Imaging prices at Northwestern Medicine Central Dupage Hospital

Winfield, IL · every code in this section with a posted price and a Medicare benchmark.

411 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295)
range across 2 matching MRF lines
$4,669–$37,820.30 $6,670–$54,029 varies
Abdomen 1 View (74018) $396.90 $567 4.3×
Abdomen 2 views (74019) $519.40 $742 4.6×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,372 $1,960 3.2×
Adrenal Cortex & Medulla Img (78075) $3,778.60 $5,398 2.7×
Angio internal mammary (75756) $1,988 $2,840 0.6×
Angio pulmonary bilat (75743) $7,009.10 $10,013 2.1×
Angiography extremity bilateral rs&i (75716) $4,183.20 $5,976 1.2×
Angiography extremity unilateral rs&i (75710) $6,422.50 $9,175 1.9×
Angiography pulmonary unilateral slctv rs&i (75741) $6,675.20 $9,536 2.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,020.90 $2,887 0.6×
Ankle 2 views (73600) $386.40 $552 4.1×
Aortography thoracic serialography rs&i (75605) $6,809.60 $9,728 1.1×
Aortography thoracic w/o serialography rs&i (75600) $3,616.90 $5,167 1.1×
Artery X-Rays Abdomen (75726) $3,462.20 $4,946 0.6×
Artery X-Rays Adrenal Gland (75731) $2,905 $4,150 0.9×
Artery X-Rays Pelvis (75736) $4,306.40 $6,152 0.7×
Artery X-Rays Spine (75705) $5,770.10 $8,243 1.0×
Arthrogram ankle (73615) $1,136.80 $1,624 3.0×
Arthrogram hip (73525) $1,407.70 $2,011 3.8×
Arthrogram Wrist (73115) $1,440.60 $2,058 3.9×
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines
$750.40–$46,884.60 $1,072–$66,978 varies
Bone age studies (77072) $462 $660 4.1×
Bone Imaging 3 Phase (78315) $1,666 $2,380 3.9×
Bone Imaging Limited Area (78300) $1,841 $2,630 4.3×
Bone Imaging Whole Body (78306) $2,215.50 $3,165 5.2×
Bone survey infant (77076) $1,250.20 $1,786 11.2×
Brachytx isodose complex (77318) $4,649.40 $6,642 11.6×
Brachytx isodose intermed (77317) $4,071.20 $5,816 10.1×
Brachytx Isodose Plan Simple (77316) $3,780.70 $5,401 9.4×
Brain Flow Imaging Only (78610) $1,183 $1,690 2.0×
Brain Image W/Flow < 4 Views (78601) $2,256.80 $3,224 5.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,261 $3,230 3.9×
Brain Imaging Pet Metabolic Evaluation (78608) $6,045.20 $8,636 3.9×
Cardiac MRI w/w/o contrast & further seq (75561) $4,342.10 $6,203 11.6×
Cardiac MRI w/w/o contrast w/stress (75563) $4,594.80 $6,564 5.5×
Cardiac Shunt Detection (78428) $2,124.50 $3,035 5.0×
Cat Scan Follow-Up Study (76380) $1,053.50 $1,505 11.3×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $3,694.60 $5,278 6.3×
Cerebrospinal Fluid Scan (78630) $3,752 $5,360 6.4×
Chest 1 view (71045) $537.60 $768 5.8×
Chest 2 views (71046) $674.10 $963 7.2×
Chest 3 views (71047) $900.20 $1,286 9.7×
Chest 4 or more views (71048) $966 $1,380 8.6×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $245.70 $351 2.2×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $440.30 $629 3.9×
Clavicle complete (73000) $547.40 $782 5.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $781.20 $1,116 7.0×
Continuing medical physics consltj pr wk (77336)
range across 2 matching MRF lines
$944.30–$49,396.90 $1,349–$70,567 varies
Contrast Exam Abdominl Aorta (75625) $4,842.60 $6,918 1.4×
Contrast X-Ray Bladder (74430) $921.20 $1,316 2.5×
Contrast X-Ray Of Elbow (73085) $765.80 $1,094 2.0×
Contrast X-Ray Of Knee Joint (73580) $2,560.60 $3,658 6.8×
CT abdomen and pelvis without and with contrast (74178) $7,105.70 $10,151 19.0×
CT abdomen and pelvis without contrast (74176) $4,802 $6,860 18.8×
CT abdomen w contrast (74160) $3,201.10 $4,573 17.0×
CT abdomen w wo contrast (74170) $3,658.90 $5,227 19.5×
CT abdomen w/o contrast (74150) $2,576 $3,680 23.0×
CT Angio Abdomen and Pelvis (74174) $5,420.10 $7,743 14.5×
CT Angio Chest (71275) $3,502.80 $5,004 18.6×
CT Angio Head (70496) $3,656.10 $5,223 19.5×
CT angio hrt w/3d image (75574) $3,641.40 $5,202 9.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,359.30 $4,799 17.9×
CT Angio Neck (70498) $3,808 $5,440 20.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,026.10 $4,323 16.1×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $2,937.20 $4,196 15.6×
CT cervical spine w/ contrast (72126) $3,497.20 $4,996 9.4×
