Imaging prices at Holy Cross Hospital-davis
Layton, UT · every code in this section with a posted price and a Medicare benchmark.
359 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) | $1,984.68 | $4,961.70 | 1.4× |
| Abdomen 1 View (74018) | $201.01 | $502.52 | 2.3× |
| Abdomen 2 views (74019) | $242.63 | $606.56 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,372.81 | $3,432.02 | 3.4× |
| Angio internal mammary (75756) | $2,054.79 | $5,136.96 | 0.6× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$4,052.72–$6,079.07 | $10,131.78–$15,197.67 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,301.50 | $10,753.75 | 1.3× |
| Angiography extremity bilateral rs&i (75716) | $2,621.60 | $6,554 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,657.84 | $6,644.59 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,109.57 | $10,273.92 | 1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,050.94 | $2,627.34 | 0.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$332.05–$498.06 | $830.11–$1,245.15 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,416.93 | $6,042.31 | 0.4× |
| Artery X-Rays Abdomen (75726) | $3,567.94 | $8,919.85 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $4,135.12 | $10,337.79 | 1.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,416.22 | $6,040.54 | 0.4× |
| Artery X-Rays Spine (75705) | $7,108.20 | $17,770.48 | 1.3× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$384.66–$576.99 | $961.64–$1,442.47 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$513.52–$836.07 | $1,283.80–$2,090.17 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$958.08–$1,192.08 | $2,395.18–$2,980.18 | varies |
| Basic radiation dosimetry calculation (77300) | $255.20 | $637.98 | 1.9× |
| Bone age studies (77072) | $212.29 | $530.72 | 2.0× |
| Bone Imaging 3 Phase (78315) | $1,247.34 | $3,118.34 | 3.1× |
| Bone Imaging Limited Area (78300) | $700.33 | $1,750.81 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,147.38 | $2,868.44 | 2.8× |
| Bone survey infant (77076) | $429.53 | $1,073.81 | 4.1× |
| Brachytx isodose complex (77318) | $164.87 | $412.16 | 0.4× |
| Brachytx isodose intermed (77317) | $508.02 | $1,270.03 | 1.3× |
| Brachytx Isodose Plan Simple (77316) | $164.87 | $412.16 | 0.4× |
| Brain Flow Imaging Only (78610) | $757.11 | $1,892.77 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $708.68 | $1,771.69 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,357.37 | $8,393.41 | 2.3× |
| Chest 1 view (71045) | $222.31 | $555.76 | 2.5× |
| Chest 2 views (71046) | $302.13 | $755.32 | 3.4× |
| Chest 3 views (71047) | $285.22 | $713.04 | 3.2× |
| Chest 4 or more views (71048) | $297.88 | $744.69 | 2.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$212.06–$318.10 | $530.14–$795.23 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,219.88 | $3,049.70 | 11.5× |
| Continuing medical physics consltj pr wk (77336) | $255.20 | $637.98 | 1.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,490.43 | $6,226.06 | 0.8× |
| Contrast X-Ray Bladder (74430) | $486.34 | $1,215.84 | 1.4× |
| Contrast X-Ray Of Elbow (73085) | $503.38 | $1,258.43 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$549.42–$701.89 | $1,373.54–$1,754.71 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,931.20 | $7,327.99 | 8.3× |
| CT abdomen and pelvis without contrast (74176) | $2,443.55 | $6,108.87 | 10.1× |
| CT abdomen w contrast (74160) | $1,466.75 | $3,666.87 | 8.3× |
| CT abdomen w wo contrast (74170) | $1,563.92 | $3,909.78 | 8.8× |
| CT abdomen w/o contrast (74150) | $1,441.89 | $3,604.72 | 13.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,297.99 | $3,244.97 | 3.7× |
| CT Angio Chest (71275) | $1,593.24 | $3,983.09 | 9.0× |
| CT Angio Head (70496) | $1,037.16 | $2,592.89 | 5.8× |
| CT angio hrt w/3d image (75574) | $260.89 | $652.22 | 0.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$799.09–$1,198.63 | $1,997.71–$2,996.56 | varies |
| CT Angio Neck (70498) | $1,097.45 | $2,743.62 | 6.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$799.09–$1,198.63 | $1,997.71–$2,996.56 | varies |
| CT cervical spine w/ contrast (72126) | $1,399.72 | $3,499.28 | 4.0× |
| CT cervical spine w/o contrast (72125) | $1,251.56 | $3,128.90 | 11.8× |
| CT cervical spine w/wo cont (72127) | $1,456.07 | $3,640.16 | 8.2× |
| CT chest w contrast (71260) | $1,308.46 | $3,271.15 | 7.4× |
| CT chest w/wo contrast (71270) | $1,569.03 | $3,922.56 | 8.8× |
