Imaging prices at Memorial Sloan Kettering Cancer Center

New York, NY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $14,290 $14,290 8.3×
Abdomen 1 View (74018) $610 $610 5.6×
Abdomen 2 views (74019) $658 $658 5.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $3,054 $3,054 6.1×
Angio internal mammary (75756) $2,582 $2,582 0.7×
Angio pulmonary bilat (75743) $7,813 $7,813 2.0×
Angiography extremity bilateral rs&i (75716) $8,846 $8,846 2.2×
Angiography extremity unilateral rs&i (75710) $7,371 $7,371 1.9×
Angiography pulmonary unilateral slctv rs&i (75741) $7,813 $7,813 2.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $6,385 $6,385 1.6×
Ankle 2 views (73600) $695 $695 6.4×
Artery X-Rays Abdomen (75726) $8,846 $8,846 1.3×
Artery X-Rays Pelvis (75736) $7,813 $7,813 1.1×
Artery X-Rays Spine (75705) $7,371 $7,371 1.1×
Arthrogram hip (73525) $988 $988 2.3×
Basic radiation dosimetry calculation (77300) $1,164 $1,164 6.9×
Bone age studies (77072) $396 $396 3.0×
Bone Imaging 3 Phase (78315) $4,768 $4,768 9.6×
Bone Imaging Limited Area (78300) $180 $180 0.4×
Bone Imaging Whole Body (78306) $3,216 $3,216 6.4×
Bone marrow imaging; whole body (78104) $4,036 $4,036 8.1×
Brachytx isodose complex (77318) $7,848 $7,848 16.8×
Brachytx isodose intermed (77317) $5,625 $5,625 12.0×
Brachytx Isodose Plan Simple (77316) $2,781 $2,781 5.9×
Brain Imaging Pet Metabolic Evaluation (78608) $4,423 $4,423 2.5×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $748 $748 1.5×
Cardiac MRI w/w/o contrast & further seq (75561) $8,591 $8,591 19.7×
Cat Scan Follow-Up Study (76380) $1,208 $1,208 11.1×
Cerebrospinal Fluid Scan (78630) $4,033 $4,033 6.0×
Chest 1 view (71045) $482 $482 4.4×
Chest 2 views (71046) $647 $647 6.0×
Chest 3 views (71047) $695 $695 6.4×
Chest 4 or more views (71048) $838 $838 6.4×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $399 $399 3.1×
Cholecystography Oral Contrast (74290) $1,265 $1,265 5.8×
Clavicle complete (73000) $776 $776 7.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $570 $570 4.4×
Continuing medical physics consltj pr wk (77336) $920 $920 5.5×
Contrast Exam Abdominl Aorta (75625) $7,634 $7,634 1.9×
Contrast X-Ray Bladder (74430) $1,500 $1,500 3.4×
CT abdomen and pelvis without and with contrast (74178) $4,654 $4,654 10.7×
CT abdomen and pelvis without contrast (74176) $4,513 $4,513 15.2×
CT abdomen w contrast (74160) $2,258 $2,258 10.3×
CT abdomen w wo contrast (74170) $2,359 $2,359 10.8×
CT abdomen w/o contrast (74150) $1,993 $1,993 15.3×
CT Angio Abdomen and Pelvis (74174) $2,107 $2,107 4.8×
CT Angio Chest (71275) $3,068 $3,068 14.0×
CT Angio Head (70496) $3,068 $3,068 14.0×
CT angio hrt w/3d image (75574) $3,445 $3,445 7.9×
Ct Angio Lwr Extr W/O&W/Dye (73706) $5,845 $5,845 26.7×
CT Angio Neck (70498) $3,068 $3,068 14.0×
Ct Angio Upr Extrm W/O&W/Dye (73206) $5,421 $5,421 24.8×
CT cervical spine w/ contrast (72126) $2,540 $2,540 5.8×
CT cervical spine w/o contrast (72125) $2,454 $2,454 18.8×
CT cervical spine w/wo cont (72127) $2,710 $2,710 12.4×
CT chest w contrast (71260) $2,874 $2,874 13.1×
CT chest w/wo contrast (71270) $3,068 $3,068 14.0×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,891 $1,891 8.6×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,891 $1,891 14.5×
CT head/brain with contrast (70460) $2,874 $2,874 13.1×
CT head/brain without and with contrast (70470) $3,068 $3,068 14.0×
CT heart contrast eval cardiac structure&morph (75572) $2,923 $2,923 6.7×
CT heart no contrast quant eval coronry calcium (75571) $155 $155 1.4×
