Imaging prices at Lowell General Hospital
Lowell, MA · every code in this section with a posted price and a Medicare benchmark.
388 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) | $3,567.90 | $5,097 | 2.2× |
| Abdomen 1 View (74018) | $422.10 | $603 | 4.0× |
| Abdomen 2 views (74019) | $438.20 | $626 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $928.20 | $1,326 | 1.9× |
| Angio internal mammary (75756) | $1,103.90 | $1,577 | 0.3× |
| Angio pulmonary bilat (75743) | $5,681.90 | $8,117 | 1.5× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,021.60–$3,032.40 | $2,888–$4,332 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$1,513.40–$2,270.10 | $2,162–$3,243 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,339.30 | $6,199 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$120.05–$360.15 | $171.50–$514.50 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,220.40 | $3,172 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,652.50 | $8,075 | 1.5× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$2,123.80–$4,319 | $3,034–$6,170 | varies |
| Artery X-Rays Adrenal Gland (75731) | $7,267.40 | $10,382 | 1.9× |
| Artery X-Rays Pelvis (75736) | $4,319 | $6,170 | 0.6× |
| Artery X-Rays Spine (75705) | $11,900 | $17,000 | 1.8× |
| Arthrogram ankle (73615) | $747.60 | $1,068 | 1.8× |
| Arthrogram hip (73525) | $1,015 | $1,450 | 2.4× |
| Arthrogram Wrist (73115) | $592.20 | $846 | 1.4× |
| Basic radiation dosimetry calculation (77300) | $355.60 | $508 | 2.2× |
| Bone age studies (77072) | $255.50 | $365 | 2.0× |
| Bone Imaging 3 Phase (78315) | $721 | $1,030 | 1.5× |
| Bone Imaging Limited Area (78300) | $761.60 | $1,088 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $1,399.30 | $1,999 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,036.70 | $1,481 | 2.2× |
| Bone marrow imaging limited area (78102) | $434 | $620 | 0.9× |
| Bone marrow imaging; multiple areas (78103) | $513.80 | $734 | 1.1× |
| Bone marrow imaging; whole body (78104) | $434 | $620 | 0.9× |
| Bone survey infant (77076) | $516.60 | $738 | 4.1× |
| Brachytx isodose complex (77318) | $1,155.70 | $1,651 | 2.6× |
| Brachytx isodose intermed (77317) | $993.30 | $1,419 | 2.2× |
| Brachytx Isodose Plan Simple (77316) | $574 | $820 | 1.3× |
| Brain imaging < 4 static views (78600) | $702.80 | $1,004 | 1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $871.50 | $1,245 | 1.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $702.80 | $1,004 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,302.90 | $6,147 | 2.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $823.90 | $1,177 | 1.7× |
| Cardiac Shunt Detection (78428) | $681.80 | $974 | 1.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,775.90 | $2,537 | 2.7× |
| Cerebrospinal Fluid Scan (78630) | $739.20 | $1,056 | 1.1× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$169.40–$338.80 | $242–$484 | varies |
| Chest 2 views (71046) | $264.60 | $378 | 2.5× |
| Chest 3 views (71047) | $324.10 | $463 | 3.1× |
| Chest 4 or more views (71048) | $389.20 | $556 | 3.1× |
| Clavicle complete (73000) | $236.60 | $338 | 2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,040.20 | $1,486 | 8.3× |
| Continuing medical physics consltj pr wk (77336) | $388.50 | $555 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) | $7,909.30 | $11,299 | 2.1× |
| Contrast X-Ray Bladder (74430) | $982.80 | $1,404 | 2.4× |
| Contrast X-Ray Of Elbow (73085) | $637.70 | $911 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $516.60 | $738 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,347.40 | $4,782 | 8.0× |
| CT abdomen and pelvis without contrast (74176) | $1,614.20 | $2,306 | 5.6× |
| CT abdomen w contrast (74160) | $1,457.40 | $2,082 | 6.9× |
| CT abdomen w wo contrast (74170) | $1,927.10 | $2,753 | 9.2× |
| CT abdomen w/o contrast (74150) | $931 | $1,330 | 7.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,230.60 | $1,758 | 2.9× |
| CT Angio Chest (71275) | $603.40 | $862 | 2.9× |
| CT Angio Head (70496) | $1,715 | $2,450 | 8.2× |
| CT angio hrt w/3d image (75574) | $534.80 | $764 | 1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$682.50–$2,047.50 | $975–$2,925 | varies |
| CT Angio Neck (70498) | $1,715 | $2,450 | 8.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$682.50–$2,047.50 | $975–$2,925 | varies |
| CT cervical spine w/ contrast (72126) | $1,540 | $2,200 | 3.7× |
| CT cervical spine w/o contrast (72125) | $909.30 | $1,299 | 7.3× |
