Imaging prices at MedStar Georgetown University Hospital
Washington, DC · every code in this section with a posted price and a Medicare benchmark.
477 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) | $4,580.08 | $7,046.28 | 2.8× |
| Abdomen 1 View (74018) | $412.02 | $633.87 | 4.0× |
| Abdomen 2 views (74019) | $484.63 | $745.58 | 3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,899.89 | $2,922.90 | 4.0× |
| Adrenal Cortex & Medulla Img (78075) | $5,009.63 | $7,707.12 | 3.3× |
| Angio internal mammary (75756) | $9,370.28 | $14,415.81 | 2.5× |
| Angio pulmonary bilat (75743) | $8,712.50 | $13,403.84 | 2.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $8,032.15 | $12,357.15 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $6,537.23 | $10,057.27 | 1.8× |
| Angiography extremity unilateral rs&i (75710) | $6,589.65 | $10,137.93 | 1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $8,299.56 | $12,768.56 | 2.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $9,370.28 | $14,415.81 | 2.5× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$342.19–$684.37 | $526.45–$1,052.87 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$8,473.96–$8,703.26 | $13,036.86–$13,389.63 | varies |
| Artery X-Rays Abdomen (75726) | $8,473.96 | $13,036.86 | 1.3× |
| Artery X-Rays Adrenal Gland (75731) | $6,364.88 | $9,792.12 | 1.7× |
| Artery X-Rays Pelvis (75736) | $8,473.96 | $13,036.86 | 1.3× |
| Artery X-Rays Spine (75705) | $9,223.06 | $14,189.32 | 1.4× |
| Arthrogram ankle (73615) | $896.86 | $1,379.78 | 2.2× |
| Arthrogram hip (73525) | $1,144.55 | $1,760.84 | 2.8× |
| Arthrogram Wrist (73115) | $1,879.87 | $2,892.10 | 4.6× |
| Basic radiation dosimetry calculation (77300) | $835.71 | $1,285.71 | 5.3× |
| Bone age studies (77072) | $248.92 | $382.95 | 2.0× |
| Bone Imaging 3 Phase (78315) | $1,876.13 | $2,886.35 | 4.0× |
| Bone Imaging Limited Area (78300) | $1,570.71 | $2,416.48 | 3.3× |
| Bone Imaging Multiple Areas (78305) | $1,570.71 | $2,416.48 | 3.3× |
| Bone Imaging Whole Body (78306) | $1,570.71 | $2,416.48 | 3.3× |
| Bone marrow imaging limited area (78102) | $1,192.06 | $1,833.94 | 2.5× |
| Bone marrow imaging; multiple areas (78103) | $1,192.06 | $1,833.94 | 2.5× |
| Bone marrow imaging; whole body (78104) | $1,315.30 | $2,023.54 | 2.8× |
| Bone survey infant (77076) | $392.63 | $604.05 | 3.2× |
| Brachytx isodose complex (77318) | $2,321.53 | $3,571.58 | 5.2× |
| Brachytx isodose intermed (77317) | $1,949.45 | $2,999.16 | 4.4× |
| Brachytx Isodose Plan Simple (77316) | $1,715.06 | $2,638.56 | 3.9× |
| Brain Flow Imaging Only (78610) | $1,653.76 | $2,544.24 | 2.6× |
| Brain Image W/Flow < 4 Views (78601) | $1,283.34 | $1,974.37 | 2.7× |
| Brain imaging < 4 static views (78600) | $1,283.34 | $1,974.37 | 2.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,377.93 | $3,658.36 | 3.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,102.51 | $1,696.17 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,838.18 | $8,981.82 | 3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,350.43 | $3,616.04 | 5.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,809.11 | $2,783.24 | 2.0× |
| Cardiac Shunt Detection (78428) | $1,564.69 | $2,407.21 | 3.3× |
| Cardiovasc nucl exam unlisted (78499) | $1,283.34 | $1,974.37 | 2.7× |
| Cat Scan Follow-Up Study (76380) | $1,200.71 | $1,847.25 | 11.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,878.28 | $2,889.66 | 2.9× |
| Cerebrospinal Fluid Scan (78630) | $2,441.46 | $3,756.09 | 3.8× |
| Chest 1 view (71045) | $442.83 | $681.28 | 4.3× |
| Chest 2 views (71046) | $442.83 | $681.28 | 4.3× |
| Chest 3 views (71047) | $509.33 | $783.59 | 5.0× |
| Chest 4 or more views (71048) | $546.33 | $840.50 | 4.4× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $284.86 | $438.24 | 2.3× |
| Cisternography Positive Contrast Rs&I (70015) | $1,644.58 | $2,530.13 | 1.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$292.19–$584.38 | $449.52–$899.05 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,525.91 | $2,347.55 | 12.4× |
| Continuing medical physics consltj pr wk (77336) | $592.62 | $911.72 | 3.7× |
| Contrast Exam Abdominl Aorta (75625) | $5,114.60 | $7,868.61 | 1.4× |
| Contrast X-Ray Bladder (74430) | $917.40 | $1,411.39 | 2.2× |
| Contrast X-Ray Of Elbow (73085) | $1,645.29 | $2,531.21 | 4.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,595.94 | $2,455.29 | 3.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $479.63 | $737.89 | 2.3× |
