | 5.5× |
| Arthrogram Wrist (73115) | $781.50 | $1,042 | 2.2× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$923.25–$937.50 | $1,231–$1,250 | varies |
| Bone age studies (77072) | $606 | $808 | 5.8× |
| Bone Imaging 3 Phase (78315) | $1,924.50 | $2,566 | 4.8× |
| Bone Imaging Limited Area (78300) | $2,562.75 | $3,417 | 6.4× |
| Bone Imaging Multiple Areas (78305) | $2,799.75 | $3,733 | 7.0× |
| Bone Imaging Whole Body (78306) | $2,102.25 | $2,803 | 5.3× |
| Bone survey infant (77076) | $264.75 | $353 | 2.5× |
| Brain Flow Imaging Only (78610) | $1,436.25 | $1,915 | 2.7× |
| Brain Image W/Flow < 4 Views (78601) | $773.25 | $1,031 | 1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,947.25 | $5,263 | 7.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $5,230.50 | $6,974 | 15.0× |
| Cat Scan Follow-Up Study (76380) | $2,688 | $3,584 | 31.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,498.25 | $3,331 | 4.6× |
| Cerebrospinal Fluid Scan (78630) | $1,560.75 | $2,081 | 2.9× |
| Chest 1 view (71045) | $302.25 | $403 | 3.5× |
| Chest 2 views (71046) | $528.75 | $705 | 6.1× |
| Chest 3 views (71047) | $455.25 | $607 | 5.3× |
| Chest 4 or more views (71048) | $473.25 | $631 | 4.5× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $433.50 | $578 | 4.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $270 | $360 | 2.6× |
| Clavicle complete (73000) | $359.25 | $479 | 4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $261 | $348 | 2.5× |
| Continuing medical physics consltj pr wk (77336) | $969 | $1,292 | 7.2× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,332.50–$5,493.75 | $7,110–$7,325 | varies |
| Contrast X-Ray Bladder (74430) | $432.75 | $577 | 1.2× |
| Contrast X-Ray Of Elbow (73085) | $1,749 | $2,332 | 5.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,980.75 | $2,641 | 5.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $471 | $628 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) | $4,317 | $5,756 | 12.4× |
| CT abdomen and pelvis without contrast (74176) | $3,798 | $5,064 | 16.0× |
| CT abdomen w contrast (74160) | $2,515.50 | $3,354 | 14.4× |
| CT abdomen w wo contrast (74170) | $3,935.25 | $5,247 | 22.5× |
| CT abdomen w/o contrast (74150) | $2,216.25 | $2,955 | 21.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,926.75 | $6,569 | 14.2× |
| CT Angio Chest (71275) | $5,683.50 | $7,578 | 32.5× |
| CT Angio Head (70496) | $11,167.50 | $14,890 | 63.9× |
| CT angio hrt w/3d image (75574) | $2,364 | $3,152 | 6.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,690.50 | $6,254 | 26.8× |
| CT Angio Neck (70498) | $5,274.75 | $7,033 | 30.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,019.75 | $6,693 | 28.7× |
| CT cervical spine w/ contrast (72126) | $2,283.75 | $3,045 | 6.6× |
| CT cervical spine w/o contrast (72125) | $3,090.75 | $4,121 | 29.7× |
| CT cervical spine w/wo cont (72127) | $2,625.75 | $3,501 | 15.0× |
| CT chest w contrast (71260) | $2,665.50 | $3,554 | 15.3× |
| CT chest w/wo contrast (71270) | $3,814.50 | $5,086 | 21.8× |
| CT head/brain with contrast (70460) | $2,262 | $3,016 | 12.9× |
| CT head/brain without and with contrast (70470) | $3,900 | $5,200 | 22.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,167.50 | $2,890 | 6.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $115.50 | $154 | 1.3× |
| CT iac w contrast (70481) | $3,532.50 | $4,710 | 20.2× |
| CT l-spine w&w/o contrast (72133) | $3,035.25 | $4,047 | 17.4× |
| CT lower ext w/o (73700) | $2,025.75 | $2,701 | 19.4× |
| CT lower extremity w/contrast material (73701) | $2,259 | $3,012 | 12.9× |
| CT lumbar spine w contrast (72132) | $2,277.75 | $3,037 | 6.6× |
| CT lumbar spine w/o contrast (72131) | $2,042.25 | $2,723 | 19.6× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$3,449.25–$4,305 | $4,599–$5,740 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$3,303.75–$3,449.25 | $4,405–$4,599 | varies |
