Imaging prices at HCA Florida Blake Hospital
Bradenton, FL · every code in this section with a posted price and a Medicare benchmark.
306 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $2,695 | $2,695 | 1.9× |
| Abdomen 2 views (74019) | $3,972.10 | $3,972.10 | 36.4× |
| Acute gi blood loss imaging (78278) | $4,441.81 | $4,441.81 | 10.6× |
| Angiography extremity bilateral rs&i (75716) | $16,292.51 | $16,292.51 | 4.9× |
| Angiography extremity unilateral rs&i (75710) | $12,834.31 | $12,834.31 | 3.9× |
| Angiography internal mammary rs&i (75756) | $13,935.31 | $13,935.31 | 4.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $13,696.66 | $13,696.66 | 2.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $15,248.60 | $15,248.60 | 4.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $14,180.54 | $14,180.54 | 4.3× |
| Angiography Spinal Selective Rs&I (75705) unusually low: confirm this is the full procedure |
$2,023.38 | $2,023.38 | 0.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $15,321.80 | $15,321.80 | 2.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) | $6,806.60 | $6,806.60 | 2.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $14,491.66 | $14,491.66 | 4.4× |
| Ankle 2 views (73600) | $2,566.56 | $2,566.56 | 28.2× |
| Aortogram thoracic (75605) | $10,530.54 | $10,530.54 | 1.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $17,184.14 | $17,184.14 | 5.2× |
| Aortography abdominal serialography rs&i (75625) | $13,515.11 | $13,515.11 | 4.1× |
| Artery X-Rays Adrenal Gland (75731) | $11,406.80 | $11,406.80 | 3.5× |
| Arthrogram ankle (73615) | $3,714.43 | $3,714.43 | 10.2× |
| Arthrogram elbow (73085) | $5,264.91 | $5,264.91 | 14.5× |
| Arthrogram hip (73525) | $5,125.81 | $5,125.81 | 14.1× |
| Arthrogram knee (73580) | $3,714.43 | $3,714.43 | 10.2× |
| Arthrogram shoulder (73040) | $5,264.91 | $5,264.91 | 14.5× |
| Arthrogram wrist (73115) | $3,489.68 | $3,489.68 | 9.6× |
| Basic dosimetry (77300) | $572 | $572 | 4.1× |
| Bone &/Joint Imaging Limited Area (78300) | $5,979.92 | $5,979.92 | 14.3× |
| Bone &/joint imaging whole body (78306) | $8,292.82 | $8,292.82 | 19.9× |
| Bone age studies (77072) | $805.26 | $805.26 | 7.4× |
| Bone Imaging 3 Phase (78315) | $7,670.40 | $7,670.40 | 18.4× |
| Bone Marrow Imaging Limited Area (78102) | $5,979.92 | $5,979.92 | 14.3× |
| Bone survey complete (77075) | $3,245.91 | $3,245.91 | 29.7× |
| Bone survey infant (77076) | $2,844.74 | $2,844.74 | 26.1× |
| Bowel imaging (78290) | $6,753.27 | $6,753.27 | 16.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $7,181.66 | $7,181.66 | 12.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,524.07 | $4,524.07 | 3.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $8,038.39 | $8,038.39 | 19.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $6,477.28 | $6,477.28 | 11.4× |
| Cervical spine 2 or 3 views (72040) | $3,052.65 | $3,052.65 | 33.6× |
| Chest 1 view (71045) | $2,704.20 | $2,704.20 | 29.8× |
| Chest xray 3 views (71047) | $2,494.82 | $2,494.82 | 27.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,818.41 | $1,818.41 | 9.9× |
| Clavicle complete (73000) | $2,351.35 | $2,351.35 | 25.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $13,200.63 | $13,200.63 | 120.9× |
| Continuing medical physics consltj pr wk (77336) | $487 | $487 | 3.5× |
| CT abdomen and pelvis without and with contrast (74178) | $45,154.48 | $45,154.48 | 123.9× |
| CT abdomen and pelvis without contrast (74176) | $36,406.50 | $36,406.50 | 146.1× |
| CT abdomen w contrast (74160) | $20,007.91 | $20,007.91 | 109.2× |
| CT abdomen w wo contrast (74170) | $21,710.05 | $21,710.05 | 118.5× |
| CT abdomen w/o contrast (74150) | $17,357.98 | $17,357.98 | 159.0× |
| CT angio hrt w/3d image (75574) | $17,508.85 | $17,508.85 | 48.1× |