| CT cervical spine w/wo cont (72127) | $603.40 | $862 | 2.9× |
| CT chest w contrast (71260) | $1,243.90 | $1,777 | 5.9× |
| CT chest w/wo contrast (71270) | $1,801.10 | $2,573 | 8.6× |
| CT head/brain with contrast (70460) | $1,339.80 | $1,914 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,676.50 | $2,395 | 8.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $235.20 | $336 | 2.3× |
| CT hrt w/3d image congen (75573) | $235.20 | $336 | 0.6× |
| CT iac w contrast (70481) | $958.30 | $1,369 | 4.6× |
| CT l-spine w&w/o contrast (72133) | $603.40 | $862 | 2.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,416.10–$2,124.15 | $2,023–$3,034.50 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,834.70–$2,752.05 | $2,621–$3,931.50 | varies |
| CT lumbar spine w contrast (72132) | $1,656.90 | $2,367 | 4.0× |
| CT lumbar spine w/o contrast (72131) | $385.70 | $551 | 3.1× |
| CT maxillofacial w contrast (70487) | $1,245.30 | $1,779 | 5.9× |
| CT maxillofacial wo contrast (70486) | $959.70 | $1,371 | 7.7× |
| CT neck tissue combo (70492) | $1,847.30 | $2,639 | 8.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,374.80 | $1,964 | 6.5× |
| CT orbits w/o contrast (70480) | $872.20 | $1,246 | 7.0× |
| CT pelvis w&w/o contrast (72194) | $1,676.50 | $2,395 | 8.0× |
| CT pelvis w/o contrast (72192) | $930.30 | $1,329 | 7.4× |
| CT scan of leg combo (73702) | $2,334.50 | $3,335 | 11.1× |
| CT scans face/jaw combo (70488) | $1,141 | $1,630 | 5.4× |
| CT soft tissue neck w contrast (70491) | $1,195.60 | $1,708 | 5.7× |
| CT soft tissue neck w/o contrast (70490) | $1,202.60 | $1,718 | 9.6× |
| CT thoracic spine w contrast (72129) | $1,730.40 | $2,472 | 8.2× |
| CT thoracic spine w/o contrast (72128) | $1,253.70 | $1,791 | 10.0× |
| CT thoracic spine w/wo cont (72130) | $603.40 | $862 | 2.9× |
| CT thorax w/o contrast (71250) | $1,195.60 | $1,708 | 9.5× |
| CT unlisted procedure (76497) | $1,540 | $2,200 | 14.8× |
| CT upper ext wo (73200) | $364 | $520 | 2.9× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,048.60–$2,097.20 | $1,498–$2,996 | varies |
| CT upper extremity with contrast (73201) | $1,596 | $2,280 | 3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,859.90 | $2,657 | 8.8× |
| Cta Abdomen (74175) | $1,514.10 | $2,163 | 7.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,430 | $4,900 | 8.2× |
| CTA pelvis (72191) | $1,739.50 | $2,485 | 8.3× |
| Dilation ureters/urethra rs&i (74485) | $1,336.30 | $1,909 | 0.5× |
| Diskography lumbar (72295) | $2,573.90 | $3,677 | 1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $707.70 | $1,011 | 5.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $444.50 | $635 | 3.5× |
| Dxa Bone Density Axial (77080) | $366.10 | $523 | 2.9× |
| Dxa bone density study (77085) | $415.80 | $594 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $309.40 | $442 | 3.0× |
| Echo exam uterus (76831) | $1,173.20 | $1,676 | 4.1× |
| Echo Guide For Artery Repair (76936) | $784.70 | $1,121 | 3.0× |
| Echograp Trans R Pros Study (76873) | $1,063.30 | $1,519 | 8.5× |
| Esophagram (74220) | $480.90 | $687 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $285.60 | $408 | 2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$364–$683.55 | $520–$976.50 | varies |
| Fluoroscopy up to 1 hr (76000) | $624.40 | $892 | 2.2× |
| Follow-Up Angiography (75898) | $1,187.90 | $1,697 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$240.10–$360.15 | $343–$514.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$118.65–$355.95 | $169.50–$508.50 | varies |
| Gastric emptying imaging study (78264) | $1,036.70 | $1,481 | 2.2× |
| Gated Heart Planar Single (78472) | $963.20 | $1,376 | 2.0× |
| GI Endoscopic US S&I (76975) | $769.30 | $1,099 | 2.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$202.30–$303.45 | $289–$433.50 | varies |
| Heart Image (Pet) Multiple (78492) | $3,598.70 | $5,141 | 2.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,141.60 | $4,488 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,275.70 | $3,251 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,195.60 | $1,708 | 1.8× |
| Hepatobiliary System Imaging (78226) | $1,036.70 | $1,481 | 2.2× |
| Ht Musc Image Planar Mult (78454) | $3,258.50 | $4,655 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $1,747.90 | $2,497 | 1.1× |
| Hysterosalpingogram (74740) | $576.10 | $823 | 2.0× |
| Image fusion (77399) | $650.30 | $929 | 4.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 4 matching MRF lines |
