Imaging prices at LewisGale Medical Center
Salem, VA · every code in this section with a posted price and a Medicare benchmark.
320 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) | $20,979 | $20,979 | 15.5× |
| Abdomen 1 View (74018) | $1,062 | $1,062 | 12.5× |
| Abdomen 2 views (74019) | $990 | $990 | 9.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,932 | $2,932 | 7.5× |
| Angio internal mammary (75756) | $7,237 | $7,237 | 2.3× |
| Angio pulmonary bilat (75743) | $7,208 | $7,208 | 2.3× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$6,950–$10,100 | $6,950–$10,100 | varies |
| Angiography extremity unilateral rs&i (75710) range across 6 matching MRF lines |
$5,831–$7,801 | $5,831–$7,801 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,849 | $4,849 | 1.6× |
| Ankle 2 views (73600) | $851 | $851 | 10.0× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$6,964–$7,545 | $6,964–$7,545 | varies |
| Artery X-Rays Abdomen (75726) | $11,471 | $11,471 | 2.1× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$9,150–$10,895 | $9,150–$10,895 | varies |
| Artery X-Rays Spine (75705) | $4,834 | $4,834 | 0.9× |
| Arthrogram hip (73525) | $1,216 | $1,216 | 3.6× |
| Basic radiation dosimetry calculation (77300) | $1,842 | $1,842 | 14.0× |
| Bone age studies (77072) | $395 | $395 | 3.9× |
| Bone Imaging 3 Phase (78315) | $6,937 | $6,937 | 17.8× |
| Bone Imaging Multiple Areas (78305) | $4,949 | $4,949 | 12.7× |
| Bone Imaging Whole Body (78306) | $4,266 | $4,266 | 10.9× |
| Bone survey infant (77076) | $2,429 | $2,429 | 23.8× |
| Brachytx Isodose Plan Simple (77316) | $3,923 | $3,923 | 10.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,459 | $2,459 | 4.6× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,333 | $1,333 | 2.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $20,353 | $20,353 | 14.6× |
| Cat Scan Follow-Up Study (76380) | $3,641 | $3,641 | 42.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,914 | $1,914 | 3.6× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$2,030–$2,257 | $2,030–$2,257 | varies |
| Chest 1 view (71045) | $811 | $811 | 9.6× |
| Chest 2 views (71046) | $1,152 | $1,152 | 13.6× |
| Chest 3 views (71047) | $1,156 | $1,156 | 13.6× |
| Chest 4 or more views (71048) | $1,368 | $1,368 | 13.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$1,106–$1,660 | $1,106–$1,660 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $545 | $545 | 5.3× |
| Continuing medical physics consltj pr wk (77336) | $1,662 | $1,662 | 12.7× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$7,545–$10,281 | $7,545–$10,281 | varies |
| Contrast X-Ray Bladder (74430) | $2,061 | $2,061 | 6.1× |
| CT abdomen and pelvis without and with contrast (74178) | $21,334 | $21,334 | 62.7× |
| CT abdomen and pelvis without contrast (74176) | $12,973 | $12,973 | 55.7× |
| CT abdomen w contrast (74160) | $8,511 | $8,511 | 49.7× |
| CT abdomen w wo contrast (74170) | $10,668 | $10,668 | 62.3× |
| CT abdomen w/o contrast (74150) | $4,889 | $4,889 | 47.9× |
| CT Angio Abdomen and Pelvis (74174) | $19,237 | $19,237 | 56.5× |
| CT Angio Chest (71275) | $9,622 | $9,622 | 56.2× |
| CT Angio Head (70496) | $7,038 | $7,038 | 41.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,861 | $3,861 | 22.6× |
| CT Angio Neck (70498) | $9,622 | $9,622 | 56.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,861 | $3,861 | 22.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $3,563 | $3,563 | 20.8× |
| CT cervical spine w/ contrast (72126) | $8,511 | $8,511 | 25.0× |
| CT cervical spine w/o contrast (72125) | $7,214 | $7,214 | 70.7× |
| CT cervical spine w/wo cont (72127) | $10,668 | $10,668 | 62.3× |
| CT chest w contrast (71260) | $8,396 | $8,396 | 49.1× |
