Imaging prices at Henry Ford Providence Southfield Hospital
Southfield, MI · every code in this section with a posted price and a Medicare benchmark.
348 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) | $1,890 | $3,375 | 1.4× |
| Abdomen 1 View (74018) | $130.48 | $233 | 1.5× |
| Abdomen 2 views (74019) | $157.36 | $281 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $685.44 | $1,224 | 1.7× |
| Adrenal Cortex & Medulla Img (78075) | $978.88 | $1,748 | 0.8× |
| Angio internal mammary (75756) | $617.12 | $1,102 | 0.2× |
| Angio pulmonary bilat (75743) | $1,307.04 | $2,334 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $1,867.04 | $3,334 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $1,400 | $2,500 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $654.08 | $1,168 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $654.08 | $1,168 | 0.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,867.04 | $3,334 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,363.60 | $2,435 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,905.12 | $3,402 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,942.08 | $3,468 | 0.4× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,159.20 | $2,070 | 0.2× |
| Arthrogram ankle (73615) | $299.60 | $535 | 0.9× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$299.60–$595.28 | $535–$1,063 | varies |
| Arthrogram Wrist (73115) | $216.72 | $387 | 0.6× |
| Basic radiation dosimetry calculation (77300) | $178.64 | $319 | 1.3× |
| Bone age studies (77072) | $119.28 | $213 | 1.1× |
| Bone Imaging 3 Phase (78315) | $901.60 | $1,610 | 2.3× |
| Bone Imaging Limited Area (78300) | $533.12 | $952 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $591.92 | $1,057 | 1.5× |
| Bone Imaging Whole Body (78306) | $775.60 | $1,385 | 1.9× |
| Bone marrow imaging limited area (78102) | $431.76 | $771 | 1.1× |
| Bone marrow imaging; multiple areas (78103) | $258.72 | $462 | 0.6× |
| Bone survey infant (77076) | $78.96 | $141 | 0.8× |
| Brachytx isodose complex (77318) | $610.96 | $1,091 | 1.6× |
| Brachytx isodose intermed (77317) | $572.88 | $1,023 | 1.5× |
| Brachytx Isodose Plan Simple (77316) | $371.28 | $663 | 1.0× |
| Brain Flow Imaging Only (78610) | $559.44 | $999 | 1.0× |
| Brain Image W/Flow < 4 Views (78601) | $720.16 | $1,286 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,546.32 | $4,547 | 1.8× |
| Cardiac Shunt Detection (78428) | $290.08 | $518 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $276.64 | $494 | 3.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $367.92 | $657 | 0.7× |
| Cerebrospinal Fluid Scan (78630) | $607.04 | $1,084 | 1.1× |
| Chest 1 view (71045) | $113.12 | $202 | 1.3× |
| Chest 2 views (71046) | $116.48 | $208 | 1.3× |
| Chest 3 views (71047) | $130.48 | $233 | 1.5× |
| Chest 4 or more views (71048) | $142.24 | $254 | 1.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$104.72–$205.52 | $187–$367 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $182.56 | $326 | 1.8× |
| Continuing medical physics consltj pr wk (77336) | $174.72 | $312 | 1.3× |
| Contrast Exam Abdominl Aorta (75625) | $1,867.04 | $3,334 | 0.6× |
| Contrast X-Ray Bladder (74430) | $434.56 | $776 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $216.72 | $387 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $322 | $575 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $1,927.52 | $3,442 | 5.5× |
| CT abdomen and pelvis without contrast (74176) | $1,640.80 | $2,930 | 6.9× |
| CT abdomen w contrast (74160) | $977.20 | $1,745 | 5.6× |
| CT abdomen w wo contrast (74170) | $1,067.92 | $1,907 | 6.1× |
| CT abdomen w/o contrast (74150) | $911.68 | $1,628 | 8.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,823.36 | $3,256 | 5.2× |
| CT Angio Chest (71275) | $964.88 | $1,723 | 5.5× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$873.04–$1,498.56 | $1,559–$2,676 | varies |
| CT angio hrt w/3d image (75574) | $445.76 | $796 | 1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$781.76–$1,550.08 | $1,396–$2,768 | varies |
| CT Angio Neck (70498) | $911.68 | $1,628 | 5.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$781.76–$1,550.08 | $1,396–$2,768 | varies |
| CT cervical spine w/ contrast (72126) | $638.96 | $1,141 | 1.8× |
| CT cervical spine w/o contrast (72125) | $560.56 | $1,001 | 5.4× |
| CT cervical spine w/wo cont (72127) | $851.76 | $1,521 | 4.9× |
| CT chest w contrast (71260) | $847.28 | $1,513 | 4.8× |
| CT chest w/wo contrast (71270) | $860.72 | $1,537 | 4.9× |
| CT head/brain with contrast (70460) | $626.08 | $1,118 | 3.6× |
| CT head/brain without and with contrast (70470) | $703.92 | $1,257 | 4.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $436.24 | $779 | 1.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $55.44 | $99 | 0.6× |