| Corpora cavernosography (74445) | $632 | $972.30 | 5.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 6 matching MRF lines |
$5,171.22–$5,331.51 | $7,955.72–$8,202.33 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,768.81 | $4,259.70 | 9.8× |
| CT abdomen w contrast (74160) | $2,542.44 | $3,911.44 | 12.3× |
| CT abdomen w wo contrast (74170) | $3,361.01 | $5,170.78 | 16.2× |
| CT abdomen w/o contrast (74150) | $1,804.53 | $2,776.20 | 14.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,175.89 | $6,424.44 | 10.1× |
| CT Angio Chest (71275) | $2,736.62 | $4,210.19 | 13.2× |
| CT Angio Head (70496) | $2,483.72 | $3,821.10 | 12.0× |
| CT angio hrt w/3d image (75574) | $1,604.96 | $2,469.17 | 3.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$2,415.87–$9,661.81 | $3,716.72–$14,864.33 | varies |
| CT Angio Neck (70498) | $2,483.72 | $3,821.10 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,753.93–$7,013.55 | $2,698.35–$10,790.07 | varies |
| CT bone density (77078) | $848.66 | $1,305.63 | 8.3× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $760.21 | $1,169.55 | 3.7× |
| CT cervical spine w/ contrast (72126) | $2,319.64 | $3,568.67 | 5.6× |
| CT cervical spine w/o contrast (72125) | $1,711.90 | $2,633.69 | 13.9× |
| CT cervical spine w/wo cont (72127) | $2,355.28 | $3,623.51 | 11.4× |
| CT chest w contrast (71260) | $2,606.10 | $4,009.38 | 12.6× |
| CT chest w/wo contrast (71270) | $3,173.68 | $4,882.58 | 15.3× |
| CT colonography screening (74263) | $1,332.74 | $2,050.37 | 4.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,515.55 | $3,870.07 | 12.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,913.45 | $2,943.77 | 15.5× |
| CT head/brain with contrast (70460) | $2,186.28 | $3,363.50 | 10.6× |
| CT head/brain without and with contrast (70470) | $2,621.44 | $4,032.98 | 12.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,768.77 | $2,721.18 | 4.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $438.29 | $674.29 | 4.3× |
| CT hrt w/3d image congen (75573) | $1,604.96 | $2,469.17 | 3.9× |
| CT iac w contrast (70481) | $2,186.28 | $3,363.50 | 10.6× |
| CT l-spine w&w/o contrast (72133) | $2,409.74 | $3,707.29 | 11.6× |
| CT lower ext w/o (73700) range across 7 matching MRF lines |
$1,435.92–$3,113.73 | $2,209.10–$4,790.36 | varies |
| CT lower extremity w/contrast material (73701) range across 9 matching MRF lines |
$1,782.16–$3,806.60 | $2,741.79–$5,856.30 | varies |
| CT lumbar spine w contrast (72132) | $2,391.10 | $3,678.62 | 5.8× |
| CT lumbar spine w/o contrast (72131) | $1,787.55 | $2,750.07 | 14.5× |
| CT maxillofacial w contrast (70487) | $2,054.45 | $3,160.69 | 9.9× |
| CT maxillofacial wo contrast (70486) | $1,698.74 | $2,613.44 | 13.8× |
| CT neck tissue combo (70492) | $2,310.83 | $3,555.12 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,258 | $3,473.85 | 10.9× |
| CT orbits w/o contrast (70480) | $1,767.06 | $2,718.56 | 14.3× |
| CT pelvis w&w/o contrast (72194) | $2,430.92 | $3,739.87 | 11.7× |
| CT pelvis w/o contrast (72192) | $1,565.04 | $2,407.76 | 12.7× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,793.71–$5,831.72 | $4,298.01–$8,971.88 | varies |
| CT scans face/jaw combo (70488) | $2,551.72 | $3,925.73 | 12.3× |
| CT soft tissue neck w contrast (70491) | $1,869.63 | $2,876.35 | 9.0× |
| CT soft tissue neck w/o contrast (70490) | $1,593.87 | $2,452.10 | 12.9× |
| CT thoracic spine w contrast (72129) | $1,883.79 | $2,898.14 | 9.1× |
| CT thoracic spine w/o contrast (72128) | $1,645.09 | $2,530.91 | 13.3× |
| CT thoracic spine w/wo cont (72130) | $2,491.95 | $3,833.77 | 12.0× |
| CT thorax w/o contrast (71250) | $2,060.95 | $3,170.69 | 16.7× |
| CT unlisted procedure (76497) | $2,281.63 | $3,510.20 | 22.2× |
| CT upper ext wo (73200) range across 5 matching MRF lines |
$1,882.94–$4,006.92 | $2,896.83–$6,164.49 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,120.07–$4,482.21 | $3,261.65–$6,895.70 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,053.53–$4,349.12 | $3,159.28–$6,690.95 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,606.10 | $4,009.38 | 12.6× |
| Cta Abdomen (74175) | $2,736.62 | $4,210.19 | 13.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 3 matching MRF lines |
$1,154.56–$4,967.43 | $1,776.25–$7,642.20 | varies |
| CTA pelvis (72191) | $2,333.66 | $3,590.25 | 11.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $548.20 | $843.39 | 1.9× |
