Imaging prices at Newark-Wayne Community Hospital
Newark, NY · every code in this section with a posted price and a Medicare benchmark.
414 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) | $4,233.80 | $6,513.54 | 2.5× |
| Abdomen 1 View (74018) | $201.75 | $310.38 | 1.9× |
| Abdomen 2 views (74019) | $275.16 | $423.33 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,067.57 | $1,642.41 | 2.1× |
| Adrenal Cortex & Medulla Img (78075) | $3,133.32 | $4,820.50 | 1.9× |
| Angio internal mammary (75756) | $5,491.15 | $8,447.92 | 1.4× |
| Angio pulmonary bilat (75743) | $5,491.15 | $8,447.92 | 1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,491.15 | $8,447.92 | 1.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$5,491.15–$5,842.81 | $8,447.92–$8,988.94 | varies |
| Angiography extremity unilateral rs&i (75710) | $5,491.15 | $8,447.92 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,491.15 | $8,447.92 | 1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,491.15 | $8,447.92 | 1.4× |
| Ankle 2 views (73600) | $201.75 | $310.38 | 1.9× |
| Aortography thoracic serialography rs&i (75605) | $9,536.59 | $14,671.68 | 1.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,491.15 | $8,447.92 | 1.4× |
| Artery X-Rays Abdomen (75726) | $9,536.59 | $14,671.68 | 1.4× |
| Artery X-Rays Pelvis (75736) | $9,536.59 | $14,671.68 | 1.4× |
| Artery X-Rays Spine (75705) | $9,536.59 | $14,671.68 | 1.4× |
| Arthrogram ankle (73615) | $732.28 | $1,126.58 | 1.7× |
| Arthrogram hip (73525) | $732.28 | $1,126.58 | 1.7× |
| Arthrogram Wrist (73115) | $732.28 | $1,126.58 | 1.7× |
| Basic radiation dosimetry calculation (77300) | $450.54 | $693.14 | 2.7× |
| Bone age studies (77072) | $275.16 | $423.33 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,067.57 | $1,642.41 | 2.1× |
| Bone Imaging Multiple Areas (78305) | $1,067.57 | $1,642.41 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,067.57 | $1,642.41 | 2.1× |
| Bone marrow imaging limited area (78102) | $1,067.57 | $1,642.41 | 2.1× |
| Bone survey infant (77076) | $275.16 | $423.33 | 2.1× |
| Brachytx isodose complex (77318) | $1,157.38 | $1,780.58 | 2.5× |
| Brachytx isodose intermed (77317) | $1,157.38 | $1,780.58 | 2.5× |
| Brachytx Isodose Plan Simple (77316) | $1,157.38 | $1,780.58 | 2.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,129.74 | $1,738.06 | 1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,067.57 | $1,642.41 | 2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,648.98 | $2,536.89 | 3.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,648.98 | $2,536.89 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $370.50 | $570 | 3.4× |
| Cerebrospinal Fluid Scan (78630) | $1,129.74 | $1,738.06 | 1.7× |
| Chest 1 view (71045) | $201.75 | $310.38 | 1.9× |
| Chest 2 views (71046) | $201.75 | $310.38 | 1.9× |
| Chest 3 views (71047) | $201.75 | $310.38 | 1.9× |
| Chest 4 or more views (71048) | $275.16 | $423.33 | 2.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $251.07 | $386.26 | 1.9× |
| Cholecystography Oral Contrast (74290) | $336.54 | $517.76 | 1.5× |
| Cisternography Positive Contrast Rs&I (70015) | $2,086.62 | $3,210.18 | 2.1× |
| Clavicle complete (73000) | $201.75 | $310.38 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $215.09 | $330.91 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $450.54 | $693.14 | 2.7× |
| Contrast Exam Abdominl Aorta (75625) | $5,491.15 | $8,447.92 | 1.4× |
| Contrast X-Ray Bladder (74430) | $732.28 | $1,126.58 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $732.28 | $1,126.58 | 1.7× |
| Contrast X-Ray Of Knee Joint (73580) | $732.28 | $1,126.58 | 1.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $336.54 | $517.76 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,266.07 | $1,947.80 | 2.9× |
| CT abdomen and pelvis without contrast (74176) | $699.10 | $1,075.54 | 2.3× |
| CT abdomen w contrast (74160) | $845.92 | $1,301.42 | 3.9× |
| CT abdomen w wo contrast (74170) | $845.92 | $1,301.42 | 3.9× |
| CT abdomen w/o contrast (74150) | $520.31 | $800.48 | 4.0× |
| CT Angio Abdomen and Pelvis (74174) | $1,266.07 | $1,947.80 | 2.9× |
