Imaging prices at Mt Sinai Hospital Medical Center
Chicago, IL · every code in this section with a posted price and a Medicare benchmark.
541 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 |
$382.58–$3,847.52 | $546.54–$5,496.46 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$17.94–$235.56 | $25.63–$336.51 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$19.03–$310.57 | $27.18–$443.67 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$82.15–$1,008.20 | $117.36–$1,440.28 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) range across 2 matching MRF lines |
$130.63–$2,285.57 | $186.62–$3,265.10 | varies |
| Adrenal Cortex & Medulla Img (78075) | $99.90 | $142.71 | 0.1× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$5,932.19 | $219.56–$8,474.55 | 1.8× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$169.06–$6,506.04 | $241.51–$9,294.34 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$169.06–$5,129.80 | $241.51–$7,328.28 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$710.82–$6,506.04 | $1,015.45–$9,294.34 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$1,181.76–$6,506.04 | $1,688.23–$9,294.34 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$6,506.04 | $208.58–$9,294.34 | 1.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$169.06–$2,071.92 | $241.51–$2,959.89 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$14.35–$235.56 | $20.50–$336.51 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,496.28 | $9,280.40 | 1.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,129.80 | $7,328.28 | 1.5× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$284.33–$6,506.04 | $406.18–$9,294.34 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$222.85–$5,129.80 | $318.35–$7,328.28 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$666.90–$6,506.04 | $952.72–$9,294.34 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$377.66–$5,928.42 | $539.52–$8,469.17 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$78.93–$846.18 | $112.75–$1,208.83 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$78.93–$969.96 | $112.75–$1,385.65 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$78.93–$923.46 | $112.75–$1,319.23 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$285.05–$427.60 | $407.22–$610.85 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$79.77–$267.06 | $113.96–$381.51 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$84.53–$1,019.46 | $120.76–$1,456.37 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$52.15–$924.93 | $74.50–$1,321.33 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$107.58–$924.93 | $153.69–$1,321.33 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$70.62–$1,019.46 | $100.89–$1,456.37 | varies |
| Bone marrow imaging limited area (78102) | $76.85 | $109.78 | 0.2× |
| Bone marrow imaging; multiple areas (78103) | $99.90 | $142.71 | 0.2× |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$107.58–$669.31 | $153.69–$956.16 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$57.64–$258.05 | $82.34–$368.64 | varies |
| Brachytx isodose complex (77318) | $905.45 | $1,293.50 | 2.3× |
| Brachytx isodose intermed (77317) | $812.43 | $1,160.61 | 2.0× |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$111.43–$427.60 | $159.18–$610.85 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$75.20–$2,064.43 | $107.43–$2,949.18 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$69.16–$669.31 | $98.80–$956.16 | varies |
| Brain imaging < 4 static views (78600) | $298.78 | $426.83 | 0.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$84.53–$868.75 | $120.76–$1,241.07 | varies |
| Brain Imaging Minimum 4 Static Views (78605) | $69.16 | $98.80 | 0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$192.11–$2,564.66 | $274.44–$3,663.80 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 2 matching MRF lines |
$153.69–$1,175.48 | $219.56–$1,679.26 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) range across 2 matching MRF lines |
$192.11–$1,175.48 | $274.44–$1,679.26 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$338.11–$1,531.82 | $483.02–$2,188.32 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$407.27–$1,275.58 | $581.82–$1,822.25 | varies |
| Cardiac Shunt Detection (78428) range across 2 matching MRF lines |
$107.58–$669.31 | $153.69–$956.16 | varies |
| Cardiovasc nucl exam unlisted (78499) | $69.16 | $98.80 | 0.2× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$130.63–$149.61 | $186.62–$213.73 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$47.57–$868.75 | $67.96–$1,241.07 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $84.53 | $120.76 | 0.1× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$92.21–$2,529.51 | $131.73–$3,613.59 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$15–$326.32 | $21.43–$466.17 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$24.39–$348.85 | $34.84–$498.36 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$30.54–$327.08 | $43.63–$467.25 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$35.13–$247.58 | $50.18–$353.68 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$46.64–$561.12 | $66.63–$801.60 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 2 matching MRF lines |
