Imaging prices at Lakeside Medical Center

Belle Glade, FL · every code in this section with a posted price and a Medicare benchmark.

552 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $1,373.43 — 1.0×
Abdomen 1 View (74018)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
Abdomen 2 views (74019) $106.74 $261 1.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $403.35 $1,251 1.0×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $1,310.41 — 1.0×
Adrenal Cortex & Medulla Img (78075) $1,310.41 — 1.0×
Angio internal mammary (75756) $3,159.40 — 1.0×
Angio pulmonary bilat (75743) $3,159.40 — 1.0×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $3,159.40 — 1.0×
Angiography extremity bilateral rs&i (75716) $3,159.40 — 1.0×
Angiography extremity unilateral rs&i (75710) $3,159.40 — 1.0×
Angiography pulmonary unilateral slctv rs&i (75741) $3,159.40 — 1.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $3,159.40 — 1.0×
Ankle 2 views (73600)
range across 5 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Aortography thoracic serialography rs&i (75605) $5,426.13 — 0.9×
Aortography thoracic w/o serialography rs&i (75600) $3,159.40 — 1.0×
Artery X-Rays Abdomen (75726) $5,426.13 — 0.9×
Artery X-Rays Adrenal Gland (75731) $3,159.40 — 1.0×
Artery X-Rays Pelvis (75736) $5,426.13 — 0.9×
Artery X-Rays Spine (75705) $5,426.13 — 0.9×
Arthrogram ankle (73615) $358.48 $1,996 1.0×
Arthrogram hip (73525) $358.48 — 1.0×
Arthrogram Wrist (73115)
range across 2 matching MRF lines		 $272.50–$358.48 $545 varies
Basic radiation dosimetry calculation (77300) $133.27 — 0.9×
Bone age studies (77072)
range across 2 matching MRF lines		 $87–$106.74 $174 varies
Bone Imaging 3 Phase (78315) $403.35 $1,293 1.0×
Bone Imaging Limited Area (78300) $403.35 $1,105 1.0×
Bone Imaging Multiple Areas (78305) $403.35 — 1.0×
Bone Imaging Whole Body (78306) $403.35 $1,091 1.0×
Bone marrow imaging limited area (78102) $403.35 — 1.0×
Bone marrow imaging; multiple areas (78103) $403.35 — 1.0×
Bone marrow imaging; whole body (78104) $403.35 — 1.0×
Bone survey infant (77076) $106.74 $739 1.0×
Brachytx isodose complex (77318) $367.45 — 0.9×
Brachytx isodose intermed (77317) $367.45 — 0.9×
Brachytx Isodose Plan Simple (77316) $367.45 — 0.9×
Brain Flow Imaging Only (78610) $540.30 $1,171 1.0×
Brain Image W/Flow < 4 Views (78601) $403.35 — 1.0×
Brain imaging < 4 static views (78600) $403.35 — 1.0×
Brain Imaging Min 4 Static Views W Vascular Flow (78606)
range across 2 matching MRF lines		 $452–$540.30 $904 varies
Brain Imaging Minimum 4 Static Views (78605)
range across 2 matching MRF lines		 $447.50–$540.30 $895 varies
Brain Imaging Pet Metabolic Evaluation (78608) $1,464.10 — 1.0×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $403.35 — 1.0×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $540.30 — 1.0×
Cardiac MRI w/w/o contrast & further seq (75561) $358.48 — 1.0×
Cardiac MRI w/w/o contrast w/stress (75563) $793.05 — 1.0×
Cardiac Shunt Detection (78428) $403.35 — 1.0×
Cardiovasc nucl exam unlisted (78499) $403.35 — 1.0×
Cat Scan Follow-Up Study (76380) $88.38 — 1.0×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $540.30 — 1.0×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $540.30 — 1.0×
Cerebrospinal Fluid Scan (78630) $540.30 — 1.0×
Chest 1 view (71045) $88.38 $247 1.0×
Chest 2 views (71046) $88.38 $247 1.0×
Chest 3 views (71047) $88.38 $217 1.0×
Chest 4 or more views (71048) $106.74 $235 1.0×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $106.74 — 1.0×
Cholecystography Oral Contrast (74290)
range across 2 matching MRF lines		 $170.50–$178.69 $341 varies
Cineradiograpy/vidradiograpy xcpt where spec (76120) $106.74 $279 1.0×
Cisternography Positive Contrast Rs&I (70015) $793.05 — 1.0×
Clavicle complete (73000)
range across 4 matching MRF lines		 $88.38 $190–$345 1.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $106.74 $261 1.0×
Continuing medical physics consltj pr wk (77336) $133.27 — 0.9×
Contrast Exam Abdominl Aorta (75625) $3,159.40 — 1.0×
Contrast X-Ray Bladder (74430) $358.48 $786 1.0×
Contrast X-Ray Of Elbow (73085)
range across 2 matching MRF lines		 $207–$358.48 $414 varies
Contrast X-Ray Of Knee Joint (73580) $358.48 $1,090 1.0×
Contrast Xray Throat/Cerv Esopha (74210) $178.69 — 1.0×
