Imaging prices at Mercy Hospital Oklahoma City, Inc
Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.
381 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) range across 2 matching MRF lines |
$5,493.15–$33,184.45 | $8,451–$51,053 | varies |
| Abdomen 1 View (74018) | $382.20 | $588 | 4.6× |
| Abdomen 2 views (74019) | $518.05 | $797 | 5.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$994.50–$1,331.85 | $1,530–$2,049 | varies |
| Angio internal mammary (75756) | $6,059.95 | $9,323 | 2.0× |
| Angio pulmonary bilat (75743) | $3,097.25 | $4,765 | 1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $11,402.95 | $17,543 | 3.8× |
| Angiography extremity bilateral rs&i (75716) | $3,719.95 | $5,723 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $2,483 | $3,820 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,275 | $3,500 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,290.25 | $1,985 | 0.4× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$244.40–$443.95 | $376–$683 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,822.95 | $4,343 | 0.5× |
| Artery X-Rays Abdomen (75726) | $2,815.80 | $4,332 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $6,815.25 | $10,485 | 2.2× |
| Artery X-Rays Pelvis (75736) | $4,694.95 | $7,223 | 0.9× |
| Artery X-Rays Spine (75705) | $5,743.40 | $8,836 | 1.1× |
| Arthrogram ankle (73615) | $412.10 | $634 | 1.2× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$529.75–$739.05 | $815–$1,137 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$583.70–$790.40 | $898–$1,216 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$667.55–$37,589.50 | $1,027–$57,830 | varies |
| Bone age studies (77072) | $339.95 | $523 | 3.4× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,485.90–$1,644.50 | $2,286–$2,530 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$817.05–$975.65 | $1,257–$1,501 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,384.50–$3,699.38 | $2,130–$5,691.36 | varies |
| Bone survey infant (77076) | $460.85 | $709 | 4.6× |
| Brachytx isodose complex (77318) | $5,315.70 | $8,178 | 14.8× |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$2,182.05–$26,578.69 | $3,357–$40,890.30 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$1,041.95–$24,874.78 | $1,603–$38,268.90 | varies |
| Brain Flow Imaging Only (78610) | $1,550.90 | $2,386 | 3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$3,925.35–$6,324.50 | $6,039–$9,730 | varies |
| Cat Scan Follow-Up Study (76380) | $732.55 | $1,127 | 8.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $908.70 | $1,398 | 1.7× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$1,102.40–$6,615.70 | $1,696–$10,178 | varies |
| Chest 1 view (71045) | $325.65 | $501 | 3.9× |
| Chest 2 views (71046) | $411.45 | $633 | 4.9× |
| Chest 3 views (71047) | $341.90 | $526 | 4.1× |
| Chest 4 or more views (71048) | $740.35 | $1,139 | 7.4× |
| Cholecystography Oral Contrast (74290) | $872.95 | $1,343 | 5.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$419.90–$629.85 | $646–$969 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $666.90 | $1,026 | 6.6× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$691.60–$32,982.95 | $1,064–$50,743 | varies |
| Contrast Exam Abdominl Aorta (75625) | $2,971.80 | $4,572 | 1.0× |
| Contrast X-Ray Bladder (74430) | $663.65 | $1,021 | 2.0× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$425.10–$1,045.85 | $654–$1,609 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $578.50 | $890 | 1.7× |
| Corpora cavernosography (74445) | $613.60 | $944 | 6.1× |
| CT abdomen and pelvis without and with contrast (74178) | $3,589.95 | $5,523 | 10.7× |
| CT abdomen and pelvis without contrast (74176) | $2,638.35 | $4,059 | 11.5× |
| CT abdomen w contrast (74160) | $1,871.35 | $2,879 | 11.1× |
| CT abdomen w wo contrast (74170) | $2,188.55 | $3,367 | 13.0× |
| CT abdomen w/o contrast (74150) | $1,575.60 | $2,424 | 15.7× |
| CT Angio Abdomen and Pelvis (74174) | $3,001.05 | $4,617 | 8.9× |
| CT Angio Chest (71275) | $2,015.65 | $3,101 | 11.9× |
| CT Angio Head (70496) | $1,784.25 | $2,745 | 10.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,603.90–$3,905.85 | $4,006–$6,009 | varies |
| CT Angio Neck (70498) | $1,698.45 | $2,613 | 10.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,492.40–$2,781.35 | $2,296–$4,279 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $911.95 | $1,403 | 5.4× |
| CT cervical spine w/ contrast (72126) | $2,155.40 | $3,316 | 6.4× |
| CT cervical spine w/o contrast (72125) | $2,093.65 | $3,221 | 20.8× |
| CT cervical spine w/wo cont (72127) | $2,425.15 | $3,731 | 14.4× |
| CT chest w contrast (71260) | $1,768 | $2,720 | 10.5× |
