Imaging prices at Medical City Dallas
Dallas, TX · every code in this section with a posted price and a Medicare benchmark.
442 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $6,806.17 | $6,806.17 | 4.9× |
| Abdomen 1 View (74018) | $772.58 | $772.58 | 8.8× |
| Abdomen 2 views (74019) | $1,275.38 | $1,275.38 | 12.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,116.06 | $4,116.06 | 10.2× |
| Adrenal Cortex & Medulla Img (78075) | $6,986.57 | $6,986.57 | 5.4× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$5,010.57–$6,220.53 | $5,010.57–$6,220.53 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,934.95–$6,231.70 | $5,934.95–$6,231.70 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,010.57 | $5,010.57 | 1.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$5,246.29–$5,508.60 | $5,246.29–$5,508.60 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$4,567.52–$5,010.57 | $4,567.52–$5,010.57 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,010.57 | $5,010.57 | 1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,231.70 | $6,231.70 | 2.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$836.42–$1,671.25 | $836.42–$1,671.25 | varies |
| Aortography thoracic serialography rs&i (75605) | $20,607.36 | $20,607.36 | 3.7× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$14,597.57–$20,607.36 | $14,597.57–$20,607.36 | varies |
| Artery X-Rays Adrenal Gland (75731) | $5,010.57 | $5,010.57 | 1.6× |
| Artery X-Rays Pelvis (75736) | $20,607.36 | $20,607.36 | 3.7× |
| Artery X-Rays Spine (75705) | $20,607.36 | $20,607.36 | 3.7× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$2,405.53–$4,809.45 | $2,405.53–$4,809.45 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,227.50–$2,455.01 | $1,227.50–$2,455.01 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,792.56–$3,580.34 | $1,792.56–$3,580.34 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$735.32–$919.79 | $735.32–$919.79 | varies |
| Bone age studies (77072) | $922.64 | $922.64 | 8.8× |
| Bone Imaging 3 Phase (78315) | $6,665.91 | $6,665.91 | 16.6× |
| Bone Imaging Limited Area (78300) | $3,640.82 | $3,640.82 | 9.1× |
| Bone Imaging Multiple Areas (78305) | $3,934.65 | $3,934.65 | 9.8× |
| Bone Imaging Whole Body (78306) | $4,841.67 | $4,841.67 | 12.1× |
| Bone marrow imaging limited area (78102) | $2,299.48 | $2,299.48 | 5.7× |
| Bone marrow imaging; multiple areas (78103) | $2,250.93 | $2,250.93 | 5.6× |
| Bone marrow imaging; whole body (78104) | $4,193.99 | $4,193.99 | 10.4× |
| Bone survey infant (77076) | $1,441.40 | $1,441.40 | 13.7× |
| Brachytx isodose complex (77318) | $3,879.70 | $3,879.70 | 10.3× |
| Brachytx isodose intermed (77317) | $2,061.51 | $2,061.51 | 5.5× |
| Brachytx Isodose Plan Simple (77316) | $759.37 | $759.37 | 2.0× |
| Brain Flow Imaging Only (78610) | $3,220.54 | $3,220.54 | 5.9× |
| Brain Image W/Flow < 4 Views (78601) | $1,649.24 | $1,649.24 | 4.1× |
| Brain imaging < 4 static views (78600) | $2,005.65 | $2,005.65 | 5.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,792.59 | $2,792.59 | 5.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,139.80 | $2,139.80 | 3.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $18,377.91 | $18,377.91 | 12.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $4,960.46 | $4,960.46 | 12.4× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $6,437.26 | $6,437.26 | 11.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $7,224.18 | $7,224.18 | 20.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $6,077 | $6,077 | 7.7× |
| Cardiac Shunt Detection (78428) | $904.46 | $904.46 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $2,081.92 | $2,081.92 | 23.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,577.97 | $2,577.97 | 4.7× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $3,916.77 | $3,916.77 | 7.2× |
| Cerebrospinal Fluid Scan (78630) | $4,526.13 | $4,526.13 | 8.3× |
| Chest 1 view (71045) | $753.42 | $753.42 | 8.6× |
| Chest 2 views (71046) | $967.31 | $967.31 | 11.1× |
| Chest 3 views (71047) | $1,328.06 | $1,328.06 | 15.2× |
| Chest 4 or more views (71048) | $2,001.69 | $2,001.69 | 19.1× |
| Cholecystography Oral Contrast (74290) | $1,559.52 | $1,559.52 | 8.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $2,790.22 | $2,790.22 | 26.6× |
