Imaging prices at Henry Ford St. John Hospital
Detroit, MI · every code in this section with a posted price and a Medicare benchmark.
364 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) | $3,844.96 | $6,866 | 2.8× |
| Abdomen 1 View (74018) | $87.92 | $157 | 1.0× |
| Abdomen 2 views (74019) | $127.12 | $227 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $494.48 | $883 | 1.2× |
| Angio internal mammary (75756) | $675.36 | $1,206 | 0.2× |
| Angio pulmonary bilat (75743) | $1,750.56 | $3,126 | 0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,204.88 | $5,723 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $1,256.64 | $2,244 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,050.56 | $1,876 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $967.12 | $1,727 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $534.80 | $955 | 0.2× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$80.08–$119.28 | $143–$213 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,332.24 | $2,379 | 0.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $801.36 | $1,431 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,010.80 | $1,805 | 0.2× |
| Artery X-Rays Adrenal Gland (75731) | $974.40 | $1,740 | 0.3× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$850.64 | $1,519 | 0.2× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$850.64 | $1,519 | 0.2× |
| Arthrogram ankle (73615) | $231.28 | $413 | 0.7× |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$361.20–$520.80 | $645–$930 | varies |
| Arthrogram Wrist (73115) | $224 | $400 | 0.6× |
| Basic radiation dosimetry calculation (77300) | $632.24 | $1,129 | 4.7× |
| Bone age studies (77072) | $90.16 | $161 | 0.9× |
| Bone Imaging 3 Phase (78315) | $781.76 | $1,396 | 2.0× |
| Bone Imaging Limited Area (78300) | $312.48 | $558 | 0.8× |
| Bone Imaging Whole Body (78306) | $1,245.44 | $2,224 | 3.1× |
| Bone marrow imaging limited area (78102) | $308.56 | $551 | 0.8× |
| Bone survey infant (77076) | $87.92 | $157 | 0.8× |
| Brachytx isodose complex (77318) | $1,411.76 | $2,521 | 3.8× |
| Brachytx isodose intermed (77317) | $1,250.48 | $2,233 | 3.4× |
| Brachytx Isodose Plan Simple (77316) | $1,103.20 | $1,970 | 3.0× |
| Brain Image W/Flow < 4 Views (78601) | $634.48 | $1,133 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,643.76 | $4,721 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $673.12 | $1,202 | 1.9× |
| Cat Scan Follow-Up Study (76380) | $125.44 | $224 | 1.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $480.48 | $858 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $685.44 | $1,224 | 1.3× |
| Chest 1 view (71045) | $73.92 | $132 | 0.9× |
| Chest 2 views (71046) | $127.12 | $227 | 1.5× |
| Chest 3 views (71047) | $154.56 | $276 | 1.8× |
| Chest 4 or more views (71048) | $127.12 | $227 | 1.2× |
| Cisternography Positive Contrast Rs&I (70015) | $127.68 | $228 | 0.2× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$84.56–$112 | $151–$200 | varies |
| Continuing medical physics consltj pr wk (77336) | $574 | $1,025 | 4.3× |
| Contrast Exam Abdominl Aorta (75625) | $1,169.28 | $2,088 | 0.4× |
| Contrast X-Ray Bladder (74430) | $162.40 | $290 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $156.24 | $279 | 0.4× |
| Contrast X-Ray Of Knee Joint (73580) | $341.04 | $609 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $1,751.68 | $3,128 | 5.0× |
| CT abdomen and pelvis without contrast (74176) | $1,430.24 | $2,554 | 6.0× |
| CT abdomen w contrast (74160) | $842.24 | $1,504 | 4.8× |
| CT abdomen w wo contrast (74170) | $876.96 | $1,566 | 5.0× |
| CT abdomen w/o contrast (74150) | $715.12 | $1,277 | 6.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,070.88 | $3,698 | 6.0× |
| CT Angio Chest (71275) | $1,076.88 | $1,923 | 6.2× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$845.60–$1,518.72 | $1,510–$2,712 | varies |
| CT angio hrt w/3d image (75574) | $379.12 | $677 | 1.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$819.84–$1,639.68 | $1,464–$2,928 | varies |
| CT Angio Neck (70498) | $811.44 | $1,449 | 4.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$819.84–$1,639.68 | $1,464–$2,928 | varies |