| Dilation ureters/urethra rs&i (74485) | $4,136.11 | $6,363.25 | 1.7× |
| Discography Cerv/Thor Spine (72285) | $6,859.20 | $10,552.61 | 3.0× |
| Diskography lumbar (72295) | $7,961.01 | $12,247.70 | 3.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $434.58 | $668.58 | 3.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $434.58 | $668.58 | 3.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $296.14 | $455.60 | 2.4× |
| Dxa Bone Density Axial (77080) | $248.92 | $382.95 | 2.0× |
| Dxa bone density study (77085) | $217.85 | $335.16 | 1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $183.99 | $283.06 | 1.8× |
| Echo exam of fetal heart (76825) | $2,910.51 | $4,477.70 | 4.5× |
| Echo exam uterus (76831) | $1,034.70 | $1,591.85 | 3.7× |
| Echo Guide For Artery Repair (76936) | $526.45 | $809.93 | 2.1× |
| Echograp Trans R Pros Study (76873) | $272.32 | $418.95 | 2.2× |
| Esophageal Motility Study (78258) | $1,217.62 | $1,873.26 | 2.6× |
| Esophagram (74220) | $479.63 | $737.89 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $566.65 | $871.77 | 4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $566.65 | $871.77 | 4.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,072.51 | $1,650.01 | 3.8× |
| Fluoroscopy up to 1 hr (76000) | $777.01 | $1,195.40 | 2.8× |
| Follow-Up Angiography (75898) | $5,267.08 | $8,103.20 | 1.4× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$501.54–$872.22 | $771.60–$1,341.87 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$315.55–$631.03 | $485.46–$970.81 | varies |
| Gastric emptying imaging study (78264) | $1,627.21 | $2,503.40 | 3.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,698.31 | $2,612.78 | 3.6× |
| Gastric Mucosa Imaging (78261) | $1,283.34 | $1,974.37 | 2.7× |
| Gastroesophageal Reflux Exam (78262) | $2,339.10 | $3,598.61 | 5.0× |
| Gated Heart Planar Single (78472) | $1,784.87 | $2,745.96 | 3.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,253.36 | $3,466.71 | 3.5× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$389.79–$779.60 | $599.67–$1,199.39 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,406.34 | $5,240.53 | 4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,406.34 | $5,240.53 | 4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,406.34 | $5,240.53 | 4.1× |
| Heart first pass single,planar (78481) | $1,564.69 | $2,407.21 | 2.4× |
| Heart Image (Pet) Multiple (78492) | $5,838.18 | $8,981.82 | 3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,114.60 | $7,868.61 | 1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,114.60 | $7,868.61 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $2,560.46 | $3,939.17 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,865.33 | $2,869.74 | 3.9× |
| Ht Musc Image Planar Mult (78454) | $5,561.50 | $8,556.15 | 3.6× |
| Ht Muscle Image Spect Sing (78451) | $3,924.20 | $6,037.23 | 2.6× |
| Hysterosalpingogram (74740) | $1,284.48 | $1,976.12 | 4.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $772.08 | $1,187.82 | 7.5× |
| Infant hip ultrasound, limited static exam (76886) | $485.76 | $747.32 | 4.7× |
| Infusion Ivp (74410) | $578.82 | $890.49 | 2.8× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $28,365.10 | $43,638.62 | 3.3× |
| Intraop radiaj tx deliver xray single tx session (77424) | $28,365.10 | $43,638.62 | 3.3× |
| Joint Survey Single View (77077) | $248.92 | $382.95 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $1,914.69 | $2,945.67 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $1,938.46 | $2,982.25 | 3.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,821.72 | $2,802.64 | 2.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $855.56 | $1,316.24 | 1.8× |
| Kidney Imaging Morphol (78700) | $1,647.69 | $2,534.91 | 3.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,746.71 | $2,687.25 | 3.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$323.14–$1,291.97 | $497.14–$1,987.65 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $2,004.28 | $3,083.51 | 4.2× |
| Leveen/Shunt Patency Exam (78291) | $1,217.62 | $1,873.26 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,707.24 | $2,626.52 | 3.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,863.35 | $2,866.69 | 3.9× |
| Liver imaging static only (78201) | $4,463.18 | $6,866.43 | 7.0× |
| Liver imaging w/vascular flow (78202) | $4,463.18 | $6,866.43 | 7.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,459.87 | $3,784.42 | 3.8× |
