Imaging prices at HCA HealthOne Rose Medical Center

Denver, CO · every code in this section with a posted price and a Medicare benchmark.

385 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $12,905 $12,905 8.8×
Acute gi blood loss imaging (78278) $8,348 $8,348 19.8×
Angiography internal mammary rs&i (75756) $25,248 $25,248 7.6×
Angiography pulmonary bilateral slctv rs&i (75743) $25,248 $25,248 7.6×
Angiography visceral slctv/supraslctv rs&i (75726) $24,150 $24,150 4.1×
Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) $20,745 $20,745 6.2×
Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) $21,488 $21,488 6.5×
Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736) $20,745 $20,745 3.5×
Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation Age Under 21 (75741) $25,248 $25,248 7.6×
Angiography, spinal, selective, radiological supervision and interpretation Age Under 21 (75705) $44,053 $44,053 7.5×
Angrph cath f-up std tcat other than thrombylsis (75898) $9,834 $9,834 3.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $20,745 $20,745 6.2×
Ankle 2 views (73600) $1,343 $1,343 14.6×
Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) $21,488 $21,488 6.5×
Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) $21,488 $21,488 6.5×
Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605) $20,698 $20,698 3.5×
Basic radiation dosimetry calculation (77300) $2,406 $2,406 17.0×
Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) $8,264.22 $8,264.22 14.4×
Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) $37,412 $37,412 24.8×
Cardiac MRI w/wo contrast & further seq (75561) $10,754 $10,754 29.2×
Clavicle complete (73000) $1,603 $1,603 17.5×
Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) $4,467 $4,467 17.7×
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including… (74262) $5,499 $5,499 29.7×
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material Age Under… (74261) $4,632 $4,632 42.0×
Computed tomographic (CT) colonography, screening, including image postprocessing (74263) $12,263.50 $12,263.50 48.7×
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) $25,492 $25,492 69.3×
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) $16,049 $16,049 86.7×
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) $11,571.50 $11,571.50 62.5×
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) $6,293 $6,293 34.0×
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) $11,846 $11,846 64.0×
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) $8,291 $8,291 44.8×
Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) $18,203 $18,203 98.4×
Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) $15,133 $15,133 81.8×
Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) $16,372 $16,372 88.5×
Computed tomography, lower extremity; without contrast material Age Under 21 (73700) $10,026 $10,026 90.9×
Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) $17,049 $17,049 92.1×
Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) $13,648 $13,648 73.8×
Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) $11,087 $11,087 59.9×
Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) $8,692 $8,692 78.8×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) $11,879 $11,879 64.2×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) $10,393 $10,393 94.2×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) $10,724 $10,724 58.0×
Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) $13,586 $13,586 73.4×
Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) $16,622 $16,622 89.8×
Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) $18,599 $18,599 100.5×
Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) $3,323 $3,323 23.4×