| Clavicle complete (73000) | $922.64 | $922.64 | 10.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$581.64–$658.08 | $581.64–$658.08 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$759.37–$1,691.19 | $759.37–$1,691.19 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$6,023.12–$6,324.28 | $6,023.12–$6,324.28 | varies |
| Contrast X-Ray Bladder (74430) | $1,795.77 | $1,795.77 | 5.1× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$1,345.63–$2,688.05 | $1,345.63–$2,688.05 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$999.23–$1,998.48 | $999.23–$1,998.48 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $12,691.28 | $12,691.28 | 36.2× |
| CT abdomen and pelvis without contrast (74176) | $9,136.03 | $9,136.03 | 38.1× |
| CT abdomen w contrast (74160) | $5,356.56 | $5,356.56 | 30.4× |
| CT abdomen w wo contrast (74170) | $6,421.22 | $6,421.22 | 36.4× |
| CT abdomen w/o contrast (74150) | $4,888.94 | $4,888.94 | 46.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,656.46 | $3,656.46 | 10.4× |
| CT Angio Chest (71275) | $6,259.81 | $6,259.81 | 35.5× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$6,557.02–$12,305.63 | $6,557.02–$12,305.63 | varies |
| CT angio hrt w/3d image (75574) | $1,314.48 | $1,314.48 | 3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,026.82–$3,041.48 | $2,026.82–$3,041.48 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$6,285.44–$12,034.17 | $6,285.44–$12,034.17 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,126.75 | $2,126.75 | 12.1× |
| CT cervical spine w/ contrast (72126) | $5,496.23 | $5,496.23 | 15.7× |
| CT cervical spine w/o contrast (72125) | $4,883.82 | $4,883.82 | 46.5× |
| CT cervical spine w/wo cont (72127) | $6,026.62 | $6,026.62 | 34.2× |
| CT chest w contrast (71260) | $5,209.24 | $5,209.24 | 29.6× |
| CT chest w/wo contrast (71270) | $6,927.29 | $6,927.29 | 39.3× |
| CT head/brain with contrast (70460) | $4,595.57 | $4,595.57 | 26.1× |
| CT head/brain without and with contrast (70470) | $5,888.27 | $5,888.27 | 33.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,693.70 | $1,693.70 | 4.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $285.71 | $285.71 | 3.3× |
| CT hrt w/3d image congen (75573) | $1,693.70 | $1,693.70 | 4.8× |
| CT iac w contrast (70481) | $4,462.31 | $4,462.31 | 25.3× |
| CT l-spine w&w/o contrast (72133) | $6,043.28 | $6,043.28 | 34.3× |
| CT lower ext w/o (73700) | $3,596.24 | $3,596.24 | 34.2× |
| CT lower extremity w/contrast material (73701) | $3,938.32 | $3,938.32 | 22.4× |
| CT lumbar spine w contrast (72132) | $5,593.59 | $5,593.59 | 16.0× |
| CT lumbar spine w/o contrast (72131) | $5,123.40 | $5,123.40 | 48.8× |
| CT maxillofacial w contrast (70487) | $4,159.95 | $4,159.95 | 23.6× |
| CT maxillofacial wo contrast (70486) | $3,999.82 | $3,999.82 | 38.1× |
| CT neck tissue combo (70492) | $5,532.09 | $5,532.09 | 31.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,576.33 | $4,576.33 | 26.0× |
| CT orbits w/o contrast (70480) | $4,147.15 | $4,147.15 | 39.5× |
| CT pelvis w&w/o contrast (72194) | $6,272.62 | $6,272.62 | 35.6× |
| CT pelvis w/o contrast (72192) | $4,248.36 | $4,248.36 | 40.5× |
| CT scan of leg combo (73702) | $4,832.58 | $4,832.58 | 27.4× |
| CT scans face/jaw combo (70488) | $5,433.44 | $5,433.44 | 30.8× |
| CT soft tissue neck w contrast (70491) | $5,096.48 | $5,096.48 | 28.9× |
| CT soft tissue neck w/o contrast (70490) | $4,671.15 | $4,671.15 | 44.5× |
| CT thoracic spine w contrast (72129) | $4,883.82 | $4,883.82 | 27.7× |
| CT thoracic spine w/o contrast (72128) | $5,888.27 | $5,888.27 | 56.1× |
| CT thoracic spine w/wo cont (72130) | $5,410.38 | $5,410.38 | 30.7× |
| CT thorax w/o contrast (71250) | $4,259.90 | $4,259.90 | 40.6× |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$627.77–$2,871.09 | $627.77–$2,871.09 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,616.76–$7,236.04 | $3,616.76–$7,236.04 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$3,578.30–$7,154.04 | $3,578.30–$7,154.04 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$3,970.34–$7,940.69 | $3,970.34–$7,940.69 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,980.59 | $3,980.59 | 22.6× |
