Imaging prices at Northside Hospital Gwinnett
Lawrenceville, GA · every code in this section with a posted price and a Medicare benchmark.
443 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) | $14,672.25 | $19,563 | 10.6× |
| Abdomen 1 View (74018) | $484.50 | $646 | 5.6× |
| Abdomen 2 views (74019) | $506.25 | $675 | 4.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,954.50 | $2,606 | 4.9× |
| Adrenal Cortex & Medulla Img (78075) | $4,429.50 | $5,906 | 3.4× |
| Angio internal mammary (75756) | $3,453.75 | $4,605 | 1.1× |
| Angio pulmonary bilat (75743) | $6,434.25 | $8,579 | 2.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,735.50 | $6,314 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $4,463.25 | $5,951 | 1.4× |
| Angiography extremity unilateral rs&i (75710) | $8,412 | $11,216 | 2.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,761.50 | $7,682 | 1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,336 | $4,448 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$451.50–$789.75 | $602–$1,053 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,846.50 | $6,462 | 0.9× |
| Artery X-Rays Abdomen (75726) | $9,741.75 | $12,989 | 1.7× |
| Artery X-Rays Adrenal Gland (75731) | $4,062.75 | $5,417 | 1.3× |
| Artery X-Rays Pelvis (75736) | $10,968.75 | $14,625 | 2.0× |
| Artery X-Rays Spine (75705) | $10,968.75 | $14,625 | 2.0× |
| Arthrogram ankle (73615) | $444 | $592 | 1.3× |
| Arthrogram hip (73525) | $451.50 | $602 | 1.3× |
| Arthrogram Wrist (73115) | $916.50 | $1,222 | 2.6× |
| Basic radiation dosimetry calculation (77300) | $1,392.75 | $1,857 | 10.3× |
| Bone age studies (77072) | $367.50 | $490 | 3.5× |
| Bone Imaging 3 Phase (78315) | $2,295 | $3,060 | 5.7× |
| Bone Imaging Limited Area (78300) | $1,506.75 | $2,009 | 3.8× |
| Bone Imaging Multiple Areas (78305) | $1,238.25 | $1,651 | 3.1× |
| Bone Imaging Whole Body (78306) | $2,216.25 | $2,955 | 5.5× |
| Bone marrow imaging limited area (78102) | $1,435.50 | $1,914 | 3.6× |
| Bone marrow imaging; whole body (78104) | $1,435.50 | $1,914 | 3.6× |
| Bone survey infant (77076) | $389.25 | $519 | 3.7× |
| Brachytx isodose complex (77318) | $2,992.50 | $3,990 | 8.0× |
| Brachytx isodose intermed (77317) | $2,184.75 | $2,913 | 5.8× |
| Brachytx Isodose Plan Simple (77316) | $2,062.50 | $2,750 | 5.5× |
| Brain Flow Imaging Only (78610) | $2,166.75 | $2,889 | 4.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,076 | $2,768 | 3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,320.75 | $5,761 | 3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,648.75 | $4,865 | 10.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,925.50 | $5,234 | 5.0× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$1,531.50–$1,656 | $2,042–$2,208 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,947 | $2,596 | 3.6× |
| Cerebrospinal Fluid Scan (78630) | $1,696.50 | $2,262 | 3.1× |
| Chest 1 view (71045) | $498 | $664 | 5.7× |
| Chest 2 views (71046) | $632.25 | $843 | 7.2× |
| Chest 3 views (71047) | $706.50 | $942 | 8.1× |
| Chest 4 or more views (71048) | $773.25 | $1,031 | 7.4× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $279 | $372 | 2.7× |
| Cholecystography Oral Contrast (74290) | $405.75 | $541 | 2.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$384–$672.75 | $512–$897 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $372.75 | $497 | 3.6× |
| Continuing medical physics consltj pr wk (77336) | $1,322.25 | $1,763 | 9.8× |
| Contrast Exam Abdominl Aorta (75625) | $5,064.75 | $6,753 | 1.6× |
| Contrast X-Ray Bladder (74430) | $521.25 | $695 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $423.75 | $565 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $582 | $776 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $6,057 | $8,076 | 17.3× |
| CT abdomen and pelvis without contrast (74176) | $4,633.50 | $6,178 | 19.4× |
