Imaging prices at Loma Linda University Medical Center
Loma Linda, CA · every code in this section with a posted price and a Medicare benchmark.
454 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) | $12,168.45 | $27,041 | 6.8× |
| Abdomen 1 View (74018) | $242.55 | $539 | 2.2× |
| Abdomen 2 views (74019) | $303.30 | $674 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,606.95 | $3,571 | 3.1× |
| Adrenal Cortex & Medulla Img (78075) | $2,330.55 | $5,179 | 1.4× |
| Angio internal mammary (75756) | $5,255.55 | $11,679 | 1.3× |
| Angio pulmonary bilat (75743) | $5,101.20 | $11,336 | 1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,463 | $12,140 | 1.3× |
| Angiography extremity bilateral rs&i (75716) | $5,778 | $12,840 | 1.4× |
| Angiography extremity unilateral rs&i (75710) | $4,962.60 | $11,028 | 1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,400.65 | $7,557 | 0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,255.55 | $11,679 | 1.3× |
| Ankle 2 views (73600) | $431.55 | $959 | 3.9× |
| Aortography thoracic serialography rs&i (75605) | $5,152.50 | $11,450 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,048.20 | $8,996 | 1.0× |
| Artery X-Rays Abdomen (75726) | $6,202.80 | $13,784 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $3,578.40 | $7,952 | 0.9× |
| Artery X-Rays Pelvis (75736) | $5,210.55 | $11,579 | 0.7× |
| Artery X-Rays Spine (75705) | $7,134.75 | $15,855 | 1.0× |
| Arthrogram ankle (73615) | $774.45 | $1,721 | 1.7× |
| Arthrogram hip (73525) | $1,034.55 | $2,299 | 2.3× |
| Arthrogram Wrist (73115) | $1,071.90 | $2,382 | 2.4× |
| Basic radiation dosimetry calculation (77300) | $1,023.30 | $2,274 | 5.9× |
| Bone age studies (77072) | $373.95 | $831 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,280.70 | $2,846 | 2.5× |
| Bone Imaging Limited Area (78300) | $741.15 | $1,647 | 1.4× |
| Bone Imaging Whole Body (78306) | $1,306.80 | $2,904 | 2.5× |
| Bone marrow imaging limited area (78102) | $583.65 | $1,297 | 1.1× |
| Bone survey infant (77076) | $203.40 | $452 | 1.5× |
| Brachytx isodose complex (77318) | $3,091.50 | $6,870 | 6.4× |
| Brachytx isodose intermed (77317) | $2,827.80 | $6,284 | 5.9× |
| Brachytx Isodose Plan Simple (77316) | $2,476.35 | $5,503 | 5.1× |
| Brain Flow Imaging Only (78610) | $1,273.50 | $2,830 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $849.15 | $1,887 | 1.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $679.50 | $1,510 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,173.85 | $7,053 | 1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$2,555.55–$5,856.75 | $5,679–$13,015 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$2,770.65–$7,168.50 | $6,157–$15,930 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$399.60–$569.70 | $888–$1,266 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $979.20 | $2,176 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $1,170.45 | $2,601 | 1.7× |
| Chest 1 view (71045) | $373.50 | $830 | 3.3× |
| Chest 2 views (71046) | $374.85 | $833 | 3.3× |
| Chest 3 views (71047) | $414.90 | $922 | 3.7× |
| Chest 4 or more views (71048) | $450.90 | $1,002 | 3.4× |
| Cholecystography Oral Contrast (74290) | $211.50 | $470 | 0.9× |
| Clavicle complete (73000) | $422.55 | $939 | 3.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $182.70 | $406 | 1.4× |
| Continuing medical physics consltj pr wk (77336) | $1,142.10 | $2,538 | 6.6× |
| Contrast Exam Abdominl Aorta (75625) | $5,713.20 | $12,696 | 1.4× |
| Contrast X-Ray Bladder (74430) | $567.45 | $1,261 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $707.40 | $1,572 | 1.6× |
| Contrast X-Ray Of Knee Joint (73580) | $985.05 | $2,189 | 2.2× |
| Corpora cavernosography (74445) | $310.50 | $690 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,937.70–$3,451.50 | $4,306–$7,670 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,611.45–$2,871.45 | $3,581–$6,381 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,348.20–$2,601.45 | $2,996–$5,781 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,577.25–$2,809.35 | $3,505–$6,243 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,199.25–$2,155.95 | $2,665–$4,791 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,710.90–$3,048.30 | $3,802–$6,774 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,646.10–$2,559.60 | $3,658–$5,688 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,928.25–$2,747.70 | $4,285–$6,106 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,448.10–$2,064.15 | $3,218–$4,587 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,231.20–$2,192.85 | $2,736–$4,873 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,928.25–$2,747.70 | $4,285–$6,106 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,351.80–$2,407.50 | $3,004–$5,350 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $247.50 | $550 | 1.1× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,300.05–$2,316.15 | $2,889–$5,147 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,207.80–$2,151 | $2,684–$4,780 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,358.10–$2,431.35 | $3,018–$5,403 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,242.45–$2,213.10 | $2,761–$4,918 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,473.30–$2,624.85 | $3,274–$5,833 | varies |
