Imaging prices at Medical City Lewisville
Lewisville, TX · every code in this section with a posted price and a Medicare benchmark.
378 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) | $2.30 | $2.30 | 0.0× |
| Abdomen 1 View (74018) | $1,005.85 | $1,005.85 | 11.5× |
| Abdomen 2 views (74019) | $1,418.30 | $1,418.30 | 13.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $8,944.19 | $8,944.19 | 22.3× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,676.15–$6,036.59 | $5,676.15–$6,036.59 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,545.91 | $5,545.91 | 1.7× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$5,516.10–$5,866.37 | $5,516.10–$5,866.37 | varies |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$4,968.23–$5,283.71 | $4,968.23–$5,283.71 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,866.37 | $5,866.37 | 1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,133.75 | $4,133.75 | 1.3× |
| Ankle 2 views (73600) | $947.58 | $947.58 | 10.8× |
| Aortography thoracic serialography rs&i (75605) | $14,403.74 | $14,403.74 | 2.6× |
| Artery X-Rays Abdomen (75726) | $14,403.74 | $14,403.74 | 2.6× |
| Artery X-Rays Adrenal Gland (75731) | $5,866.37 | $5,866.37 | 1.8× |
| Artery X-Rays Pelvis (75736) | $14,403.74 | $14,403.74 | 2.6× |
| Artery X-Rays Spine (75705) | $14,403.74 | $14,403.74 | 2.6× |
| Arthrogram ankle (73615) | $2,083.76 | $2,083.76 | 5.9× |
| Arthrogram hip (73525) | $2,083.76 | $2,083.76 | 5.9× |
| Arthrogram Wrist (73115) | $2,083.76 | $2,083.76 | 5.9× |
| Basic radiation dosimetry calculation (77300) | $2.30 | $2.30 | 0.0× |
| Bone age studies (77072) | $1,057.98 | $1,057.98 | 10.1× |
| Bone Imaging 3 Phase (78315) | $9,276.63 | $9,276.63 | 23.1× |
| Bone Imaging Limited Area (78300) | $5,290.50 | $5,290.50 | 13.2× |
| Bone Imaging Multiple Areas (78305) | $6,086.53 | $6,086.53 | 15.2× |
| Bone Imaging Whole Body (78306) | $8,696.74 | $8,696.74 | 21.7× |
| Bone marrow imaging limited area (78102) | $3,317.88 | $3,317.88 | 8.3× |
| Bone marrow imaging; multiple areas (78103) | $6,086.53 | $6,086.53 | 15.2× |
| Bone marrow imaging; whole body (78104) | $10,803.11 | $10,803.11 | 26.9× |
| Bone survey infant (77076) | $1,307.90 | $1,307.90 | 12.5× |
| Brain Flow Imaging Only (78610) | $5,141.43 | $5,141.43 | 9.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $7,100.20 | $7,100.20 | 13.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3.99 | $3.99 | 0.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $8,540.84 | $8,540.84 | 24.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $6,452.88 | $6,452.88 | 8.2× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$2,656.42–$3,388.85 | $2,656.42–$3,388.85 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $4,336.44 | $4,336.44 | 8.0× |
| Cerebrospinal Fluid Scan (78630) | $5,602.18 | $5,602.18 | 10.3× |
| Chest 1 view (71045) | $1,082.50 | $1,082.50 | 12.4× |
| Chest 2 views (71046) | $1,113.17 | $1,113.17 | 12.7× |
| Chest 3 views (71047) | $1,401.43 | $1,401.43 | 16.0× |
| Chest 4 or more views (71048) | $1,484.23 | $1,484.23 | 14.1× |
| Cholecystography Oral Contrast (74290) | $1,783.21 | $1,783.21 | 10.1× |
| Clavicle complete (73000) | $950.64 | $950.64 | 10.9× |
| Continuing medical physics consltj pr wk (77336) | $2.30 | $2.30 | 0.0× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,338.76–$5,677.77 | $5,338.76–$5,677.77 | varies |
| Contrast X-Ray Bladder (74430) | $1,655.95 | $1,655.95 | 4.7× |
| Contrast X-Ray Of Elbow (73085) | $2,905.60 | $2,905.60 | 8.3× |
| Contrast X-Ray Of Knee Joint (73580) | $2,996.06 | $2,996.06 | 8.5× |
