Imaging prices at Mercyhealth Fhn Hospital
Freeport, IL · every code in this section with a posted price and a Medicare benchmark.
359 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 5 matching MRF lines |
$708–$8,360 | $885–$10,450 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$88.35–$385.49 | $110.44–$481.86 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$142.13–$487.44 | $177.66–$609.30 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $842.40 | $1,053 | 2.0× |
| Adrenal Cortex & Medulla Img (78075) | $402.40 | $503 | 0.3× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,237.60–$5,991.03 | $1,547–$7,488.79 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$743.20–$5,784 | $929–$7,230 | varies |
| Ankle 2 views (73600) range across 7 matching MRF lines |
$52.80–$399.70 | $66–$499.62 | varies |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,802.40 | $2,253 | 0.3× |
| Basic radiation dosimetry calculation (77300) range across 5 matching MRF lines |
$105.60–$808.26 | $132–$1,010.33 | varies |
| Bone age studies (77072) | $56 | $70 | 0.5× |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$413.44–$2,963.12 | $516.80–$3,703.90 | varies |
| Bone Imaging Limited Area (78300) | $526.40 | $658 | 1.2× |
| Bone Imaging Multiple Areas (78305) range across 3 matching MRF lines |
$364–$1,823.20 | $455–$2,279 | varies |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$389.09–$2,742.88 | $486.36–$3,428.60 | varies |
| Bone marrow imaging limited area (78102) | $468.80 | $586 | 1.1× |
| Bone marrow imaging; multiple areas (78103) | $734.40 | $918 | 1.7× |
| Bone marrow imaging; whole body (78104) | $802.40 | $1,003 | 1.9× |
| Bone survey infant (77076) | $96 | $120 | 0.9× |
| Brain Flow Imaging Only (78610) | $567.20 | $709 | 1.0× |
| Brain Image W/Flow < 4 Views (78601) | $666.40 | $833 | 1.6× |
| Brain imaging < 4 static views (78600) | $493.60 | $617 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $788.80 | $986 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $592.80 | $741 | 1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,501.60 | $1,877 | 3.5× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,851.20 | $2,314 | 3.2× |
| Cardiac Shunt Detection (78428) | $537.60 | $672 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $747.20 | $934 | 8.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $864 | $1,080 | 1.5× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $739.20 | $924 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $948.80 | $1,186 | 1.6× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$82.67–$446.90 | $103.34–$558.62 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$29.60–$480.18 | $37–$600.23 | varies |
| Chest 3 views (71047) | $169.60 | $212 | 1.8× |
| Chest 4 or more views (71048) | $181.60 | $227 | 1.6× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$101.09–$481.60 | $126.36–$602 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$370.40–$987.72 | $463–$1,234.65 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$743.20–$5,197.60 | $929–$6,497 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$140–$713.60 | $175–$892 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$288–$815.20 | $360–$1,019 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$946.79–$7,170.09 | $1,183.49–$8,962.61 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$690.34–$5,105.85 | $862.93–$6,382.31 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$399.98–$3,727.12 | $499.98–$4,658.90 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$478.02–$4,424.74 | $597.52–$5,530.93 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$345.72–$3,105.97 | $432.15–$3,882.46 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$591.09–$4,568.17 | $738.86–$5,710.21 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$337.27–$4,292.68 | $421.59–$5,365.85 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$312.09–$4,044.74 | $390.11–$5,055.92 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$497.10–$3,304.07 | $621.38–$4,130.09 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$766.74–$8,158.29 | $958.43–$10,197.86 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$381.07–$4,014.27 | $476.34–$5,017.84 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$168.80–$922.40 | $211–$1,153 | varies |
