Imaging prices at INTEGRIS Baptist Medical Center, Inc
Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.
386 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) | $2,280.60 | $11,403 | 1.7× |
| Abdomen 1 View (74018) | $135.40 | $677 | 1.6× |
| Abdomen 2 views (74019) | $164.20 | $821 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $450 | $2,250 | 1.2× |
| Adrenal Cortex & Medulla Img (78075) | $680 | $3,400 | 0.5× |
| Angio internal mammary (75756) | $1,019.20 | $5,096 | 0.3× |
| Angio pulmonary bilat (75743) | $1,274.20 | $6,371 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $1,259.60 | $6,298 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,059.40 | $5,297 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,019.20 | $5,096 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,128.80 | $5,644 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$158.20–$276.40 | $791–$1,382 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,881.80 | $9,409 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,987.80 | $9,939 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,881.80 | $9,409 | 0.4× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,881.80 | $9,409 | 0.4× |
| Arthrogram ankle (73615) | $248.80 | $1,244 | 0.7× |
| Arthrogram hip (73525) | $353.60 | $1,768 | 1.1× |
| Arthrogram Wrist (73115) | $193.20 | $966 | 0.6× |
| Basic radiation dosimetry calculation (77300) | $260.40 | $1,302 | 2.0× |
| Bone age studies (77072) | $106.20 | $531 | 1.1× |
| Bone Imaging 3 Phase (78315) | $745.20 | $3,726 | 1.9× |
| Bone Imaging Limited Area (78300) | $114 | $570 | 0.3× |
| Bone Imaging Multiple Areas (78305) | $437.40 | $2,187 | 1.1× |
| Bone Imaging Whole Body (78306) | $745.20 | $3,726 | 1.9× |
| Bone marrow imaging; whole body (78104) | $641.20 | $3,206 | 1.7× |
| Bone survey infant (77076) | $172.60 | $863 | 1.7× |
| Brachytx isodose complex (77318) | $1,546.20 | $7,731 | 4.3× |
| Brachytx isodose intermed (77317) | $829 | $4,145 | 2.3× |
| Brachytx Isodose Plan Simple (77316) | $679.20 | $3,396 | 1.9× |
| Brain Flow Imaging Only (78610) | $246.80 | $1,234 | 0.5× |
| Brain Image W/Flow < 4 Views (78601) | $310.60 | $1,553 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $488.60 | $2,443 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $741.80 | $3,709 | 0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $656.40 | $3,282 | 2.0× |
| Cat Scan Follow-Up Study (76380) | $170.60 | $853 | 2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $315.40 | $1,577 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $298.20 | $1,491 | 0.6× |
| Chest 1 view (71045) | $95.80 | $479 | 1.1× |
| Chest 2 views (71046) | $184 | $920 | 2.2× |
| Chest 3 views (71047) | $270.80 | $1,354 | 3.2× |
| Chest 4 or more views (71048) | $297.60 | $1,488 | 3.0× |
| Cholecystography Oral Contrast (74290) | $145.40 | $727 | 0.9× |
| Cisternography Positive Contrast Rs&I (70015) | $391.80 | $1,959 | 0.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$189.40–$331.40 | $947–$1,657 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $70.20 | $351 | 0.7× |
| Continuing medical physics consltj pr wk (77336) | $273.60 | $1,368 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $1,150.40 | $5,752 | 0.4× |
| Contrast X-Ray Bladder (74430) | $496.60 | $2,483 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $235.80 | $1,179 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $237.80 | $1,189 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,628.80 | $8,144 | 4.9× |
| CT abdomen and pelvis without contrast (74176) | $1,056.60 | $5,283 | 4.6× |
| CT abdomen w contrast (74160) | $797.20 | $3,986 | 4.7× |
| CT abdomen w wo contrast (74170) | $996.40 | $4,982 | 5.9× |
| CT abdomen w/o contrast (74150) | $637.60 | $3,188 | 6.3× |
| CT Angio Abdomen and Pelvis (74174) | $831 | $4,155 | 2.5× |
| CT Angio Chest (71275) | $822.40 | $4,112 | 4.9× |
| CT Angio Head (70496) | $424.40 | $2,122 | 2.5× |
| CT angio hrt w/3d image (75574) | $757.80 | $3,789 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $640.60 | $3,203 | 3.8× |
| CT Angio Neck (70498) | $423 | $2,115 | 2.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $417.80 | $2,089 | 2.5× |
| CT bone density (77078) | $230.80 | $1,154 | 2.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $698.80 | $3,494 | 4.1× |
