Imaging prices at MetroHealth System
Cleveland, OH · every code in this section with a posted price and a Medicare benchmark.
432 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$427–$2,772.70 | $1,220–$7,922 | varies |
| Abdomen 1 View (74018) range across 11 matching MRF lines |
$8.05–$110.60 | $23–$316 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$10.15–$150.50 | $29–$430 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$98–$539 | $280–$1,540 | varies |
| Adrenal Cortex & Medulla Img (78075) | $63.70 | $182 | 0.1× |
| Angio internal mammary (75756) range across 3 matching MRF lines |
$65.10–$779.10 | $186–$2,226 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$165.55–$3,260.25 | $473–$9,315 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$161.35–$3,139.50 | $461–$8,970 | varies |
| Angiography extremity unilateral rs&i (75710) range across 11 matching MRF lines |
$3,018.75–$3,139.50 | $372–$8,970 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$3,104.85 | $397–$8,871 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$168.35–$868 | $481–$2,480 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$19.95–$164.85 | $57–$471 | varies |
| Aortography thoracic serialography rs&i (75605) range across 5 matching MRF lines |
$113.40–$596.05 | $324–$1,703 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $4,364.50 | $12,470 | 1.5× |
| Artery X-Rays Abdomen (75726) range across 11 matching MRF lines |
$3,537.80 | $429–$10,108 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $2,207.45 | $6,307 | 0.7× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$3,537.80 | $368–$10,108 | 0.7× |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$148.05–$867.30 | $423–$2,478 | varies |
| Arthrogram ankle (73615) range across 5 matching MRF lines |
$39.90–$309.40 | $114–$884 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$46.20–$324.80 | $132–$928 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$48.65–$324.80 | $139–$928 | varies |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$126–$302.75 | $360–$865 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$26.60–$91 | $76–$260 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$118.30–$849.80 | $338–$2,428 | varies |
| Bone Imaging Limited Area (78300) | $65.45 | $187 | 0.2× |
| Bone Imaging Multiple Areas (78305) range across 3 matching MRF lines |
$84–$539 | $240–$1,540 | varies |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$105–$904.05 | $300–$2,583 | varies |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$25.90–$284.90 | $74–$814 | varies |
| Bone survey infant (77076) range across 3 matching MRF lines |
$18.20–$114.45 | $52–$327 | varies |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$434.35–$752.50 | $1,241–$2,150 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$341.25–$734.30 | $975–$2,098 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$275.45–$417.55 | $787–$1,193 | varies |
| Brain Image W/Flow < 4 Views (78601) | $66.50 | $190 | 0.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$76.65–$949.55 | $219–$2,713 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 5 matching MRF lines |
$83.30–$2,784.60 | $130–$7,956 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $24.15 | $69 | 0.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$124.60–$1,345.05 | $356–$3,843 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 3 matching MRF lines |
$149.80–$1,365 | $428–$3,900 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$57.40–$236.60 | $164–$676 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 3 matching MRF lines |
$60.55–$455.70 | $173–$1,302 | varies |
| Chest 1 view (71045) range across 8 matching MRF lines |
$8.05–$121.80 | $23–$348 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$9.45–$121.80 | $27–$348 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$12.25–$115.85 | $35–$331 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$14–$144.90 | $40–$414 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) range across 2 matching MRF lines |
$30.10–$171.15 | $86–$489 | varies |
| Cholecystography Oral Contrast (74290) | $30.10 | $86 | 0.2× |
| Cisternography Positive Contrast Rs&I (70015) range across 3 matching MRF lines |
$154.70–$552.30 | $442–$1,578 | varies |
| Clavicle complete (73000) range across 5 matching MRF lines |
$17.15–$126.70 | $49–$362 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$24.85–$264.60 | $71–$756 | varies |
| Continuing medical physics consltj pr wk (77336) | $372.40 | $1,064 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$3,916.50 | $355–$11,190 | 1.3× |
| Contrast X-Ray Bladder (74430) range across 4 matching MRF lines |
$28.35–$449.05 | $81–$1,283 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$271.95–$309.40 | $777–$884 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$54.60–$309.40 | $156–$884 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 5 matching MRF lines |