| Lung perfusion differential (78597) | $1,055.69 | $1,624.14 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,787.64 | $2,750.22 | 2.8× |
| Lung Ventilation Imaging (78579) | $1,027.65 | $1,581 | 2.2× |
| Lymph System Imaging (78195) | $1,886.92 | $2,902.95 | 2.9× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $2,799.32 | $4,306.65 | 1.5× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,200.50 | $1,846.92 | 1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $6,925.87 | $10,655.18 | 1.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $5,405.60 | $8,316.30 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $2,119.72 | $3,261.10 | 7.5× |
| Magnetic Resonance Elastography (76391) | $1,722.67 | $2,650.26 | 6.1× |
| Mammary ductogram or galactogram multiple (77054) | $615.32 | $946.65 | 2.2× |
| Mammary ductogram or galactogram single (77053) | $615.32 | $946.65 | 2.2× |
| Meckels Divert Exam (78290) | $1,889.08 | $2,906.28 | 4.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,751.18 | $2,694.13 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $118.10 | $181.69 | 3.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,667.95 | $4,104.54 | 6.5× |
| MRA head w/o contrast (70544) | $1,564.10 | $2,406.30 | 5.5× |
| MRA head with contrast (70545) | $2,425.98 | $3,732.28 | 5.9× |
| MRA neck w contrast (70548) | $1,991 | $3,063.07 | 4.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,667.95 | $4,104.54 | 6.5× |
| MRA neck w/o contrast (70547) | $1,564.10 | $2,406.30 | 5.5× |
| MRI abdomen w contrast (74182) | $2,850.08 | $4,384.74 | 6.9× |
| MRI abdomen w/o contrast (74181) | $2,218.66 | $3,413.33 | 7.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 5 matching MRF lines |
$2,116.87–$4,408.03 | $3,256.72–$6,781.58 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$2,786.93–$5,748.14 | $4,287.58–$8,843.29 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$1,953.58–$4,081.43 | $3,005.50–$6,279.13 | varies |
| MRI brain functional w/o physician admnistration (70554) | $1,813.01 | $2,789.24 | 6.4× |
| MRI brain functional w/physician admnistration (70555) | $1,813.01 | $2,789.24 | 6.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,722.67 | $2,650.26 | 6.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,722.67 | $2,650.26 | 6.1× |
| MRI cardiac w/o cont stress (75559) | $1,244.24 | $1,914.21 | 1.9× |
| MRI cardiac w/o contrast (75557) | $1,203.53 | $1,851.58 | 4.3× |
| MRI cervical spine w contrast (72142) | $2,434.13 | $3,744.81 | 5.9× |
| MRI cervical spine w/o cont (72141) | $1,768.73 | $2,721.13 | 6.3× |
| MRI chest w/o contrast (71550) | $2,096.63 | $3,225.59 | 7.4× |
| MRI chest with contrast (71551) | $2,710.42 | $4,169.87 | 2.9× |
| MRI chest wo w contrast (71552) | $3,463.79 | $5,328.90 | 8.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$2,100.16–$4,374.60 | $3,231.02–$6,730.15 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$2,309.64–$4,793.56 | $3,553.29–$7,374.70 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$1,970.52–$4,115.33 | $3,031.57–$6,331.27 | varies |
| MRI lumbar spine w contrast (72149) | $2,213.85 | $3,405.93 | 5.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,994.20 | $4,606.46 | 7.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,400.68 | $3,693.36 | 8.5× |
| MRI orbit face neck w contrast (70542) | $2,496.44 | $3,840.68 | 6.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,915.68 | $4,485.66 | 7.1× |
| MRI pelvis w contrast (72196) | $2,483.62 | $3,820.96 | 6.0× |
| MRI pelvis w/o & w contrast (72197) | $3,288.73 | $5,059.59 | 8.0× |
| MRI pelvis w/o contrast (72195) | $1,782.33 | $2,742.04 | 6.3× |
| MRI spectroscopy (76390) | $2,253.81 | $3,467.40 | 21.9× |
| MRI thoracic spine w/o contrast (72146) | $1,776.94 | $2,733.76 | 6.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$2,710.42–$5,595.09 | $4,169.87–$8,607.83 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$1,970.64–$4,115.56 | $3,031.75–$6,331.63 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$2,253.91–$4,682.12 | $3,467.56–$7,203.26 | varies |
| MRI, abdomen, combo (74183) | $3,845 | $5,915.39 | 9.3× |
| MRI, dorsal spine combo (72157) | $2,965.49 | $4,562.29 | 7.2× |
| MRI, dorsal spine contrast (72147) | $2,208.38 | $3,397.50 | 5.4× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,841.65–$3,857.59 | $2,833.30–$5,934.75 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$2,481.04–$5,135.29 | $3,816.99–$7,900.45 | varies |