Csf shunt evaluation (78645) $4,910 $4,910 8.6×
CT abdomen and pelvis without and with contrast (74178) $22,184 $22,184 60.3×
CT abdomen and pelvis without contrast (74176) $22,183 $22,183 88.1×
CT abdomen w & w/o contrast (74170) $14,468 $14,468 78.2×
CT abdomen w/contrast (74160) $14,169 $14,169 76.6×
CT abdomen w/o contrast (74150) $11,693 $11,693 106.0×
CT angio hrt w/3d image (75574) $8,248 $8,248 22.4×
CT cervical spine w/contrast (72126) $15,034 $15,034 40.9×
CT cervical spine w/o contrast (72125) $13,186 $13,186 119.6×
CT chest w/contrast (71260) $13,157 $13,157 71.1×
CT extremity upper w & w/o contrast (73202) $15,656 $15,656 84.6×
CT extremity upper w/o contrast (73200) $10,908 $10,908 98.9×
CT head/brain with contrast (70460) $13,089 $13,089 70.7×
CT head/brain without and with contrast (70470) $15,227 $15,227 82.3×
CT heart c+ cardiac strux&morph cgen hrt ds (75573) $3,823 $3,823 10.4×
CT heart contrast eval cardiac structure&morph (75572) $3,823 $3,823 10.4×
CT heart no contrast quant eval coronry calcium (75571) $319 $319 3.5×
CT l-spine w/contrast (72132) $11,372 $11,372 30.9×
CT limited/localized follow up study (76380) $6,797 $6,797 74.0×
CT lower extremity w/dye (73701) $12,276 $12,276 66.3×
CT lumbar spine w/o contrast (72131) $10,439 $10,439 94.7×
CT maxillofacial w/wo contrast (70488) $13,186 $13,186 71.3×
CT neck w/contrast (70491) $11,759 $11,759 63.6×
CT neck w/o contrast (70490) $11,481 $11,481 104.1×
CT pelvis w & w/o contrast (72194) $18,203 $18,203 98.4×
CT pelvis w/o contrast (72192) $10,063 $10,063 91.2×
CT thoracic spine w/contrast (72129) $15,169 $15,169 82.0×
CT thoracic spine w/o contrast (72128) $13,544 $13,544 122.8×
CT thorax lung cancer scr c- (71271) $190 $190 1.7×
CT thorax w/o contrast (71250) $11,911 $11,911 108.0×
CT upper extremity w/dye (73201) $13,550 $13,550 36.8×
CTA head w contrast (70496) $19,049 $19,049 103.0×
Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) $1,462 $1,462 4.0×
Dilation ureters/urethra rs&i (74485) $11,471 $11,471 5.2×
Diskography lumbar s&i (72295) $20,698 $20,698 10.0×
Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Age Under 21 (76827) $1,098 $1,098 10.0×
Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) $1,098 $1,098 10.0×
Doppler fetal mid cerebral artery (76821) $1,303 $1,303 11.8×
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) $3,583 $3,583 32.5×
Dxa bone density study axial skeleton (77085) $1,507 $1,507 13.7×
Dxa bone density/peripheral (77081) $3,167 $3,167 34.5×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76825) $2,981 $2,981 5.2×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $2,981 $2,981 11.8×
Esophageal motility (78258) $7,455 $7,455 17.7×
Fetal biophys profile w/o nst (76819) $1,197.50 $1,197.50 10.9×
Fetal biophysical profile non-stress testing (76818) $2,496 $2,496 22.6×
Fluoroscopy up to 1 hour physician/qhp time (76000) $1,592 $1,592 6.3×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $10,734.42 $10,734.42 18.7×
Gastroesophageal reflux study (78262) $9,555 $9,555 22.7×
Gated heart planar single (78472) $11,002.49 $11,002.49 26.1×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $8,810 $8,810 12.0×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $8,810 $8,810 12.0×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $8,810 $8,810 12.0×
Heart infarct image (78466) $6,001 $6,001 14.2×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $21,907 $21,907 6.6×
Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Age Under… (75889) $24,999 $24,999 7.5×
Hepatobil syst imag inc gb w/pharma intervenj (78227) $9,480 $9,480 16.6×
