Imaging prices at Munson Medical Center
Traverse City, MI · every code in this section with a posted price and a Medicare benchmark.
358 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) | $5,488.45 | $6,457 | 4.0× |
| Abdomen 1 View (74018) | $312.80 | $368 | 3.6× |
| Abdomen 2 views (74019) | $333.20 | $392 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,836.85 | $2,161 | 4.6× |
| Angio internal mammary (75756) | $3,043.85 | $3,581 | 1.0× |
| Angio pulmonary bilat (75743) | $6,381.80 | $7,508 | 2.0× |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$6,195.65–$6,510.15 | $7,289–$7,659 | varies |
| Angiography extremity unilateral rs&i (75710) range across 6 matching MRF lines |
$6,074.10–$6,381.80 | $7,146–$7,508 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,381.80 | $7,508 | 2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,043.85 | $3,581 | 1.0× |
| Ankle 2 views (73600) | $355.30 | $418 | 4.1× |
| Aortography thoracic serialography rs&i (75605) | $6,381.80 | $7,508 | 1.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $6,185.45 | $7,277 | 2.0× |
| Artery X-Rays Abdomen (75726) range across 5 matching MRF lines |
$9,389.10–$9,863.40 | $11,046–$11,604 | varies |
| Artery X-Rays Pelvis (75736) | $6,510.15 | $7,659 | 1.2× |
| Artery X-Rays Spine (75705) | $9,863.40 | $11,604 | 1.8× |
| Arthrogram ankle (73615) | $877.20 | $1,032 | 2.5× |
| Arthrogram hip (73525) range across 7 matching MRF lines |
$850–$893.35 | $1,000–$1,051 | varies |
| Arthrogram Wrist (73115) range across 5 matching MRF lines |
$810.90–$851.70 | $954–$1,002 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$638.35–$670.65 | $751–$789 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$383.35–$426.70 | $451–$502 | varies |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$1,699.15–$1,816.45 | $1,999–$2,137 | varies |
| Bone Imaging Limited Area (78300) | $1,218.05 | $1,433 | 3.1× |
| Bone Imaging Whole Body (78306) range across 5 matching MRF lines |
$1,473.90–$1,575.90 | $1,734–$1,854 | varies |
| Bone marrow imaging; multiple areas (78103) range across 3 matching MRF lines |
$1,271.60–$1,335.35 | $1,496–$1,571 | varies |
| Bone survey infant (77076) range across 4 matching MRF lines |
$378.25–$562.70 | $445–$662 | varies |
| Brachytx isodose complex (77318) | $1,715.30 | $2,018 | 4.6× |
| Brachytx isodose intermed (77317) | $1,354.05 | $1,593 | 3.6× |
| Brachytx Isodose Plan Simple (77316) | $965.60 | $1,136 | 2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,835.15 | $2,159 | 3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,087.70 | $7,162 | 4.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,553.80 | $1,828 | 3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,805.85 | $3,301 | 8.1× |
| Cerebrospinal Fluid Scan (78630) range across 4 matching MRF lines |
$1,739.95–$1,859.80 | $2,047–$2,188 | varies |
| Chest 1 view (71045) range across 9 matching MRF lines |
$340.85–$358.70 | $401–$422 | varies |
| Chest 2 views (71046) | $358.70 | $422 | 4.1× |
| Chest 3 views (71047) | $379.95 | $447 | 4.4× |
| Chest 4 or more views (71048) | $590.75 | $695 | 5.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $294.10 | $346 | 2.8× |
| Clavicle complete (73000) | $355.30 | $418 | 4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $579.70 | $682 | 5.6× |
| Continuing medical physics consltj pr wk (77336) | $742.05 | $873 | 5.5× |
| Contrast Exam Abdominl Aorta (75625) | $6,381.80 | $7,508 | 2.0× |
| Contrast X-Ray Bladder (74430) | $888.25 | $1,045 | 2.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$834.70–$877.20 | $982–$1,032 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$890.80–$935.85 | $1,048–$1,101 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,692.40 | $4,344 | 10.6× |
| CT abdomen and pelvis without contrast (74176) | $2,283.95 | $2,687 | 9.6× |
| CT abdomen w contrast (74160) range across 9 matching MRF lines |
