Imaging prices at Los Robles Hospital & Medical Center
Thousand Oaks, CA · every code in this section with a posted price and a Medicare benchmark.
380 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) range across 2 matching MRF lines |
$13,985.14–$52,413.64 | $13,985.14–$52,413.64 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$264.48–$1,532.36 | $264.48–$1,532.36 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$442.07–$2,478.60 | $442.07–$2,478.60 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $11,900.49 | $11,900.49 | 23.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $12,781.99 | $12,781.99 | 7.7× |
| Angio pulmonary bilat (75743) | $14,263.61 | $14,263.61 | 3.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $23,360.37 | $23,360.37 | 5.8× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$12,737.09–$29,972.69 | $12,737.09–$29,972.69 | varies |
| Angiography extremity unilateral rs&i (75710) range across 7 matching MRF lines |
$11,796.39–$18,781.66 | $11,796.39–$18,781.66 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $10,357.34 | $10,357.34 | 2.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,830.15 | $6,830.15 | 1.7× |
| Ankle 2 views (73600) range across 9 matching MRF lines |
$330.97–$3,565.39 | $330.97–$3,565.39 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$11,633.09–$23,360.37 | $11,633.09–$23,360.37 | varies |
| Artery X-Rays Abdomen (75726) | $18,781.66 | $18,781.66 | 2.6× |
| Artery X-Rays Adrenal Gland (75731) | $18,781.66 | $18,781.66 | 4.6× |
| Artery X-Rays Pelvis (75736) | $18,781.66 | $18,781.66 | 2.6× |
| Artery X-Rays Spine (75705) | $4,306.35 | $4,306.35 | 0.6× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$8,275.61–$16,544.51 | $8,275.61–$16,544.51 | varies |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$4,276.31–$16,544.51 | $4,276.31–$16,544.51 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$8,275.61–$16,544.51 | $8,275.61–$16,544.51 | varies |
| Basic radiation dosimetry calculation (77300) | $671.55 | $671.55 | 3.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$228.32–$1,117.99 | $228.32–$1,117.99 | varies |
| Bone Imaging 3 Phase (78315) | $9,248.97 | $9,248.97 | 18.0× |
| Bone Imaging Limited Area (78300) | $2,925.91 | $2,925.91 | 5.7× |
| Bone Imaging Multiple Areas (78305) | $7,415.68 | $7,415.68 | 14.4× |
| Bone Imaging Whole Body (78306) | $12,030.54 | $12,030.54 | 23.4× |
| Bone marrow imaging; multiple areas (78103) | $7,962.43 | $7,962.43 | 15.5× |
| Bone survey infant (77076) | $3,482.58 | $3,482.58 | 25.9× |
| Brachytx isodose complex (77318) | $3,090.67 | $3,090.67 | 6.4× |
| Brachytx isodose intermed (77317) | $2,308.60 | $2,308.60 | 4.8× |
| Brachytx Isodose Plan Simple (77316) | $1,551.90 | $1,551.90 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $11,355.78 | $11,355.78 | 16.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $9,192.11 | $9,192.11 | 13.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $11,927.61 | $11,927.61 | 26.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $14,847.40 | $14,847.40 | 14.7× |
| Cat Scan Follow-Up Study (76380) | $3,674.45 | $3,674.45 | 32.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $11,355.78 | $11,355.78 | 16.3× |
| Cerebrospinal Fluid Scan (78630) | $16,233.37 | $16,233.37 | 23.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$241.74–$2,053.16 | $241.74–$2,053.16 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$330.97–$2,200.71 | $330.97–$2,200.71 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$514.97–$3,337.36 | $514.97–$3,337.36 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$514.97–$2,937.87 | $514.97–$2,937.87 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 2 matching MRF lines |
$496.30–$1,221.51 | $496.30–$1,221.51 | varies |
| Clavicle complete (73000) range across 9 matching MRF lines |
$334.76–$4,706.72 | $334.76–$4,706.72 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $479.97 | $479.97 | 3.6× |
| Continuing medical physics consltj pr wk (77336) | $1,491.24 | $1,491.24 | 8.6× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$10,617.45–$23,360.37 | $10,617.45–$23,360.37 | varies |
