Imaging prices at MercyOne Genesis
Davenport, IA · every code in this section with a posted price and a Medicare benchmark.
372 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) | $3,635.40 | $6,059 | 2.6× |
| Abdomen 1 View (74018) | $154.80 | $258 | 1.8× |
| Abdomen 2 views (74019) | $183.60 | $306 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $649.20 | $1,082 | 1.6× |
| Angio pulmonary bilat (75743) | $2,618.40 | $4,364 | 0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,083.40 | $5,139 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $3,594.60 | $5,991 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,594.60 | $5,991 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,073 | $3,455 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,181.40 | $1,969 | 0.4× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$133.80–$200.40 | $223–$334 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,780 | $6,300 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $47.40 | $79 | 0.0× |
| Artery X-Rays Abdomen (75726) | $5,389.20 | $8,982 | 1.0× |
| Artery X-Rays Adrenal Gland (75731) | $2,055 | $3,425 | 0.7× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,055 | $3,425 | 0.4× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,223.40 | $2,039 | 0.2× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$249–$373.80 | $415–$623 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$274.80–$412.20 | $458–$687 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$274.80–$412.20 | $458–$687 | varies |
| Basic radiation dosimetry calculation (77300) | $348 | $580 | 2.6× |
| Bone age studies (77072) | $130.20 | $217 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,048.20 | $1,747 | 2.6× |
| Bone Imaging Limited Area (78300) | $585 | $975 | 1.5× |
| Bone Imaging Whole Body (78306) | $864 | $1,440 | 2.2× |
| Bone survey infant (77076) | $469.20 | $782 | 4.5× |
| Brachytx isodose complex (77318) | $873.60 | $1,456 | 2.3× |
| Brachytx isodose intermed (77317) | $767.40 | $1,279 | 2.1× |
| Brachytx Isodose Plan Simple (77316) | $325.20 | $542 | 0.9× |
| Brain Flow Imaging Only (78610) | $235.80 | $393 | 0.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $843.60 | $1,406 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,274.20 | $5,457 | 2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,499.40 | $2,499 | 4.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,499.60 | $4,166 | 3.2× |
| Cardiac Shunt Detection (78428) | $621 | $1,035 | 1.6× |
| Cat Scan Follow-Up Study (76380) range across 6 matching MRF lines |
$417–$555.60 | $695–$926 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $550.80 | $918 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $808.20 | $1,347 | 1.5× |
| Chest 1 view (71045) | $129 | $215 | 1.5× |
| Chest 2 views (71046) range across 8 matching MRF lines |
$160.80–$201.60 | $268–$336 | varies |
| Chest 3 views (71047) | $219.60 | $366 | 2.5× |
| Chest 4 or more views (71048) | $247.80 | $413 | 2.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $180 | $300 | 1.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$196.80–$295.20 | $328–$492 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $420.60 | $701 | 4.0× |
| Continuing medical physics consltj pr wk (77336) | $411.60 | $686 | 3.1× |
| Contrast Exam Abdominl Aorta (75625) | $3,498 | $5,830 | 1.1× |
| Contrast X-Ray Bladder (74430) | $318.60 | $531 | 0.9× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$283.80–$426 | $473–$710 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$294.60–$442.20 | $491–$737 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,022.80 | $5,038 | 8.7× |
| CT abdomen and pelvis without contrast (74176) | $2,240.40 | $3,734 | 9.4× |
| CT abdomen w contrast (74160) | $1,473.60 | $2,456 | 8.5× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,077.60–$1,659.60 | $1,796–$2,766 | varies |
| CT abdomen w/o contrast (74150) | $1,077.60 | $1,796 | 10.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,978.20 | $3,297 | 5.7× |
| CT Angio Chest (71275) | $1,627.20 | $2,712 | 9.3× |
| CT Angio Head (70496) | $1,656.60 | $2,761 | 9.5× |
| CT angio hrt w/3d image (75574) | $460.80 | $768 | 1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$1,912.20–$2,868 | $3,187–$4,780 | varies |
| CT Angio Neck (70498) | $1,656.60 | $2,761 | 9.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,431.60–$2,147.40 | $2,386–$3,579 | varies |