$259.70–$1,258.60 | $742–$3,596 | varies |
| CT abdomen and pelvis without contrast (74176) range across 5 matching MRF lines |
$253.75–$1,050 | $725–$3,000 | varies |
| CT abdomen w contrast (74160) range across 5 matching MRF lines |
$128.10–$691.25 | $366–$1,975 | varies |
| CT abdomen w wo contrast (74170) range across 9 matching MRF lines |
$136.15–$811.30 | $389–$2,318 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$95.90–$462.35 | $274–$1,321 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 6 matching MRF lines |
$278.60–$1,622.60 | $796–$4,636 | varies |
| CT Angio Chest (71275) range across 6 matching MRF lines |
$278.60–$876.05 | $796–$2,503 | varies |
| CT Angio Head (70496) range across 5 matching MRF lines |
$119–$922.25 | $340–$2,635 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$268.80–$2,299.15 | $768–$6,569 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$278.60–$779.10 | $796–$2,226 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$403.55–$934.50 | $1,153–$2,670 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$278.60–$794.50 | $796–$2,270 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$70.70–$95.90 | $202–$274 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$105–$661.15 | $300–$1,889 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$98.70–$617.75 | $282–$1,765 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$117.60–$710.15 | $336–$2,029 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$113.05–$786.10 | $323–$2,246 | varies |
| CT head/brain with contrast (70460) range across 4 matching MRF lines |
$119–$561.75 | $340–$1,605 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$148.40–$726.25 | $424–$2,075 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 4 matching MRF lines |
$196–$1,042.65 | $560–$2,979 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$65.10–$435.40 | $186–$1,244 | varies |
| CT hrt w/3d image congen (75573) range across 3 matching MRF lines |
$285.60–$1,410.85 | $816–$4,031 | varies |
| CT iac w contrast (70481) range across 7 matching MRF lines |
$115.50–$631.40 | $330–$1,804 | varies |
| CT l-spine w&w/o contrast (72133) | $110.95 | $317 | 0.7× |
| CT lower ext w/o (73700) range across 20 matching MRF lines |
$124.25–$572.95 | $355–$1,637 | varies |
| CT lower extremity w/contrast material (73701) range across 14 matching MRF lines |
$117.60–$632.80 | $336–$1,808 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$91.70–$753.55 | $262–$2,153 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$117.60–$631.40 | $336–$1,804 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$115.50–$660.10 | $330–$1,886 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$115.50–$484.75 | $330–$1,385 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$163.80–$612.50 | $468–$1,750 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 7 matching MRF lines |
$138.60–$656.25 | $396–$1,875 | varies |
| CT orbits w/o contrast (70480) range across 6 matching MRF lines |
$104.65–$541.80 | $299–$1,548 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$123.55–$612.50 | $353–$1,750 | varies |
| CT pelvis w/o contrast (72192) range across 6 matching MRF lines |
$86.45–$481.60 | $247–$1,376 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$151.20–$700 | $432–$2,000 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$152.60–$619.50 | $436–$1,770 | varies |
| CT soft tissue neck w contrast (70491) range across 4 matching MRF lines |
$119–$658.70 | $340–$1,882 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$120.75–$487.20 | $345–$1,392 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$91.70–$616 | $262–$1,760 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$117.60–$535.85 | $336–$1,531 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$110.95–$630 | $317–$1,800 | varies |
| CT thorax w/o contrast (71250) range across 6 matching MRF lines |
$113.40–$647.50 | $324–$1,850 | varies |
| CT unlisted procedure (76497) | $278.60 | $796 | 3.4× |
| CT upper ext wo (73200) range across 18 matching MRF lines |
$124.25–$459.90 | $355–$1,314 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$151.20–$542.50 | $432–$1,550 | varies |
| CT upper extremity with contrast (73201) range across 16 matching MRF lines |
$117.60–$602.35 | $336–$1,721 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$433.30–$917 | $1,238–$2,620 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$278.60–$1,028.65 | $796–$2,939 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$278.60–$809.90 | $796–$2,314 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $26.60 | $76 | 0.1× |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$62.65–$213.15 | $179–$609 | varies |
| Discography Cerv/Thor Spine (72285) | $117.60 | $336 | 0.1× |
| Diskography lumbar (72295) range across 3 matching MRF lines |
