Imaging prices at HCA Florida Capital Hospital
Tallahassee, FL · every code in this section with a posted price and a Medicare benchmark.
309 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) | $4,953 | $4,953 | 3.4× |
| Acute gi blood loss imaging (78278) | $5,865.55 | $5,865.55 | 14.1× |
| Angio extremity unilateral (75710) | $8,167 | $8,167 | 2.5× |
| Angio pulmonary unilateral (75741) | $8,167 | $8,167 | 2.5× |
| Angiogram extremity bilateral (75716) | $6,127 | $6,127 | 1.9× |
| Angiogram pelvic (75736) | $6,429.50 | $6,429.50 | 1.1× |
| Angiography internal mammary rs&i (75756) | $2,586.80 | $2,586.80 | 0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $13,070.20 | $13,070.20 | 4.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $20,606.92 | $20,606.92 | 3.5× |
| Angrph cath f-up std tcat other than thrombylsis (75898) | $10,742.62 | $10,742.62 | 3.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,586.80 | $2,586.80 | 0.8× |
| Ankle 2 views (73600) | $1,977.80 | $1,977.80 | 21.8× |
| Arthrography knee lt (73580) | $2,594 | $2,594 | 7.1× |
| Arthrography wrist lt (73115) | $2,942.90 | $2,942.90 | 8.1× |
| Barium enema (74270) | $5,267.20 | $5,267.20 | 28.8× |
| Basic dosimetry (77300) | $431.68 | $431.68 | 3.1× |
| Bilat selctv renal venogram (75833) | $8,167 | $8,167 | 2.5× |
| Bone age studies (77072) | $2,364.20 | $2,364.20 | 21.7× |
| Bone imaging limited area (78300) | $11,347.95 | $11,347.95 | 27.2× |
| Bone survey complete (77075) | $2,365.42 | $2,365.42 | 21.7× |
| Bowel imaging (78290) | $9,635.85 | $9,635.85 | 23.1× |
| Brain image w/flow 4 + views (78606) | $4,183.15 | $4,183.15 | 7.4× |
| Cardiac MRI w/wo contrast & further seq (75561) | $3,663.65 | $3,663.65 | 10.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $2,930.25 | $2,930.25 | 16.0× |
| Cineradiography/videoradiography (76120) | $336.45 | $336.45 | 3.1× |
| Cisternogram (78630) | $3,585.15 | $3,585.15 | 6.3× |
| Clavicle complete (73000) | $1,902.95 | $1,902.95 | 20.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) | $11,684.40 | $11,684.40 | 63.8× |
| Continuing medical physics consltj pr wk (77336) | $450.45 | $450.45 | 3.2× |
| Contrast exam abdominl aorta (75625) | $16,038.50 | $16,038.50 | 4.9× |
| Contrast exam thoracic aorta (75605) | $8,167 | $8,167 | 1.4× |
| CT - st neck w&wo contr (70492) | $11,948.45 | $11,948.45 | 65.2× |
| CT abdomen and pelvis without and with contrast (74178) | $12,917.48 | $12,917.48 | 35.5× |
| CT abdomen and pelvis without contrast (74176) | $9,587.42 | $9,587.42 | 38.5× |
| CT abdomen w wo contrast (74170) | $12,232.80 | $12,232.80 | 66.8× |
| CT abdomen w/contrast (74160) | $11,936.85 | $11,936.85 | 65.2× |
| CT abdomen w/o contrast (74150) | $10,228.92 | $10,228.92 | 93.7× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) | $6,655.42 | $6,655.42 | 18.3× |
| CT angio abdom w/o & w/dye (74175) | $3,680.08 | $3,680.08 | 20.1× |
| CT angio abdominal arteries (75635) | $4,605.30 | $4,605.30 | 25.1× |
| CT angio hrt w/3d image (75574) | $2,949.30 | $2,949.30 | 8.1× |
| CT angiograph pelv w/o&w/dye (72191) | $3,713.30 | $3,713.30 | 20.3× |
| CT cervical spine w/contrast (72126) | $13,016.32 | $13,016.32 | 35.7× |
