Imaging prices at Lawrence + Memorial Hospital
New London, CT · every code in this section with a posted price and a Medicare benchmark.
417 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) | $2,200.10 | $6,111.40 | 1.3× |
| Abdomen 1 View (74018) | $81.97 | $227.70 | 0.8× |
| Abdomen 2 views (74019) | $148.55 | $412.63 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $555.29 | $1,542.47 | 1.2× |
| Angio internal mammary (75756) | $3,235.08 | $8,986.33 | 0.9× |
| Angio pulmonary bilat (75743) | $3,643.15 | $10,119.87 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $3,643.15 | $10,119.87 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $3,643.15 | $10,119.87 | 1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,643.15 | $10,119.87 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,675.36 | $4,653.78 | 0.4× |
| Ankle 2 views (73600) | $81.97 | $227.70 | 0.8× |
| Aortography thoracic serialography rs&i (75605) | $5,535.06 | $15,375.18 | 0.8× |
| Artery X-Rays Abdomen (75726) | $5,535.06 | $15,375.18 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $3,643.15 | $10,119.87 | 1.0× |
| Artery X-Rays Pelvis (75736) | $5,535.06 | $15,375.18 | 0.8× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,665.45 | $7,404.02 | 0.4× |
| Arthrogram ankle (73615) | $595.16 | $1,653.22 | 1.4× |
| Arthrogram hip (73525) | $595.16 | $1,653.22 | 1.4× |
| Arthrogram Wrist (73115) | $410.99 | $1,141.65 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $236.32 | $656.45 | 1.5× |
| Bone age studies (77072) | $149.16 | $414.32 | 1.2× |
| Bone Imaging 3 Phase (78315) | $555.29 | $1,542.47 | 1.2× |
| Bone Imaging Limited Area (78300) | $440.90 | $1,224.72 | 0.9× |
| Bone Imaging Multiple Areas (78305) | $440.90 | $1,224.72 | 0.9× |
| Bone Imaging Whole Body (78306) | $440.90 | $1,224.72 | 0.9× |
| Bone marrow imaging limited area (78102) | $459.86 | $1,277.39 | 1.0× |
| Bone marrow imaging; multiple areas (78103) | $459.86 | $1,277.39 | 1.0× |
| Bone marrow imaging; whole body (78104) | $459.86 | $1,277.39 | 1.0× |
| Bone survey infant (77076) | $149.16 | $414.32 | 1.2× |
| Brachytx isodose complex (77318) | $412.45 | $1,145.70 | 0.9× |
| Brachytx isodose intermed (77317) | $412.45 | $1,145.70 | 0.9× |
| Brachytx Isodose Plan Simple (77316) | $599.01 | $1,663.91 | 1.3× |
| Brain Image W/Flow < 4 Views (78601) | $752.70 | $2,090.83 | 1.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $752.70 | $2,090.83 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,749.73 | $4,860.37 | 1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $507.27 | $1,409.08 | 1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $902.22 | $2,506.16 | 2.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $902.22 | $2,506.16 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $162.65 | $451.80 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $752.70 | $2,090.83 | 1.2× |
| Chest 1 view (71045) | $81.97 | $227.70 | 0.8× |
| Chest 2 views (71046) | $81.97 | $227.70 | 0.8× |
| Chest 3 views (71047) | $116.70 | $324.16 | 1.1× |
| Chest 4 or more views (71048) | $148.55 | $412.63 | 1.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $158.79 | $441.07 | 1.3× |
| Clavicle complete (73000) | $81.97 | $227.70 | 0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $184.89 | $513.59 | 1.5× |
| Continuing medical physics consltj pr wk (77336) | $254.20 | $706.10 | 1.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,643.15 | $10,119.87 | 1.0× |
| Contrast X-Ray Bladder (74430) | $392.20 | $1,089.45 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $592.28 | $1,645.22 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $595.16 | $1,653.22 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $792.45 | $2,201.25 | 1.9× |
| CT abdomen and pelvis without contrast (74176) | $502.53 | $1,395.91 | 1.8× |
| CT abdomen w contrast (74160) | $487.94 | $1,355.39 | 2.3× |
| CT abdomen w wo contrast (74170) | $540.82 | $1,502.28 | 2.6× |
| CT abdomen w/o contrast (74150) | $285.18 | $792.17 | 2.3× |
| CT Angio Abdomen and Pelvis (74174) | $792.45 | $2,201.25 | 1.9× |
| CT Angio Chest (71275) | $557.23 | $1,547.86 | 2.7× |
| CT Angio Head (70496) | $557.23 | $1,547.86 | 2.7× |
