Imaging prices at Medical City Plano
Plano, TX · every code in this section with a posted price and a Medicare benchmark.
454 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $5,584.59 | $5,584.59 | 4.0× |
| Abdomen 1 View (74018) | $847.26 | $847.26 | 9.7× |
| Abdomen 2 views (74019) | $1,147.53 | $1,147.53 | 10.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $8,320.79 | $8,320.79 | 20.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $5,917.03 | $5,917.03 | 4.5× |
| Adrenal Cortex & Medulla Img (78075) | $6,400.84 | $6,400.84 | 4.9× |
| Angio internal mammary (75756) | $12,356.80 | $12,356.80 | 3.9× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$11,945.72–$12,781.92 | $11,945.72–$12,781.92 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $10,910.48 | $10,910.48 | 3.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$11,945.72–$12,781.92 | $11,945.72–$12,781.92 | varies |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$5,056.87–$12,275.05 | $5,056.87–$12,275.05 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,273.16 | $7,273.16 | 2.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $7,273.16 | $7,273.16 | 2.3× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$1,036.04–$1,551.84 | $1,036.04–$1,551.84 | varies |
| Aortography thoracic serialography rs&i (75605) | $21,248.70 | $21,248.70 | 3.8× |
| Aortography thoracic w/o serialography rs&i (75600) | $7,273.16 | $7,273.16 | 2.3× |
| Artery X-Rays Abdomen (75726) | $21,248.70 | $21,248.70 | 3.8× |
| Artery X-Rays Adrenal Gland (75731) | $7,273.16 | $7,273.16 | 2.3× |
| Artery X-Rays Pelvis (75736) | $21,248.70 | $21,248.70 | 3.8× |
| Artery X-Rays Spine (75705) | $21,248.70 | $21,248.70 | 3.8× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$1,493.88–$2,241.54 | $1,493.88–$2,241.54 | varies |
| Arthrogram hip (73525) range across 5 matching MRF lines |
$1,734.68–$2,048.32 | $1,734.68–$2,048.32 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$2,364.92–$3,548.14 | $2,364.92–$3,548.14 | varies |
| Basic radiation dosimetry calculation (77300) | $346.64 | $346.64 | 2.6× |
| Bone age studies (77072) range across 2 matching MRF lines |
$1,105.92–$1,129.70 | $1,105.92–$1,129.70 | varies |
| Bone Imaging 3 Phase (78315) | $4,920.44 | $4,920.44 | 12.3× |
| Bone Imaging Limited Area (78300) | $2,489.22 | $2,489.22 | 6.2× |
| Bone Imaging Multiple Areas (78305) | $3,925.36 | $3,925.36 | 9.8× |
| Bone Imaging Whole Body (78306) | $3,372.89 | $3,372.89 | 8.4× |
| Bone marrow imaging limited area (78102) | $3,493.45 | $3,493.45 | 8.7× |
| Bone marrow imaging; multiple areas (78103) | $5,234.84 | $5,234.84 | 13.0× |
| Bone marrow imaging; whole body (78104) | $6,432.89 | $6,432.89 | 16.0× |
| Bone survey infant (77076) | $1,034.57 | $1,034.57 | 9.9× |
| Brain Flow Imaging Only (78610) | $2,075.61 | $2,075.61 | 3.8× |
| Brain Image W/Flow < 4 Views (78601) | $4,810.55 | $4,810.55 | 12.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $5,453.06 | $5,453.06 | 10.0× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,214.16 | $3,214.16 | 5.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $22,517.33 | $22,517.33 | 15.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $8,386.41 | $8,386.41 | 20.9× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $10,648.22 | $10,648.22 | 19.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $8,163.20 | $8,163.20 | 23.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $8,285.47 | $8,285.47 | 10.5× |
| Cardiac Shunt Detection (78428) | $4,210.76 | $4,210.76 | 10.5× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$1,839.80–$2,421.25 | $1,839.80–$2,421.25 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $6,753.38 | $6,753.38 | 12.4× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $4,265.70 | $4,265.70 | 7.8× |
| Cerebrospinal Fluid Scan (78630) | $6,361.16 | $6,361.16 | 11.7× |
| Chest 1 view (71045) | $902.28 | $902.28 | 10.3× |
| Chest 2 views (71046) | $908.22 | $908.22 | 10.4× |
| Chest 3 views (71047) | $1,147.53 | $1,147.53 | 13.1× |
| Chest 4 or more views (71048) | $1,377.94 | $1,377.94 | 13.1× |
| Cholecystography Oral Contrast (74290) | $845.79 | $845.79 | 4.8× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $979.56 | $979.56 | 9.3× |
| Cisternography Positive Contrast Rs&I (70015) | $1,840.21 | $1,840.21 | 2.3× |
| Clavicle complete (73000) | $1,036.04 | $1,036.04 | 11.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,917.02 | $1,917.02 | 18.3× |