| CT Angio Chest (71275) | $845.92 | $1,301.42 | 3.9× |
| CT Angio Head (70496) | $845.92 | $1,301.42 | 3.9× |
| CT angio hrt w/3d image (75574) | $845.92 | $1,301.42 | 1.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $845.92 | $1,301.42 | 3.9× |
| CT Angio Neck (70498) | $845.92 | $1,301.42 | 3.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $845.92 | $1,301.42 | 3.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $267.13 | $410.97 | 1.2× |
| CT cervical spine w/ contrast (72126) | $1,772.65 | $2,727.16 | 4.1× |
| CT cervical spine w/o contrast (72125) | $520.31 | $800.48 | 4.0× |
| CT cervical spine w/wo cont (72127) | $845.92 | $1,301.42 | 3.9× |
| CT chest w contrast (71260) | $845.92 | $1,301.42 | 3.9× |
| CT chest w/wo contrast (71270) | $845.92 | $1,301.42 | 3.9× |
| CT colonography screening (74263) | $369.59 | $568.60 | 1.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $845.92 | $1,301.42 | 3.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $540.57 | $831.64 | 4.1× |
| CT head/brain with contrast (70460) | $845.92 | $1,301.42 | 3.9× |
| CT head/brain without and with contrast (70470) | $845.92 | $1,301.42 | 3.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $845.92 | $1,301.42 | 1.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $100.75 | $155 | 0.9× |
| CT iac w contrast (70481) | $845.92 | $1,301.42 | 3.9× |
| CT l-spine w&w/o contrast (72133) | $1,772.65 | $2,727.16 | 8.1× |
| CT lower ext w/o (73700) | $520.31 | $800.48 | 4.0× |
| CT lower extremity w/contrast material (73701) | $845.92 | $1,301.42 | 3.9× |
| CT lumbar spine w contrast (72132) | $1,772.65 | $2,727.16 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $520.31 | $800.48 | 4.0× |
| CT maxillofacial w contrast (70487) | $845.92 | $1,301.42 | 3.9× |
| CT maxillofacial wo contrast (70486) | $520.31 | $800.48 | 4.0× |
| CT neck tissue combo (70492) | $845.92 | $1,301.42 | 3.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $845.92 | $1,301.42 | 3.9× |
| CT orbits w/o contrast (70480) | $520.31 | $800.48 | 4.0× |
| CT pelvis w&w/o contrast (72194) | $845.92 | $1,301.42 | 3.9× |
| CT pelvis w/o contrast (72192) | $520.31 | $800.48 | 4.0× |
| CT scan of leg combo (73702) | $845.92 | $1,301.42 | 3.9× |
| CT scans face/jaw combo (70488) | $845.92 | $1,301.42 | 3.9× |
| CT soft tissue neck w contrast (70491) | $845.92 | $1,301.42 | 3.9× |
| CT soft tissue neck w/o contrast (70490) | $520.31 | $800.48 | 4.0× |
| CT thoracic spine w contrast (72129) | $845.92 | $1,301.42 | 3.9× |
| CT thoracic spine w/o contrast (72128) | $520.31 | $800.48 | 4.0× |
| CT thoracic spine w/wo cont (72130) | $845.92 | $1,301.42 | 3.9× |
| CT thorax w/o contrast (71250) | $520.31 | $800.48 | 4.0× |
| CT unlisted procedure (76497) | $211.95 | $326.07 | 2.0× |
| CT upper ext wo (73200) | $660.65 | $1,016.39 | 5.1× |
| CT upper extremity w/o & w/contrast material (73202) | $845.92 | $1,301.42 | 3.9× |
| CT upper extremity with contrast (73201) | $1,772.65 | $2,727.16 | 4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $845.92 | $1,301.42 | 3.9× |
| Cta Abdomen (74175) | $845.92 | $1,301.42 | 3.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $554 | $852.30 | 1.3× |
| CTA pelvis (72191) | $845.92 | $1,301.42 | 3.9× |
| Dilation ureters/urethra rs&i (74485) | $5,191.40 | $7,986.77 | 2.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $425.45 | $654.54 | 3.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $425.45 | $654.54 | 3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$151.64–$275.16 | $233.29–$423.33 | varies |
| Dxa Bone Density Axial (77080) | $275.16 | $423.33 | 2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $201.75 | $310.38 | 1.9× |
| Echo exam of fetal heart (76825) | $1,734.50 | $2,668.46 | 2.5× |
| Echo exam uterus (76831) | $875.65 | $1,347.15 | 2.9× |
| Echo Guide For Artery Repair (76936) | $637.83 | $981.28 | 2.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $875.65 | $1,347.15 | 2.9× |
| Echograp Trans R Pros Study (76873) | $425.45 | $654.54 | 3.3× |
| Esophagram (74220) | $336.54 | $517.76 | 1.5× |
