Imaging prices at Hurley Medical Center
Flint, MI · every code in this section with a posted price and a Medicare benchmark.
497 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 4 matching MRF lines |
$459–$4,493.25 | $459–$4,493.25 | varies |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$16–$271.25 | $16–$271.25 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$22–$53 | $22–$53 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 4 matching MRF lines |
$91–$1,019.25 | $91–$1,019.25 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) range across 4 matching MRF lines |
$96–$1,438.25 | $96–$1,438.25 | varies |
| Adrenal Cortex & Medulla Img (78075) range across 3 matching MRF lines |
$70–$848 | $70–$848 | varies |
| Angio internal mammary (75756) range across 3 matching MRF lines |
$118–$373 | $118–$373 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$219–$3,397.50 | $219–$3,397.50 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 3 matching MRF lines |
$288–$4,482.75 | $288–$4,482.75 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$304–$4,700.75 | $304–$4,700.75 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$251–$3,760.25 | $251–$3,760.25 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$198–$3,131 | $198–$3,131 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 3 matching MRF lines |
$107–$331 | $107–$331 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$304–$5,414.50 | $304–$5,414.50 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 3 matching MRF lines |
$373–$3,257.75 | $373–$3,257.75 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$353–$5,414.50 | $353–$5,414.50 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 4 matching MRF lines |
$107–$1,843.25 | $107–$1,843.25 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$341–$5,813 | $341–$5,813 | varies |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$283–$5,414.50 | $283–$5,414.50 | varies |
| Arthrogram ankle (73615) range across 4 matching MRF lines |
$59–$620.50 | $59–$620.50 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$59–$623.75 | $59–$623.75 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$53–$654.75 | $53–$654.75 | varies |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$65–$260.25 | $65–$260.25 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$22–$48 | $22–$48 | varies |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$96–$1,581.75 | $96–$1,581.75 | varies |
| Bone Imaging Limited Area (78300) range across 4 matching MRF lines |
$59–$1,768.75 | $59–$1,768.75 | varies |
| Bone Imaging Multiple Areas (78305) range across 4 matching MRF lines |
$80–$469 | $80–$469 | varies |
| Bone Imaging Whole Body (78306) range across 4 matching MRF lines |
$80–$1,423.25 | $80–$1,423.25 | varies |
| Bone marrow imaging limited area (78102) range across 4 matching MRF lines |
$53–$501 | $53–$501 | varies |
| Bone marrow imaging; multiple areas (78103) range across 3 matching MRF lines |
$70–$433 | $70–$433 | varies |
| Bone marrow imaging; whole body (78104) range across 4 matching MRF lines |
$75–$1,685 | $75–$1,685 | varies |
| Bone survey infant (77076) range across 3 matching MRF lines |
$70–$208 | $70–$208 | varies |
| Brachytx isodose complex (77318) | $1,244.50 | $1,244.50 | 3.3× |
| Brain Flow Imaging Only (78610) range across 3 matching MRF lines |
$33–$353 | $33–$353 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 4 matching MRF lines |
$48–$754.75 | $48–$754.75 | varies |
| Brain imaging < 4 static views (78600) range across 3 matching MRF lines |
$43–$363 | $43–$363 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 4 matching MRF lines |
$59–$852.25 | $59–$852.25 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 4 matching MRF lines |
$53–$1,155.50 | $53–$1,155.50 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$139–$3,769 | $139–$3,769 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 3 matching MRF lines |
$113–$459 | $113–$459 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) range across 3 matching MRF lines |
$139–$486 | $139–$486 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$240–$944 | $240–$944 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 3 matching MRF lines |
$278–$1,109 | $278–$1,109 | varies |
| Cardiac Shunt Detection (78428) range across 4 matching MRF lines |
$75–$771 | $75–$771 | varies |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$91–$326 | $91–$326 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 4 matching MRF lines |
$53–$640 | $53–$640 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) range across 3 matching MRF lines |
$59–$672 | $59–$672 | varies |
| Cerebrospinal Fluid Scan (78630) range across 4 matching MRF lines |
$65–$787 | $65–$787 | varies |
| Chest 1 view (71045) range across 5 matching MRF lines |
$16–$271.25 | $16–$271.25 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$22–$135.50 | $22–$135.50 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$27–$150.50 | $27–$150.50 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$27–$178.25 | $27–$178.25 | varies |
| Cholecystography Oral Contrast (74290) range across 4 matching MRF lines |
$33–$207 | $33–$207 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 4 matching MRF lines |
$38–$201.50 | $38–$201.50 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 3 matching MRF lines |