| CT iac w contrast (70481) | $781.76 | $1,396 | 4.5× |
| CT l-spine w&w/o contrast (72133) | $820.40 | $1,465 | 4.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$651.28–$1,302 | $1,163–$2,325 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$743.12–$1,471.68 | $1,327–$2,628 | varies |
| CT lumbar spine w contrast (72132) | $716.24 | $1,279 | 2.1× |
| CT lumbar spine w/o contrast (72131) | $651.28 | $1,163 | 6.3× |
| CT maxillofacial w contrast (70487) | $743.12 | $1,327 | 4.3× |
| CT maxillofacial wo contrast (70486) | $677.04 | $1,209 | 6.5× |
| CT neck tissue combo (70492) | $911.68 | $1,628 | 5.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $808.08 | $1,443 | 4.6× |
| CT orbits w/o contrast (70480) | $716.24 | $1,279 | 6.9× |
| CT pelvis w&w/o contrast (72194) | $860.72 | $1,537 | 4.9× |
| CT pelvis w/o contrast (72192) | $730.24 | $1,304 | 7.0× |
| CT scan of leg combo (73702) | $990.08 | $1,768 | 5.7× |
| CT scans face/jaw combo (70488) | $794.64 | $1,419 | 4.5× |
| CT soft tissue neck w contrast (70491) | $847.28 | $1,513 | 4.8× |
| CT soft tissue neck w/o contrast (70490) | $756.56 | $1,351 | 7.3× |
| CT thoracic spine w contrast (72129) | $645.12 | $1,152 | 3.7× |
| CT thoracic spine w/o contrast (72128) | $607.04 | $1,084 | 5.8× |
| CT thoracic spine w/wo cont (72130) | $865.76 | $1,546 | 5.0× |
| CT thorax w/o contrast (71250) | $730.24 | $1,304 | 7.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$651.28–$1,302 | $1,163–$2,325 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $808.08 | $1,443 | 4.6× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$703.92–$1,393.84 | $1,257–$2,489 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $990.08 | $1,768 | 5.7× |
| Cta Abdomen (74175) | $924.56 | $1,651 | 5.3× |
| CTA pelvis (72191) | $898.80 | $1,605 | 5.1× |
| Dilation ureters/urethra rs&i (74485) | $339.92 | $607 | 0.2× |
| Dxa Bone Density Axial (77080) | $310.24 | $554 | 3.0× |
| Dxa bone density study (77085) | $310.24 | $554 | 3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $313.04 | $559 | 3.6× |
| Echo exam uterus (76831) | $228.48 | $408 | 1.0× |
| Echo Guide For Artery Repair (76936) | $878.64 | $1,569 | 4.1× |
| Esophagram (74220) | $269.92 | $482 | 1.5× |
| Fetal Biophys Profile W/Nst (76818) | $228.48 | $408 | 2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $228.48 | $408 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $202.72 | $362 | 0.9× |
| Follow-Up Angiography (75898) | $471.52 | $842 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$104.72–$205.52 | $187–$367 | varies |
| Gastric emptying imaging study (78264) | $685.44 | $1,224 | 1.7× |
| Gastroesophageal Reflux Exam (78262) | $446.88 | $798 | 1.1× |
| Gated Heart Planar Single (78472) | $802.48 | $1,433 | 2.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,802.64 | $3,219 | 2.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,712.48 | $3,058 | 2.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,608.32 | $2,872 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $459.76 | $821 | 0.8× |
| Hepatobiliary System Imaging (78226) | $459.76 | $821 | 1.2× |
| Ht Musc Image Planar Mult (78454) | $1,296.96 | $2,316 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $1,692.32 | $3,022 | 1.3× |
| Hysterosalpingogram (74740) | $328.72 | $587 | 1.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $239.68 | $428 | 2.8× |
| Interstitial radiation source applic complex (77778) | $1,630.16 | $2,911 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $822.64 | $1,469 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $571.76 | $1,021 | 1.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$67.76–$103.04 | $121–$184 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $642.88 | $1,148 | 1.6× |
| Liver imaging static only (78201) | $383.04 | $684 | 0.7× |
| Liver imaging w/vascular flow (78202) | $322 | $575 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $496.16 | $886 | 0.9× |
| Lung perfusion differential (78597) | $316.40 | $565 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $496.16 | $886 | 0.9× |
| Lung Ventilation Imaging (78579) | $316.40 | $565 | 0.8× |
| Lymph System Imaging (78195) | $759.92 | $1,357 | 1.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,024.80–$1,366.40 | $1,830–$2,440 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$328.72–$654.08 | $587–$1,168 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$328.72–$654.08 | $587–$1,168 | varies |
| Meckels Divert Exam (78290) | $528.64 | $944 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) | $969.92 | $1,732 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) | $1,552.32 | $2,772 | 4.5× |