| Cta Abdomen (74175) | $5,849.82 | $5,849.82 | 33.2× |
| CTA pelvis (72191) | $6,259.81 | $6,259.81 | 35.5× |
| Dilation ureters/urethra rs&i (74485) | $8,637.23 | $8,637.23 | 4.1× |
| Discography Cerv/Thor Spine (72285) | $13,746.76 | $13,746.76 | 7.0× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$5,010.57–$13,746.76 | $5,010.57–$13,746.76 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $489.27 | $489.27 | 4.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $489.27 | $489.27 | 4.7× |
| Dxa Bone Density Axial (77080) | $1,160.47 | $1,160.47 | 11.0× |
| Dxa bone density study (77085) | $731.08 | $731.08 | 7.0× |
| Echo exam of fetal heart (76825) | $3,859.29 | $3,859.29 | 7.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,543.48 | $2,543.48 | 10.6× |
| Echograp Trans R Pros Study (76873) | $1,742.49 | $1,742.49 | 16.6× |
| Esophagram (74220) | $1,573.89 | $1,573.89 | 8.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,558.53 | $1,558.53 | 14.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $825.26 | $825.26 | 7.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,262.14 | $1,262.14 | 5.3× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$1,216.32–$2,087.87 | $1,216.32–$2,087.87 | varies |
| Follow-Up Angiography (75898) | $2,959.43 | $2,959.43 | 0.9× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$951.34–$1,897.92 | $951.34–$1,897.92 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$935.40–$1,872.38 | $935.40–$1,872.38 | varies |
| Gastric emptying imaging study (78264) | $5,518.74 | $5,518.74 | 13.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,811.47 | $1,811.47 | 4.5× |
| Gastroesophageal Reflux Exam (78262) | $2,553.68 | $2,553.68 | 6.4× |
| Gated Heart Planar Single (78472) | $4,960.46 | $4,960.46 | 12.4× |
| Gated Heart, Multiple (78473) | $8,220.62 | $8,220.62 | 20.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,401.68 | $2,401.68 | 4.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$897.09–$1,792.56 | $897.09–$1,792.56 | varies |
| Heart first pass single,planar (78481) | $3,332.96 | $3,332.96 | 6.1× |
| Heart Image (Pet) Multiple (78492) | $23,259.18 | $23,259.18 | 16.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,730.48 | $5,730.48 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$6,277.98–$6,780.81 | $6,277.98–$6,780.81 | varies |
| Hepatobil Syst Image W/Drug (78227) | $4,354.95 | $4,354.95 | 8.0× |
| Hepatobiliary System Imaging (78226) | $3,347.01 | $3,347.01 | 8.3× |
| Ht Musc Image Planar Mult (78454) | $6,016.95 | $6,016.95 | 4.6× |
| Ht Muscle Image Spect Sing (78451) | $6,016.95 | $6,016.95 | 4.6× |
| Hysterosalpingogram (74740) | $1,798.97 | $1,798.97 | 7.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $530.15 | $530.15 | 6.1× |
| Infant hip ultrasound, limited static exam (76886) | $530.15 | $530.15 | 6.1× |
| Infusion Ivp (74410) | $4,284.29 | $4,284.29 | 24.3× |
| Interstitial radiation source applic complex (77778) | $7,265.06 | $7,265.06 | 10.4× |
| K Flow/Funct Image W/Drug (78708) | $3,516.91 | $3,516.91 | 6.4× |
| K Flow/Funct Image W/O Drug (78707) | $6,986.57 | $6,986.57 | 12.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $2,942.05 | $2,942.05 | 7.3× |
| Kidney Imaging Morphol (78700) | $2,569.01 | $2,569.01 | 6.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $3,265.26 | $3,265.26 | 8.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$980.08–$1,958.58 | $980.08–$1,958.58 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,305.59 | $1,305.59 | 3.3× |
| Liver & Spleen Imaging Static Only (78215) | $3,403.23 | $3,403.23 | 8.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $3,476.04 | $3,476.04 | 8.7× |
| Liver imaging static only (78201) | $2,309.69 | $2,309.69 | 4.2× |
| Liver imaging w/vascular flow (78202) | $2,995.69 | $2,995.69 | 5.5× |
| Lung Perf&Ventilat Diferentl (78598) | $5,430.59 | $5,430.59 | 10.0× |
| Lung perfusion differential (78597) | $5,430.59 | $5,430.59 | 13.5× |
| Lung Ventilat&Perfus Imaging (78582) | $6,052.71 | $6,052.71 | 11.1× |
| Lung Ventilation Imaging (78579) | $6,052.71 | $6,052.71 | 15.1× |