| CT angio hrt w/3d image (75574) | $438.71 | $1,218.64 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $557.23 | $1,547.86 | 2.7× |
| CT Angio Neck (70498) | $557.23 | $1,547.86 | 2.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $557.23 | $1,547.86 | 2.7× |
| CT cervical spine w/ contrast (72126) | $564.16 | $1,567.11 | 1.3× |
| CT cervical spine w/o contrast (72125) | $285.18 | $792.17 | 2.3× |
| CT cervical spine w/wo cont (72127) | $540.82 | $1,502.28 | 2.6× |
| CT chest w contrast (71260) | $487.94 | $1,355.39 | 2.3× |
| CT chest w/wo contrast (71270) | $540.82 | $1,502.28 | 2.6× |
| CT colonography screening (74263) | $1,142.91 | $3,174.74 | 4.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $363.72 | $1,010.32 | 2.9× |
| CT head/brain with contrast (70460) | $487.94 | $1,355.39 | 2.3× |
| CT head/brain without and with contrast (70470) | $540.82 | $1,502.28 | 2.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $438.71 | $1,218.64 | 1.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $95.62 | $265.61 | 0.9× |
| CT hrt w/3d image congen (75573) | $438.71 | $1,218.64 | 1.0× |
| CT iac w contrast (70481) | $487.94 | $1,355.39 | 2.3× |
| CT l-spine w&w/o contrast (72133) | $540.82 | $1,502.28 | 2.6× |
| CT lower ext w/o (73700) | $285.18 | $792.17 | 2.3× |
| CT lower extremity w/contrast material (73701) | $487.94 | $1,355.39 | 2.3× |
| CT lumbar spine w contrast (72132) | $564.16 | $1,567.11 | 1.3× |
| CT lumbar spine w/o contrast (72131) | $285.18 | $792.17 | 2.3× |
| CT maxillofacial w contrast (70487) | $487.94 | $1,355.39 | 2.3× |
| CT maxillofacial wo contrast (70486) | $285.18 | $792.17 | 2.3× |
| CT neck tissue combo (70492) | $540.82 | $1,502.28 | 2.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $540.82 | $1,502.28 | 2.6× |
| CT orbits w/o contrast (70480) | $285.18 | $792.17 | 2.3× |
| CT pelvis w&w/o contrast (72194) | $540.82 | $1,502.28 | 2.6× |
| CT pelvis w/o contrast (72192) | $285.18 | $792.17 | 2.3× |
| CT scan of leg combo (73702) | $540.82 | $1,502.28 | 2.6× |
| CT scans face/jaw combo (70488) | $540.82 | $1,502.28 | 2.6× |
| CT soft tissue neck w contrast (70491) | $487.94 | $1,355.39 | 2.3× |
| CT soft tissue neck w/o contrast (70490) | $285.18 | $792.17 | 2.3× |
| CT thoracic spine w contrast (72129) | $487.94 | $1,355.39 | 2.3× |
| CT thoracic spine w/o contrast (72128) | $285.18 | $792.17 | 2.3× |
| CT thoracic spine w/wo cont (72130) | $263.13 | $730.91 | 1.3× |
| CT thorax w/o contrast (71250) | $285.18 | $792.17 | 2.3× |
| CT unlisted procedure (76497) | $162.65 | $451.80 | 1.6× |
| CT upper ext wo (73200) | $285.18 | $792.17 | 2.3× |
| CT upper extremity w/o & w/contrast material (73202) | $540.82 | $1,502.28 | 2.6× |
| CT upper extremity with contrast (73201) | $487.94 | $1,355.39 | 1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $557.23 | $1,547.86 | 2.7× |
| Cta Abdomen (74175) | $557.23 | $1,547.86 | 2.7× |
| CTA pelvis (72191) | $557.23 | $1,547.86 | 2.7× |
| Diskography lumbar (72295) | $2,247.16 | $6,242.11 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $149.16 | $414.32 | 1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $299.04 | $830.66 | 2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $149.16 | $414.32 | 1.2× |
| Dxa Bone Density Axial (77080) | $149.16 | $414.32 | 1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $81.97 | $227.70 | 0.8× |
| Echo exam of fetal heart (76825) | $631.63 | $1,754.52 | 1.0× |
| Echo exam uterus (76831) | $299.04 | $830.66 | 1.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $301.49 | $837.48 | 1.1× |
| Esophagram (74220) | $328.01 | $911.13 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $163.38 | $453.82 | 1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $163.38 | $453.82 | 1.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $449.29 | $1,248.02 | 1.6× |
| Fluoroscopy up to 1 hr (76000) | $299.04 | $830.66 | 1.0× |
| Follow-Up Angiography (75898) | $1,675.36 | $4,653.78 | 0.4× |
| Foot 2 views (73620) | $81.97 | $227.70 | 0.8× |
| Forearm 2 views (73090) | $81.97 | $227.70 | 0.8× |
| Gastric emptying imaging study (78264) | $472.93 | $1,313.70 | 1.0× |
| Gated Heart Planar Single (78472) | $507.27 | $1,409.08 | 1.1× |