| Contrast X-Ray Bladder (74430) | $4,060.82 | $4,060.82 | 9.0× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$8,275.61–$16,544.51 | $8,275.61–$16,544.51 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$8,275.61–$16,544.51 | $8,275.61–$16,544.51 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$8,513.55–$16,245.62 | $8,513.55–$16,245.62 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$4,941.45–$13,085.26 | $4,941.45–$13,085.26 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$3,548.48–$7,490.04 | $3,548.48–$7,490.04 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$4,364.67–$8,934.92 | $4,364.67–$8,934.92 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$2,461.69–$7,200.19 | $2,461.69–$7,200.19 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$8,843.35–$23,606.19 | $8,843.35–$23,606.19 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$4,419.20–$11,680.91 | $4,419.20–$11,680.91 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$4,423.28–$10,596.45 | $4,423.28–$10,596.45 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$10,151.18–$11,680.91 | $10,151.18–$11,680.91 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 9 matching MRF lines |
$4,419.20–$17,312.88 | $4,419.20–$17,312.88 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,423.28–$11,745.06 | $4,423.28–$11,745.06 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 8 matching MRF lines |
$8,840.44–$16,452.07 | $8,840.44–$16,452.07 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$3,272.34–$11,167.11 | $3,272.34–$11,167.11 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$2,533.71–$7,552.73 | $2,533.71–$7,552.73 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$4,103.69–$12,056.20 | $4,103.69–$12,056.20 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$3,264.17–$8,271.82 | $3,264.17–$8,271.82 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$4,108.06–$8,805.45 | $4,108.06–$8,805.45 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$2,626.44–$7,522.99 | $2,626.44–$7,522.99 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$3,233.55–$7,978.18 | $3,233.55–$7,978.18 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $6,830.73 | $6,830.73 | 15.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,670.76 | $2,670.76 | 23.9× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$3,890.82–$6,894.59 | $3,890.82–$6,894.59 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$4,103.69–$9,356.57 | $4,103.69–$9,356.57 | varies |
| CT lower ext w/o (73700) range across 9 matching MRF lines |
$2,533.71–$14,001.76 | $2,533.71–$14,001.76 | varies |
| CT lower extremity w/contrast material (73701) range across 9 matching MRF lines |
$3,202.06–$15,477.84 | $3,202.06–$15,477.84 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$3,268.25–$7,944.93 | $3,268.25–$7,944.93 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$2,533.71–$7,552.73 | $2,533.71–$7,552.73 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$3,295.37–$5,434.26 | $3,295.37–$5,434.26 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$2,533.71–$4,411.32 | $2,533.71–$4,411.32 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$3,963.14–$8,873.10 | $3,963.14–$8,873.10 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$4,364.67–$7,124.66 | $4,364.67–$7,124.66 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,533.71–$6,474.98 | $2,533.71–$6,474.98 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$4,148.30–$8,934.92 | $4,148.30–$8,934.92 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$2,479.18–$7,200.19 | $2,479.18–$7,200.19 | varies |
| CT scan of leg combo (73702) range across 9 matching MRF lines |
$4,250.65–$17,320.75 | $4,250.65–$17,320.75 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$3,295.37–$6,154.22 | $3,295.37–$6,154.22 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$3,161.82–$8,403.33 | $3,161.82–$8,403.33 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$2,533.71–$7,415.10 | $2,533.71–$7,415.10 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$3,279.92–$7,944.93 | $3,279.92–$7,944.93 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$2,533.71–$7,552.73 | $2,533.71–$7,552.73 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$4,108.06–$10,449.19 | $4,108.06–$10,449.19 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$2,533.71–$7,925.10 | $2,533.71–$7,925.10 | varies |
