Imaging prices at Highpoint Health – Trousdale with Ascension Saint Thomas
Hartsville, 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 |
$4,428.43–$4,855.55 | $8,734.57–$9,520.68 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$372.05–$407.93 | $733.82–$799.86 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$371.18–$406.99 | $732.12–$798.01 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$2,462.24–$2,699.72 | $4,856.49–$5,293.57 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$3,660.63–$4,013.69 | $7,220.17–$7,869.99 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$10,477.42–$11,487.96 | $20,665.52–$22,525.42 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$10,477.42–$11,487.96 | $20,665.52–$22,525.42 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$7,750.43–$8,497.96 | $15,286.85–$16,662.67 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$8,493.39–$11,487.96 | $16,653.71–$22,525.42 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$6,974.55–$7,647.25 | $13,756.51–$14,994.60 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$134.35–$605.38 | $263.44–$1,187.02 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$6,791.42–$7,446.45 | $13,395.31–$14,600.89 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$6,791.42–$7,446.45 | $13,395.31–$14,600.89 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$10,477.42–$11,487.96 | $20,665.52–$22,525.42 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$6,791.42–$7,446.45 | $13,395.31–$14,600.89 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,153.59–$1,264.86 | $2,275.33–$2,480.11 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$527.92–$1,188.66 | $1,035.13–$2,330.71 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$502.13–$1,130.62 | $984.57–$2,216.91 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$596.95–$654.53 | $1,177.42–$1,283.39 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$355.33–$389.60 | $700.85–$763.93 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,107.81–$1,214.66 | $2,185.03–$2,381.68 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,107.81–$1,214.66 | $2,185.03–$2,381.68 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,078.54–$1,182.56 | $2,127.29–$2,318.75 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$1,361.42–$1,492.72 | $2,685.24–$2,926.91 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$355.33–$389.60 | $700.85–$763.93 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$819.07–$898.07 | $1,615.52–$1,760.92 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$1,240.80–$1,360.48 | $2,447.34–$2,667.60 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$1,580.18–$1,732.59 | $3,116.73–$3,397.24 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$819.07–$898.07 | $1,615.52–$1,760.92 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$2,470.62–$2,708.91 | $4,873.01–$5,311.58 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$212.89–$296.41 | $417.44–$581.19 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$212.89–$423.22 | $417.44–$829.84 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$196.48–$215.43 | $387.53–$422.41 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$376.22–$412.51 | $742.06–$808.85 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$471–$516.43 | $928.99–$1,012.60 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$157.43–$710.46 | $308.68–$1,393.06 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$160.13–$175.57 | $315.83–$344.25 | varies |
| Continuing medical physics consltj pr wk (77336) | $568.52 | $1,121.35 | 4.4× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$6,791.42–$7,446.45 | $13,395.31–$14,600.89 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$689.78–$756.31 | $1,360.51–$1,482.96 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$496.03–$1,116.86 | $972.60–$2,189.93 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$507.56–$1,142.83 | $995.22–$2,240.84 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$6,687.28–$7,332.27 | $13,189.91–$14,377 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$4,614.21–$5,059.25 | $9,101–$9,920.09 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,359.13–$2,586.66 | $4,653.11–$5,071.89 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,377.77–$3,703.55 | $6,662.27–$7,261.87 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$2,254.61–$2,472.07 | $4,446.97–$4,847.20 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$5,981.27–$6,558.16 | $11,797.37–$12,859.13 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$3,760.96–$4,123.70 | $7,418.06–$8,085.69 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,915.62–$4,293.28 | $7,723.12–$8,418.20 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$2,635.57–$3,161.59 | $5,167.78–$6,199.20 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$1,061.94–$4,782.21 | $2,082.24–$9,376.89 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,109.71–$2,313.19 | $4,161.16–$4,535.66 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,061.94–$4,782.21 | $2,082.24–$9,376.89 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,496.59–$1,640.94 | $2,951.85–$3,217.52 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,236.50–$2,452.21 | $4,411.24–$4,808.25 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$2,288.09–$2,508.77 | $4,512.99–$4,919.16 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$2,509.61–$2,751.66 | $4,949.93–$5,395.42 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$3,312.26–$3,631.72 | $6,533.05–$7,121.02 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,907.67–$2,091.67 | $3,762.67–$4,101.31 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,945.77–$3,229.89 | $5,810.20–$6,333.12 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$724.26–$794.12 | $1,428.52–$1,557.09 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$261.97–$287.23 | $516.70–$563.20 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,903.49–$2,087.08 | $3,754.41–$4,092.31 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$3,625.78–$3,975.48 | $7,151.43–$7,795.06 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$978.49–$4,406.35 | $1,918.60–$8,639.91 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,030.05–$4,638.58 | $2,019.71–$9,095.25 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$3,145.05–$3,448.39 | $6,203.25–$6,761.54 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$3,145.05–$3,448.39 | $6,203.25–$6,761.54 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,907.67–$2,091.67 | $3,762.67–$4,101.31 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,739.03–$1,906.76 | $3,430.04–$3,738.74 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$2,109.71–$2,313.19 | $4,161.16–$4,535.66 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,907.67–$2,091.67 | $3,762.67–$4,101.31 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,838–$2,015.27 | $3,625.24–$3,951.51 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$3,710.81–$4,068.71 | $7,319.15–$7,977.87 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$2,584.89–$2,834.20 | $5,098.40–$5,557.26 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$1,061.94–$4,782.21 | $2,082.24–$9,376.89 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,962.52–$3,248.25 | $5,843.23–$6,369.12 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,109.71–$2,313.19 | $4,161.16–$4,535.66 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,109.71–$2,313.19 | $4,161.16–$4,535.66 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,553.74–$1,703.59 | $3,064.57–$3,340.38 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$3,186.84–$3,494.21 | $6,285.69–$6,851.40 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,967.56–$2,157.33 | $3,880.79–$4,230.06 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$386.40–$3,078.65 | $757.64–$6,036.57 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$961.52–$4,329.96 | $1,885.34–$8,490.11 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$1,029.37–$4,635.52 | $2,018.37–$9,089.26 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$1,013.09–$4,562.22 | $1,986.45–$8,945.52 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$3,448.82–$3,781.46 | $6,802.40–$7,414.62 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$3,284.39–$3,601.17 | $6,478.09–$7,061.12 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,995.95–$3,284.92 | $5,909.18–$6,441.01 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$8,063.97–$8,841.73 | $15,905.26–$17,336.73 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$8,063.97–$8,841.73 | $15,905.26–$17,336.73 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$285.67–$313.22 | $563.45–$614.16 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$285.67–$313.22 | $563.45–$614.16 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$2,226.74–$2,441.51 | $4,392–$4,787.28 | varies |
| Echo Guide For Artery Repair (76936) range across 3 matching MRF lines |
$358.31–$392.86 | $706.72–$770.32 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$471–$516.43 | $928.99–$1,012.60 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$652.12–$715.01 | $1,286.23–$1,401.99 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$494.55–$542.25 | $975.45–$1,063.24 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$542.07–$594.35 | $1,069.17–$1,165.40 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$954.51–$1,046.58 | $1,882.67–$2,052.11 | varies |
| Foot 2 views (73620) range across 7 matching MRF lines |
$173.72–$844.52 | $340.62–$1,655.93 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$82.79–$374.31 | $162.33–$733.95 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,984.30–$2,175.68 | $3,913.80–$4,266.04 | varies |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$922.49–$1,011.46 | $1,819.50–$1,983.26 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$2,208.64–$2,421.66 | $4,356.29–$4,748.36 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$148.60–$667.69 | $291.38–$1,309.19 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,178.47–$1,292.13 | $2,324.39–$2,533.59 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,178.47–$1,292.13 | $2,324.39–$2,533.59 | varies |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$3,741.73–$5,706.56 | $7,336.72–$11,189.33 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$928.05–$1,017.56 | $1,830.47–$1,995.21 | varies |
| Image fusion (77399) range across 2 matching MRF lines |
