Imaging prices at Logan Health Medical Center
Kalispell, MT · every code in this section with a posted price and a Medicare benchmark.
442 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) | $6,237.24 | $9,595.75 | 4.4× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$13.65–$149.99 | $21–$230.75 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$17.55–$224.58 | $27–$345.50 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$71.50–$1,520.35 | $110–$2,339 | varies |
| Adrenal Cortex & Medulla Img (78075) range across 2 matching MRF lines |
$1,378.81 | $84–$2,121.25 | 1.0× |
| Angio internal mammary (75756) | $83.20 | $128 | 0.0× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$117.65–$2,347.31 | $181–$3,611.25 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $93.60 | $144 | 0.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$142.35–$180.70 | $219–$278 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$118.95–$127.40 | $183–$196 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $92.95 | $143 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,744.60 | $2,684 | 0.5× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$13–$272.51 | $20–$419.25 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$81.90 | $126 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $36.40 | $56 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$143.65 | $221 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$80.60 | $124 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$174.85 | $269 | 0.0× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$44.20–$296.24 | $68–$455.75 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$42.25–$253.01 | $65–$389.25 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$49.40–$469.46 | $76–$722.25 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$14.30–$201.01 | $22–$309.25 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$73.45–$1,552.20 | $113–$2,388 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$46.15–$1,038.70 | $71–$1,598 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$59.80–$1,350.05 | $92–$2,077 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$62.40–$1,494.84 | $96–$2,299.75 | varies |
| Bone marrow imaging; multiple areas (78103) | $51.35 | $79 | 0.1× |
| Bone marrow imaging; whole body (78104) | $57.20 | $88 | 0.1× |
| Bone survey infant (77076) | $52 | $80 | 0.5× |
| Brachytx isodose complex (77318) | $1,339.65 | $2,061 | 3.5× |
| Brachytx isodose intermed (77317) | $590.36 | $908.25 | 1.5× |
| Brachytx Isodose Plan Simple (77316) | $482.14 | $741.75 | 1.3× |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$524.22 | $33–$806.50 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $46.80 | $72 | 0.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $39 | $60 | 0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$105.30–$4,871.91 | $162–$7,495.25 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$189.15–$1,324.38 | $291–$2,037.50 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$216.45–$1,505.56 | $333–$2,316.25 | varies |
| Cardiac Shunt Detection (78428) | $56.55 | $87 | 0.1× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$70.20–$467.19 | $108–$718.75 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$40.30–$844.51 | $62–$1,299.25 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$49.40–$1,073.96 | $76–$1,652.25 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$13.65–$136.34 | $21–$209.75 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$16.25–$142.84 | $25–$219.75 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$20.80–$147.22 | $32–$226.50 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$23.40–$219.21 | $36–$337.25 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$23.40–$262.76 | $36–$404.25 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$87.10–$600.76 | $134–$924.25 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$13–$261.62 | $20–$402.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$79.30–$515.29 | $122–$792.75 | varies |
| Continuing medical physics consltj pr wk (77336) | $686.72 | $1,056.50 | 5.0× |
| Contrast Exam Abdominl Aorta (75625) | $2,627.79 | $4,042.75 | 0.8× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$23.40–$526.18 | $36–$809.50 | varies |
| Contrast X-Ray Of Elbow (73085) | $42.90 | $66 | 0.1× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$42.90–$499.69 | $66–$768.75 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $44.20 | $68 | 0.2× |
| Corpora cavernosography (74445) | $81.90 | $126 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$146.90–$2,430.35 | $226–$3,739 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$128.05–$1,837.71 | $197–$2,827.25 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$92.95–$955.18 | $143–$1,469.50 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$102.05–$1,098.50 | $157–$1,690 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$87.10–$830.54 | $134–$1,277.75 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$159.90–$2,777.61 | $246–$4,273.25 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$133.25–$1,525.06 | $205–$2,346.25 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$128.05–$1,289.11 | $197–$1,983.25 | varies |
| CT angio hrt w/3d image (75574) | $174.20 | $268 | 0.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$137.80–$1,552.69 | $212–$2,388.75 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$128.05–$1,233.05 | $197–$1,897 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$131.30–$1,432.28 | $202–$2,203.50 | varies |
| CT bone density (77078) | $18.20 | $28 | 0.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$89.05–$1,293.66 | $137–$1,990.25 | varies |
| CT cervical spine w/o contrast (72125) range across 7 matching MRF lines |
$73.45–$1,172.92 | $113–$1,804.50 | varies |