| CT upper ext wo (73200) range across 9 matching MRF lines |
$2,533.71–$13,680.71 | $2,533.71–$13,680.71 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 9 matching MRF lines |
$4,227.91–$19,182.91 | $4,227.91–$19,182.91 | varies |
| CT upper extremity with contrast (73201) range across 9 matching MRF lines |
$3,165.90–$14,965.20 | $3,165.90–$14,965.20 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$4,416.87–$26,741.18 | $4,416.87–$26,741.18 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$4,423.28–$11,803.09 | $4,423.28–$11,803.09 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$4,419.20–$11,803.09 | $4,419.20–$11,803.09 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,623.03 | $4,623.03 | 1.7× |
| Discography Cerv/Thor Spine (72285) | $11,301.54 | $11,301.54 | 4.5× |
| Diskography lumbar (72295) | $11,301.54 | $11,301.54 | 4.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $247.57 | $247.57 | 1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $443.23 | $443.23 | 3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $1,360.61 | $1,360.61 | 10.1× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$1,128.49–$2,394.91 | $1,128.49–$2,394.91 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $272.06 | $272.06 | 2.4× |
| Echo exam of fetal heart (76825) | $1,579.01 | $1,579.01 | 2.2× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$1,045.97–$1,381.02 | $1,045.97–$1,381.02 | varies |
| Echo Guide For Artery Repair (76936) | $11,333.33 | $11,333.33 | 40.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $982.69 | $982.69 | 3.2× |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$1,115.08–$2,916.87 | $1,115.08–$2,916.87 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$1,102.54–$5,446.80 | $1,102.54–$5,446.80 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$821.15–$1,759.51 | $821.15–$1,759.51 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$625.19–$1,535.86 | $625.19–$1,535.86 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$1,132.57–$12,422.16 | $1,132.57–$12,422.16 | varies |
| Follow-Up Angiography (75898) | $11,305.33 | $11,305.33 | 2.8× |
| Foot 2 views (73620) range across 9 matching MRF lines |
$321.34–$2,824.73 | $321.34–$2,824.73 | varies |
| Forearm 2 views (73090) range across 9 matching MRF lines |
$325.43–$4,057.91 | $325.43–$4,057.91 | varies |
| Gastric emptying imaging study (78264) | $9,219.23 | $9,219.23 | 17.9× |
| Gastroesophageal Reflux Exam (78262) | $8,168.59 | $8,168.59 | 15.9× |
| Gated Heart Planar Single (78472) | $11,221.93 | $11,221.93 | 21.8× |
| Gated Heart, Multiple (78473) | $14,971.62 | $14,971.62 | 29.1× |
| Hand 2 views (73120) range across 9 matching MRF lines |
$321.34–$2,872.84 | $321.34–$2,872.84 | varies |
| Heart first pass single,planar (78481) | $12,161.47 | $12,161.47 | 17.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,266.78 | $6,266.78 | 1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,270.27 | $6,270.27 | 1.5× |
| Hepatobil Syst Image W/Drug (78227) | $13,431.39 | $13,431.39 | 19.2× |
| Hepatobiliary System Imaging (78226) | $12,087.11 | $12,087.11 | 23.5× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$6,368.25–$18,640.82 | $6,368.25–$18,640.82 | varies |
| Hysterosalpingogram (74740) | $3,787.01 | $3,787.01 | 12.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$723.75–$2,431.07 | $723.75–$2,431.07 | varies |
| Infant hip ultrasound, limited static exam (76886) | $719.96 | $719.96 | 6.4× |
| Joint Survey Single View (77077) | $480.56 | $480.56 | 3.6× |
| K Flow/Funct Image Multiple (78709) | $15,111 | $15,111 | 21.6× |
| K Flow/Funct Image W/Drug (78708) | $14,464.23 | $14,464.23 | 20.7× |
| K Flow/Funct Image W/O Drug (78707) | $13,771.10 | $13,771.10 | 19.7× |
| Kidney Imaging Morphol (78700) | $9,184.82 | $9,184.82 | 17.9× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$436.53–$4,328.51 | $436.53–$4,328.51 | varies |
| Leveen/Shunt Patency Exam (78291) | $13,258.18 | $13,258.18 | 25.8× |
| Liver & Spleen Imaging Static Only (78215) | $7,873.49 | $7,873.49 | 15.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $11,900.49 | $11,900.49 | 23.1× |