$631.25–$692.13 | $1,245.06–$1,357.12 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$300.99–$330.02 | $593.67–$647.10 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$270.33–$296.41 | $533.20–$581.19 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$11,398.51–$12,497.89 | $22,482.26–$24,505.66 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 2 matching MRF lines |
$2,368.90–$2,597.38 | $4,672.39–$5,092.91 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$2,368.90–$2,597.38 | $4,672.39–$5,092.91 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$2,368.90–$2,597.38 | $4,672.39–$5,092.91 | varies |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$239.67–$262.79 | $472.73–$515.28 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$2,986.19–$3,274.21 | $5,889.93–$6,420.02 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,523.06–$1,669.96 | $3,004.06–$3,274.43 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$2,210.04–$2,423.19 | $4,359.05–$4,751.36 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$144.53–$650.90 | $283.39–$1,276.28 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$829.35–$909.34 | $1,635.79–$1,783.01 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$1,178.87–$1,292.57 | $2,325.18–$2,534.45 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,830.08–$2,006.59 | $3,609.62–$3,934.49 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$1,830.08–$2,006.59 | $3,609.62–$3,934.49 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,362.95–$1,494.41 | $2,688.27–$2,930.21 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$802.91–$880.35 | $1,583.64–$1,726.17 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,456.19–$1,596.64 | $2,872.17–$3,130.67 | varies |
| Magnetic Image Jaw Joint (70336) range across 4 matching MRF lines |
$723.22–$2,753.21 | $1,418.08–$5,398.45 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$1,070.19–$1,173.40 | $2,110.82–$2,300.79 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$804.65–$882.26 | $1,587.09–$1,729.93 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,011.65–$1,109.22 | $1,995.37–$2,174.95 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,194.20–$1,309.38 | $2,355.42–$2,567.41 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$178.57–$195.79 | $352.20–$383.90 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.67 | $97.96 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$186.15–$204.10 | $367.16–$400.20 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$120.46–$132.08 | $237.60–$258.98 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$490.21–$537.49 | $966.88–$1,053.90 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$1,185.04–$5,593.49 | $2,323.60–$10,967.63 | varies |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$723.22–$5,048.83 | $1,418.08–$9,899.66 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$1,185.04–$1,721.85 | $2,323.60–$3,376.17 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$1,185.04–$2,313.19 | $2,323.60–$4,535.66 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$1,185.04–$5,364.31 | $2,323.60–$10,518.26 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$723.22–$2,365.12 | $1,418.08–$4,637.49 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$1,185.04–$1,909.81 | $2,323.60–$3,744.73 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$723.22–$3,703.55 | $1,418.08–$7,261.87 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,289.94–$2,904.45 | $2,529.29–$5,695 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$1,185.04–$8,235.16 | $2,323.60–$16,147.38 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$1,616.33–$3,639.36 | $3,169.27–$7,136 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$2,920.69–$3,202.39 | $5,760.73–$6,279.20 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$2,305.12–$2,527.45 | $4,546.59–$4,955.78 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$1,185.04–$2,426.22 | $2,323.60–$4,757.29 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$723.22–$3,778.40 | $1,418.08–$7,408.62 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$723.22–$4,546.93 | $1,418.08–$8,915.55 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$1,185.04–$5,072.49 | $2,323.60–$9,946.06 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$1,185.04–$2,904.45 | $2,323.60–$5,695 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$1,185.04–$8,126.70 | $2,323.60–$15,934.71 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$723.22–$5,599.63 | $1,418.08–$10,979.67 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$1,185.04–$2,505.71 | $2,323.60–$4,913.15 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$1,185.04–$5,718.81 | $2,323.60–$11,213.36 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$723.22–$3,229.89 | $1,418.08–$6,333.12 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$1,185.04–$3,425.46 | $2,323.60–$6,716.59 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,185.04–$4,527.03 | $2,323.60–$8,876.52 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$1,185.04–$6,261.15 | $2,323.60–$12,276.76 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$723.22–$4,931.92 | $1,418.08–$9,670.44 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$723.22–$3,941.89 | $1,418.08–$7,729.20 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 8 matching MRF lines |
$1,185.04–$10,791.50 | $2,323.60–$21,159.80 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 10 matching MRF lines |