| CT angio lwr extr w/o&w/dye (73706) | $14,125.20 | $14,125.20 | 77.1× |
| CT angiography upper extremity lt (73206) | $11,633.89 | $11,633.89 | 63.5× |
| CT c-spine w/contrast (72126) | $15,930.50 | $15,930.50 | 43.7× |
| CT c-spine w/o contrast (72125) | $13,466.26 | $13,466.26 | 123.4× |
| CT cervical spine w&w/o contrast (72127) | $16,858.94 | $16,858.94 | 92.0× |
| CT chest w contrast (71260) | $20,330.28 | $20,330.28 | 111.0× |
| CT chest w/wo contrast (71270) | $20,660.39 | $20,660.39 | 112.8× |
| CT head/brain with contrast (70460) | $17,208.40 | $17,208.40 | 93.9× |
| CT head/brain without and with contrast (70470) | $19,346.39 | $19,346.39 | 105.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $107.03 | $107.03 | 1.2× |
| CT iac w contrast (70481) | $14,564.92 | $14,564.92 | 79.5× |
| CT limited/localized follow up study (76380) | $4,731.18 | $4,731.18 | 52.1× |
| CT lower ext w/o (73700) | $10,689.97 | $10,689.97 | 97.9× |
| CT lower extremity w wo contrast (73702) | $12,974.97 | $12,974.97 | 70.8× |
| CT lower extremity w/contrast material (73701) | $12,542.98 | $12,542.98 | 68.5× |
| CT lumbar spine w & w/o contrast (72133) | $15,670.02 | $15,670.02 | 85.5× |
| CT lumbar spine w/contrast (72132) | $15,930.50 | $15,930.50 | 43.7× |
| CT lumbar spine w/o contrast (72131) | $13,436.61 | $13,436.61 | 123.1× |
| CT maxillofacial w contrast (70487) | $16,620.38 | $16,620.38 | 90.7× |
| CT maxillofacial w/wo contrast (70488) | $16,256.75 | $16,256.75 | 88.8× |
| CT maxillofacial wo contrast (70486) | $15,114.25 | $15,114.25 | 138.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $16,461.78 | $16,461.78 | 89.9× |
| CT orbits w/o contrast (70480) | $12,110.99 | $12,110.99 | 110.9× |
| CT pelvis w/o contrast (72192) | $19,047.23 | $19,047.23 | 174.5× |
| CT pelvis w/wo contrast (72194) | $23,447 | $23,447 | 128.0× |
| CT scan of arm combo (73202) | $12,875.67 | $12,875.67 | 70.3× |
| CT soft tissue neck w contrast (70491) | $15,930.50 | $15,930.50 | 87.0× |
| CT soft tissue neck w/o & w/contrast material (70492) | $16,648.76 | $16,648.76 | 90.9× |
| CT soft tissue neck w/o contrast (70490) | $10,807.30 | $10,807.30 | 99.0× |
| CT thoracic spine w/contrast (72129) | $16,310.91 | $16,310.91 | 89.0× |
| CT thoracic spine w/o contrast (72128) | $13,939.51 | $13,939.51 | 127.7× |
| CT thoracic spine w/wo contrast (72130) | $17,083.33 | $17,083.33 | 93.3× |
| CT thorax w/o contrast (71250) | $8,274.74 | $8,274.74 | 75.8× |
| CT upper ext wo (73200) | $10,098.09 | $10,098.09 | 92.5× |
| CT upper extremity with contrast (73201) | $13,012.36 | $13,012.36 | 35.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $23,281.96 | $23,281.96 | 127.1× |
| Cta Abdomen (74175) | $23,281.96 | $23,281.96 | 127.1× |
| CTA abdomen pelvis (74174) | $29,409.66 | $29,409.66 | 80.7× |
| CTA chest (71275) | $21,615.91 | $21,615.91 | 118.0× |
| Cta Head (70496) | $20,779.02 | $20,779.02 | 113.4× |
| Cta Neck (70498) | $17,450.83 | $17,450.83 | 95.3× |
| Cta Pelvis (72191) | $24,525.04 | $24,525.04 | 133.9× |
| Cystography minimum 3 views rs&i (74430) | $3,982.35 | $3,982.35 | 10.9× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) | $5,994.02 | $5,994.02 | 2.7× |
| Diskogram cervical (72285) | $8,907.58 | $8,907.58 | 4.4× |
| Diskography lumbar (72295) | $8,907.58 | $8,907.58 | 4.4× |
| Dxa bone density study 1/> sites axial skel (77080) | $912.13 | $912.13 | 8.4× |
| Esophagus (74220) | $2,566.56 | $2,566.56 | 14.0× |
| Facial bones min 3 views (70150) | $3,513.84 | $3,513.84 | 32.2× |
| Fetal biophysical profile non-stress testing (76818) | $3,693.92 | $3,693.92 | 33.8× |
| Fluoroscopy up to 1 hr (76000) | $3,538.73 | $3,538.73 | 14.2× |
| Foot 2 views (73620) | $2,437.73 | $2,437.73 | 26.8× |
| Forearm 2 views (73090) | $2,566.56 | $2,566.56 | 28.2× |