| CT cervical spine w/wo cont (72127) | $92.30 | $142 | 0.5× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$85.80–$1,250.28 | $132–$1,923.50 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$91–$1,444.79 | $140–$2,222.75 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$169.65–$406.58 | $261–$625.50 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 2 matching MRF lines |
$182.65–$621.56 | $281–$956.25 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$176.15–$596.05 | $271–$917 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$83.20–$1,073.64 | $128–$1,651.75 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$92.95–$1,234.51 | $143–$1,899.25 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $126.75 | $195 | 0.4× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$43.55–$412.26 | $67–$634.25 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$83.20–$1,155.21 | $128–$1,777.25 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$92.30–$1,353.30 | $142–$2,082 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$73.45–$863.04 | $113–$1,327.75 | varies |
| CT lower extremity w/contrast material (73701) | $85.15 | $131 | 0.5× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$89.05–$1,235.49 | $137–$1,900.75 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$73.45–$1,055.44 | $113–$1,623.75 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$82.55–$984.10 | $127–$1,514 | varies |
| CT maxillofacial wo contrast (70486) | $62.40 | $96 | 0.6× |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$119.60–$990.44 | $184–$1,523.75 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$92.30–$1,390.84 | $142–$2,139.75 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$93.60–$791.21 | $144–$1,217.25 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$89.05–$1,201.36 | $137–$1,848.25 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$79.95–$1,442.84 | $123–$2,219.75 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$88.40–$1,140.91 | $136–$1,755.25 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$92.95–$1,131.65 | $143–$1,741 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$100.75–$892.12 | $155–$1,372.50 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$93.60–$808.11 | $144–$1,243.25 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$89.05–$1,147.25 | $137–$1,765 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$73.45–$1,144.81 | $113–$1,761.25 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$92.30–$1,558.38 | $142–$2,397.50 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$79.30–$860.44 | $122–$1,323.75 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$73.45–$883.19 | $113–$1,358.75 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$89.05–$3,128.78 | $137–$4,813.50 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$85.15–$1,399.61 | $131–$2,153.25 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $174.20 | $268 | 1.0× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$132.60–$1,289.28 | $204–$1,983.50 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$131.95–$1,330.71 | $203–$2,047.25 | varies |
| Dilation ureters/urethra rs&i (74485) | $59.15 | $91 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $86.45 | $133 | 0.0× |
| Diskography lumbar (72295) | $62.40 | $96 | 0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$20.15–$230.75 | $31–$355 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$37.05–$409.01 | $57–$629.25 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$45.50–$126.59 | $70–$194.75 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$14.95–$172.74 | $23–$265.75 | varies |
| Dxa bone density study (77085) | $57.85 | $89 | 0.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 3 matching MRF lines |
$15.60–$46.96 | $24–$72.25 | varies |
| Echo exam of fetal heart (76825) range across 3 matching MRF lines |
$122.20–$409.01 | $188–$629.25 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$53.95–$140.24 | $83–$215.75 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$144.30–$445.90 | $222–$686 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 3 matching MRF lines |
$61.10–$254.15 | $94–$391 | varies |
| Echograp Trans R Pros Study (76873) | $417.46 | $642.25 | 3.9× |
| Esophagram (74220) range across 2 matching MRF lines |
$44.85–$368.71 | $69–$567.25 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$54.60–$269.26 | $84–$414.25 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$40.30–$294.78 | $62–$453.50 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $220.35 | $339 | 0.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$23.40–$408.36 | $36–$628.25 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$134.55–$1,170 | $207–$1,800 | varies |
| Foot 2 views (73620) range across 5 matching MRF lines |
$11.70–$186.71 | $18–$287.25 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$12.35–$177.78 | $19–$273.50 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$57.20–$1,193.56 | $88–$1,836.25 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $70.20 | $108 | 0.2× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$50.05–$639.44 | $77–$983.75 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$70.20–$1,700.08 | $108–$2,615.50 | varies |
| Gated Heart, Multiple (78473) | $104.65 | $161 | 0.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $73.45 | $113 | 0.1× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$13–$205.08 | $20–$315.50 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $928.20 | $1,428 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$592.80–$3,535.84 | $912–$5,439.75 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,535.84 | $5,439.75 | 5.0× |
| Heart first pass single,planar (78481) | $70.85 | $109 | 0.1× |
