Imaging prices at Lake Cumberland Regional Hospital
Somerset, KY · every code in this section with a posted price and a Medicare benchmark.
333 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 |
$8,164.45–$8,899.25 | $20,411.13–$22,248.13 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$425.52–$544.02 | $1,063.80–$1,360.04 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$355.54–$544.02 | $888.86–$1,360.04 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,542.51–$1,681.34 | $3,856.28–$4,203.35 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$2,149.67–$2,343.14 | $5,374.18–$5,857.86 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$370.42–$457.28 | $926.05–$1,143.21 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,037.51–$1,130.89 | $2,593.78–$2,827.22 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,037.51–$1,130.89 | $2,593.78–$2,827.22 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,037.51–$1,130.89 | $2,593.78–$2,827.22 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$530.55–$578.30 | $1,326.38–$1,445.75 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$349.54–$564.37 | $873.86–$1,410.93 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,726.91–$1,882.34 | $4,317.28–$4,705.84 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,664.34–$1,814.13 | $4,160.84–$4,535.32 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$2,133.95–$2,326.01 | $5,334.88–$5,815.02 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$638.73–$696.21 | $1,596.82–$1,740.53 | varies |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$1,353.86–$1,475.71 | $3,384.66–$3,689.28 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$1,131.82–$1,233.68 | $2,829.55–$3,084.21 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$450.96–$491.55 | $1,127.40–$1,228.87 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$1,737.03–$1,893.36 | $4,342.57–$4,733.40 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$6,577.70–$7,169.70 | $16,444.26–$17,924.24 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$1,060.07–$1,155.48 | $2,650.18–$2,888.70 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$942.22–$1,027.02 | $2,355.54–$2,567.54 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$376.13–$424.08 | $940.32–$1,060.19 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$413.17–$465.84 | $1,032.92–$1,164.60 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$427.38–$465.84 | $1,068.44–$1,164.60 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$663.18–$722.86 | $1,657.94–$1,807.15 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$692.64–$754.98 | $1,731.60–$1,887.44 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 2 matching MRF lines |
$907.82–$989.53 | $2,269.56–$2,473.82 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$334.33–$415.52 | $835.83–$1,038.81 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$219.79–$263.53 | $549.47–$658.82 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,145.87 | $2,864.68 | 8.8× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$663.18–$722.86 | $1,657.94–$1,807.15 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,037.51–$1,130.89 | $2,593.78–$2,827.22 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,037.51–$1,130.89 | $2,593.78–$2,827.22 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$5,557.34–$6,057.50 | $13,893.36–$15,143.76 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$3,666.27–$3,996.24 | $9,165.68–$9,990.59 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,096.64–$2,285.34 | $5,241.61–$5,713.35 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,721.19–$2,966.10 | $6,802.97–$7,415.24 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,790.90–$1,952.08 | $4,477.25–$4,880.20 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$5,858.98–$6,444.88 | $14,647.45–$16,112.19 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,140.19–$2,332.80 | $5,350.47–$5,832.01 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$2,438.19–$2,749.04 | $6,095.47–$6,872.59 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,040.92–$1,134.60 | $2,602.29–$2,836.50 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,052.50–$6,103.07 | $7,631.25–$15,257.67 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$3,258.90–$3,781.32 | $8,147.24–$9,453.31 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,236.02–$2,438.19 | $5,590.04–$6,095.47 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$2,070.58–$2,738.56 | $5,176.45–$6,846.41 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,478.81–$2,701.90 | $6,197.03–$6,754.76 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$2,305.20–$2,775.22 | $5,762.99–$6,938.06 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,686.36–$1,838.13 | $4,215.90–$4,595.33 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,141.94–$2,334.71 | $5,354.84–$5,836.78 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$2,652.72–$2,891.46 | $6,631.79–$7,228.65 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$3,469.15–$3,781.37 | $8,672.87–$9,453.43 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$1,040.92–$1,134.60 | $2,602.29–$2,836.50 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$143.39–$383.58 | $358.47–$958.94 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$1,040.92–$1,134.60 | $2,602.29–$2,836.50 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$2,486.66–$2,859.34 | $6,216.64–$7,148.34 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$2,257.32–$2,460.48 | $5,643.29–$6,151.19 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,850.13–$2,016.64 | $4,625.32–$5,041.60 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$2,155–$2,348.95 | $5,387.50–$5,872.38 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$2,070.58–$2,427.97 | $5,176.45–$6,069.93 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$2,197.68–$2,395.47 | $5,494.19–$5,988.67 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$1,871.15–$2,485.58 | $4,677.88–$6,213.96 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$1,935.51–$6,857.96 | $4,838.77–$17,144.90 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$3,577.24–$3,899.19 | $8,943.10–$9,747.98 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$2,305.20–$3,492.24 | $5,762.99–$8,730.59 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,281.34–$2,486.66 | $5,703.34–$6,216.64 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,114.06–$2,304.32 | $5,285.15–$5,760.81 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,877.13–$2,046.07 | $4,692.82–$5,115.17 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,800.46–$3,052.50 | $7,001.15–$7,631.25 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$2,330.85–$2,599.10 | $5,827.12–$6,497.75 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,752.92–$3,000.68 | $6,882.29–$7,501.70 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,411.02–$2,628.02 | $6,027.56–$6,570.04 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$2,070.58–$2,427.97 | $5,176.45–$6,069.93 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$2,197.68–$2,395.47 | $5,494.19–$5,988.67 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$2,257.32–$2,460.48 | $5,643.29–$6,151.19 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,379.75–$1,503.93 | $3,449.38–$3,759.82 | varies |
| CT unlisted procedure (76497) | $143.39 | $358.47 | 1.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,448.57–$1,578.94 | $3,621.43–$3,947.36 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,578.94–$2,438.19 | $3,947.36–$6,095.48 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,751.70–$1,909.35 | $4,379.25–$4,773.38 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$3,074.84–$3,351.57 | $7,687.09–$8,378.93 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$3,074.84–$3,351.57 | $7,687.09–$8,378.93 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,839.65–$3,095.22 | $7,099.13–$7,738.05 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,502.22–$1,637.42 | $3,755.54–$4,093.54 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$6,443.15–$7,023.03 | $16,107.87–$17,557.58 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$6,443.15–$7,023.03 | $16,107.87–$17,557.58 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$594.40–$647.90 | $1,486–$1,619.74 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$594.40–$647.90 | $1,486–$1,619.74 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$405.78–$442.30 | $1,014.44–$1,105.74 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$605.21–$659.68 | $1,513.03–$1,649.20 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$1,041–$1,172.65 | $2,602.51–$2,931.63 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$848.88–$925.28 | $2,122.19–$2,313.19 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$734.90–$801.04 | $1,837.25–$2,002.60 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$307.74–$346.97 | $769.34–$867.42 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$305.86–$409.09 | $764.64–$1,022.73 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,608.51–$2,843.27 | $6,521.27–$7,108.18 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$2,650.84–$2,889.42 | $6,627.10–$7,223.54 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$362.83–$409.09 | $907.08–$1,022.73 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,838.23–$2,003.67 | $4,595.58–$5,009.18 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,838.23–$2,003.67 | $4,595.58–$5,009.18 | varies |
| Ht Musc Image Planar Mult (78454) range across 2 matching MRF lines |
$2,700.86–$2,943.93 | $6,752.14–$7,359.83 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,700.86–$2,943.93 | $6,752.14–$7,359.83 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$893.07–$973.45 | $2,232.68–$2,433.62 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$245.62–$267.73 | $614.06–$669.33 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$217.85–$237.46 | $544.63–$593.65 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$4,565.60–$4,976.51 | $11,414.01–$12,441.27 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,899.13–$2,070.05 | $4,747.83–$5,175.13 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$1,542.51–$1,681.34 | $3,856.28–$4,203.35 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$2,847.24–$3,103.50 | $7,118.11–$7,758.74 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$603.12–$680.02 | $1,507.81–$1,700.05 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$1,614.22–$1,759.50 | $4,035.56–$4,398.76 | varies |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$1,255.62–$1,368.62 | $3,139.04–$3,421.55 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$3,000.80–$3,270.87 | $7,501.99–$8,177.17 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$2,362.64–$2,575.27 | $5,906.59–$6,438.18 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$2,847.24–$3,103.50 | $7,118.11–$7,758.74 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,297.51–$2,504.29 | $5,743.78–$6,260.72 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$779.11–$849.23 | $1,947.77–$2,123.07 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$779.11–$849.23 | $1,947.77–$2,123.07 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,977.76–$2,155.76 | $4,944.39–$5,389.39 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$9,786.54–$10,667.33 | $24,466.35–$26,668.32 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$162–$176.58 | $405–$441.45 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.27 | $123.17 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$168.80–$183.99 | $422–$459.98 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$109.20–$119.03 | $273–$297.57 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$444.80–$484.83 | $1,112–$1,212.08 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,463.77–$2,685.51 | $6,159.43–$6,713.78 