$53.79–$184.05 | $76.84–$262.93 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$153.69–$637.78 | $219.56–$911.12 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$14.35–$370.59 | $20.50–$529.41 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$119.62–$153.37 | $170.88–$219.10 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$230.67–$427.60 | $329.53–$610.85 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$6,496.28 | $219.56–$9,280.40 | 1.9× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$36.77–$634.45 | $52.53–$906.35 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$76.85–$969.96 | $109.78–$1,385.65 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$50.23–$923.46 | $71.75–$1,319.23 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$58.55–$310.55 | $83.64–$443.64 | varies |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$147.09–$184.05 | $210.13–$262.93 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$167.96–$5,219.53 | $239.94–$7,456.47 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$142.16–$3,960.78 | $203.09–$5,658.26 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$153.69–$2,309.71 | $219.56–$3,299.58 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$192.11–$2,937.59 | $274.44–$4,196.56 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$153.69–$2,080.18 | $219.56–$2,971.68 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$130.63–$3,487.44 | $186.62–$4,982.06 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$161.37–$4,017.78 | $230.53–$5,739.69 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$146.73–$3,531.72 | $209.62–$5,045.31 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$190.47–$2,155.94 | $272.10–$3,079.92 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$160.46–$3,688.10 | $229.23–$5,268.71 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$160.17–$3,531.72 | $228.82–$5,045.31 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$149.85–$3,662.27 | $214.07–$5,231.81 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$27.63–$124.67 | $39.47–$178.10 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$104.04–$2,177.69 | $148.63–$3,110.98 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$86.10–$2,073.44 | $123–$2,962.05 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$107.63–$2,184.43 | $153.75–$3,120.61 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$161.37–$2,309.71 | $230.53–$3,299.58 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$176.74–$1,275.25 | $252.49–$1,821.78 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$184.05–$238.22 | $262.93–$340.31 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 2 matching MRF lines |
$238.22–$310.55 | $340.31–$443.64 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$184.05–$215.17 | $262.93–$307.38 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$159.64–$1,702.84 | $228.06–$2,432.63 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$159.29–$2,807.08 | $227.55–$4,010.11 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$161.37–$1,624.81 | $230.53–$2,321.16 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$45.19–$1,356.29 | $64.56–$1,937.56 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$230.53–$1,356.29 | $329.33–$1,937.56 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$114.80–$2,127.43 | $164–$3,039.18 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$107.63–$1,761.35 | $153.75–$2,516.22 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$153.69–$3,585.71 | $219.56–$5,122.44 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$153.69–$3,980.33 | $219.56–$5,686.19 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$102.82–$2,177.69 | $146.89–$3,110.98 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$86.10–$2,073.44 | $123–$2,962.05 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$124.20–$2,127.43 | $177.43–$3,039.18 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$94.47–$2,020.16 | $134.96–$2,885.94 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$119.85–$2,434.23 | $171.21–$3,477.47 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$138.75–$1,513.06 | $198.21–$2,161.52 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$107.63–$1,044.21 | $153.75–$1,491.73 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$107.63–$2,543.75 | $153.75–$3,633.93 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$89.84–$2,080.18 | $128.34–$2,971.68 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$102.82–$3,635.21 | $146.89–$5,193.16 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$119.11–$1,513.06 | $170.15–$2,161.52 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$114.80–$2,434.23 | $164–$3,477.47 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$107.63–$2,194.19 | $153.75–$3,134.55 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$102.61–$2,177.69 | $146.58–$3,110.98 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$86.10–$2,073.44 | $123–$2,962.05 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$105.48–$1,761.35 | $150.68–$2,516.22 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$153.69–$1,249.02 | $219.56–$1,784.32 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$146.01–$969.96 | $208.58–$1,385.65 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$86.10–$3,962.32 | $123–$5,660.46 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$104.43–$3,351.70 | $149.19–$4,788.14 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$96.87–$4,151.32 | $138.38–$5,930.45 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$200.53–$2,855.83 | $286.47–$4,079.76 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$160.46–$2,855.83 | $229.23–$4,079.76 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$248.30–$7,063.43 | $354.72–$10,090.62 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$153.69–$1,831.13 | $219.56–$2,615.90 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $32.80 | $46.86 | 0.1× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $61.47 | $87.82 | 0.1× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$3,813.76 | $133.82–$5,448.23 | 1.7× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$154.27–$3,095.34 | $220.38–$4,421.91 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$107.63–$3,095.34 | $153.75–$4,421.91 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$76.85–$644.39 | $109.78–$920.55 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$76.85–$521.37 | $109.78–$744.82 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$92.21–$855.19 | $131.73–$1,221.70 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$18.30–$495.87 | $26.14–$708.38 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$24.70–$534.86 | $35.29–$764.09 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$32.94–$495.87 | $47.05–$708.38 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$215.17–$900.18 | $307.38–$1,285.97 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$92.21–$675.89 | $131.73–$965.55 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$261.27–$969.96 | $373.24–$1,385.65 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$107.58–$644.39 | $153.69–$920.55 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$184.05–$199.79 | $262.93–$285.42 | varies |
