Imaging prices at MelroseWakefield Hospital
Melrose, MA · every code in this section with a posted price and a Medicare benchmark.
408 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) | $3,855.60 | $5,508 | 2.3× |
| Abdomen 1 View (74018) | $198.10 | $283 | 1.9× |
| Abdomen 2 views (74019) | $152.60 | $218 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $548.80 | $784 | 1.1× |
| Angio internal mammary (75756) | $1,147.30 | $1,639 | 0.3× |
| Angio pulmonary bilat (75743) | $987 | $1,410 | 0.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,147.30 | $1,639 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $7,006.30 | $10,009 | 1.9× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$5,745.60–$8,618.40 | $8,208–$12,312 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,147.30 | $1,639 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,147.30 | $1,639 | 0.3× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$100.10–$300.30 | $143–$429 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$745.50 | $1,065 | 0.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,053 | $5,790 | 1.1× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$745.78–$4,319 | $1,065.40–$6,170 | varies |
| Artery X-Rays Adrenal Gland (75731) | $1,147.30 | $1,639 | 0.3× |
| Artery X-Rays Pelvis (75736) | $4,319 | $6,170 | 0.6× |
| Artery X-Rays Spine (75705) | $11,900 | $17,000 | 1.8× |
| Arthrogram ankle (73615) | $926.80 | $1,324 | 2.2× |
| Arthrogram hip (73525) | $544.60 | $778 | 1.3× |
| Arthrogram Wrist (73115) | $655.20 | $936 | 1.6× |
| Basic radiation dosimetry calculation (77300) | $315 | $450 | 2.0× |
| Bone age studies (77072) | $215.60 | $308 | 1.7× |
| Bone Imaging 3 Phase (78315) | $695.10 | $993 | 1.5× |
| Bone Imaging Limited Area (78300) | $948.50 | $1,355 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $143.50 | $205 | 0.3× |
| Bone Imaging Whole Body (78306) | $918.40 | $1,312 | 1.9× |
| Bone marrow imaging limited area (78102) | $191.10 | $273 | 0.4× |
| Bone marrow imaging; multiple areas (78103) | $189 | $270 | 0.4× |
| Bone marrow imaging; whole body (78104) | $283.50 | $405 | 0.6× |
| Bone survey infant (77076) | $81.90 | $117 | 0.7× |
| Brain Flow Imaging Only (78610) | $279.30 | $399 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $1,002.40 | $1,432 | 2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $592.90 | $847 | 0.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $335.30 | $479 | 0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,361 | $6,230 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $141.40 | $202 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $956.20 | $1,366 | 1.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$88.90–$177.80 | $127–$254 | varies |
| Chest 2 views (71046) | $198.10 | $283 | 1.9× |
| Chest 3 views (71047) | $140 | $200 | 1.3× |
| Chest 4 or more views (71048) | $170.80 | $244 | 1.4× |
| Cholecystography Oral Contrast (74290) | $143.50 | $205 | 0.7× |
| Clavicle complete (73000) | $196 | $280 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,096.20 | $1,566 | 8.7× |
| Continuing medical physics consltj pr wk (77336) | $434.70 | $621 | 2.7× |
| Contrast Exam Abdominl Aorta (75625) | $7,006.30 | $10,009 | 1.9× |
| Contrast X-Ray Bladder (74430) | $810.60 | $1,158 | 1.9× |
| Contrast X-Ray Of Elbow (73085) | $488.60 | $698 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $489.30 | $699 | 1.2× |
| Contrast Xray Throat/Cerv Esopha (74210) | $281.40 | $402 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $1,290.80 | $1,844 | 3.1× |
| CT abdomen and pelvis without contrast (74176) | $1,297.80 | $1,854 | 4.5× |
| CT abdomen w contrast (74160) | $747.60 | $1,068 | 3.6× |
| CT abdomen w wo contrast (74170) | $1,446.90 | $2,067 | 6.9× |
| CT abdomen w/o contrast (74150) | $511 | $730 | 4.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,214.50 | $1,735 | 2.9× |
| CT Angio Chest (71275) | $523.60 | $748 | 2.5× |
| CT Angio Head (70496) | $842.10 | $1,203 | 4.0× |
| CT angio hrt w/3d image (75574) | $931.70 | $1,331 | 2.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$668.85–$1,337.70 | $955.50–$1,911 | varies |
| CT Angio Neck (70498) | $782.60 | $1,118 | 3.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$386.40–$772.80 | $552–$1,104 | varies |
| CT bone density (77078) | $202.30 | $289 | 1.9× |
| CT cervical spine w/ contrast (72126) | $651.70 | $931 | 1.6× |
| CT cervical spine w/o contrast (72125) | $822.50 | $1,175 | 6.6× |
| CT cervical spine w/wo cont (72127) | $1,052.10 | $1,503 | 5.0× |