$1,868.30–$1,962.65 | $2,198–$2,309 | varies |
| CT abdomen w wo contrast (74170) range across 7 matching MRF lines |
$2,456.50–$2,581.45 | $2,890–$3,037 | varies |
| CT abdomen w/o contrast (74150) range across 9 matching MRF lines |
$1,219.75–$1,281.80 | $1,435–$1,508 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,434.85 | $4,041 | 9.9× |
| CT Angio Chest (71275) | $2,595.05 | $3,053 | 14.8× |
| CT Angio Head (70496) | $2,975 | $3,500 | 17.0× |
| CT angio hrt w/3d image (75574) | $2,551.70 | $3,002 | 7.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,630.75 | $3,095 | 15.1× |
| CT Angio Neck (70498) | $3,068.50 | $3,610 | 17.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,369.80 | $2,788 | 13.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $228.65 | $269 | 1.3× |
| CT cervical spine w/ contrast (72126) | $2,038.30 | $2,398 | 5.9× |
| CT cervical spine w/o contrast (72125) | $1,378.70 | $1,622 | 13.2× |
| CT cervical spine w/wo cont (72127) | $6,111.50 | $7,190 | 35.0× |
| CT chest w contrast (71260) | $2,020.45 | $2,377 | 11.6× |
| CT chest w/wo contrast (71270) | $2,289.90 | $2,694 | 13.1× |
| CT head/brain with contrast (70460) | $2,085.05 | $2,453 | 11.9× |
| CT head/brain without and with contrast (70470) | $2,422.50 | $2,850 | 13.9× |
| CT heart contrast eval cardiac structure&morph (75572) range across 6 matching MRF lines |
$2,250.80–$2,539.80 | $2,648–$2,988 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $468.35 | $551 | 5.4× |
| CT iac w contrast (70481) | $2,141.15 | $2,519 | 12.3× |
| CT l-spine w&w/o contrast (72133) | $2,289.90 | $2,694 | 13.1× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,095.65–$1,346.40 | $1,289–$1,584 | varies |
| CT lower extremity w/contrast material (73701) | $2,038.30 | $2,398 | 11.7× |
| CT lumbar spine w contrast (72132) | $2,038.30 | $2,398 | 5.9× |
| CT lumbar spine w/o contrast (72131) | $1,370.20 | $1,612 | 13.2× |
| CT maxillofacial w contrast (70487) | $2,141.15 | $2,519 | 12.3× |
| CT maxillofacial wo contrast (70486) | $1,436.50 | $1,690 | 13.8× |
| CT neck tissue combo (70492) | $2,426.75 | $2,855 | 13.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,448 | $2,880 | 14.0× |
| CT orbits w/o contrast (70480) | $1,837.70 | $2,162 | 17.6× |
| CT pelvis w&w/o contrast (72194) | $1,323.45 | $1,557 | 7.6× |
| CT pelvis w/o contrast (72192) | $1,286.05 | $1,513 | 12.3× |
| CT scan of leg combo (73702) | $923.95 | $1,087 | 5.3× |
| CT scans face/jaw combo (70488) | $2,398.70 | $2,822 | 13.7× |
| CT soft tissue neck w contrast (70491) range across 5 matching MRF lines |
$1,960.10–$2,038.30 | $2,306–$2,398 | varies |
| CT soft tissue neck w/o contrast (70490) range across 5 matching MRF lines |
$1,287.75–$1,339.60 | $1,515–$1,576 | varies |
| CT thoracic spine w contrast (72129) | $2,038.30 | $2,398 | 11.7× |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$1,118.60–$1,374.45 | $1,316–$1,617 | varies |
| CT thoracic spine w/wo cont (72130) | $2,317.10 | $2,726 | 13.3× |
| CT thorax w/o contrast (71250) | $1,366.80 | $1,608 | 13.1× |
| CT unlisted procedure (76497) | $707.20 | $832 | 8.2× |
| CT upper ext wo (73200) | $1,341.30 | $1,578 | 12.9× |
| CT upper extremity w/o & w/contrast material (73202) | $2,168.35 | $2,551 | 12.4× |
| CT upper extremity with contrast (73201) | $2,038.30 | $2,398 | 5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,784.60 | $3,276 | 15.9× |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$2,528.75–$2,657.10 | $2,975–$3,126 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,021.75 | $3,555 | 8.7× |
| CTA pelvis (72191) | $2,316.25 | $2,725 | 13.3× |
| Dilation ureters/urethra rs&i (74485) | $3,076.15 | $3,619 | 1.5× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 4 matching MRF lines |
$491.30–$515.95 | $578–$607 | varies |
| Dxa Bone Density Axial (77080) | $587.35 | $691 | 5.6× |