$723.22–$8,856.09 | $1,418.08–$17,364.88 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 10 matching MRF lines |
$1,185.04–$13,764.34 | $2,323.60–$26,988.90 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$1,185.04–$4,499.14 | $2,323.60–$8,821.85 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$1,185.04–$5,330.70 | $2,323.60–$10,452.36 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$1,185.04–$2,446.10 | $2,323.60–$4,796.27 | varies |
| MRI, joint upper extrem (73221) range across 5 matching MRF lines |
$723.22–$7,011.36 | $1,418.08–$13,747.77 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$1,185.04–$10,065.53 | $2,323.60–$19,736.34 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$1,185.04–$5,061.79 | $2,323.60–$9,925.08 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,885.37–$2,067.21 | $3,718.68–$4,053.36 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,885.37–$2,067.21 | $3,718.68–$4,053.36 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$1,885.37–$2,067.21 | $3,718.68–$4,053.36 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$2,968.07–$3,254.34 | $5,854.18–$6,381.06 | varies |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$4,143.58–$6,106.87 | $8,124.67–$11,974.26 | varies |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$2,063.27–$2,262.27 | $4,069.56–$4,435.82 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$420.83–$461.41 | $830.03–$904.73 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 2 matching MRF lines |
$836.09–$916.73 | $1,649.09–$1,797.51 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$4,428.43–$4,855.55 | $8,734.57–$9,520.68 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,557.89–$1,708.15 | $3,072.76–$3,349.31 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,531.45–$1,679.15 | $3,020.61–$3,292.46 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,011.84–$1,109.43 | $1,995.73–$2,175.35 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$338.59–$371.24 | $667.83–$727.93 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$12,399.61–$13,073.20 | $24,312.97–$25,633.73 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$11,923.21–$13,073.20 | $23,517.18–$25,633.73 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$12,399.61–$13,073.20 | $24,312.97–$25,633.73 | varies |
| Platelet survival study Non-Facility (78191) range across 2 matching MRF lines |
$1,248.55–$1,368.98 | $2,462.63–$2,684.27 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,194.20–$1,309.38 | $2,355.42–$2,567.41 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$724.61–$794.50 | $1,429.21–$1,557.84 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$769.50–$843.72 | $1,517.76–$1,654.36 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$215.78–$971.73 | $423.10–$1,905.36 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$170.31–$767.01 | $333.95–$1,503.94 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$170.31–$767.01 | $333.95–$1,503.94 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$629.85–$690.60 | $1,242.31–$1,354.12 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$157.43–$710.46 | $308.68–$1,393.06 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$183.21–$825.06 | $359.24–$1,617.76 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$200.85–$904.51 | $393.83–$1,773.54 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$129.60–$583.65 | $254.12–$1,144.41 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$239.67–$262.79 | $472.73–$515.28 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$586.65–$643.23 | $1,157.10–$1,261.24 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$162.17–$365.15 | $317.99–$715.99 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$171–$770.06 | $335.29–$1,509.92 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$395.73–$433.90 | $780.53–$850.78 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$295.41–$323.91 | $582.67–$635.11 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$176.96–$194.03 | $349.04–$380.45 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$831.92–$912.16 | $1,640.86–$1,788.54 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$158.78–$716.56 | $311.34–$1,405.01 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$86.17–$388.07 | $168.97–$760.93 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$196.78–$886.17 | $385.85–$1,737.58 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $23,308.10 | $45,972.59 | 3.3× |
| Radiation treatment delivery level 1 (77402) | $271.66 | $535.81 | 2.8× |
| Radiation treatment delivery level 2 (77407) | $271.66 | $535.81 | 0.7× |
