Imaging prices at Nationwide Children's Hospital
Columbus, OH · every code in this section with a posted price and a Medicare benchmark.
384 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) | $10,638 | $11,820 | 8.0× |
| Abdomen 1 View (74018) | $297 | $330 | 3.5× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$297–$333 | $330–$370 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,250 | $2,500 | 5.8× |
| Angio internal mammary (75756) | $1,854 | $2,060 | 0.6× |
| Angio pulmonary bilat (75743) | $2,682 | $2,980 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $3,186 | $3,540 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,817 | $3,130 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,124 | $2,360 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,124 | $2,360 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$225–$396 | $250–$440 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,854 | $2,060 | 0.3× |
| Artery X-Rays Abdomen (75726) | $3,303 | $3,670 | 0.6× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,854 | $2,060 | 0.3× |
| Artery X-Rays Spine (75705) | $3,519 | $3,910 | 0.7× |
| Arthrogram ankle (73615) | $855 | $950 | 2.5× |
| Arthrogram hip (73525) | $855 | $950 | 2.5× |
| Arthrogram Wrist (73115) | $657 | $730 | 2.0× |
| Basic radiation dosimetry calculation (77300) | $1,728 | $1,920 | 13.3× |
| Bone age studies (77072) | $234 | $260 | 2.3× |
| Bone Imaging 3 Phase (78315) | $2,196 | $2,440 | 5.7× |
| Bone Imaging Limited Area (78300) | $477 | $530 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $846 | $940 | 2.2× |
| Bone Imaging Whole Body (78306) | $2,286 | $2,540 | 5.9× |
| Bone marrow imaging; multiple areas (78103) | $1,971 | $2,190 | 5.1× |
| Bone survey infant (77076) | $684 | $760 | 6.8× |
| Brain Image W/Flow < 4 Views (78601) | $1,557 | $1,730 | 4.0× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,692 | $1,880 | 3.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,330 | $3,700 | 2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $657 | $730 | 1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,050 | $4,500 | 12.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,023 | $4,470 | 5.3× |
| Cardiac Shunt Detection (78428) | $1,620 | $1,800 | 4.2× |
| Cat Scan Follow-Up Study (76380) | $297 | $330 | 3.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,575 | $1,750 | 3.0× |
| Cerebrospinal Fluid Scan (78630) | $2,079 | $2,310 | 4.0× |
| Chest 1 view (71045) | $387 | $430 | 4.6× |
| Chest 2 views (71046) | $423 | $470 | 5.0× |
| Chest 3 views (71047) | $450 | $500 | 5.4× |
| Chest 4 or more views (71048) | $477 | $530 | 4.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $2,943 | $3,270 | 29.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| Continuing medical physics consltj pr wk (77336) | $2,016 | $2,240 | 15.6× |
| Contrast Exam Abdominl Aorta (75625) | $2,322 | $2,580 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $855 | $950 | 2.5× |
| Contrast X-Ray Of Knee Joint (73580) | $1,089 | $1,210 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $5,886 | $6,540 | 17.5× |
| CT abdomen and pelvis without contrast (74176) | $2,133 | $2,370 | 9.3× |
| CT abdomen w contrast (74160) | $1,494 | $1,660 | 8.8× |
| CT abdomen w wo contrast (74170) | $1,863 | $2,070 | 11.0× |
| CT abdomen w/o contrast (74150) | $1,251 | $1,390 | 12.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,773 | $1,970 | 5.3× |
| CT Angio Chest (71275) | $2,151 | $2,390 | 12.7× |
| CT Angio Head (70496) | $1,764 | $1,960 | 10.4× |
| CT angio hrt w/3d image (75574) | $2,151 | $2,390 | 6.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,818–$3,186 | $2,020–$3,540 | varies |
| CT Angio Neck (70498) | $1,764 | $1,960 | 10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,818–$3,186 | $2,020–$3,540 | varies |
| CT bone density (77078) | $270 | $300 | 3.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,854 | $2,060 | 11.0× |
| CT cervical spine w/ contrast (72126) | $1,557 | $1,730 | 4.6× |
| CT cervical spine w/o contrast (72125) | $1,296 | $1,440 | 12.9× |
| CT cervical spine w/wo cont (72127) | $1,944 | $2,160 | 11.5× |
| CT chest w contrast (71260) | $1,557 | $1,730 | 9.2× |
