Imaging prices at John H Stroger Jr Hospital
Chicago, IL · every code in this section with a posted price and a Medicare benchmark.
512 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) | $409.50 | $585 | 0.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$19.60–$187.60 | $28–$268 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$83.30–$715.40 | $119–$1,022 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $83.30 | $119 | 0.1× |
| Adrenal Cortex & Medulla Img (78075) | $63.70 | $91 | 0.0× |
| Angio internal mammary (75756) | $5,645.50 | $8,065 | 1.7× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,645.50 | $201–$8,065 | 1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,645.50 | $8,065 | 1.7× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$175–$5,645.50 | $250–$8,065 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$5,645.50 | $228–$8,065 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,645.50 | $8,065 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,645.50 | $8,065 | 1.7× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,949.10 | $14,213 | 1.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,645.50 | $8,065 | 1.7× |
| Artery X-Rays Abdomen (75726) | $9,949.10 | $14,213 | 1.7× |
| Artery X-Rays Adrenal Gland (75731) | $5,645.50 | $8,065 | 1.7× |
| Artery X-Rays Pelvis (75736) | $9,949.10 | $14,213 | 1.7× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$9,949.10 | $360–$14,213 | 1.7× |
| Arthrogram ankle (73615) range across 7 matching MRF lines |
$52.50–$935.90 | $75–$1,337 | varies |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$53.20–$935.90 | $76–$1,337 | varies |
| Arthrogram Wrist (73115) range across 6 matching MRF lines |
$51.10–$935.90 | $73–$1,337 | varies |
| Basic radiation dosimetry calculation (77300) | $60.20 | $86 | 0.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$16.80–$187.60 | $24–$268 | varies |
| Bone Imaging 3 Phase (78315) | $85.40 | $122 | 0.2× |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$51.80–$715.40 | $74–$1,022 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$71.40–$715.40 | $102–$1,022 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$71.40–$715.40 | $102–$1,022 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$46.20–$715.40 | $66–$1,022 | varies |
| Bone marrow imaging; multiple areas (78103) range across 2 matching MRF lines |
$52.50–$715.40 | $75–$1,022 | varies |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$66.50–$715.40 | $95–$1,022 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$60.20–$187.60 | $86–$268 | varies |
| Brachytx isodose complex (77318) | $277.20 | $396 | 0.7× |
| Brachytx isodose intermed (77317) | $174.30 | $249 | 0.4× |
| Brachytx Isodose Plan Simple (77316) | $134.40 | $192 | 0.3× |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$970.90 | $37–$1,387 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$44.10–$715.40 | $63–$1,022 | varies |
| Brain imaging < 4 static views (78600) | $37.10 | $53 | 0.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$53.20–$970.90 | $76–$1,387 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 2 matching MRF lines |
$46.20–$970.90 | $66–$1,387 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$123.20–$2,557.10 | $176–$3,653 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $100.10 | $143 | 0.2× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $122.50 | $175 | 0.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$220.50–$624.40 | $315–$892 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$252–$1,402.10 | $360–$2,003 | varies |
| Cardiac Shunt Detection (78428) | $64.40 | $92 | 0.2× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$84.70–$156.10 | $121–$223 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$47.60–$970.90 | $68–$1,387 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $51.80 | $74 | 0.1× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$57.40–$970.90 | $82–$1,387 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$18.90–$156.10 | $27–$223 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$23.10–$156.10 | $33–$223 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$28–$187.60 | $40–$268 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 2 matching MRF lines |
$107.80–$187.60 | $154–$268 | varies |
| Cholecystography Oral Contrast (74290) | $28 | $40 | 0.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 2 matching MRF lines |
$34.30–$187.60 | $49–$268 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$102.20–$1,402.10 | $146–$2,003 | varies |
| Clavicle complete (73000) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$91.70–$187.60 | $131–$268 | varies |
| Continuing medical physics consltj pr wk (77336) | $168 | $240 | 1.2× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,645.50 | $189–$8,065 | 1.7× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$28–$624.40 | $40–$892 | varies |
| Contrast X-Ray Of Elbow (73085) range across 5 matching MRF lines |
$46.90–$624.40 | $67–$892 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 6 matching MRF lines |