| Dxa bone density study (77085) | $485.35 | $571 | 4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$279.65–$293.25 | $329–$345 | varies |
| Echo exam of fetal heart (76825) range across 15 matching MRF lines |
$1,109.25–$1,187.45 | $1,305–$1,397 | varies |
| Echo exam uterus (76831) | $796.45 | $937 | 3.4× |
| Echo Guide For Artery Repair (76936) | $1,066.75 | $1,255 | 5.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 14 matching MRF lines |
$1,018.30–$1,069.30 | $1,198–$1,258 | varies |
| Echograp Trans R Pros Study (76873) | $936.70 | $1,102 | 9.0× |
| Esophagram (74220) | $744.60 | $876 | 4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 11 matching MRF lines |
$416.50–$657.05 | $490–$773 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$746.30–$783.70 | $878–$922 | varies |
| Follow-Up Angiography (75898) range across 5 matching MRF lines |
$2,896.80–$4,054.50 | $3,408–$4,770 | varies |
| Foot 2 views (73620) | $355.30 | $418 | 4.1× |
| Forearm 2 views (73090) | $352.75 | $415 | 4.1× |
| Gastric emptying imaging study (78264) | $1,796.05 | $2,113 | 4.5× |
| Gastroesophageal Reflux Exam (78262) | $1,286.05 | $1,513 | 3.2× |
| Gated Heart Planar Single (78472) range across 5 matching MRF lines |
$1,252.90–$1,316.65 | $1,474–$1,549 | varies |
| Hand 2 views (73120) | $355.30 | $418 | 3.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,788.45 | $4,457 | 5.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,641.80 | $3,108 | 3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,641.80 | $3,108 | 3.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,341 | $7,460 | 2.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,661.45 | $7,837 | 2.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,425.90 | $2,854 | 4.5× |
| Hepatobiliary System Imaging (78226) | $1,781.60 | $2,096 | 4.5× |
| Ht Muscle Image Spect Sing (78451) | $3,044.70 | $3,582 | 2.4× |
| Hysterosalpingogram (74740) | $1,048.90 | $1,234 | 4.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $652.80 | $768 | 7.5× |
| Interstitial radiation source applic complex (77778) | $4,624 | $5,440 | 6.7× |
| K Flow/Funct Image Multiple (78709) range across 3 matching MRF lines |
$770.10–$1,841.10 | $906–$2,166 | varies |
| K Flow/Funct Image W/Drug (78708) range across 5 matching MRF lines |
$770.10–$1,397.40 | $906–$1,644 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 3 matching MRF lines |
$770.10–$1,374.45 | $906–$1,617 | varies |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$360.40–$379.10 | $424–$446 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$1,196.80–$1,280.10 | $1,408–$1,506 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,473.05 | $1,733 | 3.7× |
| Liver imaging static only (78201) | $1,501.10 | $1,766 | 2.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,611.60 | $1,896 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,723.80 | $2,028 | 3.2× |
| Lung Ventilation Imaging (78579) | $1,241 | $1,460 | 3.1× |
| Lymph System Imaging (78195) | $1,818.15 | $2,139 | 3.4× |
| Magnetic Image Jaw Joint (70336) range across 5 matching MRF lines |
$445.40–$2,362.15 | $524–$2,779 | varies |
| Mammary ductogram or galactogram multiple (77054) | $814.30 | $958 | 3.4× |
| Mammary ductogram or galactogram single (77053) | $830.45 | $977 | 3.5× |
| Meckels Divert Exam (78290) | $1,816.45 | $2,137 | 4.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,938 | $2,280 | 5.2× |
| Mra Head W/O & W/Contrast Material (70546) | $4,135.25 | $4,865 | 11.9× |
| MRA head w/o contrast (70544) range across 5 matching MRF lines |
$445.40–$2,696.20 | $524–$3,172 | varies |
| MRA head with contrast (70545) | $3,065.10 | $3,606 | 8.8× |
| MRA neck w contrast (70548) | $3,009 | $3,540 | 8.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,149.70 | $4,882 | 11.9× |
| MRA neck w/o contrast (70547) range across 4 matching MRF lines |
$445.40–$2,628.20 | $524–$3,092 | varies |
| MRI abdomen w contrast (74182) | $3,167.95 | $3,727 | 9.1× |