| CT chest w/wo contrast (71270) | $10,549 | $10,549 | 61.6× |
| CT head/brain with contrast (70460) | $7,535 | $7,535 | 44.0× |
| CT head/brain without and with contrast (70470) | $9,691 | $9,691 | 56.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $9,877 | $9,877 | 29.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $850 | $850 | 10.0× |
| CT hrt w/3d image congen (75573) | $9,877 | $9,877 | 29.0× |
| CT iac w contrast (70481) | $7,971 | $7,971 | 46.6× |
| CT l-spine w&w/o contrast (72133) | $10,668 | $10,668 | 62.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$6,173–$7,730 | $6,173–$7,730 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$7,470–$9,027 | $7,470–$9,027 | varies |
| CT lumbar spine w contrast (72132) | $8,511 | $8,511 | 25.0× |
| CT lumbar spine w/o contrast (72131) | $7,214 | $7,214 | 70.7× |
| CT maxillofacial w contrast (70487) | $7,971 | $7,971 | 46.6× |
| CT maxillofacial wo contrast (70486) | $6,673 | $6,673 | 65.4× |
| CT neck tissue combo (70492) | $10,127 | $10,127 | 59.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $10,127 | $10,127 | 59.2× |
| CT orbits w/o contrast (70480) | $6,673 | $6,673 | 65.4× |
| CT pelvis w&w/o contrast (72194) | $10,668 | $10,668 | 62.3× |
| CT pelvis w/o contrast (72192) | $7,214 | $7,214 | 70.7× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$9,622–$11,180 | $9,622–$11,180 | varies |
| CT scans face/jaw combo (70488) | $10,127 | $10,127 | 59.2× |
| CT soft tissue neck w contrast (70491) | $7,971 | $7,971 | 46.6× |
| CT soft tissue neck w/o contrast (70490) | $6,673 | $6,673 | 65.4× |
| CT thoracic spine w contrast (72129) | $8,396 | $8,396 | 49.1× |
| CT thoracic spine w/o contrast (72128) | $6,673 | $6,673 | 65.4× |
| CT thoracic spine w/wo cont (72130) | $10,549 | $10,549 | 61.6× |
| CT thorax w/o contrast (71250) | $6,673 | $6,673 | 65.4× |
| CT upper ext wo (73200) | $6,173 | $6,173 | 60.5× |
| CT upper extremity w/o & w/contrast material (73202) | $9,622 | $9,622 | 56.2× |
| CT upper extremity with contrast (73201) | $7,470 | $7,470 | 21.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,142 | $4,142 | 24.2× |
| Cta Abdomen (74175) | $9,622 | $9,622 | 56.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $16,650 | $16,650 | 48.9× |
| CTA pelvis (72191) | $9,622 | $9,622 | 56.2× |
| Dxa Bone Density Axial (77080) | $1,659 | $1,659 | 16.3× |
| Echo Guide For Artery Repair (76936) | $3,585 | $3,585 | 17.0× |
| Esophagram (74220) | $2,070 | $2,070 | 12.1× |
| Fetal Biophys Profile W/Nst (76818) | $2,889 | $2,889 | 28.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,805 | $2,805 | 27.5× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$2,118–$2,843 | $2,118–$2,843 | varies |
| Follow-Up Angiography (75898) | $1,494 | $1,494 | 0.5× |
| Foot 2 views (73620) | $897 | $897 | 10.6× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$1,005–$1,510 | $1,005–$1,510 | varies |
| Gastric emptying imaging study (78264) | $9,017 | $9,017 | 23.1× |
| Gated Heart Planar Single (78472) | $5,156 | $5,156 | 13.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$848–$1,267 | $848–$1,267 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,383 | $4,383 | 6.4× |
| Heart Image (Pet) Multiple (78492) | $9,975 | $9,975 | 7.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $12,982 | $12,982 | 4.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,639 | $4,639 | 1.5× |
| Hepatobil Syst Image W/Drug (78227) | $9,354 | $9,354 | 17.7× |
| Hepatobiliary System Imaging (78226) | $9,354 | $9,354 | 24.0× |
| Ht Musc Image Planar Mult (78454) | $4,018 | $4,018 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $6,002 | $6,002 | 4.8× |
| Hysterosalpingogram (74740) | $2,087 | $2,087 | 9.0× |