CT cervical spine w/o contrast (72125) $3,168.20 $4,526 28.3×
CT cervical spine w/wo cont (72127) $4,095.70 $5,851 21.8×
CT chest w contrast (71260) $3,173.80 $4,534 16.9×
CT chest w/wo contrast (71270) $3,416 $4,880 18.2×
CT head/brain with contrast (70460) $2,921.80 $4,174 15.5×
CT head/brain without and with contrast (70470) $3,756.90 $5,367 20.0×
CT heart contrast eval cardiac structure&morph (75572) $3,439.10 $4,913 9.2×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines
$56–$539.70 $80–$771 varies
CT iac w contrast (70481) $3,572.10 $5,103 19.0×
CT l-spine w&w/o contrast (72133) $3,717 $5,310 19.8×
CT lower ext w/o (73700) $2,622.90 $3,747 23.4×
CT lower extremity w/contrast material (73701) $2,975.70 $4,251 15.8×
CT lumbar spine w contrast (72132) $3,506.30 $5,009 9.4×
CT lumbar spine w/o contrast (72131) $3,083.50 $4,405 27.5×
CT maxillofacial w contrast (70487) $3,161.20 $4,516 16.8×
CT maxillofacial wo contrast (70486) $2,606.10 $3,723 23.3×
CT neck tissue combo (70492) $3,704.40 $5,292 19.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,813.60 $5,448 20.3×
CT orbits w/o contrast (70480) $3,287.90 $4,697 29.3×
CT pelvis w&w/o contrast (72194) $3,318 $4,740 17.7×
CT pelvis w/o contrast (72192) $2,156.70 $3,081 19.3×
CT scan of leg combo (73702) $3,378.90 $4,827 18.0×
CT scans face/jaw combo (70488) $3,656.10 $5,223 19.5×
CT soft tissue neck w contrast (70491) $3,250.80 $4,644 17.3×
CT soft tissue neck w/o contrast (70490) $2,566.20 $3,666 22.9×
CT thoracic spine w contrast (72129) $2,947 $4,210 15.7×
CT thoracic spine w/o contrast (72128) $2,811.90 $4,017 25.1×
CT thoracic spine w/wo cont (72130) $3,208.80 $4,584 17.1×
CT thorax w/o contrast (71250) $2,611 $3,730 23.3×
CT unlisted procedure (76497) $1,941.10 $2,773 20.8×
CT upper ext wo (73200) $2,563.40 $3,662 22.9×
CT upper extremity w/o & w/contrast material (73202) $3,768.10 $5,383 20.0×
CT upper extremity with contrast (73201) $2,812.60 $4,018 7.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,889.90 $5,557 20.7×
Cta Abdomen (74175) $4,312.70 $6,161 22.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $7,464.10 $10,663 20.0×
CTA pelvis (72191) $3,382.40 $4,832 18.0×
Diskography lumbar (72295) $2,509.50 $3,585 1.2×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $387.80 $554 3.5×
Doppler Echo Fetal Spectral Display Complete (76827) $987.70 $1,411 8.8×
Doppler Fetal Mid Cerebral Artery (76821) $1,052.10 $1,503 9.4×
Dxa Bone Density Axial (77080) $637 $910 5.7×
Dxa bone density study (77085) $550.20 $786 4.9×
Dxa bone density study 1/>sites appendiclr skel (77081) $368.20 $526 3.9×
Echo exam of fetal heart (76825) $1,170.40 $1,672 2.0×
Echo exam uterus (76831) $1,399.30 $1,999 5.5×
Echo Guide For Artery Repair (76936) $721 $1,030 3.1×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $952 $1,360 3.7×
Echograp Trans R Pros Study (76873) $2,104.90 $3,007 18.8×
Esophageal Motility Study (78258) $1,381.10 $1,973 3.2×
Esophagram (74220) $828.10 $1,183 4.4×
Fetal Biophys Profile W/Nst (76818) $1,409.80 $2,014 12.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,120.70 $1,601 10.0×
Fluoroscopy up to 1 hr (76000) $1,040.90 $1,487 4.1×
Follow-Up Angiography (75898) $1,761.20 $2,516 0.5×
Foot 2 views (73620) $324.10 $463 3.5×
Forearm 2 views (73090) $515.90 $737 5.5×
Gastric emptying imaging study (78264) $1,593.20 $2,276 3.7×
Gastroesophageal Reflux Exam (78262) $1,055.60 $1,508 2.5×
Gated Heart Planar Single (78472) $2,892.40 $4,132 6.8×
GI Endoscopic US S&I (76975) $1,530.90 $2,187 6.0×
Hand 2 views (73120) $521.50 $745 4.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $6,818 $9,740 9.1×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $6,902.70 $9,861 9.2×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $5,459.30 $7,799 7.3×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,899 $5,570 1.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,462.20 $4,946 1.0×
Hepatobil Syst Image W/Drug (78227) $1,841 $2,630 3.2×
Hepatobiliary System Imaging (78226) $1,841 $2,630 4.3×
Ht Musc Image Planar Mult (78454) $3,557.40 $5,082 2.6×
Ht Muscle Image Spect Sing (78451) $4,293.10 $6,133 3.1×
Hyperthermia external generated superficial (77600) $6,412 $9,160 15.5×