| Liver imaging static only (78201) | $2,393.75 | $2,393.75 | 3.4× |
| Liver imaging w/vascular flow (78202) | $8,168.59 | $8,168.59 | 11.7× |
| Lung Perf&Ventilat Diferentl (78598) | $10,779.87 | $10,779.87 | 15.4× |
| Lung perfusion differential (78597) | $10,779.87 | $10,779.87 | 21.0× |
| Lung Ventilat&Perfus Imaging (78582) | $14,749.42 | $14,749.42 | 21.1× |
| Lung Ventilation Imaging (78579) | $10,779.87 | $10,779.87 | 21.0× |
| Lymph System Imaging (78195) | $13,258.18 | $13,258.18 | 19.0× |
| Magnetic Image Jaw Joint (70336) | $7,934.73 | $7,934.73 | 25.9× |
| Meckels Divert Exam (78290) | $6,893.72 | $6,893.72 | 13.4× |
| Medical physics dose eval radiation expos w/rprt (76145) | $749.12 | $749.12 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $2,731.13 | $2,731.13 | 5.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $102.60 | $102.60 | 2.8× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$14,290.73–$15,434.10 | $14,290.73–$15,434.10 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$14,290.73–$15,434.10 | $14,290.73–$15,434.10 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$7,346.86–$7,934.73 | $7,346.86–$7,934.73 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$7,346.86–$7,934.73 | $7,346.86–$7,934.73 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$14,290.73–$15,434.10 | $14,290.73–$15,434.10 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$7,346.86–$7,934.73 | $7,346.86–$7,934.73 | varies |
| MRI abdomen w contrast (74182) | $9,325.37 | $9,325.37 | 20.8× |
| MRI abdomen w/o contrast (74181) | $7,872.62 | $7,872.62 | 25.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$8,619.99–$18,628.57 | $8,619.99–$18,628.57 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$15,943.81–$34,441.75 | $15,943.81–$34,441.75 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$8,619.99–$18,628.57 | $8,619.99–$18,628.57 | varies |
| MRI bone marrow blood supply (77084) | $7,934.73 | $7,934.73 | 25.9× |
| MRI cardiac w/o cont stress (75559) | $12,880.85 | $12,880.85 | 18.3× |
| MRI cardiac w/o contrast (75557) | $8,739.25 | $8,739.25 | 28.5× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$8,784.16–$9,486.91 | $8,784.16–$9,486.91 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$7,346.86–$7,934.73 | $7,346.86–$7,934.73 | varies |
| MRI chest w/o contrast (71550) | $7,872.62 | $7,872.62 | 25.7× |
| MRI chest with contrast (71551) | $9,325.37 | $9,325.37 | 9.2× |
| MRI chest wo w contrast (71552) | $17,149.29 | $17,149.29 | 38.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 6 matching MRF lines |
$8,619.99–$18,616.91 | $8,619.99–$18,616.91 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$15,943.81–$34,441.75 | $15,943.81–$34,441.75 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$7,268.42–$15,697.70 | $7,268.42–$15,697.70 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$8,784.16–$9,486.91 | $8,784.16–$9,486.91 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$16,246.49–$17,546.16 | $16,246.49–$17,546.16 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$7,268.42–$7,849.87 | $7,268.42–$7,849.87 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$8,619.99–$9,309.33 | $8,619.99–$9,309.33 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$15,943.81–$17,219.27 | $15,943.81–$17,219.27 | varies |
| MRI pelvis w contrast (72196) | $9,325.37 | $9,325.37 | 20.8× |
| MRI pelvis w/o & w contrast (72197) | $17,219.27 | $17,219.27 | 38.4× |
| MRI pelvis w/o contrast (72195) | $7,872.62 | $7,872.62 | 25.7× |
| MRI spectroscopy (76390) | $7,934.73 | $7,934.73 | 70.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$8,131.56–$8,781.53 | $8,131.56–$8,781.53 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 6 matching MRF lines |
$8,619.99–$18,628.57 | $8,619.99–$18,628.57 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$7,268.42–$15,695.95 | $7,268.42–$15,695.95 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$15,943.81–$34,441.75 | $15,943.81–$34,441.75 | varies |