| MRI, lumbar spine combo (72158) | $3,052.11 | $4,695.56 | 7.4× |
| Myelogram cervical (72240) | $2,447.32 | $3,765.11 | 2.6× |
| Myelogram Lumbar (72265) | $2,179.54 | $3,353.14 | 2.4× |
| Myelography thoracic (72255) | $2,179.54 | $3,353.14 | 2.4× |
| Myelograpy 2/more regions rs&i (72270) | $3,168.95 | $4,875.30 | 3.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,283.34 | $1,974.37 | 2.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $6,662.05 | $10,249.31 | 4.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,110.68 | $6,324.13 | 2.7× |
| Myocardial Spect Multiple Studies (78452) | $5,561.50 | $8,556.15 | 3.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $5,239.36 | $8,060.55 | 3.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $5,239.36 | $8,060.55 | 3.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $8,171.29 | $12,571.22 | 3.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $9,986.72 | $15,364.19 | 3.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $9,986.72 | $15,364.19 | 5.6× |
| N-invas est c ffr sw aly CTA (75580) | $4,253.77 | $6,544.26 | 4.2× |
| Neck soft tissue (70360) | $540.04 | $830.83 | 5.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $814.88 | $1,253.66 | 1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,283.34 | $1,974.37 | 2.7× |
| Nm csf leak detection (78650) | $2,975.46 | $4,577.63 | 1.9× |
| Nm myocard infarct spect (78469) | $2,975.46 | $4,577.63 | 4.6× |
| Nm red cell survival study (78130) | $2,004.28 | $3,083.51 | 4.2× |
| Nm unlisted gi procedure (78299) | $1,307.48 | $2,011.50 | 2.8× |
| Nonvascular Shunt X-Ray (75809) | $365.64 | $562.53 | 3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,437.23 | $14,518.82 | 5.8× |
| Nuclear Rx Intra-Arterial (79445) | $1,306.14 | $2,009.44 | 4.7× |
| Nuclear Rx Oral Admin (79005) | $1,515.72 | $2,331.87 | 5.5× |
| Ob us nuchal meas 1 gest (76813) | $272.32 | $418.95 | 2.2× |
| Optic foramina (70190) | $204.43 | $314.51 | 2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,695.25 | $2,608.08 | 2.6× |
| Parathyroid Planar Imaging (78070) | $1,653.70 | $2,544.15 | 3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,752.37 | $2,695.96 | 3.7× |
| Pelvis 1 or 2 views (72170) | $335.60 | $516.31 | 2.7× |
| Peritoneogram Rs&I (74190) | $1,214.75 | $1,868.84 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $5,840.75 | $8,985.77 | 3.5× |
| PET image w/CT, full body (78816) | $5,840.75 | $8,985.77 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,840.75 | $8,985.77 | 3.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,678.60 | $2,582.46 | 1.1× |
| Pet Myocardial Sngl Study (78491) | $5,838.18 | $8,981.82 | 3.5× |
| PET whole body (78813) | $3,329.20 | $5,121.85 | 2.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $2,975.46 | $4,577.63 | 1.9× |
| Platelet survival study Non-Facility (78191) | $855.56 | $1,316.24 | 1.8× |
| Proton trmt simple w/comp (77522) | $5,018.77 | $7,721.18 | 3.4× |
| Proton tx delivery complex (77525) | $5,038.72 | $7,751.87 | 3.4× |
| Proton tx delivery intermediate (77523) | $5,028.74 | $7,736.52 | 3.4× |
| Proton tx delivery simple w/o compensation (77520) | $2,504.39 | $3,852.91 | 3.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,559.67 | $8,553.34 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,284.60 | $1,976.31 | 2.7× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $4,253.77 | $6,544.26 | 3.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $673.44 | $1,036.06 | 5.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,182.75 | $1,819.61 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$420.32–$840.59 | $646.65–$1,293.22 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$306.01–$612.05 | $470.79–$941.61 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$503.96–$1,008.30 | $775.32–$1,551.23 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $475.35 | $731.30 | 3.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$325.17–$650.37 | $500.26–$1,000.57 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$565.35–$1,130.71 | $869.77–$1,739.55 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$467.43–$934.91 | $719.13–$1,438.33 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$172.11–$246.90 | $264.79–$379.84 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$248.92–$408.85 | $382.95–$629 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $263.78 | $405.81 | 2.6× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $408.82 | $628.95 | 4.0× |
