Imaging prices at Mercy Health System Corp
Janesville, WI · every code in this section with a posted price and a Medicare benchmark.
341 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) | $6,438.05 | $8,584.07 | 4.6× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$66.68–$432.49 | $88.91–$576.65 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$80.11–$347.90 | $106.81–$463.86 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,297.27 | $1,729.69 | 3.2× |
| Angio pulmonary bilat (75743) | $463.69 | $618.25 | 0.1× |
| Angiography extremity bilateral rs&i (75716) | $4,675.79 | $6,234.39 | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $4,561.76 | $6,082.34 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $339.60 | $452.80 | 0.1× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$66.68–$328.80 | $88.91–$438.40 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,306.51 | $3,075.35 | 0.4× |
| Artery X-Rays Abdomen (75726) | $3,966.75 | $5,289 | 0.7× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$385.17–$442.90 | $513.56–$590.53 | varies |
| Arthrogram hip (73525) | $855.98 | $1,141.30 | 2.4× |
| Arthrogram Wrist (73115) | $1,148.22 | $1,530.96 | 3.3× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$268.94–$1,700.90 | $358.59–$2,267.87 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$80.11–$289.39 | $106.81–$385.85 | varies |
| Bone Imaging 3 Phase (78315) | $1,814.17 | $2,418.89 | 4.5× |
| Bone Imaging Limited Area (78300) | $1,281.04 | $1,708.05 | 3.2× |
| Bone Imaging Multiple Areas (78305) | $1,357.54 | $1,810.05 | 3.4× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$306.32–$1,591.73 | $408.43–$2,122.31 | varies |
| Bone marrow imaging limited area (78102) | $1,213.85 | $1,618.47 | 3.0× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$80.11–$398.30 | $106.81–$531.06 | varies |
| Brain Image W/Flow < 4 Views (78601) | $883.56 | $1,178.08 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,011.55 | $8,015.40 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,178.95 | $2,905.27 | 6.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,178.95 | $2,905.27 | 2.8× |
| Cat Scan Follow-Up Study (76380) | $913.65 | $1,218.20 | 10.4× |
| Cerebrospinal Fluid Scan (78630) | $1,198.09 | $1,597.45 | 2.2× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$66.68–$226.57 | $88.91–$302.09 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$66.68–$401.86 | $88.91–$535.82 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$66.68–$411.92 | $88.91–$549.22 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$80.11–$422.21 | $106.81–$562.95 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 2 matching MRF lines |
$80.11–$1,116.28 | $106.81–$1,488.38 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$66.68–$421.12 | $88.91–$561.49 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$80.11–$1,072.30 | $106.81–$1,429.74 | varies |
| Continuing medical physics consltj pr wk (77336) | $453.95 | $605.27 | 3.4× |
| Contrast Exam Abdominl Aorta (75625) | $4,561.76 | $6,082.34 | 1.4× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$267.32–$612.15 | $356.43–$816.20 | varies |
| Contrast X-Ray Of Elbow (73085) | $1,016.48 | $1,355.31 | 2.9× |
| Contrast X-Ray Of Knee Joint (73580) | $898.30 | $1,197.74 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$267.32–$8,036.40 | $356.43–$10,715.20 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$182.83–$4,463.48 | $243.77–$5,951.30 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$134.40–$2,273.91 | $179.20–$3,031.88 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$134.40–$2,797.32 | $179.20–$3,729.76 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$80.11–$1,909.25 | $106.81–$2,545.67 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$267.32–$3,488.59 | $356.43–$4,651.45 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$134.40–$3,775.97 | $179.20–$5,034.63 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$134.40–$3,547.88 | $179.20–$4,730.50 | varies |
| CT angio hrt w/3d image (75574) | $2,368.96 | $3,158.62 | 6.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$134.40–$3,914.55 | $179.20–$5,219.40 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$134.40–$3,309.98 | $179.20–$4,413.31 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$134.40–$5,691.27 | $179.20–$7,588.36 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,762.16 | $3,682.88 | 15.6× |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$267.32–$2,864.43 | $356.43–$3,819.24 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$80.11–$2,402.12 | $106.81–$3,202.82 | varies |
