Imaging prices at Henry Ford Rochester Hospital
Rochester, MI · every code in this section with a posted price and a Medicare benchmark.
353 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) | $1,395.90 | $2,970 | 1.0× |
| Abdomen 1 View (74018) | $68.62 | $146 | 0.8× |
| Abdomen 2 views (74019) | $101.99 | $217 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $432.40 | $920 | 1.1× |
| Angio internal mammary (75756) | $552.72 | $1,176 | 0.2× |
| Angio pulmonary bilat (75743) | $1,332.45 | $2,835 | 0.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,264.30–$1,517.16 | $2,690–$3,228 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$2,222.63–$2,666.78 | $4,729–$5,674 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,150.09 | $2,447 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $708.29 | $1,507 | 0.2× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$90.24–$137.71 | $192–$293 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,150.09 | $2,447 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$963.50 | $2,050 | 0.2× |
| Artery X-Rays Adrenal Gland (75731) | $954.10 | $2,030 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,739.94 | $3,702 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,037.76 | $2,208 | 0.2× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$199.28–$267.90 | $424–$570 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$150.40–$532.98 | $320–$1,134 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$244.40–$487.86 | $520–$1,038 | varies |
| Basic radiation dosimetry calculation (77300) | $89.30 | $190 | 0.7× |
| Bone age studies (77072) | $119.38 | $254 | 1.1× |
| Bone Imaging 3 Phase (78315) | $882.66 | $1,878 | 2.2× |
| Bone Imaging Limited Area (78300) | $604.42 | $1,286 | 1.5× |
| Bone Imaging Whole Body (78306) | $940.47 | $2,001 | 2.4× |
| Bone marrow imaging limited area (78102) | $373.65 | $795 | 0.9× |
| Bone marrow imaging; multiple areas (78103) | $627.45 | $1,335 | 1.6× |
| Bone survey infant (77076) | $143.35 | $305 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $580.45 | $1,235 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,234.85 | $4,755 | 1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $360.49 | $767 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $384.93 | $819 | 4.4× |
| Cerebrospinal Fluid Scan (78630) | $432.40 | $920 | 0.8× |
| Chest 1 view (71045) | $68.62 | $146 | 0.8× |
| Chest 2 views (71046) | $109.04 | $232 | 1.3× |
| Chest 3 views (71047) | $159.33 | $339 | 1.8× |
| Chest 4 or more views (71048) | $216.20 | $460 | 2.1× |
| Cisternography Positive Contrast Rs&I (70015) | $367.54 | $782 | 0.5× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$130.66–$260.38 | $278–$554 | varies |
| Continuing medical physics consltj pr wk (77336) | $148.52 | $316 | 1.1× |
| Contrast Exam Abdominl Aorta (75625) | $1,220.59 | $2,597 | 0.4× |
| Contrast X-Ray Bladder (74430) | $145.23 | $309 | 0.4× |
| Contrast X-Ray Of Elbow (73085) | $159.33 | $339 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$150.87–$302.21 | $321–$643 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $150.40 | $320 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $1,220.59 | $2,597 | 3.5× |
| CT abdomen and pelvis without contrast (74176) | $770.80 | $1,640 | 3.2× |
| CT abdomen w contrast (74160) | $1,135.05 | $2,415 | 6.5× |
| CT abdomen w wo contrast (74170) | $1,220.59 | $2,597 | 7.0× |
| CT abdomen w/o contrast (74150) | $770.33 | $1,639 | 7.4× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$327.59–$1,220.59 | $697–$2,597 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$382.11–$1,220.59 | $813–$2,597 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$382.11–$666.93 | $813–$1,419 | varies |
| CT angio hrt w/3d image (75574) | $433.81 | $923 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 5 matching MRF lines |
$569.17–$1,138.81 | $1,211–$2,423 | varies |
| CT Angio Neck (70498) | $666.93 | $1,419 | 3.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 5 matching MRF lines |
$535.80–$1,071.60 | $1,140–$2,280 | varies |
| CT cervical spine w/ contrast (72126) | $1,100.27 | $2,341 | 3.2× |
| CT cervical spine w/o contrast (72125) | $877.96 | $1,868 | 8.4× |
| CT cervical spine w/wo cont (72127) | $1,220.59 | $2,597 | 7.0× |
| CT chest w contrast (71260) | $1,151.50 | $2,450 | 6.6× |
| CT chest w/wo contrast (71270) | $1,220.59 | $2,597 | 7.0× |
| CT head/brain with contrast (70460) | $1,183.93 | $2,519 | 6.8× |
| CT head/brain without and with contrast (70470) | $1,316.47 | $2,801 | 7.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $433.81 | $923 | 1.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $41.83 | $89 | 0.5× |
| CT hrt w/3d image congen (75573) | $433.81 | $923 | 1.2× |
| CT iac w contrast (70481) | $1,108.73 | $2,359 | 6.3× |