| CT neck tissue combo (70492) | $4,834.50 | $6,446 | 27.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,348.75 | $8,465 | 36.3× |
| CT orbits w/o contrast (70480) | $3,684 | $4,912 | 35.4× |
| CT pelvis w&w/o contrast (72194) | $3,842.25 | $5,123 | 22.0× |
| CT pelvis w/o contrast (72192) | $2,052.75 | $2,737 | 19.7× |
| CT scan of leg combo (73702) | $3,777.75 | $5,037 | 21.6× |
| CT scans face/jaw combo (70488) | $6,348.75 | $8,465 | 36.3× |
| CT soft tissue neck w contrast (70491) | $3,138.75 | $4,185 | 18.0× |
| CT soft tissue neck w/o contrast (70490) | $2,812.50 | $3,750 | 27.0× |
| CT thoracic spine w contrast (72129) | $3,950.25 | $5,267 | 22.6× |
| CT thoracic spine w/o contrast (72128) | $3,303.75 | $4,405 | 31.7× |
| CT thoracic spine w/wo cont (72130) | $5,851.50 | $7,802 | 33.5× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$390–$2,133.75 | $520–$2,845 | varies |
| CT upper ext wo (73200) | $2,013.75 | $2,685 | 19.3× |
| CT upper extremity w/o & w/contrast material (73202) | $3,325.50 | $4,434 | 19.0× |
| CT upper extremity with contrast (73201) | $2,248.50 | $2,998 | 6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,204.50 | $5,606 | 24.1× |
| Cta Abdomen (74175) | $5,086.50 | $6,782 | 29.1× |
| CTA pelvis (72191) | $5,152.50 | $6,870 | 29.5× |
| Dilation ureters/urethra rs&i (74485) | $4,654.50 | $6,206 | 2.2× |
| Diskography lumbar (72295) | $7,488.75 | $9,985 | 3.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,279.50 | $1,706 | 12.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$1,279.50–$4,239 | $1,706–$5,652 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $697.50 | $930 | 6.7× |
| Dxa Bone Density Axial (77080) | $960 | $1,280 | 9.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $450.75 | $601 | 5.2× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$1,279.50–$5,175.75 | $1,706–$6,901 | varies |
| Echo exam uterus (76831) | $647.25 | $863 | 2.7× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$996.75–$1,792.50 | $1,329–$2,390 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,279.50 | $1,706 | 5.4× |
| Esophagram (74220) | $602.25 | $803 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$402.75–$996 | $537–$1,328 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,038 | $1,384 | 10.0× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$680.25–$1,213.50 | $907–$1,618 | varies |
| Follow-Up Angiography (75898) | $3,755.25 | $5,007 | 1.2× |
| Foot 2 views (73620) | $267 | $356 | 3.1× |
| Forearm 2 views (73090) | $277.50 | $370 | 3.2× |
| Gastric emptying imaging study (78264) | $2,015.25 | $2,687 | 5.1× |
| Gastroesophageal Reflux Exam (78262) | $1,083 | $1,444 | 2.7× |
| Gated Heart Planar Single (78472) | $1,391.25 | $1,855 | 3.5× |
| Gated Heart, Multiple (78473) | $2,135.25 | $2,847 | 5.4× |
| Hand 2 views (73120) | $267 | $356 | 2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,770 | $6,360 | 1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $8,063.25 | $10,751 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,245.50 | $2,994 | 4.2× |
| Hepatobiliary System Imaging (78226) | $2,133.75 | $2,845 | 5.4× |
| Ht Musc Image Planar Mult (78454) | $5,869.50 | $7,826 | 4.6× |
| Ht Muscle Image Spect Sing (78451) | $3,652.50 | $4,870 | 2.8× |
| Hysterosalpingogram (74740) | $454.50 | $606 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,273.50 | $1,698 | 14.7× |
| K Flow/Funct Image Multiple (78709) | $5,080.50 | $6,774 | 9.4× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,347.75–$3,190.50 | $1,797–$4,254 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,491 | $1,988 | 2.8× |
| Kidney Imaging Morphol (78700) | $1,743.75 | $2,325 | 4.4× |
| Knee 3 Views (73562) | $398.25 | $531 | 4.6× |
| Leveen/Shunt Patency Exam (78291) | $2,859 | $3,812 | 7.2× |
| Liver & Spleen Imaging Static Only (78215) | $1,809.75 | $2,413 | 4.5× |
| Lung perfusion differential (78597) | $2,895.75 | $3,861 | 7.3× |