Hepatobiliary syst imaging including gallbladder (78226) $9,480 $9,480 22.5×
Ht muscle image spect sing (78451) $8,346 $8,346 6.1×
Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) $18,912 $18,912 13.0×
Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) $5,340 $5,340 7.3×
Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) $11,159.26 $11,159.26 26.5×
Intraoperative radiation treatment delivery, x-ray, single treatment session (77424) $61,206 $61,206 7.9×
Isodose brachytherapy complex 10+ sources (77318) $20,970 $20,970 53.1×
Isodose brachytherapy intermed 5 to 10 sources (77317) $17,943 $17,943 45.4×
Isodose brachytherapy plan simple 1 to 4 source (77316) $14,706 $14,706 37.2×
Isodose teletherapy plan complex multi tx w/cal (77307) $21,098 $21,098 53.4×
Isodose teletherapy plan simple 1 or 2 port w/cal (77306) $9,785 $9,785 24.8×
Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) $8,366.23 $8,366.23 14.6×
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) $17,044 $17,044 29.8×
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) $17,044 $17,044 29.8×
Leveen/shunt patency exam (78291) $7,418.04 $7,418.04 17.6×
Liver and spleen imaging (78215) $9,546.37 $9,546.37 22.6×
Liver and spleen imaging; with vascular flow Age Under 21 (78216) $11,795 $11,795 28.0×
Liver imaging (78201) $2,429 $2,429 4.2×
Liver imaging with flow (78202) $11,795 $11,795 20.6×
Lung perf&ventilat diferentl (78598) $13,369.22 $13,369.22 23.3×
Lung perfusion imaging (78580) $7,014.27 $7,014.27 16.6×
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) $14,502 $14,502 39.4×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) $13,455 $13,455 36.6×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) $11,308 $11,308 44.9×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) $11,308 $11,308 30.7×
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) $15,606 $15,606 42.4×
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) $12,835.50 $12,835.50 51.0×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) $13,455 $13,455 36.6×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $13,455 $13,455 36.6×
Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) $13,903 $13,903 37.8×
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) $14,074.50 $14,074.50 38.2×
Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) $14,074.50 $14,074.50 38.2×
Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) $4,140 $4,140 16.4×
Mammary ductogram single (77053) $4,633 $4,633 18.4×
Mandible min 4v (70110) $2,376 $2,376 21.5×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $77 $77 2.5×
MRA head w/o contrast (70544) $12,025.50 $12,025.50 47.8×
MRA neck w/ contrast (70548) $12,612 $12,612 34.3×
MRA neck w/o contrast (70547) $12,025.50 $12,025.50 47.8×
MRI abdomen w/contrast (74182) $15,090 $15,090 41.0×
MRI abdomen w/o contrast (74181) $12,366 $12,366 49.1×
MRI abdomen w/wo contrast (74183) $15,202.50 $15,202.50 41.3×
MRI any jt lower extrem w/contrast material (73722) $13,455 $13,455 16.3×
MRI breast c- bilateral (77047) $12,796 $12,796 50.8×
MRI c-spine w&w/o cont (72156) $14,535 $14,535 39.5×
MRI cervical spine w/contrast (72142) $13,599.50 $13,599.50 37.0×
MRI chest w/contrast (71551) $15,659 $15,659 18.9×
MRI chest w/o contrast (71550) $11,305 $11,305 44.9×
MRI chest w/wo contrast (71552) $16,560.50 $16,560.50 45.0×
MRI fetal sngl/1st gestation (74712) $11,308 $11,308 44.9×
MRI joint upr extr w/o&w/dye (73223) $15,149 $15,149 41.2×
MRI joint upr extrem w/dye (73222) $13,455 $13,455 16.3×
MRI joint upr extrem w/o dye (73221) $13,455 $13,455 53.5×
MRI lumbar spine w/contrast (72149) $14,822 $14,822 40.3×
MRI lumbar spine w/wo contrast (72158) $17,990.50 $17,990.50 48.9×