| CT cervical spine w/wo cont (72127) | $3,051.91 | $4,069.21 | 17.3× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$134.40–$2,394.63 | $179.20–$3,192.84 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$134.40–$3,039.59 | $179.20–$4,052.79 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$134.40–$2,357.94 | $179.20–$3,143.92 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$134.40–$2,642.81 | $179.20–$3,523.75 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,024.48 | $2,699.30 | 5.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $352.30 | $469.74 | 4.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$134.40–$2,162.02 | $179.20–$2,882.69 | varies |
| CT l-spine w&w/o contrast (72133) | $3,078.46 | $4,104.61 | 17.4× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$80.11–$1,481.84 | $106.81–$1,975.78 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$134.40–$1,588.70 | $179.20–$2,118.26 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$267.32–$2,544.29 | $356.43–$3,392.39 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$80.11–$2,305.68 | $106.81–$3,074.24 | varies |
| CT maxillofacial w contrast (70487) | $2,090.52 | $2,787.36 | 11.8× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$80.11–$1,724.03 | $106.81–$2,298.71 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$134.40–$2,675.50 | $179.20–$3,567.34 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$134.40–$2,325.25 | $179.20–$3,100.33 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$80.11–$1,908.40 | $106.81–$2,544.53 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$134.40–$2,446.91 | $179.20–$3,262.55 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$80.11–$2,161.60 | $106.81–$2,882.13 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,746.55–$1,746.68 | $2,328.73–$2,328.91 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$134.40–$2,236.74 | $179.20–$2,982.32 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$134.40–$2,136.12 | $179.20–$2,848.16 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$80.11–$1,884.29 | $106.81–$2,512.39 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$134.40–$2,577.37 | $179.20–$3,436.49 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$80.11–$2,311.87 | $106.81–$3,082.49 | varies |
| CT thoracic spine w/wo cont (72130) | $3,178.51 | $4,238.01 | 18.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$80.11–$2,139.95 | $106.81–$2,853.27 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$80.11–$1,685.18 | $106.81–$2,246.90 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$134.40–$2,082.16 | $179.20–$2,776.22 | varies |
| CT upper extremity with contrast (73201) | $1,943.98 | $2,591.98 | 5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,877.12 | $6,502.83 | 27.6× |
| Cta Abdomen (74175) | $3,421.61 | $4,562.15 | 19.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $6,857.86 | $9,143.81 | 19.5× |
| CTA pelvis (72191) | $3,918.73 | $5,224.97 | 22.2× |
| Dilation ureters/urethra rs&i (74485) | $153.78 | $205.04 | 0.1× |
| Diskography lumbar (72295) | $4,993.42 | $6,657.90 | 2.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $139.10 | $185.47 | 1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $259.92 | $346.56 | 2.5× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$80.11–$599.53 | $106.81–$799.37 | varies |
| Dxa bone density study (77085) range across 3 matching MRF lines |
$80.11–$819.42 | $106.81–$1,092.56 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$66.68–$160.93 | $88.91–$214.57 | varies |
| Echo exam of fetal heart (76825) | $672.58 | $896.77 | 1.2× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$182.83–$1,772.82 | $243.77–$2,363.76 | varies |
| Echo Guide For Artery Repair (76936) | $536.07 | $714.76 | 2.5× |
| Esophagram (74220) | $861.28 | $1,148.37 | 4.9× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$80.11–$794.61 | $106.81–$1,059.48 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$80.11–$640 | $106.81–$853.34 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) range across 2 matching MRF lines |
$182.83–$4,155.82 | $243.77–$5,541.09 | varies |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$182.83–$600.56 | $243.77–$800.74 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$66.68–$280.06 | $88.91–$373.41 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$66.68–$358.89 | $88.91–$478.52 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$306.32–$2,829.57 | $408.43–$3,772.76 | varies |
| Gated Heart Planar Single (78472) | $1,445.38 | $1,927.17 | 3.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$80.11–$382.74 | $106.81–$510.32 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,275.56 | $3,034.08 | 4.2× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,871.22–$1,904.30 | $2,494.96–$2,539.06 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$992.02–$1,763.72 | $1,322.69–$2,351.63 | varies |