| Hand 2 views (73120) | $1,753.99 | $1,753.99 | 16.1× |
| Heart first pass single,planar (78481) | $5,301.42 | $5,301.42 | 9.3× |
| Heart Infarct Image (78466) | $9,636.87 | $9,636.87 | 23.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,809.55 | $5,809.55 | 1.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) | $16,027.51 | $16,027.51 | 4.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $8,532.89 | $8,532.89 | 15.0× |
| Hepatobiliary syst imaging including gallbladder (78226) | $7,253.53 | $7,253.53 | 17.4× |
| Hysterosalpingogram (74740) | $4,298.60 | $4,298.60 | 17.3× |
| Interstitial radiation source applic complex (77778) | $6,957.40 | $6,957.40 | 9.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $9,146.68 | $9,146.68 | 12.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $7,045.09 | $7,045.09 | 12.2× |
| Intracavitary Radiation Source Applic Simple (77761) | $4,950.68 | $4,950.68 | 8.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $6,359.41 | $6,359.41 | 11.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $8,432.26 | $8,432.26 | 14.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) | $8,432.26 | $8,432.26 | 14.9× |
| Liver & spleen imaging static only (78215) | $6,263.10 | $6,263.10 | 15.0× |
| Lung perf&ventilat diferentl (78598) | $8,038.39 | $8,038.39 | 14.2× |
| Lung perfusion differential (78597) | $8,038.39 | $8,038.39 | 19.3× |
| Lung ventilation imaging (78579) | $6,753.27 | $6,753.27 | 16.2× |
| Lymphoscintigraphy (78195) | $8,489.76 | $8,489.76 | 15.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) | $4,925.74 | $4,925.74 | 6.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $6,805.36 | $6,805.36 | 18.7× |
| Mammary ductogram or galactogram single (77053) | $1,003.64 | $1,003.64 | 4.0× |
| MRA head w & w/o contrast (70546) | $7,977.28 | $7,977.28 | 21.9× |
| MRA head w/o contrast (70544) | $4,485.45 | $4,485.45 | 18.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,977.28 | $7,977.28 | 21.9× |
| MRA neck w/o contrast (70547) | $4,485.45 | $4,485.45 | 18.0× |
| MRI abdomen w/o & w/contrast material (74183) | $7,085.84 | $7,085.84 | 19.4× |
| MRI abdomen w/o contrast (74181) | $7,085.84 | $7,085.84 | 28.4× |
| MRI any jt lower extrem w/contrast material (73722) | $6,034.60 | $6,034.60 | 7.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,355.45 | $7,355.45 | 20.2× |
| MRI breast w/o contrast bilateral (77047) | $4,316.95 | $4,316.95 | 17.3× |
| MRI breast wo contrast unilateral (77046) | $2,159.02 | $2,159.02 | 8.7× |
| MRI c-spine with contrast (72142) | $7,489.16 | $7,489.16 | 20.6× |
| MRI cervical spine w/o contrast (72141) | $7,085.84 | $7,085.84 | 28.4× |
| MRI chest w/o & w/contrast material (71552) | $6,533.58 | $6,533.58 | 17.9× |
| MRI chest w/o contrast (71550) | $4,314.77 | $4,314.77 | 17.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $7,355.45 | $7,355.45 | 20.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,851.81 | $4,851.81 | 19.5× |
| MRI orbit face &/neck w/o contrast (70540) | $4,081.04 | $4,081.04 | 16.4× |
| MRI orbit face neck w contrast (70542) | $4,534.37 | $4,534.37 | 12.4× |
| MRI orbit/face/neck w&w/o cont (70543) | $5,987.85 | $5,987.85 | 16.4× |
| MRI pelvis w/o & w/contrast material (72197) | $6,805.36 | $6,805.36 | 18.7× |
| MRI pelvis w/o contrast (72195) | $4,422.40 | $4,422.40 | 17.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $8,035.98 | $8,035.98 | 22.1× |
| MRI spinal canal lumbar w/contrast material (72149) | $7,489.16 | $7,489.16 | 20.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $8,989.39 | $8,989.39 | 24.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $8,108.82 | $8,108.82 | 22.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $8,035.98 | $8,035.98 | 22.1× |