| Continuing medical physics consltj pr wk (77336) | $537.15 | $537.15 | 4.0× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$7,273.16–$12,781.92 | $7,273.16–$12,781.92 | varies |
| Contrast X-Ray Bladder (74430) | $1,239.70 | $1,239.70 | 3.5× |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$1,428.47–$2,329.26 | $1,428.47–$2,329.26 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$2,052.77–$3,344.51 | $2,052.77–$3,344.51 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $1,024.16 | $1,024.16 | 5.8× |
| Corpora cavernosography (74445) | $1,251.59 | $1,251.59 | 11.9× |
| CT abdomen and pelvis without and with contrast (74178) | $19,734.92 | $19,734.92 | 56.3× |
| CT abdomen and pelvis without contrast (74176) | $13,405.45 | $13,405.45 | 55.9× |
| CT abdomen w contrast (74160) | $9,569.91 | $9,569.91 | 54.3× |
| CT abdomen w wo contrast (74170) | $10,498.13 | $10,498.13 | 59.6× |
| CT abdomen w/o contrast (74150) | $6,346.13 | $6,346.13 | 60.4× |
| CT Angio Abdomen and Pelvis (74174) | $11,770.09 | $11,770.09 | 33.6× |
| CT Angio Chest (71275) | $9,544.16 | $9,544.16 | 54.2× |
| CT Angio Head (70496) | $10,328.53 | $10,328.53 | 58.6× |
| CT angio hrt w/3d image (75574) | $7,524.21 | $7,524.21 | 21.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$9,907.59–$17,337.89 | $9,907.59–$17,337.89 | varies |
| CT Angio Neck (70498) | $10,811.58 | $10,811.58 | 61.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$12,761.90–$17,337.89 | $12,761.90–$17,337.89 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$9,102.02–$9,367.02 | $9,102.02–$9,367.02 | varies |
| CT cervical spine w/o contrast (72125) | $8,058.72 | $8,058.72 | 76.7× |
| CT cervical spine w/wo cont (72127) | $10,112.01 | $10,112.01 | 57.4× |
| CT chest w contrast (71260) | $8,435.76 | $8,435.76 | 47.9× |
| CT chest w/wo contrast (71270) | $10,973.60 | $10,973.60 | 62.3× |
| CT colonography screening (74263) | $13,405.45 | $13,405.45 | 55.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $13,405.45 | $13,405.45 | 76.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $13,405.45 | $13,405.45 | 127.6× |
| CT head/brain with contrast (70460) | $6,706.51 | $6,706.51 | 38.1× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$7,970.89–$8,201.07 | $7,970.89–$8,201.07 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $7,524.21 | $7,524.21 | 21.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $321.02 | $321.02 | 3.7× |
| CT hrt w/3d image congen (75573) | $7,524.21 | $7,524.21 | 21.5× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$7,415.17–$9,050.54 | $7,415.17–$9,050.54 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$10,112.01–$10,405.77 | $10,112.01–$10,405.77 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$5,049.95–$10,098.38 | $5,049.95–$10,098.38 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$6,842.79–$13,682.55 | $6,842.79–$13,682.55 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$7,739.21–$7,963.30 | $7,739.21–$7,963.30 | varies |
| CT lumbar spine w/o contrast (72131) | $7,757.38 | $7,757.38 | 73.9× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$5,707.12–$5,828.25 | $5,707.12–$5,828.25 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$5,707.12–$5,828.25 | $5,707.12–$5,828.25 | varies |
| CT neck tissue combo (70492) | $8,347.94 | $8,347.94 | 47.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $8,971.80 | $8,971.80 | 50.9× |
| CT orbits w/o contrast (70480) | $6,387.01 | $6,387.01 | 60.8× |
| CT pelvis w&w/o contrast (72194) | $9,238.31 | $9,238.31 | 52.4× |
| CT pelvis w/o contrast (72192) | $7,062.35 | $7,062.35 | 67.2× |
| CT scan of leg combo (73702) range across 5 matching MRF lines |
$5,410.34–$16,479.33 | $5,410.34–$16,479.33 | varies |
| CT scans face/jaw combo (70488) | $8,971.80 | $8,971.80 | 50.9× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$7,708.94–$7,913.36 | $7,708.94–$7,913.36 | varies |
| CT soft tissue neck w/o contrast (70490) | $7,766.47 | $7,766.47 | 74.0× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$6,851.87–$7,053.27 | $6,851.87–$7,053.27 | varies |
| CT thoracic spine w/o contrast (72128) | $6,608.08 | $6,608.08 | 62.9× |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$7,409.11–$7,624.12 | $7,409.11–$7,624.12 | varies |
