Imaging prices at Mercy Hospital

Canton, OH · every code in this section with a posted price and a Medicare benchmark.

408 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) $6,136.65 $9,441 4.7×
Abdomen 1 View (74018) $395.20 $608 4.8×
Abdomen 2 views (74019) $477.10 $734 4.8×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,802.45 $2,773 4.8×
Angio internal mammary (75756) $14,116.70 $21,718 4.7×
Angio pulmonary bilat (75743) $14,116.70 $21,718 4.7×
Angiography extremity bilateral rs&i (75716) $14,116.70 $21,718 4.7×
Angiography extremity unilateral rs&i (75710) $14,116.70 $21,718 4.7×
Angiography pulmonary unilateral slctv rs&i (75741) $14,116.70 $21,718 4.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $14,116.70 $21,718 4.7×
Ankle 2 views (73600) $395.20 $608 4.8×
Aortography thoracic serialography rs&i (75605) $24,244.35 $37,299 4.6×
Aortography thoracic w/o serialography rs&i (75600) $14,116.70 $21,718 4.7×
Artery X-Rays Abdomen (75726) $24,244.35 $37,299 4.6×
Artery X-Rays Adrenal Gland (75731) $14,116.70 $21,718 4.7×
Artery X-Rays Pelvis (75736) $24,244.35 $37,299 4.6×
Artery X-Rays Spine (75705) $24,244.35 $37,299 4.6×
Arthrogram ankle (73615) $1,601.60 $2,464 4.9×
Arthrogram hip (73525) $1,601.60 $2,464 4.9×
Arthrogram Wrist (73115) $1,601.60 $2,464 4.9×
Basic radiation dosimetry calculation (77300) $595.40 $916 4.7×
Bone age studies (77072) $477.10 $734 4.8×
Bone Imaging 3 Phase (78315) $1,802.45 $2,773 4.8×
Bone Imaging Limited Area (78300) $1,802.45 $2,773 4.8×
Bone Imaging Whole Body (78306) $1,802.45 $2,773 4.8×
Bone marrow imaging limited area (78102) $1,802.45 $2,773 4.8×
Bone marrow imaging; multiple areas (78103) $1,802.45 $2,773 4.8×
Bone marrow imaging; whole body (78104) $1,802.45 $2,773 4.8×
Bone survey infant (77076) $477.10 $734 4.8×
Brachytx isodose complex (77318) $1,641.90 $2,526 4.6×
Brain Flow Imaging Only (78610) $2,414.10 $3,714 4.7×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,414.10 $3,714 4.7×
Cardiac MRI w/w/o contrast & further seq (75561) $1,601.60 $2,464 4.9×
Cardiac MRI w/w/o contrast w/stress (75563) $3,543.15 $5,451 4.8×
Cardiac Shunt Detection (78428) $1,802.45 $2,773 4.8×
Cat Scan Follow-Up Study (76380) $395.20 $608 4.8×
Cerebrospinal Fluid Scan (78630) $2,414.10 $3,714 4.7×
Chest 1 view (71045) $395.20 $608 4.8×
Chest 2 views (71046) $395.20 $608 4.8×
Chest 3 views (71047) $395.20 $608 4.8×
Chest 4 or more views (71048) $477.10 $734 4.8×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $477.10 $734 4.8×
Clavicle complete (73000) $395.20 $608 4.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $477.10 $734 4.8×
Continuing medical physics consltj pr wk (77336) $595.40 $916 4.7×
Contrast Exam Abdominl Aorta (75625) $14,116.70 $21,718 4.7×
Contrast X-Ray Bladder (74430) $1,601.60 $2,464 4.9×
Contrast X-Ray Of Elbow (73085) $1,601.60 $2,464 4.9×
Contrast X-Ray Of Knee Joint (73580) $1,601.60 $2,464 4.9×
CT abdomen and pelvis without and with contrast (74178) $1,601.60 $2,464 4.9×
CT abdomen and pelvis without contrast (74176) $1,084.20 $1,668 4.8×
CT abdomen w contrast (74160) $798.20 $1,228 4.8×
CT abdomen w wo contrast (74170) $798.20 $1,228 4.8×
CT abdomen w/o contrast (74150) $477.10 $734 4.8×
CT Angio Abdomen and Pelvis (74174) $1,601.60 $2,464 4.9×
CT Angio Chest (71275) $798.20 $1,228 4.8×
CT Angio Head (70496) $798.20 $1,228 4.8×
CT angio hrt w/3d image (75574) $1,601.60 $2,464 4.9×
Ct Angio Lwr Extr W/O&W/Dye (73706) $798.20 $1,228 4.8×