| CT cervical spine w/ contrast (72126) | $1,708.20 | $2,847 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,435.80 | $2,393 | 13.8× |
| CT cervical spine w/wo cont (72127) | $1,952.40 | $3,254 | 11.2× |
| CT chest w contrast (71260) | $1,554.60 | $2,591 | 8.9× |
| CT chest w/wo contrast (71270) | $1,603.20 | $2,672 | 9.2× |
| CT colonography screening (74263) | $972 | $1,620 | 4.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $741 | $1,235 | 7.1× |
| CT head/brain with contrast (70460) | $1,263.60 | $2,106 | 7.2× |
| CT head/brain without and with contrast (70470) | $1,509 | $2,515 | 8.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $91.20 | $152 | 1.1× |
| CT iac w contrast (70481) | $1,222.20 | $2,037 | 7.0× |
| CT l-spine w&w/o contrast (72133) | $1,909.80 | $3,183 | 11.0× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,116–$1,674 | $1,860–$2,790 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,128.60–$1,693.20 | $1,881–$2,822 | varies |
| CT lumbar spine w contrast (72132) | $1,486.20 | $2,477 | 4.3× |
| CT lumbar spine w/o contrast (72131) | $1,414.80 | $2,358 | 13.6× |
| CT maxillofacial w contrast (70487) | $1,342.80 | $2,238 | 7.7× |
| CT maxillofacial wo contrast (70486) | $1,021.80 | $1,703 | 9.8× |
| CT neck tissue combo (70492) | $1,374.60 | $2,291 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,249.80 | $2,083 | 7.2× |
| CT orbits w/o contrast (70480) | $988.80 | $1,648 | 9.5× |
| CT pelvis w&w/o contrast (72194) | $1,521.60 | $2,536 | 8.7× |
| CT pelvis w/o contrast (72192) | $1,170.60 | $1,951 | 11.3× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,308.60–$1,963.20 | $2,181–$3,272 | varies |
| CT scans face/jaw combo (70488) | $1,351.80 | $2,253 | 7.8× |
| CT soft tissue neck w contrast (70491) | $1,365.60 | $2,276 | 7.8× |
| CT soft tissue neck w/o contrast (70490) | $1,053 | $1,755 | 10.1× |
| CT thoracic spine w contrast (72129) | $1,443 | $2,405 | 8.3× |
| CT thoracic spine w/o contrast (72128) | $1,381.20 | $2,302 | 13.3× |
| CT thoracic spine w/wo cont (72130) | $1,612.20 | $2,687 | 9.2× |
| CT thorax w/o contrast (71250) | $1,145.40 | $1,909 | 11.0× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$1,058.40–$1,744.80 | $1,764–$2,908 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,114.80–$1,672.20 | $1,858–$2,787 | varies |
| CT upper extremity with contrast (73201) range across 12 matching MRF lines |
$1,168.80–$1,753.80 | $1,948–$2,923 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,914 | $3,190 | 11.0× |
| Cta Abdomen (74175) | $1,745.40 | $2,909 | 10.0× |
| CTA pelvis (72191) | $1,837.80 | $3,063 | 10.5× |
| Dilation ureters/urethra rs&i (74485) | $4,820.40 | $8,034 | 2.3× |
| Discography Cerv/Thor Spine (72285) | $2,169.60 | $3,616 | 1.1× |
| Diskography lumbar (72295) | $2,169.60 | $3,616 | 1.1× |
| Dxa Bone Density Axial (77080) | $246 | $410 | 2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $229.20 | $382 | 2.6× |
| Echo exam uterus (76831) | $309.60 | $516 | 1.3× |
| Echo Guide For Artery Repair (76936) | $601.80 | $1,003 | 2.8× |
| Echograp Trans R Pros Study (76873) | $243 | $405 | 2.3× |
| Esophagram (74220) | $321.60 | $536 | 1.8× |
| Fetal Biophys Profile W/Nst (76818) | $396.60 | $661 | 3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$322.80–$324 | $538–$540 | varies |
| Fluoroscopy up to 1 hr (76000) range across 12 matching MRF lines |
$264–$291 | $440–$485 | varies |
| Follow-Up Angiography (75898) | $1,860.60 | $3,101 | 0.6× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$121.80–$183 | $203–$305 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$193.20–$289.20 | $322–$482 | varies |
| Gastric emptying imaging study (78264) | $895.80 | $1,493 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $823.80 | $1,373 | 2.1× |
| Gated Heart Planar Single (78472) | $919.80 | $1,533 | 2.3× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$141–$210.60 | $235–$351 | varies |
| Heart first pass single,planar (78481) | $919.80 | $1,533 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,211.40 | $2,019 | 2.2× |
| Hepatobiliary System Imaging (78226) | $768 | $1,280 | 1.9× |
| Ht Musc Image Planar Mult (78454) | $1,605.60 | $2,676 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $2,007.60 | $3,346 | 1.6× |
| Hysterosalpingogram (74740) | $519.60 | $866 | 2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $245.40 | $409 | 2.8× |
