Imaging prices at MercyOne Des Moines Medical Center
Des Moines, IA · every code in this section with a posted price and a Medicare benchmark.
315 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) | $2,650.05 | $4,077 | 2.0× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$463–$24,276.30 | — | varies |
| Abdomen 2 views (74019) | $579 | — | 5.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $913.90 | $1,406 | 2.4× |
| Angio pulmonary bilat (75743) | $4,765.80 | $7,332 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $42,318.61 | — | 13.9× |
| Angiography extremity unilateral rs&i (75710) | $31,253.40 | — | 10.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,858.70 | $4,398 | 0.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$1,675–$26,952.60 | — | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,002 | $3,080 | 0.4× |
| Artery X-Rays Abdomen (75726) | $87,321.68 | — | 16.2× |
| Artery X-Rays Pelvis (75736) | $4,728.75 | $7,275 | 0.9× |
| Artery X-Rays Spine (75705) | $5,958.55 | $9,167 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $221 | $340 | 1.7× |
| Bone age studies (77072) | $260 | $400 | 2.6× |
| Bone Imaging 3 Phase (78315) | $1,350.05 | $2,077 | 3.5× |
| Bone Imaging Limited Area (78300) | $1,460.55 | $2,247 | 3.8× |
| Bone Imaging Whole Body (78306) | $1,227.20 | $1,888 | 3.2× |
| Bone marrow imaging limited area (78102) | $981.50 | $1,510 | 2.5× |
| Bone survey infant (77076) | $301.60 | $464 | 3.0× |
| Brachytx Isodose Plan Simple (77316) | $443.95 | $683 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,163.50 | $1,790 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,844.40 | $4,376 | 2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,897.40 | $5,996 | 11.6× |
| Cat Scan Follow-Up Study (76380) | $1,323 | — | 15.7× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$23,317.46–$39,671.22 | — | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$545–$1,635 | — | varies |
| Chest 3 views (71047) | $228.15 | $351 | 2.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $285.35 | $439 | 2.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$550–$37,977 | — | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,140.75 | $1,755 | 11.3× |
| Continuing medical physics consltj pr wk (77336) | $47,187 | — | 363.5× |
| Contrast Exam Abdominl Aorta (75625) | $4,020.25 | $6,185 | 1.3× |
| Contrast X-Ray Bladder (74430) | $696.15 | $1,071 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$748.15–$1,122.55 | $1,151–$1,727 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,191.85 | $6,449 | 12.4× |
| CT abdomen and pelvis without contrast (74176) | $6,869 | — | 29.8× |
| CT abdomen w contrast (74160) | $1,863.55 | $2,867 | 11.0× |
| CT abdomen w wo contrast (74170) | $2,388.10 | $3,674 | 14.1× |
| CT abdomen w/o contrast (74150) | $1,441.05 | $2,217 | 14.3× |
| CT Angio Abdomen and Pelvis (74174) | $5,354.70 | $8,238 | 15.9× |
| CT Angio Chest (71275) | $3,014.70 | $4,638 | 17.8× |
| CT Angio Head (70496) | $2,465.45 | $3,793 | 14.6× |
| CT angio hrt w/3d image (75574) | $780 | $1,200 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,724.80–$4,086.55 | $4,192–$6,287 | varies |
| CT Angio Neck (70498) | $2,154.75 | $3,315 | 12.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,847.65 | $4,381 | 16.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $349.70 | $538 | 2.1× |
| CT cervical spine w/ contrast (72126) | $1,498.25 | $2,305 | 4.4× |
| CT cervical spine w/o contrast (72125) | $1,498.25 | $2,305 | 14.8× |
| CT cervical spine w/wo cont (72127) | $3,842.80 | $5,912 | 22.7× |
| CT chest w contrast (71260) | $9,415.50 | — | 55.6× |
| CT chest w/wo contrast (71270) | $2,259.40 | $3,476 | 13.3× |
| CT head/brain with contrast (70460) | $1,418.95 | $2,183 | 8.4× |
| CT head/brain without and with contrast (70470) | $1,675.05 | $2,577 | 9.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,984.15 | $4,591 | 8.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $64.35 | $99 | 0.8× |
| CT iac w contrast (70481) | $1,510.60 | $2,324 | 8.9× |
| CT l-spine w&w/o contrast (72133) | $3,981.90 | $6,126 | 23.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,295.45–$1,942.85 | $1,993–$2,989 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$4,374.35–$9,744.15 | — | varies |
| CT lumbar spine w contrast (72132) | $1,692.60 | $2,604 | 5.0× |
| CT lumbar spine w/o contrast (72131) | $1,498.25 | $2,305 | 14.8× |
