Imaging prices at Javon Bea Hospital
Rockford, IL · every code in this section with a posted price and a Medicare benchmark.
356 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) | $8,665.88 | $11,554.50 | 5.8× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$70.02–$451.16 | $93.36–$601.55 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$84.11–$659.47 | $112.15–$879.29 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,424.60 | $1,899.47 | 3.3× |
| Angio pulmonary bilat (75743) | $2,305.94 | $3,074.58 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $6,699.46 | $8,932.61 | 2.0× |
| Angiography extremity unilateral rs&i (75710) | $5,344.35 | $7,125.80 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,848.81 | $2,465.08 | 0.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$70.02–$511.63 | $93.36–$682.17 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,344.59 | $7,126.12 | 0.9× |
| Artery X-Rays Abdomen (75726) | $6,587.16 | $8,782.88 | 1.1× |
| Artery X-Rays Pelvis (75736) | $5,344.35 | $7,125.80 | 0.9× |
| Artery X-Rays Spine (75705) | $4,497.54 | $5,996.72 | 0.8× |
| Arthrogram hip (73525) | $762.40 | $1,016.54 | 2.0× |
| Arthrogram Wrist (73115) | $1,148.22 | $1,530.96 | 3.1× |
| Basic radiation dosimetry calculation (77300) | $1,102.46 | $1,469.94 | 7.7× |
| Bone age studies (77072) range across 2 matching MRF lines |
$84.11–$355.46 | $112.15–$473.95 | varies |
| Bone Imaging 3 Phase (78315) | $2,235.68 | $2,980.91 | 5.2× |
| Bone Imaging Limited Area (78300) | $1,435.82 | $1,914.42 | 3.4× |
| Bone Imaging Multiple Areas (78305) | $1,604.61 | $2,139.48 | 3.7× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$321.64–$2,091.92 | $428.85–$2,789.23 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$84.11–$644.68 | $112.15–$859.58 | varies |
| Brachytx isodose intermed (77317) | $815.74 | $1,087.66 | 2.0× |
| Brachytx Isodose Plan Simple (77316) | $815.74 | $1,087.66 | 2.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,292.91 | $1,723.88 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,032.90 | $10,710.53 | 5.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,325.35 | $3,100.47 | 6.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,325.35 | $3,100.47 | 2.8× |
| Cat Scan Follow-Up Study (76380) | $2,173.89 | $2,898.52 | 23.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $998.76 | $1,331.68 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $2,274.10 | $3,032.13 | 3.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$325.29–$365.49 | $433.72–$487.32 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$70.02–$331.19 | $93.36–$441.59 | varies |
| Chest 3 views (71047) | $342.77 | $457.03 | 3.7× |
| Chest 4 or more views (71048) | $377.06 | $502.74 | 3.4× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 2 matching MRF lines |
$84.11–$1,386.98 | $112.15–$1,849.31 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$70.02–$649.83 | $93.36–$866.44 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$84.11–$427.82 | $112.15–$570.42 | varies |
| Continuing medical physics consltj pr wk (77336) | $915.94 | $1,221.26 | 6.4× |
| Contrast Exam Abdominl Aorta (75625) | $6,681.75 | $8,909 | 2.0× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$280.69–$783.76 | $374.25–$1,045.02 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $943.22 | $1,257.63 | 2.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$280.69–$8,197.16 | $374.25–$10,929.55 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$191.97–$4,552.42 | $255.96–$6,069.90 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$141.12–$2,992.48 | $188.16–$3,989.98 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$141.12–$4,379.71 | $188.16–$5,839.61 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$84.11–$2,462.92 | $112.15–$3,283.89 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$280.69–$7,216.41 | $374.25–$9,621.88 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$141.12–$3,240.38 | $188.16–$4,320.50 | varies |
| CT Angio Head (70496) | $3,205.84 | $4,274.45 | 17.1× |
| CT angio hrt w/3d image (75574) | $2,613.13 | $3,484.17 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$141.12–$1,515.80 | $188.16–$2,021.06 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$141.12–$3,032.62 | $188.16–$4,043.49 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$141.12–$3,240.38 | $188.16–$4,320.50 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,416.89 | $3,222.52 | 12.9× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$280.69–$2,881.88 | $374.25–$3,842.51 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$84.11–$2,811.59 | $112.15–$3,748.79 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$141.12–$2,712.21 | $188.16–$3,616.28 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$141.12–$4,276.58 | $188.16–$5,702.11 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$141.12–$2,886.04 | $188.16–$3,848.06 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$141.12–$3,192.26 | $188.16–$4,256.35 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $923.10 | $1,230.80 | 2.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $371.92 | $495.90 | 4.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$141.12–$3,131.50 | $188.16–$4,175.33 | varies |
