Imaging prices at Northwest Community Hospital 1
Arlington Heights, IL · every code in this section with a posted price and a Medicare benchmark.
384 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $8,255 | $8,255 | 5.6× |
| Abdomen 1 View (74018) | $340 | $340 | 3.6× |
| Abdomen 2 views (74019) | $447 | $447 | 4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,494 | $1,494 | 3.5× |
| Angio pulmonary bilat (75743) | $8,867 | $8,867 | 2.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,019 | $5,019 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $8,867 | $8,867 | 2.6× |
| Angiography extremity unilateral rs&i (75710) | $4,900 | $4,900 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $8,867 | $8,867 | 2.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,755 | $3,755 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$282–$519 | $282–$519 | varies |
| Aortography thoracic serialography rs&i (75605) | $14,772 | $14,772 | 2.5× |
| Artery X-Rays Abdomen (75726) | $9,428 | $9,428 | 1.6× |
| Artery X-Rays Adrenal Gland (75731) | $5,019 | $5,019 | 1.5× |
| Artery X-Rays Pelvis (75736) | $14,772 | $14,772 | 2.5× |
| Artery X-Rays Spine (75705) | $15,944 | $15,944 | 2.7× |
| Arthrogram ankle (73615) | $1,140 | $1,140 | 3.0× |
| Arthrogram hip (73525) | $842 | $842 | 2.3× |
| Arthrogram Wrist (73115) | $1,476 | $1,476 | 3.9× |
| Basic radiation dosimetry calculation (77300) | $2,708 | $2,708 | 18.8× |
| Bone age studies (77072) | $180 | $180 | 1.6× |
| Bone Imaging 3 Phase (78315) | $4,059 | $4,059 | 9.5× |
| Bone Imaging Limited Area (78300) | $1,155 | $1,155 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $1,155 | $1,155 | 2.7× |
| Bone Imaging Whole Body (78306) | $2,803 | $2,803 | 6.5× |
| Bone marrow imaging; whole body (78104) | $1,397 | $1,397 | 3.3× |
| Bone survey infant (77076) | $519 | $519 | 4.6× |
| Brachytx isodose complex (77318) | $2,104 | $2,104 | 5.2× |
| Brachytx isodose intermed (77317) | $1,706 | $1,706 | 4.3× |
| Brachytx Isodose Plan Simple (77316) | $1,051 | $1,051 | 2.6× |
| Brain Flow Imaging Only (78610) | $1,516 | $1,516 | 2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,385 | $8,385 | 5.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,341 | $3,341 | 8.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,206 | $3,206 | 3.8× |
| Cat Scan Follow-Up Study (76380) | $756 | $756 | 8.1× |
| Cerebrospinal Fluid Scan (78630) | $2,399 | $2,399 | 4.1× |
| Chest 1 view (71045) | $400 | $400 | 4.3× |
| Chest 2 views (71046) | $403 | $403 | 4.3× |
| Chest 3 views (71047) | $406 | $406 | 4.4× |
| Chest 4 or more views (71048) | $507 | $507 | 4.5× |
| Clavicle complete (73000) | $330 | $330 | 3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$150–$311 | $150–$311 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,001 | $1,001 | 6.9× |
| Contrast Exam Abdominl Aorta (75625) | $4,100 | $4,100 | 1.2× |
| Contrast X-Ray Bladder (74430) | $779 | $779 | 2.1× |
| Contrast X-Ray Of Elbow (73085) | $1,451 | $1,451 | 3.9× |
| Contrast X-Ray Of Knee Joint (73580) | $1,140 | $1,140 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $4,250 | $4,250 | 11.4× |
| CT abdomen and pelvis without contrast (74176) | $2,968 | $2,968 | 11.6× |
| CT abdomen w contrast (74160) | $2,695 | $2,695 | 14.3× |
| CT abdomen w wo contrast (74170) | $2,855 | $2,855 | 15.2× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,619–$2,444 | $1,619–$2,444 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,116 | $3,116 | 8.3× |
| CT Angio Chest (71275) | $2,978 | $2,978 | 15.8× |
| CT Angio Head (70496) | $2,334 | $2,334 | 12.4× |
| CT angio hrt w/3d image (75574) | $2,183 | $2,183 | 5.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,859 | $2,859 | 15.2× |
| CT Angio Neck (70498) | $2,734 | $2,734 | 14.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,353 | $1,353 | 7.2× |
| CT cervical spine w/ contrast (72126) | $2,145 | $2,145 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,963 | $1,963 | 17.5× |
| CT cervical spine w/wo cont (72127) | $3,019 | $3,019 | 16.1× |
| CT chest w contrast (71260) | $2,655 | $2,655 | 14.1× |
| CT chest w/wo contrast (71270) | $2,822 | $2,822 | 15.0× |