| CT colonography screening (74263) range across 4 matching MRF lines |
$527.40–$939.60 | $1,172–$2,088 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 2 matching MRF lines |
$1,567.80–$2,525.85 | $3,484–$5,613 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$1,417.95–$2,234.70 | $3,151–$4,966 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,333.80–$2,374.65 | $2,964–$5,277 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,493.55–$2,466.90 | $3,319–$5,482 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$1,062–$1,513.35 | $2,360–$3,363 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$243–$432.45 | $540–$961 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$1,062–$1,840.50 | $2,360–$4,090 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,333.80–$2,374.65 | $2,964–$5,277 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,351.80–$2,302.20 | $3,004–$5,116 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,143.45–$2,036.25 | $2,541–$4,525 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,283.85–$2,286.45 | $2,853–$5,081 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,231.20–$2,192.85 | $2,736–$4,873 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,147.50–$2,044.35 | $2,550–$4,543 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,094.85–$1,949.85 | $2,433–$4,333 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$955.80–$1,702.35 | $2,124–$3,783 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,469.70–$2,231.55 | $3,266–$4,959 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,469.70–$2,492.55 | $3,266–$5,539 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,195.20–$2,128.50 | $2,656–$4,730 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,358.10–$2,418.75 | $3,018–$5,375 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,143.45–$2,036.25 | $2,541–$4,525 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,435.95–$2,401.20 | $3,191–$5,336 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,513.35–$2,250 | $3,363–$5,000 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,233–$2,196.90 | $2,740–$4,882 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,094.85–$1,949.85 | $2,433–$4,333 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,135.35–$2,192.85 | $2,523–$4,873 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,147.50–$2,044.35 | $2,550–$4,543 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,351.80–$2,302.20 | $3,004–$5,116 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,011.60–$1,802.25 | $2,248–$4,005 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,062–$1,892.25 | $2,360–$4,205 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,237.95–$2,205 | $2,751–$4,900 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,059.75–$2,048.85 | $2,355–$4,553 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,939.50–$2,909.25 | $4,310–$6,465 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,750.50–$2,494.35 | $3,890–$5,543 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $491.85 | $1,093 | 1.1× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,393.65–$2,482.20 | $3,097–$5,516 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $375.75 | $835 | 1.2× |
| Dilation ureters/urethra rs&i (74485) | $2,018.70 | $4,486 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $3,007.80 | $6,684 | 1.2× |
| Diskography lumbar (72295) | $4,378.95 | $9,731 | 1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $798.30 | $1,774 | 5.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,016.10 | $2,258 | 7.6× |
| Dxa Bone Density Axial (77080) | $258.30 | $574 | 1.9× |
| Dxa bone density study (77085) | $241.20 | $536 | 1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $148.50 | $330 | 1.3× |
| Echo exam of fetal heart (76825) | $1,553.85 | $3,453 | 2.2× |
| Echo Guide For Artery Repair (76936) | $769.50 | $1,710 | 2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $882.90 | $1,962 | 2.9× |
| Esophagram (74220) | $539.10 | $1,198 | 2.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $697.95 | $1,551 | 2.3× |
| Fluoroscopy up to 1 hr (76000) | $697.95 | $1,551 | 2.3× |
