Imaging prices at MyMichigan Medical Center Alpena
Alpena, MI · every code in this section with a posted price and a Medicare benchmark.
348 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $2,330.40 | $3,884 | 1.7× |
| Abdomen 1 View (74018) | $124.80 | $208 | 1.4× |
| Abdomen 2 views (74019) | $126.60 | $211 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $528.60 | $881 | 1.3× |
| Angio pulmonary bilat (75743) | $2,545.20 | $4,242 | 0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $702 | $1,170 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $1,185 | $1,975 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $997.80 | $1,663 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,365.20 | $3,942 | 0.8× |
| Ankle 2 views (73600) | $142.80 | $238 | 1.6× |
| Aortography thoracic serialography rs&i (75605) | $2,845.20 | $4,742 | 0.5× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,992.60 | $3,321 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,212.80 | $3,688 | 0.4× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$930 | $1,550 | 0.2× |
| Arthrogram ankle (73615) | $172.80 | $288 | 0.5× |
| Arthrogram hip (73525) | $190.20 | $317 | 0.5× |
| Arthrogram Wrist (73115) | $172.80 | $288 | 0.5× |
| Basic radiation dosimetry calculation (77300) | $264 | $440 | 2.0× |
| Bone age studies (77072) | $160.80 | $268 | 1.5× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$732.60–$811.20 | $1,221–$1,352 | varies |
| Bone Imaging Limited Area (78300) | $395.40 | $659 | 1.0× |
| Bone Imaging Whole Body (78306) | $734.40 | $1,224 | 1.8× |
| Bone marrow imaging limited area (78102) | $618 | $1,030 | 1.6× |
| Bone marrow imaging; multiple areas (78103) | $546.60 | $911 | 1.4× |
| Bone survey infant (77076) | $345.60 | $576 | 3.3× |
| Brachytx isodose complex (77318) | $3,048.60 | $5,081 | 8.2× |
| Brachytx isodose intermed (77317) | $2,954.40 | $4,924 | 7.9× |
| Brachytx Isodose Plan Simple (77316) | $2,835 | $4,725 | 7.6× |
| Brain Flow Imaging Only (78610) | $418.20 | $697 | 0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,790 | $4,650 | 2.0× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $981.60 | $1,636 | 1.8× |
| Cat Scan Follow-Up Study (76380) | $385.80 | $643 | 4.4× |
| Cerebrospinal Fluid Scan (78630) | $367.20 | $612 | 0.7× |
| Chest 1 view (71045) | $135.60 | $226 | 1.6× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$127.80–$205.80 | $213–$343 | varies |
| Chest 3 views (71047) | $194.40 | $324 | 2.2× |
| Chest 4 or more views (71048) | $254.40 | $424 | 2.4× |
| Clavicle complete (73000) | $134.40 | $224 | 1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,312.80 | $2,188 | 12.6× |
| Continuing medical physics consltj pr wk (77336) | $248.40 | $414 | 1.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,069.40 | $3,449 | 0.7× |
| Contrast X-Ray Bladder (74430) | $128.40 | $214 | 0.4× |
| Contrast X-Ray Of Elbow (73085) | $190.20 | $317 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $223.20 | $372 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $2,376.60 | $3,961 | 6.8× |
| CT abdomen and pelvis without contrast (74176) | $1,466.40 | $2,444 | 6.2× |
| CT abdomen w contrast (74160) | $1,291.80 | $2,153 | 7.4× |
| CT abdomen w wo contrast (74170) | $1,584.60 | $2,641 | 9.1× |
| CT abdomen w/o contrast (74150) | $978 | $1,630 | 9.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,074.20 | $3,457 | 6.0× |
| CT Angio Chest (71275) | $1,521.60 | $2,536 | 8.7× |
| CT Angio Head (70496) | $1,231.20 | $2,052 | 7.0× |
| CT angio hrt w/3d image (75574) | $790.20 | $1,317 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,191.60 | $1,986 | 6.8× |
| CT Angio Neck (70498) | $1,226.40 | $2,044 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,226.40 | $2,044 | 7.0× |
| CT bone density (77078) | $232.80 | $388 | 2.7× |
| CT cervical spine w/ contrast (72126) | $1,315.80 | $2,193 | 3.8× |
| CT cervical spine w/o contrast (72125) | $978 | $1,630 | 9.4× |
| CT cervical spine w/wo cont (72127) | $1,446.60 | $2,411 | 8.3× |
| CT chest w contrast (71260) | $1,288.20 | $2,147 | 7.4× |
| CT chest w/wo contrast (71270) | $1,519.20 | $2,532 | 8.7× |
| CT head/brain with contrast (70460) | $1,058.40 | $1,764 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,420.80 | $2,368 | 8.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $373.20 | $622 | 1.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $59.40 | $99 | 0.7× |
| CT iac w contrast (70481) | $1,058.40 | $1,764 | 6.1× |
| CT l-spine w&w/o contrast (72133) | $1,446.60 | $2,411 | 8.3× |
| CT lower ext w/o (73700) | $882.60 | $1,471 | 8.5× |
| CT lower extremity w/contrast material (73701) | $1,158.60 | $1,931 | 6.6× |