| Hysterosalpingogram (74740) | $1,748.48 | $2,331.30 | 7.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $708.63 | $944.84 | 8.1× |
| Infant hip ultrasound, limited static exam (76886) | $592.87 | $790.49 | 6.8× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$80.11–$394.22 | $106.81–$525.63 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$416.05–$1,059.22 | $554.73–$1,412.30 | varies |
| K Flow/Funct Image W/O Drug (78707) | $997.67 | $1,330.23 | 1.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$66.68–$480.25 | $88.91–$640.33 | varies |
| Liver & Spleen Imaging Static Only (78215) | $717.15 | $956.20 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,533.48 | $2,044.64 | 2.8× |
| Lung perfusion differential (78597) | $1,471.84 | $1,962.45 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$416.05–$1,924.96 | $554.73–$2,566.62 | varies |
| Lung Ventilation Imaging (78579) | $915.76 | $1,221.02 | 2.3× |
| Lymph System Imaging (78195) | $1,679.38 | $2,239.18 | 3.1× |
| Magnetic Image Jaw Joint (70336) | $2,697.31 | $3,596.41 | 11.2× |
| Meckels Divert Exam (78290) | $783.88 | $1,045.17 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,144.40 | $1,525.86 | 3.0× |
| Mra Head W/O & W/Contrast Material (70546) | $5,551.64 | $7,402.19 | 15.8× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$182.83–$3,875.56 | $243.77–$5,167.42 | varies |
| MRA head with contrast (70545) | $4,309.67 | $5,746.23 | 12.3× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$267.32–$4,285.14 | $356.43–$5,713.52 | varies |
| Mra Neck W/O &W/Contrast Material (70549) | $7,032.57 | $9,376.76 | 20.0× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$182.83–$3,875.56 | $243.77–$5,167.42 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$182.83–$5,882.44 | $243.77–$7,843.26 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $5,195.88 | $6,927.84 | 6.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$267.32–$6,309.64 | $356.43–$8,412.85 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,213.42 | $6,951.23 | 6.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $8,501.72 | $11,335.62 | 35.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,329.18 | $5,772.24 | 18.0× |
| MRI cardiac w/o cont stress (75559) | $1,952.12 | $2,602.83 | 3.5× |
| MRI cardiac w/o contrast (75557) | $1,952.12 | $2,602.83 | 8.1× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$267.32–$5,802.79 | $356.43–$7,737.05 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$182.83–$5,231.86 | $243.77–$6,975.81 | varies |
| MRI chest w/o contrast (71550) | $5,151.46 | $6,868.61 | 21.4× |
| MRI chest wo w contrast (71552) | $7,691.57 | $10,255.43 | 21.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$267.32–$6,506.90 | $356.43–$8,675.87 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$182.83–$4,912.76 | $243.77–$6,550.34 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$267.32–$5,996.72 | $356.43–$7,995.62 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$267.32–$7,277.22 | $356.43–$9,702.96 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$182.83–$4,583.37 | $243.77–$6,111.16 | varies |
| MRI orbit face neck w contrast (70542) | $5,177.45 | $6,903.27 | 14.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$267.32–$9,259.36 | $356.43–$12,345.82 | varies |
| MRI pelvis w contrast (72196) | $267.32 | $356.43 | 0.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$267.32–$6,375.42 | $356.43–$8,500.56 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$182.83–$4,293.83 | $243.77–$5,725.11 | varies |
| MRI spectroscopy (76390) | $3,348.32 | $4,464.42 | 38.2× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$182.83–$5,480.02 | $243.77–$7,306.69 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$182.83–$4,271.82 | $243.77–$5,695.76 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$267.32–$6,030.56 | $356.43–$8,040.75 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$267.32–$8,370.80 | $356.43–$11,161.06 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$267.32–$7,646.66 | $356.43–$10,195.55 | varies |
| MRI, dorsal spine contrast (72147) | $6,563.34 | $8,751.12 | 18.7× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$182.83–$4,746.92 | $243.77–$6,329.23 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$267.32–$6,563.95 | $356.43–$8,751.93 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$267.32–$7,535.38 | $356.43–$10,047.18 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$992.02–$3,994.64 | $1,322.69–$5,326.18 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$66.68–$247.73 | $88.91–$330.31 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$306.32–$405.46 | $408.43–$540.62 | varies |