| CT l-spine w&w/o contrast (72133) | $1,210.72 | $2,576 | 6.9× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$816.86–$1,633.25 | $1,738–$3,475 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,135.05–$2,270.10 | $2,415–$4,830 | varies |
| CT lumbar spine w contrast (72132) | $1,100.27 | $2,341 | 3.2× |
| CT lumbar spine w/o contrast (72131) | $877.96 | $1,868 | 8.4× |
| CT maxillofacial w contrast (70487) | $1,108.73 | $2,359 | 6.3× |
| CT maxillofacial wo contrast (70486) | $774.56 | $1,648 | 7.4× |
| CT neck tissue combo (70492) | $1,220.59 | $2,597 | 7.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,192.39 | $2,537 | 6.8× |
| CT orbits w/o contrast (70480) | $819.21 | $1,743 | 7.9× |
| CT pelvis w&w/o contrast (72194) | $1,220.59 | $2,597 | 7.0× |
| CT pelvis w/o contrast (72192) | $770.80 | $1,640 | 7.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,075.99–$4,151.98 | $4,417–$8,834 | varies |
| CT scans face/jaw combo (70488) | $1,220.59 | $2,597 | 7.0× |
| CT soft tissue neck w contrast (70491) | $1,135.05 | $2,415 | 6.5× |
| CT soft tissue neck w/o contrast (70490) | $816.86 | $1,738 | 7.8× |
| CT thoracic spine w contrast (72129) | $1,162.31 | $2,473 | 6.7× |
| CT thoracic spine w/o contrast (72128) | $783.02 | $1,666 | 7.5× |
| CT thoracic spine w/wo cont (72130) | $1,220.59 | $2,597 | 7.0× |
| CT thorax w/o contrast (71250) | $816.86 | $1,738 | 7.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$796.18–$1,538.78 | $1,694–$3,274 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,278.87–$2,557.74 | $2,721–$5,442 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,162.31–$2,130.51 | $2,473–$4,533 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $975.25 | $2,075 | 5.6× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$382.11–$770.80 | $813–$1,640 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$382.11–$572.46 | $813–$1,218 | varies |
| Dilation ureters/urethra rs&i (74485) | $305.03 | $649 | 0.1× |
| Discography Cerv/Thor Spine (72285) | $576.22 | $1,226 | 0.3× |
| Diskography lumbar (72295) | $836.60 | $1,780 | 0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $132.07 | $281 | 1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $132.07 | $281 | 1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $109.04 | $232 | 1.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$104.34–$239.23 | $222–$509 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $103.87 | $221 | 1.2× |
| Echo exam of fetal heart (76825) | $561.18 | $1,194 | 1.0× |
| Echo exam uterus (76831) | $152.75 | $325 | 0.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$210.56–$435.22 | $448–$926 | varies |
| Esophagram (74220) | $224.66 | $478 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$103.40–$131.60 | $220–$280 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$75.20–$133.48 | $160–$284 | varies |
| Fluoroscopy up to 1 hr (76000) | $135.83 | $289 | 0.6× |
| Follow-Up Angiography (75898) | $422.06 | $898 | 0.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$101.99–$162.15 | $217–$345 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$99.64–$260.38 | $212–$554 | varies |
| Gastric emptying imaging study (78264) | $868.56 | $1,848 | 2.2× |
| Gated Heart Planar Single (78472) | $618.52 | $1,316 | 1.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$81.31–$161.68 | $173–$344 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,020.84 | $2,172 | 1.9× |
| Hepatobiliary System Imaging (78226) | $734.61 | $1,563 | 1.8× |
| Ht Musc Image Planar Mult (78454) | $1,057.03 | $2,249 | 0.8× |
| Ht Muscle Image Spect Sing (78451) | $1,057.03 | $2,249 | 0.8× |
| Hysterosalpingogram (74740) | $222.78 | $474 | 0.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $154.16 | $328 | 1.8× |
| Joint Survey Single View (77077) | $93.53 | $199 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $777.85 | $1,655 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $846.94 | $1,802 | 1.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$159.80–$320.07 | $340–$681 | varies |
| Leveen/Shunt Patency Exam (78291) | $347.33 | $739 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $397.62 | $846 | 1.0× |
| Liver imaging static only (78201) | $593.14 | $1,262 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $658.94 | $1,402 | 1.2× |
| Lung perfusion differential (78597) | $407.02 | $866 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $680.09 | $1,447 | 1.3× |
| Lung Ventilation Imaging (78579) | $378.35 | $805 | 0.9× |
| Lymph System Imaging (78195) | $782.55 | $1,665 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $414.54 | $882 | 1.7× |
| Magnetic Resonance Elastography (76391) | $132.07 | $281 | 0.6× |
| Meckels Divert Exam (78290) | $593.14 | $1,262 | 1.5× |
| Mlc imrt design & construction per imrt plan (77338) | $614.29 | $1,307 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $360.49 | $767 | 1.0× |
| MRA head w/o contrast (70544) | $233.59 | $497 | 1.0× |