| K Flow/Funct Image Multiple (78709) | $1,234 | $1,234 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $6,867 | $6,867 | 13.0× |
| K Flow/Funct Image W/O Drug (78707) | $5,518 | $5,518 | 10.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$1,123–$1,689 | $1,123–$1,689 | varies |
| Liver & Spleen Imaging Static Only (78215) | $4,152 | $4,152 | 10.6× |
| Lung Ventilat&Perfus Imaging (78582) | $10,081 | $10,081 | 19.0× |
| Lung Ventilation Imaging (78579) | $6,450 | $6,450 | 16.5× |
| Lymph System Imaging (78195) | $4,605 | $4,605 | 8.7× |
| Magnetic Image Jaw Joint (70336) | $8,473 | $8,473 | 36.4× |
| Magnetic Resonance Elastography (76391) | $624 | $624 | 2.7× |
| Meckels Divert Exam (78290) | $4,577 | $4,577 | 11.7× |
| Mlc imrt design & construction per imrt plan (77338) | $18,386 | $18,386 | 50.3× |
| Mr safety determination physician/other qhp (76016) | $218 | $218 | 2.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $26 | $26 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $228 | $228 | 2.5× |
| Mr safety implt pos&/immoblj (76019) | $148 | $148 | 2.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $598 | $598 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) | $11,523 | $11,523 | 33.9× |
| MRA head w/o contrast (70544) | $7,847 | $7,847 | 33.7× |
| MRA head with contrast (70545) | $9,345 | $9,345 | 27.5× |
| MRA neck w contrast (70548) | $7,565 | $7,565 | 22.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $9,738 | $9,738 | 28.6× |
| MRA neck w/o contrast (70547) | $6,701 | $6,701 | 28.8× |
| MRI abdomen w contrast (74182) | $9,738 | $9,738 | 28.6× |
| MRI abdomen w/o contrast (74181) | $8,869 | $8,869 | 38.1× |
| MRI any jt lower extrem w/contrast material (73722) | $9,345 | $9,345 | 12.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $10,648 | $10,648 | 31.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $9,345 | $9,345 | 12.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $9,390 | $9,390 | 40.3× |
| MRI cervical spine w contrast (72142) | $9,731 | $9,731 | 28.6× |
| MRI cervical spine w/o cont (72141) | $8,879 | $8,879 | 38.1× |
| MRI chest w/o contrast (71550) | $7,622 | $7,622 | 32.7× |
| MRI chest wo w contrast (71552) | $10,324 | $10,324 | 30.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $9,345 | $9,345 | 27.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,648 | $10,648 | 31.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $8,473 | $8,473 | 36.4× |
| MRI lumbar spine w contrast (72149) | $9,731 | $9,731 | 28.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $11,037 | $11,037 | 32.4× |
| MRI orbit face &/neck w/o contrast (70540) | $7,147 | $7,147 | 30.7× |
| MRI orbit face neck w contrast (70542) | $8,019 | $8,019 | 23.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $10,173 | $10,173 | 29.9× |
| MRI pelvis w contrast (72196) | $9,345 | $9,345 | 27.5× |
| MRI pelvis w/o & w contrast (72197) | $10,663 | $10,663 | 31.3× |
| MRI pelvis w/o contrast (72195) | $8,473 | $8,473 | 36.4× |
| MRI spectroscopy (76390) | $5,759 | $5,759 | 67.8× |
| MRI thoracic spine w/o contrast (72146) | $8,879 | $8,879 | 38.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $9,345 | $9,345 | 27.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $8,473 | $8,473 | 36.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $10,648 | $10,648 | 31.3× |
| MRI, abdomen, combo (74183) | $11,042 | $11,042 | 32.4× |
| MRI, dorsal spine combo (72157) | $11,037 | $11,037 | 32.4× |
| MRI, dorsal spine contrast (72147) | $9,731 | $9,731 | 28.6× |
| MRI, joint upper extrem (73221) | $8,473 | $8,473 | 36.4× |
| MRI, joint upper extrem combo (73223) | $10,648 | $10,648 | 31.3× |
| MRI, lumbar spine combo (72158) | $11,037 | $11,037 | 32.4× |