| CT colonography screening (74263) | $827 | $827 | 3.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $827 | $827 | 7.4× |
| CT head/brain with contrast (70460) | $2,149 | $2,149 | 11.4× |
| CT head/brain without and with contrast (70470) | $3,038 | $3,038 | 16.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,214 | $1,214 | 3.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $76 | $76 | 0.8× |
| CT hrt w/3d image congen (75573) | $1,609 | $1,609 | 4.3× |
| CT iac w contrast (70481) | $2,171 | $2,171 | 11.6× |
| CT l-spine w&w/o contrast (72133) | $2,800 | $2,800 | 14.9× |
| CT lower ext w/o (73700) | $2,114 | $2,114 | 18.9× |
| CT lower extremity w/contrast material (73701) | $2,587 | $2,587 | 13.8× |
| CT lumbar spine w contrast (72132) | $2,607 | $2,607 | 7.0× |
| CT lumbar spine w/o contrast (72131) | $1,813 | $1,813 | 16.2× |
| CT maxillofacial w contrast (70487) | $1,849 | $1,849 | 9.8× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,378–$1,767 | $1,378–$1,767 | varies |
| CT neck tissue combo (70492) | $2,792 | $2,792 | 14.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,250 | $2,250 | 12.0× |
| CT orbits w/o contrast (70480) | $1,645 | $1,645 | 14.7× |
| CT pelvis w&w/o contrast (72194) | $2,943 | $2,943 | 15.7× |
| CT pelvis w/o contrast (72192) | $1,796 | $1,796 | 16.0× |
| CT scan of leg combo (73702) | $2,700 | $2,700 | 14.4× |
| CT scans face/jaw combo (70488) | $1,900 | $1,900 | 10.1× |
| CT soft tissue neck w contrast (70491) | $2,432 | $2,432 | 12.9× |
| CT soft tissue neck w/o contrast (70490) | $1,854 | $1,854 | 16.5× |
| CT thoracic spine w contrast (72129) | $2,126 | $2,126 | 11.3× |
| CT thoracic spine w/o contrast (72128) | $1,861 | $1,861 | 16.6× |
| CT thoracic spine w/wo cont (72130) | $2,300 | $2,300 | 12.2× |
| CT thorax w/o contrast (71250) | $1,640 | $1,640 | 14.6× |
| CT unlisted procedure (76497) | $178 | $178 | 1.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,876–$3,576 | $1,876–$3,576 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,992 | $2,992 | 15.9× |
| CT upper extremity with contrast (73201) | $2,112 | $2,112 | 5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,330 | $2,330 | 12.4× |
| Cta Abdomen (74175) | $2,317 | $2,317 | 12.3× |
| Dilation ureters/urethra rs&i (74485) | $2,238 | $2,238 | 1.0× |
| Discography Cerv/Thor Spine (72285) | $4,476 | $4,476 | 2.1× |
| Diskography lumbar (72295) | $4,476 | $4,476 | 2.1× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$457–$558 | $457–$558 | varies |
| Dxa bone density study (77085) | $476 | $476 | 4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $235 | $235 | 2.5× |
| Echo exam uterus (76831) | $810 | $810 | 3.2× |
| Echo Guide For Artery Repair (76936) | $1,093 | $1,093 | 4.7× |
| Echograp Trans R Pros Study (76873) | $1,149 | $1,149 | 10.3× |
| Esophagram (74220) | $838 | $838 | 4.5× |
| Fetal Biophys Profile W/Nst (76818) | $1,048 | $1,048 | 9.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $619 | $619 | 5.5× |
| Fluoroscopy up to 1 hr (76000) | $762 | $762 | 3.0× |
| Follow-Up Angiography (75898) | $2,982 | $2,982 | 0.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$266–$399 | $266–$399 | varies |
| Forearm 2 views (73090) | $318 | $318 | 3.4× |
| Gastric emptying imaging study (78264) | $2,171 | $2,171 | 5.1× |
| Gastroesophageal Reflux Exam (78262) | $1,863 | $1,863 | 4.3× |
| Gated Heart Planar Single (78472) | $2,911 | $2,911 | 6.8× |
| Gated Heart, Multiple (78473) | $3,202 | $3,202 | 7.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$288–$467 | $288–$467 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,221 | $6,221 | 8.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,263 | $5,263 | 7.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,029 | $5,029 | 6.7× |
| Heart Image (Pet) Multiple (78492) | $4,585 | $4,585 | 3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,184 | $4,184 | 1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $8,867 | $8,867 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,364 | $2,364 | 4.1× |
| Hepatobiliary System Imaging (78226) | $1,379 | $1,379 | 3.2× |
| Ht Musc Image Planar Mult (78454) | $5,175 | $5,175 | 3.7× |
| Ht Muscle Image Spect Sing (78451) | $4,004 | $4,004 | 2.9× |