| Infant hip ultrasound, limited static exam (76886) | $179.40 | $299 | 2.1× |
| Infusion Ivp (74410) | $429.60 | $716 | 2.5× |
| Interstitial radiation source applic complex (77778) | $3,383.40 | $5,639 | 4.9× |
| Joint Survey Single View (77077) | $121.20 | $202 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $699 | $1,165 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $949.20 | $1,582 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $806.40 | $1,344 | 1.5× |
| Kidney Imaging Morphol (78700) | $757.80 | $1,263 | 1.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $695.40 | $1,159 | 1.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$192.60–$288.60 | $321–$481 | varies |
| Leveen/Shunt Patency Exam (78291) | $695.40 | $1,159 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $589.80 | $983 | 1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $928.20 | $1,547 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $877.80 | $1,463 | 1.6× |
| Lung perfusion differential (78597) | $1,317.60 | $2,196 | 3.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,228.20 | $2,047 | 2.3× |
| Lung Ventilation Imaging (78579) | $702 | $1,170 | 1.8× |
| Lymph System Imaging (78195) | $1,086.60 | $1,811 | 2.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,570.20 | $2,617 | 0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,293.60 | $2,156 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $1,246.80 | $2,078 | 5.3× |
| Mammary ductogram or galactogram multiple (77054) range across 3 matching MRF lines |
$94.80–$469.80 | $158–$783 | varies |
| Mammary ductogram or galactogram single (77053) range across 5 matching MRF lines |
$292.80–$469.80 | $488–$783 | varies |
| Meckels Divert Exam (78290) | $750 | $1,250 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $551.40 | $919 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,329.20 | $3,882 | 6.7× |
| MRA head w/o contrast (70544) | $1,755.60 | $2,926 | 7.4× |
| MRA head with contrast (70545) | $1,891.80 | $3,153 | 5.5× |
| MRA neck w contrast (70548) | $1,764 | $2,940 | 5.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,544.60 | $4,241 | 7.3× |
| MRA neck w/o contrast (70547) | $1,595.40 | $2,659 | 6.7× |
| MRI abdomen w contrast (74182) | $1,061.40 | $1,769 | 3.1× |
| MRI abdomen w/o contrast (74181) | $1,544.40 | $2,574 | 6.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 16 matching MRF lines |
$1,779–$2,693.40 | $2,965–$4,489 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$2,454.60–$3,717 | $4,091–$6,195 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 15 matching MRF lines |
$1,605.60–$2,408.40 | $2,676–$4,014 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,151.40 | $1,919 | 4.9× |
| MRI cardiac w/o contrast (75557) | $1,232.40 | $2,054 | 5.2× |
| MRI cervical spine w contrast (72142) | $1,275.60 | $2,126 | 3.7× |
| MRI cervical spine w/o cont (72141) | $1,741.80 | $2,903 | 7.3× |
| MRI chest w/o contrast (71550) | $1,432.20 | $2,387 | 6.0× |
| MRI chest with contrast (71551) | $1,556.40 | $2,594 | 2.0× |
| MRI chest wo w contrast (71552) | $2,305.20 | $3,842 | 6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 13 matching MRF lines |
$1,560–$2,340.60 | $2,600–$3,901 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$2,527.80–$3,791.40 | $4,213–$6,319 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 11 matching MRF lines |
$1,608–$2,412 | $2,680–$4,020 | varies |
| MRI lumbar spine w contrast (72149) | $1,275.60 | $2,126 | 3.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,361.60 | $3,936 | 6.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,522.20 | $2,537 | 6.4× |
| MRI orbit face neck w contrast (70542) | $1,662 | $2,770 | 4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,674.20 | $4,457 | 7.7× |
| MRI pelvis w contrast (72196) | $1,741.20 | $2,902 | 5.0× |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$2,391–$2,616 | $3,985–$4,360 | varies |
| MRI pelvis w/o contrast (72195) | $1,576.80 | $2,628 | 6.6× |
| MRI spectroscopy (76390) | $1,117.20 | $1,862 | 12.9× |
| MRI thoracic spine w/o contrast (72146) | $1,741.80 | $2,903 | 7.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 9 matching MRF lines |
$1,061.40–$1,591.80 | $1,769–$2,653 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 11 matching MRF lines |
$1,347–$2,020.80 | $2,245–$3,368 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 9 matching MRF lines |
$2,499.60–$3,748.80 | $4,166–$6,248 | varies |
