Imaging prices at Highpoint Health – Sumner with Ascension Saint Thomas
Gallatin, TN · every code in this section with a posted price and a Medicare benchmark.
345 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) range across 2 matching MRF lines |
$2,441.34–$2,626.80 | $10,477.86–$11,420.87 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$205.10–$220.68 | $880.25–$959.47 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$185.61–$199.71 | $796.61–$868.30 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,357.41–$1,460.53 | $5,825.80–$6,350.12 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$2,018.05–$2,171.36 | $8,661.18–$9,440.69 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,776.09–$6,214.87 | $24,790.07–$27,021.18 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$5,776.09–$6,214.87 | $24,790.07–$27,021.18 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,272.73–$4,597.31 | $18,337.89–$19,988.30 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$4,270.43–$6,214.87 | $18,328.04–$27,021.18 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$3,844.99–$4,137.08 | $16,502.11–$17,987.30 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$60.59–$327.50 | $263.44–$1,423.92 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$3,744.03–$4,028.45 | $16,068.81–$17,515 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$3,744.03–$4,028.45 | $16,068.81–$17,515 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$5,776.09–$6,214.87 | $24,790.07–$27,021.18 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$3,744.03–$4,028.45 | $16,068.81–$17,515 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$574.47–$618.11 | $2,465.54–$2,687.44 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$238.08–$643.06 | $1,035.13–$2,795.90 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$226.45–$611.65 | $984.57–$2,659.35 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$313.42–$337.23 | $1,345.15–$1,466.21 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$195.89–$210.77 | $840.71–$916.37 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$610.73–$657.12 | $2,621.15–$2,857.05 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$610.73–$657.12 | $2,621.15–$2,857.05 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$594.58–$639.75 | $2,551.86–$2,781.53 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$750.54–$807.56 | $3,221.20–$3,511.11 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$195.89–$210.77 | $840.71–$916.37 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$451.53–$485.83 | $1,937.91–$2,112.32 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$579.28–$623.29 | $2,486.18–$2,709.94 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$871.14–$937.31 | $3,738.79–$4,075.28 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$451.53–$485.83 | $1,937.91–$2,112.32 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$1,362.02–$1,465.49 | $5,845.58–$6,371.68 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$104.46–$160.36 | $454.19–$697.20 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$104.46–$228.97 | $454.19–$995.51 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$108.31–$116.54 | $464.87–$506.71 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$199.71–$223.16 | $868.30–$970.26 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$259.65–$279.37 | $1,114.38–$1,214.67 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$71–$384.35 | $308.68–$1,671.09 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$88.29–$94.99 | $378.91–$413.01 | varies |
| Continuing medical physics consltj pr wk (77336) | $313.42 | $1,345.15 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,744.03–$4,028.45 | $16,068.81–$17,515 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$380.27–$409.15 | $1,632.05–$1,778.93 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$223.70–$604.21 | $972.60–$2,627.01 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$228.90–$618.26 | $995.22–$2,688.10 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,686.63–$3,966.68 | $15,822.43–$17,246.45 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,543.77–$2,737.01 | $10,917.46–$11,900.03 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,300.56–$1,399.36 | $5,581.80–$6,084.16 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,862.12–$2,003.57 | $7,991.92–$8,711.19 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,242.95–$1,337.37 | $5,334.54–$5,814.65 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,297.41–$3,547.90 | $14,151.96–$15,425.64 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,073.38–$2,230.89 | $8,898.62–$9,699.50 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,158.64–$2,322.62 | $9,264.54–$10,098.35 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,325.15–$1,425.82 | $5,687.34–$6,199.20 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$478.92–$2,587.12 | $2,082.24–$11,248.33 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,163.05–$1,251.41 | $4,991.65–$5,440.90 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$478.92–$2,587.12 | $2,082.24–$11,248.33 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$825.05–$887.72 | $3,540.98–$3,859.67 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,232.96–$1,326.62 | $5,291.66–$5,767.91 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,261.39–$1,357.22 | $5,413.71–$5,900.94 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,383.52–$1,488.62 | $5,937.87–$6,472.28 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,826.01–$1,964.73 | $7,836.96–$8,542.29 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,051.68–$1,131.57 | $4,513.64–$4,919.87 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,623.97–$1,747.33 | $6,969.81–$7,597.09 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$332.85–$358.13 | $1,428.52–$1,557.09 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$144.42–$155.39 | $619.82–$675.60 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,049.36–$1,129.08 | $4,503.71–$4,909.04 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,998.85–$2,150.70 | $8,578.76–$9,350.85 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$441.28–$2,383.78 | $1,918.60–$10,364.28 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$464.53–$2,509.42 | $2,019.71–$10,910.53 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,733.83–$1,865.54 | $7,441.32–$8,111.04 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,733.83–$1,865.54 | $7,441.32–$8,111.04 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,051.68–$1,131.57 | $4,513.64–$4,919.87 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$958.71–$1,031.54 | $4,114.64–$4,484.96 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,163.05–$1,251.41 | $4,991.65–$5,440.90 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,051.68–$1,131.57 | $4,513.64–$4,919.87 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,013.26–$1,090.24 | $4,348.77–$4,740.16 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,045.72–$2,201.13 | $8,779.93–$9,570.12 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,425.02–$1,533.27 | $6,115.96–$6,666.40 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$478.92–$2,587.12 | $2,082.24–$11,248.33 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,633.20–$1,757.26 | $7,009.43–$7,640.28 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,163.05–$1,251.41 | $4,991.65–$5,440.90 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,163.05–$1,251.41 | $4,991.65–$5,440.90 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$856.55–$921.62 | $3,676.19–$4,007.05 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,756.88–$1,890.34 | $7,540.25–$8,218.87 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,084.69–$1,167.09 | $4,655.34–$5,074.32 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$199.08–$1,665.51 | $865.58–$7,241.36 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$433.63–$2,342.46 | $1,885.34–$10,184.61 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$464.23–$2,507.77 | $2,018.37–$10,903.36 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$456.88–$2,468.10 | $1,986.45–$10,730.88 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,901.29–$2,045.72 | $8,160.05–$8,894.45 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,810.65–$1,948.19 | $7,771.02–$8,470.41 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,651.63–$1,777.10 | $7,088.55–$7,726.52 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$4,445.57–$4,783.28 | $19,079.69–$20,796.86 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$4,445.57–$4,783.28 | $19,079.69–$20,796.86 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$157.49–$169.46 | $675.94–$736.77 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$157.49–$169.46 | $675.94–$736.77 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$1,227.58–$1,320.83 | $5,268.57–$5,742.74 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$188.12–$202.41 | $807.39–$880.06 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$259.65–$279.37 | $1,114.38–$1,214.67 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$359.51–$386.82 | $1,542.96–$1,681.83 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$259.65–$279.37 | $1,114.38–$1,214.67 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$298.83–$321.53 | $1,282.53–$1,397.96 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$526.22–$566.19 | $2,258.44–$2,461.70 | varies |
| Foot 2 views (73620) range across 7 matching MRF lines |
$78.34–$435.12 | $340.62–$1,891.83 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$37.34–$202.50 | $162.33–$880.45 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,093.92–$1,177.02 | $4,694.92–$5,117.46 | varies |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$508.55–$547.19 | $2,182.63–$2,379.07 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,217.60–$1,310.10 | $5,225.76–$5,696.08 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$67.02–$361.20 | $291.38–$1,570.45 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$649.68–$699.03 | $2,788.31–$3,039.26 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$649.68–$699.03 | $2,788.31–$3,039.26 | varies |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$2,024.24–$3,087.19 | $8,801.03–$13,422.57 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$511.62–$550.49 | $2,195.80–$2,393.42 | varies |
| Image fusion (77399) range across 2 matching MRF lines |