| CT cervical spine w/ contrast (72126) | $944 | $4,720 | 2.8× |
| CT cervical spine w/o contrast (72125) | $755.40 | $3,777 | 7.5× |
| CT cervical spine w/wo cont (72127) | $1,180.20 | $5,901 | 7.0× |
| CT chest w contrast (71260) | $637.20 | $3,186 | 3.8× |
| CT chest w/wo contrast (71270) | $796.80 | $3,984 | 4.7× |
| CT head/brain with contrast (70460) | $576.80 | $2,884 | 3.4× |
| CT head/brain without and with contrast (70470) | $694.60 | $3,473 | 4.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $510.40 | $2,552 | 1.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $33.60 | $168 | 0.4× |
| CT hrt w/3d image congen (75573) | $424 | $2,120 | 1.3× |
| CT iac w contrast (70481) | $281 | $1,405 | 1.7× |
| CT l-spine w&w/o contrast (72133) | $1,000.20 | $5,001 | 5.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$585.80–$1,139.20 | $2,929–$5,696 | varies |
| CT lower extremity w/contrast material (73701) | $976 | $4,880 | 5.8× |
| CT lumbar spine w contrast (72132) | $800 | $4,000 | 2.4× |
| CT lumbar spine w/o contrast (72131) | $640 | $3,200 | 6.4× |
| CT maxillofacial w contrast (70487) | $677.80 | $3,389 | 4.0× |
| CT maxillofacial wo contrast (70486) | $609.20 | $3,046 | 6.1× |
| CT neck tissue combo (70492) | $338.20 | $1,691 | 2.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $310.40 | $1,552 | 1.8× |
| CT orbits w/o contrast (70480) | $230.20 | $1,151 | 2.3× |
| CT pelvis w&w/o contrast (72194) | $1,032.40 | $5,162 | 6.1× |
| CT pelvis w/o contrast (72192) | $660.60 | $3,303 | 6.6× |
| CT scan of leg combo (73702) | $915.40 | $4,577 | 5.4× |
| CT scans face/jaw combo (70488) | $722 | $3,610 | 4.3× |
| CT soft tissue neck w contrast (70491) | $276.60 | $1,383 | 1.6× |
| CT soft tissue neck w/o contrast (70490) | $214.20 | $1,071 | 2.1× |
| CT thoracic spine w contrast (72129) | $395.80 | $1,979 | 2.3× |
| CT thoracic spine w/o contrast (72128) | $316.60 | $1,583 | 3.1× |
| CT thoracic spine w/wo cont (72130) | $494.80 | $2,474 | 2.9× |
| CT thorax w/o contrast (71250) | $509.80 | $2,549 | 5.1× |
| CT upper ext wo (73200) | $532.80 | $2,664 | 5.3× |
| CT upper extremity w/o & w/contrast material (73202) | $832.20 | $4,161 | 4.9× |
| CT upper extremity with contrast (73201) | $666 | $3,330 | 2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $766.40 | $3,832 | 4.5× |
| Cta Abdomen (74175) | $638.20 | $3,191 | 3.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $424.40 | $2,122 | 1.3× |
| CTA pelvis (72191) | $255.20 | $1,276 | 1.5× |
| Dilation ureters/urethra rs&i (74485) | $909.20 | $4,546 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $837.20 | $4,186 | 0.4× |
| Diskography lumbar (72295) | $890 | $4,450 | 0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $92.80 | $464 | 0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $92.80 | $464 | 0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $57 | $285 | 0.6× |
| Dxa Bone Density Axial (77080) | $152.20 | $761 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $94 | $470 | 1.1× |
| Echo exam of fetal heart (76825) | $251 | $1,255 | 0.5× |
| Echo Guide For Artery Repair (76936) | $142.20 | $711 | 0.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $251 | $1,255 | 1.1× |
| Esophageal Motility Study (78258) | $225 | $1,125 | 0.6× |
| Esophagram (74220) | $337.60 | $1,688 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $276 | $1,380 | 2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $218.80 | $1,094 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $351 | $1,755 | 1.5× |
| Follow-Up Angiography (75898) | $407.60 | $2,038 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$57.60–$100.60 | $288–$503 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$157.60–$275.80 | $788–$1,379 | varies |
| Gastric emptying imaging study (78264) | $658.20 | $3,291 | 1.7× |
| Gastroesophageal Reflux Exam (78262) | $579.80 | $2,899 | 1.5× |
| Gated Heart Planar Single (78472) | $696.60 | $3,483 | 1.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$180.20–$314.60 | $901–$1,573 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,205.40 | $6,027 | 1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,078.60 | $5,393 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $907.80 | $4,539 | 1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,019.20 | $5,096 | 0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,019.20 | $5,096 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $889.60 | $4,448 | 1.7× |