| Hysterosalpingogram (74740) | $1,014 | $1,014 | 4.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $320 | $320 | 3.4× |
| Infant hip ultrasound, limited static exam (76886) | $515 | $515 | 5.5× |
| Interstitial radiation source applic complex (77778) | $8,638 | $8,638 | 11.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $6,157 | $6,157 | 8.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $7,418 | $7,418 | 12.5× |
| Intracavitary radiation source applic simple (77761) | $6,421 | $6,421 | 10.8× |
| Joint Survey Single View (77077) | $390 | $390 | 3.5× |
| K Flow/Funct Image W/Drug (78708) | $2,206 | $2,206 | 3.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,900 | $1,900 | 3.3× |
| Kidney Imaging Morphol (78700) | $1,178 | $1,178 | 2.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$350–$500 | $350–$500 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,337 | $1,337 | 3.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,704 | $1,704 | 4.0× |
| Liver imaging static only (78201) | $2,415 | $2,415 | 4.2× |
| Liver imaging w/vascular flow (78202) | $2,500 | $2,500 | 4.3× |
| Lung perfusion differential (78597) | $2,098 | $2,098 | 4.9× |
| Lung Ventilat&Perfus Imaging (78582) | $2,204 | $2,204 | 3.8× |
| Lymph System Imaging (78195) | $2,749 | $2,749 | 4.7× |
| Magnetic Image Jaw Joint (70336) | $2,138 | $2,138 | 8.4× |
| Mammary ductogram or galactogram multiple (77054) | $1,157 | $1,157 | 4.5× |
| Mammary ductogram or galactogram single (77053) | $882 | $882 | 3.4× |
| Meckels Divert Exam (78290) | $2,666 | $2,666 | 6.2× |
| Mlc imrt design & construction per imrt plan (77338) | $2,807 | $2,807 | 7.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,243 | $3,243 | 8.7× |
| MRA head w/o contrast (70544) | $2,626 | $2,626 | 10.3× |
| MRA head with contrast (70545) | $2,700 | $2,700 | 7.2× |
| MRA neck w contrast (70548) | $2,763 | $2,763 | 7.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,375 | $3,375 | 9.0× |
| MRA neck w/o contrast (70547) | $2,667 | $2,667 | 10.4× |
| MRI abdomen w contrast (74182) | $3,000 | $3,000 | 8.0× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,340–$2,766 | $2,340–$2,766 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,000 | $3,000 | 3.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,448 | $3,448 | 9.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,454 | $3,454 | 4.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,289 | $1,289 | 5.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,944 | $1,944 | 7.6× |
| MRI cardiac w/o cont stress (75559) | $2,663 | $2,663 | 4.5× |
| MRI cardiac w/o contrast (75557) | $2,805 | $2,805 | 11.0× |
| MRI cervical spine w contrast (72142) | $3,350 | $3,350 | 9.0× |
| MRI cervical spine w/o cont (72141) | $2,829 | $2,829 | 11.1× |
| MRI chest w/o contrast (71550) | $1,564 | $1,564 | 6.1× |
| MRI chest with contrast (71551) | $2,284 | $2,284 | 2.7× |
| MRI chest wo w contrast (71552) | $2,727 | $2,727 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,500 | $3,500 | 9.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,739 | $3,739 | 10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,959 | $2,959 | 11.6× |
| MRI lumbar spine w contrast (72149) | $3,807 | $3,807 | 10.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,152 | $4,152 | 11.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,501 | $2,501 | 9.8× |
| MRI orbit face neck w contrast (70542) | $3,805 | $3,805 | 10.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,840 | $3,840 | 10.3× |
| MRI pelvis w contrast (72196) | $3,000 | $3,000 | 8.0× |
| MRI pelvis w/o & w contrast (72197) | $3,258 | $3,258 | 8.7× |
| MRI pelvis w/o contrast (72195) | $2,768 | $2,768 | 10.8× |
| MRI spectroscopy (76390) | $1,002 | $1,002 | 10.7× |
| MRI thoracic spine w/o contrast (72146) | $3,254 | $3,254 | 12.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,000 | $3,000 | 8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,696 | $2,696 | 10.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,644 | $3,644 | 9.7× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$3,413–$5,099 | $3,413–$5,099 | varies |
| MRI, dorsal spine combo (72157) | $4,105 | $4,105 | 11.0× |