| CT head/brain with contrast (70460) | $1,344.81 | $3,362.01 | 7.6× |
| CT head/brain without and with contrast (70470) | $1,373.22 | $3,433.04 | 7.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $537.76 | $1,344.40 | 6.1× |
| CT iac w contrast (70481) | $1,300.34 | $3,250.85 | 7.3× |
| CT l-spine w&w/o contrast (72133) | $1,348.96 | $3,372.38 | 7.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,054.50–$1,581.74 | $2,636.25–$3,954.35 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,133.16–$1,699.75 | $2,832.90–$4,249.36 | varies |
| CT lumbar spine w contrast (72132) | $1,315.30 | $3,288.25 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,224.87 | $3,062.16 | 11.6× |
| CT maxillofacial w contrast (70487) | $1,200.94 | $3,002.33 | 6.8× |
| CT maxillofacial wo contrast (70486) | $1,064.62 | $2,661.55 | 10.1× |
| CT neck tissue combo (70492) | $1,278.97 | $3,197.41 | 7.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,443.67 | $3,609.17 | 8.1× |
| CT orbits w/o contrast (70480) | $1,066.84 | $2,667.09 | 10.1× |
| CT pelvis w&w/o contrast (72194) | $1,472.10 | $3,680.23 | 8.3× |
| CT pelvis w/o contrast (72192) | $1,128.25 | $2,820.62 | 10.7× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,210.87–$1,816.30 | $3,027.16–$4,540.73 | varies |
| CT scans face/jaw combo (70488) | $1,335.21 | $3,338.01 | 7.5× |
| CT soft tissue neck w contrast (70491) | $1,226.03 | $3,065.06 | 6.9× |
| CT soft tissue neck w/o contrast (70490) | $1,020.22 | $2,550.53 | 9.6× |
| CT thoracic spine w contrast (72129) | $1,272.14 | $3,180.35 | 7.2× |
| CT thoracic spine w/o contrast (72128) | $1,113.92 | $2,784.79 | 10.5× |
| CT thoracic spine w/wo cont (72130) | $260.89 | $652.22 | 1.5× |
| CT thorax w/o contrast (71250) | $1,274.93 | $3,187.32 | 12.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,086.22–$1,629.32 | $2,715.54–$4,073.30 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,245.67–$1,868.51 | $3,114.17–$4,671.27 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,155.14–$1,732.71 | $2,887.85–$4,331.77 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,157.26 | $5,393.13 | 12.1× |
| Cta Abdomen (74175) | $1,308.46 | $3,271.15 | 7.4× |
| CTA pelvis (72191) | $1,009.10 | $2,522.73 | 5.7× |
| Dilation ureters/urethra rs&i (74485) | $2,706.63 | $6,766.57 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $221.55 | $553.87 | 2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $139.34 | $348.35 | 1.3× |
| Dxa Bone Density Axial (77080) | $337.31 | $843.26 | 3.2× |
| Dxa bone density study (77085) | $550.71 | $1,376.76 | 5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $462.55 | $1,156.36 | 5.2× |
| Echo exam uterus (76831) | $501.27 | $1,253.16 | 2.1× |
| Echo Guide For Artery Repair (76936) | $377.44 | $943.59 | 1.7× |
| Echograp Trans R Pros Study (76873) | $383.18 | $957.93 | 3.6× |
| Esophagram (74220) | $295.38 | $738.45 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $299.56 | $748.90 | 2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $459.11 | $1,147.76 | 4.3× |
| Fluoroscopy up to 1 hr (76000) | $359.99 | $899.96 | 1.5× |
| Follow-Up Angiography (75898) | $650.54 | $1,626.35 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$256.34–$384.51 | $640.84–$961.27 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$197.59–$296.39 | $493.97–$740.96 | varies |
| Gastric emptying imaging study (78264) | $911.84 | $2,279.59 | 2.3× |
| Gated Heart Planar Single (78472) | $894.12 | $2,235.30 | 2.2× |
| Gated Heart, Multiple (78473) | $541.54 | $1,353.83 | 1.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$314.98–$472.47 | $787.44–$1,181.17 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,212.20 | $3,030.50 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $131.16 | $327.90 | 0.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,315.24 | $3,288.10 | 1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,967.38 | $12,418.43 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $721.44 | $1,803.59 | 1.3× |
| Hepatobiliary System Imaging (78226) | $721.44 | $1,803.59 | 1.8× |
| Ht Muscle Image Spect Sing (78451) | $1,818.74 | $4,546.83 | 1.4× |
| Hysterosalpingogram (74740) | $443.47 | $1,108.66 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $237.61 | $594.01 | 2.7× |
| Interstitial radiation source applic complex (77778) | $2,954.63 | $7,386.57 | 4.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,608.19 | $4,020.46 | 2.3× |