| CT thorax w/o contrast (71250) | $2,536.92 | $2,536.92 | 24.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$4,898.52–$6,320.37 | $4,898.52–$6,320.37 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$8,240.42–$12,342.47 | $8,240.42–$12,342.47 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$5,112.03–$8,921.82 | $5,112.03–$8,921.82 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$7,097.19–$11,770.09 | $7,097.19–$11,770.09 | varies |
| Cta Abdomen (74175) | $11,770.09 | $11,770.09 | 66.8× |
| CTA pelvis (72191) | $11,791.28 | $11,791.28 | 66.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,049.41 | $1,049.41 | 4.4× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $3,919.26 | $3,919.26 | 7.2× |
| Dilation ureters/urethra rs&i (74485) | $8,905.29 | $8,905.29 | 4.2× |
| Discography Cerv/Thor Spine (72285) | $7,273.16 | $7,273.16 | 3.7× |
| Diskography lumbar (72295) | $7,273.16 | $7,273.16 | 3.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,350.70 | $1,350.70 | 12.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,350.70 | $1,350.70 | 12.9× |
| Dxa Bone Density Axial (77080) | $838.36 | $838.36 | 8.0× |
| Dxa bone density study (77085) | $838.36 | $838.36 | 8.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $478.63 | $478.63 | 5.5× |
| Echo exam of fetal heart (76825) | $4,860.25 | $4,860.25 | 8.9× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$1,737.26–$1,772.27 | $1,737.26–$1,772.27 | varies |
| Echo Guide For Artery Repair (76936) | $1,465.95 | $1,465.95 | 6.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $3,411.80 | $3,411.80 | 14.2× |
| Esophageal Motility Study (78258) | $4,844.13 | $4,844.13 | 12.1× |
| Esophagram (74220) | $1,047.95 | $1,047.95 | 5.9× |
| Fetal Biophys Profile W/Nst (76818) | $2,532.22 | $2,532.22 | 24.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$2,056.71–$2,097.55 | $2,056.71–$2,097.55 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,972.50–$2,118.18 | $1,972.50–$2,118.18 | varies |
| Follow-Up Angiography (75898) | $7,273.16 | $7,273.16 | 2.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$683.77–$1,022.67 | $683.77–$1,022.67 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$955.78–$1,429.96 | $955.78–$1,429.96 | varies |
| Gastric emptying imaging study (78264) | $4,612.14 | $4,612.14 | 11.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $5,005.90 | $5,005.90 | 12.5× |
| Gastric Mucosa Imaging (78261) | $5,654.52 | $5,654.52 | 14.1× |
| Gastrointestinal Protein Loss (78282) | $3,469.03 | $3,469.03 | 8.6× |
| Gated Heart Planar Single (78472) | $6,413.05 | $6,413.05 | 16.0× |
| Gated Heart, Multiple (78473) | $10,191.89 | $10,191.89 | 25.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $5,932.32 | $5,932.32 | 10.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$765.51–$1,447.80 | $765.51–$1,447.80 | varies |
| Heart first pass single,planar (78481) | $8,183.42 | $8,183.42 | 15.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $7,273.16 | $7,273.16 | 2.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $7,273.16 | $7,273.16 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $5,413.41 | $5,413.41 | 9.9× |
| Hepatobiliary System Imaging (78226) | $5,385.93 | $5,385.93 | 13.4× |
| Ht Muscle Image Spect Sing (78451) | $6,394.74 | $6,394.74 | 4.9× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$2,348.58–$2,526.95 | $2,348.58–$2,526.95 | varies |
| Image fusion (77399) | $641.68 | $641.68 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,886.04 | $1,886.04 | 21.6× |
| Infant hip ultrasound, limited static exam (76886) | $1,662.88 | $1,662.88 | 19.0× |
| Infusion Ivp (74410) | $2,069.13 | $2,069.13 | 11.7× |
| Intraop radiaj tx deliver xray single tx session (77424) | $31,553.33 | $31,553.33 | 4.3× |
| Joint Survey Single View (77077) | $964.69 | $964.69 | 9.2× |
| K Flow/Funct Image Multiple (78709) | $9,485.28 | $9,485.28 | 17.4× |
| K Flow/Funct Image W/Drug (78708) | $6,042.18 | $6,042.18 | 11.1× |
| K Flow/Funct Image W/O Drug (78707) | $5,755.25 | $5,755.25 | 10.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $3,449.19 | $3,449.19 | 8.6× |
| Kidney Imaging Morphol (78700) | $4,899.07 | $4,899.07 | 12.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $5,295.88 | $5,295.88 | 13.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$985.50–$1,473.06 | $985.50–$1,473.06 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $2,440.37 | $2,440.37 | 6.1× |
| Leveen/Shunt Patency Exam (78291) | $5,311.14 | $5,311.14 | 13.2× |
| Liver & Spleen Imaging Static Only (78215) | $4,828.87 | $4,828.87 | 12.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $4,744.93 | $4,744.93 | 11.8× |