| CT chest w/wo contrast (71270) | $1,944 | $2,160 | 11.5× |
| CT head/brain with contrast (70460) | $1,251 | $1,390 | 7.4× |
| CT head/brain without and with contrast (70470) | $1,557 | $1,730 | 9.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,133 | $2,370 | 6.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $288 | $320 | 3.4× |
| CT hrt w/3d image congen (75573) | $2,151 | $2,390 | 6.4× |
| CT iac w contrast (70481) | $1,674 | $1,860 | 9.9× |
| CT l-spine w&w/o contrast (72133) | $1,944 | $2,160 | 11.5× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,089–$1,908 | $1,210–$2,120 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,296–$2,592 | $1,440–$2,880 | varies |
| CT lumbar spine w contrast (72132) | $1,557 | $1,730 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,296 | $1,440 | 12.9× |
| CT maxillofacial w contrast (70487) | $1,251 | $1,390 | 7.4× |
| CT maxillofacial wo contrast (70486) | $1,035 | $1,150 | 10.3× |
| CT neck tissue combo (70492) | $1,620 | $1,800 | 9.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,106 | $2,340 | 12.5× |
| CT orbits w/o contrast (70480) | $1,404 | $1,560 | 13.9× |
| CT pelvis w&w/o contrast (72194) | $1,863 | $2,070 | 11.0× |
| CT pelvis w/o contrast (72192) | $1,296 | $1,440 | 12.9× |
| CT scan of leg combo (73702) | $1,638 | $1,820 | 9.7× |
| CT scans face/jaw combo (70488) | $1,557 | $1,730 | 9.2× |
| CT soft tissue neck w contrast (70491) | $1,296 | $1,440 | 7.7× |
| CT soft tissue neck w/o contrast (70490) | $1,080 | $1,200 | 10.7× |
| CT thoracic spine w contrast (72129) | $1,557 | $1,730 | 9.2× |
| CT thoracic spine w/o contrast (72128) | $1,296 | $1,440 | 12.9× |
| CT thoracic spine w/wo cont (72130) | $1,944 | $2,160 | 11.5× |
| CT thorax w/o contrast (71250) | $1,296 | $1,440 | 12.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,089–$1,908 | $1,210–$2,120 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,638 | $1,820 | 9.7× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,296–$2,268 | $1,440–$2,520 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,052 | $2,280 | 12.1× |
| Cta Abdomen (74175) | $2,052 | $2,280 | 12.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,854 | $2,060 | 5.5× |
| CTA pelvis (72191) | $2,052 | $2,280 | 12.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $486 | $540 | 2.1× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,341–$2,358 | $1,490–$2,620 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $630 | $700 | 6.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,116 | $1,240 | 11.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $693 | $770 | 6.9× |
| Dxa Bone Density Axial (77080) | $828 | $920 | 8.2× |
| Dxa bone density study (77085) | $1,152 | $1,280 | 11.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $180 | $200 | 2.1× |
| Echo exam of fetal heart (76825) | $2,124 | $2,360 | 4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,368 | $1,520 | 5.9× |
| Esophageal Motility Study (78258) | $1,323 | $1,470 | 3.4× |
| Esophagram (74220) | $558 | $620 | 3.3× |
| Fetal Biophys Profile W/Nst (76818) | $432 | $480 | 4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $450 | $500 | 4.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,358 | $2,620 | 10.2× |
| Fluoroscopy up to 1 hr (76000) | $702 | $780 | 3.1× |
| Follow-Up Angiography (75898) | $2,664 | $2,960 | 0.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$225–$396 | $250–$440 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| Gastric emptying imaging study (78264) | $1,899 | $2,110 | 4.9× |
| Gastroesophageal Reflux Exam (78262) | $1,728 | $1,920 | 4.5× |
| Gated Heart Planar Single (78472) | $2,286 | $2,540 | 5.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$234–$405 | $260–$450 | varies |
| Heart first pass single,planar (78481) | $1,323 | $1,470 | 2.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,854 | $2,060 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,854 | $2,060 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,836 | $2,040 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,548 | $1,720 | 4.0× |
| Ht Muscle Image Spect Sing (78451) | $2,079 | $2,310 | 1.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $576 | $640 | 6.9× |