| Nm myocard infarct spect (78469) | $611.11 | $814.81 | 1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,004.67 | $12,006.23 | 6.5× |
| Nuclear Rx Oral Admin (79005) | $1,349.46 | $1,799.28 | 5.7× |
| Ob us nuchal meas 1 gest (76813) | $1,055.92 | $1,407.89 | 10.0× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$80.11–$85.17 | $106.81–$113.56 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $80.11 | $106.81 | 0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$80.11–$224.44 | $106.81–$299.26 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $22.16 | $29.55 | 0.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,395.46 | $3,193.94 | 4.4× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$306.32–$1,017.06 | $408.43–$1,356.08 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,035.25 | $1,380.33 | 2.6× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$80.11–$442.90 | $106.81–$590.53 | varies |
| Pet Image W/Ct Lmtd (78814) | $4,732.21 | $6,309.61 | 3.3× |
| PET image w/CT, full body (78816) | $5,782.34 | $7,709.78 | 4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,200.22 | $6,933.62 | 3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,098.09 | $1,464.12 | 2.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$80.11–$594.56 | $106.81–$792.75 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $587.15 | $782.87 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$66.68–$355.77 | $88.91–$474.36 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$66.68–$200.36 | $88.91–$267.14 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$66.68–$406.59 | $88.91–$542.12 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$80.11–$502.02 | $106.81–$669.36 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$66.68–$314.29 | $88.91–$419.05 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$66.68–$378.58 | $88.91–$504.78 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$66.68–$401.41 | $88.91–$535.21 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$66.68–$625.26 | $88.91–$833.68 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $80.11 | $106.81 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$66.68–$318.44 | $88.91–$424.58 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $66.68 | $88.91 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$66.68–$387.93 | $88.91–$517.24 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$66.68–$383.78 | $88.91–$511.71 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$66.68–$285 | $88.91–$380 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $580 | $773.33 | 3.3× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$66.68–$179.36 | $88.91–$239.14 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$66.68–$244.78 | $88.91–$326.38 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$66.68–$549.34 | $88.91–$732.46 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$66.68–$224.05 | $88.91–$298.73 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$80.11–$333.99 | $106.81–$445.32 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$66.68–$396.22 | $88.91–$528.30 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$80.11–$262.18 | $106.81–$349.57 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,068.14 | $20,090.86 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $630.08 | $840.11 | 6.1× |
| Radiation treatment delivery level 2 (77407) | $2,954.50 | $3,939.34 | 7.6× |
| Radiation treatment delivery level 3 (77412) | $6,000 | $8,000 | 10.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$80.11–$409.71 | $106.81–$546.28 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$80.11–$387.76 | $106.81–$517.01 | varies |
| Radiologic exam colon double contrast study (74280) | $1,464.16 | $1,952.22 | 8.3× |
| Radiologic exam colon single contrast study (74270) | $1,216.90 | $1,622.53 | 6.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $973.34 | $1,297.78 | 5.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$80.11–$528.99 | $106.81–$705.32 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$80.11–$453.97 | $106.81–$605.29 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $565.85 | $754.47 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $892.76 | $1,190.35 | 5.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,238.19 | $1,650.92 | 7.0× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$66.68–$350.59 | $88.91–$467.45 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$66.68–$415.93 | $88.91–$554.57 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$66.68–$433.57 | $88.91–$578.09 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$80.11–$461.10 | $106.81–$614.80 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$66.68–$381.70 | $88.91–$508.94 | varies |