| Lung Ventilat&Perfus Imaging (78582) | $8,471.25 | $11,295 | 15.7× |
| Lung Ventilation Imaging (78579) | $2,832.75 | $3,777 | 7.1× |
| Lymph System Imaging (78195) | $1,831.50 | $2,442 | 3.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,170 | $5,560 | 1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,060.75 | $4,081 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $4,137 | $5,516 | 17.4× |
| Magnetic Resonance Elastography (76391) | $4,685.25 | $6,247 | 19.7× |
| Meckels Divert Exam (78290) | $2,170.50 | $2,894 | 5.4× |
| Mlc imrt design & construction per imrt plan (77338) | $5,412.75 | $7,217 | 14.5× |
| Mr safety determination physician/other qhp (76016) | $352.50 | $470 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $98.25 | $131 | 3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $367.50 | $490 | 3.9× |
| Mr safety implt pos&/immoblj (76019) | $237.75 | $317 | 4.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $968.25 | $1,291 | 4.1× |
| Mra Head W/O & W/Contrast Material (70546) | $10,288.50 | $13,718 | 29.6× |
| MRA head w/o contrast (70544) | $5,100.75 | $6,801 | 21.5× |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$6,306–$6,936.75 | $8,408–$9,249 | varies |
| MRA neck w contrast (70548) | $6,936.75 | $9,249 | 20.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,322.75 | $11,097 | 23.9× |
| MRA neck w/o contrast (70547) | $5,100.75 | $6,801 | 21.5× |
| MRI abdomen w contrast (74182) | $4,192.50 | $5,590 | 12.1× |
| MRI abdomen w/o contrast (74181) | $4,088.25 | $5,451 | 17.2× |
| MRI any jt lower extrem w/contrast material (73722) | $4,342.50 | $5,790 | 5.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,553 | $7,404 | 16.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,031.50 | $8,042 | 7.7× |
| MRI brain functional w/o physician admnistration (70554) | $3,771 | $5,028 | 15.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,481 | $3,308 | 10.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,848.50 | $3,798 | 12.0× |
| MRI cardiac w/o contrast (75557) | $4,326 | $5,768 | 18.2× |
| MRI cervical spine w contrast (72142) | $5,961 | $7,948 | 17.1× |
| MRI cervical spine w/o cont (72141) | $4,551.75 | $6,069 | 19.1× |
| MRI chest w/o contrast (71550) | $4,701 | $6,268 | 19.8× |
| MRI chest with contrast (71551) | $5,943 | $7,924 | 7.6× |
| MRI chest wo w contrast (71552) | $6,895.50 | $9,194 | 19.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $5,339.25 | $7,119 | 15.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,325.75 | $7,101 | 15.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,167.75 | $5,557 | 17.5× |
| MRI lumbar spine w contrast (72149) | $4,210.50 | $5,614 | 12.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $10,088.25 | $13,451 | 29.0× |
| MRI orbit face &/neck w/o contrast (70540) | $4,137 | $5,516 | 17.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,558 | $8,744 | 18.9× |
| MRI pelvis w contrast (72196) | $5,820.75 | $7,761 | 16.7× |
| MRI pelvis w/o & w contrast (72197) | $6,555 | $8,740 | 18.9× |
| MRI pelvis w/o contrast (72195) | $3,776.25 | $5,035 | 15.9× |
| MRI spectroscopy (76390) | $3,527.25 | $4,703 | 40.7× |
| MRI thoracic spine w/o contrast (72146) | $4,579.50 | $6,106 | 19.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,184.25 | $5,579 | 17.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,877.50 | $9,170 | 19.8× |
| MRI, abdomen, combo (74183) | $5,188.50 | $6,918 | 14.9× |
| MRI, dorsal spine combo (72157) | $9,750 | $13,000 | 28.0× |
| MRI, dorsal spine contrast (72147) | $6,338.25 | $8,451 | 18.2× |
| MRI, joint upper extrem (73221) | $4,393.50 | $5,858 | 18.5× |
| MRI, joint upper extrem combo (73223) | $6,877.50 | $9,170 | 19.8× |
| MRI, lumbar spine combo (72158) | $9,002.25 | $12,003 | 25.9× |
| Myelogram cervical (72240) | $3,525.75 | $4,701 | 4.5× |
| Myelogram Lumbar (72265) | $3,525.75 | $4,701 | 4.5× |
| Myelography thoracic (72255) | $3,711.75 | $4,949 | 4.8× |