| CT maxillofacial w contrast (70487) | $2,146.95 | $3,303 | 12.7× |
| CT maxillofacial wo contrast (70486) | $1,165.45 | $1,793 | 11.5× |
| CT neck tissue combo (70492) | $1,792.70 | $2,758 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,624.35 | $2,499 | 9.6× |
| CT orbits w/o contrast (70480) | $3,491 | — | 34.6× |
| CT pelvis w&w/o contrast (72194) | $1,990.95 | $3,063 | 11.8× |
| CT pelvis w/o contrast (72192) | $1,302.60 | $2,004 | 12.9× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,800.50–$2,700.75 | $2,770–$4,155 | varies |
| CT scans face/jaw combo (70488) | $1,218.10 | $1,874 | 7.2× |
| CT soft tissue neck w contrast (70491) | $1,645.15 | $2,531 | 9.7× |
| CT soft tissue neck w/o contrast (70490) | $1,332.50 | $2,050 | 13.2× |
| CT thoracic spine w contrast (72129) | $1,451.45 | $2,233 | 8.6× |
| CT thoracic spine w/o contrast (72128) | $1,320.15 | $2,031 | 13.1× |
| CT thorax w/o contrast (71250) | $1,707.55 | $2,627 | 16.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,162.20–$1,743.95 | $1,788–$2,683 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,877.55–$4,316 | $4,427–$6,640 | varies |
| CT upper extremity with contrast (73201) | $4,230.90 | — | 12.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,700.75 | $4,155 | 15.9× |
| Cta Abdomen (74175) | $3,616.50 | — | 21.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $694.85 | $1,069 | 2.1× |
| CTA pelvis (72191) | $7,797.50 | — | 46.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $557.05 | $857 | 5.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $360.75 | $555 | 3.6× |
| Dxa Bone Density Axial (77080) | $244.40 | $376 | 2.4× |
| Dxa bone density study (77085) | $244.40 | $376 | 2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $654 | — | 7.8× |
| Echo exam of fetal heart (76825) | $993.85 | $1,529 | 1.9× |
| Echo Guide For Artery Repair (76936) | $941.85 | $1,449 | 4.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $859.95 | $1,323 | 3.7× |
| Esophagram (74220) | $356.85 | $549 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $1,010.10 | $1,554 | 10.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,502 | — | 24.8× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$3,131.75–$5,453.75 | — | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$336.70–$505.05 | $518–$777 | varies |
| Forearm 2 views (73090) | $560 | — | 6.7× |
| Gastric emptying imaging study (78264) | $1,459.25 | $2,245 | 3.8× |
| Gastroesophageal Reflux Exam (78262) | $631.15 | $971 | 1.6× |
| Gated Heart Planar Single (78472) | $1,218.10 | $1,874 | 3.2× |
| Hand 2 views (73120) | $498 | — | 4.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $808.60 | $1,244 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,369.55 | $2,107 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,668.55 | $2,567 | 4.3× |
| Ht Musc Image Planar Mult (78454) | $1,701.05 | $2,617 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $3,193.45 | $4,913 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $332.15 | $511 | 4.0× |
| Infant hip ultrasound, limited static exam (76886) | $332.15 | $511 | 4.0× |
| Intraop radiaj tx deliver xray single tx session (77424) | $5,638.10 | $8,674 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $1,680.90 | $2,586 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,647.75 | $2,535 | 3.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,023.75 | $1,575 | 2.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$685–$2,247 | — | varies |
| Leveen/Shunt Patency Exam (78291) | $427.70 | $658 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,660.75 | $2,555 | 3.2× |
| Lung perfusion differential (78597) | $1,615.25 | $2,485 | 4.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,405.30 | $2,162 | 2.7× |
| Lung Ventilation Imaging (78579) | $885.95 | $1,363 | 2.3× |
| Lymph System Imaging (78195) | $5,041 | — | 9.6× |
| Magnetic Image Jaw Joint (70336) | $2,467.40 | $3,796 | 10.7× |
| Meckels Divert Exam (78290) | $1,383.20 | $2,128 | 3.6× |
| Mlc imrt design & construction per imrt plan (77338) | $46,768 | — | 129.3× |
| Mr safety determination physician/other qhp (76016) | $120.25 | $185 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $33.15 | $51 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $125.45 | $193 | 1.4× |