| CT abdomen and pelvis without and with contrast (74178) | $23,033.29 | $23,033.29 | 65.7× |
| CT abdomen and pelvis without contrast (74176) | $16,341.48 | $16,341.48 | 68.2× |
| CT abdomen w contrast (74160) | $10,165.02 | $10,165.02 | 57.7× |
| CT abdomen w wo contrast (74170) | $12,387.28 | $12,387.28 | 70.3× |
| CT abdomen w/o contrast (74150) | $9,035.91 | $9,035.91 | 86.0× |
| CT Angio Abdomen and Pelvis (74174) | $22,764.69 | $22,764.69 | 65.0× |
| CT Angio Chest (71275) | $9,979.18 | $9,979.18 | 56.6× |
| CT Angio Head (70496) | $10,859.96 | $10,859.96 | 61.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $10,180.63 | $10,180.63 | 57.8× |
| CT Angio Neck (70498) | $10,813.11 | $10,813.11 | 61.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $13,702.22 | $13,702.22 | 77.8× |
| CT cervical spine w/ contrast (72126) | $9,702.75 | $9,702.75 | 27.7× |
| CT cervical spine w/o contrast (72125) | $9,410.73 | $9,410.73 | 89.6× |
| CT cervical spine w/wo cont (72127) | $12,134.30 | $12,134.30 | 68.9× |
| CT chest w contrast (71260) | $8,200.41 | $8,200.41 | 46.5× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$11,176.97–$11,176.98 | $11,176.97–$11,176.98 | varies |
| CT head/brain with contrast (70460) | $8,946.91 | $8,946.91 | 50.8× |
| CT head/brain without and with contrast (70470) | $10,919.29 | $10,919.29 | 62.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $140.27 | $140.27 | 1.6× |
| CT iac w contrast (70481) | $9,912.02 | $9,912.02 | 56.3× |
| CT l-spine w&w/o contrast (72133) | $9,749.60 | $9,749.60 | 55.3× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$6,402.91–$8,644.13 | $6,402.91–$8,644.13 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$6,777.73–$9,150.35 | $6,777.73–$9,150.35 | varies |
| CT lumbar spine w contrast (72132) | $8,567.40 | $8,567.40 | 24.4× |
| CT lumbar spine w/o contrast (72131) | $8,002.07 | $8,002.07 | 76.2× |
| CT maxillofacial w contrast (70487) | $9,788.65 | $9,788.65 | 55.6× |
| CT maxillofacial wo contrast (70486) | $8,659.55 | $8,659.55 | 82.5× |
| CT neck tissue combo (70492) | $9,035.91 | $9,035.91 | 51.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $9,354.50 | $9,354.50 | 53.1× |
| CT orbits w/o contrast (70480) | $6,740.23 | $6,740.23 | 64.2× |
| CT pelvis w&w/o contrast (72194) | $10,646.01 | $10,646.01 | 60.4× |
| CT pelvis w/o contrast (72192) | $7,307.13 | $7,307.13 | 69.6× |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$10,180.63–$13,743.61 | $10,180.63–$13,743.61 | varies |
| CT scans face/jaw combo (70488) | $11,295.68 | $11,295.68 | 64.1× |
| CT soft tissue neck w contrast (70491) | $7,785 | $7,785 | 44.2× |
| CT soft tissue neck w/o contrast (70490) | $7,785 | $7,785 | 74.1× |
| CT thoracic spine w contrast (72129) | $9,035.91 | $9,035.91 | 51.3× |
| CT thoracic spine w/o contrast (72128) | $8,659.55 | $8,659.55 | 82.5× |
| CT thoracic spine w/wo cont (72130) | $10,165.02 | $10,165.02 | 57.7× |
| CT thorax w/o contrast (71250) | $7,669.43 | $7,669.43 | 73.0× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$6,966.68–$9,396.66 | $6,966.68–$9,396.66 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$9,938.57–$15,652.77 | $9,938.57–$15,652.77 | varies |
| CT upper extremity with contrast (73201) range across 5 matching MRF lines |
$8,283.19–$9,938.57 | $8,283.19–$9,938.57 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $6,938.58 | $6,938.58 | 39.4× |
| Cta Abdomen (74175) | $11,473.70 | $11,473.70 | 65.1× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$11,295.68–$11,295.69 | $11,295.68–$11,295.69 | varies |