| Esophageal Motility Study (78258) range across 2 matching MRF lines |
$99.90–$669.31 | $142.71–$956.16 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$39.47–$397.60 | $56.38–$568 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$138.32–$644.39 | $197.60–$920.55 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$99.90–$613.64 | $142.71–$876.63 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $402.13 | $574.47 | 1.6× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$15–$383.33 | $21.43–$547.61 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$151.31–$2,855.83 | $216.16–$4,079.76 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$14.35–$235.56 | $20.50–$336.51 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$17.94–$314.34 | $25.63–$449.05 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$64.40–$1,008.20 | $92–$1,440.28 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $669.31 | $956.16 | 1.6× |
| Gastric Mucosa Imaging (78261) | $92.21 | $131.73 | 0.2× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$92.21–$915.96 | $131.73–$1,308.52 | varies |
| Gastrointestinal Protein Loss (78282) | $53.79 | $76.84 | 0.1× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$82.15–$1,296.27 | $117.36–$1,851.82 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$192.11–$669.31 | $274.44–$956.16 | varies |
| GI Endoscopic US S&I (76975) range across 2 matching MRF lines |
$107.58–$402.13 | $153.69–$574.47 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $868.75 | $1,241.07 | 1.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$17.94–$235.56 | $25.63–$336.51 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,242.81 | $1,775.44 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,242.81 | $1,775.44 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,242.81 | $1,775.44 | 1.7× |
| Heart first pass single,planar (78481) range across 2 matching MRF lines |
$130.63–$1,175.48 | $186.62–$1,679.26 | varies |
| Heart Image (Pet) Multiple (78492) range across 2 matching MRF lines |
$245.90–$2,564.66 | $351.29–$3,663.80 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$6,500.77 | $208.58–$9,286.81 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$6,500.77 | $208.58–$9,286.81 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$138.32–$915.96 | $197.60–$1,308.52 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$88.38–$915.96 | $126.25–$1,308.52 | varies |
| High energy neutron radj tx dlvr 1/> isocenter (77423) range across 2 matching MRF lines |
$378.74–$985.80 | $541.05–$1,408.29 | varies |
| Ht Musc Image Planar Mult (78454) range across 2 matching MRF lines |
$122.95–$2,915.09 | $175.64–$4,164.42 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$108.31–$2,915.09 | $154.73–$4,164.42 | varies |
| Hyperthermia external generated superficial (77600) | $199.79 | $285.42 | 0.5× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $199.79 | $285.42 | 0.3× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $268.95 | $384.22 | 0.5× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $199.79 | $285.42 | 0.3× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $276.64 | $395.20 | 0.4× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$35.88–$923.46 | $51.25–$1,319.23 | varies |
| Image fusion (77399) | $300.06 | $428.66 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$92.21–$662.40 | $131.73–$946.28 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$84.53–$662.40 | $120.76–$946.28 | varies |
| Infusion Ivp (74410) | $92.21 | $131.73 | 0.5× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,242.81–$1,413.94 | $1,775.44–$2,019.91 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 2 matching MRF lines |
$1,083.50–$1,242.81 | $1,547.86–$1,775.44 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$722.34–$985.80 | $1,031.91–$1,408.29 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$476.43–$985.80 | $680.62–$1,408.29 | varies |
| Intraop radiaj tx deliver xray single tx session (77424) likely a partial charge, not the full procedure |
$213.81 | $305.44 | 0.0× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$29.09–$184.05 | $41.56–$262.93 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$115.27–$868.75 | $164.67–$1,241.07 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$308.37–$868.75 | $440.53–$1,241.07 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$77.57–$1,364.55 | $110.82–$1,949.35 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $53.79 | $76.84 | 0.1× |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$45.19–$730.67 | $64.56–$1,043.81 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$69.16–$1,239.27 | $98.80–$1,770.38 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$18.30–$337.58 | $26.14–$482.26 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $84.53 | $120.76 | 0.2× |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$115.27–$669.31 | $164.67–$956.16 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$69.16–$1,141.72 | $98.80–$1,631.03 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $76.85 | $109.78 | 0.2× |
| Liver imaging static only (78201) | $61.47 | $87.82 | 0.1× |
| Liver imaging w/vascular flow (78202) range across 2 matching MRF lines |