$61.60–$935.90 | $88–$1,337 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $50.40 | $72 | 0.3× |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$98–$187.60 | $140–$268 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$172.90–$624.40 | $247–$892 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$147.70–$427 | $211–$610 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$108.50–$313.60 | $155–$448 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$118.30–$313.60 | $169–$448 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$102.20–$187.60 | $146–$268 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$187.60–$624.40 | $268–$892 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$155.40–$313.60 | $222–$448 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$148.40–$313.60 | $212–$448 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$204.40–$624.40 | $292–$892 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$162.40–$470.40 | $232–$672 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$148.40–$313.60 | $212–$448 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$154–$313.60 | $220–$448 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$21–$156.10 | $30–$223 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$104.30–$624.40 | $149–$892 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$86.80–$187.60 | $124–$268 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$107.80–$313.60 | $154–$448 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$100.10–$313.60 | $143–$448 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$107.10–$313.60 | $153–$448 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $214.20 | $306 | 1.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $206.50 | $295 | 1.8× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$97.30–$313.60 | $139–$448 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$108.50–$313.60 | $155–$448 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$147–$624.40 | $210–$892 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$49.70–$156.10 | $71–$223 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$218.40–$624.40 | $312–$892 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$97.30–$313.60 | $139–$448 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$107.80–$313.60 | $154–$448 | varies |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$86.80–$280.70 | $124–$401 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$99.40–$470.40 | $142–$672 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$104.30–$624.40 | $149–$892 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$86.80–$187.60 | $124–$268 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$97.30–$313.60 | $139–$448 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$74.20–$187.60 | $106–$268 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$136.50–$313.60 | $195–$448 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$107.80–$313.60 | $154–$448 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$109.90–$187.60 | $157–$268 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$104.30–$313.60 | $149–$448 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$92.40–$187.60 | $132–$268 | varies |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$103.60–$470.40 | $148–$672 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$108.50–$313.60 | $155–$448 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$117.60–$313.60 | $168–$448 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$109.20–$187.60 | $156–$268 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$104.30–$313.60 | $149–$448 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$86.80–$187.60 | $124–$268 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$108.50–$313.60 | $155–$448 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$91.70–$187.60 | $131–$268 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$107.80–$156.10 | $154–$223 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$86.80–$280.70 | $124–$401 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines |
$103.60–$470.40 | $148–$672 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$99.40–$935.90 | $142–$1,337 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $204.40 | $292 | 1.1× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$155.40–$313.60 | $222–$448 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$154–$313.60 | $220–$448 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 2 matching MRF lines |
$26.60–$427 | $38–$610 | varies |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $39.20 | $56 | 0.1× |
| Dilation ureters/urethra rs&i (74485) | $3,738 | $5,340 | 1.7× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$103.60–$3,491.60 | $148–$4,988 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$3,491.60 | $106–$4,988 | 1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$49–$187.60 | $70–$268 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$50.40–$187.60 | $72–$268 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$61.60–$187.60 | $88–$268 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$17.50–$187.60 | $25–$268 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$27.30–$187.60 | $39–$268 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$17.50–$156.10 | $25–$223 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$143.50–$977.20 | $205–$1,396 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$64.40–$427 | $92–$610 | varies |
| Echo Guide For Artery Repair (76936) | $179.90 | $257 | 0.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$72.10–$427 | $103–$610 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$139.30–$187.60 | $199–$268 | varies |
| Esophageal Motility Study (78258) | $63 | $90 | 0.1× |
| Esophagram (74220) range across 2 matching MRF lines |
$51.10–$313.60 | $73–$448 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$92.40–$187.60 | $132–$268 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$67.90–$187.60 | $97–$268 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$29.40–$427 | $42–$610 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$218.40–$5,645.50 | $312–$8,065 | varies |