| Dilation ureters/urethra rs&i (74485) | $6,038.09 | $6,038.09 | 2.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $624.75 | $624.75 | 5.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $624.75 | $624.75 | 5.9× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$309.72–$962.91 | $309.72–$962.91 | varies |
| Dxa bone density study (77085) | $423.20 | $423.20 | 4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $757.45 | $757.45 | 8.7× |
| Echo exam of fetal heart (76825) | $4,908.16 | $4,908.16 | 8.9× |
| Echo exam uterus (76831) | $2,310.58 | $2,310.58 | 9.6× |
| Echo Guide For Artery Repair (76936) | $2,059.82 | $2,059.82 | 9.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $3,236.84 | $3,236.84 | 13.5× |
| Esophageal Motility Study (78258) | $8,820.47 | $8,820.47 | 22.0× |
| Esophagram (74220) | $1,711.15 | $1,711.15 | 9.7× |
| Fetal Biophys Profile W/Nst (76818) | $4,399.39 | $4,399.39 | 41.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$2,045.42–$3,302.71 | $2,045.42–$3,302.71 | varies |
| Follow-Up Angiography (75898) | $3,302.71 | $3,302.71 | 1.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$952.17–$1,749.48 | $952.17–$1,749.48 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$1,005.85–$2,002.49 | $1,005.85–$2,002.49 | varies |
| Gastric emptying imaging study (78264) | $5,667.63 | $5,667.63 | 14.1× |
| Gated Heart Planar Single (78472) | $7,453.50 | $7,453.50 | 18.6× |
| Gated Heart, Multiple (78473) | $13,024.24 | $13,024.24 | 32.4× |
| Hand 2 views (73120) | $1,076.37 | $1,076.37 | 10.2× |
| Heart first pass single,planar (78481) | $2,316.56 | $2,316.56 | 4.2× |
| Heart Image (Pet) Multiple (78492) | $3.99 | $3.99 | 0.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,182.52 | $5,182.52 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $7,318.40 | $7,318.40 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $8,944.19 | $8,944.19 | 16.4× |
| Hepatobiliary System Imaging (78226) | $8,944.19 | $8,944.19 | 22.3× |
| Ht Muscle Image Spect Sing (78451) | $15,132.09 | $15,132.09 | 11.6× |
| Hysterosalpingogram (74740) | $2,138.94 | $2,138.94 | 8.9× |
| Image fusion (77399) | $2.30 | $2.30 | 0.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,658.28 | $1,658.28 | 19.0× |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$1,443.73–$1,443.75 | $1,443.73–$1,443.75 | varies |
| Intracavitary radiation source applic simple (77761) | $5.97 | $5.97 | 0.0× |
| K Flow/Funct Image Multiple (78709) | $16,431.99 | $16,431.99 | 30.1× |
| K Flow/Funct Image W/Drug (78708) | $8,346.42 | $8,346.42 | 15.3× |
| K Flow/Funct Image W/O Drug (78707) | $7,377.47 | $7,377.47 | 13.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$1,061.04–$2,017.81 | $1,061.04–$2,017.81 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $7,116.59 | $7,116.59 | 17.7× |
| Liver imaging static only (78201) | $5,853.97 | $5,853.97 | 10.7× |
| Liver imaging w/vascular flow (78202) | $5,141.43 | $5,141.43 | 9.4× |
| Lung Ventilat&Perfus Imaging (78582) | $9,840.11 | $9,840.11 | 18.0× |
| Lymph System Imaging (78195) | $6,815.48 | $6,815.48 | 12.5× |
| Magnetic Image Jaw Joint (70336) | $9,388.85 | $9,388.85 | 39.2× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$1,514.88–$2,387.32 | $1,514.88–$2,387.32 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$1,229.69–$1,743.36 | $1,229.69–$1,743.36 | varies |
| Meckels Divert Exam (78290) | $5,766.03 | $5,766.03 | 14.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $159.53 | $159.53 | 5.5× |
| Mra Head W/O & W/Contrast Material (70546) | $12,768.34 | $12,768.34 | 36.4× |