$803.60–$1,205.40 | $1,148–$1,722 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$130.20–$195.30 | $186–$279 | varies |
| Infusion Ivp (74410) | $597.10 | $853 | 2.8× |
| Interstitial radiation source applic complex (77778) | $3,862.60 | $5,518 | 4.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,232 | $1,760 | 1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $854 | $1,220 | 1.3× |
| Intracavitary radiation source applic simple (77761) | $574 | $820 | 0.9× |
| Joint Survey Single View (77077) | $273.70 | $391 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $907.90 | $1,297 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $1,422.40 | $2,032 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,203.30 | $1,719 | 1.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,260 | $1,800 | 2.6× |
| Kidney Imaging Morphol (78700) | $945 | $1,350 | 2.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$288.40–$432.60 | $412–$618 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,399.30 | $1,999 | 2.9× |
| Liver & Spleen Imaging Static Only (78215) | $567 | $810 | 1.2× |
| Liver imaging static only (78201) | $1,841 | $2,630 | 2.8× |
| Liver imaging w/vascular flow (78202) | $2,227.40 | $3,182 | 3.4× |
| Lung Perf&Ventilat Diferentl (78598) | $1,040.20 | $1,486 | 1.6× |
| Lung perfusion differential (78597) | $393.40 | $562 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,344 | $1,920 | 2.1× |
| Lung Ventilation Imaging (78579) | $295.40 | $422 | 0.6× |
| Lymph System Imaging (78195) | $1,195.60 | $1,708 | 1.8× |
| Magnetic Image Jaw Joint (70336) | $1,101.10 | $1,573 | 3.9× |
| Mammary ductogram or galactogram single (77053) | $849.10 | $1,213 | 3.0× |
| Meckels Divert Exam (78290) | $810.60 | $1,158 | 1.7× |
| Mlc imrt design & construction per imrt plan (77338) | $966 | $1,380 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,760.80 | $3,944 | 6.6× |
| MRA head w/o contrast (70544) | $1,381.10 | $1,973 | 4.8× |
| MRA head with contrast (70545) | $1,381.10 | $1,973 | 3.3× |
| MRA neck w contrast (70548) | $1,381.10 | $1,973 | 3.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,401.70 | $3,431 | 5.7× |
| MRA neck w/o contrast (70547) | $1,381.10 | $1,973 | 4.8× |
| MRI abdomen w contrast (74182) | $1,271.90 | $1,817 | 3.0× |
| MRI abdomen w/o contrast (74181) | $1,381.10 | $1,973 | 4.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,827.70 | $2,611 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,657.20 | $3,796 | 6.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,827.70 | $2,611 | 1.9× |
| MRI bone marrow blood supply (77084) | $852.60 | $1,218 | 3.0× |
| MRI brain functional w/o physician admnistration (70554) | $1,381.10 | $1,973 | 4.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,436 | $3,480 | 8.5× |
| MRI cervical spine w contrast (72142) | $1,381.10 | $1,973 | 3.3× |
| MRI cervical spine w/o cont (72141) | $1,381.10 | $1,973 | 4.8× |
| MRI chest w/o contrast (71550) | $1,381.10 | $1,973 | 4.8× |
| MRI chest with contrast (71551) | $1,271.90 | $1,817 | 1.4× |
| MRI chest wo w contrast (71552) | $2,760.80 | $3,944 | 6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,827.70 | $2,611 | 4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,328.60–$2,657.20 | $1,898–$3,796 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,827.70 | $2,611 | 6.4× |
| MRI lumbar spine w contrast (72149) | $1,381.10 | $1,973 | 3.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,760.80 | $3,944 | 6.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,381.10 | $1,973 | 4.8× |
| MRI orbit face neck w contrast (70542) | $1,381.10 | $1,973 | 3.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,760.80 | $3,944 | 6.6× |
| MRI pelvis w contrast (72196) | $1,269.80 | $1,814 | 3.0× |
| MRI pelvis w/o & w contrast (72197) | $2,720.90 | $3,887 | 6.5× |
| MRI pelvis w/o contrast (72195) | $1,381.10 | $1,973 | 4.8× |
| MRI spectroscopy (76390) | $1,343.30 | $1,919 | 12.9× |
| MRI thoracic spine w/o contrast (72146) | $1,381.10 | $1,973 | 4.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,827.70 | $2,611 | 4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,827.70 | $2,611 | 6.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,657.20 | $3,796 | 6.4× |
| MRI, abdomen, combo (74183) | $2,720.90 | $3,887 | 6.5× |
| MRI, dorsal spine combo (72157) | $2,760.80 | $3,944 | 6.6× |
| MRI, dorsal spine contrast (72147) | $1,381.10 | $1,973 | 3.3× |
| MRI, joint upper extrem (73221) | $1,827.70 | $2,611 | 6.4× |