| Lymph System Imaging (78195) | $4,190.16 | $4,190.16 | 7.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,985.72 | $1,985.72 | 3.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $6,780.81 | $6,780.81 | 2.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $4,598.75 | $4,598.75 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $7,159.04 | $7,159.04 | 29.9× |
| Magnetic Resonance Elastography (76391) | $1,379.69 | $1,379.69 | 5.8× |
| Meckels Divert Exam (78290) | $3,681.71 | $3,681.71 | 9.2× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,482.63–$1,910.44 | $1,482.63–$1,910.44 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $105 | $105 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $6,188.13 | $6,188.13 | 17.7× |
| MRA head w/o contrast (70544) | $4,084.13 | $4,084.13 | 17.0× |
| MRA head with contrast (70545) | $5,115.05 | $5,115.05 | 14.6× |
| MRA neck w contrast (70548) | $5,062.68 | $5,062.68 | 14.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,259.41 | $5,259.41 | 15.0× |
| MRA neck w/o contrast (70547) | $3,674.04 | $3,674.04 | 15.3× |
| MRI abdomen w contrast (74182) | $7,224.18 | $7,224.18 | 20.6× |
| MRI abdomen w/o contrast (74181) | $6,541.99 | $6,541.99 | 27.3× |
| MRI any jt lower extrem w/contrast material (73722) | $6,016.95 | $6,016.95 | 7.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,473.29 | $7,473.29 | 21.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,840.67 | $5,840.67 | 7.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $7,478.40 | $7,478.40 | 31.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,986.02 | $4,986.02 | 20.8× |
| MRI cardiac w/o cont stress (75559) | $5,287.51 | $5,287.51 | 9.6× |
| MRI cardiac w/o contrast (75557) | $3,634.45 | $3,634.45 | 15.2× |
| MRI cervical spine w contrast (72142) | $7,326.39 | $7,326.39 | 20.9× |
| MRI cervical spine w/o cont (72141) | $6,305.67 | $6,305.67 | 26.3× |
| MRI chest w/o contrast (71550) | $5,290.08 | $5,290.08 | 22.1× |
| MRI chest with contrast (71551) | $8,439.06 | $8,439.06 | 10.7× |
| MRI chest wo w contrast (71552) | $7,548.66 | $7,548.66 | 21.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $5,947.97 | $5,947.97 | 17.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $7,266.35 | $7,266.35 | 20.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,413.98 | $5,413.98 | 22.6× |
| MRI lumbar spine w contrast (72149) | $7,603.60 | $7,603.60 | 21.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,587.26 | $8,587.26 | 24.5× |
| MRI orbit face &/neck w/o contrast (70540) | $6,457.70 | $6,457.70 | 26.9× |
| MRI orbit face neck w contrast (70542) | $8,235.95 | $8,235.95 | 23.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,934.19 | $6,934.19 | 19.8× |
| MRI pelvis w contrast (72196) | $6,692.75 | $6,692.75 | 19.1× |
| MRI pelvis w/o & w contrast (72197) | $7,224.18 | $7,224.18 | 20.6× |
| MRI pelvis w/o contrast (72195) | $5,233.86 | $5,233.86 | 21.8× |
| MRI spectroscopy (76390) | $5,465.08 | $5,465.08 | 62.5× |
| MRI thoracic spine w/o contrast (72146) | $7,070.90 | $7,070.90 | 29.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,858.82 | $6,858.82 | 19.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $5,259.41 | $5,259.41 | 21.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$7,473.29–$14,946.58 | $7,473.29–$14,946.58 | varies |
| MRI, abdomen, combo (74183) | $8,373.93 | $8,373.93 | 23.9× |
| MRI, dorsal spine combo (72157) | $8,652.42 | $8,652.42 | 24.7× |
| MRI, dorsal spine contrast (72147) | $7,146.26 | $7,146.26 | 20.4× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$5,835.56–$11,673.67 | $5,835.56–$11,673.67 | varies |
| MRI, joint upper extrem combo (73223) | $7,473.29 | $7,473.29 | 21.3× |
| MRI, lumbar spine combo (72158) | $8,740.56 | $8,740.56 | 24.9× |
| Myelogram cervical (72240) | $4,806.27 | $4,806.27 | 6.1× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$3,591.53–$5,286.72 | $3,591.53–$5,286.72 | varies |
| Myelography thoracic (72255) | $3,497.36 | $3,497.36 | 4.4× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$4,785.50–$4,806.27 | $4,785.50–$4,806.27 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $3,511.81 | $3,511.81 | 8.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $21,509.03 | $21,509.03 | 16.5× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $2,081.04 | $2,081.04 | 3.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $6,016.95 | $6,016.95 | 4.6× |
