Imaging prices at Jefferson Healthcare
Port Townsend, WA · every code in this section with a posted price and a Medicare benchmark.
327 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$528–$3,283.20 | $660–$4,104 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$20.80–$313.60 | $26–$392 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$27.20–$460.80 | $34–$576 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$113.60–$1,621.60 | $142–$2,027 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$19.20–$295.20 | $24–$369 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$67.20–$918.40 | $84–$1,148 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$68.80–$918.40 | $86–$1,148 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$66.40–$691.20 | $83–$864 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$76.80–$316.80 | $96–$396 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$22.40–$216.80 | $28–$271 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$116–$1,492 | $145–$1,865 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$72.80–$899.20 | $91–$1,124 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$95.20–$1,024 | $119–$1,280 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$97.60–$1,721.60 | $122–$2,152 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$81.60–$548 | $102–$685 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$111.20–$940.80 | $139–$1,176 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$21.60–$286.40 | $27–$358 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$25.60–$328 | $32–$410 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$31.20–$386.40 | $39–$483 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$36.80–$461.60 | $46–$577 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$37.60–$486.40 | $47–$608 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$20–$298.40 | $25–$373 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$125.60–$588.80 | $157–$736 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$220.80–$316.80 | $276–$396 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$36.46–$690.40 | $45.57–$863 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$67.20–$918.40 | $84–$1,148 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$68.80–$918.40 | $86–$1,148 | varies |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$130.01–$1,337.60 | $162.51–$1,672 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$232.80–$4,222.40 | $291–$5,278 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$202.40–$3,235.20 | $253–$4,044 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$148.80–$1,987.20 | $186–$2,484 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$163.20–$2,383.20 | $204–$2,979 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$139.20–$1,524.80 | $174–$1,906 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$253.60–$3,628.80 | $317–$4,536 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$211.20–$2,922.40 | $264–$3,653 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$203.20–$2,592 | $254–$3,240 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$218.40–$2,348 | $273–$2,935 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$203.20–$2,412 | $254–$3,015 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$208–$1,657.60 | $260–$2,072 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$28–$432.80 | $35–$541 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) range across 2 matching MRF lines |
$115.20–$488.80 | $144–$611 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$141.60–$2,146.40 | $177–$2,683 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$116.80–$1,820 | $146–$2,275 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$148–$2,265.60 | $185–$2,832 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$135.20–$1,959.20 | $169–$2,449 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$146.40–$2,150.40 | $183–$2,688 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$131.20–$1,888.80 | $164–$2,361 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$148.80–$2,188 | $186–$2,735 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$202.40–$2,154.40 | $253–$2,693 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$67.20–$529.60 | $84–$662 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$295.20–$2,154.40 | $369–$2,693 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$130.40–$2,006.40 | $163–$2,508 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$148–$2,355.20 | $185–$2,944 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$116.80–$1,656.80 | $146–$2,071 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$135.20–$1,976 | $169–$2,470 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$141.60–$2,212.80 | $177–$2,766 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$116.80–$1,662.40 | $146–$2,078 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$130.40–$1,816.80 | $163–$2,271 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$99.20–$1,440.80 | $124–$1,801 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$188–$2,113.60 | $235–$2,642 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$148–$2,231.20 | $185–$2,789 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$149.60–$1,396.80 | $187–$1,746 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$141.60–$2,169.60 | $177–$2,712 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$126.40–$1,631.20 | $158–$2,039 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$141.60–$2,247.20 | $177–$2,809 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$148–$2,004.80 | $185–$2,506 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$160.80–$1,889.60 | $201–$2,362 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$149.60–$1,443.20 | $187–$1,804 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$142.40–$1,985.60 | $178–$2,482 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$116.80–$1,632 | $146–$2,040 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$148–$2,164 | $185–$2,705 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$125.60–$1,658.40 | $157–$2,073 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$116.80–$1,417.60 | $146–$1,772 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$141.60–$2,193.60 | $177–$2,742 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$133.60–$1,983.20 | $167–$2,479 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$274.40–$2,708 | $343–$3,385 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$209.60–$2,728.80 | $262–$3,411 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$287.20–$652.80 | $359–$816 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$208–$2,044 | $260–$2,555 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$65.60–$117.60 | $82–$147 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$67.20–$168.80 | $84–$211 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$82.40–$325.60 | $103–$407 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$23.20–$492.80 | $29–$616 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$36–$415.20 | $45–$519 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$24–$266.40 | $30–$333 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$194.40–$449.60 | $243–$562 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$84.80–$564 | $106–$705 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$97.60–$289.60 | $122–$362 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$69.60–$729.60 | $87–$912 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$123.20–$563.20 | $154–$704 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$94.40–$483.20 | $118–$604 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$36.80–$712.80 | $46–$891 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$18.40–$289.60 | $23–$362 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$19.20–$349.60 | $24–$437 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$91.20–$1,704.80 | $114–$2,131 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 2 matching MRF lines |
$112–$1,422.40 | $140–$1,778 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$112.80–$2,125.60 | $141–$2,657 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$20–$332 | $25–$415 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$103.20–$1,920.80 | $129–$2,401 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$84.80–$1,760.80 | $106–$2,201 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$157.60–$3,280 | $197–$4,100 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$44.80–$876 | $56–$1,095 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$72.80–$415.20 | $91–$519 | varies |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$55.20–$436.80 | $69–$546 | varies |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$40.80–$375.20 | $51–$469 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$160–$1,745.60 | $200–$2,182 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$137.60–$2,284.80 | $172–$2,856 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$107.20–$1,486.40 | $134–$1,858 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$51.20–$904.80 | $64–$1,131 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$56–$1,486.40 | $70–$1,858 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$22.40–$337.60 | $28–$422 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$56–$1,688.80 | $70–$2,111 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$72–$1,868.80 | $90–$2,336 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$82.40–$900 | $103–$1,125 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$121.60–$1,929.60 | $152–$2,412 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$55.20–$1,536.80 | $69–$1,921 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$136–$1,975.20 | $170–$2,469 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$172–$1,286.40 | $215–$1,608 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$52–$687.20 | $65–$859 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$42.40–$518.40 | $53–$648 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$77.60–$967.20 | $97–$1,209 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$528–$878.40 | $660–$1,098 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$172.80–$3,360 | $216–$4,200 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$140–$2,446.40 | $175–$3,058 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$46.40–$2,772 | $58–$3,465 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$175.20–$2,820.80 | $219–$3,526 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$209.60–$3,849.60 | $262–$4,812 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$140–$2,251.20 | $175–$2,814 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$201.60–$2,508 | $252–$3,135 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$169.60–$2,182.40 | $212–$2,728 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$190.40–$2,890.40 | $238–$3,613 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$249.60–$3,418.40 | $312–$4,273 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$190.40–$3,008 | $238–$3,760 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$186.40–$1,168 | $233–$1,460 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$185.60–$2,919.20 | $232–$3,649 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$168.80–$2,162.40 | $211–$2,703 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$208–$2,916.80 | $260–$3,646 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$173.60–$2,326.40 | $217–$2,908 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$169.60–$1,810.40 | $212–$2,263 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$201.60–$2,300.80 | $252–$2,876 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$262.40–$3,700 | $328–$4,625 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$188.80–$2,532.80 | $236–$3,166 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$249.60–$3,439.20 | $312–$4,299 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$156.80–$2,181.60 | $196–$2,727 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$207.20–$3,482.40 | $259–$4,353 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$266.40–$3,423.20 | $333–$4,279 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$156.80–$2,093.60 | $196–$2,617 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$188–$2,352 | $235–$2,940 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$248.80–$3,475.20 | $311–$4,344 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$201.60–$2,550.40 | $252–$3,188 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$255.20–$3,524.80 | $319–$4,406 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$171.20–$2,280.80 | $214–$2,851 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$172.80–$2,351.20 | $216–$2,939 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$189.60–$2,494.40 | $237–$3,118 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$158.40–$2,180.80 | $198–$2,726 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$250.40–$3,208 | $313–$4,010 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$254.40–$3,587.20 | $318–$4,484 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$266.40–$3,360 | $333–$4,200 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$207.20–$2,916.80 | $259–$3,646 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$159.20–$2,080.80 | $199–$2,601 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$250.40–$3,432.80 | $313–$4,291 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$266.40–$3,604.80 | $333–$4,506 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$107.20–$1,689.60 | $134–$2,112 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$96.80–$1,689.60 | $121–$2,112 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$109.60–$1,689.60 | $137–$2,112 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$162.40–$1,689.60 | $203–$2,112 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$186.40–$4,693.60 | $233–$5,867 | varies |