| MRI, joint upper extrem combo (73223) | $2,657.20 | $3,796 | 6.4× |
| MRI, lumbar spine combo (72158) | $2,760.80 | $3,944 | 6.6× |
| Myelogram cervical (72240) | $963.90 | $1,377 | 1.0× |
| Myelogram Lumbar (72265) | $994.70 | $1,421 | 1.1× |
| Myelography thoracic (72255) | $1,010.80 | $1,444 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $959 | $1,370 | 1.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,260 | $1,800 | 2.6× |
| Myocardial Spect Multiple Studies (78452) | $3,545.50 | $5,065 | 2.3× |
| N-invas est c ffr sw aly CTA (75580) | $2,160.90 | $3,087 | 2.1× |
| Neck soft tissue (70360) | $282.10 | $403 | 2.7× |
| Nm csf leak detection (78650) | $548.80 | $784 | 0.4× |
| Nm myocard infarct spect (78469) | $1,054.90 | $1,507 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $140.70 | $201 | 1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,949.40 | $5,642 | 2.4× |
| Nuclear medicine study of endocrine organs (78099) | $1,260 | $1,800 | 2.6× |
| Nuclear Rx Intra-Arterial (79445) | $845.60 | $1,208 | 3.0× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$767.20–$890.40 | $1,096–$1,272 | varies |
| Ob us nuchal meas 1 gest (76813) | $364 | $520 | 2.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $445.20 | $636 | 0.7× |
| Parathyroid Planar Imaging (78070) | $1,096.20 | $1,566 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,036.70 | $1,481 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$197.40–$592.20 | $282–$846 | varies |
| PET image w/CT, full body (78816) | $4,568.20 | $6,526 | 2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,302.90 | $6,147 | 2.5× |
| Pet Myocardial Sngl Study (78491) | $4,945.50 | $7,065 | 2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,275.70 | $3,251 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,036.70 | $1,481 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $449.40 | $642 | 3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $625.10 | $893 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$257.60–$386.40 | $368–$552 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$255.50–$383.25 | $365–$547.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$258.30–$387.45 | $369–$553.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $395.50 | $565 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$100.80–$302.40 | $144–$432 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$252.70–$379.05 | $361–$541.50 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$268.10–$402.15 | $383–$574.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $147.70 | $211 | 1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $469 | $670 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $338.80 | $484 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $311.50 | $445 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$124.60–$373.80 | $178–$534 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $241.50 | $345 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $219.10 | $313 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $322.70 | $461 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$417.90–$626.85 | $597–$895.50 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$101.50–$304.50 | $145–$435 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $208.60 | $298 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$139.30–$417.90 | $199–$597 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,643.70 | $29,491 | 2.3× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$357–$1,043.70 | $510–$1,491 | varies |
| Radiation treatment delivery level 2 (77407) range across 3 matching MRF lines |
$406.70–$2,563.40 | $581–$3,662 | varies |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$686.70–$2,640.40 | $981–$3,772 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $387.10 | $553 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $443.10 | $633 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $677.60 | $968 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $581.70 | $831 | 2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $462 | $660 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$381.50–$572.25 | $545–$817.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $496.30 | $709 | 4.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $516.60 | $738 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $625.80 | $894 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $480.90 | $687 | 2.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$232.40–$348.60 | $332–$498 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$283.50–$425.25 | $405–$607.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$242.20–$363.30 | $346–$519 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $453.60 | $648 | 3.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$119.35–$358.05 | $170.50–$511.50 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $845.60 | $1,208 | 3.0× |