| Hand 2 views (73120) | $149.16 | $414.32 | 1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,207.09 | $3,353.03 | 1.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $977.71 | $2,715.85 | 1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $977.71 | $2,715.85 | 1.2× |
| Heart Image (Pet) Multiple (78492) | $1,749.73 | $4,860.37 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,643.15 | $10,119.87 | 1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,235.08 | $8,986.33 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $720.86 | $2,002.38 | 1.1× |
| Hepatobiliary System Imaging (78226) | $516.39 | $1,434.41 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,507.95 | $4,188.76 | 1.0× |
| Hysterosalpingogram (74740) | $419.75 | $1,165.96 | 1.5× |
| Image fusion (77399) | $186.91 | $519.20 | 1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $118.89 | $330.24 | 1.1× |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$86.79–$119.48 | $241.09–$331.88 | varies |
| Interstitial radiation source applic complex (77778) | $977.71 | $2,715.85 | 1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $654.97 | $1,819.35 | 1.0× |
| Intraop radiaj tx deliver xray single tx session (77424) | $9,847.82 | $27,355.05 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $588.01 | $1,633.35 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $588.01 | $1,633.35 | 0.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $440.90 | $1,224.72 | 0.9× |
| Kidney Imaging Morphol (78700) | $546.66 | $1,518.49 | 1.1× |
| Knee 3 Views (73562) | $81.97 | $227.70 | 0.8× |
| Leveen/Shunt Patency Exam (78291) | $440.90 | $1,224.72 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $516.39 | $1,434.41 | 1.1× |
| Liver imaging static only (78201) | $631.99 | $1,755.53 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $588.01 | $1,633.35 | 0.9× |
| Lung perfusion differential (78597) | $440.90 | $1,224.72 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) | $588.01 | $1,633.35 | 0.9× |
| Lung Ventilation Imaging (78579) | $440.90 | $1,224.72 | 0.9× |
| Lymph System Imaging (78195) | $588.01 | $1,633.35 | 0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,235.08 | $8,986.33 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,675.36 | $4,653.78 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $555.77 | $1,543.81 | 1.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $746.50 | $2,073.61 | 3.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $555.77 | $1,543.81 | 0.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $1,077.45 | $2,992.91 | 5.1× |
| Magnetic Resonance Elastography (76391) | $302.68 | $840.79 | 1.1× |
| Mammary ductogram or galactogram single (77053) | $299.04 | $830.66 | 1.0× |
| Meckels Divert Exam (78290) | $555.29 | $1,542.47 | 1.2× |
| Medical physics dose eval radiation expos w/rprt (76145) | $498.83 | $1,385.65 | 1.1× |
| Mlc imrt design & construction per imrt plan (77338) | $1,075.28 | $2,986.90 | 2.4× |
| Mr safety determination physician/other qhp (76016) | $132.62 | $368.38 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $36.88 | $102.45 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $138.25 | $384.02 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $89.46 | $248.50 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $364.05 | $1,011.26 | 1.3× |
| Mra Head W/O & W/Contrast Material (70546) | $902.22 | $2,506.16 | 2.2× |
| MRA head w/o contrast (70544) | $555.77 | $1,543.81 | 1.9× |
| MRA head with contrast (70545) | $746.50 | $2,073.61 | 1.8× |
| MRA neck w contrast (70548) | $746.50 | $2,073.61 | 1.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $902.22 | $2,506.16 | 2.2× |
| MRA neck w/o contrast (70547) | $555.77 | $1,543.81 | 1.9× |
| MRI abdomen w contrast (74182) | $746.50 | $2,073.61 | 1.8× |
| MRI abdomen w/o contrast (74181) | $555.77 | $1,543.81 | 1.9× |
| MRI any jt lower extrem w/contrast material (73722) | $869.76 | $2,416.01 | 0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $902.22 | $2,506.16 | 2.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $869.76 | $2,416.01 | 0.9× |
| MRI bone marrow blood supply (77084) | $551.96 | $1,533.21 | 1.9× |