| Follow-Up Angiography (75898) | $1,176.75 | $2,615 | 0.3× |
| Foot 2 views (73620) | $383.40 | $852 | 3.4× |
| Forearm 2 views (73090) | $394.65 | $877 | 3.5× |
| Gastric emptying imaging study (78264) | $1,171.35 | $2,603 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $698.40 | $1,552 | 1.4× |
| Gastrointestinal Protein Loss (78282) | $554.85 | $1,233 | 1.1× |
| Gated Heart Planar Single (78472) | $1,486.80 | $3,304 | 2.9× |
| GI Endoscopic US S&I (76975) | $609.75 | $1,355 | 2.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$484.20–$726.30 | $1,076–$1,614 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,159.20 | $2,576 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,159.20 | $2,576 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,159.20 | $2,576 | 1.3× |
| Heart first pass single,planar (78481) | $583.65 | $1,297 | 0.8× |
| Heart Image (Pet) Multiple (78492) | $5,493.15 | $12,207 | 3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,893.65 | $13,097 | 1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,770.65 | $6,157 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $429.75 | $955 | 0.6× |
| Hepatobiliary System Imaging (78226) | $1,068.75 | $2,375 | 2.1× |
| Ht Musc Image Planar Mult (78454) | $1,017 | $2,260 | 0.6× |
| Ht Muscle Image Spect Sing (78451) | $1,233 | $2,740 | 0.7× |
| Hysterosalpingogram (74740) | $503.10 | $1,118 | 1.6× |
| Infant hip ultrasound, limited static exam (76886) | $1,016.10 | $2,258 | 9.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $13,421.25 | $29,825 | 15.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $32,291.55 | $71,759 | 45.4× |
| Intracavitary radiation source applic simple (77761) | $30,754.80 | $68,344 | 43.3× |
| K Flow/Funct Image Multiple (78709) | $1,566.90 | $3,482 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,434.15 | $3,187 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,413.90 | $3,142 | 2.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $630.90 | $1,402 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $985.05 | $2,189 | 1.9× |
| Knee 3 Views (73562) | $455.85 | $1,013 | 4.1× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $669.60 | $1,488 | 1.3× |
| Leveen/Shunt Patency Exam (78291) | $500.85 | $1,113 | 1.0× |
| Liver & Spleen Imaging Static Only (78215) | $732.15 | $1,627 | 1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $967.50 | $2,150 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,827 | $4,060 | 2.6× |
| Lung perfusion differential (78597) | $1,303.20 | $2,896 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,787.85 | $3,973 | 2.6× |
| Lung Ventilation Imaging (78579) | $657.90 | $1,462 | 1.3× |
| Lymph System Imaging (78195) | $1,216.35 | $2,703 | 1.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,160.55 | $2,579 | 0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) | $773.55 | $1,719 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,162.35 | $2,583 | 0.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $774.90 | $1,722 | 0.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,543.85–$5,265.45 | $5,653–$11,701 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $871.65 | $1,937 | 3.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $462.15 | $1,027 | 0.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $915.30 | $2,034 | 4.1× |
| Magnetic Resonance Elastography (76391) | $1,098 | $2,440 | 3.6× |
| Mammary ductogram or galactogram multiple (77054) | $510.30 | $1,134 | 1.7× |
| Mammary ductogram or galactogram single (77053) | $465.30 | $1,034 | 1.5× |
| Meckels Divert Exam (78290) | $1,386 | $3,080 | 2.7× |
| Mlc imrt design & construction per imrt plan (77338) | $1,341.90 | $2,982 | 2.8× |
| Mr safety determination physician/other qhp (76016) | $138.60 | $308 | 1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $38.70 | $86 | 1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $144.45 | $321 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $93.60 | $208 | 1.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $380.25 | $845 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,821.50–$6,025.50 | $6,270–$13,390 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,351.70–$4,597.20 | $5,226–$10,216 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,633.85–$4,827.15 | $5,853–$10,727 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,633.85–$4,542.30 | $5,853–$10,094 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,912.40–$5,388.75 | $6,472–$11,975 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$2,542.95–$4,387.05 | $5,651–$9,749 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,418.75–$5,446.35 | $5,375–$12,103 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,109.15–$4,950.90 | $4,687–$11,002 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,903.95–$3,940.65 | $4,231–$8,757 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,048.30–$6,036.30 | $6,774–$13,414 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,730.70–$3,940.65 | $3,846–$8,757 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$1,667.70–$3,452.40 | $3,706–$7,672 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$769.50–$1,327.50 | $1,710–$2,950 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$736.20–$1,588.05 | $1,636–$3,529 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$2,183.85–$4,519.80 | $4,853–$10,044 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$1,939.50–$3,172.50 | $4,310–$7,050 | varies |
| MRI cardiac w/o cont stress (75559) range across 2 matching MRF lines |
$2,358.90–$4,883.85 | $5,242–$10,853 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$2,154.15–$5,493.60 | $4,787–$12,208 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,317.50–$4,850.10 | $5,150–$10,778 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,234.25–$4,624.20 | $4,965–$10,276 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,998.90–$4,137.75 | $4,442–$9,195 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$2,234.25–$4,624.20 | $4,965–$10,276 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,766.15–$6,844.50 | $6,147–$15,210 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,007.90–$4,154.85 | $4,462–$9,233 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,255.40–$5,835.15 | $5,012–$12,967 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,802.25–$3,806.10 | $4,005–$8,458 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,317.50–$5,322.15 | $5,150–$11,827 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,550.15–$5,555.70 | $5,667–$12,346 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,978.65–$3,880.80 | $4,397–$8,624 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,257.65–$4,267.35 | $5,017–$9,483 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,021.30–$6,230.25 | $6,714–$13,845 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,317.50–$5,456.70 | $5,150–$12,126 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,781–$6,057 | $6,180–$13,460 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,109.15–$4,796.55 | $4,687–$10,659 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$1,879.65–$2,470.05 | $4,177–$5,489 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,234.25–$4,624.20 | $4,965–$10,276 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,939.50–$4,014.45 | $4,310–$8,921 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,733.40–$3,841.20 | $3,852–$8,536 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,039.85–$5,139 | $4,533–$11,420 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,781–$6,644.25 | $6,180–$14,765 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,550.15–$5,555.70 | $5,667–$12,346 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,317.50–$5,085.90 | $5,150–$11,302 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,543.95–$3,790.80 | $3,431–$8,424 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,525.40–$5,832.45 | $5,612–$12,961 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,550.15–$5,555.70 | $5,667–$12,346 | varies |
| Myelogram cervical (72240) | $1,292.40 | $2,872 | 1.3× |
| Myelogram Lumbar (72265) | $1,292.40 | $2,872 | 1.3× |
| Myelography thoracic (72255) | $1,292.85 | $2,873 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,422.90 | $3,162 | 1.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $583.65 | $1,297 | 1.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,283.85 | $2,853 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,423.25 | $5,385 | 1.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,370.70 | $3,046 | 0.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,370.70 | $3,046 | 0.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,137.95 | $4,751 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,613.15 | $5,807 | 0.9× |
| Neck soft tissue (70360) | $295.65 | $657 | 2.6× |
| Nm csf leak detection (78650) | $715.50 | $1,590 | 0.4× |
| Nm red cell survival study (78130) | $611.10 | $1,358 | 1.2× |
| Nm whole blood volume (78122) | $1,103.40 | $2,452 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $372.15 | $827 | 2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,314.50 | $11,810 | 3.0× |
| Nuclear Rx Intra-Arterial (79445) | $1,577.25 | $3,505 | 5.3× |
| Nuclear Rx Oral Admin (79005) | $984.15 | $2,187 | 3.3× |
| Ob us nuchal meas 1 gest (76813) | $392.40 | $872 | 2.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $211.05 | $469 | 1.6× |
| Optic foramina (70190) | $290.70 | $646 | 2.6× |