| Fetal Biophys Profile W/Nst (76818) | $425.45 | $654.54 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $425.45 | $654.54 | 3.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $579.34 | $891.29 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $579.34 | $891.29 | 1.9× |
| Follow-Up Angiography (75898) | $5,491.15 | $8,447.92 | 1.4× |
| Foot 2 views (73620) | $201.75 | $310.38 | 1.9× |
| Forearm 2 views (73090) | $201.75 | $310.38 | 1.9× |
| Gastric emptying imaging study (78264) | $1,067.57 | $1,642.41 | 2.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,067.57 | $1,642.41 | 2.1× |
| Gated Heart Planar Single (78472) | $1,067.57 | $1,642.41 | 2.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,129.74 | $1,738.06 | 1.7× |
| Hand 2 views (73120) | $275.16 | $423.33 | 2.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,566 | $3,947.70 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,566 | $3,947.70 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,566 | $3,947.70 | 3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,491.15 | $8,447.92 | 1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,491.15 | $8,447.92 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,129.74 | $1,738.06 | 1.7× |
| Hepatobiliary System Imaging (78226) | $1,067.57 | $1,642.41 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $3,133.32 | $4,820.50 | 1.9× |
| Hysterosalpingogram (74740) | $579.34 | $891.29 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $222.56 | $342.40 | 2.0× |
| Infant hip ultrasound, limited static exam (76886) | $222.56 | $342.40 | 2.0× |
| Interstitial radiation source applic complex (77778) | $2,566 | $3,947.70 | 3.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,566 | $3,947.70 | 3.0× |
| Intracavitary radiation source applic simple (77761) | $1,869.52 | $2,876.18 | 2.7× |
| Intraop radiaj tx deliver xray single tx session (77424) | $26,584.59 | $40,899.37 | 2.9× |
| Joint Survey Single View (77077) | $275.16 | $423.33 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $1,129.74 | $1,738.06 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $1,129.74 | $1,738.06 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,129.74 | $1,738.06 | 1.7× |
| Kidney Imaging Morphol (78700) | $1,067.57 | $1,642.41 | 2.1× |
| Knee 3 Views (73562) | $201.75 | $310.38 | 1.9× |
| Leveen/Shunt Patency Exam (78291) | $1,067.57 | $1,642.41 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,067.57 | $1,642.41 | 2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,067.57 | $1,642.41 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,129.74 | $1,738.06 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,129.74 | $1,738.06 | 1.7× |
| Lung Ventilation Imaging (78579) | $870.30 | $1,338.92 | 1.7× |
| Lymph System Imaging (78195) | $1,129.74 | $1,738.06 | 1.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $2,652.99 | $4,081.52 | 1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,491.15 | $8,447.92 | 1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $5,398.13 | $8,304.81 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $1,006.36 | $1,548.25 | 3.4× |
| Mammary ductogram or galactogram multiple (77054) | $875.65 | $1,347.15 | 2.9× |
| Mammary ductogram or galactogram single (77053) | $579.34 | $891.29 | 1.9× |
| Meckels Divert Exam (78290) | $1,067.57 | $1,642.41 | 2.1× |
| Mlc imrt design & construction per imrt plan (77338) | $1,157.38 | $1,780.58 | 2.5× |
| Mr safety determination physician/other qhp (76016) | $181.62 | $279.42 | 1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $50.71 | $78.01 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $190.38 | $292.90 | 1.6× |
| Mr safety implt pos&/immoblj (76019) | $120.95 | $186.07 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $500.44 | $769.91 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,648.98 | $2,536.89 | 3.8× |
| MRA head w/o contrast (70544) | $1,006.36 | $1,548.25 | 3.4× |
| MRA head with contrast (70545) | $1,648.98 | $2,536.89 | 3.8× |
| MRA neck w contrast (70548) | $1,648.98 | $2,536.89 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,648.98 | $2,536.89 | 3.8× |