| N-invas est c ffr sw aly CTA (75580) | $820.80 | $1,026 | 0.9× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$21.60–$287.20 | $27–$359 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$986.40–$3,283.20 | $1,233–$4,104 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$138.40–$144 | $173–$180 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$74.40–$198.40 | $93–$248 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$91.20–$1,138.40 | $114–$1,423 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$136.80–$1,640.80 | $171–$2,051 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$20.80–$396.80 | $26–$496 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$84.80–$925.60 | $106–$1,157 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$37.60–$510.40 | $47–$638 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$60.80–$720 | $76–$900 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$20.80–$356.80 | $26–$446 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$19.20–$284 | $24–$355 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$20.80–$333.60 | $26–$417 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$25.60–$431.20 | $32–$539 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$16.80–$276.80 | $21–$346 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$20–$356 | $25–$445 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$20.80–$360 | $26–$450 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$19.20–$310.40 | $24–$388 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$40.80–$452 | $51–$565 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$20.80–$320 | $26–$400 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$26.40–$340 | $33–$425 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$23.20–$358.40 | $29–$448 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$20.80–$288 | $26–$360 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$136.80–$436.80 | $171–$546 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$19.20–$247.20 | $24–$309 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$23.20–$319.20 | $29–$399 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$28–$366.40 | $35–$458 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$16–$280 | $20–$350 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$19.20–$310.40 | $24–$388 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$20.80–$341.60 | $26–$427 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$49.60–$762.40 | $62–$953 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$2,251.20–$16,800 | $2,814–$21,000 | varies |
| Radiation treatment delivery level 1 (77402) | $276 | $345 | 2.4× |
| Radiation treatment delivery level 2 (77407) | $948 | $1,185 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $1,360 | $1,700 | 2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$28.80–$491.20 | $36–$614 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$31.20–$480 | $39–$600 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$147.20–$1,104 | $184–$1,380 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$120.80–$875.20 | $151–$1,094 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$81.60–$703.20 | $102–$879 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$26.40–$488.80 | $33–$611 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$29.60–$556.80 | $37–$696 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$94.40–$657.60 | $118–$822 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$62.40–$698.40 | $78–$873 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$104–$165.60 | $130–$207 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$20–$340.80 | $25–$426 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$21.60–$360 | $27–$450 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$20–$312.80 | $25–$391 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$51.20–$492.80 | $64–$616 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 2 matching MRF lines |
$19.20–$74.40 | $24–$93 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$19.20–$349.60 | $24–$437 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$33.60–$514.40 | $42–$643 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $74.40 | $93 | 0.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $82.40 | $103 | 0.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $91.20 | $114 | 0.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $121.60 | $152 | 0.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $204 | $255 | 0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $237.60 | $297 | 0.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $165.60 | $207 | 0.1× |
| Scapula (73010) range across 2 matching MRF lines |
$21.60–$403.20 | $27–$504 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$71.20–$80.80 | $89–$101 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$18.40–$284 | $23–$355 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$65.60–$807.20 | $82–$1,009 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$44.80–$839.20 | $56–$1,049 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$21.60–$348 | $27–$435 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$115.20–$316.80 | $144–$396 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$316.80–$360 | $396–$450 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$105.60–$878.40 | $132–$1,098 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$252–$1,411.20 | $315–$1,764 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$2,241.60–$4,800 | $2,802–$6,000 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$25.60–$336 | $32–$420 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$357.60–$878.40 | $447–$1,098 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$170.40–$878.40 | $213–$1,098 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$83.20–$1,007.20 | $104–$1,259 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$196.80–$940.80 | $246–$1,176 