| Myelograpy 2/more regions rs&i (72270) | $3,878.25 | $5,171 | 5.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $6,546.75 | $8,729 | 5.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,020 | $5,360 | 3.1× |
| Myocardial Spect Multiple Studies (78452) | $5,952.75 | $7,937 | 4.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $9,344.25 | $12,459 | 6.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $9,344.25 | $12,459 | 6.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $14,573.25 | $19,431 | 6.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $17,811 | $23,748 | 8.1× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $17,811 | $23,748 | 11.8× |
| Neck soft tissue (70360) | $280.50 | $374 | 3.2× |
| Nm myocard infarct spect (78469) | $4,587.75 | $6,117 | 8.5× |
| Nonvascular Shunt X-Ray (75809) | $1,424.25 | $1,899 | 13.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $14,545.50 | $19,394 | 10.5× |
| Nuclear Rx Intra-Arterial (79445) | $933 | $1,244 | 4.0× |
| Nuclear Rx Oral Admin (79005) | $933 | $1,244 | 4.0× |
| Ob us nuchal meas 1 gest (76813) | $716.25 | $955 | 6.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,881.50 | $3,842 | 5.3× |
| Parathyroid Planar Imaging (78070) | $1,537.50 | $2,050 | 3.9× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$290.25–$657.75 | $387–$877 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,416.25 | $8,555 | 4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,699.50 | $6,266 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $844.50 | $1,126 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $579 | $772 | 5.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,413.75 | $1,885 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $376.50 | $502 | 4.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $219 | $292 | 2.5× |
| Radex elbow complete minimum 3 views (73080) | $317.25 | $423 | 3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $528 | $704 | 5.1× |
| Radex fingr minimum 2 views (73140) | $261 | $348 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $376.50 | $502 | 4.3× |
| Radex Hand Minimum 3 Views (73130) | $546.75 | $729 | 6.3× |
| Radex lower extremity infant minimum 2 views (73592) | $256.50 | $342 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $587.25 | $783 | 5.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $270 | $360 | 3.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $980.25 | $1,307 | 11.3× |
| Radex Ribs Unilateral 2 Views (71100) | $321.75 | $429 | 3.7× |
| Radex shoulder complete minimum 2 views (73030) | $347.25 | $463 | 4.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $447.75 | $597 | 5.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $216.75 | $289 | 1.2× |
| Radex Spine 1 View Specify Level (72020) | $288.75 | $385 | 3.3× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$327–$559.50 | $436–$746 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $565.50 | $754 | 6.5× |
| Radex Toe Minimum 2 Views (73660) | $233.25 | $311 | 2.7× |
| Radex upper extremity infant minimum 2 views (73092) | $256.50 | $342 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $394.50 | $526 | 4.5× |
| Radiation treatment delivery level 2 (77407) | $1,583.25 | $2,111 | 4.1× |
| Radiation treatment delivery level 3 (77412) | $3,409.50 | $4,546 | 6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $528 | $704 | 5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $539.25 | $719 | 5.2× |
| Radiologic exam colon double contrast study (74280) | $1,184.25 | $1,579 | 6.8× |
| Radiologic exam colon single contrast study (74270) | $858 | $1,144 | 4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,180.50 | $1,574 | 6.8× |
| Radiologic exam knee complete 4/more views (73564) | $382.50 | $510 | 3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $318.75 | $425 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $535.50 | $714 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $745.50 | $994 | 4.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,444.50 | $1,926 | 8.3× |