| MRI brain functional w/o physician admnistration (70554) | $555.77 | $1,543.81 | 1.9× |
| MRI brain functional w/physician admnistration (70555) | $721.46 | $2,004.05 | 2.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $302.91 | $841.42 | 1.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $302.91 | $841.42 | 1.1× |
| MRI cardiac w/o contrast (75557) | $555.77 | $1,543.81 | 1.9× |
| MRI cervical spine w contrast (72142) | $746.50 | $2,073.61 | 1.8× |
| MRI cervical spine w/o cont (72141) | $555.77 | $1,543.81 | 1.9× |
| MRI chest w/o contrast (71550) | $555.77 | $1,543.81 | 1.9× |
| MRI chest wo w contrast (71552) | $902.22 | $2,506.16 | 2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $746.50 | $2,073.61 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $902.22 | $2,506.16 | 2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $555.77 | $1,543.81 | 1.9× |
| MRI lumbar spine w contrast (72149) | $746.50 | $2,073.61 | 1.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $902.22 | $2,506.16 | 2.2× |
| MRI orbit face &/neck w/o contrast (70540) | $555.77 | $1,543.81 | 1.9× |
| MRI orbit face neck w contrast (70542) | $746.50 | $2,073.61 | 1.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $902.22 | $2,506.16 | 2.2× |
| MRI pelvis w contrast (72196) | $746.50 | $2,073.61 | 1.8× |
| MRI pelvis w/o & w contrast (72197) | $902.22 | $2,506.16 | 2.2× |
| MRI pelvis w/o contrast (72195) | $555.77 | $1,543.81 | 1.9× |
| MRI spectroscopy (76390) | $651.32 | $1,809.22 | 6.2× |
| MRI thoracic spine w/o contrast (72146) | $555.77 | $1,543.81 | 1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $555.77 | $1,543.81 | 1.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $902.22 | $2,506.16 | 2.2× |
| MRI, abdomen, combo (74183) | $902.22 | $2,506.16 | 2.2× |
| MRI, dorsal spine combo (72157) | $902.22 | $2,506.16 | 2.2× |
| MRI, dorsal spine contrast (72147) | $746.50 | $2,073.61 | 1.8× |
| MRI, joint upper extrem (73221) | $555.77 | $1,543.81 | 1.9× |
| MRI, joint upper extrem combo (73223) | $902.22 | $2,506.16 | 2.2× |
| MRI, lumbar spine combo (72158) | $902.22 | $2,506.16 | 2.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,733.69 | $4,815.80 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $1,507.95 | $4,188.76 | 1.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,946.70 | $5,407.50 | 1.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,946.70 | $5,407.50 | 1.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,512.13 | $9,755.91 | 1.3× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,598.81 | $9,996.69 | 1.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,598.81 | $9,996.69 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) | $1,506.65 | $4,185.13 | 1.5× |
| Neck soft tissue (70360) | $81.97 | $227.70 | 0.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $440.90 | $1,224.72 | 0.9× |
| Nm myocard infarct spect (78469) | $1,560.84 | $4,335.66 | 2.4× |
| Nm whole blood volume (78122) | $715.50 | $1,987.51 | 1.1× |
| Nonvascular Shunt X-Ray (75809) | $149.16 | $414.32 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,445.92 | $9,572 | 2.1× |
| Nuclear Rx Intra-Arterial (79445) | $371.97 | $1,033.26 | 1.3× |
| Nuclear Rx Oral Admin (79005) | $388.75 | $1,079.86 | 1.4× |
| Ob us nuchal meas 1 gest (76813) | $160.37 | $445.48 | 1.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$43.03–$163.38 | $119.53–$453.82 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $163.38 | $453.82 | 1.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $346.08 | $961.34 | 2.2× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $148.55 | $412.63 | 1.2× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$37.32–$108.21 | $103.68–$300.57 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $163.38 | $453.82 | 1.3× |
| Panoramic X-ray of jaws (70355) | $81.97 | $227.70 | 0.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $594.14 | $1,650.38 | 0.9× |
| Parathyroid Planar Imaging (78070) | $440.90 | $1,224.72 | 0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $528.79 | $1,468.85 | 1.1× |
| Pelvis 1 or 2 views (72170) | $149.16 | $414.32 | 1.2× |
| Perineogram (74775) | $417.12 | $1,158.67 | 1.5× |
| Peritoneogram Rs&I (74190) | $711.77 | $1,977.14 | 1.1× |