Corpora cavernosography (74445) $106.74 — 1.0×
CT abdomen and pelvis without and with contrast (74178) $358.48 $3,255 1.0×
CT abdomen and pelvis without contrast (74176) $242.63 $2,940 1.0×
CT abdomen w contrast (74160) $178.69 $1,760 1.0×
CT abdomen w wo contrast (74170) $178.69 $482 1.0×
CT abdomen w/o contrast (74150) $106.74 $1,760 1.0×
CT Angio Abdomen and Pelvis (74174) $358.48 $1,775 1.0×
CT Angio Chest (71275) $178.69 $1,293 1.0×
CT Angio Head (70496) $178.69 $1,584 1.0×
CT angio hrt w/3d image (75574) $358.48 — 1.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $178.69 $672 1.0×
CT Angio Neck (70498) $178.69 $2,218 1.0×
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 2 matching MRF lines		 $178.69 $672–$1,344 1.0×
CT bone density (77078) $88.38 — 1.0×
CT cervical spine w/ contrast (72126) $358.48 $1,145 1.0×
CT cervical spine w/o contrast (72125) $106.74 $1,203 1.0×
CT cervical spine w/wo cont (72127) $178.69 $1,087 1.0×
CT chest w contrast (71260) $178.69 $1,790 1.0×
CT chest w/wo contrast (71270) $178.69 $1,087 1.0×
CT colonography screening (74263) $242.63 — 1.0×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $178.69 — 1.0×
CT colonogrphy dx image postprocess w/o contrast (74261) $106.74 — 1.0×
CT head/brain with contrast (70460) $178.69 $1,668 1.0×
CT head/brain without and with contrast (70470) $178.69 $940 1.0×
CT heart contrast eval cardiac structure&morph (75572) $358.48 — 1.0×
CT heart no contrast quant eval coronry calcium (75571) $88.38 — 1.0×
CT hrt w/3d image congen (75573) $358.48 — 1.0×
CT iac w contrast (70481) $178.69 $1,142 1.0×
CT l-spine w&w/o contrast (72133) $178.69 $1,775 1.0×
CT lower ext w/o (73700) $106.74 $320 1.0×
CT lower extremity w/contrast material (73701)
range across 2 matching MRF lines		 $178.69 $672–$1,344 1.0×
CT lumbar spine w contrast (72132) $358.48 $1,203 1.0×
CT lumbar spine w/o contrast (72131) $106.74 $906 1.0×
CT maxillofacial w contrast (70487) $178.69 $1,172 1.0×
CT maxillofacial wo contrast (70486) $106.74 $940 1.0×
CT neck tissue combo (70492) $178.69 $1,428 1.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $178.69 $940 1.0×
CT orbits w/o contrast (70480) $106.74 $1,024 1.0×
CT pelvis w&w/o contrast (72194) $178.69 $862 1.0×
CT pelvis w/o contrast (72192) $106.74 $1,329 1.0×
CT scan of leg combo (73702) $178.69 $672 1.0×
CT scans face/jaw combo (70488) $178.69 $1,142 1.0×
CT soft tissue neck w contrast (70491) $178.69 $1,428 1.0×
CT soft tissue neck w/o contrast (70490) $106.74 $1,318 1.0×
CT thoracic spine w contrast (72129) $178.69 $1,145 1.0×
CT thoracic spine w/o contrast (72128) $106.74 $1,203 1.0×
CT thoracic spine w/wo cont (72130) $178.69 — 1.0×
CT thorax w/o contrast (71250) $106.74 $1,747 1.0×
CT unlisted procedure (76497) $88.38 — 1.0×
CT upper ext wo (73200) $106.74 $320 1.0×
CT upper extremity w/o & w/contrast material (73202) $178.69 $672 1.0×
CT upper extremity with contrast (73201)
range across 4 matching MRF lines		 $160–$358.48 $320–$987 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $178.69 $368–$2,612 1.0×
Cta Abdomen (74175) $178.69 $1,911 1.0×
CTA pelvis (72191) $178.69 $1,223 1.0×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) $242.63 — 1.0×
Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) $540.30 — 1.0×
Dilation ureters/urethra rs&i (74485) $2,056.25 — 0.9×
Discography Cerv/Thor Spine (72285) $1,960.15 — 1.0×
Diskography lumbar (72295) $1,960.15 — 1.0×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $106.74 — 1.0×
Doppler Echo Fetal Spectral Display Complete (76827) $106.74 — 1.0×
Doppler Fetal Mid Cerebral Artery (76821) $106.74 $261 1.0×
Dxa Bone Density Axial (77080) $106.74 $406 1.0×
Dxa bone density study (77085) $106.74 — 1.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $88.38 $271 1.0×
Echo exam of fetal heart (76825) $550.37 — 1.0×
Echo exam uterus (76831)
range across 2 matching MRF lines		 $237.50–$242.63 $475 varies
Echo Guide For Artery Repair (76936) $312.58 — 1.4×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $242.63 — 1.0×
Echograp Trans R Pros Study (76873) $106.74 — 1.0×
Esophageal Motility Study (78258) $403.35 — 1.0×
Esophagram (74220) $178.69 $390 1.0×
Fetal Biophys Profile W/Nst (76818) $106.74 $375 1.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $106.74 $336 1.0×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $242.63 — 1.0×