CT iac w contrast (70481) $2,874 $2,874 13.1×
CT l-spine w&w/o contrast (72133) $2,710 $2,710 12.4×
CT lower ext w/o (73700) $4,908 $4,908 37.6×
CT lower extremity w/contrast material (73701) $5,747 $5,747 26.2×
CT lumbar spine w contrast (72132) $2,874 $2,874 6.6×
CT lumbar spine w/o contrast (72131) $2,540 $2,540 19.5×
CT maxillofacial w contrast (70487) $2,874 $2,874 13.1×
CT maxillofacial wo contrast (70486) $2,777 $2,777 21.3×
CT neck tissue combo (70492) $3,068 $3,068 14.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,710 $2,710 12.4×
CT orbits w/o contrast (70480) $2,777 $2,777 21.3×
CT pelvis w&w/o contrast (72194) $2,028 $2,028 9.3×
CT pelvis w/o contrast (72192) $1,993 $1,993 15.3×
CT scan of leg combo (73702) $2,710 $2,710 12.4×
CT scans face/jaw combo (70488) $2,710 $2,710 12.4×
CT soft tissue neck w contrast (70491) $2,874 $2,874 13.1×
CT soft tissue neck w/o contrast (70490) $2,777 $2,777 21.3×
CT thoracic spine w contrast (72129) $2,874 $2,874 13.1×
CT thoracic spine w/o contrast (72128) $2,454 $2,454 18.8×
CT thoracic spine w/wo cont (72130) $2,710 $2,710 12.4×
CT thorax w/o contrast (71250) $2,454 $2,454 18.8×
CT unlisted procedure (76497)
range across 2 matching MRF lines		 $136–$6,438 $136–$6,438 varies
CT upper ext wo (73200) $4,166 $4,166 31.9×
CT upper extremity w/o & w/contrast material (73202) $2,710 $2,710 12.4×
CT upper extremity with contrast (73201) $5,080 $5,080 11.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,359 $2,359 10.8×
Cta Abdomen (74175) $2,359 $2,359 10.8×
CTA pelvis (72191) $2,028 $2,028 9.3×
Dxa Bone Density Axial (77080) $1,509 $1,509 11.6×
Dxa bone density study (77085) $1,060 $1,060 8.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $1,412 $1,412 13.0×
Echo exam uterus (76831) $1,670 $1,670 5.6×
Esophagram (74220) $1,212 $1,212 5.5×
Fluoroscopy up to 1 hr (76000) $1,964 $1,964 6.6×
Follow-Up Angiography (75898) $2,067 $2,067 0.5×
Foot 2 views (73620) $741 $741 6.8×
Forearm 2 views (73090) $655 $655 6.0×
Gastric emptying imaging study (78264) $3,594 $3,594 7.2×
Gated Heart Planar Single (78472) $2,918 $2,918 5.8×
Hand 2 views (73120) $748 $748 5.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $7,977 $7,977 9.2×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $7,977 $7,977 9.2×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $7,977 $7,977 9.2×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $7,813 $7,813 2.0×
Hepatobil Syst Image W/Drug (78227) $2,770 $2,770 4.1×
Hepatobiliary System Imaging (78226) $1,855 $1,855 3.7×
Ht Muscle Image Spect Sing (78451) $5,545 $5,545 3.4×
Interstitial radiation source applic complex (77778) $11,870 $11,870 13.7×
K Flow/Funct Image Multiple (78709) $3,408 $3,408 5.0×
K Flow/Funct Image W/Drug (78708) $3,406 $3,406 5.0×
K Flow/Funct Image W/O Drug (78707) $3,579 $3,579 5.3×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $2,602 $2,602 5.2×
Knee 3 Views (73562) $779 $779 7.2×
Leveen/Shunt Patency Exam (78291) $3,128 $3,128 6.3×
Liver & Spleen Imaging Static Only (78215) $1,683 $1,683 3.4×
Lung Perf&Ventilat Diferentl (78598) $5,284 $5,284 7.8×
Lung perfusion differential (78597) $2,652 $2,652 5.3×
Lung Ventilat&Perfus Imaging (78582) $2,930 $2,930 4.3×
Lymph System Imaging (78195)
range across 2 matching MRF lines		 $3,046–$3,499 $3,046–$3,499 varies
Lymphangiography Extremity Only Bilateral Rs&I (75803) $2,031 $2,031 1.0×
Lymphangiography extremity only unilateral rs&i (75801) $1,030 $1,030 1.3×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,031 $2,031 0.5×