| Radex Ribs Unilateral 2 Views (71100) | $189.98 | $292.27 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$318.97–$637.95 | $490.73–$981.46 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $209.79 | $322.76 | 2.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $701.72 | $1,079.57 | 3.4× |
| Radex Spine 1 View Specify Level (72020) | $293.14 | $450.98 | 2.9× |
| Radex Sternum Minimum 2 Views (71120) | $200.11 | $307.86 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $227.30 | $349.69 | 2.2× |
| Radex Toe Minimum 2 Views (73660) | $359.89 | $553.68 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$248.92–$334.04 | $382.95–$513.90 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$478.55–$957.14 | $736.23–$1,472.53 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $493.14 | $758.68 | 4.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $31,128.17 | $47,889.49 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $293.80 | $452 | 2.4× |
| Radiation treatment delivery level 2 (77407) | $1,110.62 | $1,708.65 | 2.4× |
| Radiation treatment delivery level 3 (77412) | $1,591.06 | $2,447.78 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $451.39 | $694.45 | 3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $421.40 | $648.31 | 3.4× |
| Radiologic exam colon double contrast study (74280) | $1,149.73 | $1,768.81 | 5.5× |
| Radiologic exam colon single contrast study (74270) | $790.11 | $1,215.55 | 3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $435.26 | $669.63 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$432.52–$865.04 | $665.42–$1,330.83 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $372.13 | $572.50 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $670.21 | $1,031.09 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $772.81 | $1,188.94 | 3.7× |
| Radiologic exam teeth complete full mouth (70320) | $510.13 | $784.81 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $721.49 | $1,109.99 | 3.5× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$181.27–$265.10 | $278.88–$407.84 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$181.27–$724.95 | $278.88–$1,115.31 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$287.90–$575.85 | $442.93–$885.92 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $433.69 | $667.22 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$315.26–$630.51 | $485.02–$970.01 | varies |
| Radiopharm Dacryocystography (78660) | $934.30 | $1,437.39 | 2.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $2,004.28 | $3,083.51 | 3.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $655.36 | $1,008.24 | 1.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $655.36 | $1,008.24 | 1.4× |
| Renal Cyst Study (74470) | $1,182.75 | $1,819.61 | 1.8× |
| Ribs bilateral 3 views (71110) | $351.92 | $541.41 | 2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,305.24 | $2,008.06 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,824.75 | $4,345.77 | 6.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,316.37 | $6,640.57 | 6.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,975.46 | $4,577.63 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,931.76 | $7,587.33 | 7.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,618.65 | $7,105.62 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $5,239.36 | $8,060.55 | 3.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,618.65 | $7,105.62 | 3.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,045.39 | $4,685.22 | 11.0× |
| Rp Therapy Intravenous Administration (79101) | $1,078.04 | $1,658.53 | 3.9× |
| Salivary Gland Function Study (78232) | $1,164.27 | $1,791.18 | 2.5× |
| Salivary Gland Imaging (78230) | $1,283.34 | $1,974.37 | 2.7× |
| Salivary Gland Imaging Serial Images (78231) | $992.14 | $1,526.37 | 2.1× |
| Scapula (73010) range across 2 matching MRF lines |
$351.85–$703.70 | $541.31–$1,082.62 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $145.39 | $223.68 | 6.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$284.63–$569.22 | $437.89–$875.72 | varies |
| Shoulder Arthrography (73040) | $1,136.17 | $1,747.96 | 2.8× |
| Sialogram (70390) range across 3 matching MRF lines |
$700.08–$980.23 | $1,077.05–$1,508.04 | varies |