| Joint Survey Single View (77077) | $160.34 | $400.84 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $707.24 | $1,768.09 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $928.61 | $2,321.51 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) | $765.91 | $1,914.76 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $616.41 | $1,541.02 | 1.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$455.65–$683.47 | $1,139.12–$1,708.66 | varies |
| Liver & Spleen Imaging Static Only (78215) | $876.25 | $2,190.62 | 2.2× |
| Lung Perf&Ventilat Diferentl (78598) | $703.18 | $1,757.95 | 1.3× |
| Lung perfusion differential (78597) | $450.30 | $1,125.73 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $777.24 | $1,943.08 | 1.4× |
| Lung Ventilation Imaging (78579) | $565.40 | $1,413.48 | 1.4× |
| Lymph System Imaging (78195) | $1,931.88 | $4,829.70 | 3.5× |
| Magnetic Image Jaw Joint (70336) | $1,362.28 | $3,405.68 | 5.6× |
| Mammary ductogram or galactogram multiple (77054) | $513.04 | $1,282.60 | 2.1× |
| Mammary ductogram or galactogram single (77053) | $342.03 | $855.07 | 1.4× |
| Meckels Divert Exam (78290) | $753.77 | $1,884.41 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $591.27 | $1,478.16 | 1.6× |
| Mr safety determination physician/other qhp (76016) | $476 | $1,190 | 5.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $476 | $1,190 | 16.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $476 | $1,190 | 4.9× |
| Mr safety implt pos&/immoblj (76019) | $476 | $1,190 | 8.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $476 | $1,190 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,098.81 | $5,247.02 | 5.9× |
| MRA head w/o contrast (70544) | $1,474.39 | $3,685.97 | 6.1× |
| MRA head with contrast (70545) | $1,209.56 | $3,023.88 | 3.4× |
| MRA neck w contrast (70548) | $2,018.83 | $5,047.07 | 5.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,431 | $3,577.50 | 4.1× |
| MRA neck w/o contrast (70547) | $1,335.17 | $3,337.92 | 5.5× |
| MRI abdomen w contrast (74182) | $2,008.38 | $5,020.95 | 5.7× |
| MRI abdomen w/o contrast (74181) | $1,616.58 | $4,041.45 | 6.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,325.92–$3,488.87 | $5,814.78–$8,722.17 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,325.92–$3,488.87 | $5,814.78–$8,722.17 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,359.63–$3,539.43 | $5,899.06–$8,848.57 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,619.45 | $4,048.62 | 6.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $848.91 | $2,122.26 | 3.5× |
| MRI cervical spine w contrast (72142) | $2,012 | $5,029.99 | 5.7× |
| MRI cervical spine w/o cont (72141) | $2,032.51 | $5,081.27 | 8.4× |
| MRI chest w/o contrast (71550) | $1,338.99 | $3,347.47 | 5.5× |
| MRI chest with contrast (71551) | $1,024.68 | $2,561.70 | 1.3× |
| MRI chest wo w contrast (71552) | $1,689.45 | $4,223.61 | 4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,928.58–$2,892.86 | $4,821.43–$7,232.15 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,322.64–$4,983.96 | $8,306.58–$12,459.88 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,771.02–$4,156.52 | $6,927.53–$10,391.29 | varies |
| MRI lumbar spine w contrast (72149) | $2,222.30 | $5,555.75 | 6.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,458.66 | $6,146.63 | 7.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,346.58 | $3,366.44 | 5.6× |
| MRI orbit face neck w contrast (70542) | $1,296.73 | $3,241.82 | 3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,154.04 | $5,385.08 | 6.1× |
| MRI pelvis w contrast (72196) | $2,722.69 | $6,806.72 | 7.7× |
| MRI pelvis w/o & w contrast (72197) | $2,909.36 | $7,273.40 | 8.2× |
| MRI pelvis w/o contrast (72195) | $2,536.01 | $6,340.02 | 10.5× |
| MRI thoracic spine w/o contrast (72146) | $2,153.81 | $5,384.52 | 8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$537.84–$806.76 | $1,344.59–$2,016.88 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,679.85–$2,519.77 | $4,199.61–$6,299.41 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,359.63–$3,539.43 | $5,899.06–$8,848.57 | varies |
| MRI, abdomen, combo (74183) | $2,486.07 | $6,215.16 | 7.0× |
| MRI, dorsal spine combo (72157) | $2,523 | $6,307.48 | 7.1× |