| CT bone density (77078) | $52 | $65 | 0.6× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$488–$3,453.60 | $610–$4,317 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$412.49–$3,154.64 | $515.61–$3,943.30 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$388.94–$3,251.07 | $486.18–$4,063.84 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$470.40–$3,797 | $588–$4,746.25 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$386.10–$3,426.34 | $482.62–$4,282.92 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$461.94–$3,401.74 | $577.43–$4,252.17 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$367.20–$373.60 | $459–$467 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$436–$2,908 | $545–$3,635 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$588.80–$3,787.20 | $736–$4,734 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$506.10–$2,482.32 | $632.63–$3,102.90 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$608–$3,073.30 | $760–$3,841.62 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$512.80–$3,236 | $641–$4,045 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$411.42–$3,153.38 | $514.27–$3,941.72 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$495.20–$2,773.22 | $619–$3,466.52 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$355.35–$2,584.42 | $444.19–$3,230.53 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$502.40–$3,166.40 | $628–$3,958 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$502.40–$3,166.40 | $628–$3,958 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$363.11–$2,482.40 | $453.89–$3,103 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$491.20–$3,684 | $614–$4,605 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$347.05–$3,200.80 | $433.81–$4,001 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$688.80–$3,209.60 | $861–$4,012 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$469.60–$3,008.40 | $587–$3,760.50 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$415.70–$2,829.63 | $519.62–$3,537.04 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$363.64–$2,478.76 | $454.55–$3,098.45 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$411.28–$3,185.17 | $514.10–$3,981.46 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$340.04–$2,735.45 | $425.05–$3,419.31 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$350.46–$2,035.54 | $438.08–$2,544.43 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$384.10–$2,345.40 | $480.13–$2,931.75 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$1,629.62–$5,625.18 | $2,037.02–$7,031.47 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$488.54–$5,399.90 | $610.68–$6,749.88 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $177.60 | $222 | 0.7× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $659.20 | $824 | 1.1× |
| Diskography lumbar (72295) | $1,331.20 | $1,664 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $197.60 | $247 | 1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $328 | $410 | 2.9× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$124.37–$722.34 | $155.46–$902.93 | varies |
| Echo exam of fetal heart (76825) | $511.20 | $639 | 0.9× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$503.20–$518.40 | $629–$648 | varies |
| Echo Guide For Artery Repair (76936) | $1,492 | $1,865 | 6.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $308 | $385 | 1.2× |
| Esophageal Motility Study (78258) | $701.60 | $877 | 1.6× |
| Esophagram (74220) range across 2 matching MRF lines |
$172.73–$896.34 | $215.91–$1,120.43 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$344.80–$884.80 | $431–$1,106 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$347.46–$891.74 | $434.33–$1,114.67 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$155.20–$514.37 | $194–$642.96 | varies |
| Follow-Up Angiography (75898) | $1,131.20 | $1,414 | 0.3× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$92.14–$384.22 | $115.17–$480.27 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$88.22–$413.10 | $110.27–$516.38 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$428.50–$2,415.62 | $535.63–$3,019.53 | varies |
| Gastric Mucosa Imaging (78261) | $664 | $830 | 1.5× |
| Gastroesophageal Reflux Exam (78262) | $725.60 | $907 | 1.7× |
| Gastrointestinal Protein Loss (78282) | $468.80 | $586 | 1.1× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$598.40–$2,034.40 | $748–$2,543 | varies |
| Gated Heart, Multiple (78473) | $1,592 | $1,990 | 3.7× |
| GI Endoscopic US S&I (76975) | $736.80 | $921 | 2.9× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$62.40–$364.80 | $78–$456 | varies |
| Heart first pass single,planar (78481) | $937.60 | $1,172 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$206.88–$773.82 | $258.60–$967.27 | varies |
| Hepatobiliary System Imaging (78226) | $887.11 | $1,108.89 | 2.1× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$683.20–$3,336.80 | $854–$4,171 | varies |
| Hyperthermia external generated superficial (77600) range across 3 matching MRF lines |
$803.20–$1,602.40 | $1,004–$2,003 | varies |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) range across 3 matching MRF lines |
$610.40–$1,255.20 | $763–$1,569 | varies |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) range across 3 matching MRF lines |
$887.20–$1,825.60 | $1,109–$2,282 | varies |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) range across 3 matching MRF lines |
$521.60–$1,056 | $652–$1,320 | varies |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) range across 3 matching MRF lines |