| Pet Image W/Ct Lmtd (78814) | $1,749.73 | $4,860.37 | 1.0× |
| PET image w/CT, full body (78816) | $2,256.48 | $6,268 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,256.48 | $6,268 | 1.3× |
| Pet Myocardial Sngl Study (78491) | $1,749.73 | $4,860.37 | 1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,643.15 | $10,119.87 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $440.90 | $1,224.72 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $149.16 | $414.32 | 1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $595.16 | $1,653.22 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $81.97 | $227.70 | 0.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $81.97 | $227.70 | 0.8× |
| Radex elbow complete minimum 3 views (73080) | $81.97 | $227.70 | 0.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $149.16 | $414.32 | 1.2× |
| Radex fingr minimum 2 views (73140) | $81.97 | $227.70 | 0.8× |
| Radex foot complete minimum 3 views (73630) | $81.97 | $227.70 | 0.8× |
| Radex Hand Minimum 3 Views (73130) | $81.97 | $227.70 | 0.8× |
| Radex lower extremity infant minimum 2 views (73592) | $81.97 | $227.70 | 0.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $149.16 | $414.32 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $81.97 | $227.70 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) | $81.97 | $227.70 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) | $81.97 | $227.70 | 0.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $81.97 | $227.70 | 0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $238.34 | $662.06 | 1.1× |
| Radex Spine 1 View Specify Level (72020) | $81.97 | $227.70 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $81.97 | $227.70 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $81.97 | $227.70 | 0.8× |
| Radex Toe Minimum 2 Views (73660) | $81.97 | $227.70 | 0.8× |
| Radex upper extremity infant minimum 2 views (73092) | $149.16 | $414.32 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $81.97 | $227.70 | 0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $315.45 | $876.25 | 2.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,061.39 | $47,392.75 | 1.9× |
| Radiation treatment delivery level 1 (77402) | $303.99 | $844.43 | 2.5× |
| Radiation treatment delivery level 2 (77407) | $358.84 | $996.79 | 0.8× |
| Radiation treatment delivery level 3 (77412) | $704.52 | $1,957 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $149.16 | $414.32 | 1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $148.55 | $412.63 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $328.01 | $911.13 | 1.6× |
| Radiologic exam colon single contrast study (74270) | $328.01 | $911.13 | 1.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $238.34 | $662.06 | 1.1× |
| Radiologic exam knee complete 4/more views (73564) | $149.16 | $414.32 | 1.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $149.16 | $414.32 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $187.16 | $519.89 | 0.9× |
| Radiologic exam swallow function contrast study (74230) | $187.16 | $519.89 | 0.9× |
| Radiologic exam teeth complete full mouth (70320) | $299.04 | $830.66 | 1.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $595.16 | $1,653.22 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $328.01 | $911.13 | 1.6× |
| Radiologic examination femur 1 view (73551) | $100.29 | $278.58 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) | $100.29 | $278.58 | 1.0× |
| Radiologic examination knee 1/2 views (73560) | $81.97 | $227.70 | 0.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $149.16 | $414.32 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $81.97 | $227.70 | 0.8× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $81.97 | $227.70 | 0.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $533.89 | $1,483.03 | 1.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $332.59 | $923.86 | 0.7× |