$113–$304 | $113–$304 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $107 | $107 | 1.0× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$86–$351.75 | $86–$351.75 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$198–$3,257.75 | $198–$3,257.75 | varies |
| Contrast X-Ray Bladder (74430) range across 5 matching MRF lines |
$33–$80 | $33–$80 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$59–$620.50 | $59–$620.50 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$59–$432 | $59–$432 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 4 matching MRF lines |
$38–$343.75 | $38–$343.75 | varies |
| Corpora cavernosography (74445) range across 4 matching MRF lines |
$86–$592.75 | $86–$592.75 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $193 | $193 | 0.6× |
| CT abdomen and pelvis without contrast (74176) | $171 | $171 | 0.7× |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$123–$544 | $123–$544 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$133–$629 | $133–$629 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$113–$346 | $113–$346 | varies |
| CT Angio Abdomen and Pelvis (74174) | $208 | $208 | 0.6× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$181–$789 | $181–$789 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$166–$976 | $166–$976 | varies |
| CT angio hrt w/3d image (75574) range across 5 matching MRF lines |
$219–$5,144.25 | $219–$5,144.25 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$176–$789 | $176–$789 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$166–$1,013 | $166–$1,013 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$171–$714 | $171–$714 | varies |
| CT bone density (77078) range across 3 matching MRF lines |
$27–$261 | $27–$261 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) range across 3 matching MRF lines |
$97–$493 | $97–$493 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$118–$513 | $118–$513 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$101–$421 | $101–$421 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$123–$613 | $123–$613 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$118–$513 | $118–$513 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$128–$624 | $128–$624 | varies |
| CT colonography screening (74263) | $3,142 | $3,142 | 13.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 3 matching MRF lines |
$235–$1,152 | $235–$1,152 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 4 matching MRF lines |
$224–$3,142 | $224–$3,142 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$107–$421 | $107–$421 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$123–$426 | $123–$426 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 4 matching MRF lines |
$160–$4,287.75 | $160–$4,287.75 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $3,430.25 | $3,430.25 | 39.6× |
| CT hrt w/3d image congen (75573) range across 5 matching MRF lines |
$235–$3,430.25 | $235–$3,430.25 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$128–$629 | $128–$629 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$118–$613 | $118–$613 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$96–$411 | $96–$411 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$113–$506 | $113–$506 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$118–$513 | $118–$513 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$96–$411 | $96–$411 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$123–$539 | $123–$539 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$107–$448 | $107–$448 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$139–$624 | $139–$624 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$139–$693 | $139–$693 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$123–$544 | $123–$544 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$118–$603 | $118–$603 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$101–$341 | $101–$341 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$118–$634 | $118–$634 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$133–$646 | $133–$646 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$128–$523 | $128–$523 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$123–$438 | $123–$438 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$118–$518 | $118–$518 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$96–$411 | $96–$411 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$123–$619 | $123–$619 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$96–$315 | $96–$315 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$96–$411 | $96–$411 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$118–$640 | $118–$640 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$113–$501 | $113–$501 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$224–$874 | $224–$874 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$181–$794 | $181–$794 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 4 matching MRF lines |
$242–$2,956.75 | $242–$2,956.75 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$171–$784 | $171–$784 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 3 matching MRF lines |
$33–$101 | $33–$101 | varies |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) range across 3 matching MRF lines |
$48–$155 | $48–$155 | varies |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$145–$2,270.75 | $145–$2,270.75 | varies |
| Discography Cerv/Thor Spine (72285) range across 4 matching MRF lines |
