Imaging prices at Memorial Hermann Northeast Hospital
Humble, TX · every code in this section with a posted price and a Medicare benchmark.
407 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) | $7,258.80 | $22,683.75 | 5.2× |
| Abdomen 1 View (74018) | $332 | $1,037.50 | 3.8× |
| Abdomen 2 views (74019) | $378.08 | $1,181.50 | 3.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,099.12 | $3,434.75 | 2.7× |
| Adrenal Cortex & Medulla Img (78075) | $948.88 | $2,965.25 | 0.7× |
| Angio internal mammary (75756) | $1,183.60 | $3,698.75 | 0.4× |
| Angio pulmonary bilat (75743) | $3,030.88 | $9,471.50 | 1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,977.76 | $6,180.50 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $1,249.84 | $3,905.75 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,190.32 | $3,719.75 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,926.32 | $6,019.75 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $870.16 | $2,719.25 | 0.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$300.48–$450.72 | $939–$1,408.50 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,655.20 | $8,297.50 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,337.68 | $4,180.25 | 0.4× |
| Artery X-Rays Abdomen (75726) | $3,547.28 | $11,085.25 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $797.92 | $2,493.50 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,680.32 | $8,376 | 0.5× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,939.36 | $6,060.50 | 0.3× |
| Arthrogram hip (73525) | $667.28 | $2,085.25 | 1.9× |
| Arthrogram Wrist (73115) | $481.28 | $1,504 | 1.4× |
| Basic radiation dosimetry calculation (77300) | $731.04 | $2,284.50 | 5.4× |
| Bone age studies (77072) | $303.68 | $949 | 2.9× |
| Bone Imaging 3 Phase (78315) | $1,433.28 | $4,479 | 3.6× |
| Bone Imaging Limited Area (78300) | $1,095.20 | $3,422.50 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $1,150.48 | $3,595.25 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,366.96 | $4,271.75 | 3.4× |
| Bone marrow imaging; whole body (78104) | $1,199.36 | $3,748 | 3.0× |
| Bone survey infant (77076) | $676.72 | $2,114.75 | 6.4× |
| Brachytx isodose complex (77318) | $1,557.04 | $4,865.75 | 4.1× |
| Brain Flow Imaging Only (78610) | $352.32 | $1,101 | 0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $830.32 | $2,594.75 | 1.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $688.48 | $2,151.50 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,719.92 | $11,624.75 | 2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,285.84 | $4,018.25 | 3.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,785.52 | $5,579.75 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $453.36 | $1,416.75 | 5.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $275.36 | $860.50 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $259.28 | $810.25 | 0.5× |
| Chest 1 view (71045) | $323.92 | $1,012.25 | 3.7× |
| Chest 2 views (71046) | $389.28 | $1,216.50 | 4.5× |
| Chest 3 views (71047) | $406.80 | $1,271.25 | 4.7× |
| Chest 4 or more views (71048) | $410.56 | $1,283 | 3.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $85.20 | $266.25 | 0.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$350.40–$525.60 | $1,095–$1,642.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,425.36 | $4,454.25 | 13.6× |
| Continuing medical physics consltj pr wk (77336) | $721.84 | $2,255.75 | 5.3× |
| Contrast Exam Abdominl Aorta (75625) | $714.56 | $2,233 | 0.2× |
| Contrast X-Ray Bladder (74430) | $686.32 | $2,144.75 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $490.72 | $1,533.50 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$837.60–$1,256.40 | $2,617.50–$3,926.25 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,788.24 | $11,838.25 | 10.8× |
| CT abdomen and pelvis without contrast (74176) | $2,688.48 | $8,401.50 | 11.2× |
| CT abdomen w contrast (74160) | $2,668.40 | $8,338.75 | 15.1× |
| CT abdomen w wo contrast (74170) | $2,882.40 | $9,007.50 | 16.4× |
| CT abdomen w/o contrast (74150) | $2,015.84 | $6,299.50 | 19.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,633.92 | $11,356 | 10.4× |
| CT Angio Chest (71275) | $1,476.56 | $4,614.25 | 8.4× |