| Infant hip ultrasound, limited static exam (76886) | $540 | $600 | 6.4× |
| Joint Survey Single View (77077) | $198 | $220 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $2,403 | $2,670 | 4.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,062 | $1,180 | 2.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 2 matching MRF lines |
$515.70–$972 | $573–$1,080 | varies |
| Kidney Imaging Morphol (78700) | $1,899 | $2,110 | 4.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$252–$450 | $280–$500 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,062 | $1,180 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,448 | $2,720 | 4.7× |
| Lung Ventilation Imaging (78579) | $540 | $600 | 1.4× |
| Lymph System Imaging (78195) | $1,881 | $2,090 | 3.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,890 | $2,100 | 1.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,314 | $1,460 | 2.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,890 | $2,100 | 0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,314 | $1,460 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $2,367 | $2,630 | 10.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $3,105 | $3,450 | 18.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,430 | $2,700 | 4.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $4,113 | $4,570 | 24.3× |
| Magnetic Resonance Elastography (76391) | $2,367 | $2,630 | 10.3× |
| Meckels Divert Exam (78290) | $2,286 | $2,540 | 5.9× |
| Mlc imrt design & construction per imrt plan (77338) | $5,427 | $6,030 | 15.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,762 | $4,180 | 11.2× |
| MRA head w/o contrast (70544) | $2,277 | $2,530 | 9.9× |
| MRA head with contrast (70545) | $2,817 | $3,130 | 8.4× |
| MRA neck w contrast (70548) | $2,934 | $3,260 | 8.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,915 | $4,350 | 11.6× |
| MRA neck w/o contrast (70547) | $2,385 | $2,650 | 10.4× |
| MRI abdomen w contrast (74182) | $2,808 | $3,120 | 8.3× |
| MRI abdomen w/o contrast (74181) | $2,385 | $2,650 | 10.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,799–$5,130 | $3,110–$5,700 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,672 | $4,080 | 10.9× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,799–$5,130 | $3,110–$5,700 | varies |
| MRI bone marrow blood supply (77084) | $711 | $790 | 3.1× |
| MRI brain functional w/o physician admnistration (70554) | $2,277 | $2,530 | 9.9× |
| MRI brain functional w/physician admnistration (70555) | $2,538 | $2,820 | 11.0× |
| MRI cardiac w/o cont stress (75559) | $3,420 | $3,800 | 6.5× |
| MRI cardiac w/o contrast (75557) | $2,403 | $2,670 | 10.4× |
| MRI cervical spine w contrast (72142) | $2,988 | $3,320 | 8.9× |
| MRI cervical spine w/o cont (72141) | $2,430 | $2,700 | 10.6× |
| MRI chest w/o contrast (71550) | $2,385 | $2,650 | 10.4× |
| MRI chest with contrast (71551) | $2,808 | $3,120 | 3.7× |
| MRI chest wo w contrast (71552) | $3,654 | $4,060 | 10.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,799 | $3,110 | 8.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,816 | $4,240 | 11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,340–$4,104 | $2,600–$4,560 | varies |
| MRI lumbar spine w contrast (72149) | $2,988 | $3,320 | 8.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,249 | $3,610 | 9.7× |
| MRI orbit face &/neck w/o contrast (70540) | $2,367 | $2,630 | 10.3× |
| MRI orbit face neck w contrast (70542) | $2,799 | $3,110 | 8.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,672 | $4,080 | 10.9× |
| MRI pelvis w contrast (72196) | $2,727 | $3,030 | 8.1× |
| MRI pelvis w/o & w contrast (72197) | $3,681 | $4,090 | 10.9× |
| MRI pelvis w/o contrast (72195) | $2,358 | $2,620 | 10.2× |
| MRI spectroscopy (76390) | $3,087 | $3,430 | 36.8× |
| MRI thoracic spine w/o contrast (72146) | $2,430 | $2,700 | 10.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,799 | $3,110 | 8.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,340 | $2,600 | 10.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,816 | $4,240 | 11.3× |
| MRI, abdomen, combo (74183) | $3,681 | $4,090 | 10.9× |
| MRI, dorsal spine combo (72157) | $3,249 | $3,610 | 9.7× |