| CT chest w contrast (71260) | $1,331.40 | $1,902 | 6.3× |
| CT chest w/wo contrast (71270) | $919.10 | $1,313 | 4.4× |
| CT head/brain with contrast (70460) | $861 | $1,230 | 4.1× |
| CT head/brain without and with contrast (70470) | $793.10 | $1,133 | 3.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $600.60 | $858 | 1.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $599.20 | $856 | 5.7× |
| CT hrt w/3d image congen (75573) | $202.30 | $289 | 0.5× |
| CT iac w contrast (70481) | $600.60 | $858 | 2.9× |
| CT l-spine w&w/o contrast (72133) | $1,281 | $1,830 | 6.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,278.20–$1,917.30 | $1,826–$2,739 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$703.50–$1,055.25 | $1,005–$1,507.50 | varies |
| CT lumbar spine w contrast (72132) | $712.60 | $1,018 | 1.7× |
| CT lumbar spine w/o contrast (72131) | $455.70 | $651 | 3.6× |
| CT maxillofacial w contrast (70487) | $651.70 | $931 | 3.1× |
| CT maxillofacial wo contrast (70486) | $751.10 | $1,073 | 6.0× |
| CT neck tissue combo (70492) | $756 | $1,080 | 3.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $687.40 | $982 | 3.3× |
| CT orbits w/o contrast (70480) | $445.20 | $636 | 3.6× |
| CT pelvis w&w/o contrast (72194) | $744.80 | $1,064 | 3.5× |
| CT pelvis w/o contrast (72192) | $511 | $730 | 4.1× |
| CT scan of leg combo (73702) | $1,446.90 | $2,067 | 6.9× |
| CT scans face/jaw combo (70488) | $641.20 | $916 | 3.1× |
| CT soft tissue neck w contrast (70491) | $1,148 | $1,640 | 5.5× |
| CT soft tissue neck w/o contrast (70490) | $1,198.40 | $1,712 | 9.6× |
| CT thoracic spine w contrast (72129) | $712.60 | $1,018 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $586.60 | $838 | 4.7× |
| CT thoracic spine w/wo cont (72130) | $966.70 | $1,381 | 4.6× |
| CT thorax w/o contrast (71250) | $1,339.80 | $1,914 | 10.7× |
| CT upper ext wo (73200) | $1,271.20 | $1,816 | 10.1× |
| CT upper extremity w/o & w/contrast material (73202) | $788.90 | $1,127 | 3.8× |
| CT upper extremity with contrast (73201) | $712.60 | $1,018 | 1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $854 | $1,220 | 4.1× |
| Cta Abdomen (74175) | $945 | $1,350 | 4.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,624.70 | $2,321 | 3.9× |
| CTA pelvis (72191) | $1,024.80 | $1,464 | 4.9× |
| Dilation ureters/urethra rs&i (74485) | $690.90 | $987 | 0.3× |
| Discography Cerv/Thor Spine (72285) | $583.80 | $834 | 0.2× |
| Diskography lumbar (72295) | $691.60 | $988 | 0.3× |
| Dxa Bone Density Axial (77080) | $331.10 | $473 | 2.6× |
| Dxa bone density study (77085) | $474.60 | $678 | 3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $112.70 | $161 | 1.1× |
| Echo exam uterus (76831) | $553 | $790 | 1.9× |
| Echo Guide For Artery Repair (76936) | $309.40 | $442 | 1.2× |
| Esophagram (74220) | $440.30 | $629 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$282.80–$296.80 | $404–$424 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$177.10–$354.20 | $253–$506 | varies |
| Fluoroscopy up to 1 hr (76000) | $571.20 | $816 | 2.0× |
| Follow-Up Angiography (75898) | $157.50 | $225 | 0.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$141.40–$212.10 | $202–$303 | varies |
| Forearm 2 views (73090) | $200.20 | $286 | 1.9× |
| Gastric emptying imaging study (78264) | $948.50 | $1,355 | 2.0× |
| Gastroesophageal Reflux Exam (78262) | $398.30 | $569 | 0.8× |
| Gated Heart Planar Single (78472) | $935.90 | $1,337 | 2.0× |
| Gated Heart, Multiple (78473) | $909.30 | $1,299 | 1.9× |
| GI Endoscopic US S&I (76975) | $770.70 | $1,101 | 2.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$94.19–$141.28 | $134.55–$201.83 | varies |
| Heart first pass single,planar (78481) | $398.30 | $569 | 0.6× |
| Heart Image (Pet) Multiple (78492) | $3,674.30 | $5,249 | 2.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,147.30 | $1,639 | 0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,147.30 | $1,639 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,190.70 | $1,701 | 1.8× |
| Hepatobiliary System Imaging (78226) | $918.40 | $1,312 | 1.9× |
| Ht Musc Image Planar Mult (78454) | $1,423.10 | $2,033 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $2,816.10 | $4,023 | 1.8× |
| Hysterosalpingogram (74740) | $683.90 | $977 | 2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$375.20–$562.80 | $536–$804 | varies |
| Infant hip ultrasound, limited static exam (76886) | $198.10 | $283 | 1.9× |
| Infusion Ivp (74410) | $209.30 | $299 | 1.0× |