| Myocardial Spect Multiple Studies (78452) | $8,197.63 | $8,197.63 | 6.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $26,221.67 | $26,221.67 | 18.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $26,221.67 | $26,221.67 | 18.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $32,368.92 | $32,368.92 | 14.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $28,057.42 | $28,057.42 | 12.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $21,509.03 | $21,509.03 | 14.1× |
| N-invas est c ffr sw aly CTA (75580) | $3,986.24 | $3,986.24 | 4.6× |
| Neck soft tissue (70360) | $775.76 | $775.76 | 8.9× |
| Nm csf leak detection (78650) | $4,239.97 | $4,239.97 | 3.3× |
| Nm myocard infarct spect (78469) | $4,102.01 | $4,102.01 | 7.5× |
| Nm red cell survival study (78130) | $4,434.15 | $4,434.15 | 11.0× |
| Nonvascular Shunt X-Ray (75809) | $1,302.53 | $1,302.53 | 12.4× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$4,687.20–$6,534.79 | $4,687.20–$6,534.79 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$1,060.32–$1,573.86 | $1,060.32–$1,573.86 | varies |
| Nuclear Rx Oral Admin (79005) | $2,747.86 | $2,747.86 | 11.7× |
| Optic foramina (70190) | $2,164.49 | $2,164.49 | 24.8× |
| Panoramic X-ray of jaws (70355) | $257 | $257 | 2.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,276.75 | $3,276.75 | 6.0× |
| Parathyroid Planar Imaging (78070) | $3,993.41 | $3,993.41 | 9.9× |
| Pelvis 1 or 2 views (72170) | $747.04 | $747.04 | 7.1× |
| Perineogram (74775) | $1,556.33 | $1,556.33 | 6.5× |
| Peritoneogram Rs&I (74190) | $2,470.98 | $2,470.98 | 4.5× |
| Pet Image Skull-Thigh (78812) | $28,057.42 | $28,057.42 | 19.5× |
| Pet Image W/Ct Lmtd (78814) | $26,221.67 | $26,221.67 | 18.3× |
| PET image w/CT, full body (78816) | $28,057.42 | $28,057.42 | 19.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $28,057.42 | $28,057.42 | 19.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$26,221.67–$28,057.42 | $26,221.67–$28,057.42 | varies |
| Pet Myocardial Sngl Study (78491) | $21,509.03 | $21,509.03 | 15.0× |
| PET whole body (78813) | $28,057.42 | $28,057.42 | 19.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,644.29 | $5,644.29 | 1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $5,518.74 | $5,518.74 | 13.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,173.25–$2,081.49 | $1,173.25–$2,081.49 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$964.13–$1,926.66 | $964.13–$1,926.66 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$785.33–$1,565.91 | $785.33–$1,565.91 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,021.59–$2,036.79 | $1,021.59–$2,036.79 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,075.86 | $1,075.86 | 10.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$672.02–$1,340.83 | $672.02–$1,340.83 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$964.13–$1,926.66 | $964.13–$1,926.66 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$999.23–$1,996.89 | $999.23–$1,996.89 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$826.84–$1,655.30 | $826.84–$1,655.30 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $683.19 | $683.19 | 6.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $871.54 | $871.54 | 10.0× |
| Radex Ribs Unilateral 2 Views (71100) | $826.84 | $826.84 | 9.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$1,115.75–$2,231.53 | $1,115.75–$2,231.53 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $855.58 | $855.58 | 9.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $5,845.40 | $5,845.40 | 33.2× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$381.50–$1,002.44 | $381.50–$1,002.44 | varies |
| Radex Sternum Minimum 2 Views (71120) | $1,010.42 | $1,010.42 | 11.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,181.22 | $1,181.22 | 13.5× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$756.62–$1,511.64 | $756.62–$1,511.64 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$1,205.16–$2,407.14 | $1,205.16–$2,407.14 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$980.08–$1,958.58 | $980.08–$1,958.58 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $2,809.37 | $2,809.37 | 26.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$23,758.14–$63,839.87 | $23,758.14–$63,839.87 | varies |