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$134.40–$940.80 | $168–$1,176 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$91.20–$556.80 | $114–$696 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$244.80–$436.80 | $306–$546 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$24–$435.20 | $30–$544 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$26.40–$498.40 | $33–$623 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$24.80–$404 | $31–$505 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$42.40–$587.20 | $53–$734 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$56.80–$1,128 | $71–$1,410 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$139.20–$878.40 | $174–$1,098 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$91.20–$316.80 | $114–$396 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$55.20–$316.80 | $69–$396 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$79.20–$379.20 | $99–$474 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$64–$555.20 | $80–$694 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$68.80–$616.80 | $86–$771 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$58.40–$466.40 | $73–$583 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$93.60–$717.60 | $117–$897 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $268.80 | $336 | 24.3× |
| Urea breath test c-14 isotopic analysis (78268) | $77.60 | $97 | 0.8× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$37.30–$787.20 | $46.62–$984 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$38.14–$722.40 | $47.67–$903 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$84.80–$486.40 | $106–$608 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$67.20–$706.40 | $84–$883 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$73.60–$492 | $92–$615 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$57.07–$521.60 | $71.34–$652 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$56–$492.80 | $70–$616 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$222.40–$903.20 | $278–$1,129 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$76–$540.80 | $95–$676 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$92–$571.20 | $115–$714 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$80.80–$685.60 | $101–$857 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$115.20–$528 | $144–$660 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$100–$608 | $125–$760 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$85.60–$884 | $107–$1,105 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$67.49–$594.40 | $84.36–$743 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$75.20–$661.60 | $94–$827 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$66.40–$627.20 | $83–$784 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$78.74–$263.20 | $98.43–$329 | varies |
| Vasogram (74440) range across 2 matching MRF lines |
$43.13–$430.40 | $53.91–$538 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$165.60–$1,857.60 | $207–$2,322 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$120.80–$1,732.80 | $151–$2,166 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$20–$160 | $25–$200 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$20–$295.20 | $25–$369 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$22.40–$452.80 | $28–$566 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$57.91–$798.40 | $72.39–$998 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$26.40–$118.40 | $33–$148 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$20–$285.60 | $25–$357 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$36.80–$649.60 | $46–$812 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$30.40–$300 | $38–$375 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$36.80–$505.60 | $46–$632 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$42.40–$560 | $53–$700 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$22.40–$288.80 | $28–$361 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$26.40–$354.40 | $33–$443 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$32–$496 | $40–$620 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$26.40–$512.80 | $33–$641 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$35.20–$605.60 | $44–$757 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$36.80–$680 | $46–$850 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$36–$633.60 | $45–$792 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$26.40–$372 | $33–$465 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$35.20–$638.40 | $44–$798 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$31.20–$400 | $39–$500 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$21.60–$283.20 | $27–$354 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$19.20–$302.40 | $24–$378 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$56–$846.40 | $70–$1,058 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$56–$1,054.40 | $70–$1,318 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$21.60–$333.60 | $27–$417 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$20.80–$314.40 | $26–$393 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$26.40–$456.80 | $33–$571 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$21.60–$330.40 | $27–$413 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$37.60–$510.40 | $47–$638 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$26.40–$464.80 | $33–$581 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$20–$284.80 | $25–$356 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$20.80–$351.20 | $26–$439 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$25.60–$428 | $32–$535 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$32.80–$584 | $41–$730 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$136.80–$292.80 | $171–$366 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$28.80–$560 | $36–$700 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$21.60–$324 | $27–$405 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$59.59–$1,243.20 | $74.49–$1,554 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$32–$416 | $40–$520 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$64.80–$832 | $81–$1,040 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$32–$553.60 | $40–$692 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$24–$289.60 | $30–$362 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$21.60–$313.60 | $27–$392 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$32.80–$489.60 | $41–$612 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$68–$328.80 | $85–$411 | 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.