| CT abdomen w contrast (74160) | $4,204.50 | $5,606 | 23.9× |
| CT abdomen w wo contrast (74170) | $4,519.50 | $6,026 | 25.7× |
| CT abdomen w/o contrast (74150) | $3,432.75 | $4,577 | 32.7× |
| CT Angio Abdomen and Pelvis (74174) | $5,511 | $7,348 | 15.7× |
| CT Angio Chest (71275) | $4,316.25 | $5,755 | 24.5× |
| CT Angio Head (70496) | $3,585 | $4,780 | 20.4× |
| CT angio hrt w/3d image (75574) | $2,030.25 | $2,707 | 5.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,345.75–$6,690 | $4,461–$8,920 | varies |
| CT Angio Neck (70498) | $3,585 | $4,780 | 20.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,511.50–$5,778.75 | $4,682–$7,705 | varies |
| CT cervical spine w/ contrast (72126) | $3,492.75 | $4,657 | 10.0× |
| CT cervical spine w/o contrast (72125) | $3,386.25 | $4,515 | 32.3× |
| CT cervical spine w/wo cont (72127) | $3,639 | $4,852 | 20.7× |
| CT chest w contrast (71260) | $3,821.25 | $5,095 | 21.7× |
| CT chest w/wo contrast (71270) | $4,011.75 | $5,349 | 22.8× |
| CT colonography screening (74263) | $722.25 | $963 | 3.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,631.25 | $2,175 | 9.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,070.25 | $1,427 | 10.2× |
| CT head/brain with contrast (70460) | $3,515.25 | $4,687 | 20.0× |
| CT head/brain without and with contrast (70470) | $4,034.25 | $5,379 | 22.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,180.50 | $1,574 | 3.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,131 | $1,508 | 13.0× |
| CT hrt w/3d image congen (75573) | $2,697 | $3,596 | 7.7× |
| CT iac w contrast (70481) | $3,168 | $4,224 | 18.0× |
| CT l-spine w&w/o contrast (72133) | $3,639 | $4,852 | 20.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,886–$5,451 | $3,848–$7,268 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,077.25–$5,796.75 | $4,103–$7,729 | varies |
| CT lumbar spine w contrast (72132) | $3,492.75 | $4,657 | 10.0× |
| CT lumbar spine w/o contrast (72131) | $3,318.75 | $4,425 | 31.6× |
| CT maxillofacial w contrast (70487) | $3,138 | $4,184 | 17.8× |
| CT maxillofacial wo contrast (70486) | $2,946 | $3,928 | 28.1× |
| CT neck tissue combo (70492) | $3,412.50 | $4,550 | 19.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,444 | $4,592 | 19.6× |
| CT orbits w/o contrast (70480) | $2,974.50 | $3,966 | 28.4× |
| CT pelvis w&w/o contrast (72194) | $4,114.50 | $5,486 | 23.4× |
| CT pelvis w/o contrast (72192) | $3,408 | $4,544 | 32.5× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$3,345.75–$6,310.50 | $4,461–$8,414 | varies |
| CT scans face/jaw combo (70488) | $3,412.50 | $4,550 | 19.4× |
| CT soft tissue neck w contrast (70491) | $3,138 | $4,184 | 17.8× |
| CT soft tissue neck w/o contrast (70490) | $2,946 | $3,928 | 28.1× |
| CT thoracic spine w contrast (72129) | $3,496.50 | $4,662 | 19.9× |
| CT thoracic spine w/o contrast (72128) | $3,318.75 | $4,425 | 31.6× |
| CT thoracic spine w/wo cont (72130) | $3,639 | $4,852 | 20.7× |
| CT thorax w/o contrast (71250) | $3,112.50 | $4,150 | 29.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,886–$5,451 | $3,848–$7,268 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,345.75–$6,310.50 | $4,461–$8,414 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$3,077.25–$5,796.75 | $4,103–$7,729 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,639 | $4,852 | 20.7× |
| Cta Abdomen (74175) | $3,687 | $4,916 | 21.0× |
| CTA pelvis (72191) | $3,543 | $4,724 | 20.1× |
| Dilation ureters/urethra rs&i (74485) | $4,361.25 | $5,815 | 2.1× |
| Discography Cerv/Thor Spine (72285) | $4,141.50 | $5,522 | 2.1× |
| Diskography lumbar (72295) | $4,682.25 | $6,243 | 2.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$546–$557.25 | $728–$743 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) | $994.50 | $1,326 | 9.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $744.75 | $993 | 7.1× |
| Dxa Bone Density Axial (77080) | $888 | $1,184 | 8.5× |