| Liver imaging static only (78201) | $3,690.33 | $3,690.33 | 6.8× |
| Liver imaging w/vascular flow (78202) | $4,439.70 | $4,439.70 | 8.1× |
| Lung Perf&Ventilat Diferentl (78598) | $7,287.57 | $7,287.57 | 13.4× |
| Lung perfusion differential (78597) | $5,953.67 | $5,953.67 | 14.8× |
| Lung Ventilat&Perfus Imaging (78582) | $6,394.74 | $6,394.74 | 11.7× |
| Lung Ventilation Imaging (78579) | $5,518.70 | $5,518.70 | 13.7× |
| Lymph System Imaging (78195) | $6,176.50 | $6,176.50 | 11.3× |
| Lymphangiography extremity only unilateral rs&i (75801) | $3,968.80 | $3,968.80 | 6.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $12,786.37 | $12,786.37 | 4.0× |
| Magnetic Image Jaw Joint (70336) | $6,714.56 | $6,714.56 | 28.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $31,709.99 | $31,709.99 | 180.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $23,464.27 | $23,464.27 | 42.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $34,946.56 | $34,946.56 | 198.3× |
| Mammary ductogram or galactogram multiple (77054) | $2,342.64 | $2,342.64 | 9.8× |
| Mammary ductogram or galactogram single (77053) | $1,724.28 | $1,724.28 | 7.2× |
| Meckels Divert Exam (78290) | $4,499.20 | $4,499.20 | 11.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $51.57 | $51.57 | 1.8× |
| Mra Head W/O & W/Contrast Material (70546) | $7,322.75 | $7,322.75 | 20.9× |
| MRA head w/o contrast (70544) | $5,560.82 | $5,560.82 | 23.2× |
| MRA head with contrast (70545) | $6,740.53 | $6,740.53 | 19.2× |
| MRA neck w contrast (70548) | $6,175.12 | $6,175.12 | 17.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,322.75 | $7,322.75 | 20.9× |
| MRA neck w/o contrast (70547) | $5,560.82 | $5,560.82 | 23.2× |
| MRI abdomen w contrast (74182) | $9,912.91 | $9,912.91 | 28.3× |
| MRI abdomen w/o contrast (74181) | $9,824.28 | $9,824.28 | 41.0× |
| MRI any jt lower extrem w/contrast material (73722) | $8,635.38 | $8,635.38 | 11.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $10,213.95 | $10,213.95 | 29.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,312.97 | $8,312.97 | 10.6× |
| MRI bone marrow blood supply (77084) | $7,885.09 | $7,885.09 | 32.9× |
| MRI brain functional w/o physician admnistration (70554) | $10,571.53 | $10,571.53 | 44.1× |
| MRI brain functional w/physician admnistration (70555) | $13,517.74 | $13,517.74 | 56.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $10,030.59 | $10,030.59 | 41.8× |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$5,574.57–$6,008.56 | $5,574.57–$6,008.56 | varies |
| MRI cardiac w/o cont stress (75559) | $7,891.21 | $7,891.21 | 14.4× |
| MRI cardiac w/o contrast (75557) | $7,891.21 | $7,891.21 | 32.9× |
| MRI cervical spine w contrast (72142) | $11,543.41 | $11,543.41 | 32.9× |
| MRI cervical spine w/o cont (72141) | $9,333.75 | $9,333.75 | 38.9× |
| MRI chest w/o contrast (71550) | $7,964.56 | $7,964.56 | 33.2× |
| MRI chest with contrast (71551) | $8,996.04 | $8,996.04 | 11.4× |
| MRI chest wo w contrast (71552) | $12,007.95 | $12,007.95 | 34.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $8,312.97 | $8,312.97 | 23.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,213.95 | $10,213.95 | 29.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $7,556.54 | $7,556.54 | 31.5× |
| MRI lumbar spine w contrast (72149) | $11,537.30 | $11,537.30 | 32.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $11,590.79 | $11,590.79 | 33.1× |
| MRI orbit face &/neck w/o contrast (70540) | $10,262.84 | $10,262.84 | 42.8× |
| MRI orbit face neck w contrast (70542) | $10,129.90 | $10,129.90 | 28.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $10,349.94 | $10,349.94 | 29.5× |
| MRI pelvis w contrast (72196) | $9,301.67 | $9,301.67 | 26.5× |
| MRI pelvis w/o & w contrast (72197) | $8,870.73 | $8,870.73 | 25.3× |
| MRI pelvis w/o contrast (72195) | $7,402.22 | $7,402.22 | 30.9× |
| MRI spectroscopy (76390) | $7,111.86 | $7,111.86 | 81.4× |
| MRI thoracic spine w/o contrast (72146) | $9,320 | $9,320 | 38.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $8,335.89 | $8,335.89 | 23.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,853.61 | $6,853.61 | 28.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$8,335.89–$12,351.78 | $8,335.89–$12,351.78 | varies |
| MRI, abdomen, combo (74183) | $10,892.43 | $10,892.43 | 31.1× |
| MRI, dorsal spine combo (72157) | $10,262.84 | $10,262.84 | 29.3× |
| MRI, dorsal spine contrast (72147) | $11,155.26 | $11,155.26 | 31.8× |