CT Angio Neck (70498) $798.20 $1,228 4.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $798.20 $1,228 4.8×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $803.40 $1,236 4.8×
CT cervical spine w/ contrast (72126) $1,601.60 $2,464 4.9×
CT cervical spine w/o contrast (72125) $477.10 $734 4.8×
CT cervical spine w/wo cont (72127) $798.20 $1,228 4.8×
CT chest w contrast (71260) $798.20 $1,228 4.8×
CT chest w/wo contrast (71270) $798.20 $1,228 4.8×
CT colonography screening (74263) $1,084.20 $1,668 4.8×
CT colonogrphy dx image postprocess w/o contrast (74261) $477.10 $734 4.8×
CT head/brain with contrast (70460) $798.20 $1,228 4.8×
CT head/brain without and with contrast (70470) $798.20 $1,228 4.8×
CT heart contrast eval cardiac structure&morph (75572) $1,601.60 $2,464 4.9×
CT heart no contrast quant eval coronry calcium (75571) $395.20 $608 4.8×
CT hrt w/3d image congen (75573) $1,601.60 $2,464 4.9×
CT iac w contrast (70481) $798.20 $1,228 4.8×
CT l-spine w&w/o contrast (72133) $798.20 $1,228 4.8×
CT lower ext w/o (73700) $477.10 $734 4.8×
CT lower extremity w/contrast material (73701) $798.20 $1,228 4.8×
CT lumbar spine w contrast (72132) $1,601.60 $2,464 4.9×
CT lumbar spine w/o contrast (72131) $477.10 $734 4.8×
CT maxillofacial w contrast (70487) $798.20 $1,228 4.8×
CT maxillofacial wo contrast (70486) $477.10 $734 4.8×
CT neck tissue combo (70492) $798.20 $1,228 4.8×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $798.20 $1,228 4.8×
CT orbits w/o contrast (70480) $477.10 $734 4.8×
CT pelvis w&w/o contrast (72194) $798.20 $1,228 4.8×
CT pelvis w/o contrast (72192) $477.10 $734 4.8×
CT scan of leg combo (73702) $798.20 $1,228 4.8×
CT scans face/jaw combo (70488) $798.20 $1,228 4.8×
CT soft tissue neck w contrast (70491) $798.20 $1,228 4.8×
CT soft tissue neck w/o contrast (70490) $477.10 $734 4.8×
CT thoracic spine w contrast (72129) $798.20 $1,228 4.8×
CT thoracic spine w/o contrast (72128) $477.10 $734 4.8×
CT thoracic spine w/wo cont (72130) $798.20 $1,228 4.8×
CT thorax w/o contrast (71250) $477.10 $734 4.8×
CT unlisted procedure (76497)
range across 2 matching MRF lines		 $42.25–$6,541.60 $65–$10,064 varies
CT upper ext wo (73200) $477.10 $734 4.8×
CT upper extremity w/o & w/contrast material (73202) $798.20 $1,228 4.8×
CT upper extremity with contrast (73201) $1,601.60 $2,464 4.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $798.20 $1,228 4.8×
Cta Abdomen (74175) $798.20 $1,228 4.8×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,598.35 $2,459 4.8×
CTA pelvis (72191) $798.20 $1,228 4.8×
Dilation ureters/urethra rs&i (74485) $9,187.75 $14,135 4.6×
Diskography lumbar (72295) $8,758.10 $13,474 4.7×
Doppler Echo Fetal Spectral Display Complete (76827) $477.10 $734 4.8×
Doppler Fetal Mid Cerebral Artery (76821) $477.10 $734 4.8×
Dxa Bone Density Axial (77080) $477.10 $734 4.8×
Dxa bone density study (77085) $477.10 $734 4.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $395.20 $608 4.8×
Echo exam of fetal heart (76825) $2,458.95 $3,783 4.8×
Echo exam uterus (76831) $1,084.20 $1,668 4.8×
Echo Guide For Artery Repair (76936) $1,396.85 $2,149 6.8×
Echograp Trans R Pros Study (76873) $477.10 $734 4.8×
Esophagram (74220) $798.20 $1,228 4.8×
Fetal Biophys Profile W/Nst (76818) $477.10 $734 4.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $477.10 $734 4.8×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $1,084.20 $1,668 4.8×
Fluoroscopy up to 1 hr (76000) $1,084.20 $1,668 4.8×
Follow-Up Angiography (75898) $14,116.70 $21,718 4.7×
Foot 2 views (73620) $395.20 $608 4.8×
Forearm 2 views (73090) $395.20 $608 4.8×
