Imaging prices at Queen's North Hawaiʻi Community Hospital
Kamuela, HI · every code in this section with a posted price and a Medicare benchmark.
427 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) | $4,995.20 | $7,136 | 3.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$178.50–$198.10 | $255–$283 | varies |
| Abdomen 2 views (74019) | $286.30 | $409 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,531.60 | $2,188 | 3.2× |
| Adrenal Cortex & Medulla Img (78075) | $1,191.40 | $1,702 | 0.8× |
| Angio internal mammary (75756) | $3,354.40 | $4,792 | 0.9× |
| Angio pulmonary bilat (75743) | $3,354.40 | $4,792 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,198.30 | $4,569 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $3,354.40 | $4,792 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $3,198.30 | $4,569 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,198.30 | $4,569 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,054.30 | $8,649 | 1.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$292.60–$585.20 | $418–$836 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,694.90 | $6,707 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,354.40 | $4,792 | 0.9× |
| Artery X-Rays Abdomen (75726) | $5,513.20 | $7,876 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $3,354.40 | $4,792 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,694.90 | $6,707 | 0.7× |
| Artery X-Rays Spine (75705) | $4,694.90 | $6,707 | 0.7× |
| Arthrogram ankle (73615) | $1,165.50 | $1,665 | 2.8× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,344–$1,545.60 | $1,920–$2,208 | varies |
| Arthrogram Wrist (73115) | $1,330.70 | $1,901 | 3.2× |
| Basic radiation dosimetry calculation (77300) | $618.80 | $884 | 3.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$341.60–$392.70 | $488–$561 | varies |
| Bone Imaging 3 Phase (78315) | $1,106 | $1,580 | 2.3× |
| Bone Imaging Limited Area (78300) | $956.90 | $1,367 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $1,100.40 | $1,572 | 2.3× |
| Bone Imaging Whole Body (78306) | $1,080.10 | $1,543 | 2.3× |
| Bone marrow imaging limited area (78102) | $970.90 | $1,387 | 2.1× |
| Bone survey infant (77076) | $597.80 | $854 | 4.8× |
| Brachytx isodose complex (77318) | $1,174.60 | $1,678 | 2.7× |
| Brachytx isodose intermed (77317) | $1,068.20 | $1,526 | 2.4× |
| Brachytx Isodose Plan Simple (77316) | $886.20 | $1,266 | 2.0× |
| Brain Flow Imaging Only (78610) | $976.50 | $1,395 | 1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $919.10 | $1,313 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $761.60 | $1,088 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,417.40 | $4,882 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,473.80 | $3,534 | 6.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,045.80 | $1,494 | 1.1× |
| Cardiac Shunt Detection (78428) | $654.50 | $935 | 1.4× |
| Cat Scan Follow-Up Study (76380) | $333.90 | $477 | 3.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,616.30 | $2,309 | 2.5× |
| Cerebrospinal Fluid Scan (78630) | $2,337.30 | $3,339 | 3.6× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$217.70–$653.10 | $311–$933 | varies |
| Chest 2 views (71046) | $256.90 | $367 | 2.5× |
| Chest 3 views (71047) | $308 | $440 | 3.0× |
| Chest 4 or more views (71048) | $372.40 | $532 | 3.0× |
| Cholecystography Oral Contrast (74290) | $449.40 | $642 | 2.2× |
| Clavicle complete (73000) | $239.40 | $342 | 2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $594.30 | $849 | 4.8× |
| Continuing medical physics consltj pr wk (77336) | $563.50 | $805 | 3.5× |
| Contrast Exam Abdominl Aorta (75625) | $3,474.80 | $4,964 | 0.9× |
| Contrast X-Ray Bladder (74430) | $646.10 | $923 | 1.6× |
| Contrast X-Ray Of Elbow (73085) | $847 | $1,210 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,079.40 | $1,542 | 2.6× |
| Corpora cavernosography (74445) | $1,892.80 | $2,704 | 15.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,430 | $4,900 | 8.3× |
| CT abdomen and pelvis without contrast (74176) | $2,087.40 | $2,982 | 7.4× |
| CT abdomen w contrast (74160) | $1,817.20 | $2,596 | 8.8× |
| CT abdomen w wo contrast (74170) | $1,830.50 | $2,615 | 8.8× |