| MRI, dorsal spine contrast (72147) | $3,779 | $3,779 | 10.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,734–$5,603 | $2,734–$5,603 | varies |
| MRI, joint upper extrem combo (73223) | $3,500 | $3,500 | 9.4× |
| MRI, lumbar spine combo (72158) | $4,397 | $4,397 | 11.8× |
| Myelogram Lumbar (72265) | $1,826 | $1,826 | 2.2× |
| Myelography thoracic (72255) | $2,554 | $2,554 | 3.0× |
| Myelograpy 2/more regions rs&i (72270) | $1,548 | $1,548 | 1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,048 | $4,048 | 2.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,316 | $5,316 | 3.8× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,056–$5,894 | $5,056–$5,894 | varies |
| Neck soft tissue (70360) | $351 | $351 | 3.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,079 | $1,079 | 2.5× |
| Nm csf leak detection (78650) | $6,153 | $6,153 | 4.4× |
| Nonvascular Shunt X-Ray (75809) | $1,242 | $1,242 | 11.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $10,721 | $10,721 | 7.2× |
| Nuclear Rx Intra-Arterial (79445) | $1,566 | $1,566 | 6.3× |
| Nuclear Rx Oral Admin (79005) | $1,506 | $1,506 | 6.0× |
| Panoramic X-ray of jaws (70355) | $439 | $439 | 4.7× |
| Parathyroid Planar Imaging (78070) | $1,870 | $1,870 | 4.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,290 | $2,290 | 5.3× |
| Pelvis 1 or 2 views (72170) | $364 | $364 | 3.2× |
| Peritoneogram Rs&I (74190) | $1,214 | $1,214 | 2.1× |
| Pet Image W/Ct Lmtd (78814) | $4,585 | $4,585 | 3.0× |
| PET image w/CT, full body (78816) | $8,745 | $8,745 | 5.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,828 | $8,828 | 5.8× |
| Pet Myocardial Sngl Study (78491) | $4,585 | $4,585 | 3.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,019 | $5,019 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,914 | $1,914 | 4.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $598 | $598 | 5.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,072 | $1,072 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$536–$849 | $536–$849 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $265 | $265 | 2.8× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$470–$725 | $470–$725 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $677 | $677 | 6.0× |
| Radex fingr minimum 2 views (73140) | $234 | $234 | 2.5× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$332–$404 | $332–$404 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$383–$495 | $383–$495 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $231 | $231 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $335 | $335 | 3.6× |
| Radex Ribs Unilateral 2 Views (71100) | $355 | $355 | 3.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$359–$630 | $359–$630 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $201 | $201 | 2.2× |
| Radex Spine 1 View Specify Level (72020) | $458 | $458 | 4.9× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$180–$376 | $180–$376 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $425 | $425 | 4.6× |
| Radex Toe Minimum 2 Views (73660) | $221 | $221 | 2.4× |
| Radex upper extremity infant minimum 2 views (73092) | $231 | $231 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$389–$634 | $389–$634 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $24,091 | $24,091 | 3.1× |
| Radiation treatment delivery level 1 (77402) | $371 | $371 | 3.4× |
| Radiation treatment delivery level 2 (77407) | $749 | $749 | 1.8× |
| Radiation treatment delivery level 3 (77412) | $1,162 | $1,162 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $445 | $445 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $1,547 | $1,547 | 8.2× |
| Radiologic exam colon single contrast study (74270) | $994 | $994 | 5.3× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$519–$1,001 | $519–$1,001 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $529 | $529 | 4.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $876 | $876 | 4.7× |
| Radiologic exam swallow function contrast study (74230) | $747 | $747 | 4.0× |
| Radiologic exam teeth complete full mouth (70320) | $713 | $713 | 2.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $789 | $789 | 4.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$350–$525 | $350–$525 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$388–$758 | $388–$758 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$300–$450 | $300–$450 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $857 | $857 | 7.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$324–$353 | $324–$353 | varies |