$118–$2,157.75 | $118–$2,157.75 | varies |
| Diskography lumbar (72295) range across 3 matching MRF lines |
$123–$2,157.75 | $123–$2,157.75 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 8 matching MRF lines |
$38–$566.75 | $38–$566.75 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 8 matching MRF lines |
$59–$668.50 | $59–$668.50 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 7 matching MRF lines |
$70–$290.25 | $70–$290.25 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$22–$160 | $22–$160 | varies |
| Dxa bone density study (77085) | $128.75 | $128.75 | 1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$22–$321 | $22–$321 | varies |
| Echo exam of fetal heart (76825) range across 7 matching MRF lines |
$160–$664.25 | $160–$664.25 | varies |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$70–$263.50 | $70–$263.50 | varies |
| Echo Guide For Artery Repair (76936) range across 3 matching MRF lines |
$187–$555 | $187–$555 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 7 matching MRF lines |
$80–$359.25 | $80–$359.25 | varies |
| Echograp Trans R Pros Study (76873) range across 3 matching MRF lines |
$150–$336 | $150–$336 | varies |
| Esophageal Motility Study (78258) range across 3 matching MRF lines |
$70–$448 | $70–$448 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$48–$181 | $48–$181 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 7 matching MRF lines |
$101–$690.75 | $101–$690.75 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 7 matching MRF lines |
$75–$341 | $75–$341 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$33–$279.50 | $33–$279.50 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$160–$1,856.25 | $160–$1,856.25 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Gastric emptying imaging study (78264) range across 4 matching MRF lines |
$75–$1,117.25 | $75–$1,117.25 | varies |
| Gastric Mucosa Imaging (78261) range across 3 matching MRF lines |
$65–$501 | $65–$501 | varies |
| Gastroesophageal Reflux Exam (78262) range across 4 matching MRF lines |
$65–$791.50 | $65–$791.50 | varies |
| Gastrointestinal Protein Loss (78282) range across 3 matching MRF lines |
$38–$118 | $38–$118 | varies |
| Gated Heart Planar Single (78472) range across 4 matching MRF lines |
$91–$1,802 | $91–$1,802 | varies |
| Gated Heart, Multiple (78473) range across 3 matching MRF lines |
$133–$581 | $133–$581 | varies |
| GI Endoscopic US S&I (76975) range across 3 matching MRF lines |
$86–$203 | $86–$203 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Heart first pass single,planar (78481) range across 4 matching MRF lines |
$91–$970.50 | $91–$970.50 | varies |
| Heart Image (Pet) Multiple (78492) range across 3 matching MRF lines |
$171–$1,706 | $171–$1,706 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 3 matching MRF lines |
$107–$304 | $107–$304 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 3 matching MRF lines |
$203–$3,131 | $203–$3,131 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$91–$1,298.50 | $91–$1,298.50 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$75–$573.50 | $75–$573.50 | varies |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $555 | $555 | 1.0× |
| Ht Musc Image Planar Mult (78454) range across 4 matching MRF lines |
$123–$1,438.25 | $123–$1,438.25 | varies |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$128–$4,430.75 | $128–$4,430.75 | varies |
| Hyperthermia external generated superficial (77600) range across 3 matching MRF lines |
$150–$832 | $150–$832 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$38–$155 | $38–$155 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$70–$293 | $70–$293 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 3 matching MRF lines |
$59–$208 | $59–$208 | varies |
| Infusion Ivp (74410) range across 3 matching MRF lines |
$48–$224 | $48–$224 | varies |
| Interstitial radiation source applic complex (77778) range across 3 matching MRF lines |
$566–$1,637 | $566–$1,637 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 3 matching MRF lines |
$555–$1,376 | $555–$1,376 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 3 matching MRF lines |
$433–$976 | $433–$976 | varies |
| Intracavitary radiation source applic simple (77761) range across 3 matching MRF lines |
$368–$736 | $368–$736 | varies |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$33–$80 | $33–$80 | varies |
| K Flow/Funct Image Multiple (78709) range across 4 matching MRF lines |
$128–$1,604 | $128–$1,604 | varies |
| K Flow/Funct Image W/Drug (78708) range across 4 matching MRF lines |
$113–$1,331 | $113–$1,331 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 5 matching MRF lines |
$91–$1,360.25 | $91–$1,360.25 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 4 matching MRF lines |
$38–$417 | $38–$417 | varies |
| Kidney Imaging Morphol (78700) range across 3 matching MRF lines |
$43–$353 | $43–$353 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 4 matching MRF lines |
$48–$1,149 | $48–$1,149 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$22–$207 | $22–$207 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) range across 3 matching MRF lines |
$59–$267 | $59–$267 | varies |
| Leveen/Shunt Patency Exam (78291) range across 3 matching MRF lines |
$80–$506 | $80–$506 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 3 matching MRF lines |