| MRI abdomen w/o contrast (74181) | $2,461.60 | $2,896 | 10.4× |
| MRI any jt lower extrem w/contrast material (73722) | $2,915.50 | $3,430 | 3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,754.45 | $4,417 | 10.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,908.70 | $3,422 | 3.7× |
| MRI bone marrow blood supply (77084) | $2,326.45 | $2,737 | 9.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,237.20 | $2,632 | 9.4× |
| MRI Breast Without Contrast Material Unilateral (77046) range across 5 matching MRF lines |
$445.40–$2,237.20 | $524–$2,632 | varies |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$445.40–$2,242.30 | $524–$2,638 | varies |
| MRI cervical spine w contrast (72142) | $3,235.10 | $3,806 | 9.3× |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$445.40–$2,448 | $524–$2,880 | varies |
| MRI chest w/o contrast (71550) range across 4 matching MRF lines |
$445.40–$2,764.20 | $524–$3,252 | varies |
| MRI chest with contrast (71551) | $2,944.40 | $3,464 | 3.8× |
| MRI chest wo w contrast (71552) | $4,257.65 | $5,009 | 12.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,068.50 | $3,610 | 8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,732.35 | $4,391 | 10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 7 matching MRF lines |
$445.40–$2,728.50 | $524–$3,210 | varies |
| MRI lumbar spine w contrast (72149) | $3,235.10 | $3,806 | 9.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,740.85 | $4,401 | 10.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,745.50 | $3,230 | 11.5× |
| MRI orbit face neck w contrast (70542) | $3,235.10 | $3,806 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,824.15 | $4,499 | 11.0× |
| MRI pelvis w contrast (72196) | $3,218.95 | $3,787 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $3,885.35 | $4,571 | 11.2× |
| MRI pelvis w/o contrast (72195) range across 9 matching MRF lines |
$445.40–$2,764.20 | $524–$3,252 | varies |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$445.40–$2,470.95 | $524–$2,907 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,954.60 | $3,476 | 8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 9 matching MRF lines |
$445.40–$2,565.30 | $524–$3,018 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,762.95 | $4,427 | 10.8× |
| MRI, abdomen, combo (74183) | $3,895.55 | $4,583 | 11.2× |
| MRI, dorsal spine combo (72157) | $3,740.85 | $4,401 | 10.8× |
| MRI, dorsal spine contrast (72147) | $3,405.95 | $4,007 | 9.8× |
| MRI, joint upper extrem (73221) range across 9 matching MRF lines |
$445.40–$2,669 | $524–$3,140 | varies |
| MRI, joint upper extrem combo (73223) | $3,740.85 | $4,401 | 10.8× |
| MRI, lumbar spine combo (72158) | $3,740.85 | $4,401 | 10.8× |
| Myelogram cervical (72240) | $1,376.15 | $1,619 | 1.8× |
| Myelogram Lumbar (72265) | $1,376.15 | $1,619 | 1.8× |
| Myelography thoracic (72255) | $1,376.15 | $1,619 | 1.8× |
| Myelograpy 2/more regions rs&i (72270) | $1,376.15 | $1,619 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $4,148.85 | $4,881 | 3.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) range across 2 matching MRF lines |
$1,099.05–$4,992.05 | $1,293–$5,873 | varies |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $6,709.90 | $7,894 | 3.1× |
| N-invas est c ffr sw aly CTA (75580) | $4,413.20 | $5,192 | 5.2× |
| Neck soft tissue (70360) | $355.30 | $418 | 4.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $925.65 | $1,089 | 2.4× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$547.40–$574.60 | $644–$676 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,981.10 | $10,566 | 6.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,019.15 | $1,199 | 4.4× |
| Nuclear Rx Oral Admin (79005) | $1,173.85 | $1,381 | 5.0× |
| Ob us nuchal meas 1 gest (76813) | $410.55 | $483 | 3.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $702.10 | $826 | 5.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $335.75 | $395 | 3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,255.90 | $2,654 | 4.2× |
