Imaging prices at Memorial Care Miller Children's & Women's Hosp Lb
Long Beach, CA · every code in this section with a posted price and a Medicare benchmark.
484 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) | $15,782 | $15,782 | 8.9× |
| Abdomen 1 View (74018) | $625 | $625 | 5.6× |
| Abdomen 2 views (74019) | $897 | $897 | 6.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,156 | $4,156 | 8.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $3,486 | $3,486 | 2.1× |
| Adrenal Cortex & Medulla Img (78075) | $4,699 | $4,699 | 2.8× |
| Angio pulmonary bilat (75743) | $14,313 | $14,313 | 3.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $13,540 | $13,540 | 3.3× |
| Angiography extremity bilateral rs&i (75716) | $15,063 | $15,063 | 3.7× |
| Angiography extremity unilateral rs&i (75710) | $9,413 | $9,413 | 2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $8,097 | $8,097 | 2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $7,126 | $7,126 | 1.8× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$236–$1,304 | $236–$1,304 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,458 | $9,458 | 1.3× |
| Artery X-Rays Abdomen (75726) | $10,733 | $10,733 | 1.5× |
| Artery X-Rays Adrenal Gland (75731) | $8,202 | $8,202 | 2.0× |
| Artery X-Rays Pelvis (75736) | $8,795 | $8,795 | 1.2× |
| Artery X-Rays Spine (75705) | $10,783 | $10,783 | 1.5× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$1,474–$2,737 | $1,474–$2,737 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,986–$3,634 | $1,986–$3,634 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,608–$2,981 | $1,608–$2,981 | varies |
| Basic radiation dosimetry calculation (77300) | $1,789 | $1,789 | 10.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$270–$721 | $270–$721 | varies |
| Bone Imaging 3 Phase (78315) | $4,450 | $4,450 | 8.7× |
| Bone Imaging Limited Area (78300) | $2,994 | $2,994 | 5.8× |
| Bone Imaging Multiple Areas (78305) | $3,492 | $3,492 | 6.8× |
| Bone Imaging Whole Body (78306) | $4,203 | $4,203 | 8.2× |
| Bone marrow imaging limited area (78102) | $2,311 | $2,311 | 4.5× |
| Bone marrow imaging; multiple areas (78103) | $3,078 | $3,078 | 6.0× |
| Bone marrow imaging; whole body (78104) | $3,320 | $3,320 | 6.5× |
| Bone survey infant (77076) | $1,552 | $1,552 | 11.5× |
| Brachytx isodose complex (77318) | $6,843 | $6,843 | 14.2× |
| Brachytx isodose intermed (77317) | $4,615 | $4,615 | 9.6× |
| Brachytx Isodose Plan Simple (77316) | $3,497 | $3,497 | 7.3× |
| Brain Flow Imaging Only (78610) | $2,847 | $2,847 | 4.1× |
| Brain Image W/Flow < 4 Views (78601) | $3,667 | $3,667 | 7.1× |
| Brain imaging < 4 static views (78600) | $2,656 | $2,656 | 5.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $4,096 | $4,096 | 5.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,444 | $3,444 | 4.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $12,145 | $12,145 | 6.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $3,285 | $3,285 | 6.4× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $4,282 | $4,282 | 6.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $9,274 | $9,274 | 20.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $11,550 | $11,550 | 11.5× |
| Cardiac Shunt Detection (78428) | $2,845 | $2,845 | 5.5× |
| Cat Scan Follow-Up Study (76380) | $2,869 | $2,869 | 25.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $3,225 | $3,225 | 4.6× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $3,825 | $3,825 | 5.5× |
| Cerebrospinal Fluid Scan (78630) | $4,206 | $4,206 | 6.0× |
| Chest 1 view (71045) | $916 | $916 | 8.2× |
| Chest 2 views (71046) | $1,166 | $1,166 | 10.4× |
| Chest 3 views (71047) | $1,318 | $1,318 | 11.8× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$1,386–$1,620 | $1,386–$1,620 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $1,424 | $1,424 | 10.6× |
| Cholecystography Oral Contrast (74290) | $988 | $988 | 4.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $932 | $932 | 6.9× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$229–$1,204 | $229–$1,204 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,853 | $2,853 | 21.2× |