| CT abdomen w/o contrast (74150) | $1,499.40 | $2,142 | 12.1× |
| CT Angio Abdomen and Pelvis (74174) | $3,513.30 | $5,019 | 8.5× |
| CT Angio Chest (71275) | $1,749.30 | $2,499 | 8.4× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,761.90–$3,523.80 | $2,517–$5,034 | varies |
| CT angio hrt w/3d image (75574) | $2,122.40 | $3,032 | 5.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,338 | $3,340 | 11.3× |
| CT Angio Neck (70498) | $1,719.90 | $2,457 | 8.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $987.70 | $1,411 | 4.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $362.60 | $518 | 1.7× |
| CT cervical spine w/ contrast (72126) | $3,682.70 | $5,261 | 8.9× |
| CT cervical spine w/o contrast (72125) | $1,365 | $1,950 | 11.1× |
| CT cervical spine w/wo cont (72127) | $2,097.20 | $2,996 | 10.1× |
| CT chest w contrast (71260) | $1,493.10 | $2,133 | 7.2× |
| CT chest w/wo contrast (71270) | $2,278.50 | $3,255 | 11.0× |
| CT head/brain with contrast (70460) | $2,421.30 | $3,459 | 11.7× |
| CT head/brain without and with contrast (70470) | $1,876.70 | $2,681 | 9.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $970.90 | $1,387 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $92.40 | $132 | 0.9× |
| CT hrt w/3d image congen (75573) | $432.60 | $618 | 1.0× |
| CT iac w contrast (70481) | $2,291.80 | $3,274 | 11.1× |
| CT l-spine w&w/o contrast (72133) | $3,192.70 | $4,561 | 15.4× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,194.20–$2,388.40 | $1,706–$3,412 | varies |
| CT lower extremity w/contrast material (73701) | $1,603.70 | $2,291 | 7.7× |
| CT lumbar spine w contrast (72132) | $2,414.30 | $3,449 | 5.9× |
| CT lumbar spine w/o contrast (72131) | $1,365 | $1,950 | 11.1× |
| CT maxillofacial w contrast (70487) | $1,694.70 | $2,421 | 8.2× |
| CT maxillofacial wo contrast (70486) | $1,194.20 | $1,706 | 9.7× |
| CT neck tissue combo (70492) | $3,149.30 | $4,499 | 15.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,636.20 | $3,766 | 12.7× |
| CT orbits w/o contrast (70480) | $1,430.80 | $2,044 | 11.6× |
| CT pelvis w&w/o contrast (72194) | $2,098.60 | $2,998 | 10.1× |
| CT pelvis w/o contrast (72192) | $1,282.40 | $1,832 | 10.4× |
| CT scan of leg combo (73702) | $2,150.40 | $3,072 | 10.4× |
| CT scans face/jaw combo (70488) | $4,432.40 | $6,332 | 21.4× |
| CT soft tissue neck w contrast (70491) | $1,299.20 | $1,856 | 6.3× |
| CT soft tissue neck w/o contrast (70490) | $1,709.40 | $2,442 | 13.8× |
| CT thoracic spine w contrast (72129) | $2,641.80 | $3,774 | 12.7× |
| CT thoracic spine w/o contrast (72128) | $1,159.20 | $1,656 | 9.4× |
| CT thoracic spine w/wo cont (72130) | $1,806.70 | $2,581 | 8.7× |
| CT thorax w/o contrast (71250) | $1,383.20 | $1,976 | 11.2× |
| CT upper ext wo (73200) | $1,281 | $1,830 | 10.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,974.70 | $2,821 | 9.5× |
| CT upper extremity with contrast (73201) | $1,850.80 | $2,644 | 4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,879.50 | $2,685 | 9.1× |
| Cta Abdomen (74175) | $2,043.30 | $2,919 | 9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $721 | $1,030 | 1.7× |
| CTA pelvis (72191) | $2,975.70 | $4,251 | 14.4× |
| Dilation ureters/urethra rs&i (74485) | $2,534.70 | $3,621 | 1.0× |
| Discography Cerv/Thor Spine (72285) | $4,585 | $6,550 | 2.0× |
| Diskography lumbar (72295) | $3,767.40 | $5,382 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $296.80 | $424 | 2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $343.70 | $491 | 2.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $424.90 | $607 | 3.4× |
| Dxa Bone Density Axial (77080) | $290.50 | $415 | 2.4× |
| Dxa bone density study (77085) | $195.30 | $279 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $116.20 | $166 | 1.1× |
| Echo exam of fetal heart (76825) | $1,049.30 | $1,499 | 1.6× |
| Echo exam uterus (76831) | $596.40 | $852 | 2.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $765.10 | $1,093 | 2.7× |
| Echograp Trans R Pros Study (76873) | $915.60 | $1,308 | 7.4× |
| Esophageal Motility Study (78258) | $595 | $850 | 1.3× |