| MRI, dorsal spine contrast (72147) | $2,988 | $3,320 | 8.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,367–$4,140 | $2,630–$4,600 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,672–$8,046 | $4,080–$8,940 | varies |
| MRI, lumbar spine combo (72158) | $3,249 | $3,610 | 9.7× |
| Musculoskeletal Nuclear Exam (78399) | $1,539 | $1,710 | 4.0× |
| Myelogram cervical (72240) | $1,467 | $1,630 | 1.9× |
| Myelogram Lumbar (72265) | $1,341 | $1,490 | 1.8× |
| Myelography thoracic (72255) | $1,467 | $1,630 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $2,151 | $2,390 | 2.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $639 | $710 | 1.7× |
| Neck soft tissue (70360) | $234 | $260 | 2.8× |
| Nm csf leak detection (78650) | $2,133 | $2,370 | 1.7× |
| Nm unlisted gi procedure (78299) | $3,978 | $4,420 | 10.3× |
| Nonvascular Shunt X-Ray (75809) | $783 | $870 | 7.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $18,342 | $20,380 | 13.7× |
| Nuclear medicine study of endocrine organs (78099) | $1,701 | $1,890 | 4.4× |
| Nuclear Rx Intra-Arterial (79445) | $1,332 | $1,480 | 5.9× |
| Nuclear Rx Oral Admin (79005) | $1,323 | $1,470 | 5.9× |
| Ob us nuchal meas 1 gest (76813) | $720 | $800 | 7.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $288 | $320 | 2.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $270 | $300 | 2.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $288 | $320 | 3.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $495 | $550 | 4.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $216 | $240 | 7.7× |
| Ophthalmic us dx quantitative a-scan only (76511) | $468 | $520 | 4.6× |
| Panoramic X-ray of jaws (70355) | $216 | $240 | 2.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,141 | $3,490 | 6.0× |
| Parathyroid Planar Imaging (78070) | $216 | $240 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,222 | $3,580 | 8.4× |
| Pelvis 1 or 2 views (72170) | $243 | $270 | 2.4× |
| Perineogram (74775) | $981 | $1,090 | 4.3× |
| Peritoneogram Rs&I (74190) | $774 | $860 | 1.5× |
| Pet Image W/Ct Lmtd (78814) | $3,087 | $3,430 | 2.2× |
| PET image w/CT, full body (78816) | $4,095 | $4,550 | 3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,087 | $3,430 | 2.2× |
| Proton trmt simple w/comp (77522) | $7,407 | $8,230 | 6.1× |
| Proton tx delivery complex (77525) | $9,054 | $10,060 | 7.5× |
| Proton tx delivery intermediate (77523) | $8,226 | $9,140 | 6.8× |
| Proton tx delivery simple w/o compensation (77520) | $6,669 | $7,410 | 12.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,322 | $2,580 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,692 | $1,880 | 4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $567 | $630 | 5.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $873 | $970 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$243–$432 | $270–$480 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$225–$396 | $250–$440 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$252–$450 | $280–$500 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $288 | $320 | 2.9× |
| Radex fingr minimum 2 views (73140) | $216 | $240 | 2.6× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$243–$432 | $270–$480 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$243–$432 | $270–$480 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$567–$1,008 | $630–$1,120 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $288 | $320 | 3.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $666 | $740 | 7.9× |
| Radex Ribs Unilateral 2 Views (71100) | $315 | $350 | 3.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$270–$477 | $300–$530 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $279 | $310 | 3.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $450 | $500 | 2.7× |
| Radex Spine 1 View Specify Level (72020) | $432 | $480 | 5.1× |
| Radex Sternum Minimum 2 Views (71120) | $288 | $320 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $288 | $320 | 3.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$234–$405 | $260–$450 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$702–$1,215 | $780–$1,350 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$234–$405 | $260–$450 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $720 | $800 | 7.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $22,707 | $25,230 | 3.2× |