| Heart Image (Pet) Multiple (78492) | $4,974.12 | $7,652.50 | 3.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $78 | $120 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $79.30 | $122 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$65–$1,359.96 | $100–$2,092.25 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$53.95–$1,359.96 | $83–$2,092.25 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$98.80–$1,781.65 | $152–$2,741 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$28.60–$313.14 | $44–$481.75 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$54.60–$251.55 | $84–$387 | varies |
| Infant hip ultrasound, limited static exam (76886) | $46.80 | $72 | 0.5× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$35.75–$806.65 | $55–$1,241 | varies |
| Interstitial radiation source applic complex (77778) | $4,028.54 | $6,197.75 | 5.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,711.61 | $2,633.25 | 2.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,550.74 | $2,385.75 | 2.7× |
| Intracavitary radiation source applic simple (77761) | $1,454.05 | $2,237 | 2.6× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$26–$33.15 | $40–$51 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$86.45–$1,631.34 | $133–$2,509.75 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$68.25–$1,471.76 | $105–$2,264.25 | varies |
| Kidney Imaging Morphol (78700) | $32.50 | $50 | 0.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $35.75 | $55 | 0.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$14.30–$295.59 | $22–$454.75 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $38.35 | $59 | 0.1× |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$62.40–$800.48 | $96–$1,231.50 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$35.75–$1,069.90 | $55–$1,646 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$40.30–$1,136.04 | $62–$1,747.75 | varies |
| Liver imaging static only (78201) | $31.20 | $48 | 0.1× |
| Liver imaging w/vascular flow (78202) | $36.40 | $56 | 0.1× |
| Lung Perf&Ventilat Diferentl (78598) | $641.55 | $987 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$76.70–$2,052.21 | $118–$3,157.25 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$35.10–$422.82 | $54–$650.50 | varies |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$85.80–$1,513.20 | $132–$2,328 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $85.80 | $132 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $66.95 | $103 | 0.1× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$107.90–$1,152.29 | $166–$1,772.75 | varies |
| Mammary ductogram or galactogram single (77053) | $26.65 | $41 | 0.1× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$49.40–$948.35 | $76–$1,459 | varies |
| Mr safety determination physician/other qhp (76016) | $138.45 | $213 | 1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $138.45 | $213 | 1.4× |
| Mr safety implt pos&/immoblj (76019) | $69.22 | $106.50 | 1.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $276.74 | $425.75 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$107.90–$2,105.68 | $166–$3,239.50 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$87.75–$1,336.24 | $135–$2,055.75 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$87.75–$1,589.58 | $135–$2,445.50 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$109.20–$1,230.61 | $168–$1,893.25 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$132.60–$2,158.65 | $204–$3,321 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$88.40–$1,074.78 | $136–$1,653.50 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$127.40–$1,735.34 | $196–$2,669.75 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$106.60–$1,350.86 | $164–$2,078.25 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$120.25–$1,284.72 | $185–$1,976.50 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$157.95–$2,062.78 | $243–$3,173.50 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$120.25–$1,280.50 | $185–$1,970 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$156–$1,495.32 | $240–$2,300.50 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$117–$2,362.59 | $180–$3,634.75 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,971.29 | $3,032.75 | 8.1× |
| MRI cardiac w/o cont stress (75559) | $1,545.38 | $2,377.50 | 2.8× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$170.30–$1,312.51 | $262–$2,019.25 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$131.30–$1,337.54 | $202–$2,057.75 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$108.55–$1,197.79 | $167–$1,842.75 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$106.60–$1,241.34 | $164–$1,909.75 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$127.40–$1,477.78 | $196–$2,273.50 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$165.10–$2,385.50 | $254–$3,670 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$119.60–$1,591.36 | $184–$2,448.25 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $157.95 | $243 | 0.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$98.80–$1,198.28 | $152–$1,843.50 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$131.30–$1,559.19 | $202–$2,398.75 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$168.35–$2,018.90 | $259–$3,106 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$98.15–$956.64 | $151–$1,471.75 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$119.60–$1,235.16 | $184–$1,900.25 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$157.30–$1,820.65 | $242–$2,801 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$127.40–$1,742.65 | $196–$2,681 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$161.20–$2,370.22 | $248–$3,646.50 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$106.60–$1,532.86 | $164–$2,358.25 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$104–$1,084.69 | $160–$1,668.75 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$108.55–$1,335.59 | $167–$2,054.75 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$119.60–$1,280.50 | $184–$1,970 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$98.80–$1,187.22 | $152–$1,826.50 