| Joint Survey Single View (77077) | $140 | $200 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $730.10 | $1,043 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $993.30 | $1,419 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $993.30 | $1,419 | 1.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $150.50 | $215 | 0.3× |
| Kidney Imaging Morphol (78700) | $289.10 | $413 | 0.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,281 | $1,830 | 2.7× |
| Liver & Spleen Imaging Static Only (78215) | $536.20 | $766 | 1.1× |
| Liver imaging static only (78201) | $517.30 | $739 | 0.8× |
| Liver imaging w/vascular flow (78202) | $3,206.70 | $4,581 | 4.9× |
| Lung Perf&Ventilat Diferentl (78598) | $737.80 | $1,054 | 1.1× |
| Lung perfusion differential (78597) | $618.80 | $884 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,190.70 | $1,701 | 1.8× |
| Lung Ventilation Imaging (78579) | $618.10 | $883 | 1.3× |
| Lymph System Imaging (78195) | $743.40 | $1,062 | 1.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $493.50 | $705 | 0.3× |
| Lymphangiography extremity only unilateral rs&i (75801) | $493.50 | $705 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $557.90 | $797 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $557.90 | $797 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $1,078 | $1,540 | 3.8× |
| Mammary ductogram or galactogram multiple (77054) | $403.20 | $576 | 1.4× |
| Mammary ductogram or galactogram single (77053) | $816.20 | $1,166 | 2.9× |
| Meckels Divert Exam (78290) | $681.80 | $974 | 1.4× |
| Medical physics dose eval radiation expos w/rprt (76145) | $627.20 | $896 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $847 | $1,210 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,851.50 | $2,645 | 4.4× |
| MRA head w/o contrast (70544) | $1,051.40 | $1,502 | 3.7× |
| MRA head with contrast (70545) | $1,051.40 | $1,502 | 2.5× |
| MRA neck w contrast (70548) | $1,051.40 | $1,502 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,851.50 | $2,645 | 4.4× |
| MRA neck w/o contrast (70547) | $1,949.50 | $2,785 | 6.8× |
| MRI abdomen w contrast (74182) | $1,612.10 | $2,303 | 3.9× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$836.85–$1,673.70 | $1,195.50–$2,391 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,043 | $1,490 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,404.90 | $2,007 | 3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,067.50 | $1,525 | 1.1× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$201.60–$403.20 | $288–$576 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $403.20 | $576 | 1.4× |
| MRI cervical spine w contrast (72142) | $1,242.50 | $1,775 | 3.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$371–$742 | $530–$1,060 | varies |
| MRI chest w/o contrast (71550) | $1,673.70 | $2,391 | 5.9× |
| MRI chest with contrast (71551) | $1,612.10 | $2,303 | 1.7× |
| MRI chest wo w contrast (71552) | $2,109.80 | $3,014 | 5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,759.10 | $2,513 | 4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$689.15–$1,378.30 | $984.50–$1,969 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,981 | $2,830 | 6.9× |
| MRI lumbar spine w contrast (72149) | $1,076.60 | $1,538 | 2.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,422.40 | $2,032 | 3.4× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$266–$532 | $380–$760 | varies |
| MRI orbit face neck w contrast (70542) | $1,715.70 | $2,451 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,000.30 | $1,429 | 2.4× |
| MRI pelvis w contrast (72196) | $1,239.70 | $1,771 | 3.0× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,059.80–$2,119.60 | $1,514–$3,028 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$992.95–$1,985.90 | $1,418.50–$2,837 | varies |
| MRI spectroscopy (76390) | $1,370.60 | $1,958 | 13.1× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$928.90–$1,857.80 | $1,327–$2,654 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,759.10 | $2,513 | 4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$913.50–$1,827 | $1,305–$2,610 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,378.30 | $1,969 | 3.3× |
| MRI, abdomen, combo (74183) | $1,445.50 | $2,065 | 3.5× |
| MRI, dorsal spine combo (72157) | $3,578.40 | $5,112 | 8.6× |
| MRI, dorsal spine contrast (72147) | $1,235.50 | $1,765 | 3.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$357.70–$715.40 | $511–$1,022 | varies |
| MRI, joint upper extrem combo (73223) | $1,334.20 | $1,906 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,435.70 | $2,051 | 3.4× |
| Myelogram cervical (72240) | $347.90 | $497 | 0.4× |