| CT cervical spine w/o contrast (72125) | $10,236.38 | $10,236.38 | 93.8× |
| CT chest w/contrast (71260) | $11,936.85 | $11,936.85 | 65.2× |
| CT extremity upper w & w/o contrast (73202) | $15,099.25 | $15,099.25 | 82.4× |
| CT head/brain with contrast (70460) | $9,615.72 | $9,615.72 | 52.5× |
| CT head/brain without and with contrast (70470) | $12,611.60 | $12,611.60 | 68.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,549.50 | $2,549.50 | 7.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $2,116.05 | $2,116.05 | 23.3× |
| CT limited/localized follow up study (76380) | $2,858.38 | $2,858.38 | 31.5× |
| CT lower ext w/wo contrast (73702) | $10,853.40 | $10,853.40 | 59.3× |
| CT lower extremity w contrast (73701) | $7,911.05 | $7,911.05 | 43.2× |
| CT lower extremity w/o contrast unilateral (73700) | $9,175.05 | $9,175.05 | 84.0× |
| CT lumbar spine w/contrast (72132) | $13,858.78 | $13,858.78 | 38.0× |
| CT lumbar spine w/o contrast (72131) | $7,780.32 | $7,780.32 | 71.3× |
| CT lumbar spine w/o then w/ con (72133) | $8,594.60 | $8,594.60 | 46.9× |
| CT maxillofacial area w/o contrast (70486) | $6,168.45 | $6,168.45 | 56.5× |
| CT maxillofacial w/contrast (70487) | $11,266.22 | $11,266.22 | 61.5× |
| CT maxillofacial w/o then w/ con (70488) | $11,471.92 | $11,471.92 | 62.6× |
| CT orbit sella ear w/o con (70480) | $9,360.90 | $9,360.90 | 85.7× |
| CT orbit/ear/fossa w/o then w/ con (70482) | $7,390.58 | $7,390.58 | 40.3× |
| CT pelvis w & w/o contrast (72194) | $14,341.85 | $14,341.85 | 78.3× |
| CT pelvis w/o contrast (72192) | $9,739.85 | $9,739.85 | 89.2× |
| CT soft tissue neck w/contrast (70491) | $11,697.80 | $11,697.80 | 63.9× |
| CT soft tissue neck w/o contrast (70490) | $11,468.62 | $11,468.62 | 105.1× |
| CT spine cervical w/wo contrast (72127) | $13,991.15 | $13,991.15 | 76.4× |
| CT thoracic spine w/contrast (72129) | $9,212.42 | $9,212.42 | 50.3× |
| CT thoracic spine w/o contrast (72128) | $4,889.70 | $4,889.70 | 44.8× |
| CT thoracic spine w/o then w/ con (72130) | $13,991.15 | $13,991.15 | 76.4× |
| CT thorax lung cancer scr c- (71271) | $691.40 | $691.40 | 6.3× |
| CT thorax w/o contrast (71250) | $10,319.68 | $10,319.68 | 94.5× |
| CT thorax w/o then w/ contrast (71270) | $11,606.85 | $11,606.85 | 63.4× |
| CT upper extremity w/dye (73201) | $13,090.40 | $13,090.40 | 35.9× |
| CT upper extremity w/o contrast rt (73200) | $10,088.05 | $10,088.05 | 92.4× |
| CTA chest w/wo contrast (71275) | $7,195.48 | $7,195.48 | 39.3× |
| CTA head w contrast (70496) | $5,551.85 | $5,551.85 | 30.3× |
| CTA lower extremity w/wo contrast unilateral (73706) | $2,226.40 | $2,226.40 | 12.2× |
| Cta Neck (70498) | $5,551.85 | $5,551.85 | 30.3× |
| CTA upper extremity w/wo contrast unilateral (73206) | $4,154.25 | $4,154.25 | 22.7× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) | $7,005 | $7,005 | 3.4× |
| Diskography lumbar (72295) | $8,201.35 | $8,201.35 | 4.0× |
| Esophogram (74220) | $2,930.25 | $2,930.25 | 16.0× |
| Fetal biophysical profile non-stress testing (76818) | $364.70 | $364.70 | 3.3× |
| Fetal biophysical profile w/o nst (76819) | $1,090.25 | $1,090.25 | 10.0× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) | $1,192.15 | $1,192.15 | 4.8× |
| Gastric emptying study (78264) | $5,810.15 | $5,810.15 | 13.9× |