| MRA neck w/o contrast (70547) | $1,006.36 | $1,548.25 | 3.4× |
| MRI abdomen w contrast (74182) | $1,648.98 | $2,536.89 | 3.8× |
| MRI abdomen w/o contrast (74181) | $1,006.36 | $1,548.25 | 3.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,648.98 | $2,536.89 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,648.98 | $2,536.89 | 3.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,648.98 | $2,536.89 | 1.7× |
| MRI bone marrow blood supply (77084) | $1,006.36 | $1,548.25 | 3.4× |
| MRI brain functional w/o physician admnistration (70554) | $1,006.36 | $1,548.25 | 3.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,006.36 | $1,548.25 | 3.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,006.36 | $1,548.25 | 3.4× |
| MRI cardiac w/o cont stress (75559) | $2,079.66 | $3,199.47 | 3.0× |
| MRI cardiac w/o contrast (75557) | $1,006.36 | $1,548.25 | 3.4× |
| MRI cervical spine w contrast (72142) | $1,648.98 | $2,536.89 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,006.36 | $1,548.25 | 3.4× |
| MRI chest w/o contrast (71550) | $1,006.36 | $1,548.25 | 3.4× |
| MRI chest with contrast (71551) | $1,648.98 | $2,536.89 | 1.7× |
| MRI chest wo w contrast (71552) | $1,648.98 | $2,536.89 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,648.98 | $2,536.89 | 3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,648.98 | $2,536.89 | 3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,006.36 | $1,548.25 | 3.4× |
| MRI lumbar spine w contrast (72149) | $1,648.98 | $2,536.89 | 3.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,648.98 | $2,536.89 | 3.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,006.36 | $1,548.25 | 3.4× |
| MRI orbit face neck w contrast (70542) | $1,648.98 | $2,536.89 | 3.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,648.98 | $2,536.89 | 3.8× |
| MRI pelvis w contrast (72196) | $1,648.98 | $2,536.89 | 3.8× |
| MRI pelvis w/o & w contrast (72197) | $1,648.98 | $2,536.89 | 3.8× |
| MRI pelvis w/o contrast (72195) | $1,006.36 | $1,548.25 | 3.4× |
| MRI spectroscopy (76390) | $646.80 | $995.08 | 6.0× |
| MRI thoracic spine w/o contrast (72146) | $1,006.36 | $1,548.25 | 3.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,648.98 | $2,536.89 | 3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,006.36 | $1,548.25 | 3.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,648.98 | $2,536.89 | 3.8× |
| MRI, abdomen, combo (74183) | $1,648.98 | $2,536.89 | 3.8× |
| MRI, dorsal spine combo (72157) | $1,648.98 | $2,536.89 | 3.8× |
| MRI, dorsal spine contrast (72147) | $1,648.98 | $2,536.89 | 3.8× |
| MRI, joint upper extrem (73221) | $1,006.36 | $1,548.25 | 3.4× |
| MRI, joint upper extrem combo (73223) | $1,648.98 | $2,536.89 | 3.8× |
| MRI, lumbar spine combo (72158) | $1,648.98 | $2,536.89 | 3.8× |
| Myelogram cervical (72240) | $1,494.22 | $2,298.80 | 1.5× |
| Myelogram Lumbar (72265) | $1,494.22 | $2,298.80 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,494.22 | $2,298.80 | 1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,067.57 | $1,642.41 | 2.1× |
| Myocardial Spect Multiple Studies (78452) | $3,133.32 | $4,820.50 | 1.9× |
| N-invas est c ffr sw aly CTA (75580) | $2,209.21 | $3,398.79 | 2.1× |
| Neck soft tissue (70360) | $201.75 | $310.38 | 1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $837.15 | $1,287.93 | 1.7× |
| Nm myocard infarct spect (78469) | $3,133.32 | $4,820.50 | 4.6× |
| Nonvascular Shunt X-Ray (75809) | $275.16 | $423.33 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,233.80 | $6,513.54 | 2.5× |
| Nuclear Rx Intra-Arterial (79445) | $676.80 | $1,041.23 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $676.80 | $1,041.23 | 2.3× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$275.16–$425.45 | $423.33–$654.54 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $425.45 | $654.54 | 3.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $335.52 | $516.18 | 2.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $425.45 | $654.54 | 3.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $222.56 | $342.40 | 2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $425.45 | $654.54 | 3.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $61.13 | $94.05 | 1.7× |