| Dxa bone density study (77085) | $848.25 | $1,131 | 8.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $655.50 | $874 | 7.5× |
| Echo exam of fetal heart (76825) | $1,915.50 | $2,554 | 3.5× |
| Echo exam uterus (76831) | $972 | $1,296 | 4.1× |
| Echo Guide For Artery Repair (76936) | $453 | $604 | 2.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,057.50 | $1,410 | 4.4× |
| Echograp Trans R Pros Study (76873) | $1,041 | $1,388 | 9.9× |
| Esophagram (74220) | $655.50 | $874 | 3.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,054.50 | $1,406 | 10.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,054.50 | $1,406 | 10.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $984.75 | $1,313 | 4.1× |
| Fluoroscopy up to 1 hr (76000) | $807.75 | $1,077 | 3.4× |
| Follow-Up Angiography (75898) | $2,529.75 | $3,373 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$422.25–$738.75 | $563–$985 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$465.75–$815.25 | $621–$1,087 | varies |
| Gastric emptying imaging study (78264) | $1,954.50 | $2,606 | 4.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,863.75 | $2,485 | 4.6× |
| Gastroesophageal Reflux Exam (78262) | $1,271.25 | $1,695 | 3.2× |
| Gated Heart Planar Single (78472) | $2,837.25 | $3,783 | 7.1× |
| Gated Heart, Multiple (78473) | $3,107.25 | $4,143 | 7.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,148 | $2,864 | 3.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$422.25–$738.75 | $563–$985 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $8,490 | $11,320 | 12.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $8,174.25 | $10,899 | 11.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $7,439.25 | $9,919 | 10.6× |
| Heart first pass single,planar (78481) | $1,452.75 | $1,937 | 2.7× |
| Heart Image (Pet) Multiple (78492) | $6,657.75 | $8,877 | 4.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,357.75 | $4,477 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,925.50 | $5,234 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $2,004 | $2,672 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,954.50 | $2,606 | 4.9× |
| Ht Musc Image Planar Mult (78454) | $7,230.75 | $9,641 | 5.6× |
| Ht Muscle Image Spect Sing (78451) | $6,463.50 | $8,618 | 5.0× |
| Hysterosalpingogram (74740) | $1,009.50 | $1,346 | 4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $989.25 | $1,319 | 11.3× |
| Infant hip ultrasound, limited static exam (76886) | $771.75 | $1,029 | 8.8× |
| Infusion Ivp (74410) | $1,453.50 | $1,938 | 8.3× |
| Interstitial radiation source applic complex (77778) | $11,727 | $15,636 | 16.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,960.50 | $6,614 | 7.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $3,781.50 | $5,042 | 6.8× |
| Intracavitary radiation source applic simple (77761) | $3,042.75 | $4,057 | 5.5× |
| Joint Survey Single View (77077) | $382.50 | $510 | 3.6× |
| K Flow/Funct Image Multiple (78709) | $2,397.75 | $3,197 | 4.4× |
| K Flow/Funct Image W/Drug (78708) | $1,902 | $2,536 | 3.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,653.75 | $2,205 | 3.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$651.75–$1,140.75 | $869–$1,521 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,271.25 | $1,695 | 3.2× |
| Liver & Spleen Imaging Static Only (78215) | $1,418.25 | $1,891 | 3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,451.25 | $1,935 | 3.6× |
| Liver imaging static only (78201) | $1,388.25 | $1,851 | 2.5× |
| Liver imaging w/vascular flow (78202) | $1,451.25 | $1,935 | 2.7× |
| Lung Perf&Ventilat Diferentl (78598) | $2,497.50 | $3,330 | 4.6× |
| Lung perfusion differential (78597) | $1,819.50 | $2,426 | 4.5× |
| Lung Ventilat&Perfus Imaging (78582) | $2,364.75 | $3,153 | 4.3× |
| Lung Ventilation Imaging (78579) | $1,302.75 | $1,737 | 3.2× |