$111.65–$543.20 | $319–$1,552 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$78.75–$159.25 | $225–$455 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$133.35–$221.90 | $381–$634 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$132.65–$190.75 | $379–$545 | varies |
| Dxa Bone Density Axial (77080) range across 7 matching MRF lines |
$17.50–$195.65 | $50–$559 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$8.75–$154.70 | $25–$442 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$17.50–$119.35 | $50–$341 | varies |
| Echo exam of fetal heart (76825) range across 3 matching MRF lines |
$156.45–$631.40 | $447–$1,804 | varies |
| Echo exam uterus (76831) range across 6 matching MRF lines |
$51.10–$314.65 | $146–$899 | varies |
| Echo Guide For Artery Repair (76936) | $235.55 | $673 | 1.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 3 matching MRF lines |
$130.90–$327.60 | $374–$936 | varies |
| Esophagram (74220) range across 4 matching MRF lines |
$39.20–$294 | $112–$840 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$78.75–$221.20 | $225–$632 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$144.90–$277.90 | $414–$794 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) range across 3 matching MRF lines |
$157.50–$274.05 | $450–$783 | varies |
| Fluoroscopy up to 1 hr (76000) range across 7 matching MRF lines |
$57.40–$367.50 | $164–$1,050 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$165.90–$1,221.50 | $474–$3,490 | varies |
| Foot 2 views (73620) range across 8 matching MRF lines |
$22.40–$149.45 | $64–$427 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$18.90–$135.10 | $54–$386 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$78.05–$923.65 | $223–$2,639 | varies |
| Gastroesophageal Reflux Exam (78262) range across 3 matching MRF lines |
$65.45–$455.70 | $187–$1,302 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$120.75–$723.10 | $345–$2,066 | varies |
| GI Endoscopic US S&I (76975) range across 2 matching MRF lines |
$65.10–$186.20 | $186–$532 | varies |
| Hand 2 views (73120) range across 5 matching MRF lines |
$17.85–$160.65 | $51–$459 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$904.75–$1,925 | $2,585–$5,500 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$609–$2,192.05 | $1,740–$6,263 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$311.15–$2,032.10 | $889–$5,806 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 3 matching MRF lines |
$2,415 | $254–$6,900 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$2,299.85 | $324–$6,571 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$88.90–$1,234.45 | $254–$3,527 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$74.20–$609.70 | $212–$1,742 | varies |
| Ht Musc Image Planar Mult (78454) range across 3 matching MRF lines |
$99.75–$1,724.80 | $285–$4,928 | varies |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$102.55–$1,573.25 | $293–$4,495 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$76.30–$317.80 | $218–$908 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$52.85–$180.95 | $151–$517 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 3 matching MRF lines |
$45.15–$118.65 | $129–$339 | varies |
| Interstitial radiation source applic complex (77778) | $904.40 | $2,584 | 1.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $754.25 | $2,155 | 1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $502.60 | $1,436 | 1.0× |
| Intracavitary radiation source applic simple (77761) | $358.05 | $1,023 | 0.7× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) likely a partial charge, not the full procedure |
$611.10 | $1,746 | 0.1× |
| Joint Survey Single View (77077) range across 4 matching MRF lines |
$22.40–$157.50 | $64–$450 | varies |
| K Flow/Funct Image Multiple (78709) range across 3 matching MRF lines |
$276.50–$675.50 | $790–$1,930 | varies |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$38.50–$784.35 | $110–$2,241 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$92.75–$675.50 | $265–$1,930 | varies |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$22.40–$155.75 | $64–$445 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 4 matching MRF lines |
$64.40–$341.95 | $184–$977 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 3 matching MRF lines |
$77.70–$333.90 | $222–$954 | varies |
| Liver imaging w/vascular flow (78202) | $68.95 | $197 | 0.1× |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$39.20–$348.25 | $112–$995 | varies |
| Lung perfusion differential (78597) range across 3 matching MRF lines |
$34.30–$609.35 | $98–$1,741 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 3 matching MRF lines |
$50.40–$1,092 | $144–$3,120 | varies |
| Lung Ventilation Imaging (78579) | $23.45 | $67 | 0.1× |
| Lymph System Imaging (78195) range across 4 matching MRF lines |
$74.20–$688.10 | $212–$1,966 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$128.10–$1,021.30 | $366–$2,918 | varies |