| MRI, abdomen, combo (74183) | $3,073.80 | $5,123 | 8.9× |
| MRI, dorsal spine combo (72157) | $2,361.60 | $3,936 | 6.8× |
| MRI, dorsal spine contrast (72147) | $1,275.60 | $2,126 | 3.7× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$1,461.60–$2,193.60 | $2,436–$3,656 | varies |
| MRI, joint upper extrem combo (73223) range across 13 matching MRF lines |
$2,512.80–$3,769.80 | $4,188–$6,283 | varies |
| MRI, lumbar spine combo (72158) | $2,361.60 | $3,936 | 6.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $531.60 | $886 | 1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,204.40 | $3,674 | 1.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,602.60 | $2,671 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $2,208 | $3,680 | 1.7× |
| Neck soft tissue (70360) | $144.60 | $241 | 1.7× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $365.40 | $609 | 1.0× |
| Nm myocard infarct spect (78469) | $1,186.80 | $1,978 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $219.60 | $366 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,859.40 | $8,099 | 3.5× |
| Nuclear Rx Oral Admin (79005) | $528 | $880 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $220.80 | $368 | 2.1× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $208.20 | $347 | 1.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $130.20 | $217 | 1.3× |
| Panoramic X-ray of jaws (70355) | $151.20 | $252 | 1.7× |
| Parathyroid Planar Imaging (78070) | $528 | $880 | 1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $707.40 | $1,179 | 1.8× |
| Pelvis 1 or 2 views (72170) | $172.80 | $288 | 1.7× |
| Perineogram (74775) | $347.40 | $579 | 1.5× |
| PET image w/CT, full body (78816) range across 6 matching MRF lines |
$4,069.80–$4,193.40 | $6,783–$6,989 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,760.20 | $6,267 | 2.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,204.40 | $3,674 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $252 | $420 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $383.40 | $639 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$186.60–$280.80 | $311–$468 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$172.80–$259.20 | $288–$432 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$195.60–$293.40 | $326–$489 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $294.60 | $491 | 2.8× |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$141.60–$211.80 | $236–$353 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$186.60–$280.80 | $311–$468 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$176.40–$264.60 | $294–$441 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$154.80–$232.20 | $258–$387 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $235.20 | $392 | 2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $197.40 | $329 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $243.60 | $406 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$200.40–$300.60 | $334–$501 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $207.60 | $346 | 2.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $627.60 | $1,046 | 3.6× |
| Radex Spine 1 View Specify Level (72020) | $148.20 | $247 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $176.40 | $294 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $232.20 | $387 | 2.7× |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$150.60–$226.20 | $251–$377 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$130.20–$195 | $217–$325 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$176.40–$264.60 | $294–$441 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $115.20 | $192 | 1.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,717.80 | $12,863 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $307.80 | $513 | 3.0× |
| Radiation treatment delivery level 2 (77407) | $380.40 | $634 | 1.0× |
| Radiation treatment delivery level 3 (77412) range across 8 matching MRF lines |
$525–$555.60 | $875–$926 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $232.80 | $388 | 2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$183.60–$186 | $306–$310 | varies |