| Ribs bilateral 3 views (71110) | $149.16 | $414.32 | 1.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $492.68 | $1,368.56 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $824.91 | $2,291.41 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,568.49 | $4,356.91 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,560.84 | $4,335.66 | 2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $824.91 | $2,291.41 | 1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,664.20 | $4,622.79 | 1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,888.05 | $5,244.58 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,664.20 | $4,622.79 | 1.1× |
| Rp Therapy Intravenous Administration (79101) | $388.75 | $1,079.86 | 1.4× |
| Salivary Gland Imaging Serial Images (78231) | $440.90 | $1,224.72 | 0.9× |
| Scapula (73010) | $148.55 | $412.63 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $49.23 | $136.76 | 2.1× |
| Shoulder 1 view (73020) | $81.97 | $227.70 | 0.8× |
| Shoulder Arthrography (73040) | $592.28 | $1,645.22 | 1.4× |
| Skull less than 4 views (70250) | $149.16 | $414.32 | 1.2× |
| Special dosimetry (77331) | $186.91 | $519.20 | 1.2× |
| Special Physics Consult (77370) | $263.91 | $733.09 | 1.6× |
| Special teletherapy port plan (77321) | $599.01 | $1,663.91 | 1.3× |
| Special treatment procedure (77470) | $654.97 | $1,819.35 | 1.0× |
| Stereotactic Body Radiation Delivery (77373) | $3,043.80 | $8,455 | 1.4× |
| Sternoclavicular joints (71130) | $81.97 | $227.70 | 0.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $176.53 | $490.36 | 1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $599.01 | $1,663.91 | 1.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $412.45 | $1,145.70 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $970.56 | $2,696 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $721.34 | $2,003.71 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $530.64 | $1,474 | 3.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $328.01 | $911.13 | 1.6× |
| Thoracic spine 2 views (72070) | $149.16 | $414.32 | 1.2× |
| Thoracic spine 3 views (72072) | $149.16 | $414.32 | 1.2× |
| Thoracolumbar 2 views (72080) | $81.97 | $227.70 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) | $440.90 | $1,224.72 | 0.9× |
| Thyroid Met Imaging Body (78018) | $588.01 | $1,633.35 | 0.9× |
| Thyroid Uptake Measurement (78012) | $440.90 | $1,224.72 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $440.90 | $1,224.72 | 0.9× |
| Tx Devices Design & Construction Complex (77334) | $412.45 | $1,145.70 | 0.9× |
| Tx devices design & construction intermediate (77333) | $229.23 | $636.75 | 1.4× |
| Tx devices design & construction simple (77332) | $186.91 | $519.20 | 1.2× |
| Ultrasound Breast Limited (76642) | $119.16 | $331 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $185.26 | $514.60 | 1.5× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$96.27–$163.38 | $267.43–$453.82 | varies |
| Umbilical-artery Doppler (OB) (76820) | $149.16 | $414.32 | 1.2× |
| Unlisted Dx Radiographic Procedure (76499) | $124.70 | $346.39 | 1.2× |
| Unlisted fluoroscopic procedure (76496) | $187.81 | $521.70 | 1.8× |
| Unlisted magnetic resonance procedure (76498) | $555.77 | $1,543.81 | 5.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $440.90 | $1,224.72 | 0.9× |
| Unlisted us procedure (76999) | $106.49 | $295.80 | 1.0× |
| Upper gi w/o kub (74240) | $328.01 | $911.13 | 1.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $29.54 | $82.05 | 2.7× |
| Ureteral Reflux Study (78740) | $546.66 | $1,518.49 | 1.1× |
| Urethrocystogram voiding (74455) | $344.26 | $956.27 | 1.2× |
| Urethrocystography retrograde (74450) | $417.12 | $1,158.67 | 1.5× |
| Us breast unilateral complete (76641) | $160.37 | $445.48 | 1.3× |
| Us chest (76604) range across 2 matching MRF lines |
$25.16–$149.16 | $69.90–$414.32 | varies |
| Us complete joint (76881) | $163.38 | $453.82 | 1.3× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$71.48–$149.16 | $198.55–$414.32 | varies |
| Us head (76506) | $149.16 | $414.32 | 1.2× |
| Us kidney transplant (76776) | $190.37 | $528.80 | 1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$148.55–$355.56 | $412.63–$987.68 | varies |
| Us ob detailed single fetus (76811) | $285.16 | $792.10 | 1.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$77.31–$149.16 | $214.76–$414.32 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$83.15–$149.16 | $230.96–$414.32 | varies |