| Radiologic examination femur 1 view (73551) | $154.50 | $206 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $233.25 | $311 | 2.7× |
| Radiologic examination knee 1/2 views (73560) | $446.25 | $595 | 5.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $978.75 | $1,305 | 9.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $411 | $548 | 4.7× |
| Ribs bilateral 3 views (71110) | $529.50 | $706 | 5.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,233 | $1,644 | 3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,385.50 | $4,514 | 8.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,707.50 | $3,610 | 5.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,953.75 | $2,605 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,068.25 | $4,091 | 5.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $8,237.25 | $10,983 | 6.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $9,344.25 | $12,459 | 6.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $8,237.25 | $10,983 | 6.4× |
| Scapula (73010) | $347.25 | $463 | 3.3× |
| Shoulder 1 view (73020) | $208.50 | $278 | 2.4× |
| Shoulder Arthrography (73040) | $723 | $964 | 2.1× |
| Skull less than 4 views (70250) | $343.50 | $458 | 3.3× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$3,845.25–$7,083.75 | $5,127–$9,445 | varies |
| Spleen Imaging (78185) | $1,680 | $2,240 | 4.2× |
| Stereotactic Body Radiation Delivery (77373) | $18,825.75 | $25,101 | 10.6× |
| Sternoclavicular joints (71130) | $382.50 | $510 | 4.4× |
| Superior sagittal sinus venogram (75870) | $5,029.50 | $6,706 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,186.50 | $5,582 | 11.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,470.50–$3,787.50 | $3,294–$5,050 | varies |
| Ther rad simulaj-aided field setting simple (77280) | $721.50 | $962 | 5.4× |
| Thoracic spine 2 views (72070) | $361.50 | $482 | 3.5× |
| Thoracic spine 3 views (72072) | $411.75 | $549 | 4.0× |
| Thoracolumbar 2 views (72080) | $347.25 | $463 | 4.0× |
| Thyroid Imaging With Vascular Flow (78013) | $705.75 | $941 | 1.8× |
| Thyroid Met Imaging Body (78018) | $1,545.75 | $2,061 | 2.9× |
| Thyroid Uptake Measurement (78012) | $1,027.50 | $1,370 | 2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,610.75 | $3,481 | 6.6× |
| Tx Devices Design & Construction Complex (77334) | $2,991 | $3,988 | 8.0× |
| Tx devices design & construction simple (77332) | $563.25 | $751 | 4.2× |
| Ultrasound Breast Limited (76642) | $290.25 | $387 | 3.3× |
| Ultrasound elastography first target lesion (76982) | $382.50 | $510 | 3.7× |
| Ultrasound Elastography Parenchyma (76981) | $688.50 | $918 | 6.6× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$812.25–$826.50 | $1,083–$1,102 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $864.75 | $1,153 | 2.5× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$390–$943.50 | $520–$1,258 | varies |
| Umbilical-artery Doppler (OB) (76820) | $724.50 | $966 | 7.0× |
| Unlisted us procedure (76999) | $701.25 | $935 | 8.1× |
| Upper gi w/o kub (74240) | $1,084.50 | $1,446 | 6.2× |
| Urethrocystogram voiding (74455) | $558 | $744 | 2.3× |
| Urethrocystography retrograde (74450) | $450.75 | $601 | 1.9× |
| Us breast unilateral complete (76641) | $233.25 | $311 | 2.2× |
| Us chest (76604) range across 3 matching MRF lines |
$651.75–$842.25 | $869–$1,123 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$439.50–$492.75 | $586–$657 | varies |
| Us exam, pelvic, limited (76857) | $439.50 | $586 | 4.2× |
| Us head (76506) range across 2 matching MRF lines |
$1,052.25–$1,222.50 | $1,403–$1,630 | varies |
| Us kidney transplant (76776) | $1,170.75 | $1,561 | 11.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$396–$933 | $528–$1,244 | varies |
| Us ob detailed single fetus (76811) | $1,254.75 | $1,673 | 5.3× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$182.25–$919.50 | $243–$1,226 | varies |