| Ribs bilateral 3 views (71110) | $462 | $462 | 4.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,168 | $1,168 | 2.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,168 | $1,168 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,004 | $4,004 | 6.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,004 | $4,004 | 6.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,606 | $2,606 | 4.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,102 | $2,102 | 8.4× |
| Rp Therapy Intravenous Administration (79101) | $784 | $784 | 3.1× |
| Salivary Gland Function Study (78232) | $1,155 | $1,155 | 2.7× |
| Salivary Gland Imaging Serial Images (78231) | $1,178 | $1,178 | 2.7× |
| Scapula (73010) | $474 | $474 | 4.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $112 | $112 | 4.8× |
| Sella turcica (70240) | $231 | $231 | 2.5× |
| Shoulder 1 view (73020) | $288 | $288 | 3.1× |
| Shoulder Arthrography (73040) | $926 | $926 | 2.5× |
| Sialogram (70390) | $1,157 | $1,157 | 4.5× |
| Skull less than 4 views (70250) | $441 | $441 | 3.9× |
| Special dosimetry (77331) | $393 | $393 | 2.7× |
| Special Physics Consult (77370) | $1,051 | $1,051 | 7.3× |
| Special teletherapy port plan (77321) | $2,028 | $2,028 | 5.1× |
| Special treatment procedure (77470) | $3,918 | $3,918 | 6.6× |
| Spleen Imaging (78185) | $1,178 | $1,178 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $13,012 | $13,012 | 6.8× |
| Sternoclavicular joints (71130) | $319 | $319 | 3.4× |
| Superior sagittal sinus venogram (75870) | $3,579 | $3,579 | 1.1× |
| Tbs technical calculation only (77091) | $251 | $251 | 2.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,237 | $2,237 | 5.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,049 | $1,049 | 2.6× |
| Testicular Imaging W/Flow (78761) | $1,738 | $1,738 | 4.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,590 | $2,590 | 6.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,049 | $1,049 | 2.6× |
| Ther rad simulaj-aided field setting simple (77280) | $1,443 | $1,443 | 10.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $915 | $915 | 4.9× |
| Thoracic spine 2 views (72070) | $366 | $366 | 3.3× |
| Thoracic spine 3 views (72072) | $429 | $429 | 3.8× |
| Thoracolumbar 2 views (72080) | $540 | $540 | 5.8× |
| Thyroid Imaging With Vascular Flow (78013) | $1,093 | $1,093 | 2.6× |
| Thyroid Met Imaging Body (78018) | $2,654 | $2,654 | 4.6× |
| Thyroid Uptake Measurement (78012) | $829 | $829 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,395 | $2,395 | 5.6× |
| Tx Devices Design & Construction Complex (77334) | $5,110 | $5,110 | 12.7× |
| Tx devices design & construction intermediate (77333) | $1,234 | $1,234 | 8.6× |
| Tx devices design & construction simple (77332) | $1,001 | $1,001 | 6.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$411–$822 | $411–$822 | varies |
| Ultrasound Elastography Parenchyma (76981) | $338 | $338 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $857 | $857 | 7.6× |
| Ultrasound, abdomen limited (76705) | $714 | $714 | 6.4× |
| Umbilical-artery Doppler (OB) (76820) | $284 | $284 | 2.5× |
| Unlisted fluoroscopic procedure (76496) | $1,125 | $1,125 | 12.1× |
| Unlisted magnetic resonance procedure (76498) | $2,950 | $2,950 | 31.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $371 | $371 | 3.4× |
| Unlisted us procedure (76999) | $755 | $755 | 8.1× |
| Upper gi w/o kub (74240) | $795 | $795 | 4.2× |
| Ureteral Reflux Study (78740) | $2,198 | $2,198 | 5.1× |
| Urethrocystogram voiding (74455) | $808 | $808 | 3.2× |
| Urethrocystography retrograde (74450) | $772 | $772 | 3.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$600–$900 | $600–$900 | varies |
| Us chest (76604) | $536 | $536 | 4.8× |
| Us complete joint (76881) | $1,301 | $1,301 | 11.6× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$358–$610 | $358–$610 | varies |
| Us head (76506) | $317 | $317 | 2.8× |