| Ribs bilateral 3 views (71110) | $324.10 | $463 | 2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,032.50 | $1,475 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,077.60 | $2,968 | 3.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $695.80 | $994 | 1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$811.30–$2,153.90 | $1,159–$3,077 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,085 | $1,550 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $901.60 | $1,288 | 3.2× |
| Salivary Gland Function Study (78232) | $945 | $1,350 | 2.0× |
| Salivary Gland Imaging (78230) | $1,260 | $1,800 | 2.6× |
| Salivary Gland Imaging Serial Images (78231) | $427 | $610 | 0.9× |
| Scapula (73010) | $282.10 | $403 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$26.60–$105.70 | $38–$151 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$191.10–$286.65 | $273–$409.50 | varies |
| Shoulder Arthrography (73040) | $751.80 | $1,074 | 1.8× |
| Sialogram (70390) | $381.50 | $545 | 1.3× |
| Skull less than 4 views (70250) | $338.80 | $484 | 2.7× |
| Special dosimetry (77331) | $431.90 | $617 | 2.7× |
| Special Physics Consult (77370) | $599.90 | $857 | 3.7× |
| Special teletherapy port plan (77321) | $515.20 | $736 | 1.1× |
| Special treatment procedure (77470) | $1,536.50 | $2,195 | 2.3× |
| Stereotactic Body Radiation Delivery (77373) | $4,401.60 | $6,288 | 2.1× |
| Sternoclavicular joints (71130) | $320.60 | $458 | 3.1× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $263.20 | $376 | 2.2× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $849.80 | $1,214 | 19.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,040.90 | $1,487 | 2.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $756.70 | $1,081 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,124.90 | $1,607 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $707.70 | $1,011 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $494.20 | $706 | 3.1× |
| Thoracic spine 2 views (72070) | $338.80 | $484 | 2.7× |
| Thoracic spine 3 views (72072) | $394.80 | $564 | 3.2× |
| Thoracolumbar 2 views (72080) | $261.10 | $373 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $357 | $510 | 0.7× |
| Thyroid Met Imaging Body (78018) | $1,344 | $1,920 | 2.1× |
| Thyroid Uptake Measurement (78012) | $224.70 | $321 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $530.60 | $758 | 1.1× |
| Tx Devices Design & Construction Complex (77334) | $955.50 | $1,365 | 2.1× |
| Tx devices design & construction intermediate (77333) | $399.70 | $571 | 2.5× |
| Tx devices design & construction simple (77332) | $376.60 | $538 | 2.3× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$378–$1,510.95 | $540–$2,158.50 | varies |
| Ultrasound Elastography Parenchyma (76981) | $330.40 | $472 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $316.40 | $452 | 2.5× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$364–$541.10 | $520–$773 | varies |
| Umbilical-artery Doppler (OB) (76820) | $349.30 | $499 | 2.8× |
| Unlisted Dx Radiographic Procedure (76499) | $261.10 | $373 | 2.5× |
| Unlisted us procedure (76999) | $265.30 | $379 | 2.5× |
| Upper gi w/o kub (74240) | $480.90 | $687 | 2.3× |
| Ureteral Reflux Study (78740) | $452.20 | $646 | 0.9× |
| Urethrocystogram voiding (74455) | $453.60 | $648 | 1.6× |
| Urethrocystography retrograde (74450) | $491.40 | $702 | 1.7× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$580.30–$1,510.95 | $829–$2,158.50 | varies |
| Us chest (76604) | $508.90 | $727 | 4.1× |
| Us complete joint (76881) range across 3 matching MRF lines |
$245–$367.50 | $350–$525 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$314.30–$364 | $449–$520 | varies |
| Us head (76506) | $994 | $1,420 | 7.9× |
| Us kidney transplant (76776) | $286.30 | $409 | 2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $415.10 | $593 | 3.3× |
| Us ob detailed single fetus (76811) | $669.20 | $956 | 2.3× |
| Us ob limited 1 or more fetuses (76815) | $338.10 | $483 | 2.7× |