| Radiation treatment delivery level 3 (77412) | $524.30 | $1,034.13 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$771.99–$846.45 | $1,522.66–$1,659.70 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$371.18–$406.99 | $732.12–$798.01 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,392.07–$1,526.33 | $2,745.70–$2,992.81 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$675.84–$741.02 | $1,333.02–$1,452.99 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$687.55–$753.86 | $1,356.11–$1,478.16 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$309.43–$1,393.39 | $606.72–$2,732.14 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$371.24–$444.85 | $727.93–$872.25 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$617.30–$676.84 | $1,217.55–$1,327.13 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$682.80–$748.65 | $1,346.74–$1,467.95 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$702.83–$1,029.36 | $1,378.10–$2,018.36 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$229.76–$482.66 | $450.51–$946.39 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$209.55–$459.34 | $413.31–$900.66 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$137.75–$621.84 | $270.09–$1,219.30 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$355.33–$389.60 | $700.85–$763.93 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$214.43–$965.62 | $420.45–$1,893.37 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$430.60–$472.13 | $849.31–$925.75 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,550.92–$1,700.51 | $3,059.02–$3,334.33 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$3,350.06–$3,673.17 | $6,607.61–$7,202.29 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$3,264.37–$3,579.21 | $6,438.59–$7,018.06 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,184.44–$1,298.68 | $2,336.17–$2,546.43 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$157.43–$710.46 | $308.68–$1,393.06 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$19.63–$21.52 | $38.71–$42.19 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$161.49–$727.28 | $316.65–$1,426.04 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$513.67–$1,156.59 | $1,007.20–$2,267.82 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$769.50–$843.72 | $1,517.76–$1,654.36 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$457.06–$501.14 | $901.49–$982.62 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$596.95–$654.53 | $1,177.42–$1,283.39 | varies |
| Special Physics Consult (77370) | $568.52 | $1,121.35 | 4.4× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,268.05–$1,390.35 | $2,501.08–$2,726.18 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,850.51–$2,028.99 | $3,649.92–$3,978.41 | varies |
| Stereotactic Body Radiation Delivery (77373) | $5,162.08 | $10,181.62 | 3.0× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$194.03–$224.59 | $380.45–$440.38 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,268.05–$1,390.35 | $2,501.08–$2,726.18 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$568.52–$623.36 | $1,121.35–$1,222.27 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$1,705.59–$1,870.10 | $3,364.09–$3,666.86 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,390.35 | $2,726.18 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,125.93–$1,234.52 | $2,220.76–$2,420.63 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$568.52–$623.36 | $1,121.35–$1,222.27 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$154.67–$169.59 | $305.06–$332.52 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$472.37–$517.93 | $931.70–$1,015.55 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$471.42–$516.89 | $929.83–$1,013.51 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,952.76–$3,237.56 | $5,823.99–$6,348.15 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$358.28–$392.84 | $706.67–$770.27 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$731.87–$802.46 | $1,443.54–$1,573.46 | varies |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$1,024.21–$1,122.99 | $2,020.14–$2,201.95 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$933.63–$1,023.68 | $1,841.48–$2,007.21 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$829.11–$909.08 | $1,635.32–$1,782.50 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$272.78–$545.54 | $534.86–$1,069.69 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$233.68–$256.21 | $460.90–$502.38 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$233.68–$256.21 | $460.90–$502.38 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$295.47–$323.97 | $582.79–$635.24 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$754.69–$947.29 | $1,479.78–$1,857.44 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$145.37–$349.89 | $285.03–$686.06 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$161.15–$176.69 | $317.85–$346.46 | varies |
| Unlisted magnetic resonance procedure (76498) range across 4 matching MRF lines |
$162.81–$269.97 | $319.24–$529.36 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$1,383.43–$1,516.86 | $2,728.66–$2,974.24 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$360.59–$1,029.36 | $707.03–$2,018.36 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$1,450.60–$1,590.51 | $2,861.14–$3,118.64 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$689.78–$756.31 | $1,360.51–$1,482.96 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$689.78–$756.31 | $1,360.51–$1,482.96 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$272.78–$545.54 | $534.86–$1,069.69 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$613.14–$672.27 | $1,209.34–$1,318.18 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$208.04–$936.90 | $407.93–$1,837.06 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$422.22–$462.94 | $832.78–$907.73 | varies |
| Us head (76506) range across 3 matching MRF lines |