$1,079.20–$2,187.20 | $1,349–$2,734 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$185.60–$906.40 | $232–$1,133 | varies |
| Image fusion (77399) | $258.40 | $323 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $392.80 | $491 | 4.2× |
| Infant hip ultrasound, limited static exam (76886) | $343.20 | $429 | 3.7× |
| Interstitial radiation source applic complex (77778) range across 3 matching MRF lines |
$994.40–$4,812.80 | $1,243–$6,016 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 3 matching MRF lines |
$676–$3,316.80 | $845–$4,146 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 3 matching MRF lines |
$615.20–$2,413.60 | $769–$3,017 | varies |
| Intracavitary radiation source applic simple (77761) range across 3 matching MRF lines |
$416.80–$1,610.40 | $521–$2,013 | varies |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) likely a partial charge, not the full procedure |
$582.40 | $728 | 0.1× |
| Joint Survey Single View (77077) | $53.60 | $67 | 0.5× |
| K Flow/Funct Image Multiple (78709) range across 3 matching MRF lines |
$528.80–$2,607.20 | $661–$3,259 | varies |
| K Flow/Funct Image W/Drug (78708) | $810.40 | $1,013 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $704.80 | $881 | 1.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $487.20 | $609 | 1.1× |
| Kidney Imaging Morphol (78700) | $452 | $565 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $498.40 | $623 | 1.2× |
| Knee 3 Views (73562) range across 8 matching MRF lines |
$108.26–$728.45 | $135.33–$910.56 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $591.20 | $739 | 1.4× |
| Leveen/Shunt Patency Exam (78291) | $559.20 | $699 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $765.60 | $957 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $892.80 | $1,116 | 2.1× |
| Liver imaging static only (78201) | $559.20 | $699 | 1.0× |
| Liver imaging w/vascular flow (78202) | $613.60 | $767 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$244.04–$958.40 | $305.05–$1,198 | varies |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$332.18–$2,508.38 | $415.22–$3,135.48 | varies |
| Magnetic Image Jaw Joint (70336) | $1,812 | $2,265 | 7.1× |
| Meckels Divert Exam (78290) | $640.80 | $801 | 1.5× |
| Mlc imrt design & construction per imrt plan (77338) range across 5 matching MRF lines |
$520–$2,346.57 | $650–$2,933.21 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$564.80–$4,418.40 | $706–$5,523 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$584.90–$4,005.40 | $731.13–$5,006.75 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$739.14–$5,622.95 | $923.92–$7,028.69 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$644.14–$4,509.34 | $805.17–$5,636.67 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,026.40–$4,744 | $1,283–$5,930 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,232–$5,715.20 | $1,540–$7,144 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$712.80–$4,371.20 | $891–$5,464 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$644.04–$4,991.19 | $805.05–$6,238.99 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$917.60–$5,673.60 | $1,147–$7,092 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 8 matching MRF lines |
$1,120–$5,427.46 | $1,400–$6,784.33 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 8 matching MRF lines |
$832–$4,249.70 | $1,040–$5,312.13 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$692.80–$4,628 | $866–$5,785 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$881.14–$6,283.89 | $1,101.42–$7,854.86 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$949.60–$5,284.80 | $1,187–$6,606 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$899.70–$5,230.57 | $1,124.63–$6,538.21 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$720.66–$4,382.59 | $900.82–$5,478.24 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$696–$4,819.20 | $870–$6,024 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$572.80–$3,597.60 | $716–$4,497 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$741.60–$5,080 | $927–$6,350 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$880.78–$6,284.47 | $1,100.97–$7,855.59 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$962.40–$5,599.09 | $1,203–$6,998.86 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$728–$4,814.40 | $910–$6,018 | varies |
| MRI, joint upper extrem (73221) range across 8 matching MRF lines |
$604.80–$4,296.57 | $756–$5,370.71 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$791.20–$5,189.80 | $989–$6,487.25 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$909.42–$6,463.62 | $1,136.78–$8,079.53 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $812.80 | $1,016 | 1.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $775.20 | $969 | 1.3× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$951.29–$4,035.08 | $1,189.11–$5,043.85 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$108.57–$449.49 | $135.71–$561.86 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 3 matching MRF lines |