| MRI, dorsal spine contrast (72147) | $2,097.67 | $5,244.17 | 5.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,679.85–$2,519.77 | $4,199.61–$6,299.41 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,359.63–$3,539.43 | $5,899.06–$8,848.57 | varies |
| MRI, lumbar spine combo (72158) | $2,767.60 | $6,919 | 7.8× |
| Myelogram cervical (72240) | $1,076.20 | $2,690.49 | 1.4× |
| Myelogram Lumbar (72265) | $1,081.40 | $2,703.48 | 1.4× |
| Myelography thoracic (72255) | $1,060.55 | $2,651.37 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $733.42 | $1,833.53 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $2,440.26 | $6,100.64 | 1.9× |
| Neck soft tissue (70360) | $186 | $464.99 | 2.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $466.23 | $1,165.57 | 1.2× |
| Nm myocard infarct spect (78469) | $1,871.45 | $4,678.61 | 3.4× |
| Nonvascular Shunt X-Ray (75809) | $32.87 | $82.16 | 0.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,216.02 | $5,540.05 | 1.6× |
| Nuclear Rx Intra-Arterial (79445) | $775.78 | $1,939.45 | 3.3× |
| Nuclear Rx Oral Admin (79005) | $775.78 | $1,939.45 | 3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,023.65 | $2,559.11 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,078.05 | $2,695.11 | 2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $549.77 | $1,374.41 | 1.4× |
| Pelvis 1 or 2 views (72170) | $220.87 | $552.17 | 2.1× |
| Pet Image W/Ct Lmtd (78814) | $2,155.12 | $5,387.80 | 1.5× |
| PET image w/CT, full body (78816) | $3,214.42 | $8,036.05 | 2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,214.42 | $8,036.05 | 2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,807.44 | $7,018.59 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $848.89 | $2,122.22 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $537.72 | $1,344.28 | 5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $388.86 | $972.14 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$386.86–$580.30 | $967.15–$1,450.73 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$332.05–$498.06 | $830.11–$1,245.15 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$369.15–$553.72 | $922.86–$1,384.28 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $319.95 | $799.87 | 3.0× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$198.39–$297.59 | $495.97–$743.97 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$417.18–$625.78 | $1,042.95–$1,564.44 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$385.61–$578.42 | $964.01–$1,446.04 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$455.65–$683.47 | $1,139.12–$1,708.66 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $206.48 | $516.19 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $224.42 | $561.04 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$240.75–$361.12 | $601.86–$902.78 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $214.28 | $535.70 | 2.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $572.18 | $1,430.44 | 3.2× |
| Radex Spine 1 View Specify Level (72020) | $186.34 | $465.85 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $378.16 | $945.40 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $487.48 | $1,218.68 | 5.5× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$181.82–$272.72 | $454.53–$681.80 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$314.93–$472.40 | $787.31–$1,180.98 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$356.54–$534.80 | $891.33–$1,336.99 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $742.79 | $1,856.96 | 7.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $3,786.36 | $9,465.90 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $58.32 | $145.80 | 0.6× |
| Radiation treatment delivery level 2 (77407) | $117.68 | $294.19 | 0.3× |
| Radiation treatment delivery level 3 (77412) | $383.52 | $958.80 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $288.54 | $721.34 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $252.24 | $630.58 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $513.38 | $1,283.43 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $466.96 | $1,167.38 | 2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $272.14 | $680.33 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$236.83–$355.24 | $592.07–$888.10 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $245.99 | $614.96 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $427.94 | $1,069.84 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $401.69 | $1,004.21 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $408.84 | $1,022.09 | 2.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$118.54–$165.12 | $296.34–$412.78 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$198.30–$297.46 | $495.75–$743.63 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$200.36–$300.54 | $500.88–$751.33 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $409.68 | $1,024.18 | 3.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$235.03–$352.54 | $587.56–$881.34 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $117.68 | $294.19 | 0.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $117.68 | $294.19 | 0.3× |