| MRA head w/o contrast (70544) | $8,917.21 | $8,917.21 | 37.2× |
| MRA head with contrast (70545) | $9,505.99 | $9,505.99 | 27.1× |
| MRA neck w contrast (70548) | $10,119.72 | $10,119.72 | 28.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $12,768.34 | $12,768.34 | 36.4× |
| MRA neck w/o contrast (70547) | $8,917.21 | $8,917.21 | 37.2× |
| MRI abdomen w contrast (74182) | $11,943.76 | $11,943.76 | 34.1× |
| MRI abdomen w/o contrast (74181) | $10,166.57 | $10,166.57 | 42.4× |
| MRI any jt lower extrem w/contrast material (73722) | $12,193.64 | $12,193.64 | 15.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $13,029.15 | $13,029.15 | 37.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $12,193.64 | $12,193.64 | 15.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $7,008.85 | $7,008.85 | 29.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $6,156.18 | $6,156.18 | 25.7× |
| MRI cardiac w/o cont stress (75559) | $5,145.77 | $5,145.77 | 9.4× |
| MRI cardiac w/o contrast (75557) | $5,261.32 | $5,261.32 | 22.0× |
| MRI cervical spine w contrast (72142) | $11,593.96 | $11,593.96 | 33.1× |
| MRI cervical spine w/o cont (72141) | $9,526.28 | $9,526.28 | 39.7× |
| MRI chest w/o contrast (71550) | $10,583.54 | $10,583.54 | 44.2× |
| MRI chest with contrast (71551) | $10,457.03 | $10,457.03 | 13.3× |
| MRI chest wo w contrast (71552) | $12,263.91 | $12,263.91 | 35.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $12,193.64 | $12,193.64 | 34.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $13,029.15 | $13,029.15 | 37.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $9,034.34 | $9,034.34 | 37.7× |
| MRI lumbar spine w contrast (72149) | $11,105.14 | $11,105.14 | 31.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $12,854.23 | $12,854.23 | 36.7× |
| MRI orbit face &/neck w/o contrast (70540) | $11,019.25 | $11,019.25 | 46.0× |
| MRI orbit face neck w contrast (70542) | $11,593.96 | $11,593.96 | 33.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $12,854.23 | $12,854.23 | 36.7× |
| MRI pelvis w contrast (72196) | $11,122.32 | $11,122.32 | 31.7× |
| MRI pelvis w/o & w contrast (72197) | $12,702.75 | $12,702.75 | 36.2× |
| MRI pelvis w/o contrast (72195) | $11,281.61 | $11,281.61 | 47.1× |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$4.69–$8,917.21 | $4.69–$8,917.21 | varies |
| MRI thoracic spine w/o contrast (72146) | $9,855.79 | $9,855.79 | 41.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $12,193.64 | $12,193.64 | 34.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $9,034.34 | $9,034.34 | 37.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$13,029.15–$19,541.37 | $13,029.15–$19,541.37 | varies |
| MRI, abdomen, combo (74183) | $13,717.85 | $13,717.85 | 39.1× |
| MRI, dorsal spine combo (72157) | $13,302.44 | $13,302.44 | 38.0× |
| MRI, dorsal spine contrast (72147) | $11,166.75 | $11,166.75 | 31.9× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$9,034.34–$13,550.74 | $9,034.34–$13,550.74 | varies |
| MRI, joint upper extrem combo (73223) | $13,029.15 | $13,029.15 | 37.2× |
| MRI, lumbar spine combo (72158) | $13,116.59 | $13,116.59 | 37.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $5,850.99 | $5,850.99 | 14.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3.99 | $3.99 | 0.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $2,098.90 | $2,098.90 | 3.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $17,725.90 | $17,725.90 | 13.6× |
| Myocardial Spect Multiple Studies (78452) | $20,552.28 | $20,552.28 | 15.8× |