| MRI, abdomen, combo (74183) | $17,249.89 | $17,249.89 | 38.4× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$16,246.49–$17,546.16 | $16,246.49–$17,546.16 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$8,784.16–$9,486.91 | $8,784.16–$9,486.91 | varies |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$7,268.42–$15,695.95 | $7,268.42–$15,695.95 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$15,943.81–$34,441.75 | $15,943.81–$34,441.75 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$16,246.49–$17,546.16 | $16,246.49–$17,546.16 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $10,403.12 | $10,403.12 | 20.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $6,368.25 | $6,368.25 | 3.8× |
| Myocardial Spect Multiple Studies (78452) | $27,515.08 | $27,515.08 | 16.5× |
| N-invas est c ffr sw aly CTA (75580) | $5,332.95 | $5,332.95 | 4.8× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$314.93–$3,290.12 | $314.93–$3,290.12 | varies |
| Nm csf leak detection (78650) | $15,369.65 | $15,369.65 | 9.2× |
| Nm myocard infarct spect (78469) | $11,881.53 | $11,881.53 | 17.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $13,985.14 | $13,985.14 | 7.9× |
| Nuclear Rx Intra-Arterial (79445) | $996.73 | $996.73 | 3.3× |
| Nuclear Rx Oral Admin (79005) | $14,824.36 | $14,824.36 | 49.4× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $482.60 | $482.60 | 4.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $15,123.83 | $15,123.83 | 21.7× |
| Parathyroid Planar Imaging (78070) | $10,210.96 | $10,210.96 | 19.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,484.04 | $3,484.04 | 6.8× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$292.18–$1,857.20 | $292.18–$1,857.20 | varies |
| Peritoneogram Rs&I (74190) | $642.10 | $642.10 | 0.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,709.92 | $4,709.92 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $8,951.54 | $8,951.54 | 17.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$536.84–$3,425.43 | $536.84–$3,425.43 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $5,092.21 | $5,092.21 | 7.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 9 matching MRF lines |
$391.33–$3,948.56 | $391.33–$3,948.56 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$325.43–$3,948.56 | $325.43–$3,948.56 | varies |
| Radex elbow complete minimum 3 views (73080) range across 9 matching MRF lines |
$420.20–$4,776.70 | $420.20–$4,776.70 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$492.51–$3,157.15 | $492.51–$3,157.15 | varies |
| Radex fingr minimum 2 views (73140) range across 10 matching MRF lines |
$404.16–$2,378.29 | $404.16–$2,378.29 | varies |
| Radex foot complete minimum 3 views (73630) range across 9 matching MRF lines |
$381.12–$3,863.12 | $381.12–$3,863.12 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$385.50–$3,510.57 | $385.50–$3,510.57 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$375.29–$2,854.76 | $375.29–$2,854.76 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $648.23 | $648.23 | 4.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$404.16–$3,240.55 | $404.16–$3,240.55 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 7 matching MRF lines |
$352.84–$2,081.73 | $352.84–$2,081.73 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 9 matching MRF lines |
$342.63–$4,776.70 | $342.63–$4,776.70 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$363.33–$2,067.44 | $363.33–$2,067.44 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$264.48–$1,982.30 | $264.48–$1,982.30 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$363.33–$2,824.73 | $363.33–$2,824.73 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$593.99–$3,157.15 | $593.99–$3,157.15 | varies |
| Radex Toe Minimum 2 Views (73660) range across 8 matching MRF lines |
$375.29–$3,276.42 | $375.29–$3,276.42 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$371.50–$2,854.76 | $371.50–$2,854.76 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$454.90–$3,672.41 | $454.90–$3,672.41 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$817.65–$4,786.61 | $817.65–$4,786.61 | varies |
| Radiation treatment delivery level 1 (77402) | $893.75 | $893.75 | 6.8× |
| Radiation treatment delivery level 2 (77407) | $1,049.47 | $1,049.47 | 2.1× |