| Ribs bilateral 3 views (71110) | $477.93 | $1,194.82 | 4.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $568.12 | $1,420.29 | 1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $550.56 | $1,376.40 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,936.59 | $4,841.47 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,950.31 | $4,875.76 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,052.55 | $2,631.37 | 1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,906 | $4,764.98 | 1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,160.53 | $5,401.32 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,906 | $4,764.98 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $154.79 | $386.97 | 0.7× |
| Scapula (73010) range across 2 matching MRF lines |
$216.94–$325.41 | $542.34–$813.51 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $53.57 | $133.92 | 2.3× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$267.92–$401.88 | $669.80–$1,004.69 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$489.78–$748.68 | $1,224.45–$1,871.69 | varies |
| Skull less than 4 views (70250) | $208.77 | $521.91 | 2.0× |
| Special dosimetry (77331) | $189.05 | $472.62 | 1.4× |
| Special Physics Consult (77370) | $314.82 | $787.03 | 2.3× |
| Special teletherapy port plan (77321) | $164.87 | $412.16 | 0.4× |
| Special treatment procedure (77470) | $954.97 | $2,387.42 | 1.7× |
| Stereotactic Body Radiation Delivery (77373) | $3,787.96 | $9,469.90 | 2.1× |
| Sternoclavicular joints (71130) | $219.65 | $549.11 | 2.5× |
| Superior sagittal sinus venogram (75870) | $4,100.08 | $10,250.19 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $558.82 | $1,397.03 | 1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $164.87 | $412.16 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $641.89 | $1,604.72 | 1.7× |
| Ther rad simulaj-aided field setting simple (77280) | $319.17 | $797.91 | 2.3× |
| Thoracic spine 2 views (72070) | $259.21 | $648.02 | 2.4× |
| Thoracic spine 3 views (72072) | $456.24 | $1,140.59 | 4.3× |
| Thoracolumbar 2 views (72080) | $246.59 | $616.46 | 2.8× |
| Thyroid Imaging With Vascular Flow (78013) | $347.95 | $869.87 | 0.9× |
| Thyroid Met Imaging Body (78018) | $1,198.50 | $2,996.23 | 2.2× |
| Thyroid Uptake Measurement (78012) | $847.56 | $2,118.88 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $520.25 | $1,300.62 | 1.3× |
| Tx Devices Design & Construction Complex (77334) | $538.25 | $1,345.62 | 1.4× |
| Tx devices design & construction intermediate (77333) | $293.04 | $732.58 | 2.2× |
| Tx devices design & construction simple (77332) | $380.60 | $951.48 | 2.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$172.50–$258.76 | $431.24–$646.88 | varies |
| Ultrasound Exam Aaa Screen (76706) | $525.55 | $1,313.87 | 5.0× |
| Ultrasound, abdomen limited (76705) | $747.67 | $1,869.16 | 7.1× |
| Umbilical-artery Doppler (OB) (76820) | $221.55 | $553.87 | 2.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,024.72 | $2,561.78 | 9.9× |
| Upper gi w/o kub (74240) | $416.11 | $1,040.26 | 2.3× |
| Urethrocystogram voiding (74455) | $339.81 | $849.51 | 1.4× |
| Urethrocystography retrograde (74450) | $402.39 | $1,005.97 | 1.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$345–$517.49 | $862.48–$1,293.72 | varies |
| Us chest (76604) | $243.34 | $608.35 | 2.3× |
| Us complete joint (76881) | $614.37 | $1,535.92 | 5.8× |
| Us exam, pelvic, limited (76857) | $344.95 | $862.36 | 3.3× |
| Us head (76506) | $316.76 | $791.90 | 3.0× |
| Us kidney transplant (76776) | $420.32 | $1,050.78 | 4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$614.37–$921.56 | $1,535.92–$2,303.89 | varies |
| Us ob detailed single fetus (76811) | $578.65 | $1,446.62 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $409.37 | $1,023.42 | 3.9× |