| Neck soft tissue (70360) | $947.58 | $947.58 | 10.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $2,665.36 | $2,665.36 | 6.6× |
| Nm csf leak detection (78650) | $5,882.29 | $5,882.29 | 4.5× |
| Nm myocard infarct spect (78469) | $9,622.46 | $9,622.46 | 17.6× |
| Nonvascular Shunt X-Ray (75809) | $1,418.30 | $1,418.30 | 13.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2.30 | $2.30 | 0.0× |
| Nuclear Rx Oral Admin (79005) | $7,738.23 | $7,738.23 | 33.0× |
| Ob us nuchal meas 1 gest (76813) | $624.75 | $624.75 | 5.9× |
| Optic foramina (70190) | $775.84 | $775.84 | 8.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $11,310.61 | $11,310.61 | 20.7× |
| Parathyroid Planar Imaging (78070) | $7,954.37 | $7,954.37 | 19.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $9,767.06 | $9,767.06 | 24.3× |
| Pelvis 1 or 2 views (72170) | $1,212.84 | $1,212.84 | 11.5× |
| Peritoneogram Rs&I (74190) | $5,678.86 | $5,678.86 | 10.3× |
| Pet Image Skull-Thigh (78812) | $3.99 | $3.99 | 0.0× |
| PET image w/CT, full body (78816) | $3.99 | $3.99 | 0.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3.99 | $3.99 | 0.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3.99 | $3.99 | 0.0× |
| Pet Myocardial Sngl Study (78491) | $3.99 | $3.99 | 0.0× |
| PET whole body (78813) | $3.99 | $3.99 | 0.0× |
| Proton trmt simple w/comp (77522) | $2.30 | $2.30 | 0.0× |
| Proton tx delivery complex (77525) | $2.30 | $2.30 | 0.0× |
| Proton tx delivery intermediate (77523) | $2.30 | $2.30 | 0.0× |
| Proton tx delivery simple w/o compensation (77520) | $2.30 | $2.30 | 0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,866.37 | $5,866.37 | 1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,920.44 | $4,920.44 | 12.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,591.55 | $1,591.55 | 15.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,744.88 | $1,744.88 | 3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,025.78–$2,040.80 | $1,025.78–$2,040.80 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$818.78–$1,632.96 | $818.78–$1,632.96 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$979.77–$1,948.80 | $979.77–$1,948.80 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,471.96 | $1,471.96 | 14.0× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$806.53–$1,605.36 | $806.53–$1,605.36 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,041.10–$1,902.81 | $1,041.10–$1,902.81 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$1,166.83–$2,327.54 | $1,166.83–$2,327.54 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$812.64–$1,623.76 | $812.64–$1,623.76 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,166.83 | $1,166.83 | 13.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$1,214.37–$2,427.20 | $1,214.37–$2,427.20 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $818.78 | $818.78 | 9.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $3,690.63 | $3,690.63 | 20.9× |
| Radex Spine 1 View Specify Level (72020) | $1,323.22 | $1,323.22 | 15.1× |
| Radex Sternum Minimum 2 Views (71120) | $1,151.50 | $1,151.50 | 13.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,525.62 | $1,525.62 | 17.5× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$795.79–$1,579.29 | $795.79–$1,579.29 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$768.18–$1,528.70 | $768.18–$1,528.70 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,642.15–$3,278.17 | $1,642.15–$3,278.17 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $2,716.99 | $2,716.99 | 25.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$2.30 | $2.30 | 0.0× |