| Mammary ductogram or galactogram multiple (77054) | $28.70 | $82 | 0.1× |
| Mammary ductogram or galactogram single (77053) | $21 | $60 | 0.1× |
| Meckels Divert Exam (78290) range across 3 matching MRF lines |
$74.20–$539 | $212–$1,540 | varies |
| Medical physics dose eval radiation expos w/rprt (76145) range across 2 matching MRF lines |
$167.65–$461.30 | $479–$1,318 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,100.75–$1,701.35 | $3,145–$4,861 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$18.55–$118.30 | $53–$338 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $32.90 | $94 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$23.10–$123.55 | $66–$353 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$18.55–$79.80 | $53–$228 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$23.45–$324.80 | $67–$928 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$404.60–$1,279.25 | $1,156–$3,655 | varies |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$190.05–$1,021.30 | $543–$2,918 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$274.40–$1,072.40 | $784–$3,064 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$274.40–$1,021.30 | $784–$2,918 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$404.60–$1,279.25 | $1,156–$3,655 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$274.40–$820.40 | $784–$2,344 | varies |
| MRI abdomen w contrast (74182) range across 6 matching MRF lines |
$292.60–$1,085 | $836–$3,100 | varies |
| MRI abdomen w/o contrast (74181) range across 8 matching MRF lines |
$140.70–$1,021.30 | $402–$2,918 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 10 matching MRF lines |
$262.85–$1,132.25 | $751–$3,235 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 8 matching MRF lines |
$353.85–$2,013.20 | $1,011–$5,752 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 14 matching MRF lines |
$262.85–$1,198.40 | $751–$3,424 | varies |
| MRI bone marrow blood supply (77084) | $132.30 | $378 | 0.6× |
| MRI brain functional w/o physician admnistration (70554) | $105.35 | $301 | 0.5× |
| MRI brain functional w/physician admnistration (70555) | $126 | $360 | 0.6× |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$48.65–$1,111.25 | $139–$3,175 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines |
$44.10–$748.65 | $126–$2,139 | varies |
| MRI cardiac w/o cont stress (75559) range across 3 matching MRF lines |
$144.20–$715.75 | $412–$2,045 | varies |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$113.05–$1,021.30 | $323–$2,918 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$167.30–$1,118.60 | $478–$3,196 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$140.70–$1,021.30 | $402–$2,918 | varies |
| MRI chest w/o contrast (71550) range across 5 matching MRF lines |
$140.70–$1,021.30 | $402–$2,918 | varies |
| MRI chest with contrast (71551) range across 5 matching MRF lines |
$292.60–$1,199.80 | $836–$3,428 | varies |
| MRI chest wo w contrast (71552) range across 5 matching MRF lines |
$381.50–$1,754.55 | $1,090–$5,013 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 8 matching MRF lines |
$49–$1,134 | $140–$3,240 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 8 matching MRF lines |
$138.95–$1,295 | $397–$3,700 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 8 matching MRF lines |
$221.55–$1,021.30 | $633–$2,918 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$165.55–$1,134 | $473–$3,240 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$233.45–$1,537.55 | $667–$4,393 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 5 matching MRF lines |
$143.50–$1,021.30 | $410–$2,918 | varies |
| MRI orbit face neck w contrast (70542) range across 5 matching MRF lines |
$262.85–$998.90 | $751–$2,854 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 6 matching MRF lines |
$353.85–$1,502.20 | $1,011–$4,292 | varies |
| MRI pelvis w contrast (72196) range across 8 matching MRF lines |
$140.70–$1,155 | $402–$3,300 | varies |
| MRI pelvis w/o & w contrast (72197) range across 9 matching MRF lines |
$385.70–$1,524.60 | $1,102–$4,356 | varies |
| MRI pelvis w/o contrast (72195) range across 10 matching MRF lines |
$247.45–$1,021.30 | $707–$2,918 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$44.45–$167.30 | $127–$478 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$152.60–$1,021.30 | $436–$2,918 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 8 matching MRF lines |
$262.85–$1,145.90 | $751–$3,274 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$221.55–$1,021.30 | $633–$2,918 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 8 matching MRF lines |
$185.50–$1,868.65 | $530–$5,339 | varies |
| MRI, abdomen, combo (74183) range across 7 matching MRF lines |
$385.35–$1,567.65 | $1,101–$4,479 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$233.80–$1,601.25 | $668–$4,575 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$167.30–$1,117.90 | $478–$3,194 | varies |