| Us ob transvaginal (76817) | $409.37 | $1,023.42 | 3.9× |
| Us pelvic non ob complete (76856) | $423.42 | $1,058.53 | 4.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $576.82 | $1,442.04 | 5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $243.02 | $607.55 | 2.3× |
| Us retroperitoneal complete (76770) | $556.90 | $1,392.23 | 5.3× |
| Us retroperitoneal limited (76775) | $296.39 | $740.97 | 2.8× |
| Us scrotum and contents (76870) | $375.43 | $938.57 | 3.5× |
| Us spinal canal and contents (76800) | $283.44 | $708.59 | 2.7× |
| Us thyroid (76536) | $389.44 | $973.58 | 3.7× |
| Us transrectal (76872) | $326.51 | $816.27 | 3.1× |
| Vein X-Ray Chest (75827) | $1,605.27 | $4,013.16 | 1.0× |
| Venogram Sinus/Jugular (75860) | $2,054.79 | $5,136.96 | 0.6× |
| Venography Adrenal Unilateral (75840) | $2,026.80 | $5,066.99 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $4,570.80 | $11,426.99 | 1.4× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,677.91–$1,741.49 | $4,194.77–$4,353.71 | varies |
| Venography extremity unilateral rs&i (75820) | $1,605.06 | $4,012.64 | 1.0× |
| Venography Renal Bilateral (75833) | $8,603 | $21,507.50 | 2.7× |
| Venography Renal Unilateral (75831) | $4,301.50 | $10,753.75 | 1.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$168.51–$252.76 | $421.27–$631.89 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $208.28 | $520.68 | 2.4× |
| X-ray antegrade pyelogram tube (74425) | $385.56 | $963.88 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,503.46 | $6,258.65 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $175.89 | $439.71 | 1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$167.20–$250.79 | $417.98–$626.97 | varies |
| X-Ray Exam Breast Specimen (76098) | $816.55 | $2,041.36 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $188.37 | $470.92 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $252.50 | $631.23 | 2.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $619 | $1,547.48 | 5.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $151.07 | $377.66 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $213.48 | $533.68 | 2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $765.65 | $1,914.11 | 7.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $261.70 | $654.25 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $274.78 | $686.95 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $166.46 | $416.15 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $484.42 | $1,211.03 | 4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $218.52 | $546.30 | 2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $550.78 | $1,376.93 | 5.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $285.12 | $712.79 | 2.7× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$169.09–$253.63 | $422.71–$634.07 | varies |
| X-ray humerus (73060) | $182.68 | $456.70 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $416.65 | $1,041.61 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $164.61 | $411.52 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $197.50 | $493.74 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $325.42 | $813.54 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $223.74 | $559.34 | 2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $783.97 | $1,959.92 | 7.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $274.20 | $685.49 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $186.09 | $465.22 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $325.42 | $813.54 | 3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $307.53 | $768.81 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $356.18 | $890.45 | 3.4× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$274.70–$357.11 | $686.73–$892.77 | varies |
| X-ray thoracic spine 4 vw (72074) | $530.43 | $1,326.06 | 5.0× |
| X-Ray Tmj Unilat (70328) | $539.96 | $1,349.88 | 6.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $585.50 | $1,463.73 | 1.7× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$258.67–$388 | $646.66–$969.99 | varies |
| X-Rays Bone Survey Complete (77075) | $409.68 | $1,024.18 | 3.9× |
| Xr c-spine 4 or 5 views (72050) | $531.63 | $1,329.07 | 5.0× |
| Xr facial bones less than 3 views (70140) | $286.36 | $715.89 | 3.2× |
| Xr orbits complete 4 views (70200) | $291.08 | $727.69 | 2.7× |
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.