| Continuing medical physics consltj pr wk (77336) | $1,847 | $1,847 | 10.7× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,747–$9,179 | $5,747–$9,179 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$800–$1,384 | $800–$1,384 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$1,712–$3,225 | $1,712–$3,225 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,918–$3,637 | $1,918–$3,637 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $1,078 | $1,078 | 4.8× |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$270–$2,327 | $270–$2,327 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $11,304 | $11,304 | 25.2× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$5,336–$8,937 | $5,336–$8,937 | varies |
| CT abdomen w contrast (74160) | $6,605 | $6,605 | 29.3× |
| CT abdomen w wo contrast (74170) | $7,806 | $7,806 | 34.6× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$3,952–$5,763 | $3,952–$5,763 | varies |
| CT Angio Abdomen and Pelvis (74174) | $12,576 | $12,576 | 28.0× |
| CT Angio Chest (71275) | $8,043 | $8,043 | 35.7× |
| CT Angio Head (70496) | $6,514 | $6,514 | 28.9× |
| CT angio hrt w/3d image (75574) | $8,046 | $8,046 | 17.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$7,562–$14,297 | $7,562–$14,297 | varies |
| CT Angio Neck (70498) | $6,387 | $6,387 | 28.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$7,822–$14,864 | $7,822–$14,864 | varies |
| CT bone density (77078) | $1,769 | $1,769 | 15.8× |
| CT cervical spine w/ contrast (72126) | $6,795 | $6,795 | 15.1× |
| CT cervical spine w/o contrast (72125) | $6,336 | $6,336 | 47.1× |
| CT cervical spine w/wo cont (72127) | $7,377 | $7,377 | 32.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$6,283–$6,483 | $6,283–$6,483 | varies |
| CT chest w/wo contrast (71270) | $7,547 | $7,547 | 33.5× |
| CT colonography screening (74263) | $2,203 | $2,203 | 7.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $5,138 | $5,138 | 22.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $4,247 | $4,247 | 31.6× |
| CT head/brain with contrast (70460) | $5,612 | $5,612 | 24.9× |
| CT head/brain without and with contrast (70470) | $6,068 | $6,068 | 26.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $4,403 | $4,403 | 9.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,760 | $1,760 | 15.7× |
| CT hrt w/3d image congen (75573) | $5,334 | $5,334 | 11.9× |
| CT iac w contrast (70481) | $5,790 | $5,790 | 25.7× |
| CT l-spine w&w/o contrast (72133) | $8,771 | $8,771 | 38.9× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$5,318–$9,258 | $5,318–$9,258 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$5,822–$10,854 | $5,822–$10,854 | varies |
| CT lumbar spine w contrast (72132) | $7,667 | $7,667 | 17.1× |
| CT lumbar spine w/o contrast (72131) | $6,934 | $6,934 | 51.6× |
| CT maxillofacial w contrast (70487) | $4,968 | $4,968 | 22.0× |
| CT maxillofacial wo contrast (70486) | $4,325 | $4,325 | 32.2× |
| CT neck tissue combo (70492) | $6,048 | $6,048 | 26.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,280 | $6,280 | 27.8× |
| CT orbits w/o contrast (70480) | $5,195 | $5,195 | 38.6× |
| CT pelvis w&w/o contrast (72194) | $7,505 | $7,505 | 33.3× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$4,055–$6,021 | $4,055–$6,021 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$6,664–$11,308 | $6,664–$11,308 | varies |
| CT scans face/jaw combo (70488) | $5,440 | $5,440 | 24.1× |
| CT soft tissue neck w contrast (70491) | $5,207 | $5,207 | 23.1× |
| CT soft tissue neck w/o contrast (70490) | $4,752 | $4,752 | 35.3× |
| CT thoracic spine w contrast (72129) | $7,813 | $7,813 | 34.6× |
| CT thoracic spine w/o contrast (72128) | $6,967 | $6,967 | 51.8× |
| CT thoracic spine w/wo cont (72130) | $8,964 | $8,964 | 39.7× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$5,768–$5,891 | $5,768–$5,891 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$180–$1,634 | $180–$1,634 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$5,436–$10,404 | $5,436–$10,404 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$6,934–$11,411 | $6,934–$11,411 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$5,903–$10,435 | $5,903–$10,435 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $10,733 | $10,733 | 47.6× |
| Cta Abdomen (74175) | $8,320 | $8,320 | 36.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $6,000 | $6,000 | 13.4× |