$48–$390 | $48–$390 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 4 matching MRF lines |
$53–$1,676 | $53–$1,676 | varies |
| Liver imaging static only (78201) range across 4 matching MRF lines |
$43–$2,086.25 | $43–$2,086.25 | varies |
| Liver imaging w/vascular flow (78202) range across 4 matching MRF lines |
$48–$1,438.25 | $48–$1,438.25 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $597.25 | $597.25 | 1.1× |
| Lung perfusion differential (78597) | $427.75 | $427.75 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$107–$1,458 | $107–$1,458 | varies |
| Lung Ventilation Imaging (78579) | $460.50 | $460.50 | 1.2× |
| Lymph System Imaging (78195) range across 4 matching MRF lines |
$113–$1,463.75 | $113–$1,463.75 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 4 matching MRF lines |
$113–$1,351.75 | $113–$1,351.75 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) range across 4 matching MRF lines |
$91–$835.25 | $91–$835.25 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 3 matching MRF lines |
$448–$2,610.75 | $448–$2,610.75 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 4 matching MRF lines |
$80–$1,323.25 | $80–$1,323.25 | varies |
| Magnetic Image Jaw Joint (70336) range across 6 matching MRF lines |
$139–$3,534.75 | $139–$3,534.75 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) range across 3 matching MRF lines |
$310–$986 | $310–$986 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) range across 3 matching MRF lines |
$331–$1,167 | $331–$1,167 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) range across 3 matching MRF lines |
$310–$2,037 | $310–$2,037 | varies |
| Magnetic Resonance Elastography (76391) | $459 | $459 | 1.9× |
| Mammary ductogram or galactogram multiple (77054) range across 4 matching MRF lines |
$43–$311.50 | $43–$311.50 | varies |
| Mammary ductogram or galactogram single (77053) range across 4 matching MRF lines |
$38–$263.50 | $38–$263.50 | varies |
| Meckels Divert Exam (78290) range across 4 matching MRF lines |
$65–$1,636.50 | $65–$1,636.50 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 4 matching MRF lines |
$411–$966 | $411–$966 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $73.75 | $73.75 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$171–$1,354 | $171–$1,354 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$113–$896 | $113–$896 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$113–$2,657.25 | $113–$2,657.25 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$113–$2,657.25 | $113–$2,657.25 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$171–$1,354 | $171–$1,354 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$113–$896 | $113–$896 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$160–$1,013 | $160–$1,013 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$139–$736 | $139–$736 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$155–$2,657.25 | $155–$2,657.25 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$203–$1,051 | $203–$1,051 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$155–$2,657.25 | $155–$2,657.25 | varies |
| MRI bone marrow blood supply (77084) range across 3 matching MRF lines |
$150–$859 | $150–$859 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 3 matching MRF lines |
$198–$954 | $198–$954 | varies |
| MRI brain functional w/physician admnistration (70555) range across 3 matching MRF lines |
$246–$1,093 | $246–$1,093 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $496 | $496 | 2.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $480 | $480 | 2.0× |
| MRI cardiac w/o cont stress (75559) range across 3 matching MRF lines |
$273–$966 | $273–$966 | varies |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$219–$704 | $219–$704 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$181–$959 | $181–$959 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$150–$746 | $150–$746 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$139–$917 | $139–$917 | varies |
| MRI chest with contrast (71551) range across 4 matching MRF lines |
$160–$2,657.25 | $160–$2,657.25 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$213–$1,296 | $213–$1,296 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$155–$2,657.25 | $155–$2,657.25 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$203–$1,125 | $203–$1,125 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$128–$811 | $128–$811 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$171–$928 | $171–$928 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$240–$1,099 | $240–$1,099 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$128–$794 | $128–$794 | varies |
| MRI orbit face neck w contrast (70542) range across 4 matching MRF lines |
$155–$2,657.25 | $155–$2,657.25 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$203–$1,099 | $203–$1,099 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$166–$923 | $166–$923 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$213–$1,125 | $213–$1,125 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$139–$832 | $139–$832 | varies |
| MRI spectroscopy (76390) range across 4 matching MRF lines |