| Esophagram (74220) | $490 | $700 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $811.30 | $1,159 | 6.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $376.60 | $538 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $276.50 | $395 | 1.0× |
| Follow-Up Angiography (75898) | $1,059.80 | $1,514 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$172.90–$345.80 | $247–$494 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$213.50–$427 | $305–$610 | varies |
| Gastric emptying imaging study (78264) | $1,307.60 | $1,868 | 2.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,775.20 | $2,536 | 3.8× |
| Gastric Mucosa Imaging (78261) | $514.50 | $735 | 1.1× |
| Gastroesophageal Reflux Exam (78262) | $583.10 | $833 | 1.2× |
| Gated Heart Planar Single (78472) | $578.90 | $827 | 1.2× |
| Gated Heart, Multiple (78473) | $1,017.10 | $1,453 | 2.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,070.60 | $2,958 | 3.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$241.50–$483 | $345–$690 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,056.20 | $4,366 | 3.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,634.80 | $3,764 | 3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,168.60 | $3,098 | 2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,945.50 | $7,065 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,354.40 | $4,792 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,277.50 | $1,825 | 2.0× |
| Hepatobiliary System Imaging (78226) | $798 | $1,140 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,780.80 | $2,544 | 1.2× |
| Hysterosalpingogram (74740) | $1,201.90 | $1,717 | 4.3× |
| Image fusion (77399) | $345.80 | $494 | 2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $422.80 | $604 | 4.1× |
| Infant hip ultrasound, limited static exam (76886) | $302.40 | $432 | 2.9× |
| Infusion Ivp (74410) | $926.10 | $1,323 | 4.5× |
| Interstitial radiation source applic complex (77778) | $3,285.10 | $4,693 | 4.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,612.10 | $2,303 | 2.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $744.10 | $1,063 | 1.1× |
| Intracavitary radiation source applic simple (77761) | $1,075.90 | $1,537 | 1.6× |
| K Flow/Funct Image Multiple (78709) | $1,319.50 | $1,885 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,565.20 | $2,236 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,478.40 | $2,112 | 2.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $931 | $1,330 | 2.0× |
| Kidney Imaging Morphol (78700) | $547.40 | $782 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $763 | $1,090 | 1.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$248.50–$497 | $355–$710 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $728 | $1,040 | 1.5× |
| Leveen/Shunt Patency Exam (78291) | $797.30 | $1,139 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $718.20 | $1,026 | 1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $907.90 | $1,297 | 1.9× |
| Liver imaging w/vascular flow (78202) | $1,257.20 | $1,796 | 2.0× |
| Lung Perf&Ventilat Diferentl (78598) | $1,745.10 | $2,493 | 2.7× |
| Lung perfusion differential (78597) | $670.60 | $958 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,196.30 | $1,709 | 1.9× |
| Lung Ventilation Imaging (78579) | $1,042.30 | $1,489 | 2.2× |
| Lymph System Imaging (78195) | $1,171.10 | $1,673 | 1.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,198.30 | $4,569 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,626.40 | $3,752 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,896.30 | $2,709 | 6.7× |
| Mammary ductogram or galactogram multiple (77054) | $603.40 | $862 | 2.1× |
| Mammary ductogram or galactogram single (77053) | $532.70 | $761 | 1.9× |
| Meckels Divert Exam (78290) | $1,801.80 | $2,574 | 3.8× |
| Mlc imrt design & construction per imrt plan (77338) | $1,068.20 | $1,526 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,712.10 | $5,303 | 9.0× |
| MRA head w/o contrast (70544) | $2,394.70 | $3,421 | 8.5× |
| MRA head with contrast (70545) | $3,712.10 | $5,303 | 9.0× |
| MRA neck w contrast (70548) | $2,965.90 | $4,237 | 7.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,518.20 | $5,026 | 8.5× |
| MRA neck w/o contrast (70547) | $2,364.60 | $3,378 | 8.4× |