| Us pelvic non ob complete (76856) | $163.38 | $453.82 | 1.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $163.38 | $453.82 | 1.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $149.16 | $414.32 | 1.2× |
| Us retroperitoneal complete (76770) | $163.38 | $453.82 | 1.3× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$33.55–$163.38 | $93.20–$453.82 | varies |
| Us scrotum and contents (76870) | $163.38 | $453.82 | 1.3× |
| Us spinal canal and contents (76800) | $178.59 | $496.09 | 1.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$20.79–$163.38 | $57.74–$453.82 | varies |
| Us transrectal (76872) | $163.38 | $453.82 | 1.3× |
| Vein X-Ray Chest (75827) | $1,175.36 | $3,264.90 | 0.6× |
| Vein X-Ray Spleen/Liver (75810) | $4,216.89 | $11,713.58 | 1.1× |
| Venogram Sinus/Jugular (75860) | $3,235.08 | $8,986.33 | 0.9× |
| Venography Adrenal Unilateral (75840) | $3,643.15 | $10,119.87 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $3,643.15 | $10,119.87 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,675.36 | $4,653.78 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,175.36 | $3,264.90 | 0.6× |
| Venography Renal Bilateral (75833) | $3,235.08 | $8,986.33 | 0.9× |
| Venography Renal Unilateral (75831) | $3,235.08 | $8,986.33 | 0.9× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,552.03 | $7,088.97 | 0.4× |
| Wrist 2 views (73100) | $81.97 | $227.70 | 0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $81.97 | $227.70 | 0.8× |
| X-ray antegrade pyelogram tube (74425) | $595.16 | $1,653.22 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $3,643.15 | $10,119.87 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $148.55 | $412.63 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $81.97 | $227.70 | 0.8× |
| X-Ray Exam Breast Specimen (76098) | $631.63 | $1,754.52 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $100.29 | $278.58 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $165.56 | $459.90 | 1.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $315.45 | $876.25 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $100.29 | $278.58 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $100.29 | $278.58 | 1.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $165.56 | $459.90 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $165.56 | $459.90 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $165.56 | $459.90 | 1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $314.59 | $873.87 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $149.16 | $414.32 | 1.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $81.97 | $227.70 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $149.16 | $414.32 | 1.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $149.16 | $414.32 | 1.2× |
| X-ray eye for foreign body (70030) | $81.97 | $227.70 | 0.8× |
| X-ray head for orthodontia (70350) | $100.44 | $279 | 1.0× |
| X-ray humerus (73060) | $81.97 | $227.70 | 0.8× |
| X-ray IV pyelogram (ivp) (74400) | $344.26 | $956.27 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $81.97 | $227.70 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $81.97 | $227.70 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $149.16 | $414.32 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $81.97 | $227.70 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $149.16 | $414.32 | 1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $149.16 | $414.32 | 1.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $149.16 | $414.32 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $81.97 | $227.70 | 0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $116.70 | $324.16 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $149.16 | $414.32 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $149.16 | $414.32 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $595.16 | $1,653.22 | 1.4× |
| X-Rays Bone Length Studies (77073) | $148.55 | $412.63 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $149.16 | $414.32 | 1.2× |
| Xr c-spine 4 or 5 views (72050) | $149.16 | $414.32 | 1.2× |
| Xr facial bones less than 3 views (70140) | $81.97 | $227.70 | 0.8× |
| Xr orbits complete 4 views (70200) | $149.16 | $414.32 | 1.2× |
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.