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,288.43–$2,494.39 | $5,721.08–$6,235.98 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,376.10–$2,589.95 | $5,940.26–$6,474.88 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,376.10–$2,589.95 | $5,940.26–$6,474.88 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,463.77–$2,685.51 | $6,159.43–$6,713.78 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$2,288.43–$2,494.39 | $5,721.08–$6,235.98 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,982.22–$3,250.62 | $7,455.55–$8,126.55 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,898.33–$3,159.18 | $7,245.82–$7,897.94 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,927.23–$3,190.68 | $7,318.07–$7,976.70 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,041.51–$3,315.25 | $7,603.78–$8,288.12 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,973.91–$3,241.56 | $7,434.77–$8,103.90 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$1,631.71–$1,778.57 | $4,079.28–$4,446.42 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$1,631.71–$1,778.57 | $4,079.28–$4,446.42 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$3,108.10–$3,387.83 | $7,770.25–$8,469.57 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$3,081.98–$3,359.36 | $7,704.95–$8,398.40 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,624.88–$1,771.12 | $4,062.21–$4,427.81 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,713.30–$1,867.50 | $4,283.26–$4,668.75 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,800.21–$1,962.23 | $4,500.53–$4,905.58 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,973.91–$3,241.56 | $7,434.77–$8,103.90 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,076.69–$3,353.59 | $7,691.72–$8,383.97 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,902.11–$3,163.30 | $7,255.28–$7,908.26 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,812.18–$3,065.27 | $7,030.44–$7,663.18 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$3,134.22–$3,416.30 | $7,835.54–$8,540.74 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$3,081.98–$3,359.36 | $7,704.95–$8,398.40 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$3,169.65–$3,454.92 | $7,924.13–$8,637.30 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,240.70–$3,532.36 | $8,101.74–$8,830.90 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,982.22–$3,250.62 | $7,455.55–$8,126.55 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$3,069.13–$3,345.35 | $7,672.83–$8,363.38 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,894.57–$3,155.08 | $7,236.42–$7,887.70 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,724.50–$2,969.71 | $6,811.26–$7,424.27 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,927.98–$3,191.50 | $7,319.96–$7,978.76 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,902.11–$3,191.50 | $7,255.28–$7,978.76 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,076.69–$3,353.59 | $7,691.72–$8,383.97 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$3,073.66–$3,350.29 | $7,684.16–$8,375.73 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,898.33–$3,159.18 | $7,245.82–$7,897.94 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,812.18–$3,065.27 | $7,030.44–$7,663.18 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,902.11–$3,163.30 | $7,255.28–$7,908.26 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,999.78–$3,269.76 | $7,499.45–$8,174.40 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,898.33–$3,159.18 | $7,245.82–$7,897.94 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$1,956.12–$2,132.18 | $4,890.31–$5,330.44 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$6,577.70–$7,169.70 | $16,444.26–$17,924.24 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$2,700.86–$2,943.93 | $6,752.14–$7,359.83 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,700.86–$2,943.93 | $6,752.14–$7,359.83 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$360.93–$406.94 | $902.32–$1,017.36 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$11,369.32–$12,392.56 | $28,423.29–$30,981.39 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$2,168.35–$2,363.50 | $5,420.87–$5,908.75 | varies |
| Optic foramina (70190) range across 2 matching MRF lines |
$549.22–$598.65 | $1,373.05–$1,496.62 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$487.31–$531.16 | $1,218.27–$1,327.91 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,184.88–$1,291.52 | $2,962.20–$3,228.80 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$498.65–$562.23 | $1,246.63–$1,405.57 | varies |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$6,463.52–$7,045.24 | $16,158.80–$17,613.09 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$2,133.95–$2,326.01 | $5,334.88–$5,815.02 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$563.24–$715.36 | $1,408.09–$1,788.40 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$663.18–$722.86 | $1,657.94–$1,807.15 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$437.44–$592.20 | $1,093.61–$1,480.51 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$286.67–$425.15 | $716.68–$1,062.87 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$438.82–$728.23 | $1,097.05–$1,820.57 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$425.52–$591.14 | $1,063.80–$1,477.84 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$316.32–$427.31 | $790.81–$1,068.27 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$508.15–$632.92 | $1,270.37–$1,582.29 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$432.17–$598.65 | $1,080.43–$1,496.62 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$386.58–$852.94 | $966.46–$2,132.35 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$521.10–$640.41 | $1,302.74–$1,601.02 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$435.96–$491.55 | $1,089.90–$1,228.87 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$670.99–$748.57 | $1,677.47–$1,871.43 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$476.81–$526.89 | $1,192.03–$1,317.23 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$389.43–$464.78 | $973.58–$1,161.96 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$833.15–$908.14 | $2,082.88–$2,270.34 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$375.31–$590.06 | $938.28–$1,475.16 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$405.57–$507.62 | $1,013.92–$1,269.04 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$474.90–$612.55 | $1,187.25–$1,531.37 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$292.54–$329.85 | $731.36–$824.62 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$345.74–$389.81 | $864.34–$974.53 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$444.41–$546.16 | $1,111.02–$1,365.40 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $9,747.42 | $24,368.55 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $802.11 | $2,005.27 | 8.1× |
| Radiation treatment delivery level 2 (77407) | $934.90 | $2,337.24 | 2.5× |
| Radiation treatment delivery level 3 (77412) | $1,066.62 | $2,666.54 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$582.08–$715.36 | $1,455.20–$1,788.40 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$387.54–$544.02 | $968.86–$1,360.04 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,180.95–$1,287.24 | $2,952.38–$3,218.09 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$948.10–$1,033.43 | $2,370.26–$2,583.58 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$606.94–$684.33 | $1,517.36–$1,710.82 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$498.65–$562.23 | $1,246.63–$1,405.57 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$833.15–$908.14 | $2,082.88–$2,270.34 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$631.74–$688.60 | $1,579.35–$1,721.49 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$816.45–$889.93 | $2,041.12–$2,224.82 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$494.19–$538.66 | $1,235.47–$1,346.66 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$438.30–$538.66 | $1,095.75–$1,346.66 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$282.10–$318.06 | $705.24–$795.14 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$1,085.64–$1,183.35 | $2,714.11–$2,958.38 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$361.63–$488.34 | $904.08–$1,220.85 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$670.99–$731.38 | $1,677.47–$1,828.44 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,542.51–$1,681.34 | $3,856.28–$4,203.35 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$2,608.51–$2,843.27 | $6,521.27–$7,108.18 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$3,791.41–$4,132.64 | $9,478.52–$10,331.59 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$1,579.60–$1,814.13 | $3,948.99–$4,535.32 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,257.59–$1,370.78 | $3,143.98–$3,426.94 | varies |
| Salivary Gland Imaging (78230) range across 2 matching MRF lines |
$921.24–$1,004.15 | $2,303.10–$2,510.38 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$259.30–$292.36 | $648.26–$730.89 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$70.09–$76.40 | $175.22–$190.99 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$585.56–$638.26 | $1,463.91–$1,595.66 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$453.91–$494.76 | $1,134.78–$1,236.91 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,068.95–$1,165.16 | $2,672.38–$2,912.89 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$425.52–$479.78 | $1,063.80–$1,199.44 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$986.42–$1,075.19 | $2,466.04–$2,687.98 | varies |
| Special Physics Consult (77370) | $919.91 | $2,299.78 | 7.1× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,286.07–$1,401.82 | $3,215.18–$3,504.55 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,116.28–$2,306.74 | $5,290.69–$5,766.85 | varies |
| Spleen Imaging (78185) range across 2 matching MRF lines |
$543.31–$592.20 | $1,358.27–$1,480.51 | varies |
| Stereotactic Body Radiation Delivery (77373) | $5,200.34 | $13,000.86 | 3.0× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$420.77–$474.41 | $1,051.92–$1,186.02 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$3,929.94–$4,283.64 | $9,824.86–$10,709.10 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$735.88–$802.11 | $1,839.70–$2,005.27 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$1,100.39–$1,199.42 | $2,750.97–$2,998.56 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,755.70–$1,913.71 | $4,389.24–$4,784.27 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,286.07–$1,401.82 | $3,215.18–$3,504.55 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$818.42–$892.07 | $2,046.04–$2,230.18 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$468.82–$576.16 | $1,172.04–$1,440.39 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$624.86–$681.10 | $1,562.15–$1,702.74 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$486.34–$530.11 | $1,215.84–$1,325.27 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$922.56–$1,005.59 | $2,306.39–$2,513.97 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$657.28–$716.43 | $1,643.19–$1,791.08 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,742.92–$1,899.79 | $4,357.31–$4,749.47 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,401.04–$1,527.13 | $3,502.59–$3,817.82 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$935.32–$1,019.50 | $2,338.30–$2,548.75 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$471.58–$514.02 | $1,178.95–$1,285.06 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$679.13–$765.71 | $1,697.82–$1,914.28 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$852.54–$929.27 | $2,131.36–$2,323.18 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$248.22–$1,130.30 | $620.55–$2,825.75 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$823.49–$928.48 | $2,058.72–$2,321.19 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$851.81–$928.48 | $2,129.53–$2,321.19 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$833.15–$908.14 | $2,082.88–$2,270.34 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$948.10–$1,033.43 | $2,370.26–$2,583.58 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$679.13–$765.71 | $1,697.82–$1,914.28 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$590.78–$666.11 | $1,476.96–$1,665.27 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$603–$741.07 | $1,507.50–$1,852.68 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$891.43–$971.66 | $2,228.58–$2,429.15 | varies |