MRI orbit/face/neck w&w/o cont (70543) $14,881 $14,881 40.4×
MRI pelvis w & w/o contrast (72197) $13,828.50 $13,828.50 37.6×
MRI pelvis w/contrast (72196) $14,502 $14,502 39.4×
MRI pelvis w/o contrast (72195) $10,783 $10,783 42.8×
MRI spectroscopy (76390) $7,183 $7,183 78.2×
MRI spine cervical w/o contrast (72141) $11,683 $11,683 46.4×
MRI t-spine w&w/o cont (72157) $15,348.50 $15,348.50 41.7×
MRI thoracic spine w/contrast (72147) $14,822 $14,822 40.3×
MRI thoracic spine w/o contrst (72146) $10,783 $10,783 42.8×
MRI tmj (70336) $10,786.50 $10,786.50 42.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $11,308 $11,308 44.9×
Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) $9,903 $9,903 25.1×
Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) $5,085 $5,085 6.1×
Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78454) $8,346 $8,346 6.1×
Myocardial spect multiple studies (78452) $27,076 $27,076 19.8×
Myocrd img PET metab eval single study (78459) $37,412 $37,412 27.4×
N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) $3,138 $3,138 3.5×
Nm bone 3 phase (78315) $8,366.23 $8,366.23 19.8×
Nm bone imaging whole body (78306) $8,366.23 $8,366.23 19.8×
Nm bone marrow wb (78104) $13,893.25 $13,893.25 32.9×
Nm csf cisternogram (78630) $7,543 $7,543 13.2×
Nm csf leak detection (78650) $6,684 $6,684 4.9×
Nm gastric emptying (78264) $8,945.02 $8,945.02 21.2×
Nm lung ventilation imaging (78579) $2,433.31 $2,433.31 5.8×
Nm lymph system (78195) $8,563 $8,563 15.0×
Non-cardiac vascular flow imaging (ie, angiography, venography) Age Under 21 (78445) $4,454.26 $4,454.26 10.6×
Nuclear medicine study for detecting heart shunt (78428) $10,085.45 $10,085.45 23.9×
Nuclear medicine study of bone and/or joint limited area (78300) $8,366.23 $8,366.23 19.8×
Nuclear medicine study of bone and/or joint multiple areas (78305) $9,048.11 $9,048.11 21.5×
Ob us limited fetus(s) (76815) $1,369 $1,369 12.4×
Ob us nuchal meas 1 gest (76813) $1,672.50 $1,672.50 15.2×
Parathyroid planar imaging (78070) $9,654 $9,654 22.9×
Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation Age… (75885) $20,698 $20,698 6.2×
Perineogram (eg, vaginogram, for sex determination or extent of anomalies) Age Under 21 (74775) $4,315 $4,315 17.1×
PET imaging CT attenuation skull base mid-thigh (78815) $41,864 $41,864 27.8×
PET imaging CT for attenuation limited area (78814) $37,412 $37,412 24.8×
PET imaging for CT attenuation whole body (78816) $37,412 $37,412 24.8×
PET imaging whole body (78813) $37,412 $37,412 24.8×
Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) Age Under 21 (78811) $37,412 $37,412 27.4×
Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) $37,412 $37,412 24.8×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $4,489 $4,489 1.3×
Pulmonary ventilation & perfusion imaging (78582) $13,369.22 $13,369.22 23.3×
Quant differential pulm perfusion w/wo imaging (78597) $2,433.31 $2,433.31 5.8×
Radex abscess/fistula/sinus tract rs&i (76080) $2,850 $2,850 4.9×
Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) $1,628 $1,628 17.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $4,200 $4,200 38.1×
Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) $4,200 $4,200 38.1×
Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) $4,200 $4,200 38.1×
Radex hip unilateral with pelvis 1 view (73501) $914 $914 10.0×
Radex hip unilateral with pelvis 2-3 views (73502) $1,827 $1,827 19.9×
Radex hip unilateral with pelvis minimum 4 views (73503) $2,105 $2,105 19.1×
Radex hips bilateral with pelvis 2 views (73521) $1,827 $1,827 16.6×
Radex hips bilateral with pelvis minimum 5 views (73523) $2,380 $2,380 21.6×
Radex spine cervical 2 or 3 views (72040) $1,751 $1,751 19.1×