| Parathyroid Planar Imaging (78070) range across 4 matching MRF lines |
$1,466.25–$1,568.25 | $1,725–$1,845 | varies |
| Pelvis 1 or 2 views (72170) | $351.90 | $414 | 3.4× |
| Peritoneogram Rs&I (74190) | $1,778.20 | $2,092 | 3.3× |
| Pet Image W/Ct Lmtd (78814) | $5,692.45 | $6,697 | 4.0× |
| PET image w/CT, full body (78816) | $6,016.30 | $7,078 | 4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,016.30 | $7,078 | 4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,840.80 | $8,048 | 2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 4 matching MRF lines |
$1,192.55–$1,252.90 | $1,403–$1,474 | varies |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,211.25 | $1,425 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $562.70 | $662 | 5.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 6 matching MRF lines |
$971.55–$1,020.85 | $1,143–$1,201 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $362.10 | $426 | 4.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $349.35 | $411 | 4.0× |
| Radex elbow complete minimum 3 views (73080) | $370.60 | $436 | 4.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $552.50 | $650 | 5.3× |
| Radex fingr minimum 2 views (73140) | $340.85 | $401 | 3.9× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$336.60–$358.70 | $396–$422 | varies |
| Radex Hand Minimum 3 Views (73130) | $367.20 | $432 | 4.2× |
| Radex lower extremity infant minimum 2 views (73592) | $162.35 | $191 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $360.40 | $424 | 4.2× |
| Radex Ribs Unilateral 2 Views (71100) | $354.45 | $417 | 4.1× |
| Radex shoulder complete minimum 2 views (73030) | $368.05 | $433 | 4.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $340.85 | $401 | 3.9× |
| Radex Spine 1 View Specify Level (72020) | $355.30 | $418 | 4.1× |
| Radex Sternum Minimum 2 Views (71120) | $353.60 | $416 | 4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$272–$379.10 | $320–$446 | varies |
| Radex Toe Minimum 2 Views (73660) | $340.85 | $401 | 3.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$340–$357 | $400–$420 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $24,557.35 | $28,891 | 3.3× |
| Radiation treatment delivery level 1 (77402) | $2,106.30 | $2,478 | 20.7× |
| Radiation treatment delivery level 2 (77407) | $1,499.40 | $1,764 | 3.9× |
| Radiation treatment delivery level 3 (77412) | $1,575.90 | $1,854 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $542.30 | $638 | 5.2× |
| Radiologic exam colon double contrast study (74280) | $1,030.20 | $1,212 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $812.60 | $956 | 4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $783.70 | $922 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) | $426.70 | $502 | 4.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$271.15–$436.05 | $319–$513 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $667.25 | $785 | 3.8× |
| Radiologic exam swallow function contrast study (74230) | $652.80 | $768 | 3.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 5 matching MRF lines |
$746.30–$783.70 | $878–$922 | varies |
| Radiologic examination femur minimum 2 views (73552) | $317.90 | $374 | 3.7× |
| Radiologic examination knee 1/2 views (73560) | $355.30 | $418 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $358.70 | $422 | 4.1× |
| Renal Cyst Study (74470) | $1,964.35 | $2,311 | 3.6× |
| Ribs bilateral 3 views (71110) | $552.50 | $650 | 5.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 6 matching MRF lines |
$1,760.35–$1,849.60 | $2,071–$2,176 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 5 matching MRF lines |
$3,494.35–$3,736.60 | $4,111–$4,396 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,374.05 | $2,793 | 4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 10 matching MRF lines |