| Panoramic X-ray of jaws (70355) | $478.35 | $1,063 | 4.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $988.65 | $2,197 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $541.80 | $1,204 | 1.1× |
| Pelvis 1 or 2 views (72170) | $413.55 | $919 | 3.1× |
| Peritoneogram Rs&I (74190) | $529.65 | $1,177 | 0.8× |
| Pet Image Skull-Thigh (78812) | $3,437.10 | $7,638 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $4,483.35 | $9,963 | 2.4× |
| PET image w/CT, full body (78816) | $4,741.65 | $10,537 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,823.55 | $10,719 | 2.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,437.10 | $7,638 | 2.1× |
| Pet Myocardial Sngl Study (78491) | $2,255.40 | $5,012 | 1.2× |
| PET whole body (78813) | $4,547.25 | $10,105 | 2.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $589.95 | $1,311 | 0.4× |
| Platelet survival study Non-Facility (78191) | $344.70 | $766 | 0.7× |
| Proton trmt simple w/comp (77522) | $5,671.35 | $12,603 | 3.5× |
| Proton tx delivery complex (77525) | $7,879.95 | $17,511 | 4.9× |
| Proton tx delivery intermediate (77523) | $7,420.50 | $16,490 | 4.6× |
| Proton tx delivery simple w/o compensation (77520) | $3,907.80 | $8,684 | 5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,400.20 | $7,556 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $905.85 | $2,013 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $252 | $560 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $593.10 | $1,318 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $505.35 | $1,123 | 4.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $383.40 | $852 | 3.4× |
| Radex elbow complete minimum 3 views (73080) | $557.10 | $1,238 | 5.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $762.75 | $1,695 | 5.7× |
| Radex fingr minimum 2 views (73140) | $331.20 | $736 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $494.10 | $1,098 | 4.4× |
| Radex Hand Minimum 3 Views (73130) | $485.55 | $1,079 | 4.3× |
| Radex lower extremity infant minimum 2 views (73592) | $295.65 | $657 | 2.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $517.50 | $1,150 | 3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $527.85 | $1,173 | 4.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $358.65 | $797 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $558 | $1,240 | 5.0× |
| Radex shoulder complete minimum 2 views (73030) | $518.85 | $1,153 | 4.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $437.85 | $973 | 3.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $630.45 | $1,401 | 2.8× |
| Radex Spine 1 View Specify Level (72020) | $447.75 | $995 | 4.0× |
| Radex Sternum Minimum 2 Views (71120) | $521.10 | $1,158 | 4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $511.65 | $1,137 | 4.6× |
| Radex Toe Minimum 2 Views (73660) | $333 | $740 | 3.0× |
| Radex upper extremity infant minimum 2 views (73092) | $300.60 | $668 | 2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $497.70 | $1,106 | 4.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $821.25 | $1,825 | 6.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $34,006.05 | $75,569 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $596.25 | $1,325 | 4.5× |
| Radiation treatment delivery level 2 (77407) | $709.20 | $1,576 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $1,452.15 | $3,227 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $805.50 | $1,790 | 6.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $378.90 | $842 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $891 | $1,980 | 3.9× |
| Radiologic exam colon single contrast study (74270) | $646.20 | $1,436 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $539.10 | $1,198 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) | $559.80 | $1,244 | 4.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $661.95 | $1,471 | 4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $713.25 | $1,585 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $469.80 | $1,044 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $448.20 | $996 | 2.0× |
| Radiologic examination femur 1 view (73551) | $235.35 | $523 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) | $294.75 | $655 | 2.6× |
| Radiologic examination knee 1/2 views (73560) | $396.90 | $882 | 3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $141.30 | $314 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $455.85 | $1,013 | 4.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $430.65 | $957 | 0.6× |
| Radiopharm Dacryocystography (78660) | $479.25 | $1,065 | 0.9× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $475.65 | $1,057 | 1.6× |
| Renal Cyst Study (74470) | $576.90 | $1,282 | 0.8× |