| Radiation treatment delivery level 1 (77402) | $525.40 | $525.40 | 5.1× |
| Radiation treatment delivery level 2 (77407) | $525.40 | $525.40 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $1,013.39 | $1,013.39 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,037.56 | $1,037.56 | 9.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,363.19 | $1,363.19 | 13.0× |
| Radiologic exam colon double contrast study (74280) | $1,297.74 | $1,297.74 | 7.4× |
| Radiologic exam colon single contrast study (74270) | $2,282.61 | $2,282.61 | 13.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,307.31 | $1,307.31 | 7.4× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$1,213.13–$2,423.09 | $1,213.13–$2,423.09 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $2,451.81 | $2,451.81 | 23.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,068.71 | $2,068.71 | 11.7× |
| Radiologic exam swallow function contrast study (74230) | $2,261.87 | $2,261.87 | 12.8× |
| Radiologic exam teeth complete full mouth (70320) | $909.87 | $909.87 | 3.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,304.97 | $2,304.97 | 13.1× |
| Radiologic examination femur 1 view (73551) | $437.38 | $437.38 | 5.0× |
| Radiologic examination femur minimum 2 views (73552) | $1,018.40 | $1,018.40 | 11.6× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$836.42–$1,668.07 | $836.42–$1,668.07 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $3,288.23 | $3,288.23 | 31.3× |
| Radiologic Examination Salivary Gland Calculus (70380) | $2,020.82 | $2,020.82 | 23.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$964.13–$1,923.46 | $964.13–$1,923.46 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $477.27 | $477.27 | 5.5× |
| Radiopharm Dacryocystography (78660) | $1,355.41 | $1,355.41 | 3.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $3,926.99 | $3,926.99 | 9.8× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $6,522.84 | $6,522.84 | 12.0× |
| Renal Cyst Study (74470) | $2,057.53 | $2,057.53 | 3.7× |
| Ribs bilateral 3 views (71110) | $1,189.20 | $1,189.20 | 11.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,849.06 | $3,849.06 | 9.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $4,480.15 | $4,480.15 | 11.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $8,315.15 | $8,315.15 | 15.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,051.19 | $5,051.19 | 9.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $8,132.48 | $8,132.48 | 14.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $7,667.47 | $7,667.47 | 5.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,295.99 | $8,295.99 | 5.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $7,312.33 | $7,312.33 | 5.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $7,036.39 | $7,036.39 | 30.0× |
| Rp Therapy Intravenous Administration (79101) | $2,747.86 | $2,747.86 | 11.7× |
| Salivary Gland Function Study (78232) | $2,401.68 | $2,401.68 | 6.0× |
| Salivary Gland Imaging (78230) | $3,111.96 | $3,111.96 | 7.7× |
| Scapula (73010) | $986.49 | $986.49 | 9.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $195.45 | $195.45 | 8.4× |
| Sella turcica (70240) | $1,814.93 | $1,814.93 | 20.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$747.04–$1,489.29 | $747.04–$1,489.29 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$2,351.24–$4,699.32 | $2,351.24–$4,699.32 | varies |
| Sialogram (70390) | $1,792.56 | $1,792.56 | 7.5× |
| Skull less than 4 views (70250) | $973.71 | $973.71 | 9.3× |
| Special dosimetry (77331) | $759.37 | $759.37 | 5.6× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$759.37–$2,823.54 | $759.37–$2,823.54 | varies |
| Special teletherapy port plan (77321) | $2,061.51 | $2,061.51 | 5.5× |
| Special treatment procedure (77470) | $4,434.52 | $4,434.52 | 8.0× |
| Speech evaluation, complex (70371) | $1,476.52 | $1,476.52 | 6.2× |
| Spleen Imaging (78185) | $1,829.35 | $1,829.35 | 4.6× |
| Stereotactic Body Radiation Delivery (77373) | $12,709.97 | $12,709.97 | 7.1× |
| Sternoclavicular joints (71130) | $983.29 | $983.29 | 11.2× |