| Lymph System Imaging (78195) | $2,737.50 | $3,650 | 5.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,947.75 | $2,597 | 1.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,130.25 | $1,507 | 1.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,433.25 | $1,911 | 0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,269.75 | $1,693 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $4,619.25 | $6,159 | 19.3× |
| Magnetic Resonance Elastography (76391) | $1,320.75 | $1,761 | 5.5× |
| Mammary ductogram or galactogram multiple (77054) | $924.75 | $1,233 | 3.9× |
| Mammary ductogram or galactogram single (77053) | $754.50 | $1,006 | 3.2× |
| Meckels Divert Exam (78290) | $1,593.75 | $2,125 | 4.0× |
| Mlc imrt design & construction per imrt plan (77338) | $4,495.50 | $5,994 | 12.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $59.25 | $79 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $6,133.50 | $8,178 | 17.5× |
| MRA head w/o contrast (70544) | $3,218.25 | $4,291 | 13.4× |
| MRA head with contrast (70545) | $5,654.25 | $7,539 | 16.2× |
| MRA neck w contrast (70548) | $5,654.25 | $7,539 | 16.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,133.50 | $8,178 | 17.5× |
| MRA neck w/o contrast (70547) | $4,989.75 | $6,653 | 20.8× |
| MRI abdomen w contrast (74182) | $5,286 | $7,048 | 15.1× |
| MRI abdomen w/o contrast (74181) | $4,665 | $6,220 | 19.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$5,286–$10,566.75 | $7,048–$14,089 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$5,735.25–$11,474.25 | $7,647–$15,299 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$5,336.25–$10,665.75 | $7,115–$14,221 | varies |
| MRI bone marrow blood supply (77084) | $4,405.50 | $5,874 | 18.4× |
| MRI brain functional w/o physician admnistration (70554) | $690.75 | $921 | 2.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $715.50 | $954 | 3.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $715.50 | $954 | 3.0× |
| MRI cardiac w/o cont stress (75559) | $3,306.75 | $4,409 | 6.0× |
| MRI cardiac w/o contrast (75557) | $3,060 | $4,080 | 12.8× |
| MRI cervical spine w contrast (72142) | $5,286 | $7,048 | 15.1× |
| MRI cervical spine w/o cont (72141) | $4,665 | $6,220 | 19.5× |
| MRI chest w/o contrast (71550) | $4,665 | $6,220 | 19.5× |
| MRI chest with contrast (71551) | $5,286 | $7,048 | 6.7× |
| MRI chest wo w contrast (71552) | $5,735.25 | $7,647 | 16.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$5,286–$10,566.75 | $7,048–$14,089 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$5,735.25–$11,474.25 | $7,647–$15,299 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$4,665–$9,332.25 | $6,220–$12,443 | varies |
| MRI lumbar spine w contrast (72149) | $5,286 | $7,048 | 15.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,735.25 | $7,647 | 16.4× |
| MRI orbit face &/neck w/o contrast (70540) | $4,665 | $6,220 | 19.5× |
| MRI orbit face neck w contrast (70542) | $5,286 | $7,048 | 15.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,735.25 | $7,647 | 16.4× |
| MRI pelvis w contrast (72196) | $5,286 | $7,048 | 15.1× |
| MRI pelvis w/o & w contrast (72197) | $5,735.25 | $7,647 | 16.4× |
| MRI pelvis w/o contrast (72195) | $4,665 | $6,220 | 19.5× |
| MRI thoracic spine w/o contrast (72146) | $4,665 | $6,220 | 19.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$5,286–$10,566.75 | $7,048–$14,089 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$4,665–$9,332.25 | $6,220–$12,443 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$5,735.25–$11,474.25 | $7,647–$15,299 | varies |
| MRI, abdomen, combo (74183) | $5,735.25 | $7,647 | 16.4× |
| MRI, dorsal spine combo (72157) | $5,735.25 | $7,647 | 16.4× |
| MRI, dorsal spine contrast (72147) | $5,286 | $7,048 | 15.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$4,665–$9,332.25 | $6,220–$12,443 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$5,735.25–$11,474.25 | $7,647–$15,299 | varies |
