Imaging prices at MedStar Washington Hospital Center

Washington, DC · every code in this section with a posted price and a Medicare benchmark.

476 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-Dimensional radiotherapy plan including dose-volume histograms (77295) $4,347.88 $6,689.04 3.0×
Acute gi blood loss imaging (78278) $1,931.59 $2,971.67 4.5×
Angio adrenal bilat select (75733) $4,402.98 $6,773.82 1.3×
Angio adrenal unilat select (75731) $4,402.98 $6,773.82 1.3×
Angio extremity unilateral (75710) $4,402.98 $6,773.82 1.3×
Angio pulmonary unilateral (75741) $4,402.98 $6,773.82 1.3×
Angiogram extremity bilateral (75716) $4,402.98 $6,773.82 1.3×
Angiogram pelvic (75736) $7,596.67 $11,687.19 1.3×
Angiography internal mammary rs&i (75756) $4,402.98 $6,773.82 1.3×
Angiography pulmonary bilateral slctv rs&i (75743) $4,402.98 $6,773.82 1.3×
Angiography visceral slctv/supraslctv rs&i (75726) $9,749.82 $14,999.73 1.6×
Angrph cath f-up std tcat other than thrombylsis (75898) $5,551.86 $8,541.33 1.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $4,402.98 $6,773.82 1.3×
Ankle 2 views (73600) $205.93 $316.82 2.2×
Arthrography knee lt (73580) $690.64 $1,062.52 1.9×
Arthrography wrist lt (73115) $690.64 $1,062.52 1.9×
Barium enema (74270) $951.43 $1,463.74 5.1×
Basic dosimetry (77300) $616.01 $947.71 4.3×
Bilat selctv renal venogram (75833) $4,402.98 $6,773.82 1.3×
Bone age studies (77072) $390.23 $600.36 3.5×
Bone imaging limited area (78300) $1,028.35 $1,582.08 2.4×
Bone marrow imaging whole body (78104) $1,371.23 $2,109.59 3.2×
Bone survey complete (77075) $575.61 $885.56 5.2×
Bowel imaging (78290) $1,920.61 $2,954.79 4.5×
Brachytx isodose pln cplx w/dosimetry cal (77318) $2,227.54 $3,426.99 5.6×
Brain flow imaging only - nm brain flow only brain death (78610) $932.07 $1,433.96 1.6×
Brain image w/flow 4 + views (78606) $1,922.81 $2,958.17 3.3×
Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) $914.54 $1,406.98 2.1×
Card MRI w/stress img & dye (75563) $2,868.22 $4,412.64 3.4×
Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) $1,530.44 $2,354.53 2.6×
Cardiac MRI w/stress img (75559) $1,838.63 $2,828.66 3.2×
Cardiac MRI w/wo contrast & further seq (75561) $2,471.43 $3,802.20 6.7×
Cardiac shunt detection (78428) $1,559.32 $2,398.95 3.7×
Cephalogram, orthodontic Other Diagnostic Radiology FS (70350) $205.08 $315.50 2.2×
Cerebrospinal fluid leakage (78650) $2,689.32 $4,137.42 2.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $960.49 $1,477.68 5.1×
Cisternogram (78630) $1,700.46 $2,616.09 2.9×
Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) $1,814.05 $2,790.84 2.2×
Clavicle complete (73000) $417.92 $642.94 4.5×
Computed tomographic (CT) colonography, screening, including image postprocessing UNSCHEDULED (74263) $591.17 $909.49 2.3×
Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) $288.67 $444.11 3.1×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) $1,407.16 $2,164.86 7.5×
Continuing medical physics consltj pr wk (77336) $886.43 $1,363.74 6.2×
Contrast exam abdominl aorta (75625) $4,402.98 $6,773.82 1.3×
Contrast exam thoracic aorta (75605) $7,596.67 $11,687.19 1.3×
Csf shunt evaluation (78645) $932.07 $1,433.96 1.6×
CT - st neck w&wo contr (70492) $1,479.45 $2,276.07 7.9×
CT abdomen and pelvis without and with contrast (74178) $2,598.26 $3,997.32 7.0×
CT abdomen and pelvis without contrast (74176) $1,698.63 $2,613.28 6.7×
CT abdomen w wo contrast (74170) $1,871.58 $2,879.35 10.0×
CT abdomen w/contrast (74160) $1,485.36 $2,285.17 8.0×
CT abdomen w/o contrast (74150) $1,188.30 $1,828.16 10.7×
CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) $2,722 $4,187.69 7.3×
CT angio abdom w/o & w/dye (74175) $2,196.36 $3,379.02 11.8×
CT angio abdominal arteries (75635) $1,892.77 $2,911.95 10.1×
CT angio hrt w/3d image (75574) $1,319.16 $2,029.48 3.6×
CT angiograph pelv w/o&w/dye (72191) $2,245.43 $3,454.50 12.0×
CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) $1,377.03 $2,118.51 7.4×
CT cervical spine w/contrast (72126) $1,895.52 $2,916.18 5.1×
CT cervical spine w/o contrast (72125) $1,712.13 $2,634.04 15.4×
CT chest w/contrast (71260) $2,130.21 $3,277.25 11.4×
CT colonography diag w cont (74262) $1,496.47 $2,302.26 8.0×
CT colonography w/o cntrst (74261) $1,301.26 $2,001.94 11.7×
CT extremity upper w & w/o contrast (73202) $1,783.80 $2,744.31 9.6×
CT head/brain with contrast (70460) $1,257.43 $1,934.51 6.7×
CT head/brain without and with contrast (70470) $1,526.88 $2,349.04 8.2×
CT heart contrast eval cardiac structure&morph (75572) $1,207.65 $1,857.92 3.3×
CT heart w/o contrast quant eval coronary calcium (75571) $320.83 $493.58 3.5×
CT hrt w/3d image congen (75573) $1,516.56 $2,333.17 4.1×
CT limited/localized follow up study (76380) $631.48 $971.50 6.8×
CT lower ext w/wo contrast (73702) $1,415.13 $2,177.12 7.6×
CT lower extremity w contrast (73701) $1,333.87 $2,052.11 7.1×
CT lower extremity w/o contrast unilateral (73700) $1,160.58 $1,785.50 10.4×
CT lumbar spine w/contrast (72132) $2,036.32 $3,132.80 5.5×
CT lumbar spine w/o contrast (72131) $1,777.91 $2,735.25 16.0×
CT lumbar spine w/o then w/ con (72133) $2,341.84 $3,602.83 12.5×
CT maxillofacial area w/o contrast (70486) $1,323.44 $2,036.06 11.9×
CT maxillofacial w/contrast (70487) $1,565.76 $2,408.86 8.4×
CT maxillofacial w/o then w/ con (70488) $1,904.80 $2,930.46 10.2×
CT orbit sella ear w/o con (70480) $1,164.48 $1,791.51 10.5×
CT orbit/ear/fossa w/o then w/ con (70482) $1,446.82 $2,225.87 7.7×
CT pelvis w & w/o contrast (72194) $2,523.99 $3,883.06 13.5×
CT pelvis w/o contrast (72192) $1,514.37 $2,329.80 13.6×
CT soft tissue neck w/contrast (70491) $1,223.96 $1,883.02 6.6×
CT soft tissue neck w/o contrast (70490) $1,063.48 $1,636.13 9.6×
CT spine cervical w/wo contrast (72127) $2,465.08 $3,792.43 13.2×
CT thoracic spine w/contrast (72129) $1,862.18 $2,864.89 10.0×
CT thoracic spine w/o contrast (72128) $1,396.40 $2,148.31 12.5×
CT thoracic spine w/o then w/ con (72130) $2,066.23 $3,178.82 11.1×
CT thorax lung cancer scr c- (71271) $1,465.65 $2,254.85 13.2×
CT thorax w/o contrast (71250) $1,465.65 $2,254.85 13.2×
CT thorax w/o then w/ contrast (71270) $2,370.91 $3,647.56 12.7×
CT upper extremity w/dye (73201) $1,485.71 $2,285.70 4.0×
CT upper extremity w/o contrast rt (73200) $1,304.31 $2,006.63 11.7×
CTA chest w/wo contrast (71275) $2,204.05 $3,390.85 11.8×
CTA head w contrast (70496) $2,024.83 $3,115.13 10.8×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,805.02 $5,853.88 10.2×
CTA lower extremity w/wo contrast unilateral (73706) $2,121.02 $3,263.12 11.4×
Cta Neck (70498) $1,780.19 $2,738.75 9.5×
CTA upper extremity w/wo contrast unilateral (73206) $1,476.94 $2,272.21 7.9×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Other Diagnostic Radiology FS (70170) $691.14 $1,063.29 2.7×
Dilation ureters/urethra rs&i (74485) $3,459.70 $5,322.62 1.6×
Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) $4,088.44 $6,289.91 2.0×
Diskography lumbar (72295) $4,088.44 $6,289.91 2.0×
Doppler echo fetal spectral display complete (76827) $468.30 $720.46 4.2×
Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) $432.65 $665.62 3.9×
Doppler fetal mid cerebral artery (76821) $433.60 $667.07 3.9×
Dxa bone density study axial skeleton (77085) $876.09 $1,347.83 7.9×
Echo exam of eye (76529) $149.20 $229.54 1.6×
Echo exam of eye thickness (76514) $72.92 $112.19 2.4×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,025.04 $1,576.98 4.0×
Esophageal motility (78258) $906.01 $1,393.86 2.1×
Esophogram (74220) $844.89 $1,299.83 4.5×
Fetal biophysical profile non-stress testing (76818) $458.56 $705.48 4.1×
Fetal biophysical profile w/o nst (76819) $515.88 $793.66 4.6×
Fetal echo complete (76825) $873.92 $1,344.49 1.5×
Full mouth X-ray of teeth (70320) $310.64 $477.91 1.2×
Functional MRI brain by phys/psych (70555) $1,183.98 $1,821.50 4.7×