| Gated heart planar single (78472) | $7,429.25 | $7,429.25 | 17.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) | $2,814.15 | $2,814.15 | 3.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) | $4,296.80 | $4,296.80 | 5.9× |
| Hepatobil syst image w/drug (78227) | $7,943.95 | $7,943.95 | 14.0× |
| Hepatobiliary system imaging (78226) | $7,943.95 | $7,943.95 | 19.0× |
| Humerus min 2 views (73060) | $1,946.45 | $1,946.45 | 21.4× |
| Hysterosalpingography (74740) | $4,993.45 | $4,993.45 | 20.0× |
| Image fusion (77399) | $2,046 | $2,046 | 14.6× |
| Imrt planning (77301) | $11,458.65 | $11,458.65 | 7.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) | $9,948.80 | $9,948.80 | 17.5× |
| Liver & spleen; static only (78215) | $10,061.95 | $10,061.95 | 24.1× |
| Lung perfusion differential (78597) | $760.75 | $760.75 | 1.8× |
| Lung ventilat&perfus imaging (78582) | $1,184.65 | $1,184.65 | 2.1× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) | $5,273.65 | $5,273.65 | 14.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) | $5,273.65 | $5,273.65 | 14.5× |
| Mammary ductogram single (77053) | $994.70 | $994.70 | 4.0× |
| Mlc device(s) for imrt (77338) | $2,825.45 | $2,825.45 | 7.2× |
| MRA head w & w/o contrast (70546) | $5,273.65 | $5,273.65 | 14.5× |
| MRA head w/o contrast (70544) | $3,637.30 | $3,637.30 | 14.6× |
| MRA neck w/o contrast (70547) | $3,637.30 | $3,637.30 | 14.6× |
| MRA neck w/wo contrast (70549) | $5,273.65 | $5,273.65 | 14.5× |
| MRI abdomen w/contrast (74182) | $3,902.35 | $3,902.35 | 10.7× |
| MRI abdomen w/o & w/contrast material (74183) | $5,273.65 | $5,273.65 | 14.5× |
| MRI abdomen w/o contrast (74181) | $3,637.30 | $3,637.30 | 14.6× |
| MRI any jnt lwr ext with con lt (73722) | $3,902.35 | $3,902.35 | 4.8× |
| MRI cervical spine w/o contrast (72141) | $3,637.30 | $3,637.30 | 14.6× |
| MRI cervical spine with contrast (72142) | $3,902.35 | $3,902.35 | 10.7× |
| MRI chest w & w/o contrast (71552) | $5,273.65 | $5,273.65 | 14.5× |
| MRI chest w/o contrast (71550) | $3,637.30 | $3,637.30 | 14.6× |
| MRI joint upper ext w/contrast (73222) | $3,144.15 | $3,144.15 | 3.8× |
| MRI joint upr extr w/o&w/dye (73223) | $3,850.05 | $3,850.05 | 10.6× |
| MRI joint upr extrem w/o dye (73221) | $3,637.30 | $3,637.30 | 14.6× |
| Mri Lower Extremity W/O Dye (73718) | $3,637.30 | $3,637.30 | 14.6× |
| MRI lumbar spine with contrast (72149) | $3,902.35 | $3,902.35 | 10.7× |
| MRI lumbar w/wo contrast (72158) | $5,273.65 | $5,273.65 | 14.5× |
| MRI lwr ext w/o jnts with con rt (73719) | $3,902.35 | $3,902.35 | 10.7× |
| MRI orbit/face/neck w/contrast (70542) | $3,902.35 | $3,902.35 | 10.7× |
| MRI orbit/face/neck w/o & w/contrast (70543) | $5,273.65 | $5,273.65 | 14.5× |
| MRI orbit/face/neck w/o contrast (70540) | $3,637.30 | $3,637.30 | 14.6× |
| MRI pelvis w/ contrast (72196) | $3,902.35 | $3,902.35 | 10.7× |
| MRI pelvis w/o contrast (72195) | $3,637.30 | $3,637.30 | 14.6× |
| MRI pelvis w/wo contrast (72197) | $5,273.65 | $5,273.65 | 14.5× |
| MRI spine cervical wo/w contrast (72156) | $5,273.65 | $5,273.65 | 14.5× |
| MRI spine thoracic w/contrast (72147) | $3,902.35 | $3,902.35 | 10.7× |
| MRI thoracic spine w wo contrast (72157) | $5,273.65 | $5,273.65 | 14.5× |