$348–$374.44 | $1,493.57–$1,627.99 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$165.93–$178.54 | $712.16–$776.25 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$149.03–$160.36 | $639.63–$697.20 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$6,283.87–$6,761.23 | $26,969.40–$29,396.65 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 2 matching MRF lines |
$1,305.95–$1,405.15 | $5,604.92–$6,109.36 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$1,305.95–$1,405.15 | $5,604.92–$6,109.36 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$1,305.95–$1,405.15 | $5,604.92–$6,109.36 | varies |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$132.13–$142.17 | $567.09–$618.13 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$1,646.25–$1,771.31 | $7,065.44–$7,701.33 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$839.64–$903.42 | $3,603.60–$3,927.92 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,218.37–$1,310.92 | $5,229.04–$5,699.65 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$65.18–$352.13 | $283.39–$1,530.98 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$457.21–$491.94 | $1,962.27–$2,138.87 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$649.89–$699.26 | $2,789.24–$3,040.27 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,008.90–$1,085.55 | $4,330.06–$4,719.77 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$1,008.90–$1,085.55 | $4,330.06–$4,719.77 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$751.38–$808.46 | $3,224.80–$3,515.03 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$442.63–$476.25 | $1,899.70–$2,070.67 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$802.77–$863.76 | $3,445.38–$3,755.46 | varies |
| Magnetic Image Jaw Joint (70336) range across 4 matching MRF lines |
$326.16–$1,489.46 | $1,418.08–$6,475.91 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$589.97–$634.79 | $2,532.08–$2,759.97 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$443.59–$477.29 | $1,903.84–$2,075.19 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$557.72–$600.08 | $2,393.63–$2,609.06 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$658.34–$708.35 | $2,825.49–$3,079.78 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$82.06–$88.30 | $352.20–$383.90 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $22.82 | $97.96 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$85.55–$92.05 | $367.16–$400.20 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$55.36–$59.57 | $237.60–$258.98 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$225.28–$242.40 | $966.88–$1,053.90 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$534.43–$3,026.02 | $2,323.60–$13,156.62 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$326.16–$2,467.27 | $1,418.08–$10,727.25 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$534.43–$841.43 | $2,323.60–$3,658.41 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$534.43–$1,251.41 | $2,323.60–$5,440.90 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$534.43–$2,902.04 | $2,323.60–$12,617.57 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$326.16–$1,279.51 | $1,418.08–$5,563.07 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$534.43–$1,033.19 | $2,323.60–$4,492.14 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$326.16–$2,003.57 | $1,418.08–$8,711.19 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$581.74–$1,571.28 | $2,529.29–$6,831.66 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$534.43–$4,455.13 | $2,323.60–$19,370.15 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$728.93–$1,968.86 | $3,169.27–$8,560.24 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,454.46–$1,564.95 | $6,242.31–$6,804.12 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$1,147.92–$1,235.12 | $4,926.68–$5,370.08 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$534.43–$1,312.56 | $2,323.60–$5,706.79 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$326.16–$2,044.07 | $1,418.08–$8,887.27 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$326.16–$2,459.83 | $1,418.08–$10,694.93 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$534.43–$2,744.17 | $2,323.60–$11,931.16 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$534.43–$1,571.28 | $2,323.60–$6,831.66 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$534.43–$4,396.45 | $2,323.60–$19,115.02 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$326.16–$3,029.34 | $1,418.08–$13,171.04 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$534.43–$1,355.56 | $2,323.60–$5,893.75 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$534.43–$3,093.81 | $2,323.60–$13,451.36 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$326.16–$1,747.33 | $1,418.08–$7,597.09 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$534.43–$1,853.14 | $2,323.60–$8,057.15 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$534.43–$2,449.08 | $2,323.60–$10,648.16 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$534.43–$3,387.21 | $2,323.60–$14,727 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$326.16–$2,668.12 | $1,418.08–$11,600.54 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$326.16–$2,132.52 | $1,418.08–$9,271.82 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 5 matching MRF lines |