| MRI, lumbar spine combo (72158) | $5,790 | $7,720 | 16.5× |
| Myelogram cervical (72240) | $939.75 | $1,253 | 1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,320.75 | $5,761 | 3.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $6,463.50 | $8,618 | 5.0× |
| Myocardial Spect Multiple Studies (78452) | $8,385.75 | $11,181 | 6.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,267.50 | $5,690 | 3.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,267.50 | $5,690 | 3.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $6,657.75 | $8,877 | 3.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $8,136.75 | $10,849 | 3.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $8,136.75 | $10,849 | 5.3× |
| N-invas est c ffr sw aly CTA (75580) | $4,200.75 | $5,601 | 4.9× |
| Neck soft tissue (70360) | $324 | $432 | 3.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $846.75 | $1,129 | 2.1× |
| Nm csf leak detection (78650) | $1,282.50 | $1,710 | 1.0× |
| Nm unlisted gi procedure (78299) | $2,599.50 | $3,466 | 6.5× |
| Nonvascular Shunt X-Ray (75809) | $330.75 | $441 | 3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $11,934 | $15,912 | 8.6× |
| Nuclear Rx Intra-Arterial (79445) | $1,590.75 | $2,121 | 6.8× |
| Nuclear Rx Oral Admin (79005) | $1,590.75 | $2,121 | 6.8× |
| Ob us nuchal meas 1 gest (76813) | $786 | $1,048 | 7.5× |
| Panoramic X-ray of jaws (70355) | $258.75 | $345 | 3.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,878 | $2,504 | 3.4× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$932.25–$1,863.75 | $1,243–$2,485 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,547.25 | $2,063 | 3.9× |
| Pelvis 1 or 2 views (72170) | $459 | $612 | 4.4× |
| Peritoneogram Rs&I (74190) | $915.75 | $1,221 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $7,913.25 | $10,551 | 5.5× |
| PET image w/CT, full body (78816) | $8,079 | $10,772 | 5.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,996.50 | $10,662 | 5.6× |
| Pet Myocardial Sngl Study (78491) | $4,267.50 | $5,690 | 3.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,708 | $4,944 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,653.75 | $2,205 | 4.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $596.25 | $795 | 5.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $651.75 | $869 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$587.25–$1,028.25 | $783–$1,371 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$351.75–$616.50 | $469–$822 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$587.25–$1,028.25 | $783–$1,371 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $659.25 | $879 | 6.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$386.25–$580.50 | $515–$774 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$508.50–$891 | $678–$1,188 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$540.75–$947.25 | $721–$1,263 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$429–$751.50 | $572–$1,002 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $723 | $964 | 6.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $518.25 | $691 | 5.9× |
| Radex Ribs Unilateral 2 Views (71100) | $517.50 | $690 | 5.9× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$625.50–$1,095 | $834–$1,460 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $499.50 | $666 | 5.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,714.50 | $2,286 | 9.7× |
| Radex Spine 1 View Specify Level (72020) | $451.50 | $602 | 5.2× |
| Radex Sternum Minimum 2 Views (71120) | $384 | $512 | 4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $990 | $1,320 | 11.3× |
| Radex Toe Minimum 2 Views (73660) | $309 | $412 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$473.25–$828.75 | $631–$1,105 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$531–$929.25 | $708–$1,239 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $850.50 | $1,134 | 8.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $50,491.50 | $67,322 | 6.8× |