| Foot 2 views (73620) range across 6 matching MRF lines |
$14.70–$233.80 | $21–$334 | varies |
| Forearm 2 views (73090) range across 8 matching MRF lines |
$14.70–$233.80 | $21–$334 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$66.50–$715.40 | $95–$1,022 | varies |
| Gastric Mucosa Imaging (78261) | $48.30 | $69 | 0.1× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$58.80–$715.40 | $84–$1,022 | varies |
| Gastrointestinal Protein Loss (78282) | $27.30 | $39 | 0.1× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$81.90–$715.40 | $117–$1,022 | varies |
| Gated Heart, Multiple (78473) | $124.60 | $178 | 0.3× |
| GI Endoscopic US S&I (76975) | $77.70 | $111 | 0.3× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$15.40–$280.70 | $22–$401 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$511.70–$1,245.30 | $731–$1,779 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$363.30–$1,245.30 | $519–$1,779 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$184.80–$1,245.30 | $264–$1,779 | varies |
| Heart first pass single,planar (78481) | $79.80 | $114 | 0.1× |
| Heart Image (Pet) Multiple (78492) range across 2 matching MRF lines |
$150.50–$2,557.10 | $215–$3,653 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,645.50 | $8,065 | 1.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,645.50 | $8,065 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$76.30–$970.90 | $109–$1,387 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$63–$715.40 | $90–$1,022 | varies |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $120.40 | $172 | 0.2× |
| Ht Musc Image Planar Mult (78454) range across 2 matching MRF lines |
$113.40–$2,314.90 | $162–$3,307 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$115.50–$2,314.90 | $165–$3,307 | varies |
| Hyperthermia external generated superficial (77600) | $128.10 | $183 | 0.3× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $125.30 | $179 | 0.2× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $175 | $250 | 0.3× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $181.30 | $259 | 0.3× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $210.70 | $301 | 0.3× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$32.90–$427 | $47–$610 | varies |
| Image fusion (77399) | $137.90 | $197 | 1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$63.70–$156.10 | $91–$223 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$53.90–$156.10 | $77–$223 | varies |
| Infusion Ivp (74410) | $42.70 | $61 | 0.2× |
| Interstitial radiation source applic complex (77778) | $838.60 | $1,198 | 1.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $826.70 | $1,181 | 1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $550.20 | $786 | 0.9× |
| Intracavitary radiation source applic simple (77761) | $367.50 | $525 | 0.6× |
| Joint Survey Single View (77077) | $30.80 | $44 | 0.3× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$116.90–$970.90 | $167–$1,387 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$100.10–$970.90 | $143–$1,387 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$80.50–$970.90 | $115–$1,387 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $32.20 | $46 | 0.1× |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$37.10–$715.40 | $53–$1,022 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$43.40–$715.40 | $62–$1,022 | varies |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$17.50–$233.80 | $25–$334 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $42.70 | $61 | 0.1× |
| Leveen/Shunt Patency Exam (78291) | $75.60 | $108 | 0.2× |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$42.70–$715.40 | $61–$1,022 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$49–$715.40 | $70–$1,022 | varies |
| Liver imaging static only (78201) | $36.40 | $52 | 0.1× |
| Liver imaging w/vascular flow (78202) range across 2 matching MRF lines |
$43.40–$970.90 | $62–$1,387 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$70–$970.90 | $100–$1,387 | varies |
| Lung perfusion differential (78597) | $60.90 | $87 | 0.1× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$90.30–$970.90 | $129–$1,387 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$42–$715.40 | $60–$1,022 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$98.70–$970.90 | $141–$1,387 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $100.80 | $144 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $86.10 | $123 | 0.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,645.50 | $8,065 | 1.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $5,645.50 | $8,065 | 1.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$123.20–$427 | $176–$610 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $310.10 | $443 | 1.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $281.40 | $402 | 0.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $297.50 | $425 | 1.6× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$39.90–$427 | $57–$610 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$31.50–$427 | $45–$610 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$57.40–$715.40 | $82–$1,022 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $410.20 | $586 | 1.0× |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$51.10–$156.10 | $73–$223 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$20.30–$51.80 | $29–$74 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$63–$170.10 | $90–$243 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$54.60–$105.70 | $78–$151 | varies |