| Skull less than 4 views (70250) | $438.60 | $674.77 | 3.6× |
| Special dosimetry (77331) | $355.93 | $547.58 | 2.2× |
| Special Physics Consult (77370) | $966.86 | $1,487.48 | 6.1× |
| Special teletherapy port plan (77321) | $1,162.59 | $1,788.60 | 2.6× |
| Special treatment procedure (77470) | $1,258.20 | $1,935.69 | 1.9× |
| Spleen Imaging (78185) | $1,192.06 | $1,833.94 | 2.5× |
| Stereotactic Body Radiation Delivery (77373) | $23,495.06 | $36,146.25 | 11.1× |
| Sternoclavicular joints (71130) | $263.03 | $404.66 | 2.6× |
| Superior sagittal sinus venogram (75870) | $5,405.60 | $8,316.30 | 1.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $678.56 | $1,043.94 | 5.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,850.63 | $7,462.50 | 11.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $4,479.35 | $6,891.31 | 10.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $1,213.42 | $1,866.80 | 4.3× |
| Testicular Imaging W/Flow (78761) | $1,647.69 | $2,534.91 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,663.60 | $4,097.84 | 6.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,337.67 | $3,596.42 | 5.3× |
| Ther rad simulaj-aided field setting simple (77280) | $410.87 | $632.11 | 2.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $587.89 | $904.44 | 2.8× |
| Thoracic spine 2 views (72070) | $248.92 | $382.95 | 2.0× |
| Thoracic spine 3 views (72072) | $248.92 | $382.95 | 2.0× |
| Thoracolumbar 2 views (72080) | $205.54 | $316.21 | 2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,121.43 | $1,725.27 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $1,242.98 | $1,912.27 | 2.6× |
| Thyroid Met Imaging Body (78018) | $1,776.91 | $2,733.71 | 2.8× |
| Thyroid Uptake Measurement (78012) | $855.56 | $1,316.24 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,373.09 | $2,112.45 | 2.9× |
| Tx Devices Design & Construction Complex (77334) | $1,781.08 | $2,740.13 | 4.0× |
| Tx devices design & construction intermediate (77333) | $1,014.05 | $1,560.08 | 6.4× |
| Tx devices design & construction simple (77332) | $980.69 | $1,508.76 | 6.2× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$457.40–$914.78 | $703.69–$1,407.35 | varies |
| Ultrasound elastography first target lesion (76982) | $1,046.32 | $1,609.73 | 8.5× |
| Ultrasound Elastography Parenchyma (76981) | $1,046.32 | $1,609.73 | 8.5× |
| Ultrasound Exam Aaa Screen (76706) | $644.56 | $991.63 | 5.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $704.51 | $1,083.86 | 1.7× |
| Ultrasound, abdomen limited (76705) | $623.20 | $958.77 | 5.0× |
| Umbilical-artery Doppler (OB) (76820) | $296.14 | $455.60 | 2.4× |
| Unlisted Dx Radiographic Procedure (76499) | $161.03 | $247.74 | 1.6× |
| Unlisted fluoroscopic procedure (76496) | $216.37 | $332.88 | 2.1× |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$933.95–$2,631.45 | $1,436.84–$4,048.38 | varies |
| Unlisted us procedure (76999) | $201.29 | $309.68 | 2.0× |
| Upper gi w/o kub (74240) | $969.20 | $1,491.08 | 4.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $169.83 | $261.28 | 15.4× |
| Ureteral Reflux Study (78740) | $1,627.49 | $2,503.83 | 3.4× |
| Urethrocystogram voiding (74455) | $853.34 | $1,312.83 | 3.0× |
| Urethrocystography retrograde (74450) | $853.34 | $1,312.83 | 3.0× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$546.92–$914.78 | $841.41–$1,407.35 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$520.87–$546.92 | $801.34–$841.41 | varies |
| Us complete joint (76881) | $610.75 | $939.62 | 4.9× |
| Us exam, pelvic, limited (76857) | $332.61 | $511.70 | 2.7× |
| Us head (76506) | $1,031.93 | $1,587.58 | 8.4× |
| Us kidney transplant (76776) | $839.10 | $1,290.93 | 6.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $358.31 | $551.24 | 2.9× |
| Us ob detailed single fetus (76811) | $1,064.80 | $1,638.16 | 3.8× |
| Us ob limited 1 or more fetuses (76815) | $490.82 | $755.10 | 4.0× |
| Us ob transvaginal (76817) | $831.56 | $1,279.32 | 6.7× |
| Us pelvic non ob complete (76856) | $782.26 | $1,203.47 | 6.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $541.48 | $833.05 | 4.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $370.18 | $569.50 | 3.0× |
| Us retroperitoneal complete (76770) | $677.50 | $1,042.31 | 5.5× |
| Us retroperitoneal limited (76775) | $644.56 | $991.63 | 5.2× |
| Us scrotum and contents (76870) | $395.47 | $608.42 | 3.2× |