$534.43–$4,866.75 | $2,323.60–$21,159.80 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$326.16–$3,993.92 | $1,418.08–$17,364.88 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$534.43–$6,207.45 | $2,323.60–$26,988.90 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$534.43–$2,198.65 | $2,323.60–$9,559.33 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$534.43–$2,883.85 | $2,323.60–$12,538.49 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$534.43–$1,323.31 | $2,323.60–$5,753.54 | varies |
| MRI, joint upper extrem (73221) range across 5 matching MRF lines |
$326.16–$3,793.07 | $1,418.08–$16,491.62 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$534.43–$5,445.34 | $2,323.60–$23,675.40 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$534.43–$2,738.38 | $2,323.60–$11,906.02 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,039.38–$1,118.34 | $4,460.87–$4,862.35 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,039.38–$1,118.34 | $4,460.87–$4,862.35 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$1,039.38–$1,118.34 | $4,460.87–$4,862.35 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$1,636.25–$1,760.55 | $7,022.54–$7,654.57 | varies |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$2,241.63–$3,303.75 | $9,746.21–$14,364.14 | varies |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$948.21–$1,020.24 | $4,069.56–$4,435.82 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$232–$249.62 | $995.70–$1,085.31 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 2 matching MRF lines |
$460.93–$495.94 | $1,978.22–$2,156.26 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,441.34–$2,626.80 | $10,477.86–$11,420.87 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$858.84–$924.09 | $3,686.03–$4,017.77 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$844.26–$908.40 | $3,623.44–$3,949.55 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$557.82–$600.19 | $2,394.06–$2,609.53 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$186.67–$200.85 | $801.14–$873.24 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$5,861.13–$6,388.63 | $25,483.16–$27,776.64 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$5,937.58–$6,388.63 | $25,483.16–$27,776.64 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$5,861.13–$6,388.63 | $25,483.16–$27,776.64 | varies |
| Platelet survival study Non-Facility (78191) range across 2 matching MRF lines |
$688.31–$740.60 | $2,954.12–$3,219.99 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$658.34–$708.35 | $2,825.49–$3,079.78 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$399.47–$429.81 | $1,714.46–$1,868.76 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$424.22–$456.44 | $1,820.68–$1,984.54 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$97.31–$525.70 | $423.10–$2,285.65 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$76.81–$414.94 | $333.95–$1,804.08 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$76.81–$414.94 | $333.95–$1,804.08 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$347.23–$373.61 | $1,490.25–$1,624.37 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$71–$384.35 | $308.68–$1,671.09 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$82.63–$446.35 | $359.24–$1,940.66 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$90.58–$489.33 | $393.83–$2,127.53 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$58.45–$315.75 | $254.12–$1,372.83 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$132.13–$142.17 | $567.09–$618.13 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$323.41–$347.98 | $1,388.04–$1,512.96 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$73.14–$197.55 | $317.99–$858.91 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$77.12–$416.60 | $335.29–$1,811.29 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$218.16–$234.73 | $936.31–$1,020.58 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$162.86–$175.23 | $698.98–$761.89 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$97.55–$104.97 | $418.69–$456.37 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$458.62–$493.46 | $1,968.32–$2,145.47 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$71.61–$387.65 | $311.34–$1,685.43 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$38.86–$209.95 | $168.97–$912.81 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$88.75–$479.41 | $385.85–$2,084.37 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,237.61 | $52,521.92 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $149.76 | $642.75 | 1.5× |
| Radiation treatment delivery level 2 (77407) | $149.76 | $642.75 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $289.03 | $1,240.49 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$425.58–$457.91 | $1,826.53–$1,990.92 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$185.61–$199.71 | $796.61–$868.30 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$767.43–$825.73 | $3,293.68–$3,590.11 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$372.58–$400.88 | $1,599.05–$1,742.96 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$342.39–$368.40 | $1,469.48–$1,601.73 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$139.55–$753.81 | $606.72–$3,277.44 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$186.67–$217.39 | $801.14–$945.17 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$340.31–$366.16 | $1,460.54–$1,591.99 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$376.42–$405.02 | $1,615.54–$1,760.94 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$353.38–$503.03 | $1,516.64–$2,187.10 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$118.38–$248.68 | $514.71–$1,081.20 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$110.02–$236.66 | $472.21–$1,028.97 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$62.12–$336.40 | $270.09–$1,462.63 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$195.89–$210.77 | $840.71–$916.37 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$96.70–$522.39 | $420.45–$2,271.24 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$237.38–$255.41 | $1,018.80–$1,110.49 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$855.01–$919.96 | $3,669.58–$3,999.84 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$1,846.85–$1,987.15 | $7,926.39–$8,639.77 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,524–$1,639.78 | $6,540.79–$7,129.46 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$652.97–$702.57 | $2,802.45–$3,054.67 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$71–$384.35 | $308.68–$1,671.09 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$9.77–$10.51 | $41.93–$45.70 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$72.83–$393.46 | $316.65–$1,710.68 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$231.66–$625.70 | $1,007.20–$2,720.43 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$424.22–$456.44 | $1,820.68–$1,984.54 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$251.97–$271.11 | $1,081.40–$1,178.73 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$313.42–$337.23 | $1,345.15–$1,466.21 | varies |
| Special Physics Consult (77370) | $313.42 | $1,345.15 | 2.4× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$699.06–$752.16 | $3,000.24–$3,270.26 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,020.16–$1,097.66 | $4,378.39–$4,772.45 | varies |
| Stereotactic Body Radiation Delivery (77373) | $2,710.29 | $11,632.13 | 1.6× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$97.55–$121.51 | $418.69–$528.29 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$699.06–$752.16 | $3,000.24–$3,270.26 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$313.42–$337.23 | $1,345.15–$1,466.21 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$940.28–$1,011.71 | $4,035.54–$4,398.74 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$699.06–$752.16 | $3,000.24–$3,270.26 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$620.71–$667.86 | $2,663.99–$2,903.75 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$313.42–$337.23 | $1,345.15–$1,466.21 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$85.27–$91.75 | $365.97–$398.91 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$260.42–$280.20 | $1,117.69–$1,218.28 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$259.88–$279.62 | $1,115.38–$1,215.76 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,627.82–$1,751.48 | $6,986.36–$7,615.13 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$197.51–$212.51 | $847.68–$923.97 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$403.47–$434.13 | $1,731.65–$1,887.50 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$537.75–$578.60 | $2,307.93–$2,515.64 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$514.70–$553.80 | $2,209–$2,407.81 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$457.08–$491.80 | $1,961.72–$2,138.27 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$137.15–$295.13 | $588.63–$1,283.19 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$107.39–$115.55 | $460.90–$502.38 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$107.39–$115.55 | $460.90–$502.38 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$147.14–$158.32 | $631.51–$688.35 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$388.84–$512.48 | $1,690.60–$2,228.17 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$72.57–$170.98 | $315.54–$743.40 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$88.84–$95.59 | $381.29–$415.61 | varies |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$73.43–$121.75 | $319.24–$529.36 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$762.67–$820.60 | $3,273.25–$3,567.84 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$181.30–$503.03 | $778.11–$2,187.10 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$799.71–$860.46 | $3,432.22–$3,741.12 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$380.27–$409.15 | $1,632.05–$1,778.93 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$380.27–$409.15 | $1,632.05–$1,778.93 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$137.15–$295.13 | $588.63–$1,283.19 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$338.02–$363.69 | $1,450.71–$1,581.27 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$93.82–$506.84 | $407.93–$2,203.67 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$232.76–$250.44 | $998.98–$1,088.89 | varies |
| Us head (76506) range across 2 matching MRF lines |