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$157.95–$2,424.66 | $243–$3,730.25 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$161.20–$2,175.71 | $248–$3,347.25 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$168.35–$1,766.21 | $259–$2,717.25 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$131.30–$1,535.79 | $202–$2,362.75 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$100.10–$1,127.75 | $154–$1,735 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$158.60–$2,252.58 | $244–$3,465.50 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$168.35–$2,222.51 | $259–$3,419.25 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$67.60–$847.60 | $104–$1,304 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$60.45–$820.30 | $93–$1,262 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$71.50–$689.49 | $110–$1,060.75 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$99.45–$856.54 | $153–$1,317.75 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$111.80–$4,974.12 | $172–$7,652.50 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$116.35–$3,211.16 | $179–$4,940.25 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$13.65–$208.81 | $21–$321.25 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 2 matching MRF lines |
$289.09–$393.90 | $444.75–$606 | varies |
| Nm csf leak detection (78650) | $38.35 | $59 | 0.0× |
| Nm red cell survival study (78130) | $38.35 | $59 | 0.1× |
| Nm whole blood volume (78122) | $31.20 | $48 | 0.1× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$36.40–$362.86 | $56–$558.25 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,729.29 | $10,352.75 | 4.8× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$167.70–$343.69 | $258–$528.75 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$128.70–$656.82 | $198–$1,010.50 | varies |
| Ob us nuchal meas 1 gest (76813) range across 3 matching MRF lines |
$49.40–$338.32 | $76–$520.50 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$46.80–$590.85 | $72–$909 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$16.90–$150.48 | $26–$231.50 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$15.60–$84.50 | $24–$130 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $111.80 | $172 | 0.2× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$57.85–$1,292.85 | $89–$1,989 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $85.80 | $132 | 0.2× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$13–$171.92 | $20–$264.50 | varies |
| Perineogram (74775) | $46.80 | $72 | 0.2× |
| Peritoneogram Rs&I (74190) | $685.75 | $1,055 | 1.2× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$135.85–$5,265 | $209–$8,100 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$156–$5,791.34 | $240–$8,909.75 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$175.50–$7,658.95 | $270–$11,783 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$174.20–$6,660.06 | $268–$10,246.25 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $108.55 | $167 | 0.1× |
| Pet Myocardial Sngl Study (78491) | $4,974.12 | $7,652.50 | 3.4× |
| PET whole body (78813) range across 2 matching MRF lines |
$136.50–$5,265 | $210–$8,100 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $14.30 | $22 | 0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $99.45 | $153 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$53.95–$1,165.12 | $83–$1,792.50 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$23.40–$348.89 | $36–$536.75 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $39 | $60 | 0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$13–$297.05 | $20–$457 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$12.35–$286.65 | $19–$441 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$13–$312.81 | $20–$481.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$19.50–$246.35 | $30–$379 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$10.40–$166.08 | $16–$255.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$13–$295.10 | $20–$454 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$13–$168.68 | $20–$259.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$12.35–$228.31 | $19–$351.25 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$25.35–$250.41 | $39–$385.25 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$13–$197.11 | $20–$303.25 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$16.90–$236.92 | $26–$364.50 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$14.30–$295.59 | $22–$454.75 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$13–$173.22 | $20–$266.50 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$85.80–$1,260.19 | $132–$1,938.75 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$12.35–$120.74 | $19–$185.75 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$14.95–$203.78 | $23–$313.50 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$18.20–$310.54 | $28–$477.75 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$10.40–$158.28 | $16–$243.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$12.35–$146.25 | $19–$225 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$13–$231.24 | $20–$355.75 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$31.20–$292.82 | $48–$450.50 | varies |
| Radiation treatment delivery level 1 (77402) | $623.84 | $959.75 | 6.0× |
| Radiation treatment delivery level 2 (77407) | $870.51 | $1,339.25 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $951.11 | $1,463.25 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$18.20–$271.05 | $28–$417 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$20.15–$225.06 | $31–$346.25 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$91.65–$563.06 | $141–$866.25 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$76.05–$470.44 | $117–$723.75 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$16.90–$290.39 | $26–$446.75 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$18.85–$240.01 | $29–$369.25 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$59.80–$480.19 | $92–$738.75 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$39.65–$382.52 | $61–$588.50 | varies |