| MRI, joint upper extrem (73221) range across 8 matching MRF lines |
$136.50–$1,021.30 | $390–$2,918 | varies |
| MRI, joint upper extrem combo (73223) range across 8 matching MRF lines |
$353.85–$1,867.25 | $1,011–$5,335 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$227.15–$1,430.10 | $649–$4,086 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$89.25–$552.30 | $255–$1,578 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$82.95–$552.30 | $237–$1,578 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$84–$552.30 | $240–$1,578 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$125.65–$552.30 | $359–$1,578 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$105.70–$2,453.15 | $302–$7,009 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 3 matching MRF lines |
$74.55–$1,461.60 | $213–$4,176 | varies |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$120.75–$2,431.45 | $345–$6,947 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) range across 4 matching MRF lines |
$2,116.80 | $142–$6,048 | 1.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) range across 2 matching MRF lines |
$1,414 | $186–$4,040 | 0.7× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$17.85–$120.40 | $51–$344 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $239.75 | $685 | 0.7× |
| Nm csf leak detection (78650) range across 3 matching MRF lines |
$88.20–$474.95 | $252–$1,357 | varies |
| Nm unlisted gi procedure (78299) range across 2 matching MRF lines |
$78.75–$345.80 | $225–$988 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$496.65–$5,215 | $1,419–$14,900 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$155.40–$413.70 | $444–$1,182 | varies |
| Nuclear Rx Oral Admin (79005) range across 4 matching MRF lines |
$115.85–$501.90 | $331–$1,434 | varies |
| Ob us nuchal meas 1 gest (76813) range across 3 matching MRF lines |
$58.45–$305.55 | $167–$873 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$46.20–$168.70 | $132–$482 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $139.65 | $399 | 1.4× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $88.55 | $253 | 0.7× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 2 matching MRF lines |
$50.75–$130.55 | $145–$373 | varies |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$33.25–$74.20 | $95–$212 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$57.40–$221.20 | $164–$632 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$31.50–$81.90 | $90–$234 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$22.40–$68.95 | $64–$197 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$43.75–$70.35 | $125–$201 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 3 matching MRF lines |
$166.60–$895.65 | $476–$2,559 | varies |
| Parathyroid Planar Imaging (78070) range across 3 matching MRF lines |
$58.10–$336 | $166–$960 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 3 matching MRF lines |
$166.60–$520.45 | $476–$1,487 | varies |
| Pelvis 1 or 2 views (72170) range across 5 matching MRF lines |
$18.90–$152.25 | $54–$435 | varies |
| Pet Image Skull-Thigh (78812) range across 5 matching MRF lines |
$2,624.65 | $168–$7,499 | 1.9× |
| Pet Image W/Ct Lmtd (78814) range across 5 matching MRF lines |
$83.30–$2,224.95 | $238–$6,357 | varies |
| PET image w/CT, full body (78816) range across 9 matching MRF lines |
$105.70–$2,624.65 | $302–$7,499 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 36 matching MRF lines |
$105.70–$2,624.65 | $302–$7,499 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 3 matching MRF lines |
$142.80–$2,839.90 | $408–$8,114 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$70.70–$539 | $202–$1,540 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$24.50–$231.70 | $70–$662 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 5 matching MRF lines |
$47.95–$438.20 | $137–$1,252 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$21.35–$158.55 | $61–$453 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$17.85–$120.40 | $51–$344 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$19.95–$159.95 | $57–$457 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$25.90–$224.35 | $74–$641 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$17.85–$119.70 | $51–$342 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$22.40–$162.40 | $64–$464 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$19.95–$160.30 | $57–$458 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$18.20–$110.60 | $52–$316 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $26.25 | $75 | 0.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$17.85–$132.30 | $51–$378 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $17.85 | $51 | 0.2× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$22.75–$156.80 | $65–$448 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$22.40–$153.30 | $64–$438 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 3 matching MRF lines |