$69.16–$1,086.23 | $98.80–$1,551.75 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$49.95–$1,035.97 | $71.36–$1,479.95 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$42.27–$985.71 | $60.38–$1,408.15 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$122.95–$1,035.97 | $175.64–$1,479.95 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$296.07–$669.31 | $422.95–$956.16 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$98.99–$1,089.99 | $141.41–$1,557.13 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $153.69 | $219.56 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $107.58 | $153.69 | 0.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$5,129.80 | $219.56–$7,328.28 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $107.58 | $153.69 | 0.0× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$162.37–$2,222.71 | $231.95–$3,175.30 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) range across 2 matching MRF lines |
$310.55–$422.65 | $443.64–$603.78 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) range across 2 matching MRF lines |
$384.22–$866.40 | $548.89–$1,237.71 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) range across 2 matching MRF lines |
$310.55–$407.27 | $443.64–$581.82 | varies |
| Magnetic Resonance Elastography (76391) range across 2 matching MRF lines |
$131.19–$402.13 | $187.41–$574.47 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$50.69–$671.40 | $72.41–$959.14 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$50.69–$671.40 | $72.41–$959.14 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$56.72–$1,008.20 | $81.03–$1,440.28 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$553.28–$813.18 | $790.40–$1,161.68 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$235.84–$3,249.67 | $336.92–$4,642.38 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$170.52–$2,997.61 | $243.60–$4,282.30 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$174.78–$2,997.61 | $249.69–$4,282.30 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$167.90–$2,299.23 | $239.85–$3,284.61 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$235.84–$3,717.73 | $336.92–$5,311.04 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$170.52–$2,997.61 | $243.60–$4,282.30 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$222.85–$3,599.95 | $318.35–$5,142.78 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$170.52–$3,469.44 | $243.60–$4,956.34 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$153.69–$1,528.81 | $219.56–$2,184.02 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$258.17–$2,189.71 | $368.81–$3,128.15 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$170.52–$3,057.63 | $243.60–$4,368.04 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$180.59–$3,691.50 | $257.98–$5,273.57 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$177.47–$402.13 | $253.53–$574.47 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$222.85–$402.13 | $318.35–$574.47 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$189.55–$4,008.78 | $270.78–$5,726.83 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$203.36–$2,018.65 | $290.52–$2,883.79 | varies |
| MRI cardiac w/o cont stress (75559) range across 2 matching MRF lines |
$391.91–$866.40 | $559.87–$1,237.71 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$307.38–$1,440.31 | $439.11–$2,057.59 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$170.52–$1,601.57 | $243.60–$2,287.95 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$170.05–$2,951.08 | $242.93–$4,215.83 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$153.69–$2,672.04 | $219.56–$3,817.20 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$222.85–$2,678.79 | $318.35–$3,826.84 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$258.17–$3,975.02 | $368.81–$5,678.60 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$207.48–$1,268.88 | $296.40–$1,812.69 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$192.11–$4,224.86 | $274.44–$6,035.51 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$170.52–$804.26 | $243.60–$1,148.94 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$174.30–$1,528.81 | $249–$2,184.02 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$215.89–$4,194.83 | $308.42–$5,992.61 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$167.18–$2,293.96 | $238.83–$3,277.08 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$170.52–$2,630.79 | $243.60–$3,758.27 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$258.17–$3,825.75 | $368.81–$5,465.35 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$170.52–$2,812.31 | $243.60–$4,017.59 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$259.74–$4,284.08 | $371.05–$6,120.12 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$170.52–$3,098.13 | $243.60–$4,425.90 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$170.52–$1,315.03 | $243.60–$1,878.62 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$172.20–$1,508.54 | $246–$2,155.06 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$207.48–$1,528.81 | $296.40–$2,184.02 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$170.05–$2,951.08 | $242.93–$4,215.83 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$192.11–$2,189.71 | $274.44–$3,128.15 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$260.46–$4,960.73 | $372.08–$7,086.75 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$215.89–$2,294.71 | $308.42–$3,278.16 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$170.05–$1,681.11 | $242.93–$2,401.58 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$170.52–$5,902.16 | $243.60–$8,431.65 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$258.30–$2,189.71 | $369–$3,128.15 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$199.79–$4,841.47 | $285.42–$6,916.39 | varies |