| Mr safety implt pos&/immoblj (76019) | $81.25 | $125 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $329.55 | $507 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $4,171.55 | — | 12.4× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$10,195.05–$11,106.55 | — | varies |
| MRA neck w contrast (70548) | $2,302.30 | $3,542 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,695.25 | $5,685 | 11.0× |
| MRA neck w/o contrast (70547) | $1,727.70 | $2,658 | 7.5× |
| MRI abdomen w/o contrast (74181) | $3,046.55 | $4,687 | 13.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,464.50–$5,196.75 | $5,330–$7,995 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,757.65–$5,636.80 | $5,781–$8,672 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$4,178.85–$6,268.60 | $6,429–$9,644 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 3 matching MRF lines |
$2,608.45–$3,913 | $4,013–$6,020 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $440.70 | $678 | 1.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,391.65 | $2,141 | 6.0× |
| MRI cardiac w/o contrast (75557) | $2,883.40 | $4,436 | 12.5× |
| MRI cervical spine w contrast (72142) | $2,352.35 | $3,619 | 7.0× |
| MRI cervical spine w/o cont (72141) | $2,585.70 | $3,978 | 11.2× |
| MRI chest w/o contrast (71550) | $2,861.30 | $4,402 | 12.4× |
| MRI chest wo w contrast (71552) | $3,392.35 | $5,219 | 10.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,209.40–$6,314.75 | $6,476–$9,715 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,675.40–$4,013.10 | $4,116–$6,174 | varies |
| MRI lumbar spine w contrast (72149) | $2,331.55 | $3,587 | 6.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,331.60 | $6,664 | 12.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,188.25 | $4,905 | 13.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,935.75 | $6,055 | 11.7× |
| MRI pelvis w/o & w contrast (72197) | $3,551.60 | $5,464 | 10.5× |
| MRI pelvis w/o contrast (72195) | $1,974.05 | $3,037 | 8.6× |
| MRI thoracic spine w/o contrast (72146) | $2,477.80 | $3,812 | 10.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,752.75–$4,129.45 | $4,235–$6,353 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$4,824.30–$7,237.10 | $7,422–$11,134 | varies |
| MRI, abdomen, combo (74183) | $3,996.20 | $6,148 | 11.9× |
| MRI, dorsal spine combo (72157) | $4,310.80 | $6,632 | 12.8× |
| MRI, dorsal spine contrast (72147) | $1,946.10 | $2,994 | 5.8× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$2,481.70–$3,722.55 | $3,818–$5,727 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$4,504.50–$6,756.75 | $6,930–$10,395 | varies |
| MRI, lumbar spine combo (72158) | $4,317.30 | $6,642 | 12.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,268.55 | $6,567 | 3.4× |
| Myocardial Spect Multiple Studies (78452) | $3,688.10 | $5,674 | 2.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,060.85 | $4,709 | 2.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $7,533.50 | $11,590 | 3.5× |
| N-invas est c ffr sw aly CTA (75580) | $2,854.80 | $4,392 | 3.4× |
| Neck soft tissue (70360) | $270.40 | $416 | 3.2× |
| Nonvascular Shunt X-Ray (75809) | $492.70 | $758 | 4.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,917.95 | $10,643 | 5.2× |
| Nuclear Rx Intra-Arterial (79445) | $761.80 | $1,172 | 3.4× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$2,413–$3,868.20 | — | varies |
| Ob us nuchal meas 1 gest (76813) | $384.80 | $592 | 3.8× |
| Panoramic X-ray of jaws (70355) | $362.70 | $558 | 4.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,048.50 | $4,690 | 5.8× |
| Parathyroid Planar Imaging (78070) | $798.85 | $1,229 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,668.55 | $2,567 | 4.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$1,247–$46,779.57 | — | varies |
| Peritoneogram Rs&I (74190) | $650 | $1,000 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $2,939.95 | $4,523 | 2.1× |
| PET image w/CT, full body (78816) | $7,501 | $11,540 | 5.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $9,778.20 | — | 7.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $942.50 | $1,450 | 2.4× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $2,470 | $3,800 | 2.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $246.35 | $379 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $632.45 | $973 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$648–$44,899.30 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$299–$448.50 | $460–$690 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$615–$36,246.74 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $406.90 | $626 | 4.0× |