Functional MRI brain by tech (70554) $1,183.98 $1,821.50 4.7×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $1,831.41 $2,817.55 3.2×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) $1,380.29 $2,123.52 3.2×
Gastric emptying study (78264) $1,916.22 $2,948.03 4.5×
Gastric mucosa imaging (78261) $1,054.45 $1,622.23 2.5×
Gastroesophageal reflux study (78262) $816.17 $1,255.65 1.9×
Gated heart planar single (78472) $1,483.90 $2,282.92 3.5×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $3,611.04 $5,555.45 4.9×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $3,611.04 $5,555.45 4.9×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $3,611.04 $5,555.45 4.9×
Heart infarct image (78466) $1,415.56 $2,177.78 3.3×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $4,402.98 $6,773.82 1.3×
Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) $4,402.98 $6,773.82 1.3×
Hepatobil syst image w/drug (78227) $2,603.21 $4,004.94 4.5×
Hepatobiliary system imaging (78226) $1,896.47 $2,917.65 4.5×
Humerus min 2 views (73060) $278.61 $428.63 3.0×
Hysterosalpingography (74740) $1,112.71 $1,711.86 4.4×
Imrt planning (77301) $9,411.59 $14,479.37 6.4×
Infusion of radioelement (77750) $993.02 $1,527.73 2.4×
Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) $1,054.45 $1,622.23 2.5×
Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) $3,763.75 $5,790.38 5.1×
Intracavitary radiation source applic complex (77763) $1,461.06 $2,247.79 2.0×
Intracavitary radiation source applic intermed (77762) $1,217.50 $1,873.08 2.1×
Intracavitary radiation source applic simple (77761) $1,057.65 $1,627.16 1.8×
Intraoperative radiation treatment delivery, x-ray, single treatment session 2nd-5th Sessions (77424) $38,202.77 $58,773.49 4.9×
Isodose brachytherapy intermed 5 to 10 sources (77317) $1,684.10 $2,590.92 4.2×
Isodose brachytherapy plan simple 1 to 4 source (77316) $1,093.74 $1,682.67 2.7×
Isodose teletherapy plan complex multi tx w/cal (77307) $3,987.44 $6,134.53 10.0×
Isodose teletherapy plan simple 1 or 2 port w/cal (77306) $3,511.08 $5,401.66 8.8×
Ivp w tomography (74415) $501.49 $771.53 2.7×
Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) $1,649.52 $2,537.72 2.9×
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) $1,762.57 $2,711.64 3.0×
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) $1,502.97 $2,312.26 2.6×
Kidney w vascular flow (78701) $1,354.80 $2,084.31 3.2×
Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) Age Under 21 (78140) $1,054.45 $1,622.23 2.5×
Liver & spleen; static only (78215) $1,026.19 $1,578.76 2.4×
Liver & spleen; w vasc flow (78216) $1,054.45 $1,622.23 2.5×
Liver imaging w/vascular flow (78202) $3,597.15 $5,534.08 6.2×
Lung perf&ventilat diferentl (78598) $1,705.56 $2,623.94 3.0×
Lung perfusion differential (78597) $742.66 $1,142.56 1.7×
Lung ventilat&perfus imaging (78582) $1,817.47 $2,796.11 3.1×
Lung ventilation imaging (78579) $1,044.80 $1,607.39 2.5×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) $3,045.13 $4,684.81 1.8×
Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) $1,726.36 $2,655.94 2.6×
Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) $5,852.86 $9,004.40 1.7×
Lymphangiography, pelvic/abdominal, unilateral (75805) $5,551.86 $8,541.33 1.7×
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) $2,637.64 $4,057.90 7.1×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) $2,150.77 $3,308.88 5.8×
Mammary ductogram multiple ducts (77054) $761.87 $1,172.10 3.0×
Mammary ductogram single (77053) $718.38 $1,105.20 2.8×
Mlc device(s) for imrt (77338) $1,780.40 $2,739.08 4.5×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $78.73 $121.13 2.6×
MRA head w & w/o contrast (70546) $2,295.77 $3,531.95 6.2×
MRA head w/contrast (70545) $1,616.02 $2,486.19 4.4×
MRA head w/o contrast (70544) $1,450.12 $2,230.95 5.7×
MRA neck w/contrast (70548) $1,975.97 $3,039.96 5.3×