| Ribs bilateral 3 views (71110) | $709.65 | $1,577 | 5.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $635.85 | $1,413 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $406.80 | $904 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,439.55 | $3,199 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,814.40 | $4,032 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,770.30 | $3,934 | 2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,370.70 | $3,046 | 0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,208.70 | $2,686 | 0.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,890.70 | $8,646 | 13.0× |
| Rp Therapy Intravenous Administration (79101) | $1,124.55 | $2,499 | 3.7× |
| Salivary Gland Imaging (78230) | $500.85 | $1,113 | 1.0× |
| Scapula (73010) | $540.90 | $1,202 | 4.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $52.20 | $116 | 2.2× |
| Sella turcica (70240) | $331.20 | $736 | 3.0× |
| Shoulder 1 view (73020) | $437.85 | $973 | 3.9× |
| Shoulder Arthrography (73040) | $1,276.65 | $2,837 | 2.8× |
| Sialogram (70390) | $200.70 | $446 | 0.7× |
| Skull less than 4 views (70250) | $527.85 | $1,173 | 3.9× |
| Special dosimetry (77331) | $790.20 | $1,756 | 4.6× |
| Special Physics Consult (77370) | $1,234.80 | $2,744 | 7.1× |
| Special teletherapy port plan (77321) | $2,317.95 | $5,151 | 4.8× |
| Special treatment procedure (77470) | $3,194.55 | $7,099 | 4.5× |
| Speech evaluation, complex (70371) | $358.65 | $797 | 1.2× |
| Stereotactic Body Radiation Delivery (77373) | $5,695.65 | $12,657 | 2.5× |
| Sternoclavicular joints (71130) | $446.85 | $993 | 4.0× |
| Superior sagittal sinus venogram (75870) | $1,868.40 | $4,152 | 0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $477 | $1,060 | 3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,719 | $3,820 | 3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $939.15 | $2,087 | 2.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $835.20 | $1,856 | 2.7× |
| Testicular Imaging W/Flow (78761) | $475.65 | $1,057 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,619.90 | $5,822 | 5.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,118.70 | $2,486 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $1,253.70 | $2,786 | 7.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $812.25 | $1,805 | 3.6× |
| Thoracic spine 2 views (72070) | $509.85 | $1,133 | 3.8× |
| Thoracic spine 3 views (72072) | $558.45 | $1,241 | 4.2× |
| Thoracolumbar 2 views (72080) | $521.10 | $1,158 | 4.7× |
| Thyroid Imaging With Vascular Flow (78013) | $517.95 | $1,151 | 1.0× |
| Thyroid Met Imaging Body (78018) | $1,700.10 | $3,778 | 2.4× |
| Thyroid Uptake Measurement (78012) | $346.05 | $769 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $980.55 | $2,179 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $2,532.60 | $5,628 | 5.3× |
| Tx devices design & construction intermediate (77333) | $935.10 | $2,078 | 5.4× |
| Tx devices design & construction simple (77332) | $834.30 | $1,854 | 4.8× |
| Ultrasound Breast Limited (76642) | $88.65 | $197 | 0.8× |
| Ultrasound elastography first target lesion (76982) | $435.60 | $968 | 3.2× |
| Ultrasound Elastography Parenchyma (76981) | $435.60 | $968 | 3.2× |
| Ultrasound Exam Aaa Screen (76706) | $213.75 | $475 | 1.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $293.40 | $652 | 0.7× |
| Ultrasound, abdomen limited (76705) | $988.65 | $2,197 | 7.4× |
| Umbilical-artery Doppler (OB) (76820) | $559.35 | $1,243 | 4.2× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$534.15–$614.70 | $1,187–$1,366 | varies |
| Unlisted fluoroscopic procedure (76496) | $2,956.95 | $6,571 | 26.4× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$1,423.80–$2,947.05 | $3,164–$6,549 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$26,977.50–$28,325.25 | $59,950–$62,945 | varies |
| Unlisted us procedure (76999) | $898.20 | $1,996 | 8.0× |
| Upper gi w/o kub (74240) | $501.75 | $1,115 | 2.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $210.60 | $468 | 19.0× |
| Urea breath test c-14 isotopic analysis (78268) | $204.30 | $454 | 2.2× |
| Ureteral Reflux Study (78740) | $726.30 | $1,614 | 1.4× |
| Urethrocystogram voiding (74455) | $519.75 | $1,155 | 1.7× |
| Urethrocystography retrograde (74450) | $491.85 | $1,093 | 1.6× |
| Us breast unilateral complete (76641) | $176.85 | $393 | 1.3× |
| Us chest (76604) | $804.15 | $1,787 | 6.0× |
| Us complete joint (76881) | $1,011.15 | $2,247 | 7.5× |
| Us exam, pelvic, limited (76857) | $526.50 | $1,170 | 3.9× |
| Us head (76506) | $861.30 | $1,914 | 6.4× |
| Us kidney transplant (76776) | $1,243.35 | $2,763 | 9.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $903.15 | $2,007 | 6.7× |