| CT lumbar spine w contrast (72132) | $1,315.80 | $2,193 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $978 | $1,630 | 9.4× |
| CT maxillofacial w contrast (70487) | $1,058.40 | $1,764 | 6.1× |
| CT maxillofacial wo contrast (70486) | $882.60 | $1,471 | 8.5× |
| CT neck tissue combo (70492) | $1,519.20 | $2,532 | 8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,420.80 | $2,368 | 8.1× |
| CT orbits w/o contrast (70480) | $903.60 | $1,506 | 8.7× |
| CT pelvis w&w/o contrast (72194) | $1,435.20 | $2,392 | 8.2× |
| CT pelvis w/o contrast (72192) | $882.60 | $1,471 | 8.5× |
| CT scan of leg combo (73702) | $1,519.20 | $2,532 | 8.7× |
| CT scans face/jaw combo (70488) | $1,418.40 | $2,364 | 8.1× |
| CT soft tissue neck w contrast (70491) | $1,158.60 | $1,931 | 6.6× |
| CT soft tissue neck w/o contrast (70490) | $882.60 | $1,471 | 8.5× |
| CT thoracic spine w contrast (72129) | $1,315.80 | $2,193 | 7.5× |
| CT thoracic spine w/o contrast (72128) | $978 | $1,630 | 9.4× |
| CT thoracic spine w/wo cont (72130) | $1,338.60 | $2,231 | 7.7× |
| CT thorax w/o contrast (71250) | $978 | $1,630 | 9.4× |
| CT upper ext wo (73200) | $882.60 | $1,471 | 8.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,519.20 | $2,532 | 8.7× |
| CT upper extremity with contrast (73201) | $1,158.60 | $1,931 | 3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,191.60 | $1,986 | 6.8× |
| Cta Abdomen (74175) | $1,191.60 | $1,986 | 6.8× |
| CTA pelvis (72191) | $882.60 | $1,471 | 5.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $243.60 | $406 | 2.3× |
| Dxa Bone Density Axial (77080) | $237 | $395 | 2.3× |
| Dxa bone density study (77085) | $237 | $395 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $103.20 | $172 | 1.2× |
| Echo exam uterus (76831) | $250.20 | $417 | 1.1× |
| Echo Guide For Artery Repair (76936) | $1,210.20 | $2,017 | 5.6× |
| Esophagram (74220) | $274.80 | $458 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $617.40 | $1,029 | 5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $617.40 | $1,029 | 5.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$106.20–$136.80 | $177–$228 | varies |
| Follow-Up Angiography (75898) | $790.80 | $1,318 | 0.3× |
| Foot 2 views (73620) | $142.80 | $238 | 1.6× |
| Forearm 2 views (73090) | $134.40 | $224 | 1.5× |
| Gastric emptying imaging study (78264) | $661.80 | $1,103 | 1.7× |
| Gated Heart Planar Single (78472) | $527.40 | $879 | 1.3× |
| Hand 2 views (73120) | $134.40 | $224 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,228.40 | $3,714 | 3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,041.20 | $3,402 | 2.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,690.80 | $2,818 | 2.4× |
| Heart first pass single,planar (78481) | $621.60 | $1,036 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $661.80 | $1,103 | 1.2× |
| Hepatobiliary System Imaging (78226) | $661.80 | $1,103 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,230 | $2,050 | 1.0× |
| Hysterosalpingogram (74740) | $103.80 | $173 | 0.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $307.20 | $512 | 3.5× |
| Interstitial radiation source applic complex (77778) | $439.20 | $732 | 0.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $372.60 | $621 | 0.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $300.60 | $501 | 0.5× |
| Intracavitary radiation source applic simple (77761) | $265.80 | $443 | 0.5× |
| K Flow/Funct Image W/Drug (78708) | $559.20 | $932 | 1.0× |
| K Flow/Funct Image W/O Drug (78707) | $633.60 | $1,056 | 1.2× |
| Kidney Imaging Morphol (78700) | $485.40 | $809 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $395.40 | $659 | 1.0× |
| Knee 3 Views (73562) | $171 | $285 | 2.0× |
| Liver & Spleen Imaging Static Only (78215) | $528.60 | $881 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) | $442.20 | $737 | 0.8× |
| Lung perfusion differential (78597) | $546.60 | $911 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $885 | $1,475 | 1.6× |
| Lung Ventilation Imaging (78579) | $442.20 | $737 | 1.1× |
| Lymph System Imaging (78195) | $559.20 | $932 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,282.80 | $7,138 | 1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,143.20 | $3,572 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,431 | $2,385 | 6.0× |
| Mammary ductogram or galactogram multiple (77054) | $256.20 | $427 | 1.1× |
| Mammary ductogram or galactogram single (77053) | $178.80 | $298 | 0.8× |
| Meckels Divert Exam (78290) | $528.60 | $881 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) | $1,103.40 | $1,839 | 3.0× |