$22.05–$317.10 | $63–$906 | varies |
| Radex Spine 1 View Specify Level (72020) range across 7 matching MRF lines |
$17.85–$135.10 | $51–$386 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$21–$146.30 | $60–$418 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$30.10–$123.55 | $86–$353 | varies |
| Radex Toe Minimum 2 Views (73660) range across 5 matching MRF lines |
$16.80–$121.80 | $48–$348 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$19.95–$91 | $57–$260 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$21–$157.15 | $60–$449 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$12.25–$154 | $35–$440 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$1,013.25–$3,959.20 | $2,895–$11,312 | varies |
| Radiation treatment delivery level 1 (77402) | $246.75 | $705 | 2.6× |
| Radiation treatment delivery level 2 (77407) | $179.90 | $514 | 0.5× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$110.60–$490.70 | $316–$1,402 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$27.30–$168.70 | $78–$482 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$11.90–$150.50 | $34–$430 | varies |
| Radiologic exam colon double contrast study (74280) range across 4 matching MRF lines |
$76.30–$337.05 | $218–$963 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$57.75–$258.30 | $165–$738 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$21–$294.70 | $60–$842 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$28.70–$180.25 | $82–$515 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 5 matching MRF lines |
$18.90–$155.75 | $54–$445 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 5 matching MRF lines |
$44.80–$243.95 | $128–$697 | varies |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$66.50–$323.75 | $190–$925 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$56.70–$369.95 | $162–$1,057 | varies |
| Radiologic examination femur 1 view (73551) range across 5 matching MRF lines |
$8.40–$128.80 | $24–$368 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$9.45–$145.25 | $27–$415 | varies |
| Radiologic examination knee 1/2 views (73560) range across 10 matching MRF lines |
$18.90–$134.75 | $54–$385 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $23.80 | $68 | 0.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $14.70 | $42 | 0.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$18.90–$143.15 | $54–$409 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $29.75 | $85 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $9.80 | $28 | 0.1× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$26.60–$213.50 | $76–$610 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 5 matching MRF lines |
$84–$375.55 | $240–$1,073 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$35.35–$528.50 | $101–$1,510 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 5 matching MRF lines |
$55.65–$1,869 | $159–$5,340 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 4 matching MRF lines |
$108.15–$1,861.30 | $309–$5,318 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 9 matching MRF lines |
$105.70–$1,869 | $302–$5,340 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 3 matching MRF lines |
$2,116.80 | $174–$6,048 | 1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 9 matching MRF lines |
$74.20–$1,869 | $117–$5,340 | varies |
| Rp Therapy Intravenous Administration (79101) range across 5 matching MRF lines |
$126–$321.65 | $360–$919 | varies |
| Scapula (73010) range across 5 matching MRF lines |
$20.30–$113.40 | $58–$324 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$33.25–$41.30 | $95–$118 | varies |
| Sella turcica (70240) | $17.85 | $51 | 0.2× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$18.90–$136.85 | $54–$391 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$59.50–$324.80 | $170–$928 | varies |
| Sialogram (70390) | $47.60 | $136 | 0.2× |
| Skull less than 4 views (70250) range across 5 matching MRF lines |
$21–$152.95 | $60–$437 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$155.40–$171.15 | $444–$489 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$216.65–$433.30 | $619–$1,238 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$151.20–$467.60 | $432–$1,336 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$358.05–$1,891.05 | $1,023–$5,403 | varies |
| Speech evaluation, complex (70371) | $78.40 | $224 | 0.3× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$1,605.45–$3,233.30 | $4,587–$9,238 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$24.15–$92.75 | $69–$265 | varies |
| Superior sagittal sinus venogram (75870) range across 3 matching MRF lines |