| Radex fingr minimum 2 views (73140) | $459 | — | 5.5× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$631–$3,290 | — | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$623–$1,246 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$163.80–$245.70 | $252–$378 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $350.35 | $539 | 4.2× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$636–$777 | — | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$665–$40,792.26 | — | varies |
| Radex Spine 1 View Specify Level (72020) | $301.60 | $464 | 3.6× |
| Radex Sternum Minimum 2 Views (71120) | $395.20 | $608 | 4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $492.05 | $757 | 5.9× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$296.40–$444.60 | $456–$684 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$597–$1,194 | — | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $22,795.50 | $35,070 | 3.2× |
| Radiation treatment delivery level 1 (77402) | $2,277.60 | $3,504 | 23.1× |
| Radiation treatment delivery level 2 (77407) | $2,838.55 | $4,367 | 7.6× |
| Radiation treatment delivery level 3 (77412) | $22,296 | — | 41.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $378.95 | $583 | 3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $193.70 | $298 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $930.80 | $1,432 | 5.5× |
| Radiologic exam colon single contrast study (74270) | $744.90 | $1,146 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $395.85 | $609 | 2.3× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$449.80–$674.70 | $692–$1,038 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$7,566–$58,170.03 | — | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $657.15 | $1,011 | 3.9× |
| Radiologic exam swallow function contrast study (74230) | $538.20 | $828 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $744.25 | $1,145 | 4.4× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$174.20–$261.30 | $268–$402 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$828–$65,462.18 | — | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$548–$32,148.99 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $356.85 | $549 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$767–$44,659.62 | — | varies |
| Ribs bilateral 3 views (71110) | $505.05 | $777 | 5.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $947.05 | $1,457 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,150.20 | $3,308 | 5.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,022.45 | $1,573 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,181.40 | $3,356 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,202.85 | $3,389 | 4.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,263.95 | $3,483 | 1.8× |
| Scapula (73010) range across 3 matching MRF lines |
$390.65–$585.65 | $601–$901 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
$588–$2,249 | — | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$295.75–$443.95 | $455–$683 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,482.65–$2,223.65 | $2,281–$3,421 | varies |
| Skull less than 4 views (70250) | $371.15 | $571 | 3.7× |
| Special dosimetry (77331) | $24.05 | $37 | 0.2× |
| Special Physics Consult (77370) | $601.25 | $925 | 4.6× |
| Special treatment procedure (77470) | $1,905.15 | $2,931 | 3.6× |
| Stereotactic Body Radiation Delivery (77373) | $10,934.95 | $16,823 | 6.3× |
| Sternoclavicular joints (71130) | $300.30 | $462 | 3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $513.50 | $790 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,036.45 | $3,133 | 5.6× |
| Ther rad simulaj-aided field setting simple (77280) | $380.25 | $585 | 2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $557.05 | $857 | 3.3× |
| Thoracic spine 2 views (72070) | $403.65 | $621 | 4.0× |
| Thoracic spine 3 views (72072) | $442.65 | $681 | 4.4× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$592–$62,338.03 | — | varies |
| Thyroid Met Imaging Body (78018) | $2,050.75 | $3,155 | 3.9× |
| Thyroid Uptake Measurement (78012) | $596.70 | $918 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $607.75 | $935 | 1.6× |
| Tx Devices Design & Construction Complex (77334) | $652.60 | $1,004 | 1.8× |
| Tx devices design & construction simple (77332) | $286.65 | $441 | 2.2× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$1,418–$2,387 | — | varies |