| Myelogram Lumbar (72265) | $460.60 | $658 | 0.5× |
| Myelography thoracic (72255) | $414.40 | $592 | 0.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,055.60 | $1,508 | 1.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,214.50 | $1,735 | 2.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,260.60 | $4,658 | 2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,423.10 | $2,033 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $3,140.90 | $4,487 | 2.0× |
| Neck soft tissue (70360) | $198.10 | $283 | 1.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $81.20 | $116 | 0.2× |
| Nm myocard infarct spect (78469) | $3,206.70 | $4,581 | 4.9× |
| Nonvascular Shunt X-Ray (75809) | $265.30 | $379 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,875.70 | $11,251 | 4.7× |
| Nuclear medicine study of endocrine organs (78099) | $1,214.50 | $1,735 | 2.5× |
| Nuclear Rx Intra-Arterial (79445) | $814.80 | $1,164 | 2.9× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$814.80–$832.30 | $1,164–$1,189 | varies |
| Ob us nuchal meas 1 gest (76813) | $331.10 | $473 | 2.6× |
| Optic foramina (70190) | $70.70 | $101 | 0.7× |
| Panoramic X-ray of jaws (70355) | $65.10 | $93 | 0.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,342.60 | $1,918 | 2.1× |
| Parathyroid Planar Imaging (78070) | $685.30 | $979 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,539.30 | $2,199 | 3.2× |
| Pelvis 1 or 2 views (72170) | $233.10 | $333 | 1.9× |
| Perineogram (74775) | $613.20 | $876 | 2.1× |
| Peritoneogram Rs&I (74190) | $139.30 | $199 | 0.2× |
| PET image w/CT, full body (78816) | $4,568.20 | $6,526 | 2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,361 | $6,230 | 2.5× |
| Pet Myocardial Sngl Study (78491) | $3,674.30 | $5,249 | 2.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $229.60 | $328 | 0.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,147.30 | $1,639 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $637.70 | $911 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $261.10 | $373 | 2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $809.90 | $1,157 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$159.60–$239.40 | $228–$342 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $294 | $420 | 2.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$79.80–$239.40 | $114–$342 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$148.40–$222.60 | $212–$318 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $116.20 | $166 | 0.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $159.60 | $228 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $159.60 | $228 | 1.5× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$70.70–$212.10 | $101–$303 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $116.20 | $166 | 1.1× |
| Radex Spine 1 View Specify Level (72020) | $140 | $200 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $198.10 | $283 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$125.30–$187.95 | $179–$268.50 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$100.10–$200.20 | $143–$286 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $218.40 | $312 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $386.40 | $552 | 3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,884.40 | $22,692 | 1.8× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$280–$1,276.80 | $400–$1,824 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$420–$3,150 | $600–$4,500 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$700–$3,245.90 | $1,000–$4,637 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $252.70 | $361 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $127.40 | $182 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $506.80 | $724 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $354.20 | $506 | 1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $434 | $620 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$210–$315 | $300–$450 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $136.85 | $195.50 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $281.40 | $402 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $239.40 | $342 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $426.30 | $609 | 2.0× |
| Radiologic examination femur 1 view (73551) | $182 | $260 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$191.10–$286.65 | $273–$409.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $397.60 | $568 | 3.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $73.50 | $105 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$100.10–$300.30 | $143–$429 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $814.80 | $1,164 | 2.9× |