| Radiation treatment delivery level 3 (77412) | $1,170.48 | $1,170.48 | 1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$445.86–$4,060.82 | $445.86–$4,060.82 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$442.07–$3,424.55 | $442.07–$3,424.55 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$2,321.72–$7,411.60 | $2,321.72–$7,411.60 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,421.26–$5,499.28 | $1,421.26–$5,499.28 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,022.35 | $1,022.35 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) range across 9 matching MRF lines |
$496.59–$5,463.42 | $496.59–$5,463.42 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$508.84–$2,313.85 | $508.84–$2,313.85 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$1,364.69–$6,912.38 | $1,364.69–$6,912.38 | varies |
| Radiologic exam swallow function contrast study (74230) | $6,906.55 | $6,906.55 | 30.6× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$1,415.72–$6,155.68 | $1,415.72–$6,155.68 | varies |
| Radiologic examination femur 1 view (73551) range across 9 matching MRF lines |
$288.68–$4,058.20 | $288.68–$4,058.20 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 9 matching MRF lines |
$397.74–$2,826.48 | $397.74–$2,826.48 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$334.76–$3,948.56 | $334.76–$3,948.56 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$648.23–$960.82 | $648.23–$960.82 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 9 matching MRF lines |
$314.93–$3,413.76 | $314.93–$3,413.76 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$458.40–$2,443.32 | $458.40–$2,443.32 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $10,361.42 | $10,361.42 | 20.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $11,794.93 | $11,794.93 | 22.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $15,123.83 | $15,123.83 | 21.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $12,883.47 | $12,883.47 | 18.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $13,771.10 | $13,771.10 | 19.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $13,771.10 | $13,771.10 | 8.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $15,123.83 | $15,123.83 | 8.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $15,123.83 | $15,123.83 | 9.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $6,659.27 | $6,659.27 | 22.2× |
| Rp Therapy Intravenous Administration (79101) | $5,417.05 | $5,417.05 | 18.1× |
| Salivary Gland Imaging Serial Images (78231) | $4,418.91 | $4,418.91 | 8.6× |
| Scapula (73010) range across 9 matching MRF lines |
$349.34–$4,175.71 | $349.34–$4,175.71 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $211.12 | $211.12 | 9.0× |
| Sella turcica (70240) range across 2 matching MRF lines |
$330.97–$2,214.70 | $330.97–$2,214.70 | varies |
| Shoulder 1 view (73020) range across 9 matching MRF lines |
$264.48–$4,175.71 | $264.48–$4,175.71 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$8,275.61–$16,544.51 | $8,275.61–$16,544.51 | varies |
| Sialogram (70390) | $5,352.03 | $5,352.03 | 17.4× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$409.99–$2,408.32 | $409.99–$2,408.32 | varies |
| Special dosimetry (77331) | $665.43 | $665.43 | 3.8× |
| Special Physics Consult (77370) range across 3 matching MRF lines |
$1,744.64–$15,722.20 | $1,744.64–$15,722.20 | varies |
| Special teletherapy port plan (77321) | $2,020.50 | $2,020.50 | 4.2× |
| Special treatment procedure (77470) | $5,585.89 | $5,585.89 | 7.9× |
| Spleen Imaging (78185) | $10,310.39 | $10,310.39 | 20.1× |
| Srs Multisource (77371) range across 3 matching MRF lines |
$199,167.47–$262,065 | $199,167.47–$262,065 | varies |
| Stereotactic Body Radiation Delivery (77373) | $37,310.80 | $37,310.80 | 16.2× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$436.53–$2,654.73 | $436.53–$2,654.73 | varies |
| Superior sagittal sinus venogram (75870) | $6,672.68 | $6,672.68 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,538.48 | $1,538.48 | 3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,170.48 | $1,170.48 | 2.4× |
| Testicular Imaging W/Flow (78761) | $11,374.73 | $11,374.73 | 22.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,907.94–$3,265.05 | $1,907.94–$3,265.05 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,801.40 | $2,801.40 | 5.8× |