$133–$1,473.75 | $133–$1,473.75 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$150–$746 | $150–$746 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$155–$2,657.25 | $155–$2,657.25 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$128–$816 | $128–$816 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$203–$1,119 | $203–$1,119 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$213–$1,131 | $213–$1,131 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$240–$1,024 | $240–$1,024 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$181–$848 | $181–$848 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$128–$544 | $128–$544 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$203–$1,056 | $203–$1,056 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$224–$1,077 | $224–$1,077 | varies |
| Myelogram cervical (72240) range across 4 matching MRF lines |
$86–$1,107.75 | $86–$1,107.75 | varies |
| Myelogram Lumbar (72265) range across 4 matching MRF lines |
$80–$1,156.75 | $80–$1,156.75 | varies |
| Myelography thoracic (72255) range across 4 matching MRF lines |
$86–$770 | $86–$770 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 4 matching MRF lines |
$128–$895.50 | $128–$895.50 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 3 matching MRF lines |
$70–$390 | $70–$390 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 3 matching MRF lines |
$139–$2,245 | $139–$2,245 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 3 matching MRF lines |
$75–$400 | $75–$400 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 4 matching MRF lines |
$96–$1,438.25 | $96–$1,438.25 | varies |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$150–$2,125.50 | $150–$2,125.50 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 3 matching MRF lines |
$219–$693 | $219–$693 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $91 | $91 | 0.2× |
| Nm csf leak detection (78650) range across 3 matching MRF lines |
$608–$1,438.25 | $608–$1,438.25 | varies |
| Nm myocard infarct spect (78469) range across 3 matching MRF lines |
$86–$453 | $86–$453 | varies |
| Nm red cell survival study (78130) range across 3 matching MRF lines |
$59–$320 | $59–$320 | varies |
| Nm whole blood volume (78122) range across 3 matching MRF lines |
$43–$198 | $43–$198 | varies |
| Nonvascular Shunt X-Ray (75809) range across 4 matching MRF lines |
$48–$213.25 | $48–$213.25 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 4 matching MRF lines |
$763–$4,265.25 | $763–$4,265.25 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 4 matching MRF lines |
$181–$395 | $181–$395 | varies |
| Nuclear Rx Oral Admin (79005) range across 5 matching MRF lines |
$96–$1,936 | $96–$1,936 | varies |
| Ob us nuchal meas 1 gest (76813) range across 4 matching MRF lines |
$113–$240 | $113–$240 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 3 matching MRF lines |
$65–$171 | $65–$171 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 3 matching MRF lines |
$70–$193 | $70–$193 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 3 matching MRF lines |
$166–$353 | $166–$353 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 3 matching MRF lines |
$65–$160 | $65–$160 | varies |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 3 matching MRF lines |
$65–$160 | $65–$160 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 4 matching MRF lines |
$86–$323 | $86–$323 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 3 matching MRF lines |
$16–$33 | $16–$33 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) range across 5 matching MRF lines |
$101–$266.50 | $101–$266.50 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$22–$75 | $22–$75 | varies |
| Panoramic X-ray of jaws (70355) range across 3 matching MRF lines |
$22–$43 | $22–$43 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 3 matching MRF lines |
$155–$886 | $155–$886 | varies |
| Parathyroid Planar Imaging (78070) range across 4 matching MRF lines |
$75–$1,806.50 | $75–$1,806.50 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 4 matching MRF lines |
$113–$699 | $113–$699 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$22–$59 | $22–$59 | varies |
| Perineogram (74775) range across 3 matching MRF lines |
$65–$166 | $65–$166 | varies |
| Peritoneogram Rs&I (74190) range across 4 matching MRF lines |
$48–$620.50 | $48–$620.50 | varies |
| Pet Image Skull-Thigh (78812) range across 3 matching MRF lines |
$181–$2,618 | $181–$2,618 | varies |
| Pet Image W/Ct Lmtd (78814) range across 4 matching MRF lines |
$208–$7,688 | $208–$7,688 | varies |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$230–$7,688 | $230–$7,688 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$230–$7,688 | $230–$7,688 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 3 matching MRF lines |
$150–$2,580 | $150–$2,580 | varies |
| Pet Myocardial Sngl Study (78491) range across 3 matching MRF lines |
$139–$1,370 | $139–$1,370 | varies |
| PET whole body (78813) range across 3 matching MRF lines |
$187–$2,623 | $187–$2,623 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) range across 3 matching MRF lines |
$22–$171 | $22–$171 | varies |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) range across 3 matching MRF lines |
$22–$187 | $22–$187 | varies |
| Platelet survival study Non-Facility (78191) range across 3 matching MRF lines |
$59–$320 | $59–$320 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 3 matching MRF lines |
$133–$331 | $133–$331 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 4 matching MRF lines |