| MRI temporomandibular joint (70336) | $4,635.47 | $4,635.47 | 18.6× |
| MRI thoracic spine w/o contrast (72146) | $7,409.80 | $7,409.80 | 29.7× |
| MRI up ext w/o contrast (73218) | $4,487.63 | $4,487.63 | 18.0× |
| MRI upper ext joint w/o contrast (73221) | $4,487.63 | $4,487.63 | 18.0× |
| MRI, joint upper extrem combo (73223) | $6,805.36 | $6,805.36 | 18.7× |
| Myelogram Cervical (72240) | $8,835.85 | $8,835.85 | 10.8× |
| Myelogram Lumbar (72265) | $9,034.96 | $9,034.96 | 11.0× |
| Myelogram thoracic (72255) | $8,364.40 | $8,364.40 | 10.2× |
| Myelography 2 or more regions (72270) | $10,406.83 | $10,406.83 | 12.7× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $5,059.93 | $5,059.93 | 8.9× |
| Myocardial Spect Multiple Studies (78452) | $14,841.98 | $14,841.98 | 11.0× |
| Myocardial spect single study at rest or stress (78451) | $7,377.15 | $7,377.15 | 5.5× |
| N-invas est c ffr sw aly CTA (75580) | $3,000 | $3,000 | 3.3× |
| Neck soft tissue (70360) | $2,108.30 | $2,108.30 | 23.2× |
| Nm cisternogram (78630) | $4,759.50 | $4,759.50 | 8.4× |
| Nm csf leak detection (78650) | $3,484.45 | $3,484.45 | 2.6× |
| Nm gastric emptying study (78264) | $6,359.41 | $6,359.41 | 15.2× |
| Nm peritoneal-venous shunt patency (78291) | $6,477.28 | $6,477.28 | 15.5× |
| Nonvascular shunt X-ray (75809) | $3,245.91 | $3,245.91 | 29.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,434 | $1,434 | 1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) | $5,558.74 | $5,558.74 | 13.3× |
| Nuclear Rx Oral Admin (79005) | $2,150.48 | $2,150.48 | 8.8× |
| Parathyroid Planar Imaging (78070) | $4,572.62 | $4,572.62 | 11.0× |
| Pelvis 1 or 2 views (72170) | $2,494.82 | $2,494.82 | 22.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $4,524.07 | $4,524.07 | 3.3× |
| PET whole body (78813) | $4,524.07 | $4,524.07 | 3.0× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) | $4,524.07 | $4,524.07 | 3.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) | $11,723.05 | $11,723.05 | 3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $6,753.27 | $6,753.27 | 16.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $13,506.57 | $13,506.57 | 23.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,537.28 | $2,537.28 | 4.4× |
| Radex Ankle Compl Minimum 3 Views (73610) | $2,844.74 | $2,844.74 | 31.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $2,156.62 | $2,156.62 | 23.7× |
| Radex Elbw Compl Minimum 3 Views (73080) | $2,566.56 | $2,566.56 | 28.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $3,052.65 | $3,052.65 | 28.0× |
| Radex fingr minimum 2 views (73140) | $2,223.97 | $2,223.97 | 24.5× |
| Radex Foot Compl Minimum 3 Views (73630) | $2,844.74 | $2,844.74 | 31.3× |
| Radex Hand Minimum 3 Views (73130) | $2,351.35 | $2,351.35 | 25.9× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $4,374.73 | $4,374.73 | 48.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $5,803.69 | $5,803.69 | 53.2× |
| Radex Humerus Minimum 2 Views (73060) | $2,351.35 | $2,351.35 | 25.9× |
| Radex Kne 1/2 Views (73560) | $2,108.30 | $2,108.30 | 23.2× |
| Radex Kne Compl 4/More Views (73564) | $2,844.74 | $2,844.74 | 26.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $2,893.07 | $2,893.07 | 26.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $2,351.35 | $2,351.35 | 25.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $2,494.82 | $2,494.82 | 22.9× |
| Radex Sho Compl Minimum 2 Views (73030) | $2,699.80 | $2,699.80 | 29.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $3,301.55 | $3,301.55 | 36.3× |
| Radex Toe Minimum 2 Views (73660) | $2,108.30 | $2,108.30 | 23.2× |
| Radex Wrst Compl Minimum 3 Views (73110) | $2,566.56 | $2,566.56 | 28.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $2,699.80 | $2,699.80 | 29.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $5,244.40 | $5,244.40 | 48.0× |