| MRI abdomen w contrast (74182) | $1,869 | $2,670 | 4.5× |
| MRI abdomen w/o contrast (74181) | $2,333.80 | $3,334 | 8.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,453.50–$2,821.70 | $3,505–$4,031 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,606.10 | $3,723 | 6.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,463.30 | $3,519 | 2.7× |
| MRI bone marrow blood supply (77084) | $1,843.10 | $2,633 | 6.5× |
| MRI brain functional w/o physician admnistration (70554) | $1,275.40 | $1,822 | 4.5× |
| MRI brain functional w/physician admnistration (70555) | $1,064.70 | $1,521 | 3.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,428 | $2,040 | 5.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,223.60 | $1,748 | 4.3× |
| MRI cardiac w/o cont stress (75559) | $1,064 | $1,520 | 1.6× |
| MRI cardiac w/o contrast (75557) | $1,488.90 | $2,127 | 5.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,456.70–$1,466.50 | $2,081–$2,095 | varies |
| MRI chest w/o contrast (71550) | $2,456.30 | $3,509 | 8.7× |
| MRI chest wo w contrast (71552) | $1,953 | $2,790 | 4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $737.80 | $1,054 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,433.90 | $3,477 | 5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,958.90 | $4,227 | 10.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,553.60 | $3,648 | 6.2× |
| MRI orbit face &/neck w/o contrast (70540) | $3,255 | $4,650 | 11.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,507.40 | $3,582 | 6.1× |
| MRI pelvis w/o & w contrast (72197) | $2,720.90 | $3,887 | 6.6× |
| MRI pelvis w/o contrast (72195) | $2,310 | $3,300 | 8.2× |
| MRI spectroscopy (76390) | $1,619.10 | $2,313 | 15.7× |
| MRI thoracic spine w/o contrast (72146) | $2,010.40 | $2,872 | 7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,936.20 | $2,766 | 6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,801.80 | $2,574 | 4.4× |
| MRI, abdomen, combo (74183) | $2,671.90 | $3,817 | 6.5× |
| MRI, dorsal spine combo (72157) | $2,462.60 | $3,518 | 6.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,285.50–$4,571 | $3,265–$6,530 | varies |
| MRI, joint upper extrem combo (73223) | $1,959.30 | $2,799 | 4.8× |
| MRI, lumbar spine combo (72158) | $2,461.20 | $3,516 | 6.0× |
| Myelogram cervical (72240) | $1,537.20 | $2,196 | 1.7× |
| Myelogram Lumbar (72265) | $924.70 | $1,321 | 1.0× |
| Myelography thoracic (72255) | $1,370.60 | $1,958 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,370.60 | $1,958 | 1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,164.70 | $4,521 | 2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,785 | $2,550 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $2,334.50 | $3,335 | 1.5× |
| Neck soft tissue (70360) | $287.70 | $411 | 2.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $655.90 | $937 | 1.4× |
| Nm csf leak detection (78650) | $1,191.40 | $1,702 | 0.8× |
| Nm myocard infarct spect (78469) | $1,257.20 | $1,796 | 2.0× |
| Nm red cell survival study (78130) | $687.40 | $982 | 1.5× |
| Nm whole blood volume (78122) | $1,215.90 | $1,737 | 1.9× |
| Nonvascular Shunt X-Ray (75809) | $218.40 | $312 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,525.90 | $5,037 | 2.2× |
| Nuclear Rx Intra-Arterial (79445) | $698.60 | $998 | 2.5× |
| Nuclear Rx Oral Admin (79005) | $545.30 | $779 | 2.0× |
| Ob us nuchal meas 1 gest (76813) | $369.60 | $528 | 3.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $253.40 | $362 | 2.1× |
| Optic foramina (70190) | $290.50 | $415 | 2.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $760.20 | $1,086 | 1.2× |
| Parathyroid Planar Imaging (78070) | $945.70 | $1,351 | 2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,031.80 | $1,474 | 2.2× |
| Pelvis 1 or 2 views (72170) | $280.70 | $401 | 2.3× |
| Peritoneogram Rs&I (74190) | $1,242.50 | $1,775 | 1.9× |
| Pet Image Skull-Thigh (78812) | $3,164.70 | $4,521 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $3,164.70 | $4,521 | 1.9× |
| PET image w/CT, full body (78816) | $3,290.70 | $4,701 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,626.70 | $5,181 | 2.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,637.60 | $3,768 | 1.7× |