| Hepatobiliary System Imaging (78226) | $738 | $3,690 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $794 | $3,970 | 0.6× |
| Hysterosalpingogram (74740) | $461 | $2,305 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $226.20 | $1,131 | 2.7× |
| Infant hip ultrasound, limited static exam (76886) | $61.80 | $309 | 0.7× |
| Joint Survey Single View (77077) | $104 | $520 | 1.0× |
| K Flow/Funct Image Multiple (78709) | $477 | $2,385 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $477 | $2,385 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $519 | $2,595 | 1.0× |
| Kidney Imaging Morphol (78700) | $315 | $1,575 | 0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $388.20 | $1,941 | 1.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$227.40–$398 | $1,137–$1,990 | varies |
| Liver & Spleen Imaging Static Only (78215) | $247.40 | $1,237 | 0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $371 | $1,855 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $857.60 | $4,288 | 1.6× |
| Lung perfusion differential (78597) | $649 | $3,245 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $218.40 | $1,092 | 0.4× |
| Lung Ventilation Imaging (78579) | $198.80 | $994 | 0.5× |
| Lymph System Imaging (78195) | $608.40 | $3,042 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $282.60 | $1,413 | 1.2× |
| Magnetic Resonance Elastography (76391) | $1,336.20 | $6,681 | 5.8× |
| Mammary ductogram or galactogram single (77053) | $220.20 | $1,101 | 1.0× |
| Meckels Divert Exam (78290) | $172.40 | $862 | 0.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,117.40 | $5,587 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $74 | $370 | 0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $20.60 | $103 | 0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $77.20 | $386 | 0.8× |
| Mr safety implt pos&/immoblj (76019) | $50 | $250 | 0.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $472.20 | $2,361 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $441.60 | $2,208 | 1.3× |
| MRA head w/o contrast (70544) | $282.60 | $1,413 | 1.2× |
| MRA head with contrast (70545) | $353.20 | $1,766 | 1.1× |
| MRA neck w contrast (70548) | $327.40 | $1,637 | 1.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $409 | $2,045 | 1.2× |
| MRA neck w/o contrast (70547) | $261.80 | $1,309 | 1.1× |
| MRI abdomen w contrast (74182) | $896.40 | $4,482 | 2.7× |
| MRI abdomen w/o contrast (74181) | $717.20 | $3,586 | 3.1× |
| MRI any jt lower extrem w/contrast material (73722) | $864 | $4,320 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,080 | $5,400 | 3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $784 | $3,920 | 1.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $281.80 | $1,409 | 1.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $207.60 | $1,038 | 0.9× |
| MRI cardiac w/o contrast (75557) | $457.80 | $2,289 | 2.0× |
| MRI cervical spine w contrast (72142) | $784.80 | $3,924 | 2.3× |
| MRI cervical spine w/o cont (72141) | $623.20 | $3,116 | 2.7× |
| MRI chest w/o contrast (71550) | $361.20 | $1,806 | 1.6× |
| MRI chest with contrast (71551) | $451.40 | $2,257 | 0.6× |
| MRI chest wo w contrast (71552) | $564.20 | $2,821 | 1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $574.80 | $2,874 | 1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $719 | $3,595 | 2.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $460 | $2,300 | 2.0× |
| MRI lumbar spine w contrast (72149) | $839 | $4,195 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $980.80 | $4,904 | 2.9× |
| MRI orbit face &/neck w/o contrast (70540) | $346.40 | $1,732 | 1.5× |
| MRI orbit face neck w contrast (70542) | $433 | $2,165 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $541.20 | $2,706 | 1.6× |
| MRI pelvis w contrast (72196) | $809 | $4,045 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $1,011.40 | $5,057 | 3.0× |
| MRI pelvis w/o contrast (72195) | $647.20 | $3,236 | 2.8× |
| MRI thoracic spine w/o contrast (72146) | $273.60 | $1,368 | 1.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $829.40 | $4,147 | 2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $663.60 | $3,318 | 2.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,036.80 | $5,184 | 3.1× |