$672.27–$744.24 | $1,318.18–$1,459.30 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$138.27–$622.67 | $271.12–$1,220.92 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$632.64–$693.66 | $1,247.81–$1,360.11 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$1,340.53–$1,469.83 | $2,644.05–$2,882.01 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$827.71–$1,038.96 | $1,622.97–$2,037.17 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$471–$516.43 | $928.99–$1,012.60 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$214.12–$234.77 | $422.33–$460.34 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$902.96–$990.05 | $1,780.99–$1,941.28 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$229.35–$516.43 | $449.71–$1,012.60 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$411.42–$516.43 | $806.70–$1,012.60 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$369.28–$404.90 | $728.37–$793.92 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$617.15–$774.61 | $1,210.10–$1,518.85 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$471–$516.43 | $928.99–$1,012.60 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$3,660.63–$4,013.69 | $7,220.17–$7,869.99 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$10,477.42–$11,487.96 | $20,665.52–$22,525.42 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$3,660.63–$4,013.69 | $7,220.17–$7,869.99 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,146.44–$2,353.46 | $4,233.61–$4,614.63 | varies |
| Venous thrombosis imaging (78457) range across 2 matching MRF lines |
$968.46–$1,061.87 | $1,910.18–$2,082.10 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$919.71–$1,008.41 | $1,814.02–$1,977.28 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$193.39–$870.90 | $379.20–$1,707.65 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$362.30–$397.24 | $714.60–$778.91 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$902.96–$990.05 | $1,780.99–$1,941.28 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$6,791.42–$7,446.45 | $13,395.31–$14,600.89 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$676.82–$742.10 | $1,334.95–$1,455.10 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$160.82–$725.74 | $315.33–$1,423.01 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$673.67–$1,910.58 | $1,320.93–$3,746.23 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$209.55–$229.76 | $413.31–$450.51 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$347.04–$380.52 | $684.50–$746.11 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$209.55–$229.76 | $413.31–$450.51 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$209.55–$229.76 | $413.31–$450.51 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$347.04–$380.52 | $684.50–$746.11 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$347.04–$380.52 | $684.50–$746.11 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$347.04–$380.52 | $684.50–$746.11 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$661.62–$725.43 | $1,304.97–$1,422.42 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$732.96–$803.66 | $1,445.69–$1,575.80 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$522.56–$760.88 | $1,030.70–$1,491.93 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$714.85–$783.80 | $1,409.97–$1,536.87 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$209.68–$472.13 | $411.13–$925.75 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$116.71–$525.60 | $228.85–$1,030.58 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$171–$770.06 | $335.29–$1,509.92 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$902.96–$990.05 | $1,780.99–$1,941.28 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$932.24–$1,022.16 | $1,838.74–$2,004.23 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$448.71–$491.99 | $885.03–$964.68 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$935.07–$1,393.39 | $1,833.47–$2,732.14 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$320.86–$841.84 | $629.14–$1,650.66 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$239.67–$262.79 | $472.73–$515.28 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$590.84–$647.83 | $1,165.37–$1,270.25 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$409.68–$449.19 | $808.04–$880.76 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$204.84–$262.79 | $404.02–$515.28 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$402.72–$441.56 | $794.32–$865.81 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$635.44–$696.73 | $1,253.33–$1,366.13 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$696.73–$763.93 | $1,374.23–$1,497.91 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$579.06–$641.03 | $1,135.41–$1,256.93 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$128.25–$288.78 | $251.47–$566.23 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$990.05–$1,237.57 | $1,941.28–$2,426.61 | varies |
| X-Rays Bone Length Studies (77073) range across 5 matching MRF lines |
$136.39–$644.90 | $267.43–$1,264.51 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$355.33–$389.60 | $700.85–$763.93 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$693.95–$760.88 | $1,368.74–$1,491.93 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$423.62–$464.48 | $835.55–$910.75 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$374.85–$411 | $739.34–$805.88 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$398.55–$436.99 | $786.09–$856.84 | 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.