| CT Angio Head (70496) | $1,128.40 | $3,526.25 | 6.4× |
| CT angio hrt w/3d image (75574) | $1,667.92 | $5,212.25 | 4.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,888.48 | $9,026.50 | 16.4× |
| CT Angio Neck (70498) | $1,265.92 | $3,956 | 7.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,776.88 | $11,802.75 | 21.4× |
| CT cervical spine w/ contrast (72126) | $1,667.68 | $5,211.50 | 4.8× |
| CT cervical spine w/o contrast (72125) | $1,260.72 | $3,939.75 | 12.0× |
| CT cervical spine w/wo cont (72127) | $2,290.72 | $7,158.50 | 13.0× |
| CT chest w contrast (71260) | $1,513.44 | $4,729.50 | 8.6× |
| CT chest w/wo contrast (71270) | $2,165.28 | $6,766.50 | 12.3× |
| CT colonography screening (74263) | $1,171.28 | $3,660.25 | 4.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $678.40 | $2,120 | 3.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $497.04 | $1,553.25 | 4.7× |
| CT head/brain with contrast (70460) | $1,242.24 | $3,882 | 7.1× |
| CT head/brain without and with contrast (70470) | $1,443.60 | $4,511.25 | 8.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,037.12 | $3,241 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $490.88 | $1,534 | 5.6× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$1,510–$1,701.04 | $4,718.75–$5,315.75 | varies |
| CT iac w contrast (70481) | $1,507.60 | $4,711.25 | 8.6× |
| CT l-spine w&w/o contrast (72133) | $3,005.04 | $9,390.75 | 17.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,508.16–$2,262.24 | $4,713–$7,069.50 | varies |
| CT lower extremity w/contrast material (73701) | $2,103.76 | $6,574.25 | 11.9× |
| CT lumbar spine w contrast (72132) | $2,156.48 | $6,739 | 6.2× |
| CT lumbar spine w/o contrast (72131) | $1,577.92 | $4,931 | 15.0× |
| CT maxillofacial w contrast (70487) | $1,807.12 | $5,647.25 | 10.3× |
| CT maxillofacial wo contrast (70486) | $1,308.48 | $4,089 | 12.5× |
| CT neck tissue combo (70492) | $1,741.76 | $5,443 | 9.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,108.64 | $6,589.50 | 12.0× |
| CT orbits w/o contrast (70480) | $1,179.52 | $3,686 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $2,037.12 | $6,366 | 11.6× |
| CT pelvis w/o contrast (72192) | $1,623.04 | $5,072 | 15.5× |
| CT scan of leg combo (73702) | $2,314.08 | $7,231.50 | 13.1× |
| CT scans face/jaw combo (70488) | $1,902.56 | $5,945.50 | 10.8× |
| CT soft tissue neck w contrast (70491) | $1,590.64 | $4,970.75 | 9.0× |
| CT soft tissue neck w/o contrast (70490) | $1,145.04 | $3,578.25 | 10.9× |
| CT thoracic spine w contrast (72129) | $2,608.88 | $8,152.75 | 14.8× |
| CT thoracic spine w/o contrast (72128) | $1,872.32 | $5,851 | 17.8× |
| CT thoracic spine w/wo cont (72130) | $3,467.92 | $10,837.25 | 19.7× |
| CT thorax w/o contrast (71250) | $1,251.84 | $3,912 | 11.9× |
| CT unlisted procedure (76497) | $539.52 | $1,686 | 6.2× |
| CT upper ext wo (73200) | $1,652 | $5,162.50 | 15.7× |
| CT upper extremity w/o & w/contrast material (73202) | $3,004 | $9,387.50 | 17.0× |
| CT upper extremity with contrast (73201) | $2,211.60 | $6,911.25 | 6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,842.88 | $5,759 | 10.5× |
| Cta Abdomen (74175) | $2,417.20 | $7,553.75 | 13.7× |
| CTA pelvis (72191) | $2,020.32 | $6,313.50 | 11.5× |
| Dilation ureters/urethra rs&i (74485) | $970.72 | $3,033.50 | 0.5× |
| Diskography lumbar (72295) | $1,512.64 | $4,727 | 0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $603.52 | $1,886 | 5.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $897.20 | $2,803.75 | 8.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $442.24 | $1,382 | 4.2× |
| Dxa Bone Density Axial (77080) | $311.28 | $972.75 | 3.0× |
| Dxa bone density study (77085) | $434.96 | $1,359.25 | 4.1× |
| Echo exam of fetal heart (76825) | $1,220.56 | $3,814.25 | 2.2× |
| Echo exam uterus (76831) | $712.24 | $2,225.75 | 3.0× |
| Echo Guide For Artery Repair (76936) | $127.52 | $398.50 | 0.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,057.28 | $3,304 | 4.4× |
| Echograp Trans R Pros Study (76873) | $644.96 | $2,015.50 | 6.1× |
| Esophagram (74220) | $558.08 | $1,744 | 3.2× |