| MRI, abdomen, combo (74183) | $1,120.60 | $5,603 | 3.3× |
| MRI, dorsal spine combo (72157) | $427.40 | $2,137 | 1.3× |
| MRI, dorsal spine contrast (72147) | $342 | $1,710 | 1.0× |
| MRI, joint upper extrem (73221) | $627.20 | $3,136 | 2.7× |
| MRI, joint upper extrem combo (73223) | $1,088.80 | $5,444 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,000.80 | $5,004 | 3.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $349.40 | $1,747 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $1,418.20 | $7,091 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $952 | $4,760 | 1.2× |
| Neck soft tissue (70360) | $200.40 | $1,002 | 2.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $457 | $2,285 | 1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $128.80 | $644 | 0.3× |
| Nm csf leak detection (78650) | $715.60 | $3,578 | 0.6× |
| Nm myocard infarct spect (78469) | $611 | $3,055 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,950.20 | $14,751 | 2.2× |
| Nuclear Rx Intra-Arterial (79445) | $281.80 | $1,409 | 1.3× |
| Nuclear Rx Oral Admin (79005) | $407.60 | $2,038 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $91.40 | $457 | 0.9× |
| Panoramic X-ray of jaws (70355) | $98 | $490 | 1.2× |
| Parathyroid Planar Imaging (78070) | $526.40 | $2,632 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $603 | $3,015 | 1.6× |
| Pelvis 1 or 2 views (72170) | $173 | $865 | 1.7× |
| Peritoneogram Rs&I (74190) | $279.60 | $1,398 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $741.80 | $3,709 | 0.5× |
| PET image w/CT, full body (78816) | $1,899.60 | $9,498 | 1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,446.60 | $7,233 | 1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,019.20 | $5,096 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $310 | $1,550 | 0.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $952 | $4,760 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $298.40 | $1,492 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $327.60 | $1,638 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$199–$348.20 | $995–$1,741 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$189.80–$332.40 | $949–$1,662 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$182.80–$319.60 | $914–$1,598 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $241.80 | $1,209 | 2.4× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$146.40–$256.20 | $732–$1,281 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$218.40–$382 | $1,092–$1,910 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$209–$365.40 | $1,045–$1,827 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $111.80 | $559 | 1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $149.80 | $749 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $200 | $1,000 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $226 | $1,130 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$252.40–$440.80 | $1,262–$2,204 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $39.20 | $196 | 0.5× |
| Radex Spine 1 View Specify Level (72020) | $61.80 | $309 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $77.80 | $389 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $224.20 | $1,121 | 2.7× |
| Radex Toe Minimum 2 Views (73660) | $176.80 | $884 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $174.20 | $871 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$175.60–$307 | $878–$1,535 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $313 | $1,565 | 3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,496.60 | $57,483 | 1.6× |
| Radiation treatment delivery level 1 (77402) | $171.40 | $857 | 1.7× |
| Radiation treatment delivery level 2 (77407) | $227.20 | $1,136 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $338 | $1,690 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $104 | $520 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $265.40 | $1,327 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $630 | $3,150 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $463 | $2,315 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$262.80–$459.80 | $1,314–$2,299 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $251.60 | $1,258 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $426 | $2,130 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $396 | $1,980 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $447.80 | $2,239 | 2.7× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$231.80–$406.20 | $1,159–$2,031 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$181–$316.40 | $905–$1,582 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $135 | $675 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$197.60–$345.60 | $988–$1,728 | varies |