| PET whole body (78813) | $2,637.60 | $3,768 | 1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,715.90 | $6,737 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,148 | $1,640 | 2.4× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,923.60 | $2,748 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $663.60 | $948 | 5.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $947.10 | $1,353 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$241.50–$483 | $345–$690 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$168.70–$169.40 | $241–$242 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$232.40–$464.80 | $332–$664 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $578.90 | $827 | 4.7× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$157.50–$175 | $225–$250 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$231–$462 | $330–$660 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$231–$462 | $330–$660 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $249.90 | $357 | 2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $393.40 | $562 | 3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $459.20 | $656 | 4.5× |
| Radex Ribs Unilateral 2 Views (71100) | $238.70 | $341 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$219.80–$439.60 | $314–$628 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$282.80–$325.50 | $404–$465 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,242.50 | $1,775 | 6.0× |
| Radex Spine 1 View Specify Level (72020) | $415.80 | $594 | 4.0× |
| Radex Sternum Minimum 2 Views (71120) | $394.10 | $563 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $547.40 | $782 | 5.3× |
| Radex Toe Minimum 2 Views (73660) | $156.10 | $223 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $401.80 | $574 | 3.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$262.50–$525 | $375–$750 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $581.70 | $831 | 4.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,983.20 | $29,976 | 2.4× |
| Radiation treatment delivery level 1 (77402) | $436.10 | $623 | 3.6× |
| Radiation treatment delivery level 2 (77407) | $559.30 | $799 | 1.2× |
| Radiation treatment delivery level 3 (77412) | $655.90 | $937 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $595.70 | $851 | 4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $313.60 | $448 | 2.5× |
| Radiologic exam colon double contrast study (74280) | $1,231.30 | $1,759 | 5.9× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,198.40–$1,378.30 | $1,712–$1,969 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $448 | $640 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$298.20–$596.40 | $426–$852 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $319.90 | $457 | 2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $746.90 | $1,067 | 3.6× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$432.60–$476 | $618–$680 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $384.30 | $549 | 1.9× |
| Radiologic examination femur 1 view (73551) | $251.30 | $359 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$281.40–$562.80 | $402–$804 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$186.90–$373.80 | $267–$534 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $652.40 | $932 | 5.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$197.40–$394.80 | $282–$564 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $371 | $530 | 0.6× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $548.80 | $784 | 2.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,400.70 | $2,001 | 5.1× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $687.40 | $982 | 1.1× |
| Ribs bilateral 3 views (71110) | $461.30 | $659 | 3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $822.50 | $1,175 | 1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $938.70 | $1,341 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,611.40 | $2,302 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,200.50 | $1,715 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,258.90 | $3,227 | 3.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,026.80 | $4,324 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,876.30 | $4,109 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,535.40 | $3,622 | 1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,168.60 | $3,098 | 7.9× |