| MRI, joint upper extrem (73221) range across 5 matching MRF lines |
$6,933.08–$8,644.57 | $6,933.08–$8,644.57 | varies |
| MRI, joint upper extrem combo (73223) | $10,213.95 | $10,213.95 | 29.1× |
| MRI, lumbar spine combo (72158) | $11,532.72 | $11,532.72 | 32.9× |
| Myelogram cervical (72240) | $3,479.77 | $3,479.77 | 4.4× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$3,170.57–$3,172.06 | $3,170.57–$3,172.06 | varies |
| Myelography thoracic (72255) | $2,705.32 | $2,705.32 | 3.4× |
| Myelograpy 2/more regions rs&i (72270) | $6,012.66 | $6,012.66 | 7.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $8,026.23 | $8,026.23 | 20.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $5,324.89 | $5,324.89 | 9.8× |
| Myocardial Spect Multiple Studies (78452) | $6,394.74 | $6,394.74 | 4.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $22,517.33 | $22,517.33 | 15.7× |
| N-invas est c ffr sw aly CTA (75580) | $5,340.96 | $5,340.96 | 6.2× |
| Neck soft tissue (70360) | $746.20 | $746.20 | 8.5× |
| Nm csf leak detection (78650) | $6,983.84 | $6,983.84 | 5.4× |
| Nm myocard infarct spect (78469) | $6,452.72 | $6,452.72 | 11.8× |
| Nonvascular Shunt X-Ray (75809) | $1,312.53 | $1,312.53 | 12.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,784.58 | $6,784.58 | 4.9× |
| Nuclear Rx Intra-Arterial (79445) | $4,253.50 | $4,253.50 | 18.1× |
| Nuclear Rx Oral Admin (79005) | $5,990.29 | $5,990.29 | 25.6× |
| Ob us nuchal meas 1 gest (76813) | $2,666.43 | $2,666.43 | 25.4× |
| Optic foramina (70190) | $701.60 | $701.60 | 8.0× |
| Panoramic X-ray of jaws (70355) | $1,000.38 | $1,000.38 | 11.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $7,029.63 | $7,029.63 | 12.9× |
| Parathyroid Planar Imaging (78070) | $5,695.74 | $5,695.74 | 14.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $5,695.74 | $5,695.74 | 14.2× |
| Pelvis 1 or 2 views (72170) | $948.34 | $948.34 | 9.0× |
| Perineogram (74775) | $1,070.22 | $1,070.22 | 4.5× |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$1,177.27–$2,436.28 | $1,177.27–$2,436.28 | varies |
| PET image w/CT, full body (78816) | $22,517.33 | $22,517.33 | 15.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $22,517.33 | $22,517.33 | 15.7× |
| Platelet survival study Non-Facility (78191) | $8,070.48 | $8,070.48 | 20.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,273.16 | $7,273.16 | 2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $5,491.23 | $5,491.23 | 13.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,058.36 | $1,058.36 | 10.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,493.88–$1,606.84 | $1,493.88–$1,606.84 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$1,247.13–$1,657.37 | $1,247.13–$1,657.37 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$557.42–$835.38 | $557.42–$835.38 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$822.01–$1,233.75 | $822.01–$1,233.75 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,250.09 | $1,250.09 | 11.9× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$731.33–$1,095.51 | $731.33–$1,095.51 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$813.08–$1,215.91 | $813.08–$1,215.91 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$966.19–$1,545.89 | $966.19–$1,545.89 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$1,049.41–$1,569.68 | $1,049.41–$1,569.68 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $884.44 | $884.44 | 8.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $804.17 | $804.17 | 9.2× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $1,067.26 | $1,067.26 | 12.2× |
| Radex Ribs Unilateral 2 Views (71100) | $1,117.80 | $1,117.80 | 12.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$1,036.04–$1,413.62 | $1,036.04–$1,413.62 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $439.98 | $439.98 | 5.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $2,943.15 | $2,943.15 | 16.7× |
| Radex Spine 1 View Specify Level (72020) | $826.46 | $826.46 | 9.5× |
| Radex Sternum Minimum 2 Views (71120) | $1,056.86 | $1,056.86 | 12.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $902.28 | $902.28 | 10.3× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$725.39–$1,079.16 | $725.39–$1,079.16 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$1,036.04–$1,554.82 | $1,036.04–$1,554.82 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$850.23–$1,296.17 | $850.23–$1,296.17 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,811.98 | $1,811.98 | 17.3× |