| Radiation treatment delivery level 1 (77402) | $5,643 | $6,270 | 57.4× |
| Radiation treatment delivery level 2 (77407) | $10,233 | $11,370 | 27.5× |
| Radiation treatment delivery level 3 (77412) | $17,910 | $19,900 | 33.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $288 | $320 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $333 | $370 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $765 | $850 | 4.5× |
| Radiologic exam colon single contrast study (74270) | $576 | $640 | 3.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$288–$513 | $320–$570 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $279 | $310 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $450 | $500 | 2.7× |
| Radiologic exam swallow function contrast study (74230) | $765 | $850 | 4.5× |
| Radiologic exam teeth complete full mouth (70320) | $121.50 | $135 | 0.5× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $27.90 | $31 | 0.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$252–$432 | $280–$480 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$270–$477 | $300–$530 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $477 | $530 | 4.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $27.90 | $31 | 0.3× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $882 | $980 | 2.3× |
| Ribs bilateral 3 views (71110) | $432 | $480 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,322 | $2,580 | 4.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,538 | $2,820 | 4.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,015 | $3,350 | 5.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,322 | $2,580 | 1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,015 | $3,350 | 2.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,259 | $2,510 | 10.0× |
| Rp Therapy Intravenous Administration (79101) | $1,323 | $1,470 | 5.9× |
| Scapula (73010) | $270 | $300 | 2.7× |
| Shoulder 1 view (73020) | $216 | $240 | 2.6× |
| Shoulder Arthrography (73040) | $855 | $950 | 2.5× |
| Sialogram (70390) | $621 | $690 | 2.7× |
| Skull less than 4 views (70250) | $252 | $280 | 2.5× |
| Special dosimetry (77331) | $630 | $700 | 4.9× |
| Special Physics Consult (77370) | $774 | $860 | 6.0× |
| Special teletherapy port plan (77321) | $1,296 | $1,440 | 3.6× |
| Special treatment procedure (77470) | $4,536 | $5,040 | 8.5× |
| Speech evaluation, complex (70371) | $315 | $350 | 1.4× |
| Spleen Imaging (78185) | $882 | $980 | 2.3× |
| Stereotactic Body Radiation Delivery (77373) | $7,920 | $8,800 | 4.6× |
| Sternoclavicular joints (71130) | $180 | $200 | 2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,492 | $3,880 | 9.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,600 | $4,000 | 10.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,565 | $2,850 | 7.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,953 | $2,170 | 15.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $756 | $840 | 4.5× |
| Thoracic spine 2 views (72070) | $288 | $320 | 2.9× |
| Thoracolumbar 2 views (72080) | $378 | $420 | 4.5× |
| Thyroid Imaging With Vascular Flow (78013) | $1,026 | $1,140 | 2.7× |
| Thyroid Met Imaging Body (78018) | $2,745 | $3,050 | 5.2× |
| Thyroid Uptake Measurement (78012) | $378 | $420 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,971 | $2,190 | 5.1× |
| Tx Devices Design & Construction Complex (77334) | $2,889 | $3,210 | 8.0× |
| Tx devices design & construction simple (77332) | $936 | $1,040 | 7.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$288–$513 | $320–$570 | varies |
| Ultrasound Elastography Parenchyma (76981) | $1,728 | $1,920 | 17.1× |
| Ultrasound Exam Aaa Screen (76706) | $1,728 | $1,920 | 17.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,728 | $1,920 | 5.1× |
| Ultrasound, abdomen limited (76705) | $504 | $560 | 5.0× |
| Umbilical-artery Doppler (OB) (76820) | $693 | $770 | 6.9× |
| Unlisted Dx Radiographic Procedure (76499) range across 4 matching MRF lines |
$243–$3,708 | $270–$4,120 | varies |
| Unlisted magnetic resonance procedure (76498) | $855 | $950 | 10.2× |
| Unlisted us procedure (76999) range across 4 matching MRF lines |
$252–$1,458 | $280–$1,620 | varies |
| Upper gi w/o kub (74240) | $495 | $550 | 2.9× |