| CTA pelvis (72191) | $8,122 | $8,122 | 36.0× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $858 | $858 | 2.8× |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$2,644–$5,206 | $2,644–$5,206 | varies |
| Discography Cerv/Thor Spine (72285) | $5,772 | $5,772 | 2.3× |
| Diskography lumbar (72295) | $5,351 | $5,351 | 2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$337–$1,071 | $337–$1,071 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$394–$1,287 | $394–$1,287 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$1,106–$1,210 | $1,106–$1,210 | varies |
| Dxa bone density study (77085) | $1,501 | $1,501 | 11.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $831 | $831 | 7.4× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$1,393–$3,187 | $1,393–$3,187 | varies |
| Echo exam uterus (76831) | $1,837 | $1,837 | 6.0× |
| Echo Guide For Artery Repair (76936) | $3,519 | $3,519 | 12.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$614–$1,719 | $614–$1,719 | varies |
| Echograp Trans R Pros Study (76873) | $1,983 | $1,983 | 14.7× |
| Esophageal Motility Study (78258) | $2,461 | $2,461 | 4.8× |
| Esophagram (74220) | $1,287 | $1,287 | 5.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,778 | $1,778 | 13.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$1,452–$1,565 | $1,452–$1,565 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,969 | $4,969 | 16.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$614–$1,860 | $614–$1,860 | varies |
| Follow-Up Angiography (75898) | $4,508 | $4,508 | 1.1× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$219–$1,441 | $219–$1,441 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$224–$1,369 | $224–$1,369 | varies |
| Gastric emptying imaging study (78264) | $4,046 | $4,046 | 7.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $3,301 | $3,301 | 6.4× |
| Gastric Mucosa Imaging (78261) | $2,475 | $2,475 | 4.8× |
| Gastroesophageal Reflux Exam (78262) | $2,781 | $2,781 | 5.4× |
| Gastrointestinal Protein Loss (78282) | $2,162 | $2,162 | 4.2× |
| Gated Heart Planar Single (78472) | $3,624 | $3,624 | 7.0× |
| Gated Heart, Multiple (78473) | $4,367 | $4,367 | 8.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $4,334 | $4,334 | 6.2× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$232–$1,342 | $232–$1,342 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $14,730 | $14,730 | 16.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $12,105 | $12,105 | 13.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $8,992 | $8,992 | 10.0× |
| Heart first pass single,planar (78481) | $3,492 | $3,492 | 5.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $8,005 | $8,005 | 2.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,641 | $6,641 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $4,863 | $4,863 | 7.0× |
| Hepatobiliary System Imaging (78226) | $3,933 | $3,933 | 7.6× |
| Ht Musc Image Planar Mult (78454) | $6,547 | $6,547 | 3.9× |
| Ht Muscle Image Spect Sing (78451) | $6,273 | $6,273 | 3.8× |
| Hyperthermia external generated superficial (77600) | $3,656 | $3,656 | 7.4× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $6,493 | $6,493 | 9.1× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $7,959 | $7,959 | 11.2× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $3,485 | $3,485 | 4.9× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $5,007 | $5,007 | 5.6× |
| Hysterosalpingogram (74740) | $1,722 | $1,722 | 5.6× |
| Image fusion (77399) | $269 | $269 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,913 | $1,913 | 17.1× |
| Infant hip ultrasound, limited static exam (76886) | $1,492 | $1,492 | 13.3× |
| Infusion Ivp (74410) | $1,806 | $1,806 | 8.0× |
| Interstitial radiation source applic complex (77778) | $6,884 | $6,884 | 7.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,461 | $4,461 | 5.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $3,822 | $3,822 | 5.4× |
| Intracavitary radiation source applic simple (77761) | $2,233 | $2,233 | 3.1× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $15,341 | $15,341 | 1.6× |
| Intraop radiaj tx deliver xray single tx session (77424) | $15,341 | $15,341 | 1.6× |
| Joint Survey Single View (77077) | $1,136 | $1,136 | 8.4× |
| K Flow/Funct Image Multiple (78709) | $4,377 | $4,377 | 6.3× |
| K Flow/Funct Image W/Drug (78708) | $3,885 | $3,885 | 5.6× |
| K Flow/Funct Image W/O Drug (78707) | $4,185 | $4,185 | 6.0× |