| CT cervical spine w/ contrast (72126) | $590.24 | $1,054 | 1.7× |
| CT cervical spine w/o contrast (72125) | $542.08 | $968 | 5.2× |
| CT cervical spine w/wo cont (72127) | $766.08 | $1,368 | 4.4× |
| CT chest w contrast (71260) | $874.72 | $1,562 | 5.0× |
| CT chest w/wo contrast (71270) | $1,137.36 | $2,031 | 6.5× |
| CT head/brain with contrast (70460) | $842.24 | $1,504 | 4.8× |
| CT head/brain without and with contrast (70470) | $876.96 | $1,566 | 5.0× |
| CT iac w contrast (70481) | $616.56 | $1,101 | 3.5× |
| CT l-spine w&w/o contrast (72133) | $766.08 | $1,368 | 4.4× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$519.12–$725.20 | $927–$1,295 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$592.48–$827.68 | $1,058–$1,478 | varies |
| CT lumbar spine w contrast (72132) | $590.24 | $1,054 | 1.7× |
| CT lumbar spine w/o contrast (72131) | $542.08 | $968 | 5.2× |
| CT maxillofacial w contrast (70487) | $596.40 | $1,065 | 3.4× |
| CT maxillofacial wo contrast (70486) | $544.32 | $972 | 5.2× |
| CT neck tissue combo (70492) | $659.68 | $1,178 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $700.56 | $1,251 | 4.0× |
| CT orbits w/o contrast (70480) | $497.28 | $888 | 4.8× |
| CT pelvis w&w/o contrast (72194) | $876.96 | $1,566 | 5.0× |
| CT pelvis w/o contrast (72192) | $715.12 | $1,277 | 6.9× |
| CT scan of leg combo (73702) | $768.32 | $1,372 | 4.4× |
| CT scans face/jaw combo (70488) | $670.88 | $1,198 | 3.8× |
| CT soft tissue neck w contrast (70491) | $608.72 | $1,087 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $558.32 | $997 | 5.4× |
| CT thoracic spine w contrast (72129) | $571.20 | $1,020 | 3.3× |
| CT thoracic spine w/o contrast (72128) | $537.04 | $959 | 5.2× |
| CT thoracic spine w/wo cont (72130) | $766.08 | $1,368 | 4.4× |
| CT thorax w/o contrast (71250) | $715.12 | $1,277 | 6.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$519.12–$725.20 | $927–$1,295 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $768.32 | $1,372 | 4.4× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$592.48–$827.68 | $1,058–$1,478 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,159.76 | $2,071 | 6.6× |
| Cta Abdomen (74175) | $1,056.72 | $1,887 | 6.0× |
| CTA pelvis (72191) | $1,016.40 | $1,815 | 5.8× |
| Dilation ureters/urethra rs&i (74485) | $215.60 | $385 | 0.1× |
| Diskography lumbar (72295) | $494.48 | $883 | 0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $122.08 | $218 | 1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $122.08 | $218 | 1.2× |
| Dxa Bone Density Axial (77080) | $155.12 | $277 | 1.5× |
| Dxa bone density study (77085) | $126.56 | $226 | 1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $252.56 | $451 | 2.9× |
| Echo exam of fetal heart (76825) | $482.72 | $862 | 0.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $328.72 | $587 | 1.4× |
| Esophagram (74220) | $151.76 | $271 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) | $139.44 | $249 | 1.3× |
| Fluoroscopy up to 1 hr (76000) | $156.24 | $279 | 0.7× |
| Follow-Up Angiography (75898) | $257.60 | $460 | 0.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$67.76–$103.04 | $121–$184 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$80.08–$120.40 | $143–$215 | varies |
| Gastric emptying imaging study (78264) | $776.16 | $1,386 | 1.9× |
| Gastroesophageal Reflux Exam (78262) | $1,014.16 | $1,811 | 2.5× |
| Gated Heart, Multiple (78473) | $1,060.08 | $1,893 | 2.7× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$49.84–$75.04 | $89–$134 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,811.20 | $5,020 | 4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,460.64 | $4,394 | 3.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,245.04 | $4,009 | 3.2× |
| Heart Image (Pet) Multiple (78492) | $1,811.04 | $3,234 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $642.88 | $1,148 | 0.2× |
| Hepatobil Syst Image W/Drug (78227) | $514.64 | $919 | 1.0× |
| Hepatobiliary System Imaging (78226) | $514.64 | $919 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $1,832.32 | $3,272 | 1.4× |
| Hysterosalpingogram (74740) | $383.04 | $684 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $164.08 | $293 | 1.9× |