| Us spinal canal and contents (76800) | $507.34 | $780.53 | 4.1× |
| Us thyroid (76536) | $623.16 | $958.70 | 5.0× |
| Us transrectal (76872) | $679.71 | $1,045.70 | 5.5× |
| Vascular Flow Imaging (78445) | $936.34 | $1,440.53 | 2.0× |
| Vein X-Ray Chest (75827) | $3,902.70 | $6,004.15 | 2.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,698.65 | $8,767.16 | 1.5× |
| Vein X-Ray Skull Epidural (75872) | $7,113.27 | $10,943.49 | 9.6× |
| Vein X-Ray Spleen/Liver (75810) | $10,535.45 | $16,208.38 | 2.8× |
| Venogram Sinus/Jugular (75860) | $6,518.45 | $10,028.39 | 1.7× |
| Venography Adrenal Unilateral (75840) | $7,820.53 | $12,031.59 | 2.1× |
| Venography caval inferior serialography rs&i (75825) | $5,114.60 | $7,868.61 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $2,697.30 | $4,149.69 | 1.5× |
| Venography extremity unilateral rs&i (75820) | $2,875.07 | $4,423.19 | 1.5× |
| Venography Orbital Rs&I (75880) | $6,925.87 | $10,655.18 | 9.3× |
| Venography Renal Bilateral (75833) | $7,126.77 | $10,964.26 | 1.9× |
| Venography Renal Unilateral (75831) | $6,302.92 | $9,696.80 | 1.7× |
| Venous sampling by catheter (75893) | $8,473.96 | $13,036.86 | 1.3× |
| Venous thrombosis imaging (78457) | $2,975.46 | $4,577.63 | 4.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,018.69 | $1,567.21 | 2.2× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$451.35–$656.66 | $694.39–$1,010.24 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$279.83–$319.72 | $430.50–$491.87 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,007.64 | $1,550.22 | 2.4× |
| X-Ray Aorta Leg Arteries (75630) | $5,114.60 | $7,868.61 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $583 | $896.92 | 4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$254.84–$509.66 | $392.06–$784.09 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,325.47 | $2,039.18 | 2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $183.99 | $283.06 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $256.59 | $394.75 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $493.14 | $758.68 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $181.27 | $278.88 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $181.27 | $278.88 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $300.22 | $461.87 | 2.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $300.22 | $461.87 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $300.22 | $461.87 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $572.34 | $880.53 | 4.6× |
| X-Ray Exam L-S Spine Bending (72114) | $624.12 | $960.19 | 5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $341.74 | $525.75 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $898.20 | $1,381.84 | 7.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $339.86 | $522.86 | 2.8× |
| X-ray eye for foreign body (70030) | $184.67 | $284.11 | 1.8× |
| X-ray humerus (73060) | $306.16 | $471.02 | 3.0× |
| X-ray IV pyelogram+tomography (74415) | $596.21 | $917.25 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $243.56 | $374.70 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $294.44 | $452.99 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $400.96 | $616.86 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $580.26 | $892.70 | 5.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $617.72 | $950.34 | 5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $435.10 | $669.38 | 3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $248.92 | $382.95 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $205.54 | $316.21 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $302.30 | $465.08 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $340.25 | $523.46 | 2.8× |
| X-Ray Stress View (77071) | $183.99 | $283.06 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $248.92 | $382.95 | 2.0× |
| X-Ray Tmj Unilat (70328) | $183.99 | $283.06 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $917.40 | $1,411.39 | 2.2× |
| X-Rays Bone Length Studies (77073) | $459.71 | $707.25 | 3.7× |
| X-Rays Bone Survey Complete (77075) | $459.13 | $706.35 | 3.7× |
| Xr c-spine 4 or 5 views (72050) | $732.12 | $1,126.34 | 5.9× |
| Xr facial bones less than 3 views (70140) | $162.90 | $250.61 | 1.6× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$248.92–$408.85 | $382.95–$629 | varies |
| Xr orbits complete 4 views (70200) | $488.72 | $751.88 | 4.0× |
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.