| Ophthalmic us dx quantitative a-scan only (76511) | $425.45 | $654.54 | 3.3× |
| Panoramic X-ray of jaws (70355) | $201.75 | $310.38 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,067.57 | $1,642.41 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,067.57 | $1,642.41 | 2.1× |
| Pelvis 1 or 2 views (72170) | $275.16 | $423.33 | 2.1× |
| Peritoneogram Rs&I (74190) | $1,211.40 | $1,863.69 | 1.8× |
| Pet Image W/Ct Lmtd (78814) | $3,751.71 | $5,771.86 | 2.1× |
| PET image w/CT, full body (78816) | $3,751.71 | $5,771.86 | 2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,004.95 | $6,161.46 | 2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,491.15 | $8,447.92 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,067.57 | $1,642.41 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $275.16 | $423.33 | 2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,211.40 | $1,863.69 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $201.75 | $310.38 | 1.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $201.75 | $310.38 | 1.9× |
| Radex elbow complete minimum 3 views (73080) | $201.75 | $310.38 | 1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $275.16 | $423.33 | 2.1× |
| Radex fingr minimum 2 views (73140) | $201.75 | $310.38 | 1.9× |
| Radex foot complete minimum 3 views (73630) | $201.75 | $310.38 | 1.9× |
| Radex Hand Minimum 3 Views (73130) | $201.75 | $310.38 | 1.9× |
| Radex lower extremity infant minimum 2 views (73592) | $201.75 | $310.38 | 1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $275.16 | $423.33 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $201.75 | $310.38 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $201.75 | $310.38 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $201.75 | $310.38 | 1.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $201.75 | $310.38 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $336.54 | $517.76 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $201.75 | $310.38 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $201.75 | $310.38 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $201.75 | $310.38 | 1.9× |
| Radex Toe Minimum 2 Views (73660) | $201.75 | $310.38 | 1.9× |
| Radex upper extremity infant minimum 2 views (73092) | $275.16 | $423.33 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $201.75 | $310.38 | 1.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $275.16 | $423.33 | 2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $26,584.59 | $40,899.37 | 2.9× |
| Radiation treatment delivery level 1 (77402) | $445.35 | $685.16 | 3.5× |
| Radiation treatment delivery level 2 (77407) | $545.14 | $838.67 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $786.77 | $1,210.42 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $275.16 | $423.33 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $275.16 | $423.33 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $336.54 | $517.76 | 1.5× |
| Radiologic exam colon single contrast study (74270) | $336.54 | $517.76 | 1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $336.54 | $517.76 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) | $275.16 | $423.33 | 2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $275.16 | $423.33 | 2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $336.54 | $517.76 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $336.54 | $517.76 | 1.5× |
| Radiologic exam teeth complete full mouth (70320) | $579.34 | $891.29 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $336.54 | $517.76 | 1.5× |
| Radiologic examination femur 1 view (73551) | $201.75 | $310.38 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) | $201.75 | $310.38 | 1.9× |
| Radiologic examination knee 1/2 views (73560) | $201.75 | $310.38 | 1.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $275.16 | $423.33 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $201.75 | $310.38 | 1.9× |