| Renal Cyst Study (74470) | $846.20 | $4,231 | 1.6× |
| Ribs bilateral 3 views (71110) | $313 | $1,565 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,275.80 | $6,379 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $969.40 | $4,847 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $969.40 | $4,847 | 1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $969.40 | $4,847 | 0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $969.40 | $4,847 | 0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $969.40 | $4,847 | 0.8× |
| Rp Therapy Intravenous Administration (79101) | $211.20 | $1,056 | 0.9× |
| Salivary Gland Imaging (78230) | $660.60 | $3,303 | 1.7× |
| Salivary Gland Imaging Serial Images (78231) | $660.60 | $3,303 | 1.7× |
| Scapula (73010) range across 2 matching MRF lines |
$110.20–$192.20 | $551–$961 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $34.40 | $172 | 1.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$128–$223.40 | $640–$1,117 | varies |
| Shoulder Arthrography (73040) | $235.80 | $1,179 | 0.7× |
| Skull less than 4 views (70250) | $76.60 | $383 | 0.8× |
| Special dosimetry (77331) | $186.40 | $932 | 1.4× |
| Special Physics Consult (77370) | $245 | $1,225 | 1.9× |
| Special teletherapy port plan (77321) | $274.80 | $1,374 | 0.8× |
| Special treatment procedure (77470) | $844.60 | $4,223 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $6,280 | $31,400 | 3.7× |
| Sternoclavicular joints (71130) | $99 | $495 | 1.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $186.80 | $934 | 1.9× |
| Tbs technical calculation only (77091) | $134.40 | $672 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,091.60 | $5,458 | 3.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $598.80 | $2,994 | 1.7× |
| Testicular Imaging W/Flow (78761) | $268.40 | $1,342 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$661.40–$1,158.80 | $3,307–$5,794 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $474.80 | $2,374 | 1.3× |
| Ther rad simulaj-aided field setting simple (77280) | $369.40 | $1,847 | 2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $131.20 | $656 | 0.8× |
| Thoracic spine 2 views (72070) | $202.60 | $1,013 | 2.0× |
| Thoracic spine 3 views (72072) | $247 | $1,235 | 2.5× |
| Thoracolumbar 2 views (72080) | $165.60 | $828 | 2.0× |
| Thyroid Met Imaging Body (78018) | $789.80 | $3,949 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $505.80 | $2,529 | 1.3× |
| Tx Devices Design & Construction Complex (77334) | $679 | $3,395 | 1.9× |
| Tx devices design & construction intermediate (77333) | $352.80 | $1,764 | 2.7× |
| Tx devices design & construction simple (77332) | $351.80 | $1,759 | 2.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$170–$283.40 | $850–$1,417 | varies |
| Ultrasound Elastography Parenchyma (76981) | $122.40 | $612 | 1.2× |
| Ultrasound Exam Aaa Screen (76706) | $239.80 | $1,199 | 2.4× |
| Ultrasound, abdomen limited (76705) | $361.20 | $1,806 | 3.6× |
| Umbilical-artery Doppler (OB) (76820) | $155 | $775 | 1.5× |
| Unlisted Dx Radiographic Procedure (76499) | $56.20 | $281 | 0.7× |
| Unlisted respiratory px dx nuclear medicine (78599) | $362 | $1,810 | 0.9× |
| Unlisted us procedure (76999) | $81.60 | $408 | 1.0× |
| Upper gi w/o kub (74240) | $434 | $2,170 | 2.6× |
| Urethrocystogram voiding (74455) | $490 | $2,450 | 2.1× |
| Urethrocystography retrograde (74450) | $236.40 | $1,182 | 1.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$230.60–$383.60 | $1,153–$1,918 | varies |
| Us chest (76604) | $198.20 | $991 | 2.0× |
| Us complete joint (76881) | $286 | $1,430 | 2.8× |
| Us exam, pelvic, limited (76857) | $234.80 | $1,174 | 2.3× |
| Us head (76506) | $104.20 | $521 | 1.0× |
| Us kidney transplant (76776) | $211.80 | $1,059 | 2.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $274.20 | $1,371 | 2.7× |
| Us ob detailed single fetus (76811) | $343.40 | $1,717 | 1.5× |
| Us ob limited 1 or more fetuses (76815) | $275.40 | $1,377 | 2.7× |