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines		 $239–$242.63 $478 varies
Follow-Up Angiography (75898) $3,159.40 — 1.0×
Foot 2 views (73620)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Forearm 2 views (73090)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Gastric emptying imaging study (78264) $403.35 $1,016 1.0×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $403.35 — 1.0×
Gastric Mucosa Imaging (78261) $403.35 — 1.0×
Gastroesophageal Reflux Exam (78262) $403.35 — 1.0×
Gastrointestinal Protein Loss (78282) $403.35 — 1.0×
Gated Heart Planar Single (78472) $403.35 — 1.0×
Gated Heart, Multiple (78473) $403.35 — 1.0×
GI Endoscopic US S&I (76975) $242.63 — 1.0×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $540.30 — 1.0×
Hand 2 views (73120) $106.74 $286 1.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $696.43 — 1.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $696.43 — 1.0×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $696.43 — 1.0×
Heart first pass single,planar (78481)
range across 2 matching MRF lines		 $480.50–$540.30 $961 varies
Heart Image (Pet) Multiple (78492) $1,464.10 — 1.0×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,159.40 — 1.0×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,159.40 — 1.0×
Hepatobil Syst Image W/Drug (78227) $540.30 $1,251 1.0×
Hepatobiliary System Imaging (78226) $403.35 $904 1.0×
High energy neutron radj tx dlvr 1/> isocenter (77423) $580.66 — 1.0×
Ht Musc Image Planar Mult (78454)
range across 2 matching MRF lines		 $702–$1,310.41 $1,404 varies
Ht Muscle Image Spect Sing (78451) $1,310.41 $3,461 1.0×
Hyperthermia external generated superficial (77600) $263.97 — 0.7×
Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) $580.66 — 1.0×
Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) $580.66 — 1.0×
Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) $580.66 — 1.0×
Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) $696.43 — 1.0×
Hysterosalpingogram (74740)
range across 2 matching MRF lines		 $182–$242.63 $364 varies
Image fusion (77399) $133.27 — 0.9×
Infant hip ultrasound with hip movement (dynamic) (76885) $88.38 $1,155 1.0×
Infant hip ultrasound, limited static exam (76886) $88.38 — 1.0×
Infusion Ivp (74410) $178.69 — 1.0×
Interstitial radiation source applic complex (77778) $696.43 — 1.0×
Intracavitary Radiation Source Applic Complex (77763) $696.43 — 1.0×
Intracavitary Radiation Source Applic Intermed (77762) $580.66 — 1.0×
Intracavitary radiation source applic simple (77761) $580.66 — 1.0×
Intraop radiaj tx deliver electrons sngl tx sess (77425) $7,673.39 — 1.0×
Intraop radiaj tx deliver xray single tx session (77424) $7,673.39 — 1.0×
Joint Survey Single View (77077) $106.74 — 1.0×
K Flow/Funct Image Multiple (78709) $540.30 — 1.0×
K Flow/Funct Image W/Drug (78708)
range across 2 matching MRF lines		 $452–$540.30 $904 varies
K Flow/Funct Image W/O Drug (78707)
range across 2 matching MRF lines		 $447.50–$540.30 $895 varies
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $403.35 — 1.0×
Kidney Imaging Morphol (78700) $403.35 $895 1.0×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $403.35 $895 1.0×
Knee 3 Views (73562)
range across 3 matching MRF lines		 $88.38 $183–$366 1.0×
Labeled RBC Sequestration Differntl Organ/Tissue (78140) $403.35 — 1.0×
Leveen/Shunt Patency Exam (78291) $403.35 — 1.0×
Liver & Spleen Imaging Static Only (78215) $403.35 $895 1.0×
Liver & Spleen Imaging W/Vascular Flow (78216) $403.35 $904 1.0×
Liver imaging static only (78201) $540.30 $3,461 1.0×
Liver imaging w/vascular flow (78202) $540.30 $3,461 1.0×
Lung Perf&Ventilat Diferentl (78598) $540.30 — 1.0×
Lung perfusion differential (78597) $403.35 — 1.0×
Lung Ventilat&Perfus Imaging (78582) $540.30 $1,314 1.0×
Lung Ventilation Imaging (78579) $403.35 $895 1.0×
Lymph System Imaging (78195) $540.30 $1,106 1.0×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $1,559.31 — 0.9×
Lymphangiography extremity only unilateral rs&i (75801) $620.60 — 0.9×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $3,159.40 — 1.0×
Lymphangiography, pelvic/abdominal, unilateral (75805) $3,159.40 — 1.0×