$338.02–$363.69 | $1,450.71–$1,581.27 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$62.36–$336.86 | $271.12–$1,464.60 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$348.76–$375.26 | $1,496.84–$1,631.56 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$739.02–$795.16 | $3,171.75–$3,457.21 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$426.47–$562.06 | $1,854.20–$2,443.76 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$259.65–$279.37 | $1,114.38–$1,214.67 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$118.04–$127.01 | $506.63–$552.23 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$497.80–$535.61 | $2,136.46–$2,328.74 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$103.43–$279.37 | $449.71–$1,214.67 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$211.98–$279.37 | $921.64–$1,214.67 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$203.58–$219.05 | $873.75–$952.39 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$317.97–$419.06 | $1,382.47–$1,822 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$259.65–$279.37 | $1,114.38–$1,214.67 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,018.05–$2,171.36 | $8,661.18–$9,440.69 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$5,776.09–$6,214.87 | $24,790.07–$27,021.18 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,018.05–$2,171.36 | $8,661.18–$9,440.69 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,183.31–$1,273.20 | $5,078.58–$5,535.65 | varies |
| Venous thrombosis imaging (78457) range across 2 matching MRF lines |
$533.91–$574.46 | $2,291.44–$2,497.67 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$507.01–$545.53 | $2,176.03–$2,371.87 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$87.22–$471.15 | $379.20–$2,048.48 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$199.74–$214.91 | $857.24–$934.39 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$497.80–$535.61 | $2,136.46–$2,328.74 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$3,744.03–$4,028.45 | $16,068.81–$17,515 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$373.13–$401.47 | $1,601.40–$1,745.53 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$72.53–$392.62 | $315.33–$1,707.03 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$752.85–$820.60 | $3,273.25–$3,567.84 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$110.02–$118.38 | $472.21–$514.71 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$182.21–$196.05 | $782–$852.38 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$110.02–$118.38 | $472.21–$514.71 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$110.02–$118.38 | $472.21–$514.71 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$182.21–$196.05 | $782–$852.38 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$182.21–$196.05 | $782–$852.38 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$182.21–$196.05 | $782–$852.38 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$347.38–$373.77 | $1,490.90–$1,625.08 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$404.07–$434.77 | $1,734.22–$1,890.30 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$288.08–$411.63 | $1,236.41–$1,789.70 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$394.08–$424.02 | $1,691.35–$1,843.57 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$94.56–$255.41 | $411.13–$1,110.49 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$52.64–$284.34 | $228.85–$1,236.27 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$77.12–$416.60 | $335.29–$1,811.29 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$497.80–$535.61 | $2,136.46–$2,328.74 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$513.93–$552.97 | $2,205.70–$2,404.21 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$247.36–$266.16 | $1,061.65–$1,157.20 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$505.86–$753.81 | $2,199.37–$3,277.44 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$173.57–$455.42 | $754.67–$1,980.10 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$132.13–$142.17 | $567.09–$618.13 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$325.73–$350.47 | $1,397.97–$1,523.79 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$225.85–$243.01 | $969.31–$1,056.55 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$112.93–$142.17 | $484.67–$618.13 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$222.02–$238.88 | $952.86–$1,038.62 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$350.31–$376.92 | $1,503.46–$1,638.77 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$384.10–$413.28 | $1,648.49–$1,796.85 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$291.15–$313.26 | $1,249.56–$1,362.02 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$57.84–$156.22 | $251.47–$679.23 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$497.80–$669.51 | $2,136.46–$2,910.90 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$61.51–$332.27 | $267.43–$1,444.64 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$195.89–$210.77 | $840.71–$916.37 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$382.57–$411.63 | $1,641.93–$1,789.70 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$233.54–$251.28 | $1,002.30–$1,092.51 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$206.65–$222.35 | $886.91–$966.73 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$219.71–$236.41 | $942.98–$1,027.85 | varies |
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.