$57.75–$884.10 | $165–$2,526 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$780.85–$1,016.75 | $2,231–$2,905 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$438.20–$594.30 | $1,252–$1,698 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$227.50–$1,079.05 | $650–$3,083 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$171.15–$534.80 | $489–$1,528 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$114.10–$653.10 | $326–$1,866 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 4 matching MRF lines |
$119.35–$149.80 | $341–$428 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$38.15–$149.10 | $109–$426 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$58.80–$207.20 | $168–$592 | varies |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$24.15–$173.25 | $69–$495 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $70 | $200 | 0.2× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$95.90–$570.50 | $274–$1,630 | varies |
| Thyroid Met Imaging Body (78018) range across 3 matching MRF lines |
$106.75–$935.55 | $305–$2,673 | varies |
| Thyroid Uptake Measurement (78012) range across 3 matching MRF lines |
$38.15–$376.25 | $109–$1,075 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$111.30–$665.35 | $318–$1,901 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$155.40–$854 | $444–$2,440 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$57.75–$585.20 | $165–$1,672 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$35.35–$414.75 | $101–$1,185 | varies |
| Ultrasound Breast Limited (76642) range across 10 matching MRF lines |
$37.10–$209.65 | $106–$599 | varies |
| Ultrasound elastography first target lesion (76982) range across 4 matching MRF lines |
$18.20–$411.95 | $52–$1,177 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 4 matching MRF lines |
$18.20–$411.95 | $52–$1,177 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$29.05–$270.55 | $83–$773 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) range across 3 matching MRF lines |
$47.95–$255.50 | $137–$730 | varies |
| Ultrasound, abdomen limited (76705) range across 14 matching MRF lines |
$59.85–$305.55 | $171–$873 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$132.65–$210.35 | $379–$601 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$50.40–$259.70 | $144–$742 | varies |
| Unlisted fluoroscopic procedure (76496) range across 3 matching MRF lines |
$175–$849.10 | $500–$2,426 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 2 matching MRF lines |
$105.70–$1,134 | $302–$3,240 | varies |
| Unlisted us procedure (76999) range across 4 matching MRF lines |
$48.65–$128.10 | $139–$366 | varies |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$51.10–$344.05 | $146–$983 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) range across 2 matching MRF lines |
$26.60–$38.50 | $76–$110 | varies |
| Urea breath test c-14 isotopic analysis (78268) range across 2 matching MRF lines |
$26.60–$107.45 | $76–$307 | varies |
| Ureteral Reflux Study (78740) range across 3 matching MRF lines |
$61.25–$464.45 | $175–$1,327 | varies |
| Urethrocystogram voiding (74455) range across 4 matching MRF lines |
$36.40–$440.30 | $104–$1,258 | varies |
| Urethrocystography retrograde (74450) range across 4 matching MRF lines |
$35–$228.20 | $100–$652 | varies |
| Us bone density measurement (76977) | $76.65 | $219 | 0.8× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$38.85–$186.55 | $111–$533 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$59.85–$228.20 | $171–$652 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$22.75–$293.65 | $65–$839 | varies |
| Us exam, pelvic, limited (76857) range across 8 matching MRF lines |
$68.60–$204.75 | $196–$585 | varies |
| Us head (76506) range across 3 matching MRF lines |
$55.65–$161.35 | $159–$461 | varies |
| Us kidney transplant (76776) range across 5 matching MRF lines |
$58.45–$380.10 | $167–$1,086 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 24 matching MRF lines |
$15.75–$164.50 | $45–$470 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$112.35–$432.60 | $321–$1,236 | varies |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$54.60–$244.65 | $156–$699 | varies |
| Us ob transvaginal (76817) range across 5 matching MRF lines |
$85.75–$339.85 | $245–$971 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$65.45–$285.25 | $187–$815 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 6 matching MRF lines |
$77.35–$302.40 | $221–$864 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 5 matching MRF lines |
$53.20–$205.45 | $152–$587 | varies |
| Us retroperitoneal complete (76770) range across 5 matching MRF lines |
$76.65–$359.45 | $219–$1,027 | varies |
| Us retroperitoneal limited (76775) range across 7 matching MRF lines |
$59.50–$317.10 | $170–$906 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$63.70–$279.30 | $182–$798 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$95.20–$169.40 | $272–$484 | varies |
| Us thyroid (76536) range across 5 matching MRF lines |