| Rp Therapy Intravenous Administration (79101) | $674.80 | $964 | 2.4× |
| Salivary Gland Function Study (78232) | $652.40 | $932 | 1.4× |
| Salivary Gland Imaging (78230) | $533.40 | $762 | 1.1× |
| Salivary Gland Imaging Serial Images (78231) | $658 | $940 | 1.4× |
| Scapula (73010) | $366.80 | $524 | 3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $55.30 | $79 | 2.4× |
| Sella turcica (70240) | $228.90 | $327 | 2.2× |
| Shoulder 1 view (73020) | $291.90 | $417 | 2.8× |
| Shoulder Arthrography (73040) | $1,187.90 | $1,697 | 2.9× |
| Sialogram (70390) | $623.70 | $891 | 2.2× |
| Skull less than 4 views (70250) | $507.50 | $725 | 4.1× |
| Special dosimetry (77331) | $383.60 | $548 | 2.4× |
| Special Physics Consult (77370) | $591.50 | $845 | 3.7× |
| Special teletherapy port plan (77321) | $1,068.20 | $1,526 | 2.4× |
| Special treatment procedure (77470) | $1,723.40 | $2,462 | 2.6× |
| Sternoclavicular joints (71130) | $387.80 | $554 | 3.8× |
| Superior sagittal sinus venogram (75870) | $909.30 | $1,299 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $461.30 | $659 | 1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $429.10 | $613 | 1.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $759.50 | $1,085 | 2.7× |
| Testicular Imaging W/Flow (78761) | $659.40 | $942 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,159.90 | $1,657 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,068.20 | $1,526 | 2.4× |
| Ther rad simulaj-aided field setting simple (77280) | $660.80 | $944 | 4.2× |
| Thoracic spine 2 views (72070) | $242.90 | $347 | 2.0× |
| Thoracic spine 3 views (72072) | $324.80 | $464 | 2.6× |
| Thoracolumbar 2 views (72080) | $347.20 | $496 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $401.10 | $573 | 0.8× |
| Thyroid Met Imaging Body (78018) | $1,365.70 | $1,951 | 2.1× |
| Thyroid Uptake Measurement (78012) | $1,161.30 | $1,659 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,281.70 | $1,831 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $1,205.40 | $1,722 | 2.7× |
| Tx devices design & construction intermediate (77333) | $634.20 | $906 | 4.0× |
| Tx devices design & construction simple (77332) | $386.40 | $552 | 2.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$480.20–$960.40 | $686–$1,372 | varies |
| Ultrasound Exam Aaa Screen (76706) | $506.10 | $723 | 4.1× |
| Ultrasound, abdomen limited (76705) | $557.90 | $797 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) | $392.70 | $561 | 3.2× |
| Unlisted us procedure (76999) | $192.50 | $275 | 1.9× |
| Upper gi w/o kub (74240) | $439.60 | $628 | 2.1× |
| Ureteral Reflux Study (78740) | $567 | $810 | 1.2× |
| Urethrocystogram voiding (74455) | $718.20 | $1,026 | 2.5× |
| Urethrocystography retrograde (74450) | $980.70 | $1,401 | 3.5× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$454.30–$908.60 | $649–$1,298 | varies |
| Us chest (76604) | $574.70 | $821 | 4.7× |
| Us complete joint (76881) range across 2 matching MRF lines |
$508.90–$1,017.80 | $727–$1,454 | varies |
| Us exam, pelvic, limited (76857) | $478.80 | $684 | 3.9× |
| Us head (76506) | $309.40 | $442 | 2.5× |
| Us kidney transplant (76776) | $369.60 | $528 | 3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $350 | $500 | 2.8× |
| Us ob detailed single fetus (76811) | $632.80 | $904 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $448 | $640 | 3.6× |
| Us ob transvaginal (76817) | $369.60 | $528 | 3.0× |
| Us pelvic non ob complete (76856) | $557.90 | $797 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $369.60 | $528 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $688.80 | $984 | 5.6× |
| Us retroperitoneal complete (76770) | $687.40 | $982 | 5.6× |
| Us retroperitoneal limited (76775) | $478.80 | $684 | 3.9× |
| Us scrotum and contents (76870) | $453.60 | $648 | 3.7× |
| Us spinal canal and contents (76800) | $480.20 | $686 | 3.9× |
| Us thyroid (76536) | $574.70 | $821 | 4.7× |
| Us transrectal (76872) | $690.90 | $987 | 5.6× |