| Ultrasound Elastography Parenchyma (76981) | $600.60 | $924 | 5.9× |
| Ultrasound Exam Aaa Screen (76706) | $326.95 | $503 | 3.2× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$1,259–$1,829 | — | varies |
| Umbilical-artery Doppler (OB) (76820) | $401.05 | $617 | 4.0× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $2,291.25 | $3,525 | 23.2× |
| Upper gi w/o kub (74240) | $672.75 | $1,035 | 4.0× |
| Urethrocystogram voiding (74455) | $790.40 | $1,216 | 3.4× |
| Urethrocystography retrograde (74450) | $721.50 | $1,110 | 3.1× |
| Us chest (76604) | $700.70 | $1,078 | 6.9× |
| Us complete joint (76881) | $193.70 | $298 | 1.9× |
| Us exam, pelvic, limited (76857) | $681.85 | $1,049 | 6.8× |
| Us head (76506) | $738.40 | $1,136 | 7.3× |
| Us kidney transplant (76776) | $969.80 | $1,492 | 9.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $621.40 | $956 | 6.2× |
| Us ob detailed single fetus (76811) | $830.05 | $1,277 | 3.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$2,378–$16,754.60 | — | varies |
| Us ob transvaginal (76817) | $590 | — | 5.8× |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$1,190–$2,171 | — | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $806 | $1,240 | 8.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $461.50 | $710 | 4.6× |
| Us retroperitoneal complete (76770) | $910.65 | $1,401 | 9.0× |
| Us retroperitoneal limited (76775) | $520 | $800 | 5.1× |
| Us scrotum and contents (76870) | $856.70 | $1,318 | 8.5× |
| Us spinal canal and contents (76800) | $417.95 | $643 | 4.1× |
| Us thyroid (76536) | $785.85 | $1,209 | 7.8× |
| Us transrectal (76872) | $729.30 | $1,122 | 7.2× |
| Vein X-Ray Chest (75827) | $40,241.17 | — | 26.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,025.10 | $4,654 | 1.0× |
| Venogram Sinus/Jugular (75860) | $3,728.40 | $5,736 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $4,728.10 | $7,274 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $1,936.35 | $2,979 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $4,547.49 | — | 3.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$322.40–$482.95 | $496–$743 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $352.30 | $542 | 4.2× |
| X-ray antegrade pyelogram tube (74425) | $882.05 | $1,357 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $4,300.40 | $6,616 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $603.85 | $929 | 6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$39,035.11–$40,426.78 | — | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$37,286.04–$49,427.33 | — | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $219.05 | $337 | 2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $624.65 | $961 | 6.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $299.65 | $461 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$641–$45,741.97 | — | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $362.05 | $557 | 3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $193.70 | $298 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $193.70 | $298 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$658–$49,327.32 | — | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $627.25 | $965 | 6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $210.60 | $324 | 2.1× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$294.45–$441.35 | $453–$679 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$2,719–$42,785.25 | — | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $319.80 | $492 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $479.05 | $737 | 4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $481 | $740 | 4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $390 | $600 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $406.25 | $625 | 4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $419.25 | $645 | 5.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $534.95 | $823 | 5.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $747.50 | $1,150 | 2.2× |
| X-Rays Bone Length Studies (77073) | $303.55 | $467 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $913.90 | $1,406 | 9.1× |
| Xr c-spine 4 or 5 views (72050) | $557.05 | $857 | 5.5× |
| Xr facial bones less than 3 views (70140) | $211.90 | $326 | 2.5× |
| Xr orbits complete 4 views (70200) | $313.95 | $483 | 3.1× |
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.