| Radiologic exam chest 2 views (71046) | $2,920.89 | $2,920.89 | 32.1× |
| Radiologic exam colon single contrast study (74270) | $4,390.84 | $4,390.84 | 24.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $2,688.09 | $2,688.09 | 14.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $4,509.43 | $4,509.43 | 24.6× |
| Radiologic exam upr gi trc single contrast study (74240) | $4,390.84 | $4,390.84 | 24.0× |
| Radiologic examination femur 1 view (73551) | $1,285.48 | $1,285.48 | 14.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $2,699.80 | $2,699.80 | 29.7× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) | $2,893.07 | $2,893.07 | 26.5× |
| Radiological examination surgical specimen (76098) | $2,264.24 | $2,264.24 | 4.0× |
| Renal Cyst Study (74470) | $4,095.09 | $4,095.09 | 7.2× |
| Ribs bilateral 3 views (71110) | $3,513.84 | $3,513.84 | 32.2× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) | $4,732.19 | $4,732.19 | 11.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $19,748.09 | $19,748.09 | 34.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $9,868.30 | $9,868.30 | 17.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $8,193.64 | $8,193.64 | 14.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $19,748.09 | $19,748.09 | 14.6× |
| Rp Therapy Intravenous Administration (79101) | $5,170.62 | $5,170.62 | 21.2× |
| Scapula (73010) | $2,351.35 | $2,351.35 | 21.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $57.10 | $57.10 | 2.4× |
| Shoulder 1 view (73020) | $2,156.62 | $2,156.62 | 23.7× |
| Sialogram (70390) | $2,585.61 | $2,585.61 | 10.4× |
| Simulation intermediate (77285) | $915 | $915 | 2.3× |
| Small bowel series (74250) | $4,390.84 | $4,390.84 | 24.0× |
| Special dosimetry (77331) | $1,241 | $1,241 | 8.8× |
| Special Physics Consult (77370) | $1,714 | $1,714 | 12.2× |
| Special treatment procedure (77470) | $1,475 | $1,475 | 2.6× |
| Spine thoracic 3 views (72072) | $3,052.65 | $3,052.65 | 28.0× |
| Testicular Imaging With Vascular Flow (78761) | $5,621.99 | $5,621.99 | 13.5× |
| Ther rad simulaj-aided field setting complex (77290) | $1,147 | $1,147 | 2.9× |
| Ther rad simulaj-aided field setting simple (77280) | $571 | $571 | 4.1× |
| Thyroid carcinoma metastases img whole body (78018) | $8,862.06 | $8,862.06 | 15.6× |
| Thyroid imaging w/blood flow (78013) | $4,530.94 | $4,530.94 | 10.9× |
| Thyroid uptake measurement (78012) | $2,896.52 | $2,896.52 | 6.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,896.52 | $2,896.52 | 6.9× |
| Tomogram (76100) | $5,392.28 | $5,392.28 | 49.4× |
| Treatment device complex (77334) | $535 | $535 | 1.4× |
| Treatment devices simple (77332) | $759 | $759 | 5.4× |
| Ultrasound breast complete (76641) | $579.79 | $579.79 | 5.3× |
| Ultrasound, abdomen limited (76705) | $4,639.73 | $4,639.73 | 42.5× |
| Unlisted ultrasound procedure (76999) | $1,979.46 | $1,979.46 | 21.8× |
| Urethrocystogram voiding (74455) | $4,390.84 | $4,390.84 | 17.6× |
| Urethrocystography retrograde rs&i (74450) | $5,440.60 | $5,440.60 | 21.8× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) | $4,390.84 | $4,390.84 | 24.0× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) | $10,890.71 | $10,890.71 | 59.5× |
| Us breast unilateral limited (76642) | $519.76 | $519.76 | 5.7× |
| Us chest (76604) | $2,953.09 | $2,953.09 | 27.1× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) | $8,906.12 | $8,906.12 | 39.5× |
| Us compl joint r-t w/image documentation (76881) | $3,524.82 | $3,524.82 | 32.3× |
| Us encephalogram (76506) | $3,623.65 | $3,623.65 | 33.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $4,639.73 | $4,639.73 | 42.5× |
| Us ob limited (76815) | $2,437.73 | $2,437.73 | 22.3× |
| Us ob transvaginal (76817) | $4,095.09 | $4,095.09 | 37.5× |