Radex spine cervical 4 or 5 views (72050) $2,631 $2,631 23.9×
Radex spine cervical 6 or more views (72052) $3,023 $3,023 27.4×
Radex spine thoracolumbar junction min 2 views (72080) $1,751 $1,751 19.1×
Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) $59,861 $59,861 7.7×
Radiation tx delivery lvl 1 (77402) $2,950 $2,950 27.4×
Radiation tx delivery lvl 2 (77407) $3,756 $3,756 9.2×
Radiation tx delivery lvl 3 (77412) $5,749 $5,749 9.9×
Radiologic exam abdomen 3+ views (74021) $2,438 $2,438 22.1×
Radiologic exam chest 3 views (71047) $1,486 $1,486 16.2×
Radiologic exam chest 4+ views (71048) $1,486 $1,486 13.5×
Radiologic exam colon double contrast study (74280) $4,762 $4,762 25.7×
Radiologic exam colon single contrast study (74270) $3,880 $3,880 21.0×
Radiologic exam esophagus double contrast study (74221) $2,313 $2,313 12.5×
Radiologic exam esophagus single contrast study (74220) $2,313 $2,313 12.5×
Radiologic exam small int single contrast study (74250) $3,630 $3,630 19.6×
Radiologic exam swallow function contrast study (74230) $2,732 $2,732 14.8×
Radiologic exam upr gi trc double contrast study (74246) $5,103 $5,103 27.6×
Radiologic exam upr gi trc single contrast study (74240) $5,103 $5,103 27.6×
Radiologic examination femur 1 view (73551) $914 $914 10.0×
Radiologic examination femur minimum 2 views (73552) $2,132.50 $2,132.50 23.2×
Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) $1,570 $1,570 17.1×
Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) $1,820 $1,820 19.8×
Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) $2,642 $2,642 24.0×
Radiologic examination, elbow; 2 views Age Under 21 (73070) $1,464 $1,464 15.9×
Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) $1,762 $1,762 19.2×
Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) $2,275 $2,275 24.8×
Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) $1,762 $1,762 19.2×
Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) $1,637 $1,637 17.8×
Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) $2,002 $2,002 18.2×
Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) $2,472 $2,472 22.4×
Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) $1,970 $1,970 21.5×
Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and… (74470) $2,678 $2,678 4.6×
Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) $3,061 $3,061 27.8×
Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) $2,669 $2,669 24.2×
Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) $2,678 $2,678 7.3×
Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) $2,055 $2,055 22.4×
Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) $4,194 $4,194 38.0×
Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) $1,144 $1,144 12.5×
Radiologic examination, skull; less than 4 views Age Under 21 (70250) $1,937 $1,937 17.6×
Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) $2,105 $2,105 19.1×
Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) $1,415 $1,415 12.8×
Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) $4,261 $4,261 38.6×
Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) $1,637 $1,637 17.8×
Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) $1,995 $1,995 21.7×
Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) $1,558 $1,558 17.0×
Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) $1,498 $1,498 16.3×
Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) $2,389 $2,389 21.7×
Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) $1,970 $1,970 21.5×
Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) $1,498 $1,498 16.3×
Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) $1,453 $1,453 13.2×
Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) $27,076 $27,076 47.3×
Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) $10,835.06 $10,835.06 44.0×
Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion (79403) $13,444.39 $13,444.39 54.6×
Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) $2,678 $2,678 10.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $8,366.23 $8,366.23 19.8×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $8,366.23 $8,366.23 19.8×
Rp loclzj tum plnr whole body 2+ days imaging (78804) $15,779 $15,779 27.5×
Rp loclzj tum plnr whole body single day imaging (78802) $27,076 $27,076 47.3×
Rp loclzj tum spect 2 areas (78831) $16,732.44 $16,732.44 12.3×
Rp loclzj tum spect w/CT 1 (78830) $16,732.44 $16,732.44 12.3×
Rp therapy intra-arterial particulate admn (79445) $1,793.31 $1,793.31 7.3×
Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) $2,814 $2,814 11.2×
Scapula complete (73010) $1,549 $1,549 14.0×
Screening digital breast tomosynthesis bi (77063) $127.50 $127.50 —
Shuntogram indwelling nonvascular shunt rs&i (75809) $676 $676 6.1×
Simulation intermediate (77285) $9,438 $9,438 23.9×
Special dosimetry (77331) $5,646 $5,646 39.8×
Special physics consult (77370) $6,550 $6,550 46.2×
Special teletherapy port plan (77321) $10,752 $10,752 27.2×
Special treatment procedure (77470) $24,050 $24,050 41.3×
Splenoportography, radiological supervision and interpretation Age Under 21 (75810) $21,488 $21,488 6.5×
Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) $22,784 $22,784 12.1×
Surface application of low dose rate radionuclide source (77789) $2,330.22 $2,330.22 21.7×
Temporomandibular joint arthrography, radiological supervision and interpretation Age Under 21 (70332) $1,462 $1,462 5.8×
Testicular imaging with vascular flow Age Under 21 (78761) $8,022 $8,022 19.0×
Ther rad simulaj-aided field setting complex (77290) $10,921 $10,921 27.6×
Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) $2,642 $2,642 14.3×
Thyroid imaging with vascular flow (78013) $5,111.44 $5,111.44 12.1×
Thyroid met imaging body (78018) $13,258 $13,258 23.1×
Thyroid uptake single/multiple quant measurement (78012) $4,166.46 $4,166.46 9.9×
Thyroid uptake w/blood flow sngle/mult quan meas (78014) $7,208 $7,208 17.1×
Tr simulation simple (77280) $5,785 $5,785 40.8×
Treatment device complex (77334) $6,067 $6,067 15.4×
Treatment device intermediate (77333) $4,712 $4,712 33.2×
Treatment device simple (77332) $2,770 $2,770 19.5×
Ultrasound breast limited (76642) $810 $810 8.8×
Ultrasound, abdomen limited (76705) $2,219 $2,219 20.1×
Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) $798.50 $798.50 7.2×
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) $3,026 $3,026 27.4×
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) $1,475.50 $1,475.50 5.9×
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) $2,002 $2,002 18.2×
Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) $6,397 $6,397 58.0×
Umbilical-artery Doppler (OB) (76820) $1,359 $1,359 12.3×
Urethrocystography retrograde rs&i (74450) $1,462 $1,462 5.8×
Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) $4,539 $4,539 24.5×
Urography antegrade rs&i (74425) $2,763 $2,763 7.5×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Age Under 21 (74415) $5,163 $5,163 27.9×
Us abdominal aorta real time screen study aaa (76706) $2,997 $2,997 27.2×
Us breast uni real time with image complete (76641) $810 $810 7.3×
Us chest (76604) $1,206 $1,206 10.9×
Us compl joint r-t w/image documentation (76881) $2,354 $2,354 21.3×
Us elastography organ (76981) $4,433 $4,433 40.2×
Us encephalogram (76506) $3,960 $3,960 35.9×
Us exam, pelvic, limited (76857) $2,135.50 $2,135.50 19.4×