| Us ob transvaginal (76817) | $507.50 | $725 | 4.1× |
| Us pelvic non ob complete (76856) | $541.10 | $773 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $469 | $670 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $285.60 | $408 | 2.3× |
| Us retroperitoneal complete (76770) | $727.30 | $1,039 | 5.8× |
| Us retroperitoneal limited (76775) | $285.60 | $408 | 2.3× |
| Us scrotum and contents (76870) | $758.10 | $1,083 | 6.1× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$364–$484.40 | $520–$692 | varies |
| Us thyroid (76536) | $479.50 | $685 | 3.8× |
| Us transrectal (76872) | $503.30 | $719 | 4.0× |
| Vascular Flow Imaging (78445) | $496.30 | $709 | 1.0× |
| Vein X-Ray Chest (75827) | $1,508.50 | $2,155 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,100.40 | $1,572 | 0.3× |
| Vein X-Ray Spleen/Liver (75810) | $3,399.20 | $4,856 | 0.9× |
| Venogram Sinus/Jugular (75860) | $9,259.60 | $13,228 | 2.4× |
| Venography caval inferior serialography rs&i (75825) | $7,909.30 | $11,299 | 2.1× |
| Venography extremity bilateral rs&i (75822) | $1,487.50 | $2,125 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $810.60 | $1,158 | 0.4× |
| Venography Renal Bilateral (75833) | $1,831.90 | $2,617 | 0.5× |
| Venography Renal Unilateral (75831) | $2,308.60 | $3,298 | 0.6× |
| Venous sampling by catheter (75893) | $13,690.60 | $19,558 | 2.1× |
| Vertebral fracture assessment via dxa (77086) | $420.70 | $601 | 4.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$120.05–$240.10 | $171.50–$343 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$350–$525 | $500–$750 | varies |
| X-ray antegrade pyelogram tube (74425) | $413.70 | $591 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $7,033.60 | $10,048 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) | $382.90 | $547 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$131.25–$262.50 | $187.50–$375 | varies |
| X-Ray Exam Breast Specimen (76098) | $504.70 | $721 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $257.60 | $368 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $325.50 | $465 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $252 | $360 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$232.40–$348.60 | $332–$498 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$309.40–$464.10 | $442–$663 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $366.10 | $523 | 2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$309.40–$464.10 | $442–$663 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$366.10–$549.15 | $523–$784.50 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$431.90–$647.85 | $617–$925.50 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $574.70 | $821 | 4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $394.80 | $564 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $469 | $670 | 3.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$364–$532 | $520–$760 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$228.20–$342.30 | $326–$489 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$239.40–$359.10 | $342–$513 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $338.80 | $484 | 3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$309.40–$464.10 | $442–$663 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $477.40 | $682 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $165.20 | $236 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$589.40–$884.10 | $842–$1,263 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $311.50 | $445 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $309.40 | $442 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $338.80 | $484 | 3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $394.80 | $564 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $506.10 | $723 | 4.0× |
| X-Ray Stress View (77071) | $261.10 | $373 | 2.5× |
| X-ray thoracic spine 4 vw (72074) | $366.10 | $523 | 2.9× |
| X-Ray Tmj Unilat (70328) | $312.20 | $446 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $982.80 | $1,404 | 2.4× |
| X-Rays Bone Length Studies (77073) | $589.40 | $842 | 4.7× |
| X-Rays Bone Survey Complete (77075) | $453.60 | $648 | 3.6× |
| Xr c-spine 4 or 5 views (72050) | $441.70 | $631 | 3.5× |
| Xr facial bones less than 3 views (70140) | $293.30 | $419 | 2.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $264.60 | $378 | 2.1× |
| Xr orbits complete 4 views (70200) | $420.70 | $601 | 3.4× |
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.