$266.05–$3,604 | $313–$4,240 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,852.20 | $4,532 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,709 | $5,540 | 3.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 9 matching MRF lines |
$2,411.45–$2,578.90 | $2,837–$3,034 | varies |
| Rp Therapy Intravenous Administration (79101) range across 4 matching MRF lines |
$1,078.65–$1,094.80 | $1,269–$1,288 | varies |
| Scapula (73010) | $356.15 | $419 | 3.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $156.40 | $184 | 6.7× |
| Shoulder 1 view (73020) | $349.35 | $411 | 4.0× |
| Shoulder Arthrography (73040) range across 7 matching MRF lines |
$907.80–$953.70 | $1,068–$1,122 | varies |
| Sialogram (70390) | $1,020.85 | $1,201 | 4.3× |
| Skull less than 4 views (70250) | $371.45 | $437 | 3.6× |
| Special dosimetry (77331) | $643.45 | $757 | 4.8× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$884–$929.05 | $1,040–$1,093 | varies |
| Special teletherapy port plan (77321) | $1,332.80 | $1,568 | 3.6× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,261.85–$2,376.60 | $2,661–$2,796 | varies |
| Stereotactic Body Radiation Delivery (77373) | $7,551.40 | $8,884 | 4.2× |
| Sternoclavicular joints (71130) | $355.30 | $418 | 4.1× |
| Superior sagittal sinus venogram (75870) | $2,986.05 | $3,513 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,366.80 | $1,608 | 3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $963.05 | $1,133 | 2.6× |
| Testicular Imaging W/Flow (78761) | $1,203.60 | $1,416 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 4 matching MRF lines |
$2,326.45–$2,487.95 | $2,737–$2,927 | varies |
| Ther rad simulaj-aided field setting simple (77280) | $1,490.90 | $1,754 | 11.1× |
| Thoracic spine 2 views (72070) | $383.35 | $451 | 3.7× |
| Thoracic spine 3 views (72072) | $552.50 | $650 | 5.3× |
| Thoracolumbar 2 views (72080) | $375.70 | $442 | 4.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,085.45 | $1,277 | 2.7× |
| Thyroid Met Imaging Body (78018) | $1,670.25 | $1,965 | 3.1× |
| Thyroid Uptake Measurement (78012) | $827.90 | $974 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,313.25 | $1,545 | 3.3× |
| Tx Devices Design & Construction Complex (77334) | $1,278.40 | $1,504 | 3.4× |
| Tx devices design & construction intermediate (77333) | $1,069.30 | $1,258 | 8.0× |
| Tx devices design & construction simple (77332) | $1,028.50 | $1,210 | 7.7× |
| Ultrasound Breast Limited (76642) | $425 | $500 | 4.9× |
| Ultrasound elastography first target lesion (76982) | $531.25 | $625 | 5.1× |
| Ultrasound Elastography Parenchyma (76981) | $589.90 | $694 | 5.7× |
| Ultrasound Exam Aaa Screen (76706) | $558.45 | $657 | 5.4× |
| Ultrasound, abdomen limited (76705) | $734.40 | $864 | 7.1× |
| Umbilical-artery Doppler (OB) (76820) range across 5 matching MRF lines |
$481.95–$506.60 | $567–$596 | varies |
| Unlisted magnetic resonance procedure (76498) | $1,971.15 | $2,319 | 22.7× |
| Unlisted us procedure (76999) | $384.20 | $452 | 4.4× |
| Upper gi w/o kub (74240) range across 6 matching MRF lines |
$714.85–$751.40 | $841–$884 | varies |
| Ureteral Reflux Study (78740) | $1,263.95 | $1,487 | 3.2× |
| Urethrocystogram voiding (74455) | $877.20 | $1,032 | 3.7× |
| Urethrocystography retrograde (74450) | $897.60 | $1,056 | 3.8× |
| Us breast unilateral complete (76641) | $555.90 | $654 | 5.3× |
| Us chest (76604) range across 9 matching MRF lines |
$619.65–$650.25 | $729–$765 | varies |
| Us complete joint (76881) | $670.65 | $789 | 6.4× |
| Us exam, pelvic, limited (76857) | $538.05 | $633 | 5.2× |
| Us head (76506) | $664.70 | $782 | 6.4× |
| Us kidney transplant (76776) | $753.95 | $887 | 7.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $538.05 | $633 | 5.2× |
| Us ob detailed single fetus (76811) range across 14 matching MRF lines |
$809.20–$849.15 | $952–$999 | varies |
| Us ob limited 1 or more fetuses (76815) range across 6 matching MRF lines |