| Radiation treatment delivery level 1 (77402) | $1,428.75 | $1,905 | 14.0× |
| Radiation treatment delivery level 2 (77407) | $1,877.25 | $2,503 | 4.9× |
| Radiation treatment delivery level 3 (77412) | $2,325.75 | $3,101 | 4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $582 | $776 | 5.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $551.25 | $735 | 5.3× |
| Radiologic exam colon double contrast study (74280) | $1,445.25 | $1,927 | 8.2× |
| Radiologic exam colon single contrast study (74270) | $990 | $1,320 | 5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,159.50 | $1,546 | 6.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$711.75–$1,245.75 | $949–$1,661 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $599.25 | $799 | 5.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,067.25 | $1,423 | 6.1× |
| Radiologic exam swallow function contrast study (74230) | $1,125 | $1,500 | 6.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,147.50 | $1,530 | 6.5× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$563.25–$986.25 | $751–$1,315 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$618.75–$1,083.75 | $825–$1,445 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$486–$850.50 | $648–$1,134 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $382.50 | $510 | 3.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$497.25–$870 | $663–$1,160 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $759.75 | $1,013 | 1.4× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,997.25 | $2,663 | 8.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $2,817.75 | $3,757 | 12.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $2,049.75 | $2,733 | 5.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $2,049.75 | $2,733 | 5.3× |
| Ribs bilateral 3 views (71110) | $588 | $784 | 5.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,696.50 | $2,262 | 4.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,466.25 | $1,955 | 3.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,321.50 | $5,762 | 7.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,596 | $2,128 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,198.25 | $2,931 | 4.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,871.50 | $5,162 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,392.75 | $5,857 | 3.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,871.50 | $5,162 | 3.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,270.75 | $4,361 | 14.0× |
| Rp Therapy Intravenous Administration (79101) | $1,590.75 | $2,121 | 6.8× |
| Salivary Gland Function Study (78232) | $1,575 | $2,100 | 3.9× |
| Salivary Gland Imaging (78230) | $1,271.25 | $1,695 | 3.2× |
| Salivary Gland Imaging Serial Images (78231) | $1,560.75 | $2,081 | 3.9× |
| Scapula (73010) range across 3 matching MRF lines |
$384–$672.75 | $512–$897 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $210 | $280 | 9.0× |
| Sella turcica (70240) | $489.75 | $653 | 5.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$429–$751.50 | $572–$1,002 | varies |
| Shoulder Arthrography (73040) | $563.25 | $751 | 1.6× |
| Sialogram (70390) | $478.50 | $638 | 2.0× |
| Skull less than 4 views (70250) | $579.75 | $773 | 5.5× |
| Special dosimetry (77331) | $1,162.50 | $1,550 | 8.6× |
| Special Physics Consult (77370) | $1,534.50 | $2,046 | 11.4× |
| Special teletherapy port plan (77321) | $2,001 | $2,668 | 5.3× |
| Special treatment procedure (77470) | $4,881.75 | $6,509 | 8.8× |
| Spleen Imaging (78185) | $1,377 | $1,836 | 3.4× |
| Srs Multisource (77371) | $50,491.50 | $67,322 | 6.8× |
| Stereotactic Body Radiation Delivery (77373) | $11,625.75 | $15,501 | 6.5× |
| Sternoclavicular joints (71130) | $435.75 | $581 | 5.0× |