| Interstitial radiation source applic complex (77778) | $1,727.60 | $3,085 | 2.5× |
| Intracavitary Radiation Source Applic Complex (77763) | $897.12 | $1,602 | 1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) | $734.16 | $1,311 | 1.3× |
| Intracavitary radiation source applic simple (77761) | $571.76 | $1,021 | 1.0× |
| Joint Survey Single View (77077) | $174.72 | $312 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $676.48 | $1,208 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $554.40 | $990 | 1.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$97.44–$143.92 | $174–$257 | varies |
| Leveen/Shunt Patency Exam (78291) | $545.44 | $974 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $660.24 | $1,179 | 1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $468.16 | $836 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $554.40 | $990 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $554.40 | $990 | 1.0× |
| Lung Ventilation Imaging (78579) | $355.04 | $634 | 0.9× |
| Lymph System Imaging (78195) | $602 | $1,075 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $1,080.24 | $1,929 | 4.5× |
| Mammary ductogram or galactogram multiple (77054) range across 3 matching MRF lines |
$148.96–$223.44 | $266–$399 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$124.32–$172.48 | $222–$308 | varies |
| Meckels Divert Exam (78290) | $410.48 | $733 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,047.20 | $1,870 | 2.8× |
| Mra Head W/O & W/Contrast Material (70546) | $1,009.68 | $1,803 | 2.9× |
| MRA head w/o contrast (70544) | $838.88 | $1,498 | 3.5× |
| MRA head with contrast (70545) | $866.88 | $1,548 | 2.5× |
| MRA neck w contrast (70548) | $866.88 | $1,548 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,009.68 | $1,803 | 2.9× |
| MRA neck w/o contrast (70547) | $838.88 | $1,498 | 3.5× |
| MRI abdomen w contrast (74182) | $1,148 | $2,050 | 3.3× |
| MRI abdomen w/o contrast (74181) | $983.92 | $1,757 | 4.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,148–$2,196.88 | $2,050–$3,923 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,312.08–$2,328.48 | $2,343–$4,158 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,148–$2,328.48 | $2,050–$4,158 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,093.68 | $1,953 | 4.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $983.92 | $1,757 | 4.1× |
| MRI cardiac w/o contrast (75557) | $610.40 | $1,090 | 2.6× |
| MRI cervical spine w contrast (72142) | $1,148 | $2,050 | 3.3× |
| MRI cervical spine w/o cont (72141) | $983.92 | $1,757 | 4.1× |
| MRI chest w/o contrast (71550) | $983.92 | $1,757 | 4.1× |
| MRI chest with contrast (71551) | $1,148 | $2,050 | 1.5× |
| MRI chest wo w contrast (71552) | $1,312.08 | $2,343 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,148–$2,196.88 | $2,050–$3,923 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,421.28–$2,328.48 | $2,538–$4,158 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$983.92–$2,158.80 | $1,757–$3,855 | varies |
| MRI lumbar spine w contrast (72149) | $1,148 | $2,050 | 3.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,312.08 | $2,343 | 3.8× |
| MRI orbit face &/neck w/o contrast (70540) | $983.92 | $1,757 | 4.1× |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$998.48–$1,148 | $1,783–$2,050 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,312.08 | $2,343 | 3.8× |
| MRI pelvis w contrast (72196) | $1,148 | $2,050 | 3.3× |
| MRI pelvis w/o & w contrast (72197) | $1,312.08 | $2,343 | 3.8× |
| MRI pelvis w/o contrast (72195) | $983.92 | $1,757 | 4.1× |
| MRI spectroscopy (76390) | $676.48 | $1,208 | 7.8× |
| MRI thoracic spine w/o contrast (72146) | $983.92 | $1,757 | 4.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$1,045.52–$2,196.88 | $1,867–$3,923 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$983.92–$2,158.80 | $1,757–$3,855 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,312.08–$2,328.48 | $2,343–$4,158 | varies |
| MRI, abdomen, combo (74183) | $1,312.08 | $2,343 | 3.8× |
| MRI, dorsal spine combo (72157) | $1,312.08 | $2,343 | 3.8× |
| MRI, dorsal spine contrast (72147) | $1,148 | $2,050 | 3.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$983.92–$2,158.80 | $1,757–$3,855 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,312.08–$2,418.64 | $2,343–$4,319 | varies |