MRA neck w/o contrast (70547) $1,481.97 $2,279.96 5.8×
MRA neck w/wo contrast (70549) $2,776.61 $4,271.70 7.5×
MRI abdomen w/contrast (74182) $1,935.97 $2,978.41 5.2×
MRI abdomen w/o & w/contrast material (74183) $2,723.14 $4,189.45 7.3×
MRI abdomen w/o contrast (74181) $1,683.39 $2,589.83 6.6×
MRI any jnt lwr ext with con lt (73722) $1,857.47 $2,857.65 2.2×
MRI breast without contrast bilateral (77047) $1,559.62 $2,399.41 6.1×
MRI breast without contrast material unilateral (77046) $1,559.62 $2,399.41 6.1×
MRI cardiac w/o contrast (75557) $1,443.83 $2,221.28 5.7×
MRI cervical spine w/o contrast (72141) $2,396.86 $3,687.48 9.4×
MRI cervical spine with contrast (72142) $2,755.79 $4,239.67 7.4×
MRI chest w & w/o contrast (71552) $3,165.86 $4,870.56 8.5×
MRI chest w/contrast (71551) $2,677.02 $4,118.49 3.2×
MRI chest w/o contrast (71550) $2,380.81 $3,662.79 9.4×
MRI fetal sngl/1st gestation (74712) $595.71 $916.47 2.3×
MRI joint upper ext w/contrast (73222) $2,587.14 $3,980.22 3.1×
MRI joint upr extr w/o&w/dye (73223) $2,728.88 $4,198.28 7.3×
MRI joint upr extrem w/o dye (73221) $2,207.83 $3,396.66 8.7×
Mri Lower Extremity W/O Dye (73718) $1,584.35 $2,437.46 6.2×
MRI lumbar spine with contrast (72149) $2,755.79 $4,239.67 7.4×
MRI lumbar w/wo contrast (72158) $3,855.74 $5,931.91 10.4×
MRI lwr ext w/o jnts with con rt (73719) $1,822.02 $2,803.10 4.9×
MRI orbit/face/neck w/contrast (70542) $2,093.59 $3,220.90 5.6×
MRI orbit/face/neck w/o & w/contrast (70543) $2,294.40 $3,529.84 6.2×
MRI orbit/face/neck w/o contrast (70540) $1,903.27 $2,928.10 7.5×
MRI pelvis w/ contrast (72196) $2,856.35 $4,394.39 7.7×
MRI pelvis w/o contrast (72195) $2,380.81 $3,662.79 9.4×
MRI pelvis w/wo contrast (72197) $4,213.52 $6,482.34 11.3×
MRI spectroscopy (76390) $2,545.43 $3,916.05 27.5×
MRI spine cervical wo/w contrast (72156) $3,855.74 $5,931.91 10.4×
MRI spine thoracic w/contrast (72147) $2,755.79 $4,239.67 7.4×
MRI thoracic spine w wo contrast (72157) $3,855.74 $5,931.91 10.4×
MRI thoracic spine w/o contrast (72146) $2,396.86 $3,687.48 9.4×
MRI tmj (70336) $1,777.54 $2,734.67 7.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,258.71 $3,474.94 8.9×
Mri Upper Extremity W/Dye (73219) $2,478.49 $3,813.06 6.7×
MRI upr ext w/o jnts w/o-w/con rt (73220) $2,655.53 $4,085.43 7.1×
Myelogram thoracic (72255) $1,094.84 $1,684.37 1.3×
Myelography 2 or more regions (72270) $1,094.16 $1,683.33 1.3×
Myelography lumbosacral (72265) $1,094.16 $1,683.33 1.3×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) $5,830.29 $8,969.68 3.8×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) $5,830.29 $8,969.68 3.8×
Myocardial perfusion planar 1 study rest/stress (78453) $3,667.16 $5,641.79 2.7×
Myocardial perfusion planar multiple studies (78454) $3,667.16 $5,641.79 2.7×
Myocardial spect single study at rest or stress (78451) $3,673.90 $5,652.15 2.7×
Myocrd img PET metab eval single study (78459) $3,525.22 $5,423.41 2.6×
Myocrd img PET metab eval single study cncrnt CT (78429) $4,304.90 $6,622.93 2.8×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $4,304.90 $6,622.93 2.8×
Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) $6,713.92 $10,329.10 2.9×
Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) $8,205.57 $12,623.95 3.5×
Myocrd img PET prfuj w/metab dual radiotracer (78432) $8,205.57 $12,623.95 5.1×
N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) $3,062.71 $4,711.86 3.3×
Nm adrenal imaging (78075) $4,882.90 $7,512.16 3.5×
Nm bone 3 phase (78315) $1,907.44 $2,934.52 4.5×
Nm bone imaging whole body (78306) $1,349.95 $2,076.85 3.2×
Nm bone marrow scan limited (78102) $1,286.86 $1,979.78 3.0×
Nm bone marrow scan multiple (78103) $1,286.86 $1,979.78 3.0×
Nm bone multi (78305) $1,204 $1,852.31 2.8×
Nm heart perfusion spect stress rest (78452) $4,075.25 $6,269.61 3.0×
Nm kidney function (78725) $1,054.45 $1,622.23 2.5×
Nm kidney imaging morphology (78700) $1,275.76 $1,962.71 3.0×