| Radiation treatment delivery level 1 (77402) | $2.30 | $2.30 | 0.0× |
| Radiation treatment delivery level 2 (77407) | $2.30 | $2.30 | 0.0× |
| Radiation treatment delivery level 3 (77412) | $2.30 | $2.30 | 0.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,770.95 | $1,770.95 | 16.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,418.30 | $1,418.30 | 13.5× |
| Radiologic exam colon double contrast study (74280) | $3,130.99 | $3,130.99 | 17.8× |
| Radiologic exam colon single contrast study (74270) | $2,286.14 | $2,286.14 | 13.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,711.15 | $1,711.15 | 9.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,329.35–$2,520.73 | $1,329.35–$2,520.73 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $2,088.35 | $2,088.35 | 19.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,387.32 | $2,387.32 | 13.5× |
| Radiologic exam swallow function contrast study (74230) | $2,362.80 | $2,362.80 | 13.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,382.74 | $2,382.74 | 13.5× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$1,041.10–$2,082.20 | $1,041.10–$2,082.20 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$1,010.44–$1,944.23 | $1,010.44–$1,944.23 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $3,365.57 | $3,365.57 | 32.0× |
| Radiologic Examination Salivary Gland Calculus (70380) | $1,928.88 | $1,928.88 | 22.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$1,005.85–$2,002.49 | $1,005.85–$2,002.49 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,527.15 | $1,527.15 | 2.8× |
| Renal Cyst Study (74470) | $3,612.43 | $3,612.43 | 6.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $5,405.29 | $5,405.29 | 13.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $6,815.48 | $6,815.48 | 17.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $11,552.92 | $11,552.92 | 21.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $10,013.03 | $10,013.03 | 18.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $13,039.16 | $13,039.16 | 23.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $13,039.16 | $13,039.16 | 10.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $14,161.65 | $14,161.65 | 9.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $10,011.53 | $10,011.53 | 7.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,665.36 | $2,665.36 | 11.4× |
| Rp Therapy Intravenous Administration (79101) | $3,872.84 | $3,872.84 | 16.5× |
| Scapula (73010) | $880.11 | $880.11 | 8.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $260.92 | $260.92 | 11.2× |
| Sella turcica (70240) | $700.70 | $700.70 | 8.0× |
| Shoulder 1 view (73020) | $889.31 | $889.31 | 10.2× |
| Shoulder Arthrography (73040) | $2,893.32 | $2,893.32 | 8.3× |
| Sialogram (70390) | $2,192.61 | $2,192.61 | 9.1× |
| Skull less than 4 views (70250) | $956.77 | $956.77 | 9.1× |
| Special dosimetry (77331) | $2.30 | $2.30 | 0.0× |
| Special Physics Consult (77370) | $2.30 | $2.30 | 0.0× |
| Special teletherapy port plan (77321) | $2.30 | $2.30 | 0.0× |
| Special treatment procedure (77470) | $1,281.82 | $1,281.82 | 2.3× |
| Spleen Imaging (78185) | $4,986.39 | $4,986.39 | 12.4× |
| Srs Multisource (77371) likely a partial charge, not the full procedure |
$2.30 | $2.30 | 0.0× |
| Stereotactic Body Radiation Delivery (77373) | $2.30 | $2.30 | 0.0× |
| Sternoclavicular joints (71130) | $1,212.84 | $1,212.84 | 13.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $5.68 | $5.68 | 0.1× |
| Testicular Imaging W/Flow (78761) | $4,898.44 | $4,898.44 | 12.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2.30 | $2.30 | 0.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2.30 | $2.30 | 0.0× |