| Renal Cyst Study (74470) | $1,279.63 | $1,706.17 | 2.3× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$80.11–$451.42 | $106.81–$601.89 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $922.96 | $1,230.62 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,154.01 | $2,872.01 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,538.49 | $2,051.32 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,539.34 | $3,385.78 | 4.6× |
| Rp Therapy Intravenous Administration (79101) | $1,326.38 | $1,768.50 | 5.6× |
| Scapula (73010) range across 2 matching MRF lines |
$80.11–$410.74 | $106.81–$547.66 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$19.26–$94.27 | $25.68–$125.69 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$66.68–$319.47 | $88.91–$425.96 | varies |
| Shoulder Arthrography (73040) | $1,299.64 | $1,732.86 | 3.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$80.11–$311.17 | $106.81–$414.89 | varies |
| Special dosimetry (77331) | $262.12 | $349.49 | 1.9× |
| Special Physics Consult (77370) | $568.89 | $758.52 | 4.2× |
| Special teletherapy port plan (77321) | $595.35 | $793.80 | 1.6× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$929.67–$4,222.03 | $1,239.56–$5,629.37 | varies |
| Stereotactic Body Radiation Delivery (77373) | $9,463.58 | $12,618.11 | 5.3× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$66.68–$157.66 | $88.91–$210.21 | varies |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $214.22 | $285.62 | 2.4× |
| Tbs technical calculation only (77091) range across 2 matching MRF lines |
$66.68–$214.22 | $88.91–$285.62 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,615.41 | $3,487.21 | 6.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $876.86 | $1,169.14 | 2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,625 | $3,500 | 7.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,550 | $3,400 | 6.8× |
| Ther rad simulaj-aided field setting simple (77280) | $2,518.66 | $3,358.22 | 18.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$80.11–$353.69 | $106.81–$471.59 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$80.11–$455.35 | $106.81–$607.13 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$66.68–$314.29 | $88.91–$419.05 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$306.32–$1,038.88 | $408.43–$1,385.18 | varies |
| Thyroid Met Imaging Body (78018) | $2,388.02 | $3,184.02 | 4.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$306.32–$1,497.47 | $408.43–$1,996.63 | varies |
| Tx Devices Design & Construction Complex (77334) range across 6 matching MRF lines |
$483.77–$918.75 | $645.03–$1,225 | varies |
| Tx devices design & construction intermediate (77333) | $427.35 | $569.80 | 3.2× |
| Tx devices design & construction simple (77332) | $300 | $400 | 2.2× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$66.68–$829.36 | $88.91–$1,105.81 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$80.11–$712.46 | $106.81–$949.94 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$80.11–$712.14 | $106.81–$949.52 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$80.11–$530.86 | $106.81–$707.81 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$80.11–$1,351.12 | $106.81–$1,801.49 | varies |
| Umbilical-artery Doppler (OB) (76820) | $755.10 | $1,006.80 | 7.2× |
| Unlisted magnetic resonance procedure (76498) | $438.76 | $585.02 | 5.0× |
| Unlisted us procedure (76999) | $66.68 | $88.91 | 0.8× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$914.58–$1,052.05 | $1,219.44–$1,402.73 | varies |
| Urethrocystogram voiding (74455) | $726.99 | $969.32 | 3.0× |
| Urethrocystography retrograde (74450) | $520.77 | $694.36 | 2.2× |
| Us breast unilateral complete (76641) | $991.42 | $1,321.90 | 9.4× |
| Us chest (76604) range across 2 matching MRF lines |
$80.11–$694.58 | $106.81–$926.10 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$80.11–$1,266.28 | $106.81–$1,688.38 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$80.11–$451.48 | $106.81–$601.97 | varies |
| Us head (76506) range across 2 matching MRF lines |
$705.30–$705.32 | $940.40–$940.43 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$80.11–$519.32 | $106.81–$692.42 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$80.11–$1,116.28 | $106.81–$1,488.38 | varies |