| MRA head w/o contrast (70544) | $1,361.92 | $2,432 | 5.7× |
| MRA head with contrast (70545) | $1,405.60 | $2,510 | 4.0× |
| MRA neck w contrast (70548) | $1,405.60 | $2,510 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,552.32 | $2,772 | 4.5× |
| MRA neck w/o contrast (70547) | $1,361.92 | $2,432 | 5.7× |
| MRI abdomen w contrast (74182) | $1,274 | $2,275 | 3.7× |
| MRI abdomen w/o contrast (74181) | $1,230.32 | $2,197 | 5.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,434.72–$2,869.44 | $2,562–$5,124 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,610.56–$3,206 | $2,876–$5,725 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,230.32–$2,495.36 | $2,197–$4,456 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,606.80 | $4,655 | 11.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,610.56 | $2,876 | 6.8× |
| MRI cervical spine w contrast (72142) | $1,523.20 | $2,720 | 4.4× |
| MRI cervical spine w/o cont (72141) | $1,259.44 | $2,249 | 5.3× |
| MRI chest w/o contrast (71550) | $1,069.60 | $1,910 | 4.5× |
| MRI chest with contrast (71551) | $1,112.72 | $1,987 | 1.4× |
| MRI chest wo w contrast (71552) | $1,552.32 | $2,772 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,274–$2,532.88 | $2,275–$4,523 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,434.72–$2,869.44 | $2,562–$5,124 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,230.32–$2,445.52 | $2,197–$4,367 | varies |
| MRI lumbar spine w contrast (72149) | $1,624.56 | $2,901 | 4.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,562 | $4,575 | 7.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,347.36 | $2,406 | 5.7× |
| MRI orbit face neck w contrast (70542) | $1,434.72 | $2,562 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,654.24 | $2,954 | 4.8× |
| MRI pelvis w contrast (72196) | $1,259.44 | $2,249 | 3.6× |
| MRI pelvis w/o & w contrast (72197) | $1,434.72 | $2,562 | 4.1× |
| MRI pelvis w/o contrast (72195) | $1,126.72 | $2,012 | 4.7× |
| MRI spectroscopy (76390) | $640.64 | $1,144 | 7.4× |
| MRI thoracic spine w/o contrast (72146) | $1,347.36 | $2,406 | 5.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,274–$2,532.88 | $2,275–$4,523 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,230.32–$2,445.52 | $2,197–$4,367 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,434.72–$2,869.44 | $2,562–$5,124 | varies |
| MRI, abdomen, combo (74183) | $1,434.72 | $2,562 | 4.1× |
| MRI, dorsal spine combo (72157) | $2,283.68 | $4,078 | 6.6× |
| MRI, dorsal spine contrast (72147) | $1,639.12 | $2,927 | 4.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,055.04–$2,312.80 | $1,884–$4,130 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,405.60–$2,591.68 | $2,510–$4,628 | varies |
| MRI, lumbar spine combo (72158) | $2,562 | $4,575 | 7.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $429.52 | $767 | 1.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $980.56 | $1,751 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $1,986.32 | $3,547 | 1.5× |
| Neck soft tissue (70360) | $93.52 | $167 | 1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $431.76 | $771 | 1.1× |
| Nm csf leak detection (78650) | $548.80 | $980 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,750.16 | $4,911 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $744.24 | $1,329 | 3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $685.44 | $1,224 | 1.3× |
| Parathyroid Planar Imaging (78070) | $607.04 | $1,084 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $685.44 | $1,224 | 1.7× |
| Pelvis 1 or 2 views (72170) | $104.72 | $187 | 1.0× |
| PET image w/CT, full body (78816) | $2,546.32 | $4,547 | 1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,546.32 | $4,547 | 1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,112.48 | $5,558 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $528.64 | $944 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $153.44 | $274 | 1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $209.44 | $374 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$113.12–$221.20 | $202–$395 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$119.28–$235.76 | $213–$421 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $161.84 | $289 | 1.6× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$41.44–$80.64 | $74–$144 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$146.16–$288.40 | $261–$515 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$124.88–$243.60 | $223–$435 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $116.48 | $208 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $108.64 | $194 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$116.48–$228.48 | $208–$408 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $119.28 | $213 | 1.4× |