| MRI, lumbar spine combo (72158) | $1,312.08 | $2,343 | 3.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,811.04 | $3,234 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $2,879.52 | $5,142 | 2.2× |
| Neck soft tissue (70360) | $99.12 | $177 | 1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $472.64 | $844 | 1.2× |
| Nm csf leak detection (78650) | $545.44 | $974 | 0.4× |
| Nonvascular Shunt X-Ray (75809) | $240.24 | $429 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,002.16 | $5,361 | 2.2× |
| Nuclear Rx Oral Admin (79005) | $593.04 | $1,059 | 2.6× |
| Panoramic X-ray of jaws (70355) | $31.36 | $56 | 0.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $576.80 | $1,030 | 1.1× |
| Parathyroid Planar Imaging (78070) | $497.28 | $888 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $529.76 | $946 | 1.3× |
| Pelvis 1 or 2 views (72170) | $77.84 | $139 | 0.7× |
| Pet Image Skull-Thigh (78812) | $1,811.04 | $3,234 | 1.3× |
| Pet Image W/Ct Lmtd (78814) | $1,912.96 | $3,416 | 1.3× |
| PET image w/CT, full body (78816) | $1,912.96 | $3,416 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,912.96 | $3,416 | 1.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,811.04 | $3,234 | 1.4× |
| Pet Myocardial Sngl Study (78491) | $1,811.04 | $3,234 | 1.3× |
| PET whole body (78813) | $1,811.04 | $3,234 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $974.40 | $1,740 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $519.68 | $928 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $104.72 | $187 | 1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $124.32 | $222 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$120.96–$180.88 | $216–$323 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$80.08–$119.28 | $143–$213 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$115.92–$172.48 | $207–$308 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $186.48 | $333 | 1.8× |
| Radex fingr minimum 2 views (73140) | $62.16 | $111 | 0.7× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$120.96–$180.88 | $216–$323 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$108.08–$161.84 | $193–$289 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$90.16–$134.40 | $161–$240 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$169.68–$253.68 | $303–$453 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $116.48 | $208 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $86.80 | $155 | 1.0× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$146.72–$220.64 | $262–$394 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $50.40 | $90 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $49.84 | $89 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) | $90.16 | $161 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $84.56 | $151 | 1.0× |
| Radex Toe Minimum 2 Views (73660) | $56 | $100 | 0.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$62.16–$92.40 | $111–$165 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$120.96–$180.88 | $216–$323 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $326.48 | $583 | 3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,294 | $13,025 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $305.20 | $545 | 3.0× |
| Radiation treatment delivery level 2 (77407) | $454.16 | $811 | 1.2× |
| Radiation treatment delivery level 3 (77412) | $576.80 | $1,030 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $182.56 | $326 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $62.16 | $111 | 0.6× |
| Radiologic exam colon double contrast study (74280) | $281.68 | $503 | 1.6× |
| Radiologic exam colon single contrast study (74270) | $287.84 | $514 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$137.76–$206.64 | $246–$369 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $140 | $250 | 1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $186.48 | $333 | 1.1× |