| Us ob detailed single fetus (76811) | $182.83 | $243.77 | 0.8× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$80.11–$562.28 | $106.81–$749.70 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$80.11–$436.59 | $106.81–$582.12 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$80.11–$1,324.66 | $106.81–$1,766.21 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$80.11–$1,055.92 | $106.81–$1,407.89 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$80.11–$1,153.49 | $106.81–$1,537.99 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$80.11–$520.94 | $106.81–$694.58 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$80.11–$453.13 | $106.81–$604.17 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$80.11–$716.90 | $106.81–$955.87 | varies |
| Us spinal canal and contents (76800) | $665.63 | $887.51 | 6.3× |
| Us thyroid (76536) range across 3 matching MRF lines |
$80.11–$1,170.86 | $106.81–$1,561.14 | varies |
| Us transrectal (76872) | $80.11 | $106.81 | 0.8× |
| Vein X-Ray Chest (75827) | $4,276.79 | $5,702.39 | 2.7× |
| Venogram Sinus/Jugular (75860) | $4,270.28 | $5,693.71 | 1.3× |
| Venography caval inferior serialography rs&i (75825) | $5,995.20 | $7,993.60 | 1.9× |
| Venography extremity bilateral rs&i (75822) | $1,721.26 | $2,295.01 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,679.28 | $2,239.04 | 1.1× |
| Venography Renal Bilateral (75833) | $5,568.34 | $7,424.46 | 1.8× |
| Venography Renal Unilateral (75831) | $5,388.97 | $7,185.29 | 1.7× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$66.68–$219.89 | $88.91–$293.19 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$66.68–$244.78 | $88.91–$326.38 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$66.68–$306.65 | $88.91–$408.87 | varies |
| X-ray antegrade pyelogram tube (74425) | $459.02 | $612.02 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$5,102.23–$5,416.96 | $6,802.97–$7,222.61 | varies |
| X-Ray Bend Only L-S Spine (72120) | $401.41 | $535.21 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$66.68–$382.74 | $88.91–$510.32 | varies |
| X-Ray Exam Breast Specimen (76098) | $217.47 | $289.96 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$66.68–$110.80 | $88.91–$147.73 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$80.11–$201.31 | $106.81–$268.41 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$80.11–$208.08 | $106.81–$277.44 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$66.68–$623.37 | $88.91–$831.16 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$66.68–$761.33 | $88.91–$1,015.11 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$80.11–$942.84 | $106.81–$1,257.12 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$80.11–$387.93 | $106.81–$517.24 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$80.11–$422.16 | $106.81–$562.88 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$80.11–$507.20 | $106.81–$676.27 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$80.11–$658.10 | $106.81–$877.46 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$66.68–$318.08 | $88.91–$424.11 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$80.11–$651.38 | $106.81–$868.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$80.11–$524.20 | $106.81–$698.94 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$66.68–$410.26 | $88.91–$547.02 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$66.68–$322.58 | $88.91–$430.11 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,468.51–$1,629.26 | $1,958.01–$2,172.35 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$66.68–$480.25 | $88.91–$640.33 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$80.11–$311.17 | $106.81–$414.89 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$66.68–$488.06 | $88.91–$650.74 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$80.11–$848.46 | $106.81–$1,131.28 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$80.11–$401.88 | $106.81–$535.84 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$80.11–$392.08 | $106.81–$522.77 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$66.68–$418.01 | $88.91–$557.35 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$66.68–$504.10 | $88.91–$672.13 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$80.11–$399.71 | $106.81–$532.95 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$80.11–$466.73 | $106.81–$622.31 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$267.32–$889.06 | $356.43–$1,185.41 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$80.11–$176.33 | $106.81–$235.11 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$80.11–$814.23 | $106.81–$1,085.64 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$80.11–$536.08 | $106.81–$714.78 | varies |
| Xr facial bones less than 3 views (70140) | $66.68 | $88.91 | 0.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $80.11 | $106.81 | 0.8× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$80.11–$360.94 | $106.81–$481.25 | varies |
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.