| Radiation treatment delivery level 1 (77402) | $467.04 | $467.04 | 4.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,110.37 | $1,110.37 | 10.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,361.59 | $1,361.59 | 13.0× |
| Radiologic exam colon double contrast study (74280) | $2,433.31 | $2,433.31 | 13.8× |
| Radiologic exam colon single contrast study (74270) | $2,694.92 | $2,694.92 | 15.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,047.95 | $1,047.95 | 5.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,232.25–$1,841.71 | $1,232.25–$1,841.71 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $804.17 | $804.17 | 7.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,840.21 | $1,840.21 | 10.4× |
| Radiologic exam swallow function contrast study (74230) | $1,495.37 | $1,495.37 | 8.5× |
| Radiologic exam teeth complete full mouth (70320) | $654.03 | $654.03 | 2.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $2,436.28 | $2,436.28 | 10.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,232.65 | $2,232.65 | 12.7× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$746.20–$1,490.90 | $746.20–$1,490.90 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$988.48–$1,974 | $988.48–$1,974 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$793.76–$1,187.66 | $793.76–$1,187.66 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $2,396.15 | $2,396.15 | 22.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $955.78 | $955.78 | 10.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$816.05–$1,221.87 | $816.05–$1,221.87 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $740.25 | $740.25 | 1.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $266.07 | $266.07 | 3.0× |
| Radiopharm Dacryocystography (78660) | $3,552.97 | $3,552.97 | 8.8× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $3,208.04 | $3,208.04 | 13.7× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $6,068.13 | $6,068.13 | 25.9× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $6,054.39 | $6,054.39 | 25.8× |
| Renal Cyst Study (74470) | $1,196.58 | $1,196.58 | 2.2× |
| Ribs bilateral 3 views (71110) | $2,422.91 | $2,422.91 | 23.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $9,259.41 | $9,259.41 | 23.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $12,591.06 | $12,591.06 | 31.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $9,653.14 | $9,653.14 | 17.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $8,629.07 | $8,629.07 | 15.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $11,455.57 | $11,455.57 | 21.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $8,410.82 | $8,410.82 | 6.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,410.82 | $8,410.82 | 5.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,429.35 | $3,429.35 | 2.6× |
| Rp Therapy Intravenous Administration (79101) | $5,039.48 | $5,039.48 | 21.5× |
| Salivary Gland Function Study (78232) | $5,186 | $5,186 | 12.9× |
| Salivary Gland Imaging Serial Images (78231) | $4,828.87 | $4,828.87 | 12.0× |
| Scapula (73010) | $932 | $932 | 8.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $231.93 | $231.93 | 9.9× |
| Sella turcica (70240) | $1,064.29 | $1,064.29 | 12.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$945.38–$1,165.37 | $945.38–$1,165.37 | varies |
| Shoulder Arthrography (73040) range across 5 matching MRF lines |
$2,119.67–$3,460.43 | $2,119.67–$3,460.43 | varies |
| Sialogram (70390) | $1,795.62 | $1,795.62 | 7.5× |
| Skull less than 4 views (70250) | $1,398.75 | $1,398.75 | 13.3× |
| Special dosimetry (77331) | $256.67 | $256.67 | 1.9× |
| Special Physics Consult (77370) | $628.44 | $628.44 | 4.7× |
| Special treatment procedure (77470) | $2,229.33 | $2,229.33 | 4.0× |
| Speech evaluation, complex (70371) | $1,987.38 | $1,987.38 | 8.3× |
| Spleen Imaging (78185) | $3,626.23 | $3,626.23 | 9.0× |
| Sternoclavicular joints (71130) | $1,260.51 | $1,260.51 | 14.4× |
| Superior sagittal sinus venogram (75870) | $9,556.02 | $9,556.02 | 3.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,357.46 | $1,357.46 | 3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $527.90 | $527.90 | 1.4× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 5 matching MRF lines |
$1,247.13–$3,182.48 | $1,247.13–$3,182.48 | varies |
| Testicular Imaging W/Flow (78761) | $4,195.49 | $4,195.49 | 10.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,334.95 | $1,334.95 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,334.95 | $1,334.95 | 3.5× |