Magnetic Image Jaw Joint (70336) $242.63 $1,570 1.0×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $178.69 — 1.0×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $550.37 — 1.0×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $178.69 — 1.0×
Magnetic Resonance Elastography (76391) $242.63 — 1.0×
Mammary ductogram or galactogram multiple (77054) $242.63 — 1.0×
Mammary ductogram or galactogram single (77053) $242.63 — 1.0×
Meckels Divert Exam (78290) $403.35 $944 1.0×
Medical physics dose eval radiation expos w/rprt (76145) $532.61 — 1.4×
Mlc imrt design & construction per imrt plan (77338) $367.45 — 0.9×
Mr safety determination physician/other qhp (76016) $88.38 — 1.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $24.58 — 0.8×
Mr safety implt electronics prepj supvj phys/qhp (76018) $92.14 — 0.9×
Mr safety implt pos&/immoblj (76019) $59.62 — 1.0×
Mr safety med physics xm customization plng&mntr (76017) $242.63 — 1.0×
Mra Head W/O & W/Contrast Material (70546) $358.48 $4,568 1.0×
MRA head w/o contrast (70544) $242.63 $2,931 1.0×
MRA head with contrast (70545) $358.48 $3,130 1.0×
MRA neck w contrast (70548) $358.48 $3,130 1.0×
Mra Neck W/O &W/Contrast Material (70549) $358.48 $4,568 1.0×
MRA neck w/o contrast (70547) $242.63 $2,931 1.0×
MRI abdomen w contrast (74182) $358.48 $2,688 1.0×
MRI abdomen w/o contrast (74181) $242.63 $2,688 1.0×
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines		 $644.50–$793.05 $1,289–$3,200 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 2 matching MRF lines		 $358.48 $1,289–$3,255 1.0×
MRI any jt upper extremity w/contrast matrl (73222) $793.05 $2,578 1.0×
MRI bone marrow blood supply (77084) $242.63 — 1.0×
MRI brain functional w/o physician admnistration (70554) $242.63 — 1.0×
MRI brain functional w/physician admnistration (70555) $242.63 — 1.0×
MRI Breast W/O Contrast Bilateral (77047) $242.63 — 1.0×
MRI Breast Without Contrast Material Unilateral (77046) $242.63 — 1.0×
MRI cardiac w/o cont stress (75559) $550.37 — 1.0×
MRI cardiac w/o contrast (75557) $242.63 — 1.0×
MRI cervical spine w contrast (72142) $358.48 $3,118 1.0×
MRI cervical spine w/o cont (72141) $242.63 $3,038 1.0×
MRI chest w/o contrast (71550) $242.63 $2,688 1.0×
MRI chest with contrast (71551) $793.05 $1,711 1.0×
MRI chest wo w contrast (71552) $358.48 $881 1.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 2 matching MRF lines		 $358.48 $1,289–$2,688 1.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 2 matching MRF lines		 $358.48 $1,289–$3,118 1.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $242.63 $2,422 1.0×
MRI lumbar spine w contrast (72149) $358.48 $3,118 1.0×
Mri Neck Spine W/O & W/Dye (72156) $358.48 $3,326 1.0×
MRI orbit face &/neck w/o contrast (70540) $242.63 $1,682 1.0×
MRI orbit face neck w contrast (70542) $358.48 $1,682 1.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $358.48 $2,732 1.0×
MRI pelvis w contrast (72196) $358.48 $2,688 1.0×
MRI pelvis w/o & w contrast (72197) $358.48 $3,472 1.0×
MRI pelvis w/o contrast (72195) $242.63 $2,422 1.0×
MRI spectroscopy (76390) $88.38 — 1.0×
MRI thoracic spine w/o contrast (72146) $242.63 $3,038 1.0×
MRI upper extremity oth than jt w/contr matrl (73219) $358.48 $2,578 1.0×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 2 matching MRF lines		 $242.63 $777–$2,422 1.0×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 2 matching MRF lines		 $358.48 $1,289–$2,688 1.0×
MRI, abdomen, combo (74183) $358.48 $3,472 1.0×
MRI, dorsal spine combo (72157) $358.48 $3,326 1.0×
MRI, dorsal spine contrast (72147) $358.48 $3,118 1.0×
MRI, joint upper extrem (73221)
range across 2 matching MRF lines		 $242.63 $777–$3,118 1.0×
MRI, joint upper extrem combo (73223)
range across 2 matching MRF lines		 $358.48 $1,289–$3,255 1.0×
MRI, lumbar spine combo (72158) $358.48 $3,326 1.0×
Musculoskeletal Nuclear Exam (78399) $403.35 — 1.0×
Myelogram cervical (72240)
range across 3 matching MRF lines		 $359–$793.05 $718 varies
Myelogram Lumbar (72265)
range across 3 matching MRF lines		 $375–$793.05 $750 varies
Myelography thoracic (72255)
range across 2 matching MRF lines		 $761–$793.05 $1,522 varies
Myelograpy 2/more regions rs&i (72270)
range across 2 matching MRF lines		 $647.50–$793.05 $1,295 varies
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $403.35 — 1.0×