| CT l-spine w&w/o contrast (72133) | $4,225.11 | $5,633.48 | 22.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$84.11–$2,581.70 | $112.15–$3,442.26 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$141.12–$2,785.54 | $188.16–$3,714.05 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$280.69–$2,975.26 | $374.25–$3,967.01 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$84.11–$2,388.14 | $112.15–$3,184.18 | varies |
| CT maxillofacial w contrast (70487) | $2,822.29 | $3,763.05 | 15.0× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$84.11–$2,499.49 | $112.15–$3,332.65 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$141.12–$4,695.17 | $188.16–$6,260.23 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$141.12–$3,341.36 | $188.16–$4,455.15 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$84.11–$2,921.64 | $112.15–$3,895.52 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$141.12–$4,225.11 | $188.16–$5,633.48 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$84.11–$2,208.07 | $112.15–$2,944.09 | varies |
| CT scan of leg combo (73702) | $4,421.77 | $5,895.69 | 23.5× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$141.12–$2,936.66 | $188.16–$3,915.54 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$141.12–$3,321.10 | $188.16–$4,428.13 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$84.11–$2,613.02 | $112.15–$3,484.02 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$141.12–$2,975.26 | $188.16–$3,967.01 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$84.11–$2,377.42 | $112.15–$3,169.90 | varies |
| CT thoracic spine w/wo cont (72130) | $3,952.18 | $5,269.57 | 21.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$84.11–$2,133.11 | $112.15–$2,844.15 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$84.11–$3,481.21 | $112.15–$4,641.61 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $3,162.97 | $4,217.29 | 16.8× |
| CT upper extremity with contrast (73201) | $2,521.09 | $3,361.45 | 6.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,725.63 | $3,634.17 | 14.5× |
| Cta Abdomen (74175) | $4,206.73 | $5,608.97 | 22.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $6,238.46 | $8,317.94 | 16.7× |
| CTA pelvis (72191) | $3,148.04 | $4,197.38 | 16.7× |
| Diskography lumbar (72295) | $4,993.42 | $6,657.90 | 2.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $436.65 | $582.20 | 3.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $909.92 | $1,213.22 | 8.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $874.94 | $1,166.58 | 7.8× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$84.11–$297.36 | $112.15–$396.48 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$84.11–$277.83 | $112.15–$370.44 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$70.02–$126.56 | $93.36–$168.74 | varies |
| Echo exam of fetal heart (76825) | $1,847.47 | $2,463.29 | 3.2× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$191.97–$1,825.94 | $255.96–$2,434.59 | varies |
| Echo Guide For Artery Repair (76936) | $921.02 | $1,228.02 | 4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $977.23 | $1,302.97 | 3.8× |
| Esophagram (74220) | $910.37 | $1,213.83 | 4.8× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$84.11–$987.90 | $112.15–$1,317.20 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$84.11–$795.29 | $112.15–$1,060.39 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $3,753.10 | $5,004.14 | 14.7× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$191.97–$928.10 | $255.96–$1,237.46 | varies |
| Follow-Up Angiography (75898) | $2,038.44 | $2,717.92 | 0.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$70.02–$488.60 | $93.36–$651.47 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$70.02–$496.16 | $93.36–$661.55 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$321.64–$2,446.41 | $428.85–$3,261.88 | varies |
| Gastroesophageal Reflux Exam (78262) | $2,065.04 | $2,753.39 | 4.8× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$2,304.39–$2,304.82 | $3,072.52–$3,073.10 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$84.11–$421.38 | $112.15–$561.84 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,344.59 | $7,126.12 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,344.59 | $7,126.12 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $3,005.06 | $4,006.75 | 5.2× |
| Hepatobiliary System Imaging (78226) | $2,068.85 | $2,758.47 | 4.8× |