| Fetal Biophys Profile W/Nst (76818) | $1,113.84 | $3,480.75 | 10.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,100.48 | $3,439 | 10.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $298 | $931.25 | 1.2× |
| Fluoroscopy up to 1 hr (76000) | $632.96 | $1,978 | 2.6× |
| Follow-Up Angiography (75898) | $623.36 | $1,948 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$337.76–$506.64 | $1,055.50–$1,583.25 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$340.16–$510.24 | $1,063–$1,594.50 | varies |
| Gastric emptying imaging study (78264) | $1,100.24 | $3,438.25 | 2.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,043.68 | $3,261.50 | 2.6× |
| Gastroesophageal Reflux Exam (78262) | $428.56 | $1,339.25 | 1.1× |
| Gated Heart Planar Single (78472) | $1,260.08 | $3,937.75 | 3.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,095.60 | $3,423.75 | 2.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$343.44–$515.16 | $1,073.25–$1,609.88 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,412.80 | $20,040 | 9.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,801.36 | $18,129.25 | 8.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,872.08 | $15,225.25 | 7.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,148.80 | $9,840 | 1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,231.52 | $6,973.50 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,440.88 | $4,502.75 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,297.04 | $4,053.25 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $2,825.44 | $8,829.50 | 2.2× |
| Hysterosalpingogram (74740) | $820.80 | $2,565 | 3.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,005.20 | $3,141.25 | 11.5× |
| Infant hip ultrasound, limited static exam (76886) | $640.88 | $2,002.75 | 7.3× |
| K Flow/Funct Image Multiple (78709) | $1,139.04 | $3,559.50 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,180.64 | $3,689.50 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,033.12 | $3,228.50 | 1.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $476.64 | $1,489.50 | 1.2× |
| Kidney Imaging Morphol (78700) | $801.84 | $2,505.75 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $907.36 | $2,835.50 | 2.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$420.64–$630.96 | $1,314.50–$1,971.75 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,011.20 | $3,160 | 2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,061.44 | $3,317 | 2.6× |
| Liver imaging w/vascular flow (78202) | $1,011.20 | $3,160 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $938.72 | $2,933.50 | 1.7× |
| Lung perfusion differential (78597) | $853.28 | $2,666.50 | 2.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,163.44 | $3,635.75 | 2.1× |
| Lung Ventilation Imaging (78579) | $853.28 | $2,666.50 | 2.1× |
| Lymph System Imaging (78195) | $1,142.08 | $3,569 | 2.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $332.96 | $1,040.50 | 0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $221.92 | $693.50 | 0.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $166.56 | $520.50 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $110.96 | $346.75 | 0.0× |
| Magnetic Image Jaw Joint (70336) | $1,160.64 | $3,627 | 4.8× |
| Mammary ductogram or galactogram single (77053) | $389.36 | $1,216.75 | 1.6× |
| Meckels Divert Exam (78290) | $831.12 | $2,597.25 | 2.1× |
| Medical physics dose eval radiation expos w/rprt (76145) | $540.40 | $1,688.75 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $2,500.72 | $7,814.75 | 6.6× |
| Mr safety determination physician/other qhp (76016) | $180.16 | $563 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $140.48 | $439 | 4.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $281.04 | $878.25 | 2.9× |
| Mr safety implt pos&/immoblj (76019) | $366.56 | $1,145.50 | 6.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $553.60 | $1,730 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $2,304.48 | $7,201.50 | 6.6× |
| MRA head w/o contrast (70544) | $1,345.28 | $4,204 | 5.6× |
| MRA head with contrast (70545) | $1,547.20 | $4,835 | 4.4× |
| MRA neck w contrast (70548) | $1,535.36 | $4,798 | 4.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,889.68 | $5,905.25 | 5.4× |
| MRA neck w/o contrast (70547) | $1,335.12 | $4,172.25 | 5.6× |