| Mr safety med physics xm customization plng&mntr (76017) | $427 | $610 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$126–$624.40 | $180–$892 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$102.90–$427 | $147–$610 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$102.90–$624.40 | $147–$892 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$127.40–$624.40 | $182–$892 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$152.60–$624.40 | $218–$892 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$102.90–$427 | $147–$610 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$146.30–$624.40 | $209–$892 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$122.50–$427 | $175–$610 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$138.60–$2,102.80 | $198–$3,004 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$184.10–$935.90 | $263–$1,337 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$138.60–$2,102.80 | $198–$3,004 | varies |
| MRI bone marrow blood supply (77084) | $135.80 | $194 | 0.5× |
| MRI brain functional w/o physician admnistration (70554) | $182.70 | $261 | 0.7× |
| MRI brain functional w/physician admnistration (70555) | $210.70 | $301 | 0.8× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$135.10–$427 | $193–$610 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines |
$121.80–$427 | $174–$610 | varies |
| MRI cardiac w/o cont stress (75559) range across 2 matching MRF lines |
$245.70–$977.20 | $351–$1,396 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$196.70–$427 | $281–$610 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$154.70–$624.40 | $221–$892 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$126.70–$427 | $181–$610 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$122.50–$427 | $175–$610 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$147–$1,402.10 | $210–$2,003 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$193.20–$624.40 | $276–$892 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 6 matching MRF lines |
$137.20–$935.90 | $196–$1,337 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$184.10–$935.90 | $263–$1,337 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$114.80–$640.50 | $164–$915 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$151.90–$624.40 | $217–$892 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$196–$624.40 | $280–$892 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$114.10–$427 | $163–$610 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$137.90–$624.40 | $197–$892 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$183.40–$624.40 | $262–$892 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$147–$624.40 | $210–$892 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$188.30–$624.40 | $269–$892 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$123.20–$427 | $176–$610 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$139.99–$156.10 | $199.99–$223 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$126.70–$427 | $181–$610 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 6 matching MRF lines |
$137.90–$935.90 | $197–$1,337 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$116.20–$640.50 | $166–$915 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$184.80–$935.90 | $264–$1,337 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$189–$624.40 | $270–$892 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$196–$624.40 | $280–$892 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$151.90–$624.40 | $217–$892 | varies |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$116.90–$640.50 | $167–$915 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$184.80–$935.90 | $264–$1,337 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$196–$624.40 | $280–$892 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$80.50–$1,402.10 | $115–$2,003 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$74.90–$1,402.10 | $107–$2,003 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$78.40–$1,402.10 | $112–$2,003 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$111.30–$1,402.10 | $159–$2,003 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $58.10 | $83 | 0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$129.50–$2,314.90 | $185–$3,307 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $67.20 | $96 | 0.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$84–$2,314.90 | $120–$3,307 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$135.80–$2,314.90 | $194–$3,307 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) range across 2 matching MRF lines |
$157.50–$3,938.90 | $225–$5,627 | varies |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) range across 2 matching MRF lines |
$182–$3,938.90 | $260–$5,627 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $478.80 | $684 | 1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $74.90 | $107 | 0.2× |
| Nm csf leak detection (78650) | $42.70 | $61 | 0.0× |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$78.40–$970.90 | $112–$1,387 | varies |
| Nm red cell survival study (78130) | $42.70 | $61 | 0.1× |
| Nm whole blood volume (78122) | $38.50 | $55 | 0.1× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$44.80–$187.60 | $64–$268 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $764.40 | $1,092 | 0.5× |
| Nuclear Rx Intra-Arterial (79445) | $199.50 | $285 | 0.8× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$149.10–$417.20 | $213–$596 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$104.30–$187.60 | $149–$268 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$53.90–$187.60 | $77–$268 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $58.10 | $83 | 0.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $68.60 | $98 | 0.5× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 2 matching MRF lines |