| Kidney Imaging Morphol (78700) | $2,580 | $2,580 | 5.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $3,084 | $3,084 | 6.0× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$279–$1,885 | $279–$1,885 | varies |
| Leveen/Shunt Patency Exam (78291) | $2,795 | $2,795 | 5.4× |
| Liver & Spleen Imaging Static Only (78215) | $3,267 | $3,267 | 6.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $3,066 | $3,066 | 6.0× |
| Liver imaging static only (78201) | $2,691 | $2,691 | 3.9× |
| Liver imaging w/vascular flow (78202) | $2,870 | $2,870 | 4.1× |
| Lung Perf&Ventilat Diferentl (78598) | $4,320 | $4,320 | 6.2× |
| Lung perfusion differential (78597) | $2,663 | $2,663 | 5.2× |
| Lung Ventilat&Perfus Imaging (78582) | $4,538 | $4,538 | 6.5× |
| Lung Ventilation Imaging (78579) | $2,662 | $2,662 | 5.2× |
| Lymph System Imaging (78195) | $4,391 | $4,391 | 6.3× |
| Magnetic Image Jaw Joint (70336) | $6,459 | $6,459 | 21.0× |
| Magnetic Resonance Elastography (76391) | $2,849 | $2,849 | 9.3× |
| Mammary ductogram or galactogram multiple (77054) | $2,267 | $2,267 | 7.4× |
| Mammary ductogram or galactogram single (77053) | $1,984 | $1,984 | 6.5× |
| Meckels Divert Exam (78290) | $3,872 | $3,872 | 7.5× |
| Medical physics dose eval radiation expos w/rprt (76145) | $1,056 | $1,056 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) | $5,018 | $5,018 | 10.4× |
| Mr safety determination physician/other qhp (76016) | $192 | $192 | 1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $75 | $75 | 2.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $197 | $197 | 1.6× |
| Mr safety implt pos&/immoblj (76019) | $131 | $131 | 1.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $480 | $480 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $10,421 | $10,421 | 23.2× |
| MRA head w/o contrast (70544) | $6,602 | $6,602 | 21.5× |
| MRA head with contrast (70545) | $7,402 | $7,402 | 16.5× |
| MRA neck w contrast (70548) | $8,236 | $8,236 | 18.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $10,690 | $10,690 | 23.8× |
| MRA neck w/o contrast (70547) | $6,602 | $6,602 | 21.5× |
| MRI abdomen w contrast (74182) | $8,297 | $8,297 | 18.5× |
| MRI abdomen w/o contrast (74181) | $7,211 | $7,211 | 23.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$7,321–$13,911 | $7,321–$13,911 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$10,047–$17,402 | $10,047–$17,402 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$7,535–$14,320 | $7,535–$14,320 | varies |
| MRI bone marrow blood supply (77084) | $6,865 | $6,865 | 22.4× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$3,877–$6,831 | $3,877–$6,831 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines |
$2,506–$5,564 | $2,506–$5,564 | varies |
| MRI cardiac w/o cont stress (75559) | $9,127 | $9,127 | 13.0× |
| MRI cardiac w/o contrast (75557) | $6,928 | $6,928 | 22.6× |
| MRI cervical spine w contrast (72142) | $7,886 | $7,886 | 17.6× |
| MRI cervical spine w/o cont (72141) | $6,864 | $6,864 | 22.4× |
| MRI chest w/o contrast (71550) | $6,524 | $6,524 | 21.3× |
| MRI chest with contrast (71551) | $7,431 | $7,431 | 7.4× |
| MRI chest wo w contrast (71552) | $12,285 | $12,285 | 27.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$7,321–$13,382 | $7,321–$13,382 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$10,234–$18,976 | $10,234–$18,976 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$6,363–$12,346 | $6,363–$12,346 | varies |
| MRI lumbar spine w contrast (72149) | $8,526 | $8,526 | 19.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $11,994 | $11,994 | 26.7× |
| MRI orbit face &/neck w/o contrast (70540) | $6,738 | $6,738 | 22.0× |
| MRI orbit face neck w contrast (70542) | $7,959 | $7,959 | 17.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $12,237 | $12,237 | 27.3× |
| MRI pelvis w contrast (72196) | $7,490 | $7,490 | 16.7× |
| MRI pelvis w/o & w contrast (72197) | $11,526 | $11,526 | 25.7× |
| MRI pelvis w/o contrast (72195) | $6,733 | $6,733 | 21.9× |
| MRI spectroscopy (76390) | $6,627 | $6,627 | 59.2× |
| MRI thoracic spine w/o contrast (72146) | $7,338 | $7,338 | 23.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$7,322–$13,909 | $7,322–$13,909 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$6,164–$12,802 | $6,164–$12,802 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$10,401–$19,765 | $10,401–$19,765 | varies |