| Superior sagittal sinus venogram (75870) | $2,617.50 | $3,490 | 0.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,091.25 | $1,455 | 10.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,433.75 | $3,245 | 6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,416 | $1,888 | 3.8× |
| Temporomandble Jt Arthrography Rs&I (70332) | $713.25 | $951 | 3.0× |
| Testicular Imaging W/Flow (78761) | $1,227.75 | $1,637 | 3.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,160.25 | $5,547 | 11.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,324.75 | $4,433 | 8.9× |
| Ther rad simulaj-aided field setting simple (77280) | $2,683.50 | $3,578 | 19.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,319.25 | $1,759 | 7.5× |
| Thoracic spine 2 views (72070) | $542.25 | $723 | 5.2× |
| Thoracic spine 3 views (72072) | $654 | $872 | 6.2× |
| Thoracolumbar 2 views (72080) | $655.50 | $874 | 7.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,466.25 | $1,955 | 3.7× |
| Thyroid Imaging With Vascular Flow (78013) | $707.25 | $943 | 1.8× |
| Thyroid Met Imaging Body (78018) | $2,283.75 | $3,045 | 4.2× |
| Thyroid Uptake Measurement (78012) | $707.25 | $943 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,352.25 | $1,803 | 3.4× |
| Tx Devices Design & Construction Complex (77334) | $2,508.75 | $3,345 | 6.7× |
| Tx devices design & construction intermediate (77333) | $1,263 | $1,684 | 9.4× |
| Tx devices design & construction simple (77332) | $1,189.50 | $1,586 | 8.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$827.25–$1,240.50 | $1,103–$1,654 | varies |
| Ultrasound elastography first target lesion (76982) | $1,240.50 | $1,654 | 11.8× |
| Ultrasound Elastography Parenchyma (76981) | $1,240.50 | $1,654 | 11.8× |
| Ultrasound Exam Aaa Screen (76706) | $345.75 | $461 | 3.3× |
| Ultrasound, abdomen limited (76705) | $1,072.50 | $1,430 | 10.2× |
| Umbilical-artery Doppler (OB) (76820) | $786 | $1,048 | 7.5× |
| Unlisted fluoroscopic procedure (76496) | $219 | $292 | 2.5× |
| Unlisted magnetic resonance procedure (76498) | $3,218.25 | $4,291 | 36.9× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,168.50 | $1,558 | 2.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $7,222.50 | $9,630 | 70.6× |
| Upper gi w/o kub (74240) | $1,159.50 | $1,546 | 6.6× |
| Ureteral Reflux Study (78740) | $1,889.25 | $2,519 | 4.7× |
| Urethrocystogram voiding (74455) | $630 | $840 | 2.6× |
| Urethrocystography retrograde (74450) | $396 | $528 | 1.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,034.25–$1,551.75 | $1,379–$2,069 | varies |
| Us chest (76604) | $711.75 | $949 | 6.8× |
| Us complete joint (76881) range across 3 matching MRF lines |
$1,002–$1,502.25 | $1,336–$2,003 | varies |
| Us exam, pelvic, limited (76857) | $854.25 | $1,139 | 8.1× |
| Us head (76506) | $1,098.75 | $1,465 | 10.5× |
| Us kidney transplant (76776) | $508.50 | $678 | 4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$680.25–$1,020.75 | $907–$1,361 | varies |
| Us ob detailed single fetus (76811) | $1,403.25 | $1,871 | 5.9× |
| Us ob limited 1 or more fetuses (76815) | $1,072.50 | $1,430 | 10.2× |
| Us ob transvaginal (76817) | $1,090.50 | $1,454 | 10.4× |
| Us pelvic non ob complete (76856) | $1,072.50 | $1,430 | 10.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,072.50 | $1,430 | 10.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 14 matching MRF lines |
$862.50–$1,124.25 | $1,150–$1,499 | varies |
| Us retroperitoneal complete (76770) | $1,345.50 | $1,794 | 12.8× |
| Us retroperitoneal limited (76775) | $557.25 | $743 | 5.3× |
| Us scrotum and contents (76870) | $782.25 | $1,043 | 7.5× |
| Us spinal canal and contents (76800) | $503.25 | $671 | 4.8× |
| Us thyroid (76536) | $862.50 | $1,150 | 8.2× |
| Us transrectal (76872) | $1,098.75 | $1,465 | 10.5× |
| Vascular Flow Imaging (78445) | $1,365.75 | $1,821 | 3.4× |
| Vein X-Ray Chest (75827) | $2,964 | $3,952 | 1.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,335.50 | $3,114 | 0.7× |