| MRI thoracic spine w/o contrast (72146) | $3,637.30 | $3,637.30 | 14.6× |
| MRI tmj (70336) | $3,637.30 | $3,637.30 | 14.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,637.30 | $3,637.30 | 14.6× |
| Mri Upper Extremity W/Dye (73219) | $2,076.50 | $2,076.50 | 5.7× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) | $3,743.65 | $3,743.65 | 10.3× |
| Myelogram thoracic (72255) | $8,769.60 | $8,769.60 | 10.7× |
| Myelography lumbosacral (72265) | $11,907.05 | $11,907.05 | 14.5× |
| Nm bone 3 phase (78315) | $11,347.95 | $11,347.95 | 27.2× |
| Nm bone imaging whole body (78306) | $8,277.40 | $8,277.40 | 19.8× |
| Nm heart perfusion spect stress rest (78452) | $15,675.55 | $15,675.55 | 11.6× |
| Nm kidney imaging morphology (78700) | $2,825.50 | $2,825.50 | 6.8× |
| Nm liver image static only (78201) | $6,321.10 | $6,321.10 | 11.1× |
| Nm lymph system (78195) | $2,905.95 | $2,905.95 | 5.1× |
| Nm thyroid imaging only (78013) | $5,660.15 | $5,660.15 | 13.6× |
| Nose to rectum for fb child (76010) | $2,343.20 | $2,343.20 | 25.8× |
| Nuclear rx IV admin (79101) | $2,813 | $2,813 | 11.5× |
| Ob us < 14 wks single fetus (76801) | $2,796.88 | $2,796.88 | 25.6× |
| Oral radiopharm rx (79005) | $2,822.60 | $2,822.60 | 11.6× |
| Parathyroid imaging (78070) | $3,015.10 | $3,015.10 | 7.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) | $6,624.05 | $6,624.05 | 2.0× |
| Pulmonary perfusion imaging particulate (78580) | $760.75 | $760.75 | 1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,576.80 | $2,576.80 | 4.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $392.25 | $392.25 | 4.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $647.70 | $647.70 | 5.9× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) | $1,223 | $1,223 | 11.2× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) | $1,694.75 | $1,694.75 | 15.5× |
| Radex hip unilateral with pelvis 1 view (73501) | $392.25 | $392.25 | 4.3× |
| Radex hip unilateral with pelvis 2-3 views (73502) | $647.70 | $647.70 | 7.1× |
| Radex hip unilateral with pelvis minimum 4 views (73503) | $1,458.88 | $1,458.88 | 13.4× |
| Radex hips bilateral with pelvis 2 views (73521) | $784.15 | $784.15 | 7.2× |
| Radex hips bilateral with pelvis minimum 5 views (73523) | $2,442.70 | $2,442.70 | 22.4× |
| Radex spine cervical 2 or 3 views (72040) | $2,930.25 | $2,930.25 | 32.2× |
| Radex spine cervical 4 or 5 views (72050) | $3,714.75 | $3,714.75 | 34.0× |
| Radex spine cervical 6 or more views (72052) | $4,252.85 | $4,252.85 | 39.0× |
| Radiation tx delivery lvl 3 (77412) | $1,290.40 | $1,290.40 | 2.2× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) | $3,327.75 | $3,327.75 | 30.5× |
| Radiologic exam esophagus double contrast study (74221) | $1,379.60 | $1,379.60 | 7.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,103.40 | $1,103.40 | 6.0× |
| Radiologic exam upr gi trc single contrast study (74240) | $1,221.90 | $1,221.90 | 6.7× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) | $392.25 | $392.25 | 4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $1,694.75 | $1,694.75 | 18.6× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) | $1,966.40 | $1,966.40 | 18.0× |