| MRI, abdomen, combo (74183) | $11,509 | $11,509 | 25.6× |
| MRI, dorsal spine combo (72157) | $12,379 | $12,379 | 27.6× |
| MRI, dorsal spine contrast (72147) | $8,365 | $8,365 | 18.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$6,193–$11,537 | $6,193–$11,537 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$11,114–$21,126 | $11,114–$21,126 | varies |
| MRI, lumbar spine combo (72158) | $12,470 | $12,470 | 27.8× |
| Myelogram cervical (72240) | $3,346 | $3,346 | 3.3× |
| Myelogram Lumbar (72265) | $3,475 | $3,475 | 3.4× |
| Myelography thoracic (72255) | $3,407 | $3,407 | 3.4× |
| Myelograpy 2/more regions rs&i (72270) | $4,232 | $4,232 | 4.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,653 | $2,653 | 5.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $10,013 | $10,013 | 6.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $2,745 | $2,745 | 3.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,483 | $5,483 | 3.3× |
| Myocardial Spect Multiple Studies (78452) | $8,597 | $8,597 | 5.2× |
| N-invas est c ffr sw aly CTA (75580) | $5,681 | $5,681 | 5.1× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$422–$625 | $422–$625 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,184 | $1,184 | 2.4× |
| Nm csf leak detection (78650) | $3,685 | $3,685 | 2.2× |
| Nm myocard infarct spect (78469) | $3,422 | $3,422 | 4.9× |
| Nm red cell survival study (78130) | $2,843 | $2,843 | 5.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $18,388 | $18,388 | 10.3× |
| Nuclear Rx Intra-Arterial (79445) | $2,630 | $2,630 | 8.8× |
| Nuclear Rx Oral Admin (79005) | $3,086 | $3,086 | 10.3× |
| Ob us nuchal meas 1 gest (76813) | $1,434 | $1,434 | 10.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $1,295 | $1,295 | 9.6× |
| Optic foramina (70190) | $452 | $452 | 4.0× |
| Panoramic X-ray of jaws (70355) | $679 | $679 | 6.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,448 | $4,448 | 6.4× |
| Parathyroid Planar Imaging (78070) | $3,045 | $3,045 | 5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $4,196 | $4,196 | 8.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$232–$795 | $232–$795 | varies |
| Perineogram (74775) | $1,169 | $1,169 | 3.8× |
| Peritoneogram Rs&I (74190) | $1,687 | $1,687 | 2.4× |
| Pet Image Skull-Thigh (78812) | $11,916 | $11,916 | 6.5× |
| Pet Image W/Ct Lmtd (78814) | $11,926 | $11,926 | 6.5× |
| PET image w/CT, full body (78816) | $16,042 | $16,042 | 8.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $15,256 | $15,256 | 8.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $10,181 | $10,181 | 6.1× |
| PET whole body (78813) | $12,325 | $12,325 | 6.7× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $2,333 | $2,333 | 1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,635 | $7,635 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,384 | $3,384 | 6.6× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $5,300 | $5,300 | 4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,287 | $1,287 | 9.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,774 | $1,774 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$251–$1,880 | $251–$1,880 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$622–$1,159 | $622–$1,159 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$279–$1,801 | $279–$1,801 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,195 | $1,195 | 8.9× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$208–$616 | $208–$616 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$245–$1,818 | $245–$1,818 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$272–$1,787 | $272–$1,787 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$236–$1,483 | $236–$1,483 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $986 | $986 | 7.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $898 | $898 | 8.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $796 | $796 | 7.1× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$838–$839 | $838–$839 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$259–$1,782 | $259–$1,782 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $722 | $722 | 6.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $2,206 | $2,206 | 9.8× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$248–$722 | $248–$722 | varies |