$40.60–$187.60 | $58–$268 | varies |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $58.10 | $83 | 0.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$54.60–$187.60 | $78–$268 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$22.40–$51.80 | $32–$74 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) | $63 | $90 | 0.6× |
| Optic foramina (70190) | $19.60 | $28 | 0.2× |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$35.70–$156.10 | $51–$223 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$130.20–$970.90 | $186–$1,387 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$67.20–$715.40 | $96–$1,022 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$100.10–$715.40 | $143–$1,022 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$16.10–$187.60 | $23–$268 | varies |
| Perineogram (74775) range across 2 matching MRF lines |
$53.90–$427 | $77–$610 | varies |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$40.60–$977.20 | $58–$1,396 | varies |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$159.60–$2,557.10 | $228–$3,653 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$182–$2,557.10 | $260–$3,653 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$205.10–$2,557.10 | $293–$3,653 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$202.30–$2,557.10 | $289–$3,653 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$126.70–$2,314.90 | $181–$3,307 | varies |
| Pet Myocardial Sngl Study (78491) range across 2 matching MRF lines |
$129.50–$2,557.10 | $185–$3,653 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$163.10–$2,557.10 | $233–$3,653 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $2,314.90 | $3,307 | 1.7× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $14.70 | $21 | 0.0× |
| Platelet survival study Non-Facility (78191) | $42.70 | $61 | 0.1× |
| Proton trmt simple w/comp (77522) | $1,400.70 | $2,001 | 1.0× |
| Proton tx delivery complex (77525) | $1,768.90 | $2,527 | 1.3× |
| Proton tx delivery intermediate (77523) | $1,661.80 | $2,374 | 1.2× |
| Proton tx delivery simple w/o compensation (77520) | $1,364.30 | $1,949 | 2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$5,645.50 | $172–$8,065 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$63–$715.40 | $90–$1,022 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $28 | $40 | 0.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$45.50–$977.20 | $65–$1,396 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$14.70–$233.80 | $21–$334 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$23.10–$187.60 | $33–$268 | varies |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$12.60–$233.80 | $18–$334 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$14.70–$233.80 | $21–$334 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 6 matching MRF lines |
$30.10–$280.70 | $43–$401 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $28.70 | $41 | 0.3× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$19.60–$156.10 | $28–$223 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$16.80–$233.80 | $24–$334 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $100.10 | $143 | 0.5× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$14.70–$156.10 | $21–$223 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$17.50–$156.10 | $25–$223 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$21–$156.10 | $30–$223 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$12.60–$233.80 | $18–$334 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$14.70–$280.70 | $21–$401 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,659 | $2,370 | 0.2× |
| Radiation treatment delivery level 1 (77402) | $182.70 | $261 | 1.7× |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$690.20–$1,051.40 | $986–$1,502 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$988.40–$1,051.40 | $1,412–$1,502 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 6 matching MRF lines |
$21.70–$280.70 | $31–$401 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$23.10–$187.60 | $33–$268 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$107.10–$313.60 | $153–$448 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$88.90–$313.60 | $127–$448 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$20.30–$280.70 | $29–$401 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$23.80–$187.60 | $34–$268 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$70–$313.60 | $100–$448 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$46.20–$313.60 | $66–$448 | varies |
| Radiologic exam teeth complete full mouth (70320) | $21.70 | $31 | 0.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $15.40 | $22 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$77–$313.60 | $110–$448 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$39.20–$187.60 | $56–$268 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 7 matching MRF lines |
$14.70–$233.80 | $21–$334 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $30.80 | $44 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $27.30 | $39 | 0.3× |
| Radiopharm Dacryocystography (78660) | $37.80 | $54 | 0.1× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $111.30 | $159 | 0.4× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $139.30 | $199 | 0.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $139.30 | $199 | 0.6× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $16.80 | $24 | 0.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 2 matching MRF lines |
$970.90 | $39–$1,387 | 1.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) range across 2 matching MRF lines |