| Vein X-Ray Skull Epidural (75872) | $2,667.75 | $3,557 | 4.2× |
| Vein X-Ray Spleen/Liver (75810) | $7,701.75 | $10,269 | 2.4× |
| Venogram Sinus/Jugular (75860) | $6,759.75 | $9,013 | 2.1× |
| Venography Adrenal Unilateral (75840) | $692.25 | $923 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $3,541.50 | $4,722 | 1.1× |
| Venography extremity bilateral rs&i (75822) | $2,871.75 | $3,829 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $2,346 | $3,128 | 1.5× |
| Venography Renal Bilateral (75833) | $4,302.75 | $5,737 | 1.4× |
| Venography Renal Unilateral (75831) | $3,765.75 | $5,021 | 1.2× |
| Venous sampling by catheter (75893) | $10,968.75 | $14,625 | 2.0× |
| Venous thrombosis imaging (78457) | $1,311.75 | $1,749 | 2.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,311.75 | $1,749 | 3.3× |
| Vertebral fracture assessment via dxa (77086) | $875.25 | $1,167 | 10.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$422.25–$738.75 | $563–$985 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $503.25 | $671 | 5.8× |
| X-ray antegrade pyelogram tube (74425) | $626.25 | $835 | 1.8× |
| X-Ray Aorta Leg Arteries (75630) | $6,023.25 | $8,031 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) | $690.75 | $921 | 6.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$451.50–$789.75 | $602–$1,053 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,305.75 | $1,741 | 2.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $386.25 | $515 | 4.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $456.75 | $609 | 4.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $771.75 | $1,029 | 7.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $465.75 | $621 | 5.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $531 | $708 | 6.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $584.25 | $779 | 5.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $584.25 | $779 | 5.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $618 | $824 | 5.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $771.75 | $1,029 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) | $796.50 | $1,062 | 7.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $591.75 | $789 | 6.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $616.50 | $822 | 5.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $588 | $784 | 5.6× |
| X-ray eye for foreign body (70030) | $240 | $320 | 2.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$497.25–$870 | $663–$1,160 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,284 | $1,712 | 7.3× |
| X-ray IV pyelogram+tomography (74415) | $1,782.75 | $2,377 | 10.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $240.75 | $321 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $539.25 | $719 | 5.1× |
| X-ray nose-rectum child f.b. (76010) | $481.50 | $642 | 5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $684 | $912 | 6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $514.50 | $686 | 4.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $381 | $508 | 3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $532.50 | $710 | 6.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $599.25 | $799 | 6.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $790.50 | $1,054 | 7.5× |
| X-Ray Stress View (77071) | $204.75 | $273 | 2.3× |
| X-ray thoracic spine 4 vw (72074) | $760.50 | $1,014 | 7.3× |
| X-Ray Tmj Unilat (70328) | $565.50 | $754 | 6.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $726.75 | $969 | 2.1× |
| X-Rays Bone Length Studies (77073) | $522 | $696 | 5.0× |
| X-Rays Bone Survey Complete (77075) | $846 | $1,128 | 8.1× |
| Xr c-spine 4 or 5 views (72050) | $833.25 | $1,111 | 7.9× |
| Xr facial bones less than 3 views (70140) | $231 | $308 | 2.6× |
| Xr orbits complete 4 views (70200) | $659.25 | $879 | 6.3× |
| Xr Tomogram Single Plane (76100) | $828.75 | $1,105 | 7.9× |
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.