| Ther rad simulaj-aided field setting simple (77280) | $1,742.89 | $1,742.89 | 10.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,426.80 | $1,426.80 | 6.3× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$375.29–$1,963.93 | $375.29–$1,963.93 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$442.07–$2,541.88 | $442.07–$2,541.88 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$409.99–$1,818.42 | $409.99–$1,818.42 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $2,969.95 | $2,969.95 | 5.8× |
| Thyroid Met Imaging Body (78018) | $9,088.59 | $9,088.59 | 13.0× |
| Thyroid Uptake Measurement (78012) | $2,969.95 | $2,969.95 | 5.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,969.95 | $2,969.95 | 5.8× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,629.75–$11,527.24 | $1,629.75–$11,527.24 | varies |
| Tx devices design & construction intermediate (77333) | $1,065.51 | $1,065.51 | 6.2× |
| Tx devices design & construction simple (77332) | $671.55 | $671.55 | 3.9× |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$539.17–$1,166.69 | $539.17–$1,166.69 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$905.71–$2,024.87 | $905.71–$2,024.87 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$257.77–$980.94 | $257.77–$980.94 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$1,271.96–$5,042.64 | $1,271.96–$5,042.64 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $2,200.41 | $2,200.41 | 199.0× |
| Ureteral Reflux Study (78740) | $14,507.39 | $14,507.39 | 28.2× |
| Urethrocystogram voiding (74455) | $5,315.87 | $5,315.87 | 17.3× |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$918.54–$4,117.98 | $918.54–$4,117.98 | varies |
| Us breast unilateral complete (76641) range across 8 matching MRF lines |
$719.96–$1,554.81 | $719.96–$1,554.81 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$709.46–$1,977.05 | $709.46–$1,977.05 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$999.60–$2,362.25 | $999.60–$2,362.25 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$719.96–$2,514.76 | $719.96–$2,514.76 | varies |
| Us head (76506) range across 2 matching MRF lines |
$723.75–$2,431.07 | $723.75–$2,431.07 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$1,325.91–$2,159.30 | $1,325.91–$2,159.30 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$496.30–$1,221.51 | $496.30–$1,221.51 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,161.15–$3,186.90 | $1,161.15–$3,186.90 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$695.47–$1,702.07 | $695.47–$1,702.07 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$719.96–$2,415.61 | $719.96–$2,415.61 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$1,056.76–$2,514.76 | $1,056.76–$2,514.76 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$948.57–$1,743.77 | $948.57–$1,743.77 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$719.96–$1,644.04 | $719.96–$1,644.04 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,115.08–$2,570.45 | $1,115.08–$2,570.45 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$293.93–$2,078.82 | $293.93–$2,078.82 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,069.88–$2,439.82 | $1,069.88–$2,439.82 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$912.42–$2,207.70 | $912.42–$2,207.70 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,056.76–$2,386.16 | $1,056.76–$2,386.16 | varies |
| Us transrectal (76872) | $2,916.87 | $2,916.87 | 21.7× |
| Vascular Flow Imaging (78445) | $1,723.94 | $1,723.94 | 3.4× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$8,006.75–$16,960.33 | $8,006.75–$16,960.33 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,762.41 | $4,762.41 | 1.2× |
| Vein X-Ray Spleen/Liver (75810) | $19,789.43 | $19,789.43 | 4.9× |
| Venogram Sinus/Jugular (75860) | $3,813.54 | $3,813.54 | 0.9× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$7,865.33–$16,960.33 | $7,865.33–$16,960.33 | varies |
| Venography extremity bilateral rs&i (75822) | $10,035.71 | $10,035.71 | 5.0× |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$7,338.41–$12,096.73 | $7,338.41–$12,096.73 | varies |
| Venous sampling by catheter (75893) | $16,960.33 | $16,960.33 | 2.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $11,642.42 | $11,642.42 | 22.6× |
| Vertebral fracture assessment via dxa (77086) | $2,668.72 | $2,668.72 | 23.8× |