Lymphangiography, pelvic/abdominal, unilateral (75805) $1,353 $1,353 0.3×
Magnetic Image Jaw Joint (70336) $6,467 $6,467 21.7×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $1,170 $1,170 5.3×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $1,060 $1,060 1.6×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $1,265 $1,265 5.8×
Magnetic Resonance Elastography (76391) $499 $499 1.7×
Mammary ductogram or galactogram single (77053) $100 $100 0.3×
Meckels Divert Exam (78290) $3,128 $3,128 6.3×
Mlc imrt design & construction per imrt plan (77338) $14,895 $14,895 31.9×
Mr safety determination physician/other qhp (76016) $135 $135 1.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $38 $38 1.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $141 $141 1.2×
Mr safety implt pos&/immoblj (76019) $91 $91 1.2×
Mr safety med physics xm customization plng&mntr (76017) $372 $372 1.2×
Mra Head W/O & W/Contrast Material (70546) $7,589 $7,589 17.4×
MRA head w/o contrast (70544) $6,467 $6,467 21.7×
MRA head with contrast (70545) $7,279 $7,279 16.7×
MRA neck w contrast (70548) $7,279 $7,279 16.7×
Mra Neck W/O &W/Contrast Material (70549) $6,444 $6,444 14.8×
MRA neck w/o contrast (70547) $5,492 $5,492 18.4×
MRI abdomen w contrast (74182) $7,279 $7,279 16.7×
MRI abdomen w/o contrast (74181) $5,492 $5,492 18.4×
MRI any jt lower extrem w/contrast material (73722) $7,279 $7,279 7.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $7,589 $7,589 17.4×
MRI any jt upper extremity w/contrast matrl (73222) $7,279 $7,279 7.4×
MRI bone marrow blood supply (77084) $6,467 $6,467 21.7×
MRI brain functional w/o physician admnistration (70554) $6,467 $6,467 21.7×
MRI brain functional w/physician admnistration (70555) $6,467 $6,467 21.7×
MRI Breast W/O Contrast Bilateral (77047) $7,589 $7,589 25.5×
MRI Breast Without Contrast Material Unilateral (77046) $6,467 $6,467 21.7×
MRI cardiac w/o contrast (75557) $6,467 $6,467 21.7×
MRI cervical spine w contrast (72142)
range across 2 matching MRF lines		 $3,644–$7,279 $3,644–$7,279 varies
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines		 $3,664–$5,492 $3,664–$5,492 varies
MRI chest w/o contrast (71550) $6,467 $6,467 21.7×
MRI chest with contrast (71551) $7,279 $7,279 7.4×
MRI chest wo w contrast (71552) $7,589 $7,589 17.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $14,557 $14,557 33.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $7,589 $7,589 17.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $12,936 $12,936 43.4×
MRI lumbar spine w contrast (72149) $7,266 $7,266 16.7×
Mri Neck Spine W/O & W/Dye (72156)
range across 2 matching MRF lines		 $4,296–$6,450 $4,296–$6,450 varies
MRI orbit face &/neck w/o contrast (70540) $5,492 $5,492 18.4×
MRI orbit face neck w contrast (70542) $7,279 $7,279 16.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $6,444 $6,444 14.8×
MRI pelvis w contrast (72196) $6,180 $6,180 14.2×
MRI pelvis w/o & w contrast (72197) $7,159 $7,159 16.4×
MRI pelvis w/o contrast (72195) $5,492 $5,492 18.4×
MRI spectroscopy (76390) $2,586 $2,586 23.8×
MRI thoracic spine w/o contrast (72146) $5,492 $5,492 18.4×
MRI upper extremity oth than jt w/contr matrl (73219) $7,279 $7,279 16.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $6,467 $6,467 21.7×
Mri Uppr Extremity W/O&W/Dye (73220) $7,589 $7,589 17.4×
MRI, abdomen, combo (74183) $6,444 $6,444 14.8×
MRI, dorsal spine combo (72157) $7,589 $7,589 17.4×
MRI, dorsal spine contrast (72147) $7,279 $7,279 16.7×
MRI, joint upper extrem (73221) $5,492 $5,492 18.4×