| MRI abdomen w contrast (74182) | $1,806.64 | $5,645.75 | 5.2× |
| MRI abdomen w/o contrast (74181) | $1,506.24 | $4,707 | 6.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,810.40 | $5,657.50 | 2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,963.60 | $6,136.25 | 5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,319.44 | $4,123.25 | 1.7× |
| MRI bone marrow blood supply (77084) | $404.24 | $1,263.25 | 1.7× |
| MRI brain functional w/o physician admnistration (70554) | $778 | $2,431.25 | 3.2× |
| MRI brain functional w/physician admnistration (70555) | $226.16 | $706.75 | 0.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,123.60 | $3,511.25 | 4.7× |
| MRI cardiac w/o cont stress (75559) | $1,572.48 | $4,914 | 2.9× |
| MRI cardiac w/o contrast (75557) | $1,173.68 | $3,667.75 | 4.9× |
| MRI cervical spine w contrast (72142) | $2,036.48 | $6,364 | 5.8× |
| MRI cervical spine w/o cont (72141) | $1,715.60 | $5,361.25 | 7.2× |
| MRI chest w/o contrast (71550) | $1,164.56 | $3,639.25 | 4.9× |
| MRI chest with contrast (71551) | $1,336.64 | $4,177 | 1.7× |
| MRI chest wo w contrast (71552) | $1,586.96 | $4,959.25 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,629.44 | $5,092 | 4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,813.44–$2,720.16 | $5,667–$8,500.50 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,416.88–$2,125.32 | $4,427.75–$6,641.63 | varies |
| MRI lumbar spine w contrast (72149) | $1,792.88 | $5,602.75 | 5.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,509.52 | $7,842.25 | 7.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,332 | $4,162.50 | 5.6× |
| MRI orbit face neck w contrast (70542) | $1,501.92 | $4,693.50 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,918.24 | $5,994.50 | 5.5× |
| MRI pelvis w contrast (72196) | $1,978.40 | $6,182.50 | 5.6× |
| MRI pelvis w/o & w contrast (72197) | $2,055.12 | $6,422.25 | 5.9× |
| MRI pelvis w/o contrast (72195) | $1,641.36 | $5,129.25 | 6.8× |
| MRI spectroscopy (76390) | $1,066.16 | $3,331.75 | 12.2× |
| MRI thoracic spine w/o contrast (72146) | $1,633.28 | $5,104 | 6.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,748.32 | $5,463.50 | 5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,323.92 | $4,137.25 | 5.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,868.16–$2,802.24 | $5,838–$8,757 | varies |
| MRI, abdomen, combo (74183) | $2,069.84 | $6,468.25 | 5.9× |
| MRI, dorsal spine combo (72157) | $2,041.52 | $6,379.75 | 5.8× |
| MRI, dorsal spine contrast (72147) | $1,660.48 | $5,189 | 4.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,362.24–$2,043.36 | $4,257–$6,385.50 | varies |
| MRI, joint upper extrem combo (73223) | $1,455.92 | $4,549.75 | 4.2× |
| MRI, lumbar spine combo (72158) | $2,175.68 | $6,799 | 6.2× |
| Myelogram cervical (72240) | $1,795.04 | $5,609.50 | 2.3× |
| Myelogram Lumbar (72265) | $1,592.24 | $4,975.75 | 2.0× |
| Myelography thoracic (72255) | $1,533.52 | $4,792.25 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $1,709.12 | $5,341 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $4,005.76 | $12,518 | 3.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,649.52 | $5,154.75 | 1.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,291.52 | $7,161 | 1.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,369.76 | $7,405.50 | 1.1× |
| Neck soft tissue (70360) | $265.44 | $829.50 | 3.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $343.84 | $1,074.50 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $445.76 | $1,393 | 4.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,489.60 | $23,405 | 5.4× |
| Nuclear Rx Intra-Arterial (79445) | $246.56 | $770.50 | 1.1× |
| Nuclear Rx Oral Admin (79005) | $1,378.72 | $4,308.50 | 5.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $334.08 | $1,044 | 3.2× |
| Panoramic X-ray of jaws (70355) | $238.72 | $746 | 2.7× |
| Parathyroid Planar Imaging (78070) | $1,016.56 | $3,176.75 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,214 | $3,793.75 | 3.0× |
| Pelvis 1 or 2 views (72170) | $301.84 | $943.25 | 2.9× |
| Peritoneogram Rs&I (74190) | $456.16 | $1,425.50 | 0.8× |
| Pet Image W/Ct Lmtd (78814) | $3,421.76 | $10,693 | 2.4× |