| MRA head with contrast (70545) | $287.17 | $611 | 0.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $360.49 | $767 | 1.0× |
| MRA neck w/o contrast (70547) | $233.59 | $497 | 1.0× |
| MRI abdomen w contrast (74182) | $349.21 | $743 | 1.0× |
| MRI abdomen w/o contrast (74181) | $277.30 | $590 | 1.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 9 matching MRF lines |
$775.97–$1,552.88 | $1,651–$3,304 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $360.49 | $767 | 1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 9 matching MRF lines |
$296.57–$445.56 | $631–$948 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $466.24 | $992 | 2.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $233.59 | $497 | 1.0× |
| MRI cardiac w/o contrast (75557) | $296.10 | $630 | 1.2× |
| MRI cervical spine w contrast (72142) | $287.17 | $611 | 0.8× |
| MRI cervical spine w/o cont (72141) | $360.49 | $767 | 1.5× |
| MRI chest w/o contrast (71550) | $233.59 | $497 | 1.0× |
| MRI chest with contrast (71551) | $287.17 | $611 | 0.4× |
| MRI chest wo w contrast (71552) | $360.49 | $767 | 1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,069.25 | $2,275 | 3.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $421.59 | $897 | 1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $317.25 | $675 | 1.3× |
| MRI lumbar spine w contrast (72149) | $287.17 | $611 | 0.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $360.49 | $767 | 1.0× |
| MRI orbit face &/neck w/o contrast (70540) | $233.59 | $497 | 1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $360.49 | $767 | 1.0× |
| MRI pelvis w contrast (72196) | $370.83 | $789 | 1.1× |
| MRI pelvis w/o & w contrast (72197) | $418.77 | $891 | 1.2× |
| MRI pelvis w/o contrast (72195) | $321.95 | $685 | 1.4× |
| MRI spectroscopy (76390) | $979.95 | $2,085 | 11.3× |
| MRI thoracic spine w/o contrast (72146) | $233.59 | $497 | 1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $383.05 | $815 | 1.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $317.72 | $676 | 1.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $418.77 | $891 | 1.2× |
| MRI, abdomen, combo (74183) | $420.18 | $894 | 1.2× |
| MRI, dorsal spine combo (72157) | $360.49 | $767 | 1.0× |
| MRI, dorsal spine contrast (72147) | $287.17 | $611 | 0.8× |
| MRI, joint upper extrem (73221) | $233.59 | $497 | 1.0× |
| MRI, joint upper extrem combo (73223) | $360.49 | $767 | 1.0× |
| MRI, lumbar spine combo (72158) | $360.49 | $767 | 1.0× |
| Myelogram cervical (72240) | $541.91 | $1,153 | 0.7× |
| Myelogram Lumbar (72265) | $483.63 | $1,029 | 0.6× |
| Myelography thoracic (72255) | $435.69 | $927 | 0.6× |
| Myelograpy 2/more regions rs&i (72270) | $541.91 | $1,153 | 0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,720.20 | $3,660 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,057.03 | $2,249 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $1,057.03 | $2,249 | 0.8× |
| N-invas est c ffr sw aly CTA (75580) | $3,891.13 | $8,279 | 4.5× |
| Neck soft tissue (70360) | $129.72 | $276 | 1.5× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$94–$133.95 | $200–$285 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,856.50 | $3,950 | 1.3× |
| Nuclear Rx Intra-Arterial (79445) | $168.26 | $358 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $828.14 | $1,762 | 3.6× |
| Ob us nuchal meas 1 gest (76813) | $98.23 | $209 | 0.9× |
| Parathyroid Planar Imaging (78070) | $639.20 | $1,360 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $407.49 | $867 | 1.0× |
| Pelvis 1 or 2 views (72170) | $92.59 | $197 | 0.9× |
| Pet Image W/Ct Lmtd (78814) | $2,451.05 | $5,215 | 1.7× |
| PET image w/CT, full body (78816) | $2,469.38 | $5,254 | 1.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,466.09 | $5,247 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,788.51 | $5,933 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $354.38 | $754 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $177.19 | $377 | 1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $188 | $400 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$134.42–$266.02 | $286–$566 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$81.78–$150.87 | $174–$321 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$130.66–$260.38 | $278–$554 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $222.78 | $474 | 2.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$79.90–$159.33 | $170–$339 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$121.73–$193.64 | $259–$412 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$95.88–$154.16 | $204–$328 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$130.66–$260.38 | $278–$554 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $198.81 | $423 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $130.66 | $278 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $134.42 | $286 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$134.42–$266.02 | $286–$566 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $90.71 | $193 | 1.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $156.04 | $332 | 0.9× |