| Us ob transvaginal (76817) | $1,241.25 | $1,655 | 11.9× |
| Us pelvic non ob complete (76856) | $1,536.75 | $2,049 | 14.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$680.25–$1,009.50 | $907–$1,346 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$732–$1,065 | $976–$1,420 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$1,383–$1,759.50 | $1,844–$2,346 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$636.75–$1,155.75 | $849–$1,541 | varies |
| Us scrotum and contents (76870) | $1,284.75 | $1,713 | 12.3× |
| Us spinal canal and contents (76800) | $506.25 | $675 | 4.9× |
| Us thyroid (76536) | $870.75 | $1,161 | 8.4× |
| Us transrectal (76872) | $1,260.75 | $1,681 | 12.1× |
| Vein X-Ray Chest (75827) | $1,946.25 | $2,595 | 1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,702.50 | $6,270 | 1.5× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$4,401.75–$5,022 | $5,869–$6,696 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$3,977.25–$4,091.25 | $5,303–$5,455 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$1,442.25–$1,858.50 | $1,923–$2,478 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$2,421.75–$2,937.75 | $3,229–$3,917 | varies |
| Venography Renal Bilateral (75833) | $9,030 | $12,040 | 2.9× |
| Venography Renal Unilateral (75831) | $5,832.75 | $7,777 | 1.9× |
| Venous sampling by catheter (75893) | $10,083 | $13,444 | 1.8× |
| Wrist 2 views (73100) | $339.75 | $453 | 3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $376.50 | $502 | 4.3× |
| X-ray antegrade pyelogram tube (74425) | $450.75 | $601 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$4,886.25–$5,339.25 | $6,515–$7,119 | varies |
| X-Ray Bend Only L-S Spine (72120) | $411 | $548 | 3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $352.50 | $470 | 4.1× |
| X-Ray Exam Breast Specimen (76098) | $1,117.50 | $1,490 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$154.50–$583.50 | $206–$778 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $233.25 | $311 | 2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $307.50 | $410 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $384 | $512 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $462 | $616 | 4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $538.50 | $718 | 5.2× |
| X-Ray Exam L-S Spine Bending (72114) | $709.50 | $946 | 6.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$398.25–$788.25 | $531–$1,051 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $592.50 | $790 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $438.75 | $585 | 4.2× |
| X-ray eye for foreign body (70030) | $219 | $292 | 2.5× |
| X-ray humerus (73060) | $290.25 | $387 | 3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $376.50 | $502 | 4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $432 | $576 | 5.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$434.25–$846 | $579–$1,128 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $868.50 | $1,158 | 8.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $327 | $436 | 3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $275.25 | $367 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $416.25 | $555 | 4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $501.75 | $669 | 5.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $558 | $744 | 5.4× |
| X-ray thoracic spine 4 vw (72074) | $543 | $724 | 5.2× |
| X-Ray Tmj Unilat (70328) | $237 | $316 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$730.50–$1,894.50 | $974–$2,526 | varies |
| X-Rays Bone Length Studies (77073) | $771.75 | $1,029 | 7.4× |
| X-Rays Bone Survey Complete (77075) | $978.75 | $1,305 | 9.4× |
| Xr c-spine 4 or 5 views (72050) | $606.75 | $809 | 5.8× |
| Xr facial bones less than 3 views (70140) | $303.75 | $405 | 3.5× |
| Xr orbits complete 4 views (70200) | $528 | $704 | 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.