| Superior sagittal sinus venogram (75870) | $2,249.09 | $2,249.09 | 0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $759.37 | $759.37 | 2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $759.37 | $759.37 | 2.0× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$2,001.69–$4,003.36 | $2,001.69–$4,003.36 | varies |
| Testicular Imaging W/Flow (78761) | $2,768.30 | $2,768.30 | 6.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,061.51 | $2,061.51 | 5.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,061.51 | $2,061.51 | 5.5× |
| Ther rad simulaj-aided field setting simple (77280) | $759.37 | $759.37 | 5.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,578.68 | $1,578.68 | 9.0× |
| Thoracic spine 2 views (72070) | $1,248.25 | $1,248.25 | 11.9× |
| Thoracic spine 3 views (72072) | $1,422.26 | $1,422.26 | 13.5× |
| Thoracolumbar 2 views (72080) | $1,971.35 | $1,971.35 | 22.6× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $807.37 | $807.37 | 2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $2,818.14 | $2,818.14 | 7.0× |
| Thyroid Imaging With Vascular Flow (78013) | $2,475.77 | $2,475.77 | 6.2× |
| Thyroid Met Imaging Body (78018) | $4,366.45 | $4,366.45 | 8.0× |
| Thyroid Uptake Measurement (78012) | $1,193.17 | $1,193.17 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,602.24 | $2,602.24 | 6.5× |
| Tx Devices Design & Construction Complex (77334) | $1,413.12 | $1,413.12 | 3.8× |
| Tx devices design & construction intermediate (77333) | $1,370.33 | $1,370.33 | 10.1× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$1,268.73–$1,370.33 | $1,268.73–$1,370.33 | varies |
| Ultrasound Breast Limited (76642) | $549.32 | $549.32 | 6.3× |
| Ultrasound elastography first target lesion (76982) | $673.23 | $673.23 | 6.4× |
| Ultrasound Elastography Parenchyma (76981) | $673.23 | $673.23 | 6.4× |
| Ultrasound Exam Aaa Screen (76706) | $643.86 | $643.86 | 6.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,207.22 | $1,207.22 | 3.4× |
| Ultrasound, abdomen limited (76705) | $1,849.81 | $1,849.81 | 17.6× |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$247.43–$1,937.84 | $247.43–$1,937.84 | varies |
| Unlisted magnetic resonance procedure (76498) | $2,369.72 | $2,369.72 | 27.1× |
| Unlisted us procedure (76999) | $527.60 | $527.60 | 6.0× |
| Upper gi w/o kub (74240) | $2,121.39 | $2,121.39 | 12.0× |
| Ureteral Reflux Study (78740) | $2,930.56 | $2,930.56 | 7.3× |
| Urethrocystogram voiding (74455) | $2,071.91 | $2,071.91 | 8.6× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,829.27–$1,893.12 | $1,829.27–$1,893.12 | varies |
| Us breast unilateral complete (76641) | $1,267.27 | $1,267.27 | 12.1× |
| Us chest (76604) | $1,541.93 | $1,541.93 | 14.7× |
| Us complete joint (76881) | $1,502.32 | $1,502.32 | 14.3× |
| Us exam, pelvic, limited (76857) | $1,849.81 | $1,849.81 | 17.6× |
| Us head (76506) | $2,234.33 | $2,234.33 | 21.3× |
| Us kidney transplant (76776) | $2,436.16 | $2,436.16 | 23.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$471.39–$527.60 | $471.39–$527.60 | varies |
| Us ob detailed single fetus (76811) | $3,247.38 | $3,247.38 | 13.5× |
| Us ob limited 1 or more fetuses (76815) | $1,089.69 | $1,089.69 | 10.4× |
| Us ob transvaginal (76817) | $530.15 | $530.15 | 5.0× |
| Us pelvic non ob complete (76856) | $2,005.65 | $2,005.65 | 19.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,753.99 | $1,753.99 | 16.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,179.12 | $1,179.12 | 11.2× |
| Us retroperitoneal complete (76770) | $1,918.77 | $1,918.77 | 18.3× |
| Us retroperitoneal limited (76775) | $1,598.13 | $1,598.13 | 15.2× |
| Us scrotum and contents (76870) | $1,810.21 | $1,810.21 | 17.2× |
| Us spinal canal and contents (76800) | $1,936.67 | $1,936.67 | 18.4× |
| Us thyroid (76536) | $1,539.37 | $1,539.37 | 14.7× |
| Us transrectal (76872) range across 2 matching MRF lines |
$1,853.64–$1,856.18 | $1,853.64–$1,856.18 | varies |
| Vascular Flow Imaging (78445) | $1,217.43 | $1,217.43 | 3.0× |
| Vasogram (74440) | $1,452.56 | $1,452.56 | 6.1× |
| Vein X-Ray Chest (75827) | $5,125.51 | $5,125.51 | 3.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,383.33 | $6,383.33 | 2.0× |
| Vein X-Ray Skull Epidural (75872) | $5,010.57 | $5,010.57 | 8.0× |