| Mr safety determination physician/other qhp (76016) | $137.40 | $229 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.20 | $62 | 1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $140.40 | $234 | 1.5× |
| Mr safety implt pos&/immoblj (76019) | $90.60 | $151 | 1.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $371.40 | $619 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,842.20 | $4,737 | 8.2× |
| MRA head w/o contrast (70544) | $1,431 | $2,385 | 6.0× |
| MRA head with contrast (70545) | $1,887 | $3,145 | 5.4× |
| MRA neck w contrast (70548) | $1,887 | $3,145 | 5.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,842.20 | $4,737 | 8.2× |
| MRA neck w/o contrast (70547) | $1,431 | $2,385 | 6.0× |
| MRI abdomen w contrast (74182) | $2,028 | $3,380 | 5.8× |
| MRI abdomen w/o contrast (74181) | $1,431 | $2,385 | 6.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,028 | $3,380 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,982.60 | $4,971 | 8.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,028 | $3,380 | 2.6× |
| MRI bone marrow blood supply (77084) | $1,431 | $2,385 | 6.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,951.20 | $3,252 | 8.2× |
| MRI cervical spine w contrast (72142) | $2,028 | $3,380 | 5.8× |
| MRI cervical spine w/o cont (72141) | $1,431 | $2,385 | 6.0× |
| MRI chest w/o contrast (71550) | $1,431 | $2,385 | 6.0× |
| MRI chest with contrast (71551) | $2,028 | $3,380 | 2.6× |
| MRI chest wo w contrast (71552) | $2,982.60 | $4,971 | 8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,028 | $3,380 | 5.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,982.60 | $4,971 | 8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,431 | $2,385 | 6.0× |
| MRI lumbar spine w contrast (72149) | $2,028 | $3,380 | 5.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,004.20 | $5,007 | 8.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,431 | $2,385 | 6.0× |
| MRI orbit face neck w contrast (70542) | $2,028 | $3,380 | 5.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,982.60 | $4,971 | 8.6× |
| MRI pelvis w contrast (72196) | $2,028 | $3,380 | 5.8× |
| MRI pelvis w/o & w contrast (72197) | $2,982.60 | $4,971 | 8.6× |
| MRI pelvis w/o contrast (72195) | $1,431 | $2,385 | 6.0× |
| MRI thoracic spine w/o contrast (72146) | $1,431 | $2,385 | 6.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,028 | $3,380 | 5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,431 | $2,385 | 6.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,662.60–$2,982.60 | $2,771–$4,971 | varies |
| MRI, abdomen, combo (74183) | $2,982.60 | $4,971 | 8.6× |
| MRI, dorsal spine combo (72157) | $3,004.20 | $5,007 | 8.6× |
| MRI, dorsal spine contrast (72147) | $2,028 | $3,380 | 5.8× |
| MRI, joint upper extrem (73221) | $1,431 | $2,385 | 6.0× |
| MRI, joint upper extrem combo (73223) | $3,077.40 | $5,129 | 8.9× |
| MRI, lumbar spine combo (72158) | $2,982.60 | $4,971 | 8.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $577.80 | $963 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $1,334.40 | $2,224 | 1.0× |
| N-invas est c ffr sw aly CTA (75580) | $1,557 | $2,595 | 1.8× |
| Neck soft tissue (70360) | $134.40 | $224 | 1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,871.60 | $4,786 | 2.1× |
| Nuclear Rx Oral Admin (79005) range across 4 matching MRF lines |
$279–$931.80 | $465–$1,553 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $229.80 | $383 | 2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,053.60 | $1,756 | 1.9× |
| Parathyroid Planar Imaging (78070) | $354 | $590 | 0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $597 | $995 | 1.5× |
| Pelvis 1 or 2 views (72170) | $104.40 | $174 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $3,192.60 | $5,321 | 2.2× |
| PET image w/CT, full body (78816) | $3,192.60 | $5,321 | 2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,431.40 | $5,719 | 2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $442.20 | $737 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $378.60 | $631 | 3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$86.40–$838.20 | $144–$1,397 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $181.80 | $303 | 2.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $134.40 | $224 | 1.5× |
| Radex elbow complete minimum 3 views (73080) | $200.40 | $334 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $247.80 | $413 | 2.4× |
| Radex fingr minimum 2 views (73140) | $106.20 | $177 | 1.2× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$156–$181.80 | $260–$303 | varies |
| Radex Hand Minimum 3 Views (73130) | $181.80 | $303 | 2.1× |