| Ther rad simulaj-aided field setting simple (77280) | $796.48 | $796.48 | 5.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,972.50 | $1,972.50 | 11.2× |
| Thoracic spine 2 views (72070) | $1,059.84 | $1,059.84 | 10.1× |
| Thoracic spine 3 views (72072) | $2,335.21 | $2,335.21 | 22.2× |
| Thoracolumbar 2 views (72080) | $2,693.45 | $2,693.45 | 30.8× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $5,729.32 | $5,729.32 | 14.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $4,364.89 | $4,364.89 | 10.9× |
| Thyroid Imaging With Vascular Flow (78013) | $3,775.78 | $3,775.78 | 9.4× |
| Thyroid Met Imaging Body (78018) | $6,243.64 | $6,243.64 | 11.4× |
| Thyroid Uptake Measurement (78012) | $708.16 | $708.16 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,450.37 | $4,450.37 | 11.1× |
| Tx Devices Design & Construction Complex (77334) | $3,643.67 | $3,643.67 | 9.7× |
| Tx devices design & construction intermediate (77333) | $3,643.67 | $3,643.67 | 27.0× |
| Tx devices design & construction simple (77332) | $993.61 | $993.61 | 7.4× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$491.58–$1,563.68 | $491.58–$1,563.68 | varies |
| Ultrasound elastography first target lesion (76982) | $1,607.44 | $1,607.44 | 15.3× |
| Ultrasound Elastography Parenchyma (76981) | $1,607.44 | $1,607.44 | 15.3× |
| Ultrasound Exam Aaa Screen (76706) | $2,555.58 | $2,555.58 | 24.3× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,247.15–$1,271.95 | $1,247.15–$1,271.95 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$437.02–$5,575.65 | $437.02–$5,575.65 | varies |
| Unlisted fluoroscopic procedure (76496) | $330.32 | $330.32 | 3.8× |
| Unlisted magnetic resonance procedure (76498) | $1,789.43 | $1,789.43 | 20.5× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$428.85–$1,867.10 | $428.85–$1,867.10 | varies |
| Upper gi w/o kub (74240) | $1,811.98 | $1,811.98 | 10.3× |
| Ureteral Reflux Study (78740) | $4,198.54 | $4,198.54 | 10.5× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$2,000.75–$2,159.80 | $2,000.75–$2,159.80 | varies |
| Urethrocystography retrograde (74450) | $2,347.08 | $2,347.08 | 9.8× |
| Us breast unilateral complete (76641) range across 10 matching MRF lines |
$822.69–$3,817.30 | $822.69–$3,817.30 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$2,017.32–$2,058.16 | $2,017.32–$2,058.16 | varies |
| Us complete joint (76881) | $1,711 | $1,711 | 16.3× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$1,324.46–$1,350.70 | $1,324.46–$1,350.70 | varies |
| Us head (76506) | $1,382.80 | $1,382.80 | 13.2× |
| Us kidney transplant (76776) | $2,555.58 | $2,555.58 | 24.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$822.69–$1,438.23 | $822.69–$1,438.23 | varies |
| Us ob detailed single fetus (76811) | $2,666.43 | $2,666.43 | 11.1× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$1,162.56–$1,185.89 | $1,162.56–$1,185.89 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$1,533.04–$1,563.68 | $1,533.04–$1,563.68 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$1,799.99–$1,836.46 | $1,799.99–$1,836.46 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,608.89 | $1,608.89 | 15.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$1,506.80–$1,537.43 | $1,506.80–$1,537.43 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$1,681.84–$2,555.58 | $1,681.84–$2,555.58 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$1,713.92–$2,505.97 | $1,713.92–$2,505.97 | varies |
| Us scrotum and contents (76870) | $1,533.04 | $1,533.04 | 14.6× |
| Us spinal canal and contents (76800) | $3,515.37 | $3,515.37 | 33.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,522.86–$1,553.48 | $1,522.86–$1,553.48 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$859.16–$2,185.08 | $859.16–$2,185.08 | varies |
| Vascular Flow Imaging (78445) | $3,176.01 | $3,176.01 | 7.9× |
| Vasogram (74440) | $1,526.58 | $1,526.58 | 6.4× |
| Vein X-Ray Chest (75827) | $3,555.58 | $3,555.58 | 2.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,373.12 | $4,373.12 | 1.4× |
| Vein X-Ray Skull Epidural (75872) | $7,273.16 | $7,273.16 | 11.5× |
| Vein X-Ray Spleen/Liver (75810) | $6,430.37 | $6,430.37 | 2.0× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$7,273.16–$12,781.92 | $7,273.16–$12,781.92 | varies |