| CT chest w/wo contrast (71270) | $3,023.80 | $4,652 | 17.9× |
| CT head/brain with contrast (70460) | $1,528.80 | $2,352 | 9.1× |
| CT head/brain without and with contrast (70470) | $3,149.90 | $4,846 | 18.7× |
| CT iac w contrast (70481) | $1,781 | $2,740 | 10.6× |
| CT l-spine w&w/o contrast (72133) | $1,972.10 | $3,034 | 11.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,347.45–$2,021.50 | $2,073–$3,110 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,325.05–$3,488.55 | $3,577–$5,367 | varies |
| CT lumbar spine w contrast (72132) | $1,815.45 | $2,793 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,595.10 | $2,454 | 15.9× |
| CT maxillofacial w contrast (70487) | $2,835.95 | $4,363 | 16.8× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,433.25–$3,342.30 | $2,205–$5,142 | varies |
| CT neck tissue combo (70492) | $2,933.45 | $4,513 | 17.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,784.90 | $2,746 | 10.6× |
| CT orbits w/o contrast (70480) | $1,600.30 | $2,462 | 15.9× |
| CT pelvis w&w/o contrast (72194) | $1,676.35 | $2,579 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,447.55 | $2,227 | 14.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,558.70–$3,979.30 | $2,398–$6,122 | varies |
| CT scans face/jaw combo (70488) | $1,845.35 | $2,839 | 10.9× |
| CT soft tissue neck w contrast (70491) | $2,284.10 | $3,514 | 13.5× |
| CT soft tissue neck w/o contrast (70490) | $1,965.60 | $3,024 | 19.5× |
| CT thoracic spine w contrast (72129) | $1,641.90 | $2,526 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,595.10 | $2,454 | 15.9× |
| CT thoracic spine w/wo cont (72130) | $1,796.60 | $2,764 | 10.6× |
| CT thorax w/o contrast (71250) | $1,416.35 | $2,179 | 14.1× |
| CT unlisted procedure (76497) | $584.35 | $899 | 7.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,297.40–$1,945.45 | $1,996–$2,993 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,605.50–$3,306.55 | $2,470–$5,087 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,428.70–$2,711.80 | $2,198–$4,172 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,685.50 | $5,670 | 21.8× |
| Cta Abdomen (74175) | $2,148.25 | $3,305 | 12.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,682.90 | $5,666 | 11.0× |
| CTA pelvis (72191) | $1,575.60 | $2,424 | 9.3× |
| Dilation ureters/urethra rs&i (74485) | $2,847 | $4,380 | 1.4× |
| Discography Cerv/Thor Spine (72285) | $2,375.10 | $3,654 | 1.3× |
| Diskography lumbar (72295) | $2,575.30 | $3,962 | 1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $466.05 | $717 | 4.6× |
| Dxa Bone Density Axial (77080) | $366.60 | $564 | 3.6× |
| Dxa bone density study (77085) | $528.45 | $813 | 5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $234.65 | $361 | 2.8× |
| Echo exam of fetal heart (76825) | $2,518.75 | $3,875 | 4.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $826.15 | $1,271 | 3.6× |
| Echograp Trans R Pros Study (76873) | $817.70 | $1,258 | 8.1× |
| Esophageal Motility Study (78258) | $1,608.10 | $2,474 | 4.2× |
| Esophagram (74220) | $567.45 | $873 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $568.10 | $874 | 5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $572 | $880 | 5.7× |
| Fluoroscopy up to 1 hr (76000) | $474.50 | $730 | 2.1× |
| Follow-Up Angiography (75898) | $842.40 | $1,296 | 0.3× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$250.90–$638.95 | $386–$983 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$401.70–$603.20 | $618–$928 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,268.80–$1,989 | $1,952–$3,060 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,552.85 | $2,389 | 4.0× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,996.80–$2,334.15 | $3,072–$3,591 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$219.70–$555.10 | $338–$854 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,207.45 | $6,473 | 6.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,103.75 | $4,775 | 4.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,652 | $4,080 | 4.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,466.45 | $5,333 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,852.50 | $2,850 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,463.80–$2,064.85 | $2,252–$3,176.69 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$2,182.05–$2,566.85 | $3,357–$3,949 | varies |
| Ht Muscle Image Spect Sing (78451) | $2,331.55 | $3,587 | 1.9× |
| Hysterosalpingogram (74740) | $1,061.45 | $1,633 | 4.6× |
| Interstitial radiation source applic complex (77778) | $6,247.80 | $9,612 | 9.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,743.70 | $7,298 | 7.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $17,893.20 | $27,528 | 33.7× |