Myocardial Imaging Pet Metabolic Evaluation (78459) $1,310.41 — 1.0×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $540.30 — 1.0×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,310.41 $3,461 1.0×
Myocardial Spect Multiple Studies (78452) $1,310.41 $3,517 1.0×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $1,464.10 — 1.0×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $1,464.10 — 1.0×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $2,259.01 — 1.0×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $1,957.87 — 0.9×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $1,857.49 — 1.2×
N-invas est c ffr sw aly CTA (75580) $1,021.24 — 1.1×
Neck soft tissue (70360) $88.38 $206 1.0×
Nervous system nuclear exam (78699) $403.35 — 1.0×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $263.97 — 0.7×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $403.35 — 1.0×
Nm csf leak detection (78650) $1,310.41 — 1.0×
Nm myocard infarct spect (78469) $540.30 — 1.0×
Nm red cell survival study (78130) $403.35 — 1.0×
Nm unlisted gi procedure (78299) $403.35 — 1.0×
Nm whole blood volume (78122) $540.30 — 1.0×
Nonvascular Shunt X-Ray (75809) $106.74 — 1.0×
Ntsty modul radthx pln dose-vol histos (77301) $1,373.43 — 1.0×
Nuclear medicine study of endocrine organs (78099) $403.35 — 1.0×
Nuclear Rx Intra-Arterial (79445) $224.98 — 0.9×
Nuclear Rx Oral Admin (79005) $224.98 — 0.9×
Ob us nuchal meas 1 gest (76813) $106.74 — 1.0×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $106.74 — 1.0×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $106.74 — 1.0×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $129.39 — 0.9×
Ophthalmic Biometry US Echograpy a-Scan (76516) $106.74 — 1.0×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $88.38 $220 1.0×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $106.74 — 1.0×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $24.58 — 0.8×
Ophthalmic us dx quantitative a-scan only (76511) $106.74 — 1.0×
Optic foramina (70190) $88.38 $348 1.0×
Panoramic X-ray of jaws (70355) $88.38 — 1.0×
Parathyroid imaging w/tomographic spect & CT (78072) $540.30 — 1.0×
Parathyroid Planar Imaging (78070)
range across 2 matching MRF lines		 $280.50–$403.35 $561 varies
Parathyroid planar imaging w/wo subtraction (78071) $403.35 — 1.0×
Pelvis 1 or 2 views (72170)
range across 2 matching MRF lines		 $87–$106.74 $174 varies
Perineogram (74775) $242.63 — 1.0×
Peritoneogram Rs&I (74190) $550.37 — 1.0×
Pet Image Skull-Thigh (78812) $1,464.10 — 1.0×
Pet Image W/Ct Lmtd (78814) $1,464.10 — 1.0×
PET image w/CT, full body (78816) $1,464.10 — 1.0×
PET imaging CT attenuation skull base mid-thigh (78815) $1,464.10 — 1.0×
Pet Imaging Limited Area Chest Head/Neck (78811) $1,310.41 — 1.0×
Pet Myocardial Sngl Study (78491) $1,464.10 — 1.0×
PET whole body (78813) $1,464.10 — 1.0×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $1,310.41 — 1.0×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $1,310.41 — 1.0×
Platelet survival study Non-Facility (78191) $403.35 — 1.0×
Proton trmt simple w/comp (77522) $1,280.33 — 1.0×
Proton tx delivery complex (77525) $1,280.33 — 1.0×
Proton tx delivery intermediate (77523) $1,280.33 — 1.0×
Proton tx delivery simple w/o compensation (77520) $580.66 — 1.0×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $3,159.40 — 1.0×
Pulmonary Perfusion Imaging Particulate (78580) $403.35 $895 1.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $106.74 $490 1.0×
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines		 $387.50–$550.37 $775 varies
Radex Ankle Complete Minimum 3 Views (73610)
range across 4 matching MRF lines		 $86.50–$88.38 $173–$434 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 2 matching MRF lines		 $86.50–$88.38 $173 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $106.74 $348 1.0×
Radex fingr minimum 2 views (73140)
range across 2 matching MRF lines		 $86.50–$88.38 $173 varies
Radex foot complete minimum 3 views (73630)
range across 4 matching MRF lines		 $86.50–$88.38 $173–$521 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$348 varies
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $106.74 $455 1.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $88.38 $235 1.0×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $88.38 — 1.0×