| Renal cyst study (74470) | $933.75 | $933.75 | 1.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $4,147.90 | $4,147.90 | 9.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $4,147.90 | $4,147.90 | 9.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $10,092.80 | $10,092.80 | 17.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $9,635.85 | $9,635.85 | 17.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $8,074.30 | $8,074.30 | 6.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) | $8,074.30 | $8,074.30 | 6.0× |
| Rp therapy intra-arterial particulate admn (79445) | $1,665.85 | $1,665.85 | 6.8× |
| Saline infused sonohysterogram (76831) | $1,036.65 | $1,036.65 | 4.2× |
| Selective spinal angiogram (75705) | $25,290.30 | $25,290.30 | 4.4× |
| Shoulder arthrogram (73040) | $4,914.90 | $4,914.90 | 13.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) | $1,559.85 | $1,559.85 | 14.3× |
| Simulation complex (77290) | $8,626.78 | $8,626.78 | 22.1× |
| Simulation simple (77280) | $803.40 | $803.40 | 5.7× |
| Small bowel series (74250) | $3,023.85 | $3,023.85 | 16.5× |
| Special dosimetry (77331) | $287.60 | $287.60 | 2.0× |
| Special physics consult (77370) | $851.20 | $851.20 | 6.1× |
| Special treatment procedure (77470) | $2,138.05 | $2,138.05 | 3.7× |
| Stereotactic body radiation delivery (77373) | $10,220.45 | $10,220.45 | 5.5× |
| Thyroid met imaging body (78018) | $2,017.75 | $2,017.75 | 3.6× |
| Thyroid uptake single/multiple quant measurement (78012) | $4,328.95 | $4,328.95 | 10.4× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) | $8,808.60 | $8,808.60 | 21.1× |
| Treatment device intermediate (77333) | $426.90 | $426.90 | 3.0× |
| Treatment devices complex (77334) | $594 | $594 | 1.5× |
| Treatment devices simple (77332) | $396.85 | $396.85 | 2.8× |
| Ultrasound breast limited (76642) | $1,156.75 | $1,156.75 | 12.7× |
| Ultrasound, abdomen limited (76705) | $1,133.75 | $1,133.75 | 10.4× |
| Unlisted diagnostic radiographic procedure (76499) | $183.70 | $183.70 | 2.0× |
| Unlisted miscellaneous procedure, diagnostic nuclear medicine UNSCHEDULED (78999) | $1,140.20 | $1,140.20 | 2.7× |
| Unlisted procedure, clinical brachytherapy (77799) | $458.42 | $458.42 | 4.3× |
| Urethrocystography retrograde rs&i (74450) | $3,005.85 | $3,005.85 | 12.1× |
| Urethrocystography voiding (74455) | $3,885.45 | $3,885.45 | 15.6× |
| Urography antegrade (74425) | $2,315.15 | $2,315.15 | 6.4× |
| Urography retrograde w/wo kub (74420) | $5,157.45 | $5,157.45 | 14.2× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) | $3,812.20 | $3,812.20 | 20.8× |
| Us abdominal aorta real time screen study aaa (76706) | $616.40 | $616.40 | 5.6× |
| Us breast uni real time with image complete (76641) | $1,395.65 | $1,395.65 | 12.8× |
| Us chest (76604) | $897.75 | $897.75 | 8.2× |
| Us compl joint r-t w/image documentation (76881) | $897.75 | $897.75 | 8.2× |
| Us encephalogram (76506) | $1,131.10 | $1,131.10 | 10.4× |
| Us guided compression repair (76936) | $819.90 | $819.90 | 3.6× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) | $999.90 | $999.90 | 11.0× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) | $189.52 | $189.52 | 1.7× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $701.55 | $701.55 | 6.4× |