$289.60–$1,927.20 | $362–$2,409 | varies |
| Nm csf leak detection (78650) | $864 | $1,080 | 0.6× |
| Nm myocard infarct spect (78469) | $748 | $935 | 1.3× |
| Nm red cell survival study (78130) | $601.60 | $752 | 1.4× |
| Nm whole blood volume (78122) | $749.60 | $937 | 1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 5 matching MRF lines |
$1,320–$9,469.60 | $1,650–$11,837 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $419.20 | $524 | 3.7× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $440.80 | $551 | 3.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $419.20 | $524 | 3.7× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $379.20 | $474 | 4.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$452.80–$1,205.60 | $566–$1,507 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $78.40 | $98 | 2.5× |
| Ophthalmic us dx quantitative a-scan only (76511) | $539.20 | $674 | 4.8× |
| Optic foramina (70190) | $145.60 | $182 | 1.6× |
| Panoramic X-ray of jaws (70355) | $133.60 | $167 | 1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$144.40–$853.80 | $180.50–$1,067.25 | varies |
| Parathyroid Planar Imaging (78070) range across 3 matching MRF lines |
$140.80–$866.40 | $176–$1,083 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$93.13–$372.51 | $116.41–$465.64 | varies |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$629.60–$7,326.75 | $787–$9,158.44 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$766.45–$8,238.59 | $958.06–$10,298.24 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $402.40 | $503 | 0.3× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $268.80 | $336 | 0.2× |
| Platelet survival study Non-Facility (78191) | $857.60 | $1,072 | 2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$269.60–$1,568.26 | $337–$1,960.33 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$174.40–$652 | $218–$815 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$92–$467.37 | $115–$584.21 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$84.80–$288.80 | $106–$361 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$96.15–$452 | $120.19–$565 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$136–$605.60 | $170–$757 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$68.04–$396.05 | $85.05–$495.06 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$85.60–$467.42 | $107–$584.28 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$89.74–$487.55 | $112.18–$609.44 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $140.80 | $176 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $189.60 | $237 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$89.60–$437.60 | $112–$547 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $308 | $385 | 3.3× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$105.60–$486.40 | $132–$608 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$117.11–$467.73 | $146.39–$584.66 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$93.60–$250.40 | $117–$313 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$92.80–$501.60 | $116–$627 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$92–$360.80 | $115–$451 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$203.20–$602.40 | $254–$753 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$72.06–$358.16 | $90.08–$447.70 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$80–$228.80 | $100–$286 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$89.77–$467.28 | $112.21–$584.10 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$2,132 | $2,665 | 0.3× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$145.60–$1,492.80 | $182–$1,866 | varies |
| Radiation treatment delivery level 2 (77407) range across 3 matching MRF lines |
$284.80–$1,492.80 | $356–$1,866 | varies |
| Radiation treatment delivery level 3 (77412) range across 4 matching MRF lines |
$359.20–$1,493.64 | $449–$1,867.05 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$129.60–$602.40 | $162–$753 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $223.20 | $279 | 2.0× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$268.80–$1,399.20 | $336–$1,749 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$119.20–$916.80 | $149–$1,146 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $184 | $230 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$193.58–$1,079.76 | $241.97–$1,349.70 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$209.30–$1,135.55 | $261.62–$1,419.44 | varies |
| Radiologic exam teeth complete full mouth (70320) | $154.40 | $193 | 0.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $84 | $105 | 0.3× |
| Radiologic examination femur minimum 2 views (73552) range across 7 matching MRF lines |
$58.40–$348.78 | $73–$435.98 | varies |
| Radiologic examination knee 1/2 views (73560) range across 8 matching MRF lines |
$91.27–$608 | $114.09–$760 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $78.40 | $98 | 0.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $169.60 | $212 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 7 matching MRF lines |