| PET image w/CT, full body (78816) | $4,323.28 | $13,510.25 | 3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,119.92 | $12,874.75 | 2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $772.16 | $2,413 | 0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $481.92 | $1,506 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $533.20 | $1,666.25 | 5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $840.72 | $2,627.25 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$398.80–$598.20 | $1,246.25–$1,869.38 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$297.68–$446.52 | $930.25–$1,395.38 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$415.68–$623.52 | $1,299–$1,948.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $519.52 | $1,623.50 | 4.9× |
| Radex fingr minimum 2 views (73140) | $289.92 | $906 | 3.3× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$389.76–$584.64 | $1,218–$1,827 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$396.16–$594.24 | $1,238–$1,857 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $221.44 | $692 | 2.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $285.84 | $893.25 | 2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $331.76 | $1,036.75 | 3.8× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $1,657.04 | $5,178.25 | 19.0× |
| Radex Ribs Unilateral 2 Views (71100) | $393.20 | $1,228.75 | 4.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$439.20–$658.80 | $1,372.50–$2,058.75 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $320.56 | $1,001.75 | 3.7× |
| Radex Spine 1 View Specify Level (72020) | $282.24 | $882 | 3.2× |
| Radex Sternum Minimum 2 Views (71120) | $307.20 | $960 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $436.88 | $1,365.25 | 5.0× |
| Radex Toe Minimum 2 Views (73660) | $294.24 | $919.50 | 3.4× |
| Radex upper extremity infant minimum 2 views (73092) | $174.16 | $544.25 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$385.04–$577.56 | $1,203.25–$1,804.88 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $758.48 | $2,370.25 | 7.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,457.84 | $51,430.75 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $788.72 | $2,464.75 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $462.24 | $1,444.50 | 4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $419.76 | $1,311.75 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $1,033.52 | $3,229.75 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $770.24 | $2,407 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $657.60 | $2,055 | 3.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$527.36–$791.04 | $1,648–$2,472 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $394.96 | $1,234.25 | 3.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $676.32 | $2,113.50 | 3.8× |
| Radiologic exam swallow function contrast study (74230) | $482.56 | $1,508 | 2.7× |
| Radiologic exam teeth complete full mouth (70320) | $218.72 | $683.50 | 0.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,082.48 | $3,382.75 | 6.1× |
| Radiologic examination femur 1 view (73551) | $333.60 | $1,042.50 | 3.8× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$470.64–$705.96 | $1,470.75–$2,206.13 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$294.56–$441.84 | $920.50–$1,380.75 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $652.32 | $2,038.50 | 6.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$417.12–$625.68 | $1,303.50–$1,955.25 | varies |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $548.72 | $1,714.75 | 2.3× |
| Renal Cyst Study (74470) | $298.88 | $934 | 0.5× |
| Ribs bilateral 3 views (71110) | $886.96 | $2,771.75 | 8.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,116.24 | $3,488.25 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,557.44 | $4,867 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,717.04 | $5,365.75 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,635.36 | $5,110.50 | 3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,724.72 | $5,389.75 | 3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,901.60 | $5,942.50 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,810.96 | $5,659.25 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $217.92 | $681 | 0.9× |