Gastric emptying imaging study (78264) $1,802.45 $2,773 4.8×
Gated Heart Planar Single (78472) $1,802.45 $2,773 4.8×
Hand 2 views (73120) $477.10 $734 4.8×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $3,111.55 $4,787 4.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $3,111.55 $4,787 4.7×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $3,111.55 $4,787 4.7×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $14,116.70 $21,718 4.7×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $14,116.70 $21,718 4.7×
Hepatobil Syst Image W/Drug (78227) $2,414.10 $3,714 4.7×
Hepatobiliary System Imaging (78226) $1,802.45 $2,773 4.8×
Ht Musc Image Planar Mult (78454) $5,855.20 $9,008 4.8×
Ht Muscle Image Spect Sing (78451) $5,855.20 $9,008 4.8×
Hysterosalpingogram (74740) $1,084.20 $1,668 4.8×
Infant hip ultrasound with hip movement (dynamic) (76885) $395.20 $608 4.8×
Infant hip ultrasound, limited static exam (76886) $395.20 $608 4.8×
Interstitial radiation source applic complex (77778) $3,111.55 $4,787 4.7×
Joint Survey Single View (77077) $477.10 $734 4.8×
K Flow/Funct Image Multiple (78709) $2,414.10 $3,714 4.7×
K Flow/Funct Image W/Drug (78708) $2,414.10 $3,714 4.7×
K Flow/Funct Image W/O Drug (78707) $2,414.10 $3,714 4.7×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,802.45 $2,773 4.8×
Knee 3 Views (73562) $395.20 $608 4.8×
Lung Perf&Ventilat Diferentl (78598) $2,414.10 $3,714 4.7×
Lung perfusion differential (78597) $1,802.45 $2,773 4.8×
Lung Ventilat&Perfus Imaging (78582) $2,414.10 $3,714 4.7×
Lung Ventilation Imaging (78579) $1,802.45 $2,773 4.8×
Lymph System Imaging (78195) $2,414.10 $3,714 4.7×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $6,967.35 $10,719 4.7×
Lymphangiography extremity only unilateral rs&i (75801) $2,772.90 $4,266 4.7×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $14,116.70 $21,718 4.7×
Magnetic Image Jaw Joint (70336) $1,084.20 $1,668 4.8×
Mammary ductogram or galactogram single (77053) $1,084.20 $1,668 4.8×
Meckels Divert Exam (78290) $1,802.45 $2,773 4.8×
Medical physics dose eval radiation expos w/rprt (76145) $2,379.65 $3,661 6.7×
Mlc imrt design & construction per imrt plan (77338) $1,641.90 $2,526 4.6×
Mr safety determination physician/other qhp (76016) $395.20 $608 4.8×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $109.85 $169 4.0×
Mr safety implt electronics prepj supvj phys/qhp (76018) $411.45 $633 4.6×
Mr safety implt pos&/immoblj (76019) $266.50 $410 4.8×
Mr safety med physics xm customization plng&mntr (76017) $1,084.20 $1,668 4.8×
Mra Head W/O & W/Contrast Material (70546) $1,601.60 $2,464 4.9×
MRA head w/o contrast (70544) $1,084.20 $1,668 4.8×
MRA head with contrast (70545) $1,601.60 $2,464 4.9×
MRA neck w contrast (70548) $1,601.60 $2,464 4.9×
Mra Neck W/O &W/Contrast Material (70549) $1,601.60 $2,464 4.9×
MRA neck w/o contrast (70547) $1,084.20 $1,668 4.8×
MRI abdomen w contrast (74182) $1,601.60 $2,464 4.9×
MRI abdomen w/o contrast (74181) $1,084.20 $1,668 4.8×
MRI any jt lower extrem w/contrast material (73722) $3,543.15 $5,451 4.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,601.60 $2,464 4.9×
MRI any jt upper extremity w/contrast matrl (73222) $3,543.15 $5,451 4.8×
MRI brain functional w/o physician admnistration (70554) $1,084.20 $1,668 4.8×
MRI Breast W/O Contrast Bilateral (77047) $1,084.20 $1,668 4.8×
MRI Breast Without Contrast Material Unilateral (77046) $1,084.20 $1,668 4.8×
MRI cardiac w/o contrast (75557) $1,084.20 $1,668 4.8×
MRI cervical spine w contrast (72142) $1,601.60 $2,464 4.9×