| Wrist 2 views (73100) range across 9 matching MRF lines |
$359.54–$1,902.11 | $359.54–$1,902.11 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$445.86–$3,167.65 | $445.86–$3,167.65 | varies |
| X-ray antegrade pyelogram tube (74425) | $5,890.90 | $5,890.90 | 13.1× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$12,732.71–$67,028.63 | $12,732.71–$67,028.63 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$545–$3,359.23 | $545–$3,359.23 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 9 matching MRF lines |
$334.76–$4,175.71 | $334.76–$4,175.71 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,725.11–$1,863.03 | $1,725.11–$1,863.03 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$326.88–$2,824.73 | $326.88–$2,824.73 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$490.76–$3,478.20 | $490.76–$3,478.20 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$654.35–$4,132.56 | $654.35–$4,132.56 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 9 matching MRF lines |
$391.33–$2,703.42 | $391.33–$2,703.42 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 9 matching MRF lines |
$445.86–$3,314.91 | $445.86–$3,314.91 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 9 matching MRF lines |
$609.74–$4,055.86 | $609.74–$4,055.86 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$609.74–$3,401.51 | $609.74–$3,401.51 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$773.03–$4,273.98 | $773.03–$4,273.98 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$861.97–$4,709.92 | $861.97–$4,709.92 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$916.50–$5,315.87 | $916.50–$5,315.87 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$445.86–$2,408.32 | $445.86–$2,408.32 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$805.69–$4,054.41 | $805.69–$4,054.41 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 7 matching MRF lines |
$431.86–$2,733.46 | $431.86–$2,733.46 | varies |
| X-ray eye for foreign body (70030) | $330.97 | $330.97 | 3.0× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$334.76–$2,214.70 | $334.76–$2,214.70 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,437.59–$6,644.11 | $1,437.59–$6,644.11 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$1,837.08–$7,534.36 | $1,837.08–$7,534.36 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$391.33–$2,824.73 | $391.33–$2,824.73 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$397.74–$2,163.96 | $397.74–$2,163.96 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$474.72–$3,359.23 | $474.72–$3,359.23 | varies |
| X-ray nose-rectum child f.b. (76010) | $1,429.42 | $1,429.42 | 12.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$607.40–$3,197.39 | $607.40–$3,197.39 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$414.36–$2,313.85 | $414.36–$2,313.85 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$349.34–$1,960.14 | $349.34–$1,960.14 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$284.89–$2,824.73 | $284.89–$2,824.73 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$436.53–$2,569.87 | $436.53–$2,569.87 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$503.01–$3,553.15 | $503.01–$3,553.15 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$552.87–$2,829.98 | $552.87–$2,829.98 | varies |
| X-Ray Tmj Unilat (70328) | $300.93 | $300.93 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$1,651.62–$5,890.90 | $1,651.62–$5,890.90 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$397.74–$1,657.75 | $397.74–$1,657.75 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,237.55–$8,445.03 | $1,237.55–$8,445.03 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$607.40–$4,036.04 | $607.40–$4,036.04 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$334.76–$2,343.88 | $334.76–$2,343.88 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $426.32 | $426.32 | 3.2× |
| Xr myelogram posterior fossa (70010) | $20,467.40 | $20,467.40 | 45.6× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$599.82–$2,414.45 | $599.82–$2,414.45 | varies |
| Xr Tomogram Single Plane (76100) range across 3 matching MRF lines |
$1,237.55–$6,111.06 | $1,237.55–$6,111.06 | 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.