Nm liver image static only (78201) $3,597.15 $5,534.08 6.2×
Nm lymph system (78195) $1,918.41 $2,951.40 3.3×
Nm myocard infarct spect (78469) $1,540.39 $2,369.83 2.7×
Nm thyroid ca mets limited (78015) $1,401.01 $2,155.40 3.3×
Nm thyroid imaging only (78013) $1,381.09 $2,124.76 3.2×
Nose to rectum for fb child (76010) $589.12 $906.34 6.4×
Nuclear medicine study of brain, 4 static views or more (78605) $1,358.80 $2,090.46 2.4×
Nuclear medicine study of brain, less than 4 static views (78600) $1,054.45 $1,622.23 2.5×
Nuclear medicine study of red blood cell survival (78130) $1,054.45 $1,622.23 2.5×
Nuclear medicine study of salivary gland with serial images (78231) $824.38 $1,268.28 1.9×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $1,130.98 $1,739.97 2.7×
Nuclear rx IV admin (79101) $1,387.01 $2,133.86 5.6×
Ob us < 14 wks single fetus (76801) $630.51 $970.02 5.7×
Ob us nuchal meas 1 gest (76813) $361.60 $556.30 3.2×
Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Age Under 21 (76519) $618.35 $951.30 5.6×
Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) $215.02 $330.80 1.9×
Ophthalmic us dx quantitative a-scan only (76511) $229.87 $353.64 2.1×
Oral radiopharm rx (79005) $1,117.02 $1,718.49 4.5×
Orthopantogram (70355) $161.99 $249.21 1.7×
Parathyrd planar w/spect&CT (78072) $2,166.40 $3,332.92 3.7×
Parathyroid imaging (78070) $1,681.30 $2,586.61 3.9×
Parathyroid planar imaging w/wo subtraction (78071) $1,927.20 $2,964.92 4.5×
Peritoneal-venous shunt patency test (78291) $1,054.45 $1,622.23 2.5×
PET brain metabolic eval (78608) $8,155.62 $12,547.11 5.4×
PET imaging CT attenuation skull base mid-thigh (78815) $6,847.74 $10,534.98 4.5×
PET imaging CT for attenuation limited area (78814) $5,228.87 $8,044.41 3.4×
PET imaging for CT attenuation whole body (78816) $7,904.44 $12,160.68 5.2×
PET imaging limited area chest head/neck (78811) $2,521.87 $3,879.80 1.8×
PET imaging whole body (78813) $5,533.70 $8,513.39 3.6×
Plasma volume multiple (78111) $3,667.16 $5,641.79 2.7×
Platelet survival study (78191) $1,054.45 $1,622.23 2.5×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $5,551.86 $8,541.33 1.7×
Pulmonary perfusion imaging particulate (78580) $1,334.80 $2,053.54 3.1×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $3,062.71 $4,711.86 3.1×
Radex abscess/fistula/sinus tract rs&i (76080) $929.55 $1,430.08 1.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $151.39 $232.90 1.6×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $205.48 $316.13 1.8×
Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) $201.38 $309.81 1.8×
Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) $201.38 $309.81 1.8×
Radex hip unilateral with pelvis 1 view (73501) $115.57 $177.80 1.2×
Radex hip unilateral with pelvis 2-3 views (73502) $134.39 $206.76 1.5×
Radex hip unilateral with pelvis minimum 4 views (73503) $201.38 $309.81 1.8×
Radex hips bilateral with pelvis 2 views (73521) $177.57 $273.19 1.6×
Radex hips bilateral with pelvis minimum 5 views (73523) $338.53 $520.82 3.0×
Radex spine cervical 2 or 3 views (72040) $340.33 $523.58 3.7×
Radex spine cervical 4 or 5 views (72050) $492.84 $758.21 4.4×
Radex spine cervical 6 or more views (72052) $588.80 $905.84 5.3×
Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) $278.61 $428.63 3.0×
Radiation delivery stereotactic cranial linear (77372) $14,208.55 $21,859.30 1.8×
Radiation tx delivery lvl 1 (77402) $352.55 $542.39 3.2×
Radiation tx delivery lvl 2 (77407) $1,332.75 $2,050.38 3.2×
Radiation tx delivery lvl 3 (77412) $1,909.26 $2,937.33 3.2×
Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) $649.32 $998.95 5.8×
Radiologic exam phrnx&/crv esoph contrast study (74210) $375.16 $577.17 2.0×
Radiologic exam upr gi trc double contrast study (74246) $978.78 $1,505.81 5.2×
Radiologic exam upr gi trc single contrast study (74240) $480.71 $739.55 2.6×
Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) $115.57 $177.80 1.2×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $173.36 $266.70 1.9×
Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) $517.09 $795.52 4.6×
Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) $231.36 $355.94 2.1×
Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) $321.53 $494.66 2.9×
Radiologic examination, teeth; partial examination, less than full mouth Other Diagnostic Radiology FS (70310) $310.64 $477.91 1.2×
Radiologic examination, teeth; single view Other Diagnostic Radiology FS (70300) $119.10 $183.23 1.3×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Other Diagnostic… (70370) $160.51 $246.94 1.7×
Radiopharmaceutical dacryocystography Age Under 21 (78660) $911.72 $1,402.65 2.1×
Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion UNSCHEDULED (79403) $1,906.35 $2,932.85 7.7×
Red cell mass multiple (78121) $1,358.80 $2,090.46 2.4×
Renal cyst study (74470) $1,262.86 $1,942.86 2.2×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,465.91 $2,255.24 3.4×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,093.20 $1,681.85 2.6×
Rp loclzj tum plnr whole body 2+ days imaging (78804) $4,675.46 $7,193.01 8.1×
Rp loclzj tum plnr whole body single day imaging (78802) $2,452.18 $3,772.58 4.2×
Rp loclzj tum spect 1 area single day imaging (78803) $2,452.18 $3,772.58 4.2×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,794.91 $5,838.32 2.8×
Rp loclzj tum spect CT 2area/sep acquisj img (78832) $4,304.90 $6,622.93 2.8×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $3,794.91 $5,838.32 2.8×
Rp therapy intra-arterial particulate admn (79445) $1,408.99 $2,167.68 5.7×
Saline infused sonohysterogram (76831) $1,130.47 $1,739.18 4.4×
Salivary gland funct study (78232) $906.47 $1,394.57 2.1×
Salivary gland imaging (78230) $1,054.45 $1,622.23 2.5×
Screening digital breast tomosynthesis; bilateral (77063) $153.56 $236.25 6.6×
Selective spinal angiogram (75705) $9,749.82 $14,999.73 1.6×
Shoulder arthrogram (73040) $767.38 $1,180.58 2.1×
Shuntogram indwelling nonvascular shunt rs&i (75809) $671.74 $1,033.45 6.0×
Simulation complex (77290) $2,656.37 $4,086.72 6.7×
Simulation intermediate (77285) $2,331.32 $3,586.64 5.8×
Simulation simple (77280) $859.94 $1,322.98 6.0×
Small bowel series (74250) $1,216.38 $1,871.36 6.5×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,355.22 $2,084.96 3.4×
Special dosimetry (77331) $700.78 $1,078.12 4.9×
Special physics consult (77370) $886.43 $1,363.74 6.2×
Special treatment procedure (77470) $1,583.56 $2,436.25 2.7×
Spleen imaging only (78185) $1,054.45 $1,622.23 2.5×
Splenoportography (75810) $4,402.98 $6,773.82 1.3×
Stereotactic body radiation delivery (77373) $12,561.80 $19,325.84 6.6×
Superior sagittal sinus venogram (75870) $5,852.86 $9,004.40 1.7×
Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) $412.65 $634.84 1.6×
Testicular imaging w/flow (78761) $1,472.05 $2,264.69 3.5×
Therapeutic enema barium or air (74283) $401.19 $617.22 2.1×
Thyroid met imaging body (78018) $2,527.32 $3,888.19 4.4×
Thyroid uptake single/multiple quant measurement (78012) $718.09 $1,104.76 1.7×
Thyroid uptake w/blood flow sngle/mult quan meas (78014) $1,605.43 $2,469.89 3.8×
Treatment device intermediate (77333) $912.16 $1,403.33 6.4×
Treatment devices complex (77334) $1,970.02 $3,030.80 4.9×
Treatment devices simple (77332) $875.69 $1,347.21 6.1×
Ultrasound breast limited (76642) $920.84 $1,416.68 9.9×
Ultrasound, abdomen limited (76705) $366.59 $563.99 3.3×
Ultrasound, elastography; first target lesion (76982) $858.64 $1,320.99 7.7×
Umbilical-artery Doppler (OB) (76820) $288.57 $443.95 2.6×
Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) $1,054.45 $1,622.23 2.5×
Unlisted CT procedure (76497) $1,655.02 $2,546.18 17.9×
Unlisted diagnostic radiographic procedure (76499) $744.65 $1,145.61 8.0×
Unlisted fluoroscopic procedure (76496) $161.23 $248.04 1.7×