$64.75–$351.40 | $185–$1,004 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$130.90–$318.85 | $374–$911 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$120.75–$1,168.65 | $345–$3,339 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,207.45 | $6,307 | 0.7× |
| Vein X-Ray Skull Epidural (75872) | $74.90 | $214 | 0.1× |
| Vein X-Ray Spleen/Liver (75810) | $4,025.35 | $11,501 | 1.3× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$126.70–$1,418.20 | $362–$4,052 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$116.20–$1,390.20 | $332–$3,972 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$113.05–$1,170.75 | $323–$3,345 | varies |
| Venography extremity unilateral rs&i (75820) range across 7 matching MRF lines |
$80.85–$1,051.75 | $231–$3,005 | varies |
| Venography Orbital Rs&I (75880) range across 3 matching MRF lines |
$91.70–$785.05 | $262–$2,243 | varies |
| Venography Renal Bilateral (75833) range across 3 matching MRF lines |
$162.75–$2,547.65 | $465–$7,279 | varies |
| Venography Renal Unilateral (75831) range across 3 matching MRF lines |
$124.25–$587.65 | $355–$1,679 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$102.90–$268.45 | $294–$767 | varies |
| Vertebral fracture assessment via dxa (77086) range across 3 matching MRF lines |
$5.25–$86.45 | $15–$247 | varies |
| Wrist 2 views (73100) range across 7 matching MRF lines |
$17.85–$131.60 | $51–$376 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$19.60–$139.65 | $56–$399 | varies |
| X-ray antegrade pyelogram tube (74425) range across 5 matching MRF lines |
$37.80–$228.20 | $108–$652 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 6 matching MRF lines |
$2,299.85–$3,260.25 | $425–$9,315 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 4 matching MRF lines |
$24.15–$166.60 | $69–$476 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$17.50–$151.90 | $50–$434 | varies |
| X-Ray Exam Breast Specimen (76098) range across 13 matching MRF lines |
$763.70 | $51–$2,182 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$13.65–$142.80 | $39–$408 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$16.80–$172.55 | $48–$493 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$18.90–$241.50 | $54–$690 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 7 matching MRF lines |
$9.45–$141.75 | $27–$405 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 8 matching MRF lines |
$11.55–$152.25 | $33–$435 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 5 matching MRF lines |
$14.70–$157.15 | $42–$449 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$12.25–$235.55 | $35–$673 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$15.75–$245 | $45–$700 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$9.45–$154.70 | $27–$442 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 6 matching MRF lines |
$30.10–$343.70 | $86–$982 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$21–$161 | $60–$460 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$43.75–$307.65 | $125–$879 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$30.10–$149.10 | $86–$426 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$5.60–$113.75 | $16–$325 | varies |
| X-ray head for orthodontia (70350) range across 2 matching MRF lines |
$40.25–$64.40 | $115–$184 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$18.90–$133.70 | $54–$382 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$41.30–$228.20 | $118–$652 | varies |
| X-ray IV pyelogram+tomography (74415) | $46.20 | $132 | 0.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$17.15–$64.05 | $49–$183 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$19.60–$124.25 | $56–$355 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$24.15–$150.50 | $69–$430 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$35.35–$234.85 | $101–$671 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$23.10–$164.50 | $66–$470 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$18.90–$92.40 | $54–$264 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$19.95–$147 | $57–$420 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$21–$167.65 | $60–$479 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$30.10–$122.50 | $86–$350 | varies |
| X-ray thoracic spine 4 vw (72074) | $14.70 | $42 | 0.1× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$24.50–$64.40 | $70–$184 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$29.40–$632.10 | $84–$1,806 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$31.50–$149.10 | $90–$426 | varies |
| X-Rays Bone Survey Complete (77075) range across 5 matching MRF lines |
$51.10–$271.95 | $146–$777 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$31.85–$208.60 | $91–$596 | varies |
| Xr facial bones less than 3 views (70140) | $24.50 | $70 | 0.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $29.75 | $85 | 0.3× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$27.30–$188.30 | $78–$538 | 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.