MRI cervical spine w/o cont (72141) $1,084.20 $1,668 4.8×
MRI chest w/o contrast (71550) $1,084.20 $1,668 4.8×
MRI chest with contrast (71551) $3,543.15 $5,451 4.8×
MRI chest wo w contrast (71552) $1,601.60 $2,464 4.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,601.60 $2,464 4.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,601.60 $2,464 4.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,084.20 $1,668 4.8×
MRI lumbar spine w contrast (72149) $1,601.60 $2,464 4.9×
Mri Neck Spine W/O & W/Dye (72156) $1,601.60 $2,464 4.9×
MRI orbit face &/neck w/o contrast (70540) $1,084.20 $1,668 4.8×
MRI orbit face neck w contrast (70542) $1,601.60 $2,464 4.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,601.60 $2,464 4.9×
MRI pelvis w contrast (72196) $1,601.60 $2,464 4.9×
MRI pelvis w/o & w contrast (72197) $1,601.60 $2,464 4.9×
MRI pelvis w/o contrast (72195) $1,084.20 $1,668 4.8×
MRI spectroscopy (76390) $395.20 $608 4.8×
MRI thoracic spine w/o contrast (72146) $1,084.20 $1,668 4.8×
MRI upper extremity oth than jt w/contr matrl (73219) $1,601.60 $2,464 4.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,084.20 $1,668 4.8×
Mri Uppr Extremity W/O&W/Dye (73220) $1,601.60 $2,464 4.9×
MRI, abdomen, combo (74183) $1,601.60 $2,464 4.9×
MRI, dorsal spine combo (72157) $1,601.60 $2,464 4.9×
MRI, dorsal spine contrast (72147) $1,601.60 $2,464 4.9×
MRI, joint upper extrem (73221) $1,084.20 $1,668 4.8×
MRI, joint upper extrem combo (73223) $1,601.60 $2,464 4.9×
MRI, lumbar spine combo (72158) $1,601.60 $2,464 4.9×
Myelogram cervical (72240) $3,543.15 $5,451 4.8×
Myelogram Lumbar (72265) $3,543.15 $5,451 4.8×
Myelography thoracic (72255) $3,543.15 $5,451 4.8×
Myelograpy 2/more regions rs&i (72270) $3,543.15 $5,451 4.8×
Myocardial Imaging Pet Metabolic Evaluation (78459) $5,855.20 $9,008 4.8×
Myocardial Spect Multiple Studies (78452) $5,855.20 $9,008 4.8×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $9,479.60 $14,584 4.5×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $8,216 $12,640 3.9×
N-invas est c ffr sw aly CTA (75580) $4,563 $7,020 5.6×
Neck soft tissue (70360) $395.20 $608 4.8×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,802.45 $2,773 4.8×
Nm myocard infarct spect (78469) $2,414.10 $3,714 4.7×
Nonvascular Shunt X-Ray (75809) $477.10 $734 4.8×
Ntsty modul radthx pln dose-vol histos (77301) $6,136.65 $9,441 4.7×
Nuclear Rx Intra-Arterial (79445) $1,004.90 $1,546 4.6×
Nuclear Rx Oral Admin (79005) $1,004.90 $1,546 4.6×
Ob us nuchal meas 1 gest (76813) $477.10 $734 4.8×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $477.10 $734 4.8×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $109.85 $169 4.0×
Ophthalmic us dx quantitative a-scan only (76511) $477.10 $734 4.8×
Panoramic X-ray of jaws (70355) $395.20 $608 4.8×
Parathyroid imaging w/tomographic spect & CT (78072) $2,414.10 $3,714 4.7×
Parathyroid Planar Imaging (78070) $1,802.45 $2,773 4.8×
Parathyroid planar imaging w/wo subtraction (78071) $1,802.45 $2,773 4.8×
Pelvis 1 or 2 views (72170) $477.10 $734 4.8×
Perineogram (74775) $1,084.20 $1,668 4.8×
Pet Image Skull-Thigh (78812) $6,541.60 $10,064 4.8×
Pet Image W/Ct Lmtd (78814) $6,541.60 $10,064 4.8×
PET image w/CT, full body (78816) $6,541.60 $10,064 4.8×
PET imaging CT attenuation skull base mid-thigh (78815) $6,541.60 $10,064 4.8×
Pet Imaging Limited Area Chest Head/Neck (78811) $5,855.20 $9,008 4.8×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $14,116.70 $21,718 4.7×