| Radiologic exam colon double contrast study (74280) | $445.20 | $742 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $327.60 | $546 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$195.60–$293.40 | $326–$489 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $243 | $405 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $352.80 | $588 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $295.20 | $492 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $363.60 | $606 | 2.1× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$127.80–$191.40 | $213–$319 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$154.20–$231.60 | $257–$386 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$159–$238.20 | $265–$397 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $244.20 | $407 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$166.20–$249 | $277–$415 | varies |
| Ribs bilateral 3 views (71110) | $280.80 | $468 | 2.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $695.40 | $1,159 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,378.20 | $2,297 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,383 | $2,305 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,131 | $1,885 | 2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $787.80 | $1,313 | 0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $804.60 | $1,341 | 3.5× |
| Scapula (73010) range across 3 matching MRF lines |
$159–$238.20 | $265–$397 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $26.40 | $44 | 1.1× |
| Sella turcica (70240) | $157.80 | $263 | 1.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$110.40–$165.60 | $184–$276 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$274.80–$412.20 | $458–$687 | varies |
| Sialogram (70390) | $288.60 | $481 | 1.2× |
| Skull less than 4 views (70250) | $165 | $275 | 1.6× |
| Special dosimetry (77331) | $272.40 | $454 | 2.0× |
| Special Physics Consult (77370) | $477 | $795 | 3.6× |
| Special teletherapy port plan (77321) | $536.40 | $894 | 1.4× |
| Special treatment procedure (77470) | $1,545.60 | $2,576 | 2.8× |
| Stereotactic Body Radiation Delivery (77373) | $4,348.20 | $7,247 | 2.4× |
| Sternoclavicular joints (71130) | $192 | $320 | 2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $690 | $1,150 | 1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $395.40 | $659 | 1.1× |
| Testicular Imaging W/Flow (78761) | $629.40 | $1,049 | 1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,458 | $2,430 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $657.60 | $1,096 | 1.8× |
| Ther rad simulaj-aided field setting simple (77280) | $596.40 | $994 | 4.5× |
| Thoracic spine 2 views (72070) | $223.20 | $372 | 2.1× |
| Thoracic spine 3 views (72072) | $246 | $410 | 2.4× |
| Thoracolumbar 2 views (72080) | $165 | $275 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $505.80 | $843 | 1.3× |
| Thyroid Met Imaging Body (78018) | $716.40 | $1,194 | 1.3× |
| Thyroid Uptake Measurement (78012) | $295.80 | $493 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $875.40 | $1,459 | 2.2× |
| Tx Devices Design & Construction Complex (77334) | $701.40 | $1,169 | 1.9× |
| Tx devices design & construction intermediate (77333) | $409.20 | $682 | 3.1× |
| Tx devices design & construction simple (77332) | $441 | $735 | 3.3× |
| Ultrasound Breast Limited (76642) range across 15 matching MRF lines |
$344.40–$516.60 | $574–$861 | varies |
| Ultrasound Exam Aaa Screen (76706) | $193.20 | $322 | 1.9× |
| Ultrasound, abdomen limited (76705) | $438 | $730 | 4.2× |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$33–$272.40 | $55–$454 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $879 | $1,465 | 10.2× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $233.40 | $389 | 0.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,797 | $2,995 | 17.7× |
| Unlisted us procedure (76999) | $145.80 | $243 | 1.7× |
| Upper gi w/o kub (74240) | $346.80 | $578 | 2.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $79.80 | $133 | 7.2× |
| Urea breath test c-14 isotopic analysis (78268) range across 3 matching MRF lines |
$257.40–$258 | $429–$430 | varies |
| Ureteral Reflux Study (78740) | $802.80 | $1,338 | 2.0× |
| Urethrocystogram voiding (74455) | $480.60 | $801 | 2.0× |
| Urethrocystography retrograde (74450) | $343.20 | $572 | 1.4× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$369.60–$553.80 | $616–$923 | varies |
| Us chest (76604) | $310.20 | $517 | 3.0× |
| Us complete joint (76881) | $238.80 | $398 | 2.3× |
| Us exam, pelvic, limited (76857) | $213.60 | $356 | 2.1× |
| Us head (76506) | $374.40 | $624 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$154.20–$1,887.60 | $257–$3,146 | varies |
| Us ob detailed single fetus (76811) | $361.80 | $603 | 1.5× |