| Radex lower extremity infant minimum 2 views (73592) | $190.20 | $317 | 2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $229.80 | $383 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $134.40 | $224 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $175.80 | $293 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) | $200.40 | $334 | 2.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $172.80 | $288 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $115.20 | $192 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $200.40 | $334 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $266.40 | $444 | 3.1× |
| Radex Toe Minimum 2 Views (73660) | $106.20 | $177 | 1.2× |
| Radex upper extremity infant minimum 2 views (73092) | $190.20 | $317 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $181.80 | $303 | 2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,702.80 | $2,838 | 0.2× |
| Radiation treatment delivery level 1 (77402) | $237 | $395 | 2.3× |
| Radiation treatment delivery level 2 (77407) | $419.40 | $699 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $419.40 | $699 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $292.20 | $487 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $545.40 | $909 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $358.20 | $597 | 2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $283.80 | $473 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) | $200.40 | $334 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $205.80 | $343 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $274.20 | $457 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $594.60 | $991 | 3.4× |
| Radiologic examination femur 1 view (73551) | $151.20 | $252 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) | $200.40 | $334 | 2.3× |
| Radiologic examination knee 1/2 views (73560) | $139.80 | $233 | 1.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $162 | $270 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $134.40 | $224 | 1.5× |
| Ribs bilateral 3 views (71110) | $197.40 | $329 | 1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$485.40–$786 | $809–$1,310 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $591.60 | $986 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$661.80–$2,043.60 | $1,103–$3,406 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$661.80–$865.20 | $1,103–$1,442 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$724.80–$2,086.80 | $1,208–$3,478 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,043.60 | $3,406 | 1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,319 | $3,865 | 1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 8 matching MRF lines |
$1,956–$2,043.60 | $3,260–$3,406 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,045.20 | $1,742 | 4.5× |
| Rp Therapy Intravenous Administration (79101) | $483.60 | $806 | 2.1× |
| Scapula (73010) | $200.40 | $334 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $40.80 | $68 | 1.7× |
| Shoulder 1 view (73020) | $134.40 | $224 | 1.5× |
| Shoulder Arthrography (73040) | $190.20 | $317 | 0.5× |
| Sialogram (70390) | $128.40 | $214 | 0.5× |
| Skull less than 4 views (70250) | $200.40 | $334 | 1.9× |
| Special dosimetry (77331) | $72 | $120 | 0.5× |
| Special Physics Consult (77370) | $291.60 | $486 | 2.2× |
| Special teletherapy port plan (77321) | $336 | $560 | 0.9× |
| Special treatment procedure (77470) | $930.60 | $1,551 | 1.7× |
| Speech evaluation, complex (70371) | $390.60 | $651 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $3,445.20 | $5,742 | 1.9× |
| Sternoclavicular joints (71130) | $147 | $245 | 1.7× |
| Tbs technical calculation only (77091) | $135 | $225 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,365.40 | $5,609 | 9.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,958.60 | $4,931 | 7.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $723 | $1,205 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $549.60 | $916 | 1.5× |
| Ther rad simulaj-aided field setting simple (77280) | $466.20 | $777 | 3.5× |
| Thoracic spine 2 views (72070) | $140.40 | $234 | 1.3× |
| Thoracic spine 3 views (72072) | $178.20 | $297 | 1.7× |
| Thyroid Met Imaging Body (78018) | $921 | $1,535 | 1.7× |
| Thyroid Uptake Measurement (78012) | $574.20 | $957 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $442.20 | $737 | 1.1× |
| Tx Devices Design & Construction Complex (77334) | $297 | $495 | 0.8× |
| Tx devices design & construction intermediate (77333) | $159.60 | $266 | 1.2× |
| Tx devices design & construction simple (77332) | $111.60 | $186 | 0.8× |
| Ultrasound Breast Limited (76642) | $307.20 | $512 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) | $457.20 | $762 | 4.4× |