| Ht Muscle Image Spect Sing (78451) | $3,221.29 | $4,295.05 | 2.3× |
| Hysterosalpingogram (74740) | $1,423.66 | $1,898.22 | 5.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,602.01 | $3,469.35 | 27.9× |
| Infant hip ultrasound, limited static exam (76886) | $447.52 | $596.70 | 4.8× |
| Interstitial radiation source applic complex (77778) | $1,641.22 | $2,188.30 | 2.2× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$84.11–$227.70 | $112.15–$303.60 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$436.85–$2,312.51 | $582.47–$3,083.35 | varies |
| K Flow/Funct Image W/O Drug (78707) | $2,039.24 | $2,718.98 | 3.5× |
| Kidney Imaging Morphol (78700) | $761.18 | $1,014.91 | 1.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$70.02–$524.42 | $93.36–$699.23 | varies |
| Liver imaging static only (78201) | $1,059.45 | $1,412.60 | 1.8× |
| Liver imaging w/vascular flow (78202) | $1,059.45 | $1,412.60 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $2,297.15 | $3,062.87 | 3.9× |
| Lung perfusion differential (78597) | $1,471.84 | $1,962.45 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$436.85–$2,163.26 | $582.47–$2,884.34 | varies |
| Lung Ventilation Imaging (78579) | $1,635.15 | $2,180.20 | 3.8× |
| Lymph System Imaging (78195) | $2,108.38 | $2,811.17 | 3.6× |
| Magnetic Image Jaw Joint (70336) | $1,715.32 | $2,287.09 | 6.7× |
| Meckels Divert Exam (78290) | $1,464.12 | $1,952.16 | 3.4× |
| Mlc imrt design & construction per imrt plan (77338) | $8,356.37 | $11,141.83 | 20.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,519.60 | $4,692.80 | 9.4× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$191.97–$2,968.30 | $255.96–$3,957.74 | varies |
| MRA head with contrast (70545) | $3,219.66 | $4,292.88 | 8.6× |
| MRA neck w contrast (70548) | $280.69 | $374.25 | 0.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,839.37 | $5,119.16 | 10.3× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$191.97–$2,780.95 | $255.96–$3,707.93 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$191.97–$4,973.81 | $255.96–$6,631.75 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,996.95 | $5,329.27 | 4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$280.69–$4,913.38 | $374.25–$6,551.18 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,176.25 | $5,568.33 | 5.0× |
| MRI brain functional w/o physician admnistration (70554) | $2,856.20 | $3,808.26 | 11.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $9,072.94 | $12,097.25 | 35.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,291.71 | $1,722.28 | 5.1× |
| MRI cardiac w/o cont stress (75559) | $1,478.53 | $1,971.37 | 2.5× |
| MRI cardiac w/o contrast (75557) | $1,478.53 | $1,971.37 | 5.8× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$280.69–$4,196.90 | $374.25–$5,595.86 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$191.97–$3,753.74 | $255.96–$5,004.99 | varies |
| MRI chest w/o contrast (71550) | $3,667.24 | $4,889.65 | 14.3× |
| MRI chest wo w contrast (71552) | $5,174.84 | $6,899.78 | 13.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$280.69–$4,741.33 | $374.25–$6,321.77 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$191.97–$3,844.23 | $255.96–$5,125.64 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$280.69–$4,040.17 | $374.25–$5,386.89 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$280.69–$4,834.46 | $374.25–$6,445.94 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$191.97–$2,852.36 | $255.96–$3,803.14 | varies |
| MRI orbit face neck w contrast (70542) | $3,865.96 | $5,154.61 | 10.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$280.69–$4,765.60 | $374.25–$6,354.14 | varies |
| MRI pelvis w contrast (72196) | $280.69 | $374.25 | 0.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$280.69–$4,723.78 | $374.25–$6,298.37 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$191.97–$3,396.94 | $255.96–$4,529.26 | varies |
| MRI spectroscopy (76390) | $2,851.33 | $3,801.77 | 30.6× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$191.97–$3,774.22 | $255.96–$5,032.30 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$191.97–$3,875.53 | $255.96–$5,167.37 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$280.69–$4,577.60 | $374.25–$6,103.46 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$280.69–$5,522.49 | $374.25–$7,363.32 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$280.69–$4,757.15 | $374.25–$6,342.87 | varies |
| MRI, dorsal spine contrast (72147) | $4,040.17 | $5,386.89 | 10.8× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$191.97–$3,731.35 | $255.96–$4,975.13 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$280.69–$4,806.35 | $374.25–$6,408.47 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$280.69–$5,387.72 | $374.25–$7,183.62 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,041.62–$5,262.69 | $1,388.82–$7,016.92 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$70.02–$392.04 | $93.36–$522.72 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $321.64 | $428.85 | 0.8× |