| Myelogram cervical (72240) | $4,231 | $4,231 | 5.5× |
| Myelogram Lumbar (72265) | $4,947 | $4,947 | 6.5× |
| Myelography thoracic (72255) | $3,185 | $3,185 | 4.2× |
| Myelograpy 2/more regions rs&i (72270) | $6,351 | $6,351 | 8.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $9,975 | $9,975 | 7.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,018 | $4,018 | 3.2× |
| Myocardial Spect Multiple Studies (78452) | $13,036 | $13,036 | 10.3× |
| Neck soft tissue (70360) | $1,005 | $1,005 | 11.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $831 | $831 | 2.1× |
| Nm csf leak detection (78650) | $1,935 | $1,935 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $957 | $957 | 9.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $24,861 | $24,861 | 18.4× |
| Nuclear Rx Oral Admin (79005) | $10,079 | $10,079 | 44.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,947 | $4,947 | 9.3× |
| Parathyroid Planar Imaging (78070) | $3,580 | $3,580 | 9.2× |
| Pelvis 1 or 2 views (72170) | $1,047 | $1,047 | 10.3× |
| Pet Image W/Ct Lmtd (78814) | $19,687 | $19,687 | 14.1× |
| PET image w/CT, full body (78816) | $19,687 | $19,687 | 14.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $19,687 | $19,687 | 14.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,577 | $4,577 | 11.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,784 | $1,784 | 17.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$3,093–$3,124 | $3,093–$3,124 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,079–$1,610 | $1,079–$1,610 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $990 | $990 | 11.7× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,294–$1,952 | $1,294–$1,952 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,527 | $1,527 | 15.0× |
| Radex fingr minimum 2 views (73140) | $889 | $889 | 10.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,098–$1,657 | $1,098–$1,657 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$995–$1,496 | $995–$1,496 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$940–$1,417 | $940–$1,417 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,069 | $1,069 | 12.6× |
| Radex Ribs Unilateral 2 Views (71100) | $1,510 | $1,510 | 17.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$1,172–$1,761 | $1,172–$1,761 | varies |
| Radex Spine 1 View Specify Level (72020) | $958 | $958 | 11.3× |
| Radex Sternum Minimum 2 Views (71120) | $1,131 | $1,131 | 13.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,095 | $1,095 | 12.9× |
| Radex Toe Minimum 2 Views (73660) | $891 | $891 | 10.5× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$1,020–$1,520 | $1,020–$1,520 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,294–$1,952 | $1,294–$1,952 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,233 | $1,233 | 12.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $62,014 | $62,014 | 8.6× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$6,269–$10,319.55 | $6,269–$10,319.55 | varies |
| Radiation treatment delivery level 2 (77407) | $12,221.75 | $12,221.75 | 32.5× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$8,511–$12,621.75 | $8,511–$12,621.75 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,610 | $1,610 | 15.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,635 | $1,635 | 16.0× |
| Radiologic exam colon double contrast study (74280) | $3,508 | $3,508 | 20.5× |
| Radiologic exam colon single contrast study (74270) | $2,717 | $2,717 | 15.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$2,038–$3,068 | $2,038–$3,068 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,036 | $2,036 | 11.9× |
| Radiologic exam swallow function contrast study (74230) | $2,070 | $2,070 | 12.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $3,012 | $3,012 | 17.6× |