| Radiologic exam swallow function contrast study (74230) | $125.44 | $224 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$344.40–$374.64 | $615–$669 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$57.12–$86.24 | $102–$154 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$100.80–$151.76 | $180–$271 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$91.28–$136.08 | $163–$243 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $87.92 | $157 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$80.08–$119.28 | $143–$213 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $311.92 | $557 | 0.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $311.92 | $557 | 0.8× |
| Ribs bilateral 3 views (71110) | $137.20 | $245 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $251.44 | $449 | 0.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $519.68 | $928 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $906.08 | $1,618 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $861.84 | $1,539 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $994.56 | $1,776 | 1.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $655.76 | $1,171 | 2.8× |
| Rp Therapy Intravenous Administration (79101) | $1,283.52 | $2,292 | 5.5× |
| Scapula (73010) range across 4 matching MRF lines |
$90.16–$134.40 | $161–$240 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $20.72 | $37 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$71.68–$106.96 | $128–$191 | varies |
| Shoulder Arthrography (73040) | $281.68 | $503 | 0.8× |
| Skull less than 4 views (70250) | $146.72 | $262 | 1.4× |
| Special dosimetry (77331) | $621.60 | $1,110 | 4.6× |
| Special Physics Consult (77370) | $622.16 | $1,111 | 4.6× |
| Special teletherapy port plan (77321) | $1,181.60 | $2,110 | 3.2× |
| Special treatment procedure (77470) | $2,206.96 | $3,941 | 4.0× |
| Spleen Imaging (78185) | $272.16 | $486 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $1,840.72 | $3,287 | 1.0× |
| Sternoclavicular joints (71130) | $90.16 | $161 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,392.72 | $2,487 | 3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,052.24 | $1,879 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,248.80 | $2,230 | 3.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $995.68 | $1,778 | 2.7× |
| Ther rad simulaj-aided field setting simple (77280) | $603.68 | $1,078 | 4.5× |
| Thoracic spine 2 views (72070) | $102.48 | $183 | 1.0× |
| Thoracic spine 3 views (72072) | $145.60 | $260 | 1.4× |
| Thoracolumbar 2 views (72080) | $87.92 | $157 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $343.84 | $614 | 0.9× |
| Thyroid Met Imaging Body (78018) | $444.64 | $794 | 0.8× |
| Thyroid Uptake Measurement (78012) | $210 | $375 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $436.80 | $780 | 1.1× |
| Tx Devices Design & Construction Complex (77334) | $1,645.28 | $2,938 | 4.4× |
| Tx devices design & construction intermediate (77333) | $1,178.80 | $2,105 | 8.8× |
| Tx devices design & construction simple (77332) | $710.08 | $1,268 | 5.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$386.96–$580.72 | $691–$1,037 | varies |
| Ultrasound Elastography Parenchyma (76981) | $129.92 | $232 | 1.2× |
| Ultrasound Exam Aaa Screen (76706) | $122.64 | $219 | 1.2× |
| Ultrasound, abdomen limited (76705) | $386.96 | $691 | 3.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $176.96 | $316 | 1.7× |
| Unlisted us procedure (76999) | $75.04 | $134 | 0.9× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$61.04–$64.96 | $109–$116 | varies |
| Ureteral Reflux Study (78740) | $497.28 | $888 | 1.2× |
| Urethrocystogram voiding (74455) | $194.88 | $348 | 0.8× |
| Urethrocystography retrograde (74450) | $174.72 | $312 | 0.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$425.60–$638.40 | $760–$1,140 | varies |
| Us chest (76604) | $80.64 | $144 | 0.8× |
| Us complete joint (76881) range across 2 matching MRF lines |
$638.40–$957.60 | $1,140–$1,710 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$190.96–$261.52 | $341–$467 | varies |
| Us head (76506) | $537.60 | $960 | 5.2× |
| Us kidney transplant (76776) | $528.08 | $943 | 5.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$571.20–$858.48 | $1,020–$1,533 | varies |
| Us ob limited 1 or more fetuses (76815) | $115.36 | $206 | 1.1× |
| Us ob transvaginal (76817) | $289.52 | $517 | 2.8× |