| Scapula (73010) | $392.16 | $1,225.50 | 3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $32 | $100 | 1.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$365.68–$548.52 | $1,142.75–$1,714.13 | varies |
| Shoulder Arthrography (73040) | $1,001.44 | $3,129.50 | 2.9× |
| Sialogram (70390) | $423.12 | $1,322.25 | 1.8× |
| Skull less than 4 views (70250) | $387.36 | $1,210.50 | 3.7× |
| Special dosimetry (77331) | $476.56 | $1,489.25 | 3.5× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$3,733.60–$3,769.20 | $11,667.50–$11,778.75 | varies |
| Special teletherapy port plan (77321) | $1,389.12 | $4,341 | 3.7× |
| Special treatment procedure (77470) | $3,733.20 | $11,666.25 | 6.7× |
| Srs Multisource (77371) range across 4 matching MRF lines |
$1,309.60–$62,255.12 | $4,092.50–$194,547.25 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$3,846.24–$11,524.16 | $12,019.50–$36,013 | varies |
| Sternoclavicular joints (71130) | $164.16 | $513 | 1.9× |
| Superior sagittal sinus venogram (75870) | $518.32 | $1,619.75 | 0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $550.08 | $1,719 | 5.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,455.04 | $4,547 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,482.56 | $7,758 | 6.6× |
| Ther rad simulaj-aided field setting simple (77280) | $861.28 | $2,691.50 | 6.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $994.88 | $3,109 | 5.6× |
| Thoracic spine 2 views (72070) | $470.64 | $1,470.75 | 4.5× |
| Thoracic spine 3 views (72072) | $546 | $1,706.25 | 5.2× |
| Thoracolumbar 2 views (72080) | $380.08 | $1,187.75 | 4.3× |
| Thyroid Imaging With Vascular Flow (78013) | $710.72 | $2,221 | 1.8× |
| Thyroid Met Imaging Body (78018) | $1,085.28 | $3,391.50 | 2.0× |
| Thyroid Uptake Measurement (78012) | $447.28 | $1,397.75 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,315.04 | $4,109.50 | 3.3× |
| Tx Devices Design & Construction Complex (77334) | $1,438.40 | $4,495 | 3.8× |
| Tx devices design & construction intermediate (77333) | $1,179.44 | $3,685.75 | 8.7× |
| Tx devices design & construction simple (77332) | $1,142.24 | $3,569.50 | 8.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$715.28–$1,072.92 | $2,235.25–$3,352.88 | varies |
| Ultrasound Elastography Parenchyma (76981) | $840.08 | $2,625.25 | 8.0× |
| Ultrasound Exam Aaa Screen (76706) | $629.28 | $1,966.50 | 6.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,317.28 | $4,116.50 | 3.8× |
| Ultrasound, abdomen limited (76705) | $824.48 | $2,576.50 | 7.9× |
| Umbilical-artery Doppler (OB) (76820) | $394.72 | $1,233.50 | 3.8× |
| Unlisted Dx Radiographic Procedure (76499) | $180.16 | $563 | 2.1× |
| Unlisted fluoroscopic procedure (76496) | $202.16 | $631.75 | 2.3× |
| Unlisted respiratory px dx nuclear medicine (78599) | $766.56 | $2,395.50 | 1.9× |
| Unlisted us procedure (76999) | $148.96 | $465.50 | 1.7× |
| Upper gi w/o kub (74240) | $736.56 | $2,301.75 | 4.2× |
| Urethrocystogram voiding (74455) | $742.96 | $2,321.75 | 3.1× |
| Urethrocystography retrograde (74450) | $753.60 | $2,355 | 3.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$737.12–$1,105.68 | $2,303.50–$3,455.25 | varies |
| Us chest (76604) | $601.28 | $1,879 | 5.7× |
| Us complete joint (76881) | $976.80 | $3,052.50 | 9.3× |
| Us exam, pelvic, limited (76857) | $721.28 | $2,254 | 6.9× |
| Us head (76506) | $558.88 | $1,746.50 | 5.3× |
| Us kidney transplant (76776) | $997.68 | $3,117.75 | 9.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $853.92 | $2,668.50 | 8.1× |
| Us ob detailed single fetus (76811) | $1,130.96 | $3,534.25 | 4.7× |
| Us ob limited 1 or more fetuses (76815) | $767.20 | $2,397.50 | 7.3× |
| Us ob transvaginal (76817) | $1,142.64 | $3,570.75 | 10.9× |
| Us pelvic non ob complete (76856) | $1,009.04 | $3,153.25 | 9.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $833.60 | $2,605 | 7.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $703.92 | $2,199.75 | 6.7× |
| Us retroperitoneal complete (76770) | $738.32 | $2,307.25 | 7.0× |
| Us retroperitoneal limited (76775) | $1,003.04 | $3,134.50 | 9.6× |
| Us scrotum and contents (76870) | $904.16 | $2,825.50 | 8.6× |