| Venography Adrenal Unilateral (75840) | $7,273.16 | $7,273.16 | 2.3× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$6,201.44–$14,727.66 | $6,201.44–$14,727.66 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$4,117.58–$4,405.81 | $4,117.58–$4,405.81 | varies |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$4,602.42–$4,924.59 | $4,602.42–$4,924.59 | varies |
| Venography Orbital Rs&I (75880) | $7,273.16 | $7,273.16 | 11.5× |
| Venography Renal Bilateral (75833) | $7,273.16 | $7,273.16 | 2.3× |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$6,797.35–$14,727.66 | $6,797.35–$14,727.66 | varies |
| Venous sampling by catheter (75893) | $21,248.70 | $21,248.70 | 3.8× |
| Venous thrombosis imaging (78457) | $3,385.09 | $3,385.09 | 6.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $4,508.36 | $4,508.36 | 11.2× |
| Vertebral fracture assessment via dxa (77086) | $437.02 | $437.02 | 5.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$822.01–$1,229.28 | $822.01–$1,229.28 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,195.10 | $1,195.10 | 13.7× |
| X-ray antegrade pyelogram tube (74425) | $2,436.28 | $2,436.28 | 7.0× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$8,823.52–$12,781.92 | $8,823.52–$12,781.92 | varies |
| X-Ray Bend Only L-S Spine (72120) | $805.67 | $805.67 | 7.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$625.80–$936.46 | $625.80–$936.46 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$1,580.09–$3,424.76 | $1,580.09–$3,424.76 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $826.46 | $826.46 | 9.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,132.67 | $1,132.67 | 10.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,377.94 | $1,377.94 | 13.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $835.38 | $835.38 | 9.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $888.89 | $888.89 | 10.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 5 matching MRF lines |
$945.38–$1,144.56 | $945.38–$1,144.56 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,236.72 | $1,236.72 | 11.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,348.21 | $1,348.21 | 12.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,490.90 | $1,490.90 | 14.2× |
| X-Ray Exam L-S Spine Bending (72114) | $3,134.91 | $3,134.91 | 29.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,132.67 | $1,132.67 | 13.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,756.98 | $1,756.98 | 16.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$1,440.36–$1,639.55 | $1,440.36–$1,639.55 | varies |
| X-ray eye for foreign body (70030) range across 5 matching MRF lines |
$330–$691.20 | $330–$691.20 | varies |
| X-ray head for orthodontia (70350) | $387.96 | $387.96 | 4.4× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$961.72–$1,438.87 | $961.72–$1,438.87 | varies |
| X-ray IV pyelogram (ivp) (74400) | $2,428.85 | $2,428.85 | 13.8× |
| X-ray IV pyelogram+tomography (74415) | $2,428.85 | $2,428.85 | 13.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $637.69 | $637.69 | 7.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $722.41 | $722.41 | 8.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $832.42 | $832.42 | 7.9× |
| X-ray nose-rectum child f.b. (76010) | $722.41 | $722.41 | 8.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,418.06 | $1,418.06 | 13.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $740.25 | $740.25 | 7.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $466.74 | $466.74 | 4.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $807.13 | $807.13 | 9.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,718.32 | $1,718.32 | 19.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,256.42 | $2,256.42 | 21.5× |
| X-Ray Stress View (77071) | $321.07 | $321.07 | 3.7× |
| X-ray thoracic spine 4 vw (72074) | $750.66 | $750.66 | 7.1× |
| X-Ray Tmj Unilat (70328) | $560.38 | $560.38 | 6.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,713.87 | $1,713.87 | 4.9× |
| X-Rays Bone Length Studies (77073) | $1,160.92 | $1,160.92 | 11.1× |
| X-Rays Bone Survey Complete (77075) | $2,958 | $2,958 | 28.2× |
| Xr c-spine 4 or 5 views (72050) | $1,361.59 | $1,361.59 | 13.0× |
| Xr facial bones less than 3 views (70140) | $753.62 | $753.62 | 8.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $541.07 | $541.07 | 5.2× |
| Xr myelogram posterior fossa (70010) | $3,653.66 | $3,653.66 | 10.4× |
| Xr orbits complete 4 views (70200) | $868.07 | $868.07 | 8.3× |
| Xr Tomogram Single Plane (76100) | $1,615.77 | $1,615.77 | 15.4× |
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.