$135.10–$690.20 | $193–$986 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) range across 2 matching MRF lines |
$100.10–$690.20 | $143–$986 | varies |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$46.20–$977.20 | $66–$1,396 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$24.50–$187.60 | $35–$268 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$59.50–$715.40 | $85–$1,022 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$61.60–$715.40 | $88–$1,022 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$83.30–$970.90 | $119–$1,387 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$66.50–$970.90 | $95–$1,387 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$90.30–$970.90 | $129–$1,387 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$172.20–$2,557.10 | $246–$3,653 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$119.70–$2,314.90 | $171–$3,307 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $156.10 | $223 | 0.6× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$163.80–$417.20 | $234–$596 | varies |
| Salivary Gland Function Study (78232) | $33.60 | $48 | 0.1× |
| Salivary Gland Imaging (78230) | $39.90 | $57 | 0.1× |
| Salivary Gland Imaging Serial Images (78231) | $37.10 | $53 | 0.1× |
| Scapula (73010) range across 6 matching MRF lines |
$16.80–$280.70 | $24–$401 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$42–$51.10 | $60–$73 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$16.80–$156.10 | $24–$223 | varies |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$14–$233.80 | $20–$334 | varies |
| Shoulder Arthrography (73040) range across 6 matching MRF lines |
$49.70–$935.90 | $71–$1,337 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$32.20–$427 | $46–$610 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$16.10–$187.60 | $23–$268 | varies |
| Special dosimetry (77331) | $84 | $120 | 0.6× |
| Special Physics Consult (77370) | $277.20 | $396 | 1.9× |
| Special teletherapy port plan (77321) | $91 | $130 | 0.2× |
| Special treatment procedure (77470) | $193.20 | $276 | 0.3× |
| Spleen Imaging (78185) range across 2 matching MRF lines |
$28.70–$715.40 | $41–$1,022 | varies |
| Srs Multisource (77371) range across 2 matching MRF lines |
$2,074.80–$13,169.10 | $2,964–$18,813 | varies |
| Stereotactic Body Radiation Delivery (77373) | $1,740.20 | $2,486 | 0.9× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$19.60–$156.10 | $28–$223 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$5,645.50 | $181–$8,065 | 1.7× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $72.10 | $103 | 1.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $109.20 | $156 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $277.20 | $396 | 0.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $135.10 | $193 | 0.3× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 5 matching MRF lines |
$46.90–$427 | $67–$610 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$60.90–$715.40 | $87–$1,022 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $149.80 | $214 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $101.50 | $145 | 0.3× |
| Ther rad simulaj-aided field setting simple (77280) | $67.90 | $97 | 0.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $190.40 | $272 | 1.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$18.20–$187.60 | $26–$268 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$19.60–$187.60 | $28–$268 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$18.90–$156.10 | $27–$223 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $57.40 | $82 | 0.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $58.10 | $83 | 0.1× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$31.50–$715.40 | $45–$1,022 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$70.70–$970.90 | $101–$1,387 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$715.40 | $23–$1,022 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$42.70–$715.40 | $61–$1,022 | varies |
| Tx Devices Design & Construction Complex (77334) | $109.90 | $157 | 0.3× |
| Tx devices design & construction intermediate (77333) | $71.40 | $102 | 0.5× |
| Tx devices design & construction simple (77332) | $43.40 | $62 | 0.3× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$58.80–$156.10 | $84–$223 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$49–$187.60 | $70–$268 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$51.10–$187.60 | $73–$268 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$44.10–$187.60 | $63–$268 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $139.99 | $199.99 | 1.5× |
| Unlisted magnetic resonance procedure (76498) | $156.10 | $223 | 1.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$133.70–$182.70 | $191–$261 | varies |
| Upper gi w/o kub (74240) | $70 | $100 | 0.4× |
| Ureteral Reflux Study (78740) | $49.70 | $71 | 0.1× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$29.40–$427 | $42–$610 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$28.70–$427 | $41–$610 | varies |
| Us bone density measurement (76977) | $15.40 | $22 | 0.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$63–$187.60 | $90–$268 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$52.50–$187.60 | $75–$268 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$78.40–$187.60 | $112–$268 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$44.10–$187.60 | $63–$268 | varies |
| Us head (76506) range across 2 matching MRF lines |