| Radex Sternum Minimum 2 Views (71120) | $740 | $740 | 6.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,009 | $1,009 | 9.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$182–$1,141 | $182–$1,141 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$270–$1,406 | $270–$1,406 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$876–$1,782 | $876–$1,782 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$478–$1,852 | $478–$1,852 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $34,488 | $34,488 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $1,705 | $1,705 | 13.0× |
| Radiation treatment delivery level 2 (77407) | $2,137 | $2,137 | 4.3× |
| Radiation treatment delivery level 3 (77412) | $2,827 | $2,827 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,145 | $1,145 | 8.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,088 | $1,088 | 8.1× |
| Radiologic exam colon double contrast study (74280) | $2,306 | $2,306 | 10.2× |
| Radiologic exam colon single contrast study (74270) | $1,861 | $1,861 | 8.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,580 | $1,580 | 7.0× |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$282–$2,296 | $282–$2,296 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$270–$1,004 | $270–$1,004 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,646 | $1,646 | 7.3× |
| Radiologic exam swallow function contrast study (74230) | $1,483 | $1,483 | 6.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $519 | $519 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,636 | $1,636 | 7.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$219–$544 | $219–$544 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$232–$1,951 | $232–$1,951 | varies |
| Radiologic examination knee 1/2 views (73560) range across 8 matching MRF lines |
$236–$1,476 | $236–$1,476 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,506 | $1,506 | 11.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $495 | $495 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$237–$1,594 | $237–$1,594 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,088 | $1,088 | 1.5× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $374 | $374 | 3.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $2,492 | $2,492 | 8.3× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $2,457 | $2,457 | 4.8× |
| Ribs bilateral 3 views (71110) | $1,071 | $1,071 | 8.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,757 | $2,757 | 5.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,437 | $3,437 | 6.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $7,769 | $7,769 | 11.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,040 | $5,040 | 7.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $5,297 | $5,297 | 7.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $7,678 | $7,678 | 4.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,907 | $8,907 | 4.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $6,143 | $6,143 | 3.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,045 | $3,045 | 10.1× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$2,279–$2,314 | $2,279–$2,314 | varies |
| Salivary Gland Imaging Serial Images (78231) | $2,549 | $2,549 | 5.0× |
| Scapula (73010) range across 4 matching MRF lines |
$270–$1,257 | $270–$1,257 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $154 | $154 | 6.6× |
| Sella turcica (70240) | $486 | $486 | 4.3× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$225–$1,351 | $225–$1,351 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,955–$3,527 | $1,955–$3,527 | varies |
| Sialogram (70390) | $1,119 | $1,119 | 3.6× |
| Skull less than 4 views (70250) | $855 | $855 | 6.4× |
| Special dosimetry (77331) | $1,507 | $1,507 | 8.7× |
| Special Physics Consult (77370) | $2,222 | $2,222 | 12.9× |
| Special teletherapy port plan (77321) | $3,411 | $3,411 | 7.1× |
| Special treatment procedure (77470) | $6,021 | $6,021 | 8.5× |
| Speech evaluation, complex (70371) | $1,128 | $1,128 | 3.7× |
| Spleen Imaging (78185) | $2,306 | $2,306 | 4.5× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$24,572–$24,828 | $24,572–$24,828 | varies |