| Musculoskeletal Nuclear Exam (78399) | $138.32 | $197.60 | 0.3× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$122.70–$1,610.57 | $175.28–$2,300.82 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$107.63–$1,610.57 | $153.75–$2,300.82 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$115.27–$1,534.05 | $164.67–$2,191.50 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$110.51–$1,514.57 | $157.87–$2,163.67 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$92.21–$669.31 | $131.73–$956.16 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$199.79–$2,285.57 | $285.42–$3,265.10 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $107.58 | $153.69 | 0.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$192.11–$2,285.57 | $274.44–$3,265.10 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,274.70–$2,468.74 | $1,821–$3,526.77 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,564.66 | $3,663.80 | 1.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,564.66 | $3,663.80 | 1.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,736.36 | $6,766.23 | 2.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,358.76 | $4,798.23 | 1.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,186.56 | $4,552.23 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$1,183.88–$1,609.01 | $1,691.25–$2,298.58 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$20.81–$321.08 | $29.73–$458.69 | varies |
| Nervous system nuclear exam (78699) | $69.16 | $98.80 | 0.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 2 matching MRF lines |
$452.77–$614.75 | $646.82–$878.22 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$115.27–$669.31 | $164.67–$956.16 | varies |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$76.85–$2,285.57 | $109.78–$3,265.10 | varies |
| Nm myocard infarct spect (78469) | $122.95 | $175.64 | 0.2× |
| Nm red cell survival study (78130) | $84.53 | $120.76 | 0.2× |
| Nm unlisted gi procedure (78299) range across 2 matching MRF lines |
$115.27–$915.96 | $164.67–$1,308.52 | varies |
| Nm whole blood volume (78122) range across 2 matching MRF lines |
$61.47–$868.75 | $87.82–$1,241.07 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$61.47–$184.05 | $87.82–$262.93 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$673.86–$3,847.52 | $962.65–$5,496.46 | varies |
| Nuclear medicine study of endocrine organs (78099) range across 2 matching MRF lines |
$99.90–$1,144.74 | $142.71–$1,635.34 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$315.06–$675.89 | $450.09–$965.55 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$145.10–$755.42 | $207.28–$1,079.17 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$146.01–$613.64 | $208.58–$876.63 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $290.37 | $414.81 | 2.6× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $223.58 | $319.40 | 2.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $207.48 | $296.40 | 1.5× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $76.85 | $109.78 | 0.7× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$76.85–$149.61 | $109.78–$213.73 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$268.95–$534.86 | $384.22–$764.09 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $24.51 | $35.02 | 0.8× |
| Ophthalmic us dx quantitative a-scan only (76511) | $130.63 | $186.62 | 1.2× |
| Optic foramina (70190) | $25.19 | $35.98 | 0.3× |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$23.68–$149.61 | $33.83–$213.73 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$49.95–$868.75 | $71.36–$1,241.07 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$66.79–$1,262.51 | $95.41–$1,803.59 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$326.59–$919.70 | $466.56–$1,313.85 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$17.94–$370.59 | $25.63–$529.41 | varies |
| Perineogram (74775) | $86.10 | $123 | 0.3× |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$61.47–$1,017.95 | $87.82–$1,454.22 | varies |
| Pet Image Skull-Thigh (78812) | $245.90 | $351.29 | 0.2× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$276.64–$2,564.66 | $395.20–$3,663.80 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$315.06–$2,564.66 | $450.09–$3,663.80 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$307.38–$2,564.66 | $439.11–$3,663.80 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $199.79 | $285.42 | 0.1× |
| Pet Myocardial Sngl Study (78491) range across 2 matching MRF lines |
$199.79–$2,564.66 | $285.42–$3,663.80 | varies |
| PET whole body (78813) | $253.59 | $362.27 | 0.2× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $30.74 | $43.91 | 0.0× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $30.74 | $43.91 | 0.0× |
| Platelet survival study Non-Facility (78191) | $84.53 | $120.76 | 0.2× |
| Proton trmt simple w/comp (77522) | $2,278.59 | $3,255.13 | 1.7× |
| Proton tx delivery complex (77525) | $2,278.59 | $3,255.13 | 1.7× |
| Proton tx delivery intermediate (77523) range across 2 matching MRF lines |
$226.70–$2,278.59 | $323.85–$3,255.13 | varies |
| Proton tx delivery simple w/o compensation (77520) range across 2 matching MRF lines |
$192.11–$985.80 | $274.44–$1,408.29 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$184.43–$5,129.80 | $263.47–$7,328.28 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$59.83–$878.44 | $85.47–$1,254.91 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$25.25–$184.05 | $36.07–$262.93 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$45.19–$737.41 | $64.56–$1,053.44 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$17.94–$360.08 | $25.63–$514.40 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$61.47–$320.33 | $87.82–$457.61 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$14.35–$326.32 | $20.50–$466.17 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$28.99–$431.36 | $41.42–$616.23 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$14.35–$582.11 | $20.50–$831.58 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$14.35–$345.84 | $20.50–$494.05 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$17.94–$333.07 | $25.63–$475.81 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$14.35–$310.60 | $20.50–$443.72 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$37.41–$589.65 | $53.44–$842.35 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$19.80–$370.59 | $28.29–$529.41 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$34.44–$149.61 | $49.20–$213.73 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$30.86–$386.34 | $44.08–$551.91 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$18.30–$370.59 | $26.14–$529.41 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$22.25–$224.29 | $31.78–$320.42 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 3 matching MRF lines |