$58.40–$451.74 | $73–$564.68 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $221.60 | $277 | 0.4× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $44.80 | $56 | 0.5× |
| Radiopharm Dacryocystography (78660) | $493.60 | $617 | 1.2× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $447.20 | $559 | 1.8× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $857.60 | $1,072 | 3.4× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $703.20 | $879 | 2.8× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $294.40 | $368 | 0.7× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $496 | $620 | 0.9× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$124.80–$539.68 | $156–$674.60 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $478.40 | $598 | 1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $602.40 | $753 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $759.20 | $949 | 1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$82.40–$2,586.51 | $103–$3,233.14 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$190.40–$2,582.40 | $238–$3,228 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$365.60–$2,629.60 | $457–$3,287 | varies |
| Salivary Gland Function Study (78232) | $502.40 | $628 | 1.2× |
| Salivary Gland Imaging (78230) | $472 | $590 | 1.1× |
| Salivary Gland Imaging Serial Images (78231) | $491.20 | $614 | 1.1× |
| Scapula (73010) range across 5 matching MRF lines |
$111.20–$294 | $139–$367.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 8 matching MRF lines |
$115.20–$149.23 | $144–$186.54 | varies |
| Sella turcica (70240) | $124.80 | $156 | 1.3× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$92–$450.40 | $115–$563 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$248–$884 | $310–$1,105 | varies |
| Sialogram (70390) | $340.80 | $426 | 1.3× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$115.20–$519.20 | $144–$649 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$61.60–$300.80 | $77–$376 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$503.20–$518.40 | $629–$648 | varies |
| Special teletherapy port plan (77321) range across 5 matching MRF lines |
$160–$1,840.80 | $200–$2,301 | varies |
| Special treatment procedure (77470) range across 5 matching MRF lines |
$239.20–$3,573.60 | $299–$4,467 | varies |
| Speech evaluation, complex (70371) | $531.20 | $664 | 2.1× |
| Spleen Imaging (78185) | $455.20 | $569 | 1.1× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$3,238.40–$3,948.80 | $4,048–$4,936 | varies |
| Sternoclavicular joints (71130) | $135.20 | $169 | 1.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 3 matching MRF lines |
$85.60–$404.80 | $107–$506 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 5 matching MRF lines |
$460.80–$1,151.20 | $576–$1,439 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,015.20 | $1,269 | 2.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $417.60 | $522 | 1.6× |
| Testicular Imaging W/Flow (78761) | $518.40 | $648 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 5 matching MRF lines |
$261.60–$2,787.20 | $327–$3,484 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 3 matching MRF lines |
$521.60–$1,786.40 | $652–$2,233 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 5 matching MRF lines |
$116.80–$1,236.44 | $146–$1,545.55 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$120.40–$532.24 | $150.50–$665.30 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$126.69–$666.21 | $158.36–$832.76 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$124–$392 | $155–$490 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $640 | $800 | 1.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $601.60 | $752 | 1.4× |
| Thyroid Met Imaging Body (78018) | $960.80 | $1,201 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$271.08–$1,633.54 | $338.85–$2,041.92 | varies |
| Tx Devices Design & Construction Complex (77334) range across 5 matching MRF lines |
$207.20–$1,793.90 | $259–$2,242.37 | varies |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$240–$506.40 | $300–$633 | varies |
| Tx devices design & construction simple (77332) range across 4 matching MRF lines |
$92–$889.60 | $115–$1,112 | varies |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$73.81–$311.50 | $92.26–$389.37 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$53.97–$534.65 | $67.46–$668.31 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$269.40–$923.60 | $336.75–$1,154.50 | varies |
| Ultrasound, abdomen limited (76705) range across 9 matching MRF lines |
$395.20–$1,125.95 | $494–$1,407.44 | varies |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$468.26–$2,835.42 | $585.33–$3,544.27 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$168.16–$1,001.81 | $210.20–$1,252.26 | varies |
| Ureteral Reflux Study (78740) | $388.80 | $486 | 0.9× |