| Radex Spine 1 View Specify Level (72020) | $94.47 | $201 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $116.09 | $247 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $205.86 | $438 | 2.4× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$79.90–$159.80 | $170–$340 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $130.66 | $278 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$121.73–$193.64 | $259–$412 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $278.24 | $592 | 2.7× |
| Radiation treatment delivery level 3 (77412) | $305.03 | $649 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $192.23 | $409 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $131.13 | $279 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $350.62 | $746 | 2.0× |
| Radiologic exam colon single contrast study (74270) | $274.01 | $583 | 1.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$85.54–$156.98 | $182–$334 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$115.62–$184.71 | $246–$393 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $192.23 | $409 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $257.09 | $547 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $291.40 | $620 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $317.25 | $675 | 1.8× |
| Radiologic examination femur 1 view (73551) | $100.58 | $214 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) | $149.93 | $319 | 1.7× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$90.71–$180.95 | $193–$385 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $144.76 | $308 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$130.66–$260.38 | $278–$554 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $78.49 | $167 | 0.1× |
| Ribs bilateral 3 views (71110) | $192.23 | $409 | 1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $539.56 | $1,148 | 1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $697.48 | $1,484 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,263.36 | $2,688 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $716.75 | $1,525 | 1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,304.72 | $2,776 | 2.4× |
| Scapula (73010) range across 3 matching MRF lines |
$97.29–$193.64 | $207–$412 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $17.39 | $37 | 0.7× |
| Sella turcica (70240) | $46.06 | $98 | 0.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$97.29–$146.17 | $207–$311 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$237.35–$474.70 | $505–$1,010 | varies |
| Sialogram (70390) | $173.43 | $369 | 0.7× |
| Skull less than 4 views (70250) | $118.44 | $252 | 1.1× |
| Special dosimetry (77331) | $89.30 | $190 | 0.7× |
| Special Physics Consult (77370) | $174.37 | $371 | 1.3× |
| Special teletherapy port plan (77321) | $288.58 | $614 | 0.8× |
| Special treatment procedure (77470) | $554.60 | $1,180 | 1.0× |
| Stereotactic Body Radiation Delivery (77373) | $1,770.96 | $3,768 | 1.0× |
| Sternoclavicular joints (71130) | $126.90 | $270 | 1.5× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $78.49 | $167 | 0.9× |
| Tbs technical calculation only (77091) | $78.49 | $167 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $242.05 | $515 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $529.69 | $1,127 | 1.4× |
| Ther rad simulaj-aided field setting simple (77280) | $173.43 | $369 | 1.3× |
| Thoracic spine 2 views (72070) | $134.42 | $286 | 1.3× |
| Thoracic spine 3 views (72072) | $148.05 | $315 | 1.4× |
| Thoracolumbar 2 views (72080) | $108.10 | $230 | 1.2× |
| Thyroid Imaging With Vascular Flow (78013) | $450.73 | $959 | 1.1× |
| Thyroid Met Imaging Body (78018) | $606.77 | $1,291 | 1.1× |
| Thyroid Uptake Measurement (78012) | $343.57 | $731 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $792.42 | $1,686 | 2.0× |
| Tx Devices Design & Construction Complex (77334) | $371.30 | $790 | 1.0× |
| Tx devices design & construction intermediate (77333) | $333.70 | $710 | 2.5× |
| Tx devices design & construction simple (77332) | $296.10 | $630 | 2.2× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$154.16–$176.72 | $328–$376 | varies |
| Ultrasound elastography first target lesion (76982) | $129.72 | $276 | 1.2× |
| Ultrasound Elastography Parenchyma (76981) | $129.72 | $276 | 1.2× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$96.82–$125.02 | $206–$266 | varies |
| Ultrasound, abdomen limited (76705) | $184.24 | $392 | 1.8× |
| Umbilical-artery Doppler (OB) (76820) | $109.04 | $232 | 1.0× |
| Unlisted fluoroscopic procedure (76496) | $82.72 | $176 | 1.0× |
| Unlisted magnetic resonance procedure (76498) | $346.39 | $737 | 4.0× |
| Unlisted us procedure (76999) | $87.42 | $186 | 1.0× |
| Upper gi w/o kub (74240) | $267.43 | $569 | 1.5× |