| Radiologic examination femur 1 view (73551) | $391 | $391 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $391 | $391 | 4.6× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$786–$1,172 | $786–$1,172 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$1,265–$1,889 | $1,265–$1,889 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,224 | $1,224 | 3.3× |
| Ribs bilateral 3 views (71110) | $1,605 | $1,605 | 15.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,561 | $2,561 | 6.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $4,941 | $4,941 | 12.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,992 | $4,992 | 9.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $6,391 | $6,391 | 12.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $6,066 | $6,066 | 11.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,617 | $5,617 | 4.4× |
| Rp Therapy Intravenous Administration (79101) | $1,358 | $1,358 | 6.0× |
| Scapula (73010) range across 3 matching MRF lines |
$1,106–$1,660 | $1,106–$1,660 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $102 | $102 | 4.4× |
| Shoulder 1 view (73020) | $748 | $748 | 8.8× |
| Skull less than 4 views (70250) | $1,187 | $1,187 | 11.6× |
| Special dosimetry (77331) | $1,953 | $1,953 | 14.9× |
| Special Physics Consult (77370) | $2,240 | $2,240 | 17.1× |
| Special teletherapy port plan (77321) | $2,336 | $2,336 | 6.4× |
| Special treatment procedure (77470) | $7,353 | $7,353 | 13.6× |
| Stereotactic Body Radiation Delivery (77373) | $47,835 | $47,835 | 27.4× |
| Sternoclavicular joints (71130) | $793 | $793 | 9.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $11,957 | $11,957 | 32.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,215 | $5,215 | 14.3× |
| Ther rad simulaj-aided field setting simple (77280) | $2,610 | $2,610 | 19.9× |
| Thoracic spine 2 views (72070) | $1,441 | $1,441 | 14.1× |
| Thoracic spine 3 views (72072) | $1,928 | $1,928 | 18.9× |
| Thoracolumbar 2 views (72080) | $1,197 | $1,197 | 14.1× |
| Thyroid Imaging With Vascular Flow (78013) | $4,237 | $4,237 | 10.9× |
| Thyroid Met Imaging Body (78018) | $6,606 | $6,606 | 12.5× |
| Thyroid Uptake Measurement (78012) | $5,918 | $5,918 | 15.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $5,918 | $5,918 | 15.2× |
| Tx Devices Design & Construction Complex (77334) | $3,309 | $3,309 | 9.1× |
| Tx devices design & construction intermediate (77333) | $1,907 | $1,907 | 14.5× |
| Tx devices design & construction simple (77332) | $1,368 | $1,368 | 10.4× |
| Ultrasound Breast Limited (76642) | $931 | $931 | 11.0× |
| Ultrasound elastography first target lesion (76982) | $1,092 | $1,092 | 10.7× |
| Ultrasound Elastography Parenchyma (76981) | $606 | $606 | 5.9× |
| Ultrasound Exam Aaa Screen (76706) | $2,033 | $2,033 | 19.9× |
| Ultrasound, abdomen limited (76705) | $2,889 | $2,889 | 28.3× |
| Umbilical-artery Doppler (OB) (76820) | $899 | $899 | 8.8× |
| Upper gi w/o kub (74240) | $2,569 | $2,569 | 15.0× |
| Ureteral Reflux Study (78740) | $995 | $995 | 2.6× |
| Urethrocystogram voiding (74455) | $2,398 | $2,398 | 10.3× |
| Urethrocystography retrograde (74450) | $980 | $980 | 4.2× |
| Us breast unilateral complete (76641) | $931 | $931 | 9.1× |
| Us chest (76604) range across 2 matching MRF lines |
$621–$2,377 | $621–$2,377 | varies |
| Us exam, pelvic, limited (76857) | $2,425 | $2,425 | 23.8× |
| Us head (76506) | $2,771 | $2,771 | 27.2× |
| Us kidney transplant (76776) | $1,244 | $1,244 | 12.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$1,743–$5,226 | $1,743–$5,226 | varies |
| Us ob detailed single fetus (76811) | $4,121 | $4,121 | 17.7× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$1,594–$1,650 | $1,594–$1,650 | varies |