$55.30–$187.60 | $79–$268 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$64.40–$187.60 | $92–$268 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$59.50–$280.70 | $85–$401 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$165.90–$427 | $237–$610 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$57.40–$187.60 | $82–$268 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$65.80–$187.60 | $94–$268 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$60.20–$187.60 | $86–$268 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$86.10–$187.60 | $123–$268 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$74.90–$187.60 | $107–$268 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$63.70–$187.60 | $91–$268 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$50.40–$187.60 | $72–$268 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$56–$187.60 | $80–$268 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$130.90–$187.60 | $187–$268 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$49–$187.60 | $70–$268 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$57.40–$187.60 | $82–$268 | varies |
| Vascular Flow Imaging (78445) | $42.70 | $61 | 0.1× |
| Vasogram (74440) | $32.90 | $47 | 0.1× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$103.60–$2,814.70 | $148–$4,021 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$5,645.50 | $172–$8,065 | 1.7× |
| Vein X-Ray Skull Epidural (75872) range across 2 matching MRF lines |
$98–$1,122.10 | $140–$1,603 | varies |
| Vein X-Ray Spleen/Liver (75810) | $5,645.50 | $8,065 | 1.7× |
| Venogram Sinus/Jugular (75860) | $5,645.50 | $8,065 | 1.7× |
| Venography Adrenal Unilateral (75840) | $5,645.50 | $8,065 | 1.7× |
| Venography caval inferior serialography rs&i (75825) | $5,645.50 | $8,065 | 1.7× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$128.80–$2,814.70 | $184–$4,021 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$91–$2,814.70 | $130–$4,021 | varies |
| Venography Orbital Rs&I (75880) range across 2 matching MRF lines |
$60.20–$1,122.10 | $86–$1,603 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$5,645.50 | $203–$8,065 | 1.7× |
| Venography Renal Unilateral (75831) | $5,645.50 | $8,065 | 1.7× |
| Venous sampling by catheter (75893) | $9,949.10 | $14,213 | 1.7× |
| Venous thrombosis imaging (78457) range across 2 matching MRF lines |
$65.10–$970.90 | $93–$1,387 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$77.70–$715.40 | $111–$1,022 | varies |
| Vertebral fracture assessment via dxa (77086) | $15.40 | $22 | 0.2× |
| Wrist 2 views (73100) range across 7 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 5 matching MRF lines |
$17.50–$156.10 | $25–$223 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$44.10–$624.40 | $63–$892 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$177.10–$5,645.50 | $253–$8,065 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$19.60–$187.60 | $28–$268 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$28–$977.20 | $40–$1,396 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$28–$187.60 | $40–$268 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$16.80–$233.80 | $24–$334 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$19.60–$156.10 | $28–$223 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $187.60 | $268 | 1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$26.60–$187.60 | $38–$268 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$27.30–$187.60 | $39–$268 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$19.60–$156.10 | $28–$223 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$27.30–$187.60 | $39–$268 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$24.50–$187.60 | $35–$268 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| X-ray head for orthodontia (70350) | $34.30 | $49 | 0.4× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$15.40–$233.80 | $22–$334 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$42.70–$313.60 | $61–$448 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$42.70–$313.60 | $61–$448 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 5 matching MRF lines |
$16.80–$233.80 | $24–$334 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 6 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$19.60–$187.60 | $28–$268 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $28 | $40 | 0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$19.60–$187.60 | $28–$268 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$16.10–$187.60 | $23–$268 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$16.10–$156.10 | $23–$223 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $19.60 | $28 | 0.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$23.80–$187.60 | $34–$268 | varies |
| X-Ray Stress View (77071) | $108.50 | $155 | 1.2× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$21–$187.60 | $30–$268 | varies |
| X-Ray Tmj Unilat (70328) | $16.10 | $23 | 0.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$45.50–$624.40 | $65–$892 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$24.50–$187.60 | $35–$268 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$47.60–$187.60 | $68–$268 | varies |
| Xr c-spine 4 or 5 views (72050) | $24.50 | $35 | 0.2× |
| Xr facial bones less than 3 views (70140) range across 6 matching MRF lines |
$18.20–$233.80 | $26–$334 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 6 matching MRF lines |
$16.10–$280.70 | $23–$401 | varies |
| Xr myelogram posterior fossa (70010) | $95.90 | $137 | 0.3× |
| Xr orbits complete 4 views (70200) range across 6 matching MRF lines |
$23.80–$187.60 | $34–$268 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$50.40–$187.60 | $72–$268 | 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.