| Radiopharm Dacryocystography (78660) | $1,067.57 | $1,642.41 | 2.1× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $511.86 | $787.48 | 1.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $786.77 | $1,210.42 | 1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $786.77 | $1,210.42 | 1.6× |
| Ribs bilateral 3 views (71110) | $275.16 | $423.33 | 2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,067.57 | $1,642.41 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,067.57 | $1,642.41 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,219.59 | $4,953.21 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,133.32 | $4,820.50 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,146.40 | $3,302.15 | 3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,219.59 | $4,953.21 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,219.59 | $4,953.21 | 1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,146.40 | $3,302.15 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $676.80 | $1,041.23 | 2.3× |
| Rp Therapy Unlisted Procedure (79999) | $676.80 | $1,041.23 | 2.3× |
| Scapula (73010) | $275.16 | $423.33 | 2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $80.17 | $123.34 | 3.4× |
| Shoulder 1 view (73020) | $201.75 | $310.38 | 1.9× |
| Shoulder Arthrography (73040) | $732.28 | $1,126.58 | 1.7× |
| Sialogram (70390) | $579.34 | $891.29 | 1.9× |
| Skull less than 4 views (70250) | $275.16 | $423.33 | 2.1× |
| Special dosimetry (77331) | $450.54 | $693.14 | 2.7× |
| Special Physics Consult (77370) | $286.81 | $441.24 | 1.7× |
| Special teletherapy port plan (77321) | $1,157.38 | $1,780.58 | 2.5× |
| Special treatment procedure (77470) | $1,869.52 | $2,876.18 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $6,002.01 | $9,233.86 | 2.7× |
| Sternoclavicular joints (71130) | $201.75 | $310.38 | 1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,157.38 | $1,780.58 | 2.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,157.38 | $1,780.58 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,157.38 | $1,780.58 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,157.38 | $1,780.58 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $450.54 | $693.14 | 2.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $336.54 | $517.76 | 1.5× |
| Thoracic spine 2 views (72070) | $275.16 | $423.33 | 2.1× |
| Thoracic spine 3 views (72072) | $275.16 | $423.33 | 2.1× |
| Thoracolumbar 2 views (72080) | $201.75 | $310.38 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $1,067.57 | $1,642.41 | 2.1× |
| Thyroid Met Imaging Body (78018) | $1,129.74 | $1,738.06 | 1.7× |
| Thyroid Uptake Measurement (78012) | $1,067.57 | $1,642.41 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,067.57 | $1,642.41 | 2.1× |
| Tx Devices Design & Construction Complex (77334) | $1,157.38 | $1,780.58 | 2.5× |
| Tx devices design & construction simple (77332) | $450.54 | $693.14 | 2.7× |
| Ultrasound Breast Limited (76642) | $222.56 | $342.40 | 2.0× |
| Ultrasound Elastography Parenchyma (76981) | $328.61 | $505.56 | 2.5× |
| Ultrasound Exam Aaa Screen (76706) | $425.45 | $654.54 | 3.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $435.65 | $670.23 | 1.0× |
| Ultrasound, abdomen limited (76705) | $425.45 | $654.54 | 3.3× |
| Umbilical-artery Doppler (OB) (76820) | $425.45 | $654.54 | 3.3× |
| Unlisted fluoroscopic procedure (76496) | $222.56 | $342.40 | 2.0× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$206.02–$344.66 | $316.95–$530.25 | varies |
| Unlisted us procedure (76999) | $222.56 | $342.40 | 2.0× |
| Upper gi w/o kub (74240) | $336.54 | $517.76 | 1.5× |
| Urethrocystogram voiding (74455) | $579.34 | $891.29 | 1.9× |
| Urethrocystography retrograde (74450) | $579.34 | $891.29 | 1.9× |
| Us breast unilateral complete (76641) | $425.45 | $654.54 | 3.3× |
| Us chest (76604) | $425.45 | $654.54 | 3.3× |
| Us complete joint (76881) | $425.45 | $654.54 | 3.3× |
| Us exam, pelvic, limited (76857) | $425.45 | $654.54 | 3.3× |
| Us head (76506) | $425.45 | $654.54 | 3.3× |
| Us kidney transplant (76776) | $425.45 | $654.54 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $425.45 | $654.54 | 3.3× |