$57.64–$356.35 | $82.34–$509.07 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$18.26–$152.29 | $26.08–$217.56 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$30.74–$370.59 | $43.91–$529.41 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$26.69–$377.34 | $38.13–$539.05 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$53.79–$582.11 | $76.84–$831.58 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$22.96–$582.11 | $32.80–$831.58 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$16.51–$330.84 | $23.58–$472.63 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$39.47–$627.89 | $56.38–$896.98 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$2,165.37–$13,243.17 | $3,093.38–$18,918.81 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$230.53–$290.50 | $329.33–$415 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$284.33–$1,098.30 | $406.18–$1,569 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$346.57–$1,573.60 | $495.10–$2,248 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$94.51–$306.09 | $135.02–$437.27 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$22.88–$456.87 | $32.68–$652.67 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$92.21–$604.64 | $131.73–$863.77 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$57.64–$342.07 | $82.34–$488.67 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$32.29–$310.55 | $46.13–$443.64 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$21.53–$444.85 | $30.75–$635.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$21.53–$444.85 | $30.75–$635.50 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$58.55–$360.08 | $83.64–$514.40 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$53.82–$470.36 | $76.88–$671.94 | varies |
| Radiologic exam teeth complete full mouth (70320) | $25.96 | $37.08 | 0.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) range across 2 matching MRF lines |
$17.94–$402.13 | $25.63–$574.47 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$58.12–$576.87 | $83.03–$824.10 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$14.35–$171.81 | $20.50–$245.44 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$15.79–$264.83 | $22.55–$378.33 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$17.94–$314.34 | $25.63–$449.05 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$38.42–$184.05 | $54.89–$262.93 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 2 matching MRF lines |
$22.60–$149.61 | $32.29–$213.73 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$14.35–$339.84 | $20.50–$485.49 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $45.21 | $64.58 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 2 matching MRF lines |
$12.20–$149.61 | $17.43–$213.73 | varies |
| Radiopharm Dacryocystography (78660) range across 2 matching MRF lines |
$69.16–$669.31 | $98.80–$956.16 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $207.48 | $296.40 | 0.8× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $261.27 | $373.24 | 1.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) range across 2 matching MRF lines |
$253.59–$1,430.56 | $362.27–$2,043.65 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $30.74 | $43.91 | 0.1× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $46.11 | $65.87 | 0.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $452.77 | $646.82 | 1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $452.77 | $646.82 | 1.1× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$71.75–$923.46 | $102.50–$1,319.23 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$38.42–$391.57 | $54.89–$559.39 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$92.21–$1,128.23 | $131.73–$1,611.76 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$107.58–$669.31 | $153.69–$956.16 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$138.32–$3,065.13 | $197.60–$4,378.75 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$70.62–$2,122.18 | $100.89–$3,031.69 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$92.21–$2,285.57 | $131.73–$3,265.10 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$141.46–$2,285.57 | $202.08–$3,265.10 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,564.66 | $3,663.80 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,285.57 | $3,265.10 | 1.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 2 matching MRF lines |
$307.38–$430.04 | $439.11–$614.34 | varies |
| Rp Therapy Intravenous Administration (79101) range across 3 matching MRF lines |
$253.59–$687.15 | $362.27–$981.64 | varies |
| Rp Therapy Unlisted Procedure (79999) range across 2 matching MRF lines |
$315.06–$430.04 | $450.09–$614.34 | varies |
| Salivary Gland Function Study (78232) range across 2 matching MRF lines |
$61.47–$812.43 | $87.82–$1,160.61 | varies |
| Salivary Gland Imaging (78230) | $61.47 | $87.82 | 0.1× |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$69.16–$669.31 | $98.80–$956.16 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$17.94–$224.29 | $25.63–$320.42 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$98.11–$98.24 | $140.15–$140.34 | varies |