Us guided compression repair (76936) $3,251 $3,251 14.3×
Us inft hips r-t img dynamic req phys/qhp manj (76885) $3,226 $3,226 35.1×
US OB Follow-Up/Repeat (76816) $1,273 $1,273 11.5×
Us ob transvaginal (76817) $2,196 $2,196 19.9×
Us retroperitoneal complete (76770) $3,592 $3,592 32.6×
Us retroperitoneal ltd (76775) $2,969.50 $2,969.50 26.9×
Us scrotum (76870) $3,967 $3,967 36.0×
Us soft tissue head/neck (76536) $3,880 $3,880 35.2×
Us spinal canal (76800) $2,231 $2,231 20.2×
Us transrectal (76872) $3,117 $3,117 28.3×
Venogram sinus/jugular (75860) $20,745 $20,745 6.2×
Venography adrenal unilateral selective rs&i (75840) $10,130 $10,130 3.0×
Venography renal unilateral selective rs&i (75831) $24,699 $24,699 7.4×
Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) $24,150 $24,150 7.3×
Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) $8,737 $8,737 5.3×
Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) $8,542 $8,542 5.1×
Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) $7,767 $7,767 4.7×
Venous sampling thru cath w/wo angiography rs& (75893) $20,745 $20,745 3.5×
Vertebral fracture assessment via dxa (77086) $1,005 $1,005 10.9×
X-ray exam hips bi 3-4 views (73522) $2,105 $2,105 19.1×
X-ray exam of finger(s) (73140) $1,532 $1,532 16.7×
X-ray exam of knee 1 or 2 (73560) $1,563 $1,563 17.0×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $3,806 $3,806 20.6×
X-ray exam ribs bil 3 views (71110) $2,669 $2,669 24.2×
X-ray exam ribs uni 2 views (71100) $1,052 $1,052 11.5×
X-ray heel (73650) $1,762 $1,762 19.2×
X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) $2,055 $2,055 18.6×
Xr abdomen 1 view (74018) $1,563 $1,563 17.0×
Xr abdomen 2 views (74019) $2,438 $2,438 22.1×
Xr arthrogram ankle (73615) $2,678 $2,678 7.3×
Xr arthrogram elbow (73085) $2,678 $2,678 7.3×
Xr arthrogram hip (73525) $2,678 $2,678 7.3×
Xr arthrogram knee (73580) $2,678 $2,678 7.3×
Xr arthrogram wrist (73115) $1,462 $1,462 4.0×
Xr bone age studies (77072) $1,540 $1,540 14.0×
Xr bone length study (77073) $1,453 $1,453 13.2×
Xr bone survey infant (77076) $3,571 $3,571 32.4×
Xr bone survey ltd (77074) $2,797 $2,797 25.4×
Xr chest 1 view (71045) $816 $816 8.9×
Xr chest 2 views (71046) $1,023 $1,023 11.1×
Xr eye foreign body (70030) $723 $723 7.9×
Xr facial bones 3+ views (70150) $2,532 $2,532 23.0×
Xr foot arthritis pa only bilateral - report(ortho pro) (73620) $1,343 $1,343 14.6×
Xr forearm 2 views (73090) $1,603 $1,603 17.5×
Xr hand 2v (73120) $1,532 $1,532 13.9×
Xr hysterosalpingogram (74740) $4,315 $4,315 17.1×
Xr myelogram c-spine (72240) $5,085 $5,085 6.1×
Xr myelogram l-spine (72265) $5,085 $5,085 6.1×
Xr myelogram t-spine (72255) $5,085 $5,085 6.1×
Xr neck soft tissue (70360) $1,715 $1,715 18.7×
Xr o knee w/ merchant view bilat - report(ortho pro) (73562) $1,791 $1,791 19.5×
Xr osseous survey complete (77075) $8,329 $8,329 75.5×
Xr pelvis 1-2 views (72170) $1,525 $1,525 13.8×
Xr pelvis min 3 view (72190) $2,338 $2,338 21.2×
Xr peritoneogram (74190) $8,129 $8,129 14.1×
Xr sacrum/coccyx 2+ views (72220) $1,820 $1,820 19.8×
Xr shoulder 1 view (73020) $1,189 $1,189 13.0×
Xr sialogram (70390) $2,275 $2,275 9.0×
Xr sinuses 3+ views (70220) $2,523 $2,523 27.5×
Xr skull min 4 view (70260) $2,595 $2,595 23.5×
Xr spine 1 view (72020) $1,626 $1,626 17.7×
Xr spine thoracic 3v (72072) $2,188 $2,188 19.8×
Xr sternum 2+ views (71120) $2,127 $2,127 23.2×
Xr surgical specimen (76098) $2,678 $2,678 4.6×
Xr t-spine 2 views (72070) $1,720 $1,720 15.6×
Xr tibia/fibula 2 views (73590) $1,626 $1,626 17.7×
Xr tmj bilateral (70330) $2,906 $2,906 31.7×
Xr venogram renal bilat (75833) $24,699 $24,699 7.4×
Xr wrist 2 views (73100) $1,218 $1,218 13.3×