MRI, joint upper extrem combo (73223) $6,444 $6,444 14.8×
MRI, lumbar spine combo (72158) $6,444 $6,444 14.8×
Myocardial Spect Multiple Studies (78452) $6,531 $6,531 4.0×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $8,161 $8,161 4.6×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $7,813 $7,813 4.4×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $7,813 $7,813 2.8×
Neck soft tissue (70360) $709 $709 6.5×
Nm csf leak detection (78650) $4,095 $4,095 2.5×
Nonvascular Shunt X-Ray (75809) $630 $630 4.8×
Ntsty modul radthx pln dose-vol histos (77301) $17,143 $17,143 9.9×
Nuclear Rx Intra-Arterial (79445)
range across 2 matching MRF lines		 $1,467–$2,812 $1,467–$2,812 varies
Nuclear Rx Oral Admin (79005) $2,272 $2,272 7.8×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $566 $566 4.3×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $276 $276 1.7×
Ophthalmic Biometry US Echograpy a-Scan (76516) $147 $147 1.1×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $534 $534 4.1×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $366 $366 10.1×
Ophthalmic us dx quantitative a-scan only (76511) $654 $654 5.0×
Panoramic X-ray of jaws (70355) $145 $145 1.3×
Parathyroid imaging w/tomographic spect & CT (78072) $2,430 $2,430 3.6×
Parathyroid Planar Imaging (78070) $1,701 $1,701 3.4×
Parathyroid planar imaging w/wo subtraction (78071) $340 $340 0.7×
Pelvis 1 or 2 views (72170) $654 $654 5.0×
Pet Image Skull-Thigh (78812)
range across 3 matching MRF lines		 $3,908–$7,813 $3,908–$7,813 varies
Pet Image W/Ct Lmtd (78814)
range across 3 matching MRF lines		 $1,956–$3,910 $1,956–$3,910 varies
PET image w/CT, full body (78816) $8,846 $8,846 5.0×
PET imaging CT attenuation skull base mid-thigh (78815)
range across 3 matching MRF lines		 $4,426–$8,846 $4,426–$8,846 varies
Pet Imaging Limited Area Chest Head/Neck (78811) $3,435 $3,435 2.1×
PET whole body (78813)
range across 2 matching MRF lines		 $3,908–$7,813 $3,908–$7,813 varies
Pulmonary Perfusion Imaging Particulate (78580) $3,159 $3,159 6.3×
Radex abscess/fistula/sinus tract rs&i (76080) $1,377 $1,377 2.0×
Radex Ankle Complete Minimum 3 Views (73610) $807 $807 7.4×
Radex Calcaneus Minimum 2 Views (73650) $659 $659 6.1×
Radex elbow complete minimum 3 views (73080) $773 $773 7.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $791 $791 6.1×
Radex fingr minimum 2 views (73140) $658 $658 6.1×
Radex foot complete minimum 3 views (73630) $766 $766 7.1×
Radex Hand Minimum 3 Views (73130) $742 $742 6.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $614 $614 5.7×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $1,355 $1,355 12.5×
Radex Ribs Unilateral 2 Views (71100) $750 $750 6.9×
Radex shoulder complete minimum 2 views (73030)
range across 2 matching MRF lines		 $779–$1,558 $779–$1,558 varies
Radex Spine 1 View Specify Level (72020) $488 $488 4.5×
Radex Sternum Minimum 2 Views (71120) $723 $723 6.7×
Radex Toe Minimum 2 Views (73660) $651 $651 6.0×
Radex Wrist Complete Minimum 3 Views (73110) $742 $742 6.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,944 $1,944 14.9×
Radiation Delivery Stereotactic Cranial Linear (77372) $31,869 $31,869 3.5×
Radiation treatment delivery level 1 (77402) $1,610 $1,610 12.6×
Radiation treatment delivery level 2 (77407) $2,121 $2,121 4.4×
Radiation treatment delivery level 3 (77412) $3,143 $3,143 4.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $695 $695 5.3×
Radiologic exam colon double contrast study (74280) $325 $325 1.5×