| Radiologic exam teeth complete full mouth (70320) | $17.55 | $27 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$65.65–$496.44 | $101–$763.75 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$13–$146.74 | $20–$225.75 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$13.65–$292.34 | $21–$449.75 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$13–$240.18 | $20–$369.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$32.50–$234.32 | $50–$360.50 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $13 | $20 | 0.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$12.35–$267.80 | $19–$412 | varies |
| Radiopharm Dacryocystography (78660) | $39.65 | $61 | 0.1× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $20.80 | $32 | 0.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,022.61 | $1,573.25 | 2.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,022.61 | $1,573.25 | 2.6× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$39–$873.28 | $60–$1,343.50 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$21.45–$68.90 | $33–$106 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $47.45 | $73 | 0.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$53.30–$2,613.65 | $82–$4,021 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $72.15 | $111 | 0.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$57.20–$2,613.65 | $88–$4,021 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$76.70–$2,272.56 | $118–$3,496.25 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$130–$2,613.65 | $200–$4,021 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$150.15–$3,005.60 | $231–$4,624 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$104.65–$2,613.65 | $161–$4,021 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,007.50 | $1,550 | 4.2× |
| Rp Therapy Intravenous Administration (79101) range across 4 matching MRF lines |
$143–$670.64 | $220–$1,031.75 | varies |
| Salivary Gland Function Study (78232) | $29.25 | $45 | 0.1× |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$32.50–$1,193.56 | $50–$1,836.25 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$13.65–$147.88 | $21–$227.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$40.14–$50.54 | $61.75–$77.75 | varies |
| Sella turcica (70240) | $14.30 | $22 | 0.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$11.70–$154.54 | $18–$237.75 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$41.60–$316.39 | $64–$486.75 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$28.60–$437.45 | $44–$673 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$13.65–$195.32 | $21–$300.50 | varies |
| Special dosimetry (77331) | $356.36 | $548.25 | 2.6× |
| Special Physics Consult (77370) | $1,084.69 | $1,668.75 | 7.9× |
| Special teletherapy port plan (77321) | $549.41 | $845.25 | 1.4× |
| Special treatment procedure (77470) | $2,340 | $3,600 | 4.1× |
| Speech evaluation, complex (70371) range across 3 matching MRF lines |
$62.40–$442.16 | $96–$680.25 | varies |
| Srs Multisource (77371) | $14,591.36 | $22,448.25 | 1.9× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$16.25–$214.66 | $25–$330.25 | varies |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $102.05 | $157 | 1.0× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $102.05 | $157 | 1.0× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $37.70 | $58 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,109.06 | $1,706.25 | 2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $566.15 | $871 | 1.5× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$52.65–$1,136.04 | $81–$1,747.75 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$122.85–$1,531.89 | $189–$2,356.75 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,107.28 | $1,703.50 | 2.9× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$633.75–$765.21 | $975–$1,177.25 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$153.40–$416.16 | $236–$640.25 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$15.60–$180.54 | $24–$277.75 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$16.90–$207.35 | $26–$319 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$15.60–$185.41 | $24–$285.25 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $49.40 | $76 | 0.1× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$26.65–$814.29 | $41–$1,252.75 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$61.10–$1,527.50 | $94–$2,350 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$531.54 | $21–$817.75 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $36.40 | $56 | 0.1× |
| Tx Devices Design & Construction Complex (77334) | $1,005.39 | $1,546.75 | 2.6× |
| Tx devices design & construction intermediate (77333) | $733.20 | $1,128 | 5.3× |
| Tx devices design & construction simple (77332) | $606.12 | $932.50 | 4.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$50.70–$245.86 | $78–$378.25 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$41.60–$359.12 | $64–$552.50 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$40.30–$480.35 | $62–$739 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$18.20–$458.25 | $28–$705 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $282.75 | $435 | 3.2× |
| Unlisted us procedure (76999) | $154.05 | $237 | 1.7× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$59.15–$433.55 | $91–$667 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $493.19 | $758.75 | 44.6× |
| Ureteral Reflux Study (78740) | $40.95 | $63 | 0.1× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$23.40–$530.08 | $36–$815.50 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$24.05–$465.56 | $37–$716.25 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$53.95–$348.08 | $83–$535.50 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$36.89–$618.31 | $56.75–$951.25 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$46.15–$322.72 | $71–$496.50 | varies |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$19.50–$241.15 | $30–$371 | varies |