| Intracavitary radiation source applic simple (77761) | $7,001.80 | $10,772 | 13.2× |
| K Flow/Funct Image Multiple (78709) | $1,763.45 | $2,713 | 3.4× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$2,102.10–$2,757.30 | $3,234–$4,242 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,555.45 | $2,393 | 3.0× |
| Kidney Imaging Morphol (78700) | $3,072.55 | $4,727 | 8.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$472.55–$709.15 | $727–$1,091 | varies |
| Liver & Spleen Imaging Static Only (78215) | $915.20 | $1,408 | 2.4× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$725.40–$44,123.49 | $1,116–$67,882.29 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $2,407.60 | $3,704 | 4.6× |
| Lung perfusion differential (78597) | $2,189.20 | $3,368 | 5.7× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,247.35–$1,879.15 | $1,919–$2,891 | varies |
| Lung Ventilation Imaging (78579) | $932.10 | $1,434 | 2.4× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,258.40–$18,029.90 | $1,936–$27,738.31 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,452.15 | $5,311 | 1.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,118.35 | $3,259 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,155.05 | $1,777 | 5.0× |
| Magnetic Resonance Elastography (76391) | $1,372.15 | $2,111 | 6.0× |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$359.45–$668.20 | $553–$1,028 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,153.75–$1,186.25 | $1,775–$1,825 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$6,785.35–$41,990 | $10,439–$64,600 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $2,253.55 | $3,467 | 6.7× |
| MRA head w/o contrast (70544) | $1,781 | $2,740 | 7.8× |
| MRA head with contrast (70545) | $1,901.90 | $2,926 | 5.7× |
| MRA neck w contrast (70548) | $2,051.40 | $3,156 | 6.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,165.15 | $3,331 | 6.5× |
| MRA neck w/o contrast (70547) | $1,493.05 | $2,297 | 6.5× |
| MRI abdomen w contrast (74182) | $2,960.10 | $4,554 | 8.8× |
| MRI abdomen w/o contrast (74181) | $2,073.50 | $3,190 | 9.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,959.75 | $3,015 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,611.05–$3,916.25 | $4,017–$6,025 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,082.95–$4,455.75 | $4,743–$6,855 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,177.50 | $3,350 | 9.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,979.25 | $3,045 | 8.6× |
| MRI cervical spine w contrast (72142) | $5,954 | $9,160 | 17.7× |
| MRI cervical spine w/o cont (72141) | $2,096.25 | $3,225 | 9.1× |
| MRI chest w/o contrast (71550) | $1,676.35 | $2,579 | 7.3× |
| MRI chest wo w contrast (71552) | $2,165.80 | $3,332 | 6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,603.25–$3,903.90 | $4,005–$6,006 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,408.90–$3,613.35 | $3,706–$5,559 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,903.20–$2,854.80 | $2,928–$4,392 | varies |
| MRI lumbar spine w contrast (72149) | $1,950.65 | $3,001 | 5.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,003 | $4,620 | 8.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,632.80 | $2,512 | 7.1× |
| MRI orbit face neck w contrast (70542) | $2,203.50 | $3,390 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,717–$5,450.90 | $4,180–$8,386 | varies |
| MRI pelvis w contrast (72196) | $2,736.50 | $4,210 | 8.2× |
| MRI pelvis w/o & w contrast (72197) | $2,783.95 | $4,283 | 8.3× |
| MRI pelvis w/o contrast (72195) | $2,049.45 | $3,153 | 8.9× |
| MRI thoracic spine w/o contrast (72146) | $2,037.75 | $3,135 | 8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,189.25 | $6,445 | 12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,680.90–$2,522 | $2,586–$3,880 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,601.65–$4,169.10 | $5,541–$6,414 | varies |
| MRI, abdomen, combo (74183) | $2,923.05 | $4,497 | 8.7× |
| MRI, dorsal spine combo (72157) | $3,027.05 | $4,657 | 9.0× |
| MRI, dorsal spine contrast (72147) | $2,176.85 | $3,349 | 6.5× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,994.85–$2,993.25 | $3,069–$4,605 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,215.85–$3,324.10 | $3,409–$5,114 | varies |
| MRI, lumbar spine combo (72158) | $2,995.20 | $4,608 | 8.9× |
| Myelogram cervical (72240) | $2,841.15 | $4,371 | 3.8× |
| Myelogram Lumbar (72265) | $2,652 | $4,080 | 3.5× |
| Myelography thoracic (72255) | $3,418.35 | $5,259 | 4.5× |
| Myelograpy 2/more regions rs&i (72270) | $4,312.10 | $6,634 | 5.7× |