$70–$1,462 | $70–$1,462 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$33–$96 | $33–$96 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$53–$844.50 | $53–$844.50 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$22–$189.75 | $22–$189.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$22–$70 | $22–$70 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$27–$86 | $27–$86 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$16–$91.75 | $16–$91.75 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$16–$227.25 | $16–$227.25 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$22–$348.50 | $22–$348.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 4 matching MRF lines |
$33–$169.50 | $33–$169.50 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$22–$70 | $22–$70 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 3 matching MRF lines |
$33–$166 | $33–$166 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$22–$399.75 | $22–$399.75 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 4 matching MRF lines |
$22–$180.25 | $22–$180.25 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 4 matching MRF lines |
$65–$832 | $65–$832 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$16–$48 | $16–$48 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$27–$237 | $27–$237 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$16–$65 | $16–$65 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$16–$70 | $16–$70 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$22–$304 | $22–$304 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $43 | $43 | 0.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$1,509–$17,714 | $1,509–$17,714 | varies |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$326–$554.25 | $326–$554.25 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$475–$1,153 | $475–$1,153 | varies |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$506–$737.75 | $506–$737.75 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$27–$80 | $27–$80 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$27–$65 | $27–$65 | varies |
| Radiologic exam colon double contrast study (74280) range across 4 matching MRF lines |
$96–$493.75 | $96–$493.75 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$101–$315 | $101–$315 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$27–$91 | $27–$91 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$27–$91 | $27–$91 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$80–$219 | $80–$219 | varies |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$53–$348.50 | $53–$348.50 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 5 matching MRF lines |
$65–$384 | $65–$384 | varies |
| Radiologic examination femur 1 view (73551) | $22 | $22 | 0.3× |
| Radiologic examination femur minimum 2 views (73552) | $22 | $22 | 0.3× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$43–$139 | $43–$139 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 3 matching MRF lines |
$22–$80 | $22–$80 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$22–$146.25 | $22–$146.25 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 3 matching MRF lines |
$33–$96 | $33–$96 | varies |
| Radiopharm Dacryocystography (78660) range across 3 matching MRF lines |
$53–$373 | $53–$373 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) range across 3 matching MRF lines |
$155–$326 | $155–$326 | varies |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) range across 3 matching MRF lines |
$96–$278 | $96–$278 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) range across 3 matching MRF lines |
$113–$304 | $113–$304 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) range across 3 matching MRF lines |
$22–$181 | $22–$181 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 3 matching MRF lines |
$27–$155 | $27–$155 | varies |
| Renal Cyst Study (74470) range across 4 matching MRF lines |
$53–$545 | $53–$545 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$27–$86 | $27–$86 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$65–$1,233.50 | $65–$1,233.50 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 3 matching MRF lines |
$75–$486 | $75–$486 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 3 matching MRF lines |
$96–$1,125 | $96–$1,125 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 4 matching MRF lines |
$80–$2,704 | $80–$2,704 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$96–$4,430.75 | $96–$4,430.75 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$171–$1,721.50 | $171–$1,721.50 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,953 | $1,953 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,721.50 | $1,721.50 | 1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 3 matching MRF lines |
$160–$368 | $160–$368 | varies |
| Rp Therapy Intravenous Administration (79101) range across 3 matching MRF lines |
$101–$278 | $101–$278 | varies |
| Salivary Gland Function Study (78232) range across 3 matching MRF lines |
$38–$193 | $38–$193 | varies |
| Salivary Gland Imaging (78230) range across 3 matching MRF lines |
$43–$346 | $43–$346 | varies |
| Salivary Gland Imaging Serial Images (78231) range across 3 matching MRF lines |
$48–$256 | $48–$256 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| Sella turcica (70240) range across 4 matching MRF lines |
$22–$100.25 | $22–$100.25 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$16–$48 | $16–$48 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$53–$623.75 | $53–$623.75 | varies |