| Us ob followup per fetus (76816) | $697.90 | $697.90 | 6.4× |
| Us ob limited 1 or more fetuses (76815) | $573.95 | $573.95 | 5.3× |
| Us obstetric transvaginal (76817) | $1,784.28 | $1,784.28 | 16.3× |
| Us pelvic limited or f/u non-ob (76857) | $889.35 | $889.35 | 8.1× |
| Us pelvis complete (76856) | $1,790.90 | $1,790.90 | 16.4× |
| Us retroperitoneal complete (76770) | $1,790.90 | $1,790.90 | 16.4× |
| Us retroperitoneal limited (76775) | $897.75 | $897.75 | 8.2× |
| Us scrotum (76870) | $1,790.90 | $1,790.90 | 16.4× |
| Us soft tissue head/neck (76536) | $1,790.90 | $1,790.90 | 16.4× |
| Us spinal canal (76800) | $1,090.25 | $1,090.25 | 10.0× |
| Us transrectal (76872) | $2,815.55 | $2,815.55 | 25.8× |
| Us unlstd proc (76999) | $1,632.78 | $1,632.78 | 18.0× |
| Venogram extremity bilateral (75822) | $4,542.30 | $4,542.30 | 2.8× |
| Venogram ivc w serialography (75825) | $11,241.70 | $11,241.70 | 3.4× |
| Venogram svc w serialography (75827) | $3,612 | $3,612 | 2.2× |
| Venography ext unilateral (75820) | $4,168.35 | $4,168.35 | 2.5× |
| Venography renal unilateral selective rs&i (75831) | $8,167 | $8,167 | 2.5× |
| Venography venous sinus/jugular cath rs&i (75860) | $12,229.15 | $12,229.15 | 3.7× |
| Venous sampling by catheter (75893) | $8,167 | $8,167 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $2,129.90 | $2,129.90 | 23.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $2,534.90 | $2,534.90 | 27.9× |
| X-ray aorta leg arteries (75630) | $16,038.50 | $16,038.50 | 4.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $6,389.50 | $6,389.50 | 34.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $2,521.28 | $2,521.28 | 27.7× |
| X-ray exam hips bi 3-4 views (73522) | $1,293.40 | $1,293.40 | 11.8× |
| X-ray exam of finger(s) (73140) | $1,698.02 | $1,698.02 | 18.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) | $4,168.35 | $4,168.35 | 22.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,584.70 | $1,584.70 | 17.4× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) | $1,605.35 | $1,605.35 | 17.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $2,621.10 | $2,621.10 | 28.8× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) | $1,913.28 | $1,913.28 | 17.5× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) | $2,637.28 | $2,637.28 | 29.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $1,836.30 | $1,836.30 | 20.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $3,281.20 | $3,281.20 | 36.1× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) | $1,619.05 | $1,619.05 | 17.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $1,727 | $1,727 | 15.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,957.30 | $1,957.30 | 21.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $3,254.20 | $3,254.20 | 29.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $4,838.85 | $4,838.85 | 44.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $3,038.60 | $3,038.60 | 33.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $4,116.80 | $4,116.80 | 37.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,888.90 | $1,888.90 | 17.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $2,761.40 | $2,761.40 | 30.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $2,948.32 | $2,948.32 | 32.