| Myocardial Spect Multiple Studies (78452) | $4,838.60 | $7,444 | 3.9× |
| Neck soft tissue (70360) | $508.30 | $782 | 6.1× |
| Nm csf leak detection (78650) | $1,034.80 | $1,592 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $350.35 | $539 | 3.5× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$5,317–$38,901.85 | $8,180–$59,849 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$804.05–$29,899.82 | $1,237–$45,999.72 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,495.65–$10,894 | $2,301–$16,760 | varies |
| Ob us nuchal meas 1 gest (76813) | $399.10 | $614 | 4.0× |
| Panoramic X-ray of jaws (70355) | $288.60 | $444 | 3.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,732.90 | $2,666 | 3.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$917.15–$1,724.45 | $1,411–$2,653 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,051.70–$1,859 | $1,618–$2,860 | varies |
| Pelvis 1 or 2 views (72170) | $259.35 | $399 | 2.6× |
| Peritoneogram Rs&I (74190) | $1,194.05 | $1,837 | 2.3× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$5,801.90–$10,026.25 | $8,926–$15,425 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,680.65–$7,086.95 | $7,201–$10,903 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$4,498–$6,904.30 | $6,920–$10,622 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,946.75 | $2,995 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $906.75 | $1,395 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $831.35 | $1,279 | 8.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $552.50 | $850 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$435.50–$652.60 | $670–$1,004 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$239.20–$358.15 | $368–$551 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$273.65–$410.15 | $421–$631 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $320.45 | $493 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$331.50–$497.90 | $510–$766 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$436.15–$654.55 | $671–$1,007 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$256.75–$384.80 | $395–$592 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$239.85–$359.45 | $369–$553 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $310.70 | $478 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $243.10 | $374 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $450.45 | $693 | 5.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$465.40–$698.10 | $716–$1,074 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $289.25 | $445 | 3.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,885 | $2,900 | 11.2× |
| Radex Spine 1 View Specify Level (72020) | $246.35 | $379 | 2.9× |
| Radex Sternum Minimum 2 Views (71120) | $228.15 | $351 | 2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $248.95 | $383 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$345.80–$518.70 | $532–$798 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$250.25–$375.70 | $385–$578 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$416–$623.35 | $640–$959 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $897.65 | $1,381 | 8.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$32,388.20–$46,780.40 | $49,828–$71,969.84 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$416.65–$13,238.55 | $641–$20,367 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$2,630.55–$37,928.15 | $4,047–$58,351 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,977.65–$17,669.60 | $4,581–$27,184 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $333.45 | $513 | 3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $679.25 | $1,045 | 6.8× |
| Radiologic exam colon double contrast study (74280) | $1,041.30 | $1,602 | 6.2× |
| Radiologic exam colon single contrast study (74270) | $1,275.30 | $1,962 | 7.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$345.15–$845.65 | $531–$1,301 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $329.55 | $507 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $686.40 | $1,056 | 4.1× |
| Radiologic exam swallow function contrast study (74230) | $582.40 | $896 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$636.35–$1,500.20 | $979–$2,308 | varies |
| Radiologic examination femur 1 view (73551) | $256.75 | $395 | 3.1× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$278.20–$416.65 | $428–$641 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$250.25–$375.70 | $385–$578 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $469.30 | $722 | 4.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$428.35–$642.85 | $659–$989 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $4,019.60 | $6,184 | 10.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $2,648.10 | $4,074 | 7.1× |