| Us ob transvaginal (76817) | $3,491 | $3,491 | 34.2× |
| Us pelvic non ob complete (76856) | $2,999 | $2,999 | 29.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,860 | $1,860 | 18.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,650 | $1,650 | 16.2× |
| Us retroperitoneal complete (76770) | $3,140 | $3,140 | 30.8× |
| Us retroperitoneal limited (76775) | $2,033 | $2,033 | 19.9× |
| Us scrotum and contents (76870) | $2,867 | $2,867 | 28.1× |
| Us spinal canal and contents (76800) | $754 | $754 | 7.4× |
| Us thyroid (76536) | $2,470 | $2,470 | 24.2× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$4,295–$4,639 | $4,295–$4,639 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $7,788 | $7,788 | 2.5× |
| Venogram Sinus/Jugular (75860) | $4,639 | $4,639 | 1.5× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$4,928–$9,645 | $4,928–$9,645 | varies |
| Venography extremity bilateral rs&i (75822) | $10,929 | $10,929 | 7.1× |
| Venography extremity unilateral rs&i (75820) range across 6 matching MRF lines |
$5,786–$7,745 | $5,786–$7,745 | varies |
| Venography Renal Unilateral (75831) | $4,639 | $4,639 | 1.5× |
| Venous sampling by catheter (75893) | $5,026 | $5,026 | 0.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$833–$1,259 | $833–$1,259 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,233 | $1,233 | 14.5× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$1,393–$1,406 | $1,393–$1,406 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$5,850–$7,304 | $5,850–$7,304 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$833–$1,259 | $833–$1,259 | varies |
| X-Ray Exam Breast Specimen (76098) | $610 | $610 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $645 | $645 | 6.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $391 | $391 | 4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $391 | $391 | 4.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $645 | $645 | 6.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $645 | $645 | 6.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $645 | $645 | 6.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,233 | $1,233 | 12.1× |
| X-Ray Exam L-S Spine Bending (72114) | $2,075 | $2,075 | 20.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,440 | $1,440 | 17.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $2,204 | $2,204 | 21.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,739 | $1,739 | 17.0× |
| X-ray eye for foreign body (70030) | $1,267 | $1,267 | 14.9× |
| X-ray humerus (73060) | $1,005 | $1,005 | 11.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,727 | $1,727 | 16.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,606 | $2,606 | 25.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,156 | $1,156 | 11.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,166 | $1,166 | 13.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,619 | $1,619 | 19.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,668 | $1,668 | 16.4× |
| X-ray thoracic spine 4 vw (72074) | $2,449 | $2,449 | 24.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,718 | $3,718 | 10.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$873–$2,140 | $873–$2,140 | varies |
| X-Rays Bone Survey Complete (77075) | $2,796 | $2,796 | 27.4× |
| Xr c-spine 4 or 5 views (72050) | $2,043 | $2,043 | 20.0× |
| Xr facial bones less than 3 views (70140) | $1,075 | $1,075 | 12.7× |
| XR Mastoids < 3 Views Bilateral (70120) | $1,419 | $1,419 | 13.9× |
| Xr orbits complete 4 views (70200) | $1,544 | $1,544 | 15.1× |
| Xr Tomogram Single Plane (76100) | $2,508 | $2,508 | 24.6× |
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.