Radiologic exam colon single contrast study (74270) $1,721 $1,721 7.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $190 $190 0.9×
Radiologic exam knee complete 4/more views (73564) $858 $858 6.6×
Radiologic exam pelvis compl minimum 3 views (72190) $763 $763 5.8×
Radiologic Exam Small Int Single Contrast Study (74250) $1,301 $1,301 5.9×
Radiologic exam swallow function contrast study (74230) $543 $543 2.5×
Radiologic exam teeth complete full mouth (70320) $390 $390 1.3×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $390 $390 1.3×
Radiologic exam upr gi trc double contrast study (74246) $240 $240 1.1×
Radiologic examination femur 1 view (73551) $836 $836 7.7×
Radiologic examination femur minimum 2 views (73552) $1,257 $1,257 11.6×
Radiologic examination knee 1/2 views (73560) $1,495 $1,495 13.8×
Radiologic Examination Osseous Survey Limited (77074) $135 $135 1.0×
Radiologic examination tibia & fibula 2 views (73590) $895 $895 8.2×
Radiologic examination, teeth; single view Non-Facility (70300) $145 $145 1.3×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $1,091 $1,091 3.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $428 $428 0.9×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $428 $428 0.9×
Ribs bilateral 3 views (71110) $850 $850 6.5×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $7,086 $7,086 10.5×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802)
range across 2 matching MRF lines		 $1,823–$3,645 $1,823–$3,645 varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,677 $4,677 6.9×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $4,131 $4,131 2.6×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,677 $4,677 2.6×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $4,677 $4,677 2.9×
Rp Therapy Intravenous Administration (79101)
range across 3 matching MRF lines		 $2,272–$3,761 $2,272–$3,761 varies
Salivary Gland Imaging Serial Images (78231) $2,448.60 $2,448.60 4.9×
Scapula (73010) $827 $827 6.3×
Screening Digital Breast Tomosynthesis Bi (77063) $197 $197 8.4×
Shoulder 1 view (73020) $40 $40 0.4×
Skull less than 4 views (70250) $853 $853 6.5×
Special dosimetry (77331) $1,080 $1,080 6.4×
Special Physics Consult (77370) $3,975 $3,975 23.7×
Special teletherapy port plan (77321) $8,239 $8,239 17.6×
Special treatment procedure (77470) $6,556 $6,556 9.5×
Spleen Imaging (78185) $100 $100 0.2×
Stereotactic Body Radiation Delivery (77373) $13,994 $13,994 6.3×
Sternoclavicular joints (71130) $798 $798 7.3×
Tbs technical calculation only (77091) $145 $145 1.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $8,239 $8,239 17.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $5,071 $5,071 10.8×
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines		 $6,031–$6,393 $6,031–$6,393 varies
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,839 $2,839 6.1×
Ther rad simulaj-aided field setting simple (77280) $2,153 $2,153 12.8×
Thoracic spine 2 views (72070) $919 $919 7.0×
Thoracic spine 3 views (72072) $1,136 $1,136 8.7×
Thyroid Met Imaging Body (78018) $3,266 $3,266 4.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,581 $2,581 5.2×
Tx Devices Design & Construction Complex (77334) $3,220 $3,220 6.9×
Tx devices design & construction intermediate (77333) $1,659 $1,659 9.9×
Tx devices design & construction simple (77332) $1,520 $1,520 9.1×
Ultrasound Breast Limited (76642) $834 $834 7.7×
Ultrasound Elastography Parenchyma (76981) $243 $243 1.9×
Ultrasound, abdomen limited (76705) $1,668 $1,668 12.8×