| Ther rad simulaj-aided field setting simple (77280) | $2.30 | $2.30 | 0.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,382.74 | $2,382.74 | 13.5× |
| Thoracic spine 2 views (72070) | $1,467.34 | $1,467.34 | 14.0× |
| Thoracic spine 3 views (72072) | $1,619.17 | $1,619.17 | 15.4× |
| Thoracolumbar 2 views (72080) | $1,335.50 | $1,335.50 | 15.3× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $1,747.10 | $1,747.10 | 4.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $3,676.06 | $3,676.06 | 9.2× |
| Thyroid Imaging With Vascular Flow (78013) | $4,080.05 | $4,080.05 | 10.2× |
| Thyroid Met Imaging Body (78018) | $7,298.45 | $7,298.45 | 13.4× |
| Thyroid Uptake Measurement (78012) | $4,642.04 | $4,642.04 | 11.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,642.04 | $4,642.04 | 11.6× |
| Tx Devices Design & Construction Complex (77334) | $2.30 | $2.30 | 0.0× |
| Tx devices design & construction intermediate (77333) | $2.30 | $2.30 | 0.0× |
| Tx devices design & construction simple (77332) | $2.30 | $2.30 | 0.0× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$552.29–$1,104.55 | $552.29–$1,104.55 | varies |
| Ultrasound elastography first target lesion (76982) | $3,195.08 | $3,195.08 | 30.4× |
| Ultrasound Elastography Parenchyma (76981) | $3,195.08 | $3,195.08 | 30.4× |
| Ultrasound, abdomen limited (76705) | $3,190.46 | $3,190.46 | 30.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $5.68 | $5.68 | 0.1× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$2,064.16–$2,842.57 | $2,064.16–$2,842.57 | varies |
| Upper gi w/o kub (74240) | $2,382.74 | $2,382.74 | 13.5× |
| Ureteral Reflux Study (78740) | $4,744.90 | $4,744.90 | 11.8× |
| Urethrocystogram voiding (74455) | $2,726.19 | $2,726.19 | 11.4× |
| Urethrocystography retrograde (74450) | $2,125.14 | $2,125.14 | 8.9× |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$723.33–$1,445.20 | $723.33–$1,445.20 | varies |
| Us chest (76604) | $1,769.90 | $1,769.90 | 16.9× |
| Us complete joint (76881) | $2,301.89 | $2,301.89 | 21.9× |
| Us exam, pelvic, limited (76857) | $1,390.12 | $1,390.12 | 13.2× |
| Us head (76506) | $2,865.76 | $2,865.76 | 27.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$491.38–$2,201.86 | $491.38–$2,201.86 | varies |
| Us ob detailed single fetus (76811) | $4,131.21 | $4,131.21 | 17.2× |
| Us ob limited 1 or more fetuses (76815) | $2,212.01 | $2,212.01 | 21.1× |
| Us ob transvaginal (76817) | $2,477.27 | $2,477.27 | 23.6× |
| Us pelvic non ob complete (76856) | $3,054.19 | $3,054.19 | 29.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,761.38 | $2,761.38 | 26.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $2,097.50 | $2,097.50 | 20.0× |
| Us retroperitoneal complete (76770) | $2,977.36 | $2,977.36 | 28.4× |
| Us retroperitoneal limited (76775) | $2,430.87 | $2,430.87 | 23.1× |
| Us scrotum and contents (76870) | $2,277.24 | $2,277.24 | 21.7× |
| Us spinal canal and contents (76800) | $2,866.63 | $2,866.63 | 27.3× |
| Us thyroid (76536) | $2,428 | $2,428 | 23.1× |
| Vein X-Ray Chest (75827) | $3,781.09 | $3,781.09 | 2.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,612.43 | $3,612.43 | 1.1× |
| Vein X-Ray Skull Epidural (75872) | $5,746.77 | $5,746.77 | 9.1× |
| Venogram Sinus/Jugular (75860) | $5,847.97 | $5,847.97 | 1.8× |
| Venography Adrenal Unilateral (75840) | $5,866.37 | $5,866.37 | 1.8× |
| Venography caval inferior serialography rs&i (75825) | $5,866.37 | $5,866.37 | 1.8× |