Radex Ribs Unilateral 2 Views (71100) $88.38 $242 1.0×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$380 varies
Radex Sinuses Paransl < 3 Views (70210) $88.38 $318 1.0×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $178.69 — 1.0×
Radex Spine 1 View Specify Level (72020)
range across 2 matching MRF lines		 $81.50–$88.38 $163 varies
Radex Sternum Minimum 2 Views (71120) $88.38 $318 1.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $88.38 $318 1.0×
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
Radex upper extremity infant minimum 2 views (73092) $106.74 $286 1.0×
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$348 varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $106.74 — 1.0×
Radiation Delivery Stereotactic Cranial Linear (77372) $7,673.39 — 1.0×
Radiation treatment delivery level 1 (77402) $109.91 — 1.0×
Radiation treatment delivery level 2 (77407) $263.97 — 0.7×
Radiation treatment delivery level 3 (77412) $263.97 — 0.5×
Radiolog exam mandible compl minimum 4 views (70110) $106.74 $247 1.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 3 matching MRF lines		 $95–$106.74 $190–$231 varies
Radiologic exam colon double contrast study (74280) $178.69 $689 1.0×
Radiologic exam colon single contrast study (74270) $178.69 $462 1.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $178.69 — 1.0×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines		 $106.50–$106.74 $213–$572 varies
Radiologic exam pelvis compl minimum 3 views (72190) $106.74 $240 1.0×
Radiologic Exam Small Int Single Contrast Study (74250) $178.69 $378 1.0×
Radiologic exam swallow function contrast study (74230) $178.69 $419 1.0×
Radiologic exam teeth complete full mouth (70320) $242.63 — 1.0×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $242.63 — 1.0×
Radiologic exam upr gi trc double contrast study (74246) $178.69 $505 1.0×
Radiologic examination femur 1 view (73551)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
Radiologic Examination Osseous Survey Limited (77074) $106.74 $739 1.0×
Radiologic Examination Salivary Gland Calculus (70380) $88.38 — 1.0×
Radiologic examination tibia & fibula 2 views (73590)
range across 5 matching MRF lines		 $86.50–$88.38 $173–$345 varies
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $550.37 — 1.0×
Radiologic examination, teeth; single view Non-Facility (70300) $88.38 — 1.0×
Radiopharm Dacryocystography (78660) $403.35 — 1.0×
Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) $224.98 — 0.9×
Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) $224.98 — 0.9×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $224.98 — 0.9×
Red Cell Volume Determination Spx 1 Sampling (78120) $403.35 — 1.0×
Red Cell Volume Determination Spx Mult Samplings (78121) $540.30 — 1.0×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $263.97 — 0.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $263.97 — 0.7×
Renal Cyst Study (74470) $550.37 — 1.0×
Ribs bilateral 3 views (71110) $106.74 — 1.0×
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines		 $401.50–$403.35 $803 varies
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $403.35 — 1.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,310.41 $2,835 2.3×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802)
range across 4 matching MRF lines		 $1,108.50–$1,310.41 $2,217 varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines		 $1,293.50–$1,310.41 $2,587 varies
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,310.41 — 1.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $1,464.10 — 1.0×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,310.41 — 1.0×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $224.98 — 0.9×
Rp Therapy Intravenous Administration (79101) $224.98 — 0.9×
Rp Therapy Unlisted Procedure (79999) $224.98 — 0.9×
Salivary Gland Function Study (78232) $403.35 — 1.0×
Salivary Gland Imaging (78230) $403.35 — 1.0×
Salivary Gland Imaging Serial Images (78231) $403.35 — 1.0×
Scapula (73010)
range across 4 matching MRF lines		 $86.50–$106.74 $173–$190 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines		 $37.50–$65.52 $75 varies
Sella turcica (70240) $88.38 $252 1.0×
Shoulder 1 view (73020) $88.38 — 1.0×
Shoulder Arthrography (73040) $358.48 — 1.0×
Sialogram (70390)