$619.65–$650.25 | $729–$765 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$763.30–$801.55 | $898–$943 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 10 matching MRF lines |
$635.80–$667.25 | $748–$785 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 22 matching MRF lines |
$512.55–$538.05 | $603–$633 | varies |
| Us retroperitoneal complete (76770) | $815.15 | $959 | 7.8× |
| Us retroperitoneal limited (76775) | $691.05 | $813 | 6.6× |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$708.05–$744.60 | $833–$876 | varies |
| Us spinal canal and contents (76800) | $520.20 | $612 | 5.0× |
| Us thyroid (76536) | $701.25 | $825 | 6.7× |
| Us transrectal (76872) range across 5 matching MRF lines |
$883.15–$945.20 | $1,039–$1,112 | varies |
| Vein X-Ray Chest (75827) | $2,572.10 | $3,026 | 1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,043.85 | $3,581 | 1.0× |
| Venogram Sinus/Jugular (75860) range across 6 matching MRF lines |
$3,937.20–$4,136.10 | $4,632–$4,866 | varies |
| Venography caval inferior serialography rs&i (75825) | $6,381.80 | $7,508 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $2,144.55 | $2,523 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $2,062.10 | $2,426 | 1.3× |
| Venography Renal Bilateral (75833) | $6,381.80 | $7,508 | 2.0× |
| Venography Renal Unilateral (75831) | $6,381.80 | $7,508 | 2.0× |
| Venous sampling by catheter (75893) | $6,794.05 | $7,993 | 1.2× |
| Vertebral fracture assessment via dxa (77086) | $301.75 | $355 | 3.5× |
| Wrist 2 views (73100) | $349.35 | $411 | 4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $357 | $420 | 4.1× |
| X-ray antegrade pyelogram tube (74425) range across 8 matching MRF lines |
$842.35–$884.85 | $991–$1,041 | varies |
| X-Ray Aorta Leg Arteries (75630) | $6,510.15 | $7,659 | 2.1× |
| X-Ray Bend Only L-S Spine (72120) | $542.30 | $638 | 5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $355.30 | $418 | 4.1× |
| X-Ray Exam Breast Specimen (76098) range across 9 matching MRF lines |
$775.20–$814.30 | $912–$958 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $96.90 | $114 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $569.50 | $670 | 5.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $311.95 | $367 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $332.35 | $391 | 3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $515.95 | $607 | 5.0× |
| X-Ray Exam L-S Spine Bending (72114) | $643.45 | $757 | 6.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $391.85 | $461 | 4.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $592.45 | $697 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $552.50 | $650 | 5.3× |
| X-ray humerus (73060) | $355.30 | $418 | 4.1× |
| X-ray IV pyelogram (ivp) (74400) | $925.65 | $1,089 | 5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$224.40–$340.85 | $264–$401 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $409.70 | $482 | 3.9× |
| X-ray nose-rectum child f.b. (76010) | $783.70 | $922 | 9.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $579.70 | $682 | 5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $358.70 | $422 | 3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $358.70 | $422 | 4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $420.75 | $495 | 4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $562.70 | $662 | 5.4× |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$215.90–$557.60 | $254–$656 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $900.15 | $1,059 | 2.6× |
| X-Rays Bone Length Studies (77073) | $448.80 | $528 | 4.3× |
| X-Rays Bone Survey Complete (77075) | $844.90 | $994 | 8.1× |
| Xr c-spine 4 or 5 views (72050) | $562.70 | $662 | 5.4× |
| Xr facial bones less than 3 views (70140) | $349.35 | $411 | 4.0× |
| Xr orbits complete 4 views (70200) | $424.15 | $499 | 4.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.