| Venography extremity bilateral rs&i (75822) | $5,561.25 | $5,561.25 | 3.5× |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$2,992.98–$5,038.40 | $2,992.98–$5,038.40 | varies |
| Venography Renal Bilateral (75833) | $5,866.37 | $5,866.37 | 1.8× |
| Venography Renal Unilateral (75831) | $5,866.37 | $5,866.37 | 1.8× |
| Venous sampling by catheter (75893) | $14,403.74 | $14,403.74 | 2.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $2,799.54 | $2,799.54 | 7.0× |
| Vertebral fracture assessment via dxa (77086) | $277.53 | $277.53 | 3.2× |
| Wrist 2 views (73100) | $984.36 | $984.36 | 11.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,510.29 | $1,510.29 | 17.3× |
| X-ray antegrade pyelogram tube (74425) | $1,856.82 | $1,856.82 | 5.3× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$5,516.10–$5,866.37 | $5,516.10–$5,866.37 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$978.24–$979.77 | $978.24–$979.77 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$344.99–$1,651.35 | $344.99–$1,651.35 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $2,292.28 | $2,292.28 | 26.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,672.82 | $1,672.82 | 15.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $2,508.47 | $2,508.47 | 23.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $1,487.29 | $1,487.29 | 17.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,628.37 | $1,628.37 | 18.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,767.89 | $1,767.89 | 16.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,795.48 | $1,795.48 | 17.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,976.41 | $1,976.41 | 18.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,155.82 | $2,155.82 | 20.5× |
| X-Ray Exam L-S Spine Bending (72114) | $2,773.72 | $2,773.72 | 26.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,386.09 | $1,386.09 | 15.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $3,009.84 | $3,009.84 | 28.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$1,172.98–$1,269.57 | $1,172.98–$1,269.57 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$962.91–$1,919.68 | $962.91–$1,919.68 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$1,010.44–$2,010.14 | $1,010.44–$2,010.14 | varies |
| X-ray IV pyelogram (ivp) (74400) | $2,690.92 | $2,690.92 | 15.3× |
| X-ray IV pyelogram+tomography (74415) | $2,643.39 | $2,643.39 | 15.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,418.30 | $1,418.30 | 13.5× |
| X-ray nose-rectum child f.b. (76010) | $979.77 | $979.77 | 11.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,763.29 | $1,763.29 | 16.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,286.43 | $1,286.43 | 12.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,229.69 | $1,229.69 | 14.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,724.94 | $1,724.94 | 19.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,970.27 | $1,970.27 | 18.8× |
| X-ray thoracic spine 4 vw (72074) | $1,774.01 | $1,774.01 | 16.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,580.53 | $2,580.53 | 7.4× |
| X-Rays Bone Length Studies (77073) | $1,266.50 | $1,266.50 | 12.1× |
| X-Rays Bone Survey Complete (77075) | $2,864.19 | $2,864.19 | 27.3× |
| Xr c-spine 4 or 5 views (72050) | $1,869.07 | $1,869.07 | 17.8× |
| Xr facial bones less than 3 views (70140) | $1,471.96 | $1,471.96 | 16.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $1,510.29 | $1,510.29 | 14.4× |
| Xr orbits complete 4 views (70200) | $1,448.95 | $1,448.95 | 13.8× |
| Xr Tomogram Single Plane (76100) | $2,433.33 | $2,433.33 | 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.