Unlisted gastrointestinal procedure, diagnostic nuclear medicine UNSCHEDULED (78299) $1,063.43 $1,636.05 2.5×
Unlisted magnetic resonance procedure (76498) $2,317.02 $3,564.65 25.0×
Urea breath test, C-14 (isotopic); acquisition for analysis Other Outpatient (78267) $521.14 $801.76 47.1×
Ureteral reflux study (78740) $1,054.45 $1,622.23 2.5×
Urethrocystography retrograde rs&i (74450) $569.24 $875.75 2.2×
Urethrocystography voiding (74455) $1,203.51 $1,851.55 4.7×
Urography antegrade (74425) $2,593.87 $3,990.57 7.0×
Urography retrograde w/wo kub (74420) $729.64 $1,122.53 2.0×
Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) $501.49 $771.53 2.7×
Us abdominal aorta real time screen study aaa (76706) $438.37 $674.42 3.9×
Us breast uni real time with image complete (76641) $920.84 $1,416.68 8.3×
Us chest (76604) $399.15 $614.07 3.6×
Us compl joint r-t w/image documentation (76881) $415.94 $639.91 3.7×
Us elastography parenchyma (76981) $858.64 $1,320.99 7.7×
Us encephalogram (76506) $426.29 $655.83 3.8×
Us guided compression repair (76936) $852.59 $1,311.68 3.7×
Us inft hips r-t img dynamic req phys/qhp manj (76885) $422.27 $649.65 4.6×
Us inft hips r-t img lmtd static phys/qhp manj (76886) $358.15 $551 3.9×
Us kidney transplanted (76776) $523.93 $806.04 4.7×
Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) $305.30 $469.69 2.7×
Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $244.16 $375.63 2.2×
Us ob detailed single fetus (76811) $642.79 $988.90 2.5×
Us ob followup per fetus (76816) $612.57 $942.41 5.5×
Us ob limited 1 or more fetuses (76815) $409.75 $630.38 3.7×
Us obstetric transvaginal (76817) $630.51 $970.02 5.7×
Us pelvic limited or f/u non-ob (76857) $396.55 $610.08 3.6×
Us pelvis complete (76856) $630.51 $970.02 5.7×
Us retroperitoneal complete (76770) $534.75 $822.69 4.8×
Us retroperitoneal limited (76775) $321.09 $493.98 2.9×
Us scrotum (76870) $528.24 $812.68 4.7×
Us soft tissue head/neck (76536) $466.03 $716.97 4.2×
Us spinal canal (76800) $507.59 $780.90 4.6×
Us transrectal (76872) $714.98 $1,099.97 6.4×
Us transrectal prostate volume (76873) $1,027.87 $1,581.34 9.2×
Us trgt dyn mbubb 1st les (76978) $589.40 $906.77 1.6×
Us unlstd proc (76999) $115.57 $177.80 1.2×
Vascular flow imaging (78445) $1,054.45 $1,622.23 2.5×
Vein X-ray liver w/hemodynam (75885) $4,640.77 $7,139.65 1.4×
Venogram extremity bilateral (75822) $2,350.92 $3,616.80 1.4×
Venogram ivc w serialography (75825) $4,402.98 $6,773.82 1.3×
Venogram svc w serialography (75827) $2,254.38 $3,468.27 1.3×
Venography adrenal unilateral selective rs&i (75840) $4,402.98 $6,773.82 1.3×
Venography ext unilateral (75820) $2,350.92 $3,616.80 1.4×
Venography renal unilateral selective rs&i (75831) $4,402.98 $6,773.82 1.3×
Venography venous sinus/jugular cath rs&i (75860) $4,402.98 $6,773.82 1.3×
Venous sampling by catheter (75893) $9,254.94 $14,238.37 1.6×
Venous thrombosis imaging - nm extremity veins thrombosis right (78457) $2,444.77 $3,761.19 4.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $251.55 $387 2.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $301.03 $463.13 3.2×
X-ray aorta leg arteries (75630) $4,402.98 $6,773.82 1.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,354.34 $2,083.60 7.3×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $492.44 $757.59 5.3×
X-ray exam hips bi 3-4 views (73522) $177.57 $273.19 1.6×
X-ray exam of finger(s) (73140) $325.54 $500.84 3.5×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $1,094.67 $1,684.10 5.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $205.93 $316.82 2.2×
X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) $205.93 $316.82 2.2×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $242.66 $373.32 2.6×
X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) $278.61 $428.63 2.5×
X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) $328.29 $505.06 3.5×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $308.90 $475.22 3.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $301.03 $463.13 3.2×