| Us head (76506) range across 2 matching MRF lines |
$245.62–$267.73 | $614.06–$669.33 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$1,451.31–$1,636.34 | $3,628.27–$4,090.86 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$360.96–$393.45 | $902.40–$983.62 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$977.36–$1,101.96 | $2,443.39–$2,754.91 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$683.87–$1,008.80 | $1,709.67–$2,522.01 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$532.84–$600.79 | $1,332.11–$1,501.97 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$971.66–$1,095.54 | $2,429.15–$2,738.84 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$369.48–$416.59 | $923.71–$1,041.47 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$610.73–$688.60 | $1,526.83–$1,721.49 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$848.20–$1,274.40 | $2,120.50–$3,185.99 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$778.16–$898.48 | $1,945.41–$2,246.21 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$784.54–$884.57 | $1,961.36–$2,211.42 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$221.05–$240.94 | $552.62–$602.36 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$689.72–$751.79 | $1,724.29–$1,879.48 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,323.58–$2,532.71 | $5,808.96–$6,331.77 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$5,768.72–$6,287.91 | $14,421.81–$15,719.77 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,323.58–$2,532.71 | $5,808.96–$6,331.77 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,086.63–$1,184.43 | $2,716.58–$2,961.07 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$1,944.34–$2,119.34 | $4,860.86–$5,298.34 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$623.87–$680.02 | $1,559.68–$1,700.05 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$383.16–$417.64 | $957.90–$1,044.11 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$443.56–$550.45 | $1,108.90–$1,376.13 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$524.66–$571.88 | $1,311.65–$1,429.70 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$6,412.68–$6,989.82 | $16,031.70–$17,474.55 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$852.94–$961.68 | $2,132.35–$2,404.20 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$294.44–$331.99 | $736.11–$829.97 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$264.52–$855.14 | $661.29–$2,137.86 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$486.34–$530.11 | $1,215.84–$1,325.27 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$390.04–$425.15 | $975.11–$1,062.87 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$474.90–$535.45 | $1,187.25–$1,338.63 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$435.69–$474.90 | $1,089.22–$1,187.25 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$435.69–$474.90 | $1,089.22–$1,187.25 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$474.90–$703.60 | $1,187.25–$1,759 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$745.60–$1,070.91 | $1,864.01–$2,677.28 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$492.02–$590.06 | $1,230.04–$1,475.16 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$700.01–$895.27 | $1,750.03–$2,238.17 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$731.38–$824.62 | $1,828.44–$2,061.55 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$405.57–$507.62 | $1,013.92–$1,269.04 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,306.71–$1,424.31 | $3,266.77–$3,560.78 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$1,697.74–$1,850.53 | $4,244.34–$4,626.33 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$582.08–$634.47 | $1,455.20–$1,586.17 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$603.12–$680.02 | $1,507.81–$1,700.05 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$596.49–$672.54 | $1,491.23–$1,681.34 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$188.63–$205.60 | $471.57–$514.01 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$731.38–$925.28 | $1,828.44–$2,313.19 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$464.46–$1,655.54 | $1,161.16–$4,138.84 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$487.27–$1,655.54 | $1,218.18–$4,138.84 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$422.66–$476.56 | $1,056.66–$1,191.39 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$523.35–$590.06 | $1,308.37–$1,475.16 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$603.12–$680.02 | $1,507.81–$1,700.05 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$435.69–$474.90 | $1,089.22–$1,187.25 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$778.12–$848.16 | $1,945.31–$2,120.39 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$427.38–$465.84 | $1,068.44–$1,164.60 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$1,106.53–$1,247.61 | $2,766.33–$3,119.02 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$678.17–$751.67 | $1,695.43–$1,879.18 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$491.24–$535.45 | $1,228.10–$1,338.63 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$579.48–$712.15 | $1,448.69–$1,780.37 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$992.32–$1,081.63 | $2,480.81–$2,704.08 | 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.