| Us pelvic non ob complete (76856) | $509.04 | $909 | 4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $217.84 | $389 | 2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $95.20 | $170 | 0.9× |
| Us retroperitoneal complete (76770) | $509.04 | $909 | 4.9× |
| Us retroperitoneal limited (76775) | $200.48 | $358 | 1.9× |
| Us scrotum and contents (76870) | $353.36 | $631 | 3.4× |
| Us spinal canal and contents (76800) | $124.32 | $222 | 1.2× |
| Us thyroid (76536) | $430.64 | $769 | 4.1× |
| Us transrectal (76872) | $308.56 | $551 | 3.0× |
| Vein X-Ray Chest (75827) | $1,127.28 | $2,013 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $463.68 | $828 | 0.1× |
| Vein X-Ray Spleen/Liver (75810) | $850.64 | $1,519 | 0.3× |
| Venogram Sinus/Jugular (75860) | $927.92 | $1,657 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $974.40 | $1,740 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $390.32 | $697 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $379.12 | $677 | 0.2× |
| Venography Renal Bilateral (75833) | $1,948.80 | $3,480 | 0.6× |
| Venography Renal Unilateral (75831) | $974.40 | $1,740 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$974.40 | $1,740 | 0.2× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$76.16–$103.04 | $136–$184 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$77.28–$115.36 | $138–$206 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $104.16 | $186 | 1.2× |
| X-ray antegrade pyelogram tube (74425) | $301.28 | $538 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $1,232.56 | $2,201 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $75.60 | $135 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$78.40–$116.48 | $140–$208 | varies |
| X-Ray Exam Breast Specimen (76098) | $222.32 | $397 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $134.40 | $240 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $166.88 | $298 | 1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $246.96 | $441 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $103.60 | $185 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $166.88 | $298 | 1.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $268.80 | $480 | 2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $211.12 | $377 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $268.80 | $480 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $281.68 | $503 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $166.32 | $297 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $141.68 | $253 | 1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $186.48 | $333 | 1.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $99.68 | $178 | 1.0× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$100.80–$147.28 | $180–$263 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$80.64–$122.08 | $144–$218 | varies |
| X-ray IV pyelogram (ivp) (74400) | $231.28 | $413 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $123.20 | $220 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $109.20 | $195 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $154 | $275 | 1.5× |
| X-ray nose-rectum child f.b. (76010) | $32.48 | $58 | 0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $166.32 | $297 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $90.16 | $161 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $98 | $175 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $186.48 | $333 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $201.04 | $359 | 1.9× |
| X-Ray Stress View (77071) | $49.84 | $89 | 0.6× |
| X-ray thoracic spine 4 vw (72074) | $182 | $325 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $226.80 | $405 | 0.7× |
| X-Rays Bone Length Studies (77073) | $156.24 | $279 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $117.04 | $209 | 1.1× |
| Xr c-spine 4 or 5 views (72050) | $182 | $325 | 1.7× |
| Xr facial bones less than 3 views (70140) | $42 | $75 | 0.5× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$146.72–$220.08 | $262–$393 | varies |
| Xr orbits complete 4 views (70200) | $174.72 | $312 | 1.7× |
| Xr Tomogram Single Plane (76100) | $248.08 | $443 | 2.4× |
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.