| Us ob transvaginal (76817) | $377.40 | $1,887 | 3.8× |
| Us pelvic non ob complete (76856) | $433.40 | $2,167 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $304.80 | $1,524 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $307.20 | $1,536 | 3.1× |
| Us retroperitoneal complete (76770) | $415.80 | $2,079 | 4.1× |
| Us retroperitoneal limited (76775) | $213.80 | $1,069 | 2.1× |
| Us scrotum and contents (76870) | $435 | $2,175 | 4.3× |
| Us spinal canal and contents (76800) | $250.80 | $1,254 | 2.5× |
| Us thyroid (76536) | $330.20 | $1,651 | 3.3× |
| Us transrectal (76872) | $252.80 | $1,264 | 2.5× |
| Vein X-Ray Chest (75827) | $953.20 | $4,766 | 0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $901.40 | $4,507 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,019.20 | $5,096 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,016.20 | $5,081 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $525.40 | $2,627 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $398 | $1,990 | 0.3× |
| Venography Renal Bilateral (75833) | $735.20 | $3,676 | 0.2× |
| Venography Renal Unilateral (75831) | $607 | $3,035 | 0.2× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$1,881.80 | $9,409 | 0.4× |
| Venous thrombosis imaging (78457) | $533.60 | $2,668 | 1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $616.80 | $3,084 | 1.6× |
| Vertebral fracture assessment via dxa (77086) | $142.60 | $713 | 1.7× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$161.40–$282 | $807–$1,410 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $161.40 | $807 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $257.20 | $1,286 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $1,150.40 | $5,752 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $149.80 | $749 | 1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$168.40–$294 | $842–$1,470 | varies |
| X-Ray Exam Breast Specimen (76098) | $347.80 | $1,739 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $154.60 | $773 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $182.80 | $914 | 1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $269.20 | $1,346 | 2.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $139.80 | $699 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $185.60 | $928 | 2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $247 | $1,235 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $250.80 | $1,254 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $258.20 | $1,291 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $437.80 | $2,189 | 4.4× |
| X-Ray Exam L-S Spine Bending (72114) | $292.40 | $1,462 | 2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $93.40 | $467 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $159.20 | $796 | 1.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $249.20 | $1,246 | 2.5× |
| X-ray eye for foreign body (70030) | $41.60 | $208 | 0.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$167–$292.20 | $835–$1,461 | varies |
| X-ray IV pyelogram (ivp) (74400) | $344.40 | $1,722 | 2.0× |
| X-ray IV pyelogram+tomography (74415) | $343 | $1,715 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $63.80 | $319 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $43.20 | $216 | 0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $168 | $840 | 1.7× |
| X-ray nose-rectum child f.b. (76010) | $125 | $625 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $353.80 | $1,769 | 3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $159.40 | $797 | 1.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $88.80 | $444 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $181.60 | $908 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $245 | $1,225 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $158.60 | $793 | 1.6× |
| X-ray thoracic spine 4 vw (72074) | $202.60 | $1,013 | 2.0× |
| X-Ray Tmj Unilat (70328) | $46.60 | $233 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $498.40 | $2,492 | 1.5× |
| X-Rays Bone Length Studies (77073) | $83.60 | $418 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $403.40 | $2,017 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $124.80 | $624 | 1.2× |
| Xr facial bones less than 3 views (70140) | $52 | $260 | 0.6× |
| Xr orbits complete 4 views (70200) | $253.80 | $1,269 | 2.5× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.