Pulmonary Perfusion Imaging Particulate (78580) $1,802.45 $2,773 4.8×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $4,262.70 $6,558 4.8×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $477.10 $734 4.8×
Radex abscess/fistula/sinus tract rs&i (76080) $2,458.95 $3,783 4.8×
Radex Ankle Complete Minimum 3 Views (73610) $395.20 $608 4.8×
Radex Calcaneus Minimum 2 Views (73650) $395.20 $608 4.8×
Radex elbow complete minimum 3 views (73080) $395.20 $608 4.8×
Radex Facial Bones Complete Minimum 3 Views (70150) $477.10 $734 4.8×
Radex fingr minimum 2 views (73140) $395.20 $608 4.8×
Radex foot complete minimum 3 views (73630) $395.20 $608 4.8×
Radex Hand Minimum 3 Views (73130) $395.20 $608 4.8×
Radex lower extremity infant minimum 2 views (73592) $395.20 $608 4.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $395.20 $608 4.8×
Radex Ribs Unilateral 2 Views (71100) $395.20 $608 4.8×
Radex shoulder complete minimum 2 views (73030) $395.20 $608 4.8×
Radex Sinuses Paransl < 3 Views (70210) $395.20 $608 4.8×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $798.20 $1,228 4.8×
Radex Spine 1 View Specify Level (72020) $395.20 $608 4.8×
Radex Sternum Minimum 2 Views (71120) $395.20 $608 4.8×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $395.20 $608 4.8×
Radex Toe Minimum 2 Views (73660) $395.20 $608 4.8×
Radex upper extremity infant minimum 2 views (73092) $477.10 $734 4.8×
Radex Wrist Complete Minimum 3 Views (73110) $395.20 $608 4.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $477.10 $734 4.8×
Radiation treatment delivery level 1 (77402) $583.05 $897 6.0×
Radiation treatment delivery level 2 (77407) $2,202.20 $3,388 6.0×
Radiation treatment delivery level 3 (77412) $3,155.75 $4,855 6.0×
Radiolog exam mandible compl minimum 4 views (70110) $477.10 $734 4.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $477.10 $734 4.8×
Radiologic exam colon double contrast study (74280) $798.20 $1,228 4.8×
Radiologic exam colon single contrast study (74270) $798.20 $1,228 4.8×
Radiologic Exam Esophagus Double Contrast Study (74221) $798.20 $1,228 4.8×
Radiologic exam knee complete 4/more views (73564) $477.10 $734 4.8×
Radiologic exam pelvis compl minimum 3 views (72190) $477.10 $734 4.8×
Radiologic Exam Small Int Single Contrast Study (74250) $798.20 $1,228 4.8×
Radiologic exam swallow function contrast study (74230) $798.20 $1,228 4.8×
Radiologic exam teeth complete full mouth (70320) $1,084.20 $1,668 4.8×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $1,084.20 $1,668 4.8×
Radiologic exam upr gi trc double contrast study (74246) $798.20 $1,228 4.8×
Radiologic examination femur 1 view (73551) $395.20 $608 4.8×
Radiologic examination femur minimum 2 views (73552) $395.20 $608 4.8×
Radiologic examination knee 1/2 views (73560) $395.20 $608 4.8×
Radiologic Examination Osseous Survey Limited (77074) $477.10 $734 4.8×
Radiologic examination tibia & fibula 2 views (73590) $395.20 $608 4.8×
Radiologic examination, teeth; single view Non-Facility (70300) $395.20 $608 4.8×
Ribs bilateral 3 views (71110) $477.10 $734 4.8×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,802.45 $2,773 4.8×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,802.45 $2,773 4.8×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $5,855.20 $9,008 11.4×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $5,855.20 $9,008 11.4×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $5,855.20 $9,008 11.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $5,855.20 $9,008 4.8×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $6,541.60 $10,064 4.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $5,855.20 $9,008 4.8×