| Sella turcica (70240) | $21.53 | $30.75 | 0.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$17.94–$448.58 | $25.63–$640.83 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$46.11–$969.96 | $65.87–$1,385.65 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$52.74–$402.13 | $75.34–$574.47 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$20.56–$295.58 | $29.37–$422.25 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$73–$300.06 | $104.29–$428.66 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$366.48–$465.12 | $523.54–$664.46 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$78.31–$812.43 | $111.87–$1,160.61 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$616.22–$1,408.02 | $880.31–$2,011.46 | varies |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$95.12–$402.13 | $135.88–$574.47 | varies |
| Spleen Imaging (78185) range across 2 matching MRF lines |
$53.79–$988.72 | $76.84–$1,412.45 | varies |
| Srs Multisource (77371) | $13,243.17 | $18,918.81 | 1.7× |
| Stereotactic Body Radiation Delivery (77373) | $3,043.55 | $4,347.93 | 1.6× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$30.74–$194.30 | $43.91–$277.57 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$153.69–$2,055.42 | $219.56–$2,936.32 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 2 matching MRF lines |
$146.01–$210.76 | $208.58–$301.08 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$438.01–$1,093.72 | $625.73–$1,562.46 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$118.56–$465.12 | $169.37–$664.46 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$62.31–$402.13 | $89.02–$574.47 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$92.21–$669.31 | $131.73–$956.16 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$617.72–$1,222.56 | $882.46–$1,746.51 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$138.32–$812.43 | $197.60–$1,160.61 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$57.64–$465.12 | $82.34–$664.46 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$261.27–$310.55 | $373.24–$443.64 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$18.30–$348.85 | $26.14–$498.36 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$18.30–$182.32 | $26.14–$260.45 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$21.33–$149.61 | $30.47–$213.73 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $107.58 | $153.69 | 0.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 2 matching MRF lines |
$55.26–$669.31 | $78.94–$956.16 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $188.27 | $268.96 | 0.4× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$69.16–$1,262.51 | $98.80–$1,803.59 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$76.85–$669.31 | $109.78–$956.16 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$219.01–$1,262.51 | $312.87–$1,803.59 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$105.39–$812.43 | $150.56–$1,160.61 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$70.62–$465.12 | $100.89–$664.46 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$45.19–$752.41 | $64.56–$1,074.87 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$100.63–$161.29 | $143.76–$230.42 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$154.58–$297.84 | $220.83–$425.48 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$172.22–$297.84 | $246.03–$425.48 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$153.32–$337.58 | $219.03–$482.26 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) range across 2 matching MRF lines |
$191.74–$310.55 | $273.92–$443.64 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$266.58–$730.67 | $380.83–$1,043.81 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$69.16–$855.19 | $98.80–$1,221.70 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$146.01–$201.05 | $208.58–$287.21 | varies |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$116.73–$149.61 | $166.76–$213.73 | varies |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $161.37 | $230.53 | 0.4× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$146.01–$969.96 | $208.58–$1,385.65 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 2 matching MRF lines |
$230.53–$669.31 | $329.33–$956.16 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$300.06–$401.33 | $428.66–$573.33 | varies |
| Unlisted respiratory px dx nuclear medicine (78599) range across 2 matching MRF lines |
$161.37–$669.31 | $230.53–$956.16 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$146.01–$324.81 | $208.58–$464.02 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$57.64–$310.55 | $82.34–$443.64 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $161.37 | $230.53 | 14.6× |
| Urea breath test c-14 isotopic analysis (78268) | $161.37 | $230.53 | 1.7× |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$76.85–$669.31 | $109.78–$956.16 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$209.68–$923.46 | $299.54–$1,319.23 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$32.29–$923.46 | $46.13–$1,319.23 | varies |
| Us bone density measurement (76977) | $76.85 | $109.78 | 0.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$100.63–$732.17 | $143.76–$1,045.96 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$236.57–$662.40 | $337.96–$946.28 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$84.53–$696.16 | $120.76–$994.51 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$53.79–$590.65 | $76.84–$843.78 | varies |
| Us head (76506) range across 2 matching MRF lines |
$290.37–$662.40 | $414.81–$946.28 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$292.56–$376.54 | $417.94–$537.91 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$40.80–$696.16 | $58.29–$994.51 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$261.27–$675.89 | $373.24–$965.55 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$239.68–$613.64 | $342.40–$876.63 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$339.58–$613.64 | $485.11–$876.63 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$56.72–$730.67 | $81.03–$1,043.81 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$130.63–$644.39 | $186.62–$920.55 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$115.27–$613.64 | $164.67–$876.63 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$292.01–$1,460.54 | $417.15–$2,086.49 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$251.94–$730.67 | $359.92–$1,043.81 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$313.42–$730.67 | $447.74–$1,043.81 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$276.64–$696.16 | $395.20–$994.51 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$347.26–$696.16 | $496.09–$994.51 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$344.89–$730.67 | $492.70–$1,043.81 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$69.16–$669.31 | $98.80–$956.16 | varies |