| Sternoclavicular joints (71130) | $797 | $797 | 7.1× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $833 | $833 | 6.3× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $833 | $833 | 6.3× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $304 | $304 | 6.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,294 | $1,294 | 9.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $5,218 | $5,218 | 10.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $3,010 | $3,010 | 6.3× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$1,028–$2,044 | $1,028–$2,044 | varies |
| Testicular Imaging W/Flow (78761) | $2,819 | $2,819 | 5.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,559 | $4,559 | 9.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,254 | $3,254 | 6.8× |
| Ther rad simulaj-aided field setting simple (77280) | $2,468 | $2,468 | 14.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,299 | $2,299 | 10.2× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$366–$753 | $366–$753 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$394–$901 | $394–$901 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$224–$892 | $224–$892 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $3,738 | $3,738 | 7.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $2,893 | $2,893 | 5.6× |
| Thyroid Imaging With Vascular Flow (78013) | $2,638 | $2,638 | 5.1× |
| Thyroid Met Imaging Body (78018) | $4,384 | $4,384 | 6.3× |
| Thyroid Uptake Measurement (78012) | $2,025 | $2,025 | 3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,083 | $3,083 | 6.0× |
| Tx Devices Design & Construction Complex (77334) | $3,619 | $3,619 | 7.5× |
| Tx devices design & construction intermediate (77333) | $2,347 | $2,347 | 13.6× |
| Tx devices design & construction simple (77332) | $1,521 | $1,521 | 8.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$772–$1,517 | $772–$1,517 | varies |
| Ultrasound elastography first target lesion (76982) | $774 | $774 | 5.8× |
| Ultrasound Elastography Parenchyma (76981) | $841 | $841 | 6.3× |
| Ultrasound Exam Aaa Screen (76706) | $1,033 | $1,033 | 7.7× |
| Ultrasound, abdomen limited (76705) | $1,970 | $1,970 | 14.7× |
| Umbilical-artery Doppler (OB) (76820) | $999 | $999 | 7.4× |
| Unlis px ther radiol clinical tx planning (77299) | $269 | $269 | 1.6× |
| Unlisted Dx Radiographic Procedure (76499) | $120 | $120 | 1.1× |
| Unlisted fluoroscopic procedure (76496) | $1,853 | $1,853 | 16.6× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $813 | $813 | 1.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $237 | $237 | 1.8× |
| Unlisted us procedure (76999) | $139 | $139 | 1.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$1,534–$1,602 | $1,534–$1,602 | varies |
| Ureteral Reflux Study (78740) | $2,943 | $2,943 | 5.7× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$628–$1,653 | $628–$1,653 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$614–$1,433 | $614–$1,433 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,030–$1,899 | $1,030–$1,899 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$834–$1,565 | $834–$1,565 | varies |
| Us complete joint (76881) | $1,654 | $1,654 | 12.3× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$270–$1,445 | $270–$1,445 | varies |
| Us head (76506) | $2,148 | $2,148 | 16.0× |
| Us kidney transplant (76776) | $2,109 | $2,109 | 15.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$854–$1,704 | $854–$1,704 | varies |
| Us ob detailed single fetus (76811) | $2,823 | $2,823 | 9.2× |
| Us ob limited 1 or more fetuses (76815) | $1,276 | $1,276 | 9.5× |
| Us ob transvaginal (76817) | $1,635 | $1,635 | 12.2× |
| Us pelvic non ob complete (76856) | $2,265 | $2,265 | 16.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,002 | $2,002 | 14.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$1,195–$1,202 | $1,195–$1,202 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$420–$2,198 | $420–$2,198 | varies |
| Us retroperitoneal limited (76775) | $1,511 | $1,511 | 11.2× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$363–$1,964 | $363–$1,964 | varies |
| Us spinal canal and contents (76800) | $1,828 | $1,828 | 13.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$801–$1,862 | $801–$1,862 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$363–$1,705 | $363–$1,705 | varies |
| Vascular Flow Imaging (78445) | $2,541 | $2,541 | 4.9× |