| Us bone density measurement (76977) | $280 | $350 | 2.5× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$195.02–$670.78 | $243.77–$838.47 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$173.18–$453.60 | $216.48–$567 | varies |
| Us complete joint (76881) | $392.80 | $491 | 3.5× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$300–$1,000.62 | $375–$1,250.77 | varies |
| Us head (76506) | $375.20 | $469 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$164.58–$392.80 | $205.72–$491 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$594.40–$612.80 | $743–$766 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$244.98–$828 | $306.22–$1,035 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$407.20–$746.54 | $509–$933.17 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$330.39–$1,139.64 | $412.99–$1,424.55 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$333.69–$1,130.90 | $417.11–$1,413.63 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$216.80–$828 | $271–$1,035 | varies |
| Us retroperitoneal complete (76770) | $509.60 | $637 | 4.5× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$269.62–$924.32 | $337.02–$1,155.40 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$281.66–$1,014.33 | $352.07–$1,267.91 | varies |
| Us spinal canal and contents (76800) | $580.80 | $726 | 5.2× |
| Us thyroid (76536) range across 3 matching MRF lines |
$259.80–$1,039.26 | $324.75–$1,299.07 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$185.60–$899.04 | $232–$1,123.80 | varies |
| Vascular Flow Imaging (78445) | $646.40 | $808 | 1.5× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$364.80–$1,666.40 | $456–$2,083 | varies |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,094.40 | $1,368 | 0.2× |
| Venous thrombosis imaging (78457) | $539.20 | $674 | 0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $837.60 | $1,047 | 2.0× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$81.95–$349.90 | $102.44–$437.37 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $144.80 | $181 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$167.20–$580 | $209–$725 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$89.60–$202.32 | $112–$252.90 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$82.62–$603.78 | $103.27–$754.73 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$75.20–$261.60 | $94–$327 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $169.60 | $212 | 1.5× |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$59.20–$208.78 | $74–$260.97 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 7 matching MRF lines |
$60.80–$357 | $76–$446.25 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $166.40 | $208 | 1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $194.40 | $243 | 1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$92.96–$453.58 | $116.20–$566.98 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$208–$849.60 | $260–$1,062 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$121.12–$649.78 | $151.40–$812.23 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$186.08–$909.60 | $232.60–$1,137 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$115.52–$662.99 | $144.40–$828.74 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$119.45–$531.55 | $149.31–$664.44 | varies |
| X-ray head for orthodontia (70350) | $136 | $170 | 1.5× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$96.17–$410.22 | $120.21–$512.77 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $103.20 | $129 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$91.20–$428.80 | $114–$536 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$116.26–$661.54 | $145.33–$826.93 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$96–$246.40 | $120–$308 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$140–$704 | $175–$880 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$116–$382.40 | $145–$478 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $144 | $180 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$98.94–$398.26 | $123.67–$497.83 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$154–$664.40 | $192.50–$830.50 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$156–$652 | $195–$815 | varies |
| X-Ray Stress View (77071) | $105.60 | $132 | 1.1× |
| X-ray thoracic spine 4 vw (72074) | $163.20 | $204 | 1.5× |
| X-Ray Tmj Unilat (70328) | $184.80 | $231 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$175.02–$592.59 | $218.77–$740.74 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$36.80–$384 | $46–$480 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$112.80–$682.40 | $141–$853 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$156.66–$918.97 | $195.82–$1,148.71 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$108–$442.40 | $135–$553 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $103.20 | $129 | 0.9× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$137.84–$480.84 | $172.30–$601.05 | 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.