| Vasogram (74440) | $71.90 | $102.71 | 0.3× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$94.41–$2,156.70 | $134.87–$3,081 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$184.43–$5,129.80 | $263.47–$7,328.28 | varies |
| Vein X-Ray Skull Epidural (75872) | $146.01 | $208.58 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $153.69 | $219.56 | 0.0× |
| Venogram Sinus/Jugular (75860) | $5,575.84 | $7,965.48 | 1.6× |
| Venography Adrenal Unilateral (75840) range across 2 matching MRF lines |
$6,506.04 | $219.56–$9,294.34 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $6,506.04 | $9,294.34 | 1.9× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$89.10–$2,562.08 | $127.29–$3,660.11 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$209.68–$1,883.62 | $299.54–$2,690.88 | varies |
| Venography Orbital Rs&I (75880) | $92.21 | $131.73 | 0.1× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$6,506.04 | $173.30–$9,294.34 | 1.9× |
| Venography Renal Unilateral (75831) | $6,506.04 | $9,294.34 | 1.9× |
| Venous sampling by catheter (75893) | $8,850.68 | $12,643.83 | 1.5× |
| Venous thrombosis imaging (78457) | $99.90 | $142.71 | 0.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $122.95 | $175.64 | 0.3× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$14.64–$495.87 | $20.91–$708.38 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$17.94–$306.09 | $25.63–$437.27 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$21.53–$1,024.70 | $30.75–$1,463.85 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$46.64–$574.61 | $66.63–$820.87 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$1,995–$6,496.28 | $2,850–$9,280.40 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$21.53–$432.83 | $30.75–$618.33 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$14.35–$235.56 | $20.50–$336.51 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$84.53–$1,324.76 | $120.76–$1,892.51 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$22.25–$171.81 | $31.78–$245.44 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$27.27–$283.56 | $38.95–$405.08 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$29.09–$534.86 | $41.56–$764.09 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$15.79–$171.81 | $22.55–$245.44 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$18.66–$264.83 | $26.65–$378.33 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$25.12–$283.56 | $35.88–$405.08 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$19.38–$283.56 | $27.68–$405.08 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$25.83–$376.58 | $36.90–$537.97 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$27.27–$534.86 | $38.95–$764.09 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$32.29–$450.09 | $46.13–$642.98 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$39.10–$369.08 | $55.86–$527.26 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$32.29–$456.11 | $46.13–$651.59 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$30.86–$291.05 | $44.08–$415.79 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$20.56–$326.32 | $29.37–$466.17 | varies |
| X-ray head for orthodontia (70350) | $19.80 | $28.29 | 0.2× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$28.70–$370.59 | $41–$529.41 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$46.64–$534.86 | $66.63–$764.09 | varies |
| X-ray IV pyelogram+tomography (74415) | $92.21 | $131.73 | 0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$69.16–$294.82 | $98.80–$421.17 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$20.09–$314.34 | $28.70–$449.05 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$20.81–$432.83 | $29.73–$618.33 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$18.30–$320.33 | $26.14–$457.61 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$46.11–$404.35 | $65.87–$577.64 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$17.94–$448.62 | $25.63–$640.88 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$14.35–$444.85 | $20.50–$635.50 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$25.12–$369.84 | $35.88–$528.34 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$24.40–$473.37 | $34.85–$676.24 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$31.30–$295.58 | $44.71–$422.25 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$115.27–$149.61 | $164.67–$213.73 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$21.53–$196.56 | $30.75–$280.80 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$20.81–$289.84 | $29.73–$414.05 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$32.29–$757.68 | $46.13–$1,082.40 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$26.90–$186.80 | $38.43–$266.86 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$45.19–$271.57 | $64.56–$387.96 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$28.70–$516.10 | $41–$737.28 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$22.88–$261.07 | $32.69–$372.95 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$20.56–$368.11 | $29.37–$525.87 | varies |
| Xr myelogram posterior fossa (70010) | $137.76 | $196.80 | 0.4× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$31.16–$417.84 | $44.51–$596.91 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$76.85–$462.11 | $109.78–$660.15 | 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.