| Vein X-Ray Chest (75827) | $7,844 | $7,844 | 3.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,121 | $6,121 | 1.5× |
| Vein X-Ray Skull Epidural (75872) | $6,819 | $6,819 | 8.5× |
| Vein X-Ray Spleen/Liver (75810) | $6,862 | $6,862 | 1.7× |
| Venogram Sinus/Jugular (75860) | $6,891 | $6,891 | 1.7× |
| Venography Adrenal Unilateral (75840) | $7,551 | $7,551 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $8,420 | $8,420 | 2.1× |
| Venography extremity bilateral rs&i (75822) | $6,687 | $6,687 | 3.3× |
| Venography extremity unilateral rs&i (75820) | $3,797 | $3,797 | 1.9× |
| Venography Renal Bilateral (75833) | $11,250 | $11,250 | 2.8× |
| Venography Renal Unilateral (75831) | $7,565 | $7,565 | 1.9× |
| Venous sampling by catheter (75893) | $7,013 | $7,013 | 1.0× |
| Venous thrombosis imaging (78457) | $2,269 | $2,269 | 3.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $3,685 | $3,685 | 7.2× |
| Vertebral fracture assessment via dxa (77086) | $930 | $930 | 8.3× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$235–$1,328 | $235–$1,328 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $909 | $909 | 8.1× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$865–$1,926 | $865–$1,926 | varies |
| X-Ray Aorta Leg Arteries (75630) | $11,042 | $11,042 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$407–$1,093 | $407–$1,093 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$224–$1,385 | $224–$1,385 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,512 | $1,512 | 2.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$224–$762 | $224–$762 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$366–$1,151 | $366–$1,151 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$399–$1,542 | $399–$1,542 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $784 | $784 | 7.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,073 | $1,073 | 9.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,281 | $1,281 | 9.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,119 | $1,119 | 8.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,153 | $1,153 | 8.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,726 | $1,726 | 12.8× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$506–$1,622 | $506–$1,622 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$224–$988 | $224–$988 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$270–$1,507 | $270–$1,507 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,028 | $1,028 | 7.6× |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$452–$917 | $452–$917 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$263–$1,340 | $263–$1,340 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,791–$2,316 | $1,791–$2,316 | varies |
| X-ray IV pyelogram+tomography (74415) | $2,168 | $2,168 | 9.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $709 | $709 | 6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $753 | $753 | 6.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$270–$923 | $270–$923 | varies |
| X-ray nose-rectum child f.b. (76010) | $641 | $641 | 5.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,233 | $1,233 | 9.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $901 | $901 | 6.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $683 | $683 | 5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $877 | $877 | 7.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,058 | $1,058 | 9.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,381 | $1,381 | 10.3× |
| X-Ray Stress View (77071) | $550 | $550 | 4.9× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$422–$1,068 | $422–$1,068 | varies |
| X-Ray Tmj Unilat (70328) | $480 | $480 | 4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$908–$2,093 | $908–$2,093 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$270–$2,033 | $270–$2,033 | varies |
| X-Rays Bone Survey Complete (77075) | $2,501 | $2,501 | 18.6× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$270–$1,420 | $270–$1,420 | varies |
| Xr facial bones less than 3 views (70140) | $765 | $765 | 6.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $682 | $682 | 5.1× |
| Xr orbits complete 4 views (70200) | $1,068 | $1,068 | 7.9× |
| Xr Tomogram Single Plane (76100) | $1,221 | $1,221 | 9.1× |
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.