| Sialogram (70390) range across 4 matching MRF lines |
$38–$314.50 | $38–$314.50 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$27–$75 | $27–$75 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$38–$123 | $38–$123 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$230–$351.75 | $230–$351.75 | varies |
| Special teletherapy port plan (77321) range across 3 matching MRF lines |
$86–$176 | $86–$176 | varies |
| Special treatment procedure (77470) range across 4 matching MRF lines |
$96–$1,794.50 | $96–$1,794.50 | varies |
| Speech evaluation, complex (70371) range across 4 matching MRF lines |
$80–$314.50 | $80–$314.50 | varies |
| Spleen Imaging (78185) range across 4 matching MRF lines |
$38–$629.25 | $38–$629.25 | varies |
| Srs Multisource (77371) likely a partial charge, not the full procedure |
$1,919 | $1,919 | 0.3× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$2,436–$3,360.75 | $2,436–$3,360.75 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$22–$75 | $22–$75 | varies |
| Superior sagittal sinus venogram (75870) range across 3 matching MRF lines |
$107–$304 | $107–$304 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 3 matching MRF lines |
$113–$230 | $113–$230 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $916.50 | $916.50 | 2.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $440.25 | $440.25 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$53–$145 | $53–$145 | varies |
| Testicular Imaging W/Flow (78761) range across 4 matching MRF lines |
$70–$1,230.75 | $70–$1,230.75 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 4 matching MRF lines |
$150–$1,048 | $150–$1,048 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 3 matching MRF lines |
$101–$619 | $101–$619 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 4 matching MRF lines |
$70–$840 | $70–$840 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 3 matching MRF lines |
$187–$395 | $187–$395 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$22–$70 | $22–$70 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$22–$75 | $22–$75 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$27–$75 | $27–$75 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) range across 3 matching MRF lines |
$70–$555 | $70–$555 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 3 matching MRF lines |
$65–$433 | $65–$433 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 4 matching MRF lines |
$38–$945.75 | $38–$945.75 | varies |
| Thyroid Met Imaging Body (78018) range across 4 matching MRF lines |
$80–$2,050.50 | $80–$2,050.50 | varies |
| Thyroid Uptake Measurement (78012) range across 4 matching MRF lines |
$22–$1,278.25 | $22–$1,278.25 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 4 matching MRF lines |
$48–$1,170 | $48–$1,170 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$128–$835.25 | $128–$835.25 | varies |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$22–$113 | $22–$113 | varies |
| Tx devices design & construction simple (77332) range across 4 matching MRF lines |
$59–$413 | $59–$413 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$65–$171 | $65–$171 | varies |
| Ultrasound elastography first target lesion (76982) | $187 | $187 | 1.8× |
| Ultrasound Elastography Parenchyma (76981) | $208 | $208 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$53–$192 | $53–$192 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $629 | $629 | 1.8× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$59–$213 | $59–$213 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 7 matching MRF lines |
$33–$290.25 | $33–$290.25 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$70–$230 | $70–$230 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $22 | $22 | 2.0× |
| Urea breath test c-14 isotopic analysis (78268) | $145 | $145 | 1.5× |
| Ureteral Reflux Study (78740) range across 4 matching MRF lines |
$53–$1,019.25 | $53–$1,019.25 | varies |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$33–$171 | $33–$171 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$33–$139 | $33–$139 | varies |
| Us bone density measurement (76977) range across 3 matching MRF lines |
$6–$16 | $6–$16 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$70–$203 | $70–$203 | varies |
| Us chest (76604) | $53 | $53 | 0.5× |
| Us complete joint (76881) | $65 | $65 | 0.6× |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$48–$187 | $48–$187 | varies |
| Us head (76506) range across 3 matching MRF lines |
$65–$251 | $65–$251 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$75–$304 | $75–$304 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$65–$131 | $65–$131 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$181–$672.75 | $181–$672.75 | varies |
| Us ob limited 1 or more fetuses (76815) range across 8 matching MRF lines |
$65–$349.75 | $65–$349.75 | varies |
| Us ob transvaginal (76817) range across 8 matching MRF lines |
$75–$271.25 | $75–$271.25 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$65–$246 | $65–$246 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 6 matching MRF lines |
$96–$377.50 | $96–$377.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 8 matching MRF lines |
$86–$241 | $86–$241 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$70–$261 | $70–$261 | varies |