| Vein X-Ray Spleen/Liver (75810) | $5,010.57 | $5,010.57 | 1.6× |
| Venogram Sinus/Jugular (75860) | $5,010.57 | $5,010.57 | 1.6× |
| Venography Adrenal Unilateral (75840) | $6,277.98 | $6,277.98 | 2.0× |
| Venography caval inferior serialography rs&i (75825) | $5,641.09 | $5,641.09 | 1.8× |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$4,230.01–$6,780.81 | $4,230.01–$6,780.81 | varies |
| Venography extremity unilateral rs&i (75820) range across 6 matching MRF lines |
$2,775.84–$5,288.31 | $2,775.84–$5,288.31 | varies |
| Venography Renal Bilateral (75833) | $5,010.57 | $5,010.57 | 1.6× |
| Venography Renal Unilateral (75831) | $5,010.57 | $5,010.57 | 1.6× |
| Venous sampling by catheter (75893) | $20,607.36 | $20,607.36 | 3.7× |
| Venous thrombosis imaging (78457) | $4,538.91 | $4,538.91 | 8.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,992.88 | $1,992.88 | 5.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$715.12–$1,433.42 | $715.12–$1,433.42 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,031.17 | $1,031.17 | 11.8× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$842.82–$846.01 | $842.82–$846.01 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$4,771.97–$5,010.57 | $4,771.97–$5,010.57 | varies |
| X-Ray Bend Only L-S Spine (72120) | $3,869.27 | $3,869.27 | 36.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$905.07–$1,803.73 | $905.07–$1,803.73 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$935.40–$938.58 | $935.40–$938.58 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $437.38 | $437.38 | 5.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $724.69 | $724.69 | 6.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $2,783.84 | $2,783.84 | 26.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $727.88 | $727.88 | 8.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,053.51 | $1,053.51 | 12.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,170.04 | $1,170.04 | 11.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $727.88 | $727.88 | 6.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,053.51 | $1,053.51 | 10.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,170.04 | $1,170.04 | 11.1× |
| X-Ray Exam L-S Spine Bending (72114) | $5,583.64 | $5,583.64 | 53.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $983.29 | $983.29 | 11.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,703.18 | $1,703.18 | 16.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,045.55 | $1,045.55 | 10.0× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$1,027.97–$2,052.77 | $1,027.97–$2,052.77 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$973.71–$1,947.39 | $973.71–$1,947.39 | varies |
| X-ray IV pyelogram (ivp) (74400) | $2,282.61 | $2,282.61 | 13.0× |
| X-ray IV pyelogram+tomography (74415) | $2,426.28 | $2,426.28 | 13.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,045.55 | $1,045.55 | 12.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,123.75 | $1,123.75 | 12.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,383.94 | $1,383.94 | 13.2× |
| X-ray nose-rectum child f.b. (76010) | $1,015.20 | $1,015.20 | 11.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,773.43 | $1,773.43 | 16.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,256.23 | $1,256.23 | 12.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $877.92 | $877.92 | 10.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,556.33 | $1,556.33 | 17.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,818.10 | $1,818.10 | 17.3× |
| X-ray thoracic spine 4 vw (72074) | $1,597.83 | $1,597.83 | 15.2× |
| X-Ray Tmj Unilat (70328) | $1,181.22 | $1,181.22 | 13.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,946.66 | $2,946.66 | 8.4× |
| X-Rays Bone Length Studies (77073) | $1,356.80 | $1,356.80 | 12.9× |
| X-Rays Bone Survey Complete (77075) | $3,288.23 | $3,288.23 | 31.3× |
| Xr c-spine 4 or 5 views (72050) | $1,629.76 | $1,629.76 | 15.5× |
| Xr facial bones less than 3 views (70140) | $1,059.90 | $1,059.90 | 12.1× |
| Xr orbits complete 4 views (70200) | $1,395.11 | $1,395.11 | 13.3× |
| Xr Tomogram Single Plane (76100) | $2,440.64 | $2,440.64 | 23.2× |
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.