| Us ob detailed single fetus (76811) | $646.80 | $995.08 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $425.45 | $654.54 | 3.3× |
| Us ob transvaginal (76817) | $425.45 | $654.54 | 3.3× |
| Us pelvic non ob complete (76856) | $425.45 | $654.54 | 3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $425.45 | $654.54 | 3.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $425.45 | $654.54 | 3.3× |
| Us retroperitoneal complete (76770) | $425.45 | $654.54 | 3.3× |
| Us retroperitoneal limited (76775) | $425.45 | $654.54 | 3.3× |
| Us scrotum and contents (76870) | $425.45 | $654.54 | 3.3× |
| Us spinal canal and contents (76800) | $425.45 | $654.54 | 3.3× |
| Us thyroid (76536) | $425.45 | $654.54 | 3.3× |
| Us transrectal (76872) | $425.45 | $654.54 | 3.3× |
| Vein X-Ray Chest (75827) | $2,652.99 | $4,081.52 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,491.15 | $8,447.92 | 1.4× |
| Venogram Sinus/Jugular (75860) | $5,491.15 | $8,447.92 | 1.4× |
| Venography Adrenal Unilateral (75840) | $5,491.15 | $8,447.92 | 1.4× |
| Venography caval inferior serialography rs&i (75825) | $5,491.15 | $8,447.92 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $2,652.99 | $4,081.52 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $2,652.99 | $4,081.52 | 1.4× |
| Venography Renal Bilateral (75833) | $5,491.15 | $8,447.92 | 1.4× |
| Venography Renal Unilateral (75831) | $5,491.15 | $8,447.92 | 1.4× |
| Venous sampling by catheter (75893) | $9,536.59 | $14,671.68 | 1.4× |
| Vertebral fracture assessment via dxa (77086) | $201.75 | $310.38 | 1.9× |
| Wrist 2 views (73100) | $201.75 | $310.38 | 1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $201.75 | $310.38 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $732.28 | $1,126.58 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $5,491.15 | $8,447.92 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $275.16 | $423.33 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $201.75 | $310.38 | 1.9× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,131.32–$1,211.40 | $1,740.49–$1,863.69 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $201.75 | $310.38 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $201.75 | $310.38 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $201.75 | $310.38 | 1.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam L-S Spine Bending (72114) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $201.75 | $310.38 | 1.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $275.16 | $423.33 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $275.16 | $423.33 | 2.1× |
| X-ray eye for foreign body (70030) | $201.75 | $310.38 | 1.9× |
| X-ray humerus (73060) | $201.75 | $310.38 | 1.9× |
| X-ray IV pyelogram (ivp) (74400) | $336.54 | $517.76 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $201.75 | $310.38 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $201.75 | $310.38 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $275.16 | $423.33 | 2.1× |
| X-ray nose-rectum child f.b. (76010) | $201.75 | $310.38 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $275.16 | $423.33 | 2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $275.16 | $423.33 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $275.16 | $423.33 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $201.75 | $310.38 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $201.75 | $310.38 | 1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $275.16 | $423.33 | 2.1× |
| X-ray thoracic spine 4 vw (72074) | $275.16 | $423.33 | 2.1× |
| X-Ray Tmj Unilat (70328) | $201.75 | $310.38 | 1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $732.28 | $1,126.58 | 1.7× |
| X-Rays Bone Length Studies (77073) | $275.16 | $423.33 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $275.16 | $423.33 | 2.1× |
| Xr c-spine 4 or 5 views (72050) | $275.16 | $423.33 | 2.1× |
| Xr facial bones less than 3 views (70140) | $201.75 | $310.38 | 1.9× |
| Xr orbits complete 4 views (70200) | $275.16 | $423.33 | 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.