| Us retroperitoneal limited (76775) | $59 | $59 | 0.6× |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$65–$246 | $65–$246 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$107–$256 | $107–$256 | varies |
| Us thyroid (76536) range across 5 matching MRF lines |
$53–$240 | $53–$240 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$65–$145 | $65–$145 | varies |
| Vascular Flow Imaging (78445) range across 3 matching MRF lines |
$43–$341 | $43–$341 | varies |
| Vasogram (74440) range across 3 matching MRF lines |
$38–$166 | $38–$166 | varies |
| Vein X-Ray Chest (75827) range across 4 matching MRF lines |
$107–$4,768 | $107–$4,768 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 3 matching MRF lines |
$133–$331 | $133–$331 | varies |
| Vein X-Ray Skull Epidural (75872) range across 3 matching MRF lines |
$107–$304 | $107–$304 | varies |
| Vein X-Ray Spleen/Liver (75810) range across 3 matching MRF lines |
$113–$981 | $113–$981 | varies |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$107–$304 | $107–$304 | varies |
| Venography Adrenal Unilateral (75840) range across 3 matching MRF lines |
$198–$3,131 | $198–$3,131 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$187–$3,397.50 | $187–$3,397.50 | varies |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$101–$1,843.25 | $101–$1,843.25 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$187–$4,768 | $187–$4,768 | varies |
| Venography Orbital Rs&I (75880) range across 3 matching MRF lines |
$75–$464 | $75–$464 | varies |
| Venography Renal Bilateral (75833) range across 3 matching MRF lines |
$235–$3,131 | $235–$3,131 | varies |
| Venography Renal Unilateral (75831) range across 3 matching MRF lines |
$203–$3,131 | $203–$3,131 | varies |
| Venous sampling by catheter (75893) | $16,168 | $16,168 | 2.9× |
| Venous thrombosis imaging (78457) range across 3 matching MRF lines |
$75–$406 | $75–$406 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 3 matching MRF lines |
$80–$373 | $80–$373 | varies |
| Vertebral fracture assessment via dxa (77086) | $90.75 | $90.75 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$22–$86 | $22–$86 | varies |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$38–$620.50 | $38–$620.50 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$166–$3,257.75 | $166–$3,257.75 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$27–$86 | $27–$86 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$16–$59 | $16–$59 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$33–$38 | $33–$38 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $27 | $27 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $33 | $33 | 0.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $38 | $38 | 0.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $22 | $22 | 0.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $27 | $27 | 0.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$33–$155.75 | $33–$155.75 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$27–$155.75 | $27–$155.75 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $33 | $33 | 0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $33 | $33 | 0.3× |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$33–$128 | $33–$128 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$27–$75 | $27–$75 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$38–$128 | $38–$128 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$27–$80 | $27–$80 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$16–$214.25 | $16–$214.25 | varies |
| X-ray head for orthodontia (70350) range across 3 matching MRF lines |
$22–$43 | $22–$43 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$22–$59 | $22–$59 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$48–$554.50 | $48–$554.50 | varies |
| X-ray IV pyelogram+tomography (74415) range across 4 matching MRF lines |
$48–$669.50 | $48–$669.50 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$22–$70 | $22–$70 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$22–$75 | $22–$75 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 5 matching MRF lines |
$27–$233.50 | $27–$233.50 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$22–$53 | $22–$53 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$33–$107 | $33–$107 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$22–$70 | $22–$70 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$22–$59 | $22–$59 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$27–$80 | $27–$80 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$33–$96 | $33–$96 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$101–$274.50 | $101–$274.50 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$22–$91 | $22–$91 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$53–$224 | $53–$224 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$33–$80 | $33–$80 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$53–$208 | $53–$208 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$33–$261.25 | $33–$261.25 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$22–$65 | $22–$65 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 4 matching MRF lines |
$22–$155.75 | $22–$155.75 | varies |
| Xr myelogram posterior fossa (70010) | $123 | $123 | 0.4× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$27–$91 | $27–$91 | varies |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$65–$252.75 | $65–$252.75 | 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.