| Ureteral Reflux Study (78740) | $981 | $1,090 | 2.5× |
| Urethrocystogram voiding (74455) | $981 | $1,090 | 4.3× |
| Urethrocystography retrograde (74450) | $981 | $1,090 | 4.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$576–$1,017 | $640–$1,130 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$351–$486 | $390–$540 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$801–$1,413 | $890–$1,570 | varies |
| Us exam, pelvic, limited (76857) | $486 | $540 | 4.8× |
| Us head (76506) | $702 | $780 | 7.0× |
| Us kidney transplant (76776) | $801 | $890 | 7.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$540–$954 | $600–$1,060 | varies |
| Us ob detailed single fetus (76811) | $1,593 | $1,770 | 6.9× |
| Us ob limited 1 or more fetuses (76815) | $702 | $780 | 7.0× |
| Us ob transvaginal (76817) | $720 | $800 | 7.1× |
| Us pelvic non ob complete (76856) | $756 | $840 | 7.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $576 | $640 | 5.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $720 | $800 | 7.1× |
| Us retroperitoneal complete (76770) | $756 | $840 | 7.5× |
| Us retroperitoneal limited (76775) | $621 | $690 | 6.2× |
| Us scrotum and contents (76870) | $666 | $740 | 6.6× |
| Us spinal canal and contents (76800) | $909 | $1,010 | 9.0× |
| Us thyroid (76536) | $486 | $540 | 4.8× |
| Us transrectal (76872) | $801 | $890 | 7.9× |
| Vein X-Ray Chest (75827) | $1,854 | $2,060 | 1.2× |
| Vein X-Ray Spleen/Liver (75810) | $1,854 | $2,060 | 0.6× |
| Venogram Sinus/Jugular (75860) | $1,854 | $2,060 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $1,854 | $2,060 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $2,394 | $2,660 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $1,692 | $1,880 | 1.1× |
| Venography Renal Bilateral (75833) | $2,412 | $2,680 | 0.8× |
| Venography Renal Unilateral (75831) | $1,854 | $2,060 | 0.6× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$873 | $970 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $324 | $360 | 3.9× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$225–$396 | $250–$440 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $234 | $260 | 2.8× |
| X-ray antegrade pyelogram tube (74425) | $351 | $390 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,231 | $3,590 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $216 | $240 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $270 | $300 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $387 | $430 | 3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $540 | $600 | 5.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $360 | $400 | 4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $360 | $400 | 4.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $477 | $530 | 4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $477 | $530 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $477 | $530 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $360 | $400 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $468 | $520 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $333 | $370 | 3.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$216–$378 | $240–$420 | varies |
| X-ray IV pyelogram (ivp) (74400) | $729 | $810 | 4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $180 | $200 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $297 | $330 | 2.9× |
| X-ray nose-rectum child f.b. (76010) | $234 | $260 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $279 | $310 | 2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $288 | $320 | 2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $279 | $310 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $288 | $320 | 3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $351 | $390 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $468 | $520 | 4.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $639 | $710 | 1.9× |
| X-Rays Bone Length Studies (77073) | $360 | $400 | 3.6× |
| X-Rays Bone Survey Complete (77075) | $702 | $780 | 7.0× |
| Xr c-spine 4 or 5 views (72050) | $387 | $430 | 3.8× |
| Xr facial bones less than 3 views (70140) | $135 | $150 | 1.6× |
| Xr Tomogram Single Plane (76100) | $216 | $240 | 2.1× |
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.