| Renal Cyst Study (74470) | $2,229.50 | $3,430 | 4.2× |
| Ribs bilateral 3 views (71110) | $675.35 | $1,039 | 6.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $759.20 | $1,168 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,118.65 | $1,721 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,882.40 | $2,896 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,602.25 | $2,465 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,911–$21,703.72 | $2,940–$33,390.34 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$776.75–$97,366.75 | $1,195–$149,795 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$247–$642.20 | $380–$988 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $107.90 | $166 | 4.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$219.70–$490.75 | $338–$755 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$641.55–$3,337.75 | $987–$5,135 | varies |
| Sialogram (70390) | $838.50 | $1,290 | 3.7× |
| Skull less than 4 views (70250) | $273.65 | $421 | 2.7× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$656.50–$18,529.55 | $1,010–$28,507 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$1,052.35–$32,940.70 | $1,619–$50,678 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$975.65–$17,465.50 | $1,501–$26,870 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,239.25–$46,255.32 | $3,445–$71,162.03 | varies |
| Speech evaluation, complex (70371) | $684.45 | $1,053 | 3.0× |
| Srs Multisource (77371) range across 2 matching MRF lines |
$37,161.15–$50,441.36 | $57,171–$77,602.09 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$11,855.35–$59,170.15 | $18,239–$91,031 | varies |
| Sternoclavicular joints (71130) | $211.25 | $325 | 2.5× |
| Superior sagittal sinus venogram (75870) | $2,117.05 | $3,257 | 0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $349.70 | $538 | 3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$2,438.15–$36,822.50 | $3,751–$56,650 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,166.10 | $1,794 | 3.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $2,065.70 | $3,178 | 9.0× |
| Testicular Imaging W/Flow (78761) | $984.75 | $1,515 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,849.90–$32,940.70 | $2,846–$50,678 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,540.50–$42,805.75 | $2,370–$65,855 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$945.10–$41,018.25 | $1,454–$63,105 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,355.25 | $2,085 | 8.0× |
| Thoracic spine 2 views (72070) | $286.65 | $441 | 2.9× |
| Thoracic spine 3 views (72072) | $575.90 | $886 | 5.7× |
| Thoracolumbar 2 views (72080) | $286.65 | $441 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $644.80 | $992 | 1.7× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,378.35–$10,337.37 | $3,659–$15,903.65 | varies |
| Thyroid Uptake Measurement (78012) | $892.45 | $1,373 | 2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$915.85–$1,869.40 | $1,409–$2,876 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,482–$32,461 | $2,280–$49,940 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$842.40–$50,788 | $1,296–$78,135.39 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$770.90–$28,798.90 | $1,186–$44,306 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$301.60–$452.40 | $464–$696 | varies |
| Ultrasound elastography first target lesion (76982) | $252.85 | $389 | 2.5× |
| Ultrasound Elastography Parenchyma (76981) | $302.25 | $465 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $317.20 | $488 | 3.2× |
| Ultrasound, abdomen limited (76705) | $901.55 | $1,387 | 9.0× |
| Umbilical-artery Doppler (OB) (76820) | $1,047.15 | $1,611 | 10.4× |
| Unlisted fluoroscopic procedure (76496) | $646.75 | $995 | 7.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $3,658.20 | $5,628 | 37.3× |
| Unlisted us procedure (76999) | $253.50 | $390 | 3.0× |
| Upper gi w/o kub (74240) | $1,124.50 | $1,730 | 6.7× |
| Ureteral Reflux Study (78740) | $1,175.85 | $1,809 | 3.1× |
| Urethrocystogram voiding (74455) | $622.05 | $957 | 2.7× |
| Urethrocystography retrograde (74450) | $656.50 | $1,010 | 2.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$354.90–$533 | $546–$820 | varies |
| Us chest (76604) | $598 | $920 | 5.9× |
| Us complete joint (76881) range across 3 matching MRF lines |
$354.90–$533.65 | $546–$821 | varies |
| Us exam, pelvic, limited (76857) | $410.80 | $632 | 4.1× |
| Us head (76506) | $715.65 | $1,101 | 7.1× |
| Us kidney transplant (76776) | $584.35 | $899 | 5.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$376.35–$564.20 | $579–$868 | varies |