| Us pelvic non ob complete (76856) | $4,592.89 | $4,592.89 | 42.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $2,903.31 | $2,903.31 | 26.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,437.73 | $2,437.73 | 22.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $1,696.89 | $1,696.89 | 15.5× |
| Us retroperitoneal complete (76770) | $4,963.30 | $4,963.30 | 45.5× |
| Us retroperitoneal limited (76775) | $5,898.86 | $5,898.86 | 54.0× |
| Us scrotum and contents (76870) | $3,913.54 | $3,913.54 | 35.8× |
| Us soft tissue head/neck (76536) | $3,693.92 | $3,693.92 | 33.8× |
| Us transrectal (76872) | $4,572.38 | $4,572.38 | 41.9× |
| Us,transplanted kidney, real time/ doppler (76776) | $4,592.89 | $4,592.89 | 42.1× |
| Venogram extremity bilateral (75822) | $14,838.65 | $14,838.65 | 9.0× |
| Venogram Extremity Unilateral (75820) | $6,468.40 | $6,468.40 | 3.9× |
| Venography caval inferior serialography rs&i (75825) | $11,387.77 | $11,387.77 | 3.5× |
| Venography caval superior serialography rs&i (75827) | $12,582.48 | $12,582.48 | 7.7× |
| Venography Renal Bilateral (75833) | $10,371.68 | $10,371.68 | 3.1× |
| Venography renal unilateral selective rs&i (75831) | $11,065.67 | $11,065.67 | 3.4× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) | $1,847.69 | $1,847.69 | 2.8× |
| Venous sampling by catheter (75893) | $5,199.02 | $5,199.02 | 0.9× |
| Wrist 2 views (73100) | $2,156.62 | $2,156.62 | 23.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $2,351.35 | $2,351.35 | 25.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $6,001.35 | $6,001.35 | 32.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $2,223.97 | $2,223.97 | 24.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $4,651.45 | $4,651.45 | 51.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $5,808.09 | $5,808.09 | 53.2× |
| X-ray exam of femur 2/> (73552) | $1,938.47 | $1,938.47 | 21.3× |
| X-ray eye for foreign body (70030) | $2,844.74 | $2,844.74 | 31.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $2,645.63 | $2,645.63 | 29.1× |
| X-ray IV pyelogram (ivp) (74400) | $7,562.08 | $7,562.08 | 41.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,607.58 | $1,607.58 | 17.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $3,127.32 | $3,127.32 | 28.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $3,301.55 | $3,301.55 | 30.2× |
| X-ray retrograde pyelogram (74420) | $5,125.81 | $5,125.81 | 14.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $3,052.65 | $3,052.65 | 33.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $3,513.84 | $3,513.84 | 32.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $4,305.92 | $4,305.92 | 39.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $2,108.30 | $2,108.30 | 19.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $3,301.55 | $3,301.55 | 36.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $3,449.42 | $3,449.42 | 38.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $3,513.84 | $3,513.84 | 32.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $2,494.82 | $2,494.82 | 22.9× |
| X-Ray Small Bowel Enteroclysis (74251) | $5,125.81 | $5,125.81 | 28.0× |
| X-Ray Spine One View - Xr Spine (72020) | $2,156.62 | $2,156.62 | 23.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $1,691.04 | $1,691.04 | 18.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $2,566.56 | $2,566.56 | 28.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $2,699.80 | $2,699.80 | 24.7× |
| Xr bone length studies (77073) | $5,371.78 | $5,371.78 | 49.2× |
| Xr c-spine 4 or 5 views (72050) | $4,046.77 | $4,046.77 | 37.1× |
| Xr c-spine 6 or more views (72052) | $3,645.61 | $3,645.61 | 33.4× |
| Xr chest 4+ views (71048) | $2,494.82 | $2,494.82 | 22.9× |
| Xr urogram antegrade (74425) | $5,023.33 | $5,023.33 | 13.8× |