| Ultrasound, abdomen limited (76705) | $229.80 | $383 | 2.2× |
| Umbilical-artery Doppler (OB) (76820) | $244.20 | $407 | 2.3× |
| Unlisted Dx Radiographic Procedure (76499) | $98.40 | $164 | 1.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$293.40–$372 | $489–$620 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$279–$399.60 | $465–$666 | varies |
| Ureteral Reflux Study (78740) | $259.80 | $433 | 0.7× |
| Urethrocystogram voiding (74455) | $631.20 | $1,052 | 2.7× |
| Urethrocystography retrograde (74450) | $285 | $475 | 1.2× |
| Us breast unilateral complete (76641) | $307.20 | $512 | 2.9× |
| Us chest (76604) | $490.80 | $818 | 4.7× |
| Us complete joint (76881) | $307.20 | $512 | 2.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$166.20–$457.20 | $277–$762 | varies |
| Us head (76506) | $490.80 | $818 | 4.7× |
| Us kidney transplant (76776) | $389.40 | $649 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $169.80 | $283 | 1.6× |
| Us ob detailed single fetus (76811) | $545.40 | $909 | 2.3× |
| Us ob limited 1 or more fetuses (76815) | $318 | $530 | 3.1× |
| Us ob transvaginal (76817) | $346.20 | $577 | 3.3× |
| Us pelvic non ob complete (76856) | $516 | $860 | 5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $545.40 | $909 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $405.60 | $676 | 3.9× |
| Us retroperitoneal complete (76770) | $490.80 | $818 | 4.7× |
| Us retroperitoneal limited (76775) | $457.20 | $762 | 4.4× |
| Us scrotum and contents (76870) | $362.40 | $604 | 3.5× |
| Us spinal canal and contents (76800) | $490.80 | $818 | 4.7× |
| Us thyroid (76536) | $362.40 | $604 | 3.5× |
| Us transrectal (76872) | $498 | $830 | 4.8× |
| Vein X-Ray Chest (75827) | $1,168.20 | $1,947 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) | $2,459.40 | $4,099 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $1,168.20 | $1,947 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $805.20 | $1,342 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $299.40 | $499 | 0.2× |
| Venography Renal Unilateral (75831) | $2,143.20 | $3,572 | 0.7× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$852 | $1,420 | 0.2× |
| Wrist 2 views (73100) | $134.40 | $224 | 1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $200.40 | $334 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $239.40 | $399 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $1,962 | $3,270 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $136.80 | $228 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $134.40 | $224 | 1.5× |
| X-Ray Exam Breast Specimen (76098) | $100.20 | $167 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $205.80 | $343 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $162 | $270 | 1.6× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$139.80–$520.80 | $233–$868 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$238.80–$520.80 | $398–$868 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $251.40 | $419 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $251.40 | $419 | 2.4× |
| X-Ray Exam L-S Spine Bending (72114) | $190.80 | $318 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $155.40 | $259 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $255.60 | $426 | 2.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $200.40 | $334 | 1.9× |
| X-ray eye for foreign body (70030) | $200.40 | $334 | 2.3× |
| X-ray humerus (73060) | $134.40 | $224 | 1.5× |
| X-ray IV pyelogram (ivp) (74400) | $949.80 | $1,583 | 5.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $200.40 | $334 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $117.60 | $196 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $155.40 | $259 | 1.5× |
| X-ray nose-rectum child f.b. (76010) | $139.80 | $233 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $254.40 | $424 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $171.60 | $286 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $155.40 | $259 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $247.80 | $413 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $277.20 | $462 | 2.7× |
| X-ray thoracic spine 4 vw (72074) | $200.40 | $334 | 1.9× |
| X-Ray Tmj Unilat (70328) | $135 | $225 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $385.20 | $642 | 1.1× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$186.60–$266.40 | $311–$444 | varies |
| X-Rays Bone Survey Complete (77075) | $342.60 | $571 | 3.3× |
| Xr c-spine 4 or 5 views (72050) | $200.40 | $334 | 1.9× |
| Xr facial bones less than 3 views (70140) | $167.40 | $279 | 1.9× |
| Xr orbits complete 4 views (70200) | $292.20 | $487 | 2.8× |
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.