| Ureteral Reflux Study (78740) | $473.29 | $1,007 | 1.2× |
| Urethrocystogram voiding (74455) | $171.55 | $365 | 0.7× |
| Urethrocystography retrograde (74450) | $122.20 | $260 | 0.5× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$129.72–$152.28 | $276–$324 | varies |
| Us chest (76604) | $99.64 | $212 | 1.0× |
| Us complete joint (76881) range across 2 matching MRF lines |
$220.90–$441.80 | $470–$940 | varies |
| Us exam, pelvic, limited (76857) | $209.15 | $445 | 2.0× |
| Us head (76506) | $253.33 | $539 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$64.39–$129.25 | $137–$275 | varies |
| Us ob detailed single fetus (76811) | $340.28 | $724 | 1.4× |
| Us ob limited 1 or more fetuses (76815) range across 6 matching MRF lines |
$167.79–$204.92 | $357–$436 | varies |
| Us ob transvaginal (76817) | $134.89 | $287 | 1.3× |
| Us pelvic non ob complete (76856) | $442.74 | $942 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $350.15 | $745 | 3.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $240.64 | $512 | 2.3× |
| Us retroperitoneal complete (76770) | $326.18 | $694 | 3.1× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$163.09–$255.68 | $347–$544 | varies |
| Us scrotum and contents (76870) | $282 | $600 | 2.7× |
| Us spinal canal and contents (76800) | $557.89 | $1,187 | 5.4× |
| Us thyroid (76536) | $188.94 | $402 | 1.8× |
| Us transrectal (76872) | $147.11 | $313 | 1.4× |
| Vascular Flow Imaging (78445) | $270.25 | $575 | 0.7× |
| Vein X-Ray Chest (75827) | $1,204.61 | $2,563 | 0.8× |
| Venogram Sinus/Jugular (75860) | $1,222 | $2,600 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $348.27 | $741 | 0.1× |
| Venography extremity bilateral rs&i (75822) | $505.25 | $1,075 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $392.45 | $835 | 0.3× |
| Venography Renal Bilateral (75833) | $1,588.13 | $3,379 | 0.5× |
| Venography Renal Unilateral (75831) | $1,588.13 | $3,379 | 0.5× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,037.76 | $2,208 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $82.72 | $176 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$90.71–$180.95 | $193–$385 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $192.23 | $409 | 2.2× |
| X-ray antegrade pyelogram tube (74425) | $381.64 | $812 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $1,013.79 | $2,157 | 0.3× |
| X-Ray Bend Only L-S Spine (72120) | $198.81 | $423 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$93.06–$161.21 | $198–$343 | varies |
| X-Ray Exam Breast Specimen (76098) | $42.77 | $91 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $140.06 | $298 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $195.05 | $415 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $250.04 | $532 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $100.58 | $214 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $122.67 | $261 | 1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $81.31 | $173 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $147.11 | $313 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $157.92 | $336 | 1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $169.20 | $360 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $222.78 | $474 | 2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $149.93 | $319 | 1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $236.41 | $503 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $155.10 | $330 | 1.5× |
| X-ray eye for foreign body (70030) | $135.83 | $289 | 1.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$116.09–$231.24 | $247–$492 | varies |
| X-ray IV pyelogram (ivp) (74400) | $169.20 | $360 | 1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $76.61 | $163 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $92.59 | $197 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $124.55 | $265 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $77.55 | $165 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $209.15 | $445 | 2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $121.73 | $259 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $109.04 | $232 | 1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $159.80 | $340 | 1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $184.71 | $393 | 1.8× |
| X-Ray Tmj Unilat (70328) | $108.10 | $230 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $202.57 | $431 | 0.6× |
| X-Rays Bone Length Studies (77073) | $120.32 | $256 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $191.76 | $408 | 1.8× |
| Xr c-spine 4 or 5 views (72050) | $193.17 | $411 | 1.9× |
| Xr facial bones less than 3 views (70140) | $96.82 | $206 | 1.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $151.34 | $322 | 1.5× |
| Xr orbits complete 4 views (70200) | $192.23 | $409 | 1.8× |
| Xr Tomogram Single Plane (76100) | $260.85 | $555 | 2.5× |
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.