Rp Therapy Intravenous Administration (79101) $1,004.90 $1,546 4.6×
Salivary Gland Function Study (78232) $1,802.45 $2,773 4.8×
Salivary Gland Imaging Serial Images (78231) $1,802.45 $2,773 4.8×
Scapula (73010) $477.10 $734 4.8×
Screening Digital Breast Tomosynthesis Bi (77063) $91 $140 3.9×
Shoulder 1 view (73020) $395.20 $608 4.8×
Shoulder Arthrography (73040) $1,601.60 $2,464 4.9×
Skull less than 4 views (70250) $477.10 $734 4.8×
Special dosimetry (77331) $595.40 $916 4.7×
Special Physics Consult (77370) $595.40 $916 4.7×
Special teletherapy port plan (77321) $1,641.90 $2,526 4.6×
Special treatment procedure (77470) $2,594.15 $3,991 5.0×
Stereotactic Body Radiation Delivery (77373) $7,875.40 $12,116 4.7×
Sternoclavicular joints (71130) $395.20 $608 4.8×
Superior sagittal sinus venogram (75870) $14,116.70 $21,718 4.7×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $395.20 $608 4.8×
Tbs technical calculation only (77091) $395.20 $608 4.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,641.90 $2,526 4.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,641.90 $2,526 4.6×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,641.90 $2,526 4.6×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,641.90 $2,526 4.6×
Ther rad simulaj-aided field setting simple (77280) $595.40 $916 4.7×
Thoracic spine 2 views (72070) $477.10 $734 4.8×
Thoracic spine 3 views (72072) $477.10 $734 4.8×
Thoracolumbar 2 views (72080) $395.20 $608 4.8×
Thyroid Imaging With Vascular Flow (78013) $1,802.45 $2,773 4.8×
Thyroid Met Imaging Body (78018) $2,414.10 $3,714 4.7×
Thyroid Uptake Measurement (78012) $1,802.45 $2,773 4.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,802.45 $2,773 4.8×
Tx Devices Design & Construction Complex (77334) $1,641.90 $2,526 4.6×
Tx devices design & construction intermediate (77333) $595.40 $916 4.7×
Tx devices design & construction simple (77332) $595.40 $916 4.7×
Ultrasound Breast Limited (76642) $395.20 $608 4.8×
Ultrasound elastography first target lesion (76982) $477.10 $734 4.8×
Ultrasound Elastography Parenchyma (76981) $477.10 $734 4.8×
Ultrasound Exam Aaa Screen (76706) $477.10 $734 4.8×
Ultrasound, abdomen limited (76705) $477.10 $734 4.8×
Umbilical-artery Doppler (OB) (76820) $477.10 $734 4.8×
Unlisted Dx Radiographic Procedure (76499)
range across 7 matching MRF lines		 $477.10–$14,116.70 $734–$21,718 varies
Unlisted fluoroscopic procedure (76496)
range across 22 matching MRF lines		 $2,080.65–$24,244.35 $3,201–$37,299 varies
Unlisted magnetic resonance procedure (76498)
range across 17 matching MRF lines		 $146.25–$6,541.60 $225–$10,064 varies
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $426.40 $656 1.1×
Upper gi w/o kub (74240) $798.20 $1,228 4.8×
Urethrocystogram voiding (74455) $1,084.20 $1,668 4.8×
Urethrocystography retrograde (74450) $1,084.20 $1,668 4.8×
Us breast unilateral complete (76641) $477.10 $734 4.8×
Us chest (76604) $477.10 $734 4.8×
Us complete joint (76881) $477.10 $734 4.8×
Us exam, pelvic, limited (76857) $477.10 $734 4.8×
Us head (76506) $477.10 $734 4.8×
Us kidney transplant (76776) $477.10 $734 4.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $477.10 $734 4.8×
Us ob detailed single fetus (76811) $1,084.20 $1,668 4.8×
Us ob limited 1 or more fetuses (76815) $477.10 $734 4.8×
Us ob transvaginal (76817) $477.10 $734 4.8×
Us pelvic non ob complete (76856) $477.10 $734 4.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $477.10 $734 4.8×
Us preg uterus real time f/u trnsabdl per fetus (76816) $477.10 $734 4.8×