| Radex Spine 1 View Specify Level (72020) | $93.52 | $167 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $113.12 | $202 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $139.44 | $249 | 1.6× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$41.44–$61.60 | $74–$110 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$78.96–$154 | $141–$275 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$116.48–$228.48 | $208–$408 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,902.88 | $3,398 | 0.3× |
| Radiation treatment delivery level 1 (77402) | $133.84 | $239 | 1.3× |
| Radiation treatment delivery level 3 (77412) | $286.16 | $511 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $139.44 | $249 | 1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $146.16 | $261 | 1.4× |
| Radiologic exam colon double contrast study (74280) | $356.16 | $636 | 2.0× |
| Radiologic exam colon single contrast study (74270) | $259.28 | $463 | 1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $97.44 | $174 | 0.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$146.16–$288.40 | $261–$515 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $124.88 | $223 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $224 | $400 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $228.48 | $408 | 1.3× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$371.28–$381.92 | $663–$682 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$77.28–$115.36 | $138–$206 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$133.84–$202.16 | $239–$361 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$104.72–$205.52 | $187–$367 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $216.72 | $387 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$108.64–$214.48 | $194–$383 | varies |
| Ribs bilateral 3 views (71110) | $146.16 | $261 | 1.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $253.12 | $452 | 0.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $681.52 | $1,217 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $802.48 | $1,433 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $661.92 | $1,182 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 11 matching MRF lines |
$393.68–$1,136.24 | $703–$2,029 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,076.88 | $1,923 | 0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,076.88 | $1,923 | 0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,076.88 | $1,923 | 0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $678.16 | $1,211 | 2.9× |
| Rp Therapy Intravenous Administration (79101) | $368.48 | $658 | 1.6× |
| Salivary Gland Imaging Serial Images (78231) | $243.60 | $435 | 0.6× |
| Scapula (73010) range across 2 matching MRF lines |
$108.64–$214.48 | $194–$383 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $15.68 | $28 | 0.7× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$93.52–$188.72 | $167–$337 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$351.12–$702.24 | $627–$1,254 | varies |
| Skull less than 4 views (70250) | $116.48 | $208 | 1.1× |
| Special dosimetry (77331) | $361.20 | $645 | 2.7× |
| Special Physics Consult (77370) | $185.92 | $332 | 1.4× |
| Special teletherapy port plan (77321) | $296.80 | $530 | 0.8× |
| Special treatment procedure (77470) | $791.28 | $1,413 | 1.4× |
| Stereotactic Body Radiation Delivery (77373) | $3,520.72 | $6,287 | 2.0× |
| Sternoclavicular joints (71130) | $119.28 | $213 | 1.4× |
| Tbs technical calculation only (77091) | $103.04 | $184 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $967.12 | $1,727 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $474.88 | $848 | 1.3× |
| Testicular Imaging W/Flow (78761) | $309.12 | $552 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $913.36 | $1,631 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $635.04 | $1,134 | 1.7× |
| Ther rad simulaj-aided field setting simple (77280) | $542.64 | $969 | 4.1× |
| Thoracic spine 2 views (72070) | $110.88 | $198 | 1.1× |
| Thoracic spine 3 views (72072) | $129.36 | $231 | 1.2× |
| Thoracolumbar 2 views (72080) | $124.88 | $223 | 1.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $509.60 | $910 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $328.72 | $587 | 0.8× |
| Thyroid Met Imaging Body (78018) | $920.08 | $1,643 | 1.7× |
| Thyroid Uptake Measurement (78012) | $254.80 | $455 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $665.84 | $1,189 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $222.32 | $397 | 0.6× |
| Tx devices design & construction intermediate (77333) | $218.40 | $390 | 1.6× |
| Tx devices design & construction simple (77332) | $218.40 | $390 | 1.6× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$245.84–$369.04 | $439–$659 | varies |