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines		 $398–$754 $398–$754 varies
Unlisted magnetic resonance procedure (76498)
range across 6 matching MRF lines		 $370–$5,492 $370–$5,492 varies
Unlisted us procedure (76999) $912 $912 8.4×
Upper gi w/o kub (74240) $1,427 $1,427 6.5×
Urethrocystogram voiding (74455) $1,382 $1,382 4.6×
Urethrocystography retrograde (74450) $1,325 $1,325 4.4×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $610–$1,666 $610–$1,666 varies
Us chest (76604) $1,242 $1,242 9.5×
Us complete joint (76881) $375 $375 2.9×
Us exam, pelvic, limited (76857) $912 $912 7.0×
Us head (76506) $205 $205 1.6×
Us kidney transplant (76776) $351 $351 2.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $560 $560 4.3×
Us pelvic non ob complete (76856) $1,778 $1,778 13.6×
Us retroperitoneal complete (76770) $1,670 $1,670 12.8×
Us retroperitoneal limited (76775) $1,497 $1,497 11.5×
Us scrotum and contents (76870) $1,778 $1,778 13.6×
Us spinal canal and contents (76800) $755 $755 5.8×
Us thyroid (76536) $1,796 $1,796 13.8×
Us transrectal (76872) $1,667 $1,667 12.8×
Vascular Flow Imaging (78445) $2,168 $2,168 4.3×
Vein X-Ray Chest (75827) $6,856 $6,856 3.5×
Vein X-Ray Liver W/O Hemodyn (75887) $4,697 $4,697 1.2×
Venography Adrenal Unilateral (75840) $7,813 $7,813 2.0×
Venography caval inferior serialography rs&i (75825) $7,813 $7,813 2.0×
Venography extremity bilateral rs&i (75822) $3,824 $3,824 1.9×
Venography extremity unilateral rs&i (75820) $2,826 $2,826 1.4×
Venography Renal Bilateral (75833) $7,813 $7,813 2.0×
Venous sampling by catheter (75893) $7,045 $7,045 1.0×
Vertebral fracture assessment via dxa (77086) $55 $55 0.5×
Wrist 2 views (73100) $729 $729 6.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $659 $659 6.1×
X-ray antegrade pyelogram tube (74425) $1,707 $1,707 3.9×
X-Ray Bend Only L-S Spine (72120) $55 $55 0.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $720 $720 6.6×
X-Ray Exam Breast Specimen (76098) $1,216 $1,216 1.8×
X-Ray Exam Entire Spi 1 Vw (72081) $933 $933 8.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $1,588 $1,588 12.2×
X-Ray Exam Entire Spi 4/5 Vw (72083) $2,242 $2,242 17.2×
X-Ray Exam Hip Uni 1 View (73501) $419 $419 3.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $741 $741 6.8×
X-Ray Exam Hip Uni 4/> Views (73503) $1,481 $1,481 11.3×
X-Ray Exam Hips Bi 2 Views (73521) $810 $810 6.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $1,217 $1,217 9.3×
X-Ray Exam Hips Bi 5/> Views (73523) $1,622 $1,622 12.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $860 $860 7.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $954 $954 7.3×
X-Ray Exam Unilat Ribs/Chest (71101) $65 $65 0.5×
X-ray humerus (73060) $718 $718 6.6×
X-ray IV pyelogram (ivp) (74400) $1,707 $1,707 7.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $795 $795 7.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $1,028 $1,028 7.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $875 $875 6.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $711 $711 6.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $919 $919 8.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,203 $1,203 9.2×
X-ray thoracic spine 4 vw (72074) $1,233 $1,233 9.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $2,758 $2,758 6.3×
X-Rays Bone Length Studies (77073) $65 $65 0.5×
X-Rays Bone Survey Complete (77075) $1,971 $1,971 15.1×
Xr c-spine 4 or 5 views (72050) $1,025 $1,025 7.9×
Xr orbits complete 4 views (70200) $773 $773 5.9×

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.