| Us ob limited 1 or more fetuses (76815) | $322.20 | $537 | 3.1× |
| Us ob transvaginal (76817) | $384 | $640 | 3.7× |
| Us pelvic non ob complete (76856) | $373.80 | $623 | 3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $379.20 | $632 | 3.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 6 matching MRF lines |
$251.40–$275.40 | $419–$459 | varies |
| Us retroperitoneal complete (76770) | $486 | $810 | 4.7× |
| Us retroperitoneal limited (76775) | $372 | $620 | 3.6× |
| Us scrotum and contents (76870) | $472.80 | $788 | 4.5× |
| Us spinal canal and contents (76800) | $398.40 | $664 | 3.8× |
| Us thyroid (76536) | $351 | $585 | 3.4× |
| Us transrectal (76872) | $318.60 | $531 | 3.1× |
| Vascular Flow Imaging (78445) | $470.40 | $784 | 1.2× |
| Vein X-Ray Chest (75827) | $1,707.60 | $2,846 | 1.1× |
| Vein X-Ray Skull Epidural (75872) | $1,108.20 | $1,847 | 1.8× |
| Venogram Sinus/Jugular (75860) | $705.60 | $1,176 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $3,594.60 | $5,991 | 1.1× |
| Venography extremity bilateral rs&i (75822) | $1,332.60 | $2,221 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,326 | $2,210 | 0.8× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$3,257.40–$3,456.60 | $5,429–$5,761 | varies |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$2,173.20–$2,716.20 | $3,622–$4,527 | varies |
| Venous sampling by catheter (75893) | $2,970 | $4,950 | 0.5× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$122.40–$184.20 | $204–$307 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $175.20 | $292 | 2.0× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$481.20–$601.80 | $802–$1,003 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,594.60 | $5,991 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $144.60 | $241 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$129–$193.20 | $215–$322 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $158.40 | $264 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$192–$268.80 | $320–$448 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $91.80 | $153 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 8 matching MRF lines |
$171.60–$264.60 | $286–$441 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $309.60 | $516 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$66–$83.40 | $110–$139 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $232.80 | $388 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$304.80–$393.60 | $508–$656 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $376.20 | $627 | 3.6× |
| X-Ray Exam L-S Spine Bending (72114) | $438.60 | $731 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $223.20 | $372 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $309 | $515 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $323.40 | $539 | 3.1× |
| X-ray eye for foreign body (70030) | $161.40 | $269 | 1.9× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$187.20–$281.40 | $312–$469 | varies |
| X-ray IV pyelogram (ivp) (74400) | $426 | $710 | 2.4× |
| X-ray IV pyelogram+tomography (74415) | $481.20 | $802 | 2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 6 matching MRF lines |
$111–$181.20 | $185–$302 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $128.40 | $214 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $257.40 | $429 | 2.5× |
| X-ray nose-rectum child f.b. (76010) | $166.80 | $278 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $345.60 | $576 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $184.80 | $308 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $170.40 | $284 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $186.60 | $311 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $250.20 | $417 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $273 | $455 | 2.6× |
| X-Ray Tmj Unilat (70328) | $169.80 | $283 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $640.20 | $1,067 | 1.8× |
| X-Rays Bone Length Studies (77073) | $186 | $310 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $464.40 | $774 | 4.5× |
| Xr c-spine 4 or 5 views (72050) | $263.40 | $439 | 2.5× |
| Xr facial bones less than 3 views (70140) | $175.80 | $293 | 2.0× |
| Xr myelogram posterior fossa (70010) | $445.20 | $742 | 1.3× |
| Xr orbits complete 4 views (70200) | $161.40 | $269 | 1.6× |
| Xr Tomogram Single Plane (76100) | $250.80 | $418 | 2.4× |
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.