| Ultrasound elastography first target lesion (76982) | $146.16 | $261 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $142.80 | $255 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $140 | $250 | 1.3× |
| Ultrasound, abdomen limited (76705) | $243.60 | $435 | 2.3× |
| Umbilical-artery Doppler (OB) (76820) | $90.72 | $162 | 0.9× |
| Unlisted magnetic resonance procedure (76498) | $412.72 | $737 | 4.8× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$274.96–$333.20 | $491–$595 | varies |
| Urethrocystogram voiding (74455) | $224 | $400 | 0.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$263.76–$395.92 | $471–$707 | varies |
| Us chest (76604) | $179.76 | $321 | 1.7× |
| Us complete joint (76881) range across 2 matching MRF lines |
$434.56–$866.32 | $776–$1,547 | varies |
| Us exam, pelvic, limited (76857) | $190.96 | $341 | 1.8× |
| Us head (76506) | $417.76 | $746 | 4.0× |
| Us kidney transplant (76776) | $224 | $400 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$359.52–$718.48 | $642–$1,283 | varies |
| Us ob detailed single fetus (76811) | $214.48 | $383 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $190.96 | $341 | 1.8× |
| Us ob transvaginal (76817) | $216.72 | $387 | 2.1× |
| Us pelvic non ob complete (76856) | $322 | $575 | 3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $194.88 | $348 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $157.36 | $281 | 1.5× |
| Us retroperitoneal complete (76770) | $258.16 | $461 | 2.5× |
| Us retroperitoneal limited (76775) | $216.72 | $387 | 2.1× |
| Us scrotum and contents (76870) | $269.92 | $482 | 2.6× |
| Us spinal canal and contents (76800) | $93.52 | $167 | 0.9× |
| Us thyroid (76536) | $243.60 | $435 | 2.3× |
| Us transrectal (76872) | $371.28 | $663 | 3.6× |
| Vein X-Ray Chest (75827) | $1,345.12 | $2,402 | 0.9× |
| Venogram Sinus/Jugular (75860) | $1,363.60 | $2,435 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,345.12 | $2,402 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $658 | $1,175 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $583.52 | $1,042 | 0.4× |
| Venography Renal Unilateral (75831) | $1,330 | $2,375 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,159.20 | $2,070 | 0.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $119.28 | $213 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $1,867.04 | $3,334 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $100.24 | $179 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$98–$194.88 | $175–$348 | varies |
| X-Ray Exam Breast Specimen (76098) | $365.12 | $652 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $208.32 | $372 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $235.20 | $420 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $282.24 | $504 | 2.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $150.08 | $268 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $235.20 | $420 | 2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $277.20 | $495 | 2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $224 | $400 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $337.12 | $602 | 3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $381.92 | $682 | 3.7× |
| X-Ray Exam L-S Spine Bending (72114) | $205.52 | $367 | 2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $119.28 | $213 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $188.72 | $337 | 1.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $139.44 | $249 | 1.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$150.08–$299.60 | $268–$535 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $164.08 | $293 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $139.44 | $249 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $153.44 | $274 | 1.5× |
| X-ray nose-rectum child f.b. (76010) | $78.96 | $141 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $214.48 | $383 | 2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $139.44 | $249 | 1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $62.72 | $112 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $139.44 | $249 | 1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $171.92 | $307 | 2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $176.96 | $316 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $153.44 | $274 | 1.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $399.28 | $713 | 1.1× |
| X-Rays Bone Length Studies (77073) | $98 | $175 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $313.04 | $559 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $171.92 | $307 | 1.7× |
| Xr facial bones less than 3 views (70140) | $116.48 | $208 | 1.3× |
| Xr orbits complete 4 views (70200) | $139.44 | $249 | 1.3× |
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.