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $3,136.42 | $3,136.42 | 34.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $3,492.70 | $3,492.70 | 32.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $3,491.85 | $3,491.85 | 32.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $2,885.75 | $2,885.75 | 31.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $1,480.55 | $1,480.55 | 16.3× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) | $1,600.80 | $1,600.80 | 17.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $2,324.25 | $2,324.25 | 25.6× |
| Xr abdomen 1 view (74018) | $1,106.25 | $1,106.25 | 12.2× |
| Xr abdomen 2 views (74019) | $2,979 | $2,979 | 27.3× |
| Xr abdomen 3 views (74021) | $2,979 | $2,979 | 27.3× |
| Xr arthrogram ankle (73615) | $2,247.15 | $2,247.15 | 6.2× |
| Xr arthrogram elbow (73085) | $2,247.15 | $2,247.15 | 6.2× |
| Xr arthrogram hip (73525) | $4,590.70 | $4,590.70 | 12.6× |
| Xr bone survey infant (77076) | $703.45 | $703.45 | 6.4× |
| Xr bone survey limited (77074) | $4,042.10 | $4,042.10 | 37.0× |
| Xr chest 1 view (71045) | $1,309.50 | $1,309.50 | 14.4× |
| Xr chest 2 views (71046) | $1,683.55 | $1,683.55 | 18.5× |
| Xr chest 3 views (71047) | $2,955.55 | $2,955.55 | 32.5× |
| Xr cystogram 3+ views (74430) | $3,358.45 | $3,358.45 | 9.2× |
| Xr eye foreign body (70030) | $854.50 | $854.50 | 9.4× |
| Xr facial bones 3 views (70150) | $3,434 | $3,434 | 31.5× |
| Xr lower extremity 2 views infant (73592) | $2,661.42 | $2,661.42 | 29.3× |
| Xr lumbar spine 4 views w/ flex ext (72120) | $3,250.70 | $3,250.70 | 29.8× |
| Xr mandible 4 views (70110) | $3,221.60 | $3,221.60 | 29.5× |
| Xr myelogram c-spine (72240) | $7,357.65 | $7,357.65 | 9.0× |
| Xr nasal bones (70160) | $2,550.88 | $2,550.88 | 28.1× |
| Xr pelvis 3 views (72190) | $2,219.80 | $2,219.80 | 20.3× |
| Xr sella turcica (70240) | $1,088.30 | $1,088.30 | 12.0× |
| Xr sialogram (70390) | $1,633.40 | $1,633.40 | 6.6× |
| Xr spine 1 view (72020) | $1,156.30 | $1,156.30 | 12.7× |
| Xr sternum 2 views (71120) | $2,558.92 | $2,558.92 | 28.2× |
| Xr surgical specimen (76098) | $2,072.60 | $2,072.60 | 3.6× |
| Xr upper extremity 2 views infant (73092) | $2,247.15 | $2,247.15 | 20.6× |
| Xray elbow 2 views (73070) | $1,922.95 | $1,922.95 | 21.2× |
| Xray forearm 2 views (73090) | $2,408.70 | $2,408.70 | 26.5× |
| Xray knee 1 or 2 views rt (73560) | $1,653.20 | $1,653.20 | 18.2× |
| Xray neck soft tissue (70360) | $1,820.25 | $1,820.25 | 20.0× |
| Xray orbits complete min 4 views (70200) | $3,408.72 | $3,408.72 | 31.2× |
| Xray pelvis 1 or 2 views (72170) | $1,615.52 | $1,615.52 | 14.8× |
| Xray scapula complete (73010) | $2,617.30 | $2,617.30 | 24.0× |
| Xray shoulder 1 view (73020) | $2,067.88 | $2,067.88 | 22.8× |
| Xray sinuses paranasal <3 views (70210) | $2,449.05 | $2,449.05 | 26.9× |
| Xray spine thoracic 2 views (72070) | $3,169.70 | $3,169.70 | 29.0× |
| Xray spine thoracic 3 views (72072) | $2,238.72 | $2,238.72 | 20.5× |
| Xray tibia-fibula 2 views bil (73590) | $2,639.68 | $2,639.68 | 29.0× |
| Xray tmj open - closed unilat (70328) | $1,790.58 | $1,790.58 | 19.7× |
| Xray tmj's bilateral open-clsc (70330) | $2,311.48 | $2,311.48 | 25.4× |