| Nm unlisted gi procedure (78299) | $816.22 | $1,088.30 | 1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,454.77 | $11,273.03 | 5.7× |
| Nuclear Rx Intra-Arterial (79445) | $524.43 | $699.24 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $1,795.57 | $2,394.09 | 7.2× |
| Ob us nuchal meas 1 gest (76813) | $1,219.04 | $1,625.38 | 10.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$84.11–$252.52 | $112.15–$336.70 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $84.11 | $112.15 | 0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$84.11–$252.52 | $112.15–$336.70 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$23.27–$57.29 | $31.03–$76.39 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,354.18 | $3,138.90 | 4.0× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$321.64–$1,847.17 | $428.85–$2,462.89 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$84.11–$566.38 | $112.15–$755.18 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,807 | $9,076 | 4.4× |
| PET image w/CT, full body (78816) | $8,032.90 | $10,710.53 | 5.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,967.04 | $10,622.72 | 5.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,862.36 | $10,483.14 | 2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,344.48 | $1,792.64 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$84.11–$730.82 | $112.15–$974.43 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,533.01 | $2,044.01 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$70.02–$530.06 | $93.36–$706.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$70.02–$341.44 | $93.36–$455.25 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$70.02–$497.44 | $93.36–$663.26 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$84.11–$961.50 | $112.15–$1,282 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$70.02–$417.26 | $93.36–$556.35 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$70.02–$509.91 | $93.36–$679.88 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$70.02–$445.73 | $93.36–$594.31 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$70.02–$208.45 | $93.36–$277.93 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $84.11 | $112.15 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$70.02–$867.10 | $93.36–$1,156.14 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $70.02 | $93.36 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$70.02–$519.47 | $93.36–$692.63 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$70.02–$555.70 | $93.36–$740.94 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$70.02–$734.07 | $93.36–$978.76 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$70.02–$489.10 | $93.36–$652.14 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$70.02–$445.73 | $93.36–$594.31 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $70.02 | $93.36 | 0.8× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$70.02–$373.44 | $93.36–$497.92 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$84.11–$224.93 | $112.15–$299.91 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$70.02–$607.24 | $93.36–$809.65 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $84.11 | $112.15 | 0.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,316.72 | $21,755.62 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $787.09 | $1,049.45 | 7.2× |
| Radiation treatment delivery level 2 (77407) | $2,169.93 | $2,893.24 | 5.3× |
| Radiation treatment delivery level 3 (77412) | $3,445.15 | $4,593.53 | 5.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$84.11–$1,156.47 | $112.15–$1,541.96 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $84.11 | $112.15 | 0.8× |
| Radiologic exam colon double contrast study (74280) | $1,776.98 | $2,369.31 | 9.5× |
| Radiologic exam colon single contrast study (74270) | $1,481.20 | $1,974.94 | 7.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,028.72 | $1,371.63 | 5.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$84.11–$601.56 | $112.15–$802.08 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$84.11–$767.55 | $112.15–$1,023.40 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,259.11 | $1,678.81 | 6.7× |
| Radiologic exam swallow function contrast study (74230) | $729.68 | $972.91 | 3.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,058.50 | $1,411.34 | 5.6× |
| Radiologic examination femur 1 view (73551) | $169.64 | $226.18 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$70.02–$545.28 | $93.36–$727.04 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$70.02–$511.63 | $93.36–$682.17 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$84.11–$563.27 | $112.15–$751.03 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$70.02–$463.90 | $93.36–$618.54 | varies |