| Vascular Flow Imaging (78445) | $823.20 | $1,176 | 1.7× |
| Vasogram (74440) | $569.10 | $813 | 2.0× |
| Vein X-Ray Chest (75827) | $1,380.40 | $1,972 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,626.40 | $3,752 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) | $3,354.40 | $4,792 | 0.9× |
| Venogram Sinus/Jugular (75860) | $3,354.40 | $4,792 | 0.9× |
| Venography Adrenal Unilateral (75840) | $3,354.40 | $4,792 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $3,623.20 | $5,176 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,380.40 | $1,972 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,380.40 | $1,972 | 0.7× |
| Venography Orbital Rs&I (75880) | $3,354.40 | $4,792 | 4.5× |
| Venography Renal Bilateral (75833) | $3,354.40 | $4,792 | 0.9× |
| Venography Renal Unilateral (75831) | $3,623.20 | $5,176 | 1.0× |
| Venous sampling by catheter (75893) | $4,694.90 | $6,707 | 0.7× |
| Venous thrombosis imaging (78457) | $1,213.80 | $1,734 | 1.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $708.40 | $1,012 | 1.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$182.70–$365.40 | $261–$522 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $466.20 | $666 | 4.5× |
| X-ray antegrade pyelogram tube (74425) | $834.40 | $1,192 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,198.30 | $4,569 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $347.90 | $497 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$330.40–$660.80 | $472–$944 | varies |
| X-Ray Exam Breast Specimen (76098) | $703.50 | $1,005 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $368.90 | $527 | 3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $406 | $580 | 3.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $496.30 | $709 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $298.20 | $426 | 2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$314.30–$628.60 | $449–$898 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $447.30 | $639 | 3.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $645.40 | $922 | 5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $546.70 | $781 | 4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,075.90 | $1,537 | 8.7× |
| X-Ray Exam L-S Spine Bending (72114) | $501.90 | $717 | 4.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $277.20 | $396 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $601.30 | $859 | 4.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$265.30–$287 | $379–$410 | varies |
| X-ray eye for foreign body (70030) | $255.50 | $365 | 2.5× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$177.80–$401.80 | $254–$574 | varies |
| X-ray IV pyelogram (ivp) (74400) | $946.40 | $1,352 | 4.6× |
| X-ray IV pyelogram+tomography (74415) | $1,028.30 | $1,469 | 5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $326.20 | $466 | 3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $387.80 | $554 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$281.40–$284.20 | $402–$406 | varies |
| X-ray nose-rectum child f.b. (76010) | $464.80 | $664 | 4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $733.60 | $1,048 | 5.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $224 | $320 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $218.40 | $312 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $227.50 | $325 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $452.20 | $646 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $733.60 | $1,048 | 5.9× |
| X-Ray Stress View (77071) | $198.80 | $284 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $231.70 | $331 | 1.9× |
| X-Ray Tmj Unilat (70328) | $124.60 | $178 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $810.60 | $1,158 | 2.0× |
| X-Rays Bone Length Studies (77073) | $1,379.70 | $1,971 | 11.2× |
| X-Rays Bone Survey Complete (77075) | $815.50 | $1,165 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $319.90 | $457 | 2.6× |
| Xr facial bones less than 3 views (70140) | $196.70 | $281 | 1.9× |
| Xr orbits complete 4 views (70200) | $471.80 | $674 | 3.8× |
| Xr Tomogram Single Plane (76100) | $438.20 | $626 | 3.5× |
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.