X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) $384.52 $591.56 4.1×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $451.40 $694.46 4.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $144.20 $221.85 1.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $407.30 $626.61 3.7×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $515.55 $793.16 4.6×
X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) $231.36 $355.94 2.1×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $296.91 $456.78 3.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $342.67 $527.19 3.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $298.22 $458.80 2.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $277.55 $427 2.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $399.52 $614.65 4.3×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $344.67 $530.26 3.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $297.06 $457.02 3.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $372.31 $572.78 3.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $270.37 $415.96 2.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $420.50 $646.92 4.5×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $205.93 $316.82 2.2×
X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) $278.61 $428.63 3.0×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $310.90 $478.30 3.4×
Xr abdomen 1 view (74018) $319.14 $490.98 3.4×
Xr abdomen 2 views (74019) $418.11 $643.24 3.8×
Xr abdomen 3 views (74021) $350.79 $539.68 3.2×
Xr arthrogram ankle (73615) $690.64 $1,062.52 1.9×
Xr arthrogram elbow (73085) $767.38 $1,180.58 2.1×
Xr arthrogram hip (73525) $767.38 $1,180.58 2.1×
Xr bone density appendicular (77081) $365.36 $562.09 3.9×
Xr bone density axial (77080) $548.50 $843.85 4.9×
Xr bone length study (77073) $401.72 $618.03 3.6×
Xr bone survey infant (77076) $407.30 $626.61 3.7×
Xr bone survey limited (77074) $310.90 $478.30 2.8×
Xr chest 1 view (71045) $413.09 $635.53 4.5×
Xr chest 2 views (71046) $437.57 $673.18 4.7×
Xr chest 3 views (71047) $648.99 $998.45 7.0×
Xr cystogram 3+ views (74430) $1,204.07 $1,852.42 3.2×
Xr eye foreign body (70030) $418.11 $643.24 4.5×
Xr facial bones 3 views (70150) $372.31 $572.78 3.3×
Xr joint survey 1 view (77077) $201.38 $309.81 1.8×
Xr lower extremity 2 views infant (73592) $173.36 $266.70 1.9×
Xr lumbar spine 4 views w/ flex ext (72120) $504.40 $776 4.5×
Xr mandible 4 views (70110) $346.56 $533.17 3.1×
Xr myelogram c-spine (72240) $1,094.84 $1,684.37 1.3×
Xr nasal bones (70160) $217.60 $334.77 2.3×
Xr pelvis 3 views (72190) $407.30 $626.61 3.7×
Xr sialogram (70390) $732 $1,126.16 2.9×
Xr spine 1 view (72020) $234.77 $361.18 2.5×
Xr sternum 2 views (71120) $278.61 $428.63 3.0×
Xr stress view joint (77071) $115.57 $177.80 1.2×
Xr surgical specimen (76098) $879.55 $1,353.16 1.5×
Xr upper extremity 2 views infant (73092) $213.26 $328.10 1.9×
Xray elbow 2 views (73070) $417.92 $642.94 4.5×
Xray forearm 2 views (73090) $417.92 $642.94 4.5×
Xray knee 1 or 2 views rt (73560) $193.82 $298.18 2.1×
Xray neck soft tissue (70360) $286.02 $440.03 3.1×
Xray optic foramina (70190) $115.57 $177.80 1.2×
Xray orbits complete min 4 views (70200) $209.80 $322.77 1.9×
Xray pelvis 1 or 2 views (72170) $278.61 $428.63 2.5×
Xray ribs bilateral 3 views (71110) $321.87 $495.19 2.9×
Xray ribs unilat w/ pa chest 3v rt (71101) $302.07 $464.72 2.7×
Xray scapula complete (73010) $417.92 $642.94 3.8×
Xray shoulder 1 view (73020) $290.72 $447.27 3.1×
Xray sinuses paranasal <3 views (70210) $229.78 $353.50 2.5×
Xray spine thoracic 2 views (72070) $193.82 $298.18 1.7×
Xray spine thoracic 3 views (72072) $142.17 $218.73 1.3×
Xray tibia-fibula 2 views bil (73590) $205.93 $316.82 2.2×
Xray tmj open - closed unilat (70328) $205.82 $316.64 2.2×
Xray tmj's bilateral open-clsc (70330) $342.67 $527.19 3.7×