| Us ob detailed single fetus (76811) | $998.10 | $2,218 | 3.3× |
| Us ob transvaginal (76817) | $726.75 | $1,615 | 5.4× |
| Us pelvic non ob complete (76856) | $1,180.35 | $2,623 | 8.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $847.35 | $1,883 | 6.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $926.55 | $2,059 | 6.9× |
| Us retroperitoneal complete (76770) | $1,093.50 | $2,430 | 8.1× |
| Us retroperitoneal limited (76775) | $941.40 | $2,092 | 7.0× |
| Us scrotum and contents (76870) | $1,044.90 | $2,322 | 7.8× |
| Us spinal canal and contents (76800) | $1,093.50 | $2,430 | 8.1× |
| Us thyroid (76536) | $823.95 | $1,831 | 6.1× |
| Us transrectal (76872) | $1,042.65 | $2,317 | 7.8× |
| Vascular Flow Imaging (78445) | $700.20 | $1,556 | 1.4× |
| Vein X-Ray Chest (75827) | $2,856.15 | $6,347 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,563.30 | $3,474 | 0.4× |
| Vein X-Ray Skull Epidural (75872) | $5,255.55 | $11,679 | 6.5× |
| Venogram Sinus/Jugular (75860) | $5,255.55 | $11,679 | 1.3× |
| Venography Adrenal Unilateral (75840) | $3,400.65 | $7,557 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $5,755.95 | $12,791 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $2,627.55 | $5,839 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,751.40 | $3,892 | 0.9× |
| Venography Orbital Rs&I (75880) | $5,255.55 | $11,679 | 6.5× |
| Venography Renal Bilateral (75833) | $5,101.20 | $11,336 | 1.3× |
| Venography Renal Unilateral (75831) | $3,400.65 | $7,557 | 0.8× |
| Venous sampling by catheter (75893) | $5,189.85 | $11,533 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $522 | $1,160 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $120.60 | $268 | 1.1× |
| Wrist 2 views (73100) | $413.55 | $919 | 3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $568.80 | $1,264 | 5.1× |
| X-ray antegrade pyelogram tube (74425) | $446.85 | $993 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $6,305.85 | $14,013 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $647.55 | $1,439 | 4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $393.75 | $875 | 3.5× |
| X-Ray Exam Breast Specimen (76098) | $740.70 | $1,646 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $480.60 | $1,068 | 4.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $711.45 | $1,581 | 5.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $781.65 | $1,737 | 5.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $358.20 | $796 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $497.70 | $1,106 | 4.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $614.25 | $1,365 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $583.20 | $1,296 | 4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $650.70 | $1,446 | 4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $683.55 | $1,519 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $1,000.80 | $2,224 | 7.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $509.85 | $1,133 | 4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $832.50 | $1,850 | 6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $535.50 | $1,190 | 4.0× |
| X-ray eye for foreign body (70030) | $196.65 | $437 | 1.8× |
| X-ray humerus (73060) | $470.70 | $1,046 | 4.2× |
| X-ray IV pyelogram (ivp) (74400) | $561.60 | $1,248 | 2.5× |
| X-ray IV pyelogram+tomography (74415) | $358.65 | $797 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $517.50 | $1,150 | 4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $446.40 | $992 | 4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$108.45–$546.30 | $241–$1,214 | varies |
| X-ray nose-rectum child f.b. (76010) | $110.70 | $246 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $681.30 | $1,514 | 5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $561.15 | $1,247 | 4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $517.95 | $1,151 | 4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $774.90 | $1,722 | 6.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $705.60 | $1,568 | 5.2× |
| X-ray thoracic spine 4 vw (72074) | $752.40 | $1,672 | 5.6× |
| X-Ray Tmj Unilat (70328) | $431.55 | $959 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $415.80 | $924 | 0.9× |
| X-Rays Bone Length Studies (77073) | $620.10 | $1,378 | 4.6× |
| X-Rays Bone Survey Complete (77075) | $1,360.35 | $3,023 | 10.1× |
| Xr c-spine 4 or 5 views (72050) | $791.10 | $1,758 | 5.9× |
| Xr facial bones less than 3 views (70140) | $509.85 | $1,133 | 4.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $517.50 | $1,150 | 3.8× |
| Xr orbits complete 4 views (70200) | $721.35 | $1,603 | 5.4× |
| Xr Tomogram Single Plane (76100) | $306.90 | $682 | 2.3× |
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.