| Renal Cyst Study (74470) | $1,198.08 | $1,597.44 | 2.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$84.11–$629.18 | $112.15–$838.90 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $816.22 | $1,088.30 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,910.60 | $2,547.46 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,725.52 | $2,300.70 | 3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,787.27 | $3,716.36 | 4.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,945.44 | $3,927.25 | 2.1× |
| Scapula (73010) range across 2 matching MRF lines |
$84.11–$497.36 | $112.15–$663.14 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$70.02–$414.28 | $93.36–$552.37 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$70.02–$465.17 | $93.36–$620.23 | varies |
| Shoulder Arthrography (73040) | $1,184.80 | $1,579.73 | 3.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$84.11–$734.07 | $112.15–$978.76 | varies |
| Special dosimetry (77331) | $1,058.18 | $1,410.91 | 7.3× |
| Special Physics Consult (77370) | $1,139.36 | $1,519.15 | 7.9× |
| Special teletherapy port plan (77321) | $1,443.17 | $1,924.23 | 3.6× |
| Special treatment procedure (77470) | $3,805.70 | $5,074.27 | 6.4× |
| Stereotactic Body Radiation Delivery (77373) | $10,248.02 | $13,664.03 | 5.3× |
| Sternoclavicular joints (71130) | $70.02 | $93.36 | 0.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $200.56 | $267.42 | 2.2× |
| Tbs technical calculation only (77091) range across 2 matching MRF lines |
$70.02–$270.95 | $93.36–$361.27 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,369.29 | $3,159.05 | 5.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$1,039.94–$1,293.44 | $1,386.58–$1,724.58 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,451.67 | $4,602.23 | 8.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,030.39 | $2,707.19 | 5.1× |
| Ther rad simulaj-aided field setting simple (77280) | $2,639.51 | $3,519.35 | 18.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $509.68 | $679.57 | 2.7× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$84.11–$700.44 | $112.15–$933.92 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$84.11–$656.67 | $112.15–$875.56 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$70.02–$346.94 | $93.36–$462.58 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $321.64 | $428.85 | 0.8× |
| Thyroid Met Imaging Body (78018) | $2,420.07 | $3,226.76 | 4.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$321.64–$2,145.69 | $428.85–$2,860.92 | varies |
| Tx Devices Design & Construction Complex (77334) | $2,048.70 | $2,731.60 | 5.1× |
| Tx devices design & construction intermediate (77333) | $485.90 | $647.87 | 3.4× |
| Tx devices design & construction simple (77332) range across 5 matching MRF lines |
$352.77–$648.93 | $470.36–$865.24 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$70.02–$328.21 | $93.36–$437.61 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$84.11–$733.81 | $112.15–$978.41 | varies |
| Ultrasound Elastography Parenchyma (76981) | $733.81 | $978.41 | 6.6× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$84.11–$331.29 | $112.15–$441.72 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$84.11–$1,630.55 | $112.15–$2,174.07 | varies |
| Umbilical-artery Doppler (OB) (76820) | $986.12 | $1,314.83 | 8.8× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$373.86–$3,396.94 | $498.48–$4,529.26 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$70.02–$401.59 | $93.36–$535.45 | varies |
| Upper gi w/o kub (74240) | $943.02 | $1,257.36 | 5.0× |
| Urethrocystogram voiding (74455) | $1,177.37 | $1,569.83 | 4.6× |
| Urethrocystography retrograde (74450) | $1,196.92 | $1,595.90 | 4.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$84.11–$339.50 | $112.15–$452.66 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$84.11–$666.91 | $112.15–$889.21 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$84.11–$1,421.66 | $112.15–$1,895.55 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$84.11–$807.14 | $112.15–$1,076.19 | varies |
| Us head (76506) range across 2 matching MRF lines |
$799.52–$873.82 | $1,066.03–$1,165.09 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$84.11–$1,849.65 | $112.15–$2,466.20 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$84.11–$1,387.82 | $112.15–$1,850.43 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$191.97–$1,478.30 | $255.96–$1,971.06 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$84.11–$1,123.89 | $112.15–$1,498.52 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$84.11–$711.84 | $112.15–$949.12 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$84.11–$1,647.20 | $112.15–$2,196.27 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$84.11–$1,259.74 | $112.15–$1,679.65 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$84.11–$1,434.22 | $112.15–$1,912.30 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$84.11–$1,844.23 | $112.15–$2,458.97 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$84.11–$1,194.46 | $112.15–$1,592.61 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$84.11–$1,296.20 | $112.15–$1,728.26 | varies |