| Us kidney transplant (76776) | $1,298 | $1,298 | 11.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $785 | $785 | 7.0× |
| Us ob limited 1 or more fetuses (76815) | $639 | $639 | 5.7× |
| Us ob transvaginal (76817) | $501 | $501 | 4.5× |
| Us pelvic non ob complete (76856) | $875 | $875 | 7.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $628 | $628 | 5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$640–$710 | $640–$710 | varies |
| Us retroperitoneal complete (76770) | $838 | $838 | 7.5× |
| Us retroperitoneal limited (76775) | $672 | $672 | 6.0× |
| Us scrotum and contents (76870) | $893 | $893 | 8.0× |
| Us spinal canal and contents (76800) | $435 | $435 | 3.9× |
| Us thyroid (76536) | $763 | $763 | 6.8× |
| Us transrectal (76872) | $797 | $797 | 7.1× |
| Vascular Flow Imaging (78445) | $1,072 | $1,072 | 2.5× |
| Vein X-Ray Chest (75827) | $3,816 | $3,816 | 2.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,755 | $3,755 | 1.1× |
| Vein X-Ray Skull Epidural (75872) | $3,755 | $3,755 | 5.6× |
| Vein X-Ray Spleen/Liver (75810) | $8,867 | $8,867 | 2.6× |
| Venogram Sinus/Jugular (75860) | $3,491 | $3,491 | 1.0× |
| Venography Adrenal Unilateral (75840) | $5,019 | $5,019 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $8,867 | $8,867 | 2.6× |
| Venography extremity bilateral rs&i (75822) | $2,689 | $2,689 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $4,355 | $4,355 | 2.6× |
| Venography Orbital Rs&I (75880) | $3,579 | $3,579 | 5.3× |
| Venography Renal Bilateral (75833) | $8,867 | $8,867 | 2.6× |
| Venography Renal Unilateral (75831) | $8,867 | $8,867 | 2.6× |
| Vertebral fracture assessment via dxa (77086) | $297 | $297 | 3.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$349–$506 | $349–$506 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $231 | $231 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $1,122 | $1,122 | 3.0× |
| X-Ray Aorta Leg Arteries (75630) | $8,867 | $8,867 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) | $460 | $460 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$303–$527 | $303–$527 | varies |
| X-Ray Exam Breast Specimen (76098) | $618 | $618 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $212 | $212 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $457 | $457 | 4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $583 | $583 | 5.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $304 | $304 | 3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$341–$385 | $341–$385 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $435 | $435 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $504 | $504 | 4.5× |
| X-Ray Exam L-S Spine Bending (72114) | $463 | $463 | 4.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $407 | $407 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $520 | $520 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $434 | $434 | 3.9× |
| X-ray eye for foreign body (70030) | $549 | $549 | 5.9× |
| X-ray humerus (73060) | $349 | $349 | 3.7× |
| X-ray IV pyelogram (ivp) (74400) | $1,125 | $1,125 | 6.0× |
| X-ray IV pyelogram+tomography (74415) | $1,635 | $1,635 | 8.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $231 | $231 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $418 | $418 | 4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $404 | $404 | 3.6× |
| X-ray nose-rectum child f.b. (76010) | $245 | $245 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $760 | $760 | 6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $335 | $335 | 3.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $279 | $279 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $344 | $344 | 3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $491 | $491 | 5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $670 | $670 | 6.0× |
| X-ray thoracic spine 4 vw (72074) | $647 | $647 | 5.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $799 | $799 | 2.1× |
| X-Rays Bone Length Studies (77073) | $449 | $449 | 4.0× |
| X-Rays Bone Survey Complete (77075) | $1,009 | $1,009 | 9.0× |
| Xr c-spine 4 or 5 views (72050) | $486 | $486 | 4.3× |
| Xr facial bones less than 3 views (70140) | $626 | $626 | 6.7× |
| Xr Tomogram Single Plane (76100) | $583 | $583 | 5.2× |
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.