range across 2 matching MRF lines		 $180.50–$242.63 $361 varies
Skull less than 4 views (70250) $106.74 $311 1.0×
Special dosimetry (77331) $133.27 — 0.9×
Special Physics Consult (77370) $133.27 — 0.9×
Special teletherapy port plan (77321) $367.45 — 0.9×
Special treatment procedure (77470) $580.66 — 1.0×
Speech evaluation, complex (70371) $242.63 — 1.0×
Spleen Imaging (78185) $403.35 $904 1.0×
Srs Multisource (77371) $7,673.39 — 1.0×
Stereotactic Body Radiation Delivery (77373) $1,762.55 — 0.9×
Sternoclavicular joints (71130) $88.38 $190 1.0×
Superior sagittal sinus venogram (75870) $3,159.40 — 1.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $109.91 — 1.0×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $88.38 — 1.0×
Tbs technical calculation only (77091) $88.38 — 1.0×
Telethx isodose pln cplx w/basic dosimetry (77307) $367.45 — 0.9×
Telethx isodose pln smpl w/dosimetry calculation (77306) $367.45 — 0.9×
Temporomandble Jt Arthrography Rs&I (70332) $242.63 — 1.0×
Testicular Imaging W/Flow (78761) $403.35 $842 1.0×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $367.45 — 0.9×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $367.45 — 0.9×
Ther rad simulaj-aided field setting simple (77280) $133.27 — 0.9×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $178.69 $561 1.0×
Thoracic spine 2 views (72070) $106.74 $298 1.0×
Thoracic spine 3 views (72072) $106.74 — 1.0×
Thoracolumbar 2 views (72080) $88.38 — 1.0×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $403.35 — 1.0×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $403.35 — 1.0×
Thyroid Imaging With Vascular Flow (78013)
range across 2 matching MRF lines		 $308.50–$403.35 $617 varies
Thyroid Met Imaging Body (78018) $540.30 — 1.0×
Thyroid Uptake Measurement (78012) $403.35 $831 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $403.35 $929 1.0×
Tx Devices Design & Construction Complex (77334) $367.45 — 0.9×
Tx devices design & construction intermediate (77333) $133.27 — 0.9×
Tx devices design & construction simple (77332) $133.27 — 0.9×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $88.38 $250–$262 1.0×
Ultrasound elastography first target lesion (76982) $106.74 — 1.0×
Ultrasound Elastography Parenchyma (76981) $106.74 — 1.0×
Ultrasound Exam Aaa Screen (76706) $106.74 $375 1.0×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $178.69 — 0.5×
Ultrasound, abdomen limited (76705) $106.74 $411 1.0×
Umbilical-artery Doppler (OB) (76820) $106.74 $375 1.0×
Unlis px ther radiol clinical tx planning (77299) $133.27 — 0.9×
Unlisted Dx Radiographic Procedure (76499) $88.38 $194 1.0×
Unlisted fluoroscopic procedure (76496) $88.38 — 1.0×
Unlisted genitourinary px dx nuclear medicine (78799) $403.35 — 1.0×
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) $403.35 — 1.0×
Unlisted magnetic resonance procedure (76498) $88.38 — 1.0×
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $403.35 — 1.0×
Unlisted Procedure Clinical Brachytherapy (77799) $109.91 — 1.0×
Unlisted respiratory px dx nuclear medicine (78599) $403.35 — 1.0×
Unlisted us procedure (76999) $88.38 $400 1.0×
Upper gi w/o kub (74240) $178.69 $483 1.0×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $11.06 — 1.0×
Urea breath test c-14 isotopic analysis (78268) $94.41 — 1.0×
Ureteral Reflux Study (78740) $403.35 — 1.0×
Urethrocystogram voiding (74455) $242.63 $604 1.0×
Urethrocystography retrograde (74450) $242.63 $492 1.0×
Us bone density measurement (76977) $106.74 — 1.0×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $106.74 $262–$325 1.0×
Us chest (76604) $106.74 $400 1.0×
Us complete joint (76881) $106.74 $1,276 1.0×
Us exam, pelvic, limited (76857) $106.74 $375 1.0×
Us head (76506) $106.74 $789 1.0×
Us kidney transplant (76776) $106.74 $261 1.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $106.74 $861 1.0×
Us ob detailed single fetus (76811) $242.63 — 1.0×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $104–$106.74 $208 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines		 $94.50–$106.74 $189 varies
Us pelvic non ob complete (76856) $106.74 $545 1.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $106.74 $231 1.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $106.74 $275 1.0×
Us retroperitoneal complete (76770) $106.74 $261 1.0×