| Us spinal canal and contents (76800) | $1,078.98 | $1,438.64 | 9.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$84.11–$1,455.76 | $112.15–$1,941.01 | varies |
| Us transrectal (76872) | $84.11 | $112.15 | 0.8× |
| Vein X-Ray Chest (75827) | $4,056.77 | $5,409.03 | 2.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $7,670.59 | $10,227.45 | 2.3× |
| Venogram Sinus/Jugular (75860) | $5,344.59 | $7,126.12 | 1.6× |
| Venography Adrenal Unilateral (75840) | $6,509.02 | $8,678.69 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $6,681.75 | $8,909 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $3,478.64 | $4,638.18 | 2.1× |
| Venography extremity unilateral rs&i (75820) | $3,071.78 | $4,095.70 | 1.8× |
| Venography Renal Bilateral (75833) | $5,478.20 | $7,304.27 | 1.6× |
| Venography Renal Unilateral (75831) | $5,344.59 | $7,126.12 | 1.6× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,455.35 | $1,940.47 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $70.02 | $93.36 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$70.02–$439.37 | $93.36–$585.83 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$70.02–$381.28 | $93.36–$508.37 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,320.57 | $1,760.76 | 3.5× |
| X-Ray Aorta Leg Arteries (75630) | $6,848.79 | $9,131.72 | 2.0× |
| X-Ray Bend Only L-S Spine (72120) | $563.27 | $751.03 | 5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$70.02–$419.08 | $93.36–$558.77 | varies |
| X-Ray Exam Breast Specimen (76098) | $372.08 | $496.10 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $476.72 | $635.63 | 5.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $890.24 | $1,186.99 | 7.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,335.38 | $1,780.51 | 11.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$70.02–$292.04 | $93.36–$389.39 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$70.02–$587.89 | $93.36–$783.85 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $741.41 | $988.55 | 6.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $859.28 | $1,145.70 | 7.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$84.11–$902.24 | $112.15–$1,202.99 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$84.11–$1,023.45 | $112.15–$1,364.60 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$70.02–$537.56 | $93.36–$716.74 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$84.11–$903.22 | $112.15–$1,204.30 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$84.11–$598.81 | $112.15–$798.41 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$70.02–$452.98 | $93.36–$603.97 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$70.02–$509.91 | $93.36–$679.88 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,337.37 | $1,783.16 | 7.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $488.75 | $651.67 | 5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$70.02–$373.44 | $93.36–$497.92 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$84.11–$602.34 | $112.15–$803.12 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$70.02–$298.09 | $93.36–$397.45 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$84.11–$757.22 | $112.15–$1,009.62 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$84.11–$447.17 | $112.15–$596.23 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$84.11–$447.07 | $112.15–$596.09 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$70.02–$534.95 | $93.36–$713.27 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$70.02–$952.19 | $93.36–$1,269.59 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$84.11–$752.42 | $112.15–$1,003.23 | varies |
| X-ray thoracic spine 4 vw (72074) | $84.11 | $112.15 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$280.69–$848.21 | $374.25–$1,130.95 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$84.11–$775.38 | $112.15–$1,033.84 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$84.11–$1,440.68 | $112.15–$1,920.90 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$84.11–$715.34 | $112.15–$953.79 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$70.02–$227.57 | $93.36–$303.43 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $84.11 | $112.15 | 0.8× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$84.11–$813.42 | $112.15–$1,084.56 | varies |
| Xr Tomogram Single Plane (76100) | $257.10 | $342.80 | 2.3× |
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.