| Renal Cyst Study (74470) | $112 | $160 | 0.2× |
| Ribs bilateral 3 views (71110) | $294 | $420 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $203 | $290 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $855.40 | $1,222 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,964.90 | $2,807 | 3.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,017.10 | $1,453 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 6 matching MRF lines |
$207.90–$2,704.10 | $297–$3,863 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,389.10 | $3,413 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,850.70 | $5,501 | 2.5× |
| Rp Therapy Intravenous Administration (79101) | $158.20 | $226 | 0.6× |
| Salivary Gland Imaging (78230) | $1,214.50 | $1,735 | 2.5× |
| Salivary Gland Imaging Serial Images (78231) | $296.80 | $424 | 0.6× |
| Scapula (73010) | $140 | $200 | 1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$40.25–$80.50 | $57.50–$115 | varies |
| Sella turcica (70240) | $49 | $70 | 0.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$140–$210 | $200–$300 | varies |
| Shoulder Arthrography (73040) | $926.80 | $1,324 | 2.2× |
| Sialogram (70390) | $261.10 | $373 | 0.9× |
| Skull less than 4 views (70250) | $252.70 | $361 | 2.0× |
| Special dosimetry (77331) | $287.70 | $411 | 1.8× |
| Special Physics Consult (77370) | $632.10 | $903 | 3.9× |
| Special teletherapy port plan (77321) | $948.50 | $1,355 | 2.1× |
| Special treatment procedure (77470) | $1,919.40 | $2,742 | 2.9× |
| Spleen Imaging (78185) | $221.90 | $317 | 0.5× |
| Stereotactic Body Radiation Delivery (77373) | $4,179.70 | $5,971 | 2.0× |
| Sternoclavicular joints (71130) | $148.40 | $212 | 1.4× |
| Superior sagittal sinus venogram (75870) | $1,147.30 | $1,639 | 0.3× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $413 | $590 | 3.4× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $413 | $590 | 3.4× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $1,199.10 | $1,713 | 26.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,217.30 | $1,739 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $424.20 | $606 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,659 | $2,370 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,048.60 | $1,498 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $884.10 | $1,263 | 5.5× |
| Thoracic spine 2 views (72070) | $261.10 | $373 | 2.1× |
| Thoracic spine 3 views (72072) | $294 | $420 | 2.3× |
| Thoracolumbar 2 views (72080) | $151.20 | $216 | 1.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $553.70 | $791 | 1.2× |
| Thyroid Imaging With Vascular Flow (78013) | $313.60 | $448 | 0.7× |
| Thyroid Met Imaging Body (78018) | $553.70 | $791 | 0.9× |
| Thyroid Uptake Measurement (78012) | $391.30 | $559 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $918.40 | $1,312 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $817.60 | $1,168 | 1.8× |
| Tx devices design & construction intermediate (77333) | $496.30 | $709 | 3.1× |
| Tx devices design & construction simple (77332) | $496.30 | $709 | 3.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$134.40–$403.20 | $192–$576 | varies |
| Ultrasound Elastography Parenchyma (76981) | $325.50 | $465 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $320.60 | $458 | 2.6× |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$177.10–$354.20 | $253–$506 | varies |
| Umbilical-artery Doppler (OB) (76820) | $190.40 | $272 | 1.5× |
| Unlisted Dx Radiographic Procedure (76499) | $211.40 | $302 | 2.0× |
| Unlisted fluoroscopic procedure (76496) | $92.40 | $132 | 0.9× |
| Unlisted us procedure (76999) | $255.50 | $365 | 2.4× |
| Upper gi w/o kub (74240) | $440.30 | $629 | 2.1× |
| Ureteral Reflux Study (78740) | $307.30 | $439 | 0.6× |
| Urethrocystogram voiding (74455) | $345.80 | $494 | 1.2× |
| Urethrocystography retrograde (74450) | $400.40 | $572 | 1.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$211.40–$350.70 | $302–$501 | varies |
| Us chest (76604) | $322.70 | $461 | 2.6× |
| Us complete joint (76881) | $303.80 | $434 | 2.4× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$249.90–$364 | $357–$520 | varies |
| Us head (76506) | $322.70 | $461 | 2.6× |
| Us kidney transplant (76776) | $223.30 | $319 | 1.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 12 matching MRF lines |
$214.20–$480.90 | $306–$687 | varies |
| Us ob detailed single fetus (76811) | $678.30 | $969 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $312.20 | $446 | 2.5× |