Us retroperitoneal limited (76775) $106.74 $537 1.0×
Us scrotum and contents (76870) $106.74 $416 1.0×
Us spinal canal and contents (76800) $106.74 $313 1.0×
Us thyroid (76536) $106.74 $411 1.0×
Us transrectal (76872) $106.74 $345 1.0×
Vascular Flow Imaging (78445)
range across 2 matching MRF lines		 $351–$403.35 $702 varies
Vasogram (74440) $242.63 — 1.0×
Vein X-Ray Chest (75827) $1,559.31 — 0.9×
Vein X-Ray Liver W/O Hemodyn (75887) $3,159.40 — 1.0×
Vein X-Ray Skull Epidural (75872) $620.60 — 0.9×
Vein X-Ray Spleen/Liver (75810) $3,159.40 — 1.0×
Venogram Sinus/Jugular (75860) $3,159.40 — 1.0×
Venography Adrenal Unilateral (75840) $3,159.40 — 1.0×
Venography caval inferior serialography rs&i (75825) $3,159.40 — 1.0×
Venography extremity bilateral rs&i (75822)
range across 3 matching MRF lines		 $374–$1,559.31 $748 varies
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines		 $1,025–$1,559.31 $2,050 varies
Venography Orbital Rs&I (75880) $620.60 — 0.9×
Venography Renal Bilateral (75833) $3,159.40 — 1.0×
Venography Renal Unilateral (75831) $3,159.40 — 1.0×
Venous sampling by catheter (75893) $5,426.13 — 0.9×
Venous thrombosis imaging (78457) $540.30 — 1.0×
Venous Thrombosis Imaging Venogram Bilateral (78458) $403.35 — 1.0×
Vertebral fracture assessment via dxa (77086) $88.38 — 1.0×
Wrist 2 views (73100)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 2 matching MRF lines		 $87–$88.38 $174 varies
X-ray antegrade pyelogram tube (74425) $358.48 — 1.0×
X-Ray Aorta Leg Arteries (75630) $3,159.40 — 1.0×
X-Ray Bend Only L-S Spine (72120) $106.74 $261 1.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$345 varies
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines		 $417.50–$550.37 $835 varies
X-Ray Exam Entire Spi 1 Vw (72081) $88.38 $281 1.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $106.74 $261 1.0×
X-Ray Exam Entire Spi 4/5 Vw (72083) $106.74 — 1.0×
X-Ray Exam Hip Uni 1 View (73501) $88.38 $339 1.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $88.38 $211 1.0×
X-Ray Exam Hip Uni 4/> Views (73503) $106.74 — 1.0×
X-Ray Exam Hips Bi 2 Views (73521) $106.74 $414 1.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $106.74 — 1.0×
X-Ray Exam Hips Bi 5/> Views (73523) $106.74 — 1.0×
X-Ray Exam L-S Spine Bending (72114) $106.74 $348 1.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $88.38 $191 1.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $106.74 $414 1.0×
X-Ray Exam Unilat Ribs/Chest (71101) $106.74 $318 1.0×
X-ray eye for foreign body (70030)
range across 2 matching MRF lines		 $86.50–$88.38 $173 varies
X-ray head for orthodontia (70350) $88.38 — 1.0×
X-ray humerus (73060)
range across 3 matching MRF lines		 $86.50–$88.38 $173–$348 varies
X-ray IV pyelogram (ivp) (74400) $178.69 $534 1.0×
X-ray IV pyelogram+tomography (74415) $178.69 — 1.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $88.38 — 1.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $88.38 — 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines		 $95–$106.74 $190 varies
X-ray nose-rectum child f.b. (76010)
range across 2 matching MRF lines		 $75.50–$88.38 $151 varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $106.74 $261 1.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $106.74 $235 1.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $106.74 — 1.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $88.38 $268 1.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $88.38 $360 1.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $106.74 $348 1.0×
X-Ray Stress View (77071) $88.38 — 1.0×
X-ray thoracic spine 4 vw (72074) $106.74 $334 1.0×
X-Ray Tmj Unilat (70328) $88.38 — 1.0×
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 4 matching MRF lines		 $282.50–$358.48 $565 varies
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines		 $106.74 $226–$261 1.0×
X-Rays Bone Survey Complete (77075) $106.74 $1,024 1.0×
Xr c-spine 4 or 5 views (72050) $106.74 $378 1.0×
Xr facial bones less than 3 views (70140) $88.38 $348 1.0×
XR Mastoids < 3 Views Bilateral (70120) $106.74 — 1.0×
Xr myelogram posterior fossa (70010) $358.48 — 1.0×
Xr orbits complete 4 views (70200) $106.74 $348 1.0×
Xr Tomogram Single Plane (76100) $106.74 $326 1.0×

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.