| Us ob detailed single fetus (76811) | $714.35 | $1,099 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $668.20 | $1,028 | 6.6× |
| Us ob transvaginal (76817) | $697.45 | $1,073 | 6.9× |
| Us pelvic non ob complete (76856) | $990.60 | $1,524 | 9.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $744.25 | $1,145 | 7.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $587.60 | $904 | 5.8× |
| Us retroperitoneal complete (76770) | $984.75 | $1,515 | 9.8× |
| Us retroperitoneal limited (76775) | $482.30 | $742 | 4.8× |
| Us scrotum and contents (76870) | $954.85 | $1,469 | 9.5× |
| Us spinal canal and contents (76800) | $305.50 | $470 | 3.0× |
| Us thyroid (76536) | $512.85 | $789 | 5.1× |
| Us transrectal (76872) | $527.15 | $811 | 5.2× |
| Vein X-Ray Chest (75827) | $1,827.15 | $2,811 | 1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,553.50 | $2,390 | 0.5× |
| Vein X-Ray Skull Epidural (75872) | $1,249.95 | $1,923 | 2.1× |
| Vein X-Ray Spleen/Liver (75810) | $4,716.40 | $7,256 | 1.6× |
| Venogram Sinus/Jugular (75860) | $4,063.15 | $6,251 | 1.3× |
| Venography Adrenal Unilateral (75840) | $4,181.45 | $6,433 | 1.4× |
| Venography caval inferior serialography rs&i (75825) | $2,241.20 | $3,448 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,493.05 | $2,297 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,163.50 | $1,790 | 0.8× |
| Venography Orbital Rs&I (75880) | $1,497.60 | $2,304 | 2.5× |
| Venography Renal Bilateral (75833) | $5,428.15 | $8,351 | 1.8× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,022.80–$5,837.65 | $3,112–$8,981 | varies |
| Venous sampling by catheter (75893) | $7,471.10 | $11,494 | 1.4× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$235.30–$453.05 | $362–$697 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $388.05 | $597 | 4.6× |
| X-ray antegrade pyelogram tube (74425) | $702.65 | $1,081 | 2.1× |
| X-Ray Aorta Leg Arteries (75630) | $5,073.25 | $7,805 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $300.30 | $462 | 3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$388.05–$582.40 | $597–$896 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$318.50–$477.75 | $490–$735 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $301.60 | $464 | 3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $375.70 | $578 | 3.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,079.65 | $1,661 | 10.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $159.90 | $246 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $244.40 | $376 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$291.85–$576.55 | $449–$887 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $391.30 | $602 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $454.35 | $699 | 4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,155.70 | $1,778 | 11.5× |
| X-Ray Exam L-S Spine Bending (72114) | $525.20 | $808 | 5.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $425.10 | $654 | 5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $553.80 | $852 | 5.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $320.45 | $493 | 3.2× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$158.60–$220.35 | $244–$339 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$273.65–$624.65 | $421–$961 | varies |
| X-ray IV pyelogram (ivp) (74400) | $955.50 | $1,470 | 5.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $227.50 | $350 | 2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $174.85 | $269 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $317.20 | $488 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $200.20 | $308 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $419.90 | $646 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $300.30 | $462 | 3.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $618.80 | $952 | 6.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $271.05 | $417 | 3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $353.60 | $544 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $353.60 | $544 | 3.5× |
| X-ray thoracic spine 4 vw (72074) | $334.10 | $514 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $758.55 | $1,167 | 2.3× |
| X-Rays Bone Length Studies (77073) | $178.10 | $274 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $1,242.15 | $1,911 | 12.4× |
| Xr c-spine 4 or 5 views (72050) | $585.65 | $901 | 5.8× |
| Xr facial bones less than 3 views (70140) | $465.40 | $716 | 5.6× |
| Xr orbits complete 4 views (70200) | $280.80 | $432 | 2.8× |
| Xr Tomogram Single Plane (76100) | $902.85 | $1,389 | 9.0× |
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.