| Us ob transvaginal (76817) | $312.20 | $446 | 2.5× |
| Us pelvic non ob complete (76856) | $354.20 | $506 | 2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $377.30 | $539 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $252.70 | $361 | 2.0× |
| Us retroperitoneal complete (76770) | $354.20 | $506 | 2.8× |
| Us retroperitoneal limited (76775) | $303.80 | $434 | 2.4× |
| Us scrotum and contents (76870) | $303.80 | $434 | 2.4× |
| Us spinal canal and contents (76800) | $250.60 | $358 | 2.0× |
| Us thyroid (76536) range across 6 matching MRF lines |
$151.90–$350.70 | $217–$501 | varies |
| Vein X-Ray Chest (75827) | $1,323 | $1,890 | 0.7× |
| Vein X-Ray Skull Epidural (75872) | $1,147.30 | $1,639 | 1.5× |
| Vein X-Ray Spleen/Liver (75810) | $1,147.30 | $1,639 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,147.30 | $1,639 | 0.3× |
| Venography Adrenal Unilateral (75840) | $1,147.30 | $1,639 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $3,537.10 | $5,053 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,239.70 | $1,771 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,526 | $2,180 | 0.8× |
| Venography Orbital Rs&I (75880) | $1,147.30 | $1,639 | 1.5× |
| Venography Renal Bilateral (75833) | $730.80 | $1,044 | 0.2× |
| Venography Renal Unilateral (75831) | $1,147.30 | $1,639 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$745.50 | $1,065 | 0.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$70–$210 | $100–$300 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$204.40–$306.60 | $292–$438 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$306.60–$613.20 | $438–$876 | varies |
| X-Ray Aorta Leg Arteries (75630) | $5,745.60 | $8,208 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $218.40 | $312 | 1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$191.10–$286.65 | $273–$409.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $925.40 | $1,322 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $144.20 | $206 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $239.40 | $342 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $386.40 | $552 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $161 | $230 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $161 | $230 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $203 | $290 | 1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$285.60–$428.40 | $408–$612 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$239.40–$359.10 | $342–$513 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$504–$756 | $720–$1,080 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $306.60 | $438 | 2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $204.40 | $292 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $294 | $420 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $245 | $350 | 2.0× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$198.10–$297.15 | $283–$424.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$200.20–$300.30 | $286–$429 | varies |
| X-ray IV pyelogram (ivp) (74400) | $352.10 | $503 | 1.7× |
| X-ray IV pyelogram+tomography (74415) | $264.60 | $378 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $123.90 | $177 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $198.10 | $283 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $236.60 | $338 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $93.80 | $134 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$177.10–$265.65 | $253–$379.50 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $261.10 | $373 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $140 | $200 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $204.40 | $292 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $178.50 | $255 | 1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $245 | $350 | 2.0× |
| X-Ray Stress View (77071) | $252 | $360 | 2.4× |
| X-ray thoracic spine 4 vw (72074) | $293.30 | $419 | 2.3× |
| X-Ray Tmj Unilat (70328) | $148.40 | $212 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $870.80 | $1,244 | 2.1× |
| X-Rays Bone Length Studies (77073) | $227.50 | $325 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $350.70 | $501 | 2.8× |
| Xr c-spine 4 or 5 views (72050) | $294 | $420 | 2.3× |
| Xr facial bones less than 3 views (70140) | $94.50 | $135 | 0.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $170.80 | $244 | 1.4× |
| Xr orbits complete 4 views (70200) | $252.70 | $361 | 2.0× |
| Xr Tomogram Single Plane (76100) | $133.70 | $191 | 1.1× |
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.