| Us spinal canal and contents (76800) | $794.40 | $2,482.50 | 7.6× |
| Us thyroid (76536) | $706.08 | $2,206.50 | 6.7× |
| Us transrectal (76872) | $969.44 | $3,029.50 | 9.2× |
| Vascular Flow Imaging (78445) | $322 | $1,006.25 | 0.8× |
| Vein X-Ray Chest (75827) | $1,701.92 | $5,318.50 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $735.52 | $2,298.50 | 0.2× |
| Vein X-Ray Skull Epidural (75872) | $222.08 | $694 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $757.92 | $2,368.50 | 0.2× |
| Venogram Sinus/Jugular (75860) | $454.08 | $1,419 | 0.1× |
| Venography Adrenal Unilateral (75840) | $959.04 | $2,997 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,354.32 | $4,232.25 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $1,067.04 | $3,334.50 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $836.80 | $2,615 | 0.5× |
| Venography Orbital Rs&I (75880) | $579.20 | $1,810 | 0.9× |
| Venography Renal Bilateral (75833) | $2,991.28 | $9,347.75 | 0.9× |
| Venography Renal Unilateral (75831) | $1,380.64 | $4,314.50 | 0.4× |
| Venous sampling by catheter (75893) | $2,835.92 | $8,862.25 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $554.48 | $1,732.75 | 6.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$324–$486 | $1,012.50–$1,518.75 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $500.48 | $1,564 | 5.7× |
| X-ray antegrade pyelogram tube (74425) | $548.96 | $1,715.50 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $750.40 | $2,345 | 0.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$371.12–$556.68 | $1,159.75–$1,739.63 | varies |
| X-Ray Exam Breast Specimen (76098) | $290.80 | $908.75 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $523.60 | $1,636.25 | 6.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $529.20 | $1,653.75 | 5.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $664.72 | $2,077.25 | 6.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $228.32 | $713.50 | 2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$367.68–$551.52 | $1,149–$1,723.50 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $831.28 | $2,597.75 | 7.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $795.44 | $2,485.75 | 7.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $954.32 | $2,982.25 | 9.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,445.20 | $4,516.25 | 13.8× |
| X-Ray Exam L-S Spine Bending (72114) | $769.04 | $2,403.25 | 7.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $374 | $1,168.75 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $697.76 | $2,180.50 | 6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $434.80 | $1,358.75 | 4.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$370.56–$555.84 | $1,158–$1,737 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,204.80 | $3,765 | 6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $383.52 | $1,198.50 | 4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $379.28 | $1,185.25 | 4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $443.92 | $1,387.25 | 4.2× |
| X-ray nose-rectum child f.b. (76010) | $209.76 | $655.50 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $895.36 | $2,798 | 8.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $271.12 | $847.25 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $228.64 | $714.50 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $346.16 | $1,081.75 | 4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $497.04 | $1,553.25 | 5.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $588.16 | $1,838 | 5.6× |
| X-ray thoracic spine 4 vw (72074) | $573.44 | $1,792 | 5.5× |
| X-Ray Tmj Unilat (70328) | $258.64 | $808.25 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,082.16 | $3,381.75 | 3.1× |
| X-Rays Bone Length Studies (77073) | $413.92 | $1,293.50 | 3.9× |
| X-Rays Bone Survey Complete (77075) | $812.32 | $2,538.50 | 7.7× |
| Xr c-spine 4 or 5 views (72050) | $664.72 | $2,077.25 | 6.3× |
| Xr facial bones less than 3 views (70140) | $393.36 | $1,229.25 | 4.5× |
| Xr orbits complete 4 views (70200) | $516 | $1,612.50 | 4.9× |
| Xr Tomogram Single Plane (76100) | $529.12 | $1,653.50 | 5.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.