Us retroperitoneal complete (76770) $477.10 $734 4.8×
Us retroperitoneal limited (76775) $477.10 $734 4.8×
Us scrotum and contents (76870) $477.10 $734 4.8×
Us spinal canal and contents (76800) $477.10 $734 4.8×
Us thyroid (76536) $477.10 $734 4.8×
Us transrectal (76872) $477.10 $734 4.8×
Vasogram (74440) $1,084.20 $1,668 4.8×
Vein X-Ray Chest (75827) $6,967.35 $10,719 4.7×
Vein X-Ray Liver W/O Hemodyn (75887) $14,116.70 $21,718 4.7×
Vein X-Ray Skull Epidural (75872) $2,772.90 $4,266 4.7×
Vein X-Ray Spleen/Liver (75810) $14,116.70 $21,718 4.7×
Venogram Sinus/Jugular (75860) $14,116.70 $21,718 4.7×
Venography caval inferior serialography rs&i (75825) $14,116.70 $21,718 4.7×
Venography extremity bilateral rs&i (75822) $6,967.35 $10,719 4.7×
Venography extremity unilateral rs&i (75820) $6,967.35 $10,719 4.7×
Venography Renal Bilateral (75833) $14,116.70 $21,718 4.7×
Venography Renal Unilateral (75831) $14,116.70 $21,718 4.7×
Venous sampling by catheter (75893) $24,244.35 $37,299 4.6×
Vertebral fracture assessment via dxa (77086) $395.20 $608 4.8×
Wrist 2 views (73100) $395.20 $608 4.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $395.20 $608 4.8×
X-ray antegrade pyelogram tube (74425) $1,601.60 $2,464 4.9×
X-Ray Aorta Leg Arteries (75630) $14,116.70 $21,718 4.7×
X-Ray Bend Only L-S Spine (72120) $477.10 $734 4.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $395.20 $608 4.8×
X-Ray Exam Breast Specimen (76098) $2,458.95 $3,783 4.8×
X-Ray Exam Entire Spi 1 Vw (72081) $395.20 $608 4.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $477.10 $734 4.8×
X-Ray Exam Entire Spi 4/5 Vw (72083) $477.10 $734 4.8×
X-Ray Exam Hip Uni 1 View (73501) $395.20 $608 4.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $395.20 $608 4.8×
X-Ray Exam Hip Uni 4/> Views (73503) $477.10 $734 4.8×
X-Ray Exam Hips Bi 2 Views (73521) $477.10 $734 4.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $477.10 $734 4.8×
X-Ray Exam Hips Bi 5/> Views (73523) $477.10 $734 4.8×
X-Ray Exam L-S Spine Bending (72114) $477.10 $734 4.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $395.20 $608 4.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $477.10 $734 4.8×
X-Ray Exam Unilat Ribs/Chest (71101) $477.10 $734 4.8×
X-ray eye for foreign body (70030) $395.20 $608 4.8×
X-ray humerus (73060) $395.20 $608 4.8×
X-ray IV pyelogram (ivp) (74400) $798.20 $1,228 4.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $395.20 $608 4.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $395.20 $608 4.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $477.10 $734 4.8×
X-ray nose-rectum child f.b. (76010) $395.20 $608 4.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $477.10 $734 4.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $477.10 $734 4.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $477.10 $734 4.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $395.20 $608 4.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $395.20 $608 4.8×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $477.10 $734 4.8×
X-Ray Stress View (77071) $395.20 $608 4.8×
X-ray thoracic spine 4 vw (72074) $477.10 $734 4.8×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,601.60 $2,464 4.9×
X-Rays Bone Length Studies (77073) $477.10 $734 4.8×
X-Rays Bone Survey Complete (77075) $477.10 $734 4.8×
Xr c-spine 4 or 5 views (72050) $477.10 $734 4.8×
Xr facial bones less than 3 views (70140) $395.20 $608 4.8×
Xr orbits complete 4 views (70200) $477.10 $734 4.8×

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.