| Us head (76506) range across 2 matching MRF lines |
$47.45–$438.75 | $73–$675 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$55.90–$484.09 | $86–$744.75 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$26.65–$235.79 | $41–$362.75 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$66.95–$311.68 | $103–$479.50 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$41.60–$357.50 | $64–$550 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$47.45–$362.38 | $73–$557.50 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$51.35–$468.65 | $79–$721 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$58.50–$322.08 | $90–$495.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$57.20–$285.35 | $88–$439 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$54.60–$431.76 | $84–$664.25 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$24.05–$325.65 | $37–$501 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$47.45–$460.85 | $73–$709 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$88.40–$219.21 | $136–$337.25 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$38.35–$247.98 | $59–$381.50 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$49.40–$364.65 | $76–$561 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$37.70–$351.65 | $58–$541 | varies |
| Vasogram (74440) | $27.30 | $42 | 0.1× |
| Vein X-Ray Chest (75827) | $83.20 | $128 | 0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,302.14 | $3,541.75 | 0.7× |
| Venogram Sinus/Jugular (75860) | $83.20 | $128 | 0.0× |
| Venography Adrenal Unilateral (75840) | $83.20 | $128 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $82.55 | $127 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $106.60 | $164 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $77.35 | $119 | 0.0× |
| Venography Renal Bilateral (75833) | $106.60 | $164 | 0.0× |
| Venography Renal Unilateral (75831) | $79.30 | $122 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$39 | $60 | 0.0× |
| Vertebral fracture assessment via dxa (77086) | $39 | $60 | 0.4× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$13–$238.71 | $20–$367.25 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$14.30–$221.81 | $22–$341.25 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$37.05–$665.44 | $57–$1,023.75 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$144.95–$2,768.51 | $176–$4,259.25 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$16.90–$230.26 | $26–$354.25 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$13–$270.89 | $20–$416.75 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$622.70 | $36–$958 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$19.50–$192.72 | $30–$296.50 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$23.40–$221.65 | $36–$341 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$26.65–$371.80 | $41–$572 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$14.30–$138.94 | $22–$213.75 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$16.90–$159.90 | $26–$246 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$20.80–$183.62 | $32–$282.50 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$16.90–$222.46 | $26–$342.25 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$22.10–$84.50 | $34–$130 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$23.40–$62.40 | $36–$96 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$22.75–$311.68 | $35–$479.50 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$16.90–$169.32 | $26–$260.50 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$22.10–$324.68 | $34–$499.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$20.15–$253.66 | $31–$390.25 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$13.65–$274.95 | $21–$423 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$13–$259.68 | $20–$399.50 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$35.75–$504.89 | $55–$776.75 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$35.75–$927.55 | $55–$1,427 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$37.05–$204.26 | $57–$314.25 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$13–$129.84 | $20–$199.75 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$16.90–$186.88 | $26–$287.50 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$13.65–$179.08 | $21–$275.50 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$23.40–$272.84 | $36–$419.75 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$16.90–$179.08 | $26–$275.50 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$13–$123.99 | $20–$190.75 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$13–$202.31 | $20–$311.25 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$16.25–$195.98 | $25–$301.50 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$20.80–$215.15 | $32–$331 | varies |
| X-Ray Stress View (77071) | $85.15 | $131 | 1.0× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$18.20–$238.39 | $28–$366.75 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$13.65–$294.45 | $21–$453 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$37.70–$528.78 | $58–$813.50 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$20.80–$458.74 | $32–$705.75 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$41.60–$269.26 | $64–$414.25 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$20.80–$248.30 | $32–$382 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$15.60–$193.21 | $24–$297.25 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$13.65–$37.05 | $21–$57 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$20.80–$44.20 | $32–$68 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$44.20–$246.35 | $68–$379 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.