Hysterosalpingogram (74740) $1,134.70 $1,621 4.4×
Image fusion (77399) $1,124.20 $1,606 7.8×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,275.40 $1,822 13.7×
Infant hip ultrasound, limited static exam (76886) $1,087.80 $1,554 11.7×
Interstitial radiation source applic complex (77778) $5,336.80 $7,624 7.2×
Joint Survey Single View (77077) $485.10 $693 4.3×
K Flow/Funct Image W/Drug (78708) $2,074.80 $2,964 3.6×
K Flow/Funct Image W/O Drug (78707) $2,039.80 $2,914 3.5×
Kidney Imaging Morphol (78700) $1,493.80 $2,134 3.5×
Knee 3 Views (73562) $598.50 $855 6.4×
Liver & Spleen Imaging Static Only (78215) $2,182.60 $3,118 5.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,261.40 $1,802 2.9×
Liver imaging static only (78201) $1,508.50 $2,155 2.6×
Lung Perf&Ventilat Diferentl (78598) $2,243.50 $3,205 3.9×
Lung perfusion differential (78597) $1,313.20 $1,876 3.1×
Lung Ventilat&Perfus Imaging (78582) $2,198 $3,140 3.8×
Lung Ventilation Imaging (78579) $1,782.90 $2,547 4.2×
Lymph System Imaging (78195) $1,883 $2,690 3.2×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $1,635.90 $2,337 1.0×
Lymphangiography extremity only unilateral rs&i (75801) $1,558.20 $2,226 2.3×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,283.40 $3,262 0.7×
Lymphangiography, pelvic/abdominal, unilateral (75805) $898.10 $1,283 0.3×
Magnetic Image Jaw Joint (70336) $3,850 $5,500 15.1×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $5,653.90 $8,077 30.1×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $5,490.80 $7,844 9.4×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $6,161.40 $8,802 32.8×
Magnetic Resonance Elastography (76391) $493.50 $705 1.9×
Meckels Divert Exam (78290) $1,292.90 $1,847 3.0×
Mlc imrt design & construction per imrt plan (77338)
range across 2 matching MRF lines
$3,426.50–$54,317.90 $4,895–$77,597 varies
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $65.10 $93 2.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $214.20 $306 2.1×
Mr safety implt pos&/immoblj (76019) $133 $190 2.1×
Mra Head W/O & W/Contrast Material (70546) $5,710.60 $8,158 15.3×
MRA head w/o contrast (70544) $3,946.60 $5,638 15.4×
MRA head with contrast (70545) $4,889.50 $6,985 13.1×
MRA neck w contrast (70548) $3,843 $5,490 10.3×
Mra Neck W/O &W/Contrast Material (70549) $4,370.10 $6,243 11.7×
MRA neck w/o contrast (70547) $3,378.90 $4,827 13.2×
MRI abdomen w contrast (74182) $3,770.20 $5,386 10.1×
MRI abdomen w/o contrast (74181) $3,700.20 $5,286 14.5×
MRI any jt lower extrem w/contrast material (73722) $4,038.30 $5,769 4.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,428.90 $6,327 11.8×
MRI any jt upper extremity w/contrast matrl (73222) $3,827.60 $5,468 4.6×
MRI brain functional w/o physician admnistration (70554) $3,640 $5,200 14.2×
MRI brain functional w/physician admnistration (70555) $4,162.20 $5,946 16.3×
MRI Breast W/O Contrast Bilateral (77047) $3,491.60 $4,988 13.7×
MRI Breast Without Contrast Material Unilateral (77046) $3,670.10 $5,243 14.4×
MRI cardiac w/o contrast (75557) $3,834.60 $5,478 15.0×
MRI cervical spine w contrast (72142) $4,534.60 $6,478 12.1×
MRI cervical spine w/o cont (72141) $4,171.30 $5,959 16.3×
MRI chest w/o contrast (71550) $2,934.40 $4,192 11.5×
MRI chest with contrast (71551) $3,717.70 $5,311 4.4×
MRI chest wo w contrast (71552) $4,372.20 $6,246 11.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,678.50 $5,255 9.8×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,053 $5,790 10.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,432.80 $4,904 13.4×
MRI lumbar spine w contrast (72149) $4,172.70 $5,961 11.2×
Mri Neck Spine W/O & W/Dye (72156) $5,142.90 $7,347 13.8×
MRI orbit face &/neck w/o contrast (70540) $4,151 $5,930 16.2×
MRI orbit face neck w contrast (70542) $4,818.10 $6,883 12.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $5,085.50 $7,265 13.6×
MRI pelvis w contrast (72196) $3,948 $5,640 10.6×
MRI pelvis w/o & w contrast (72197) $4,765.60 $6,808 12.7×
MRI pelvis w/o contrast (72195) $3,615.50 $5,165 14.1×
MRI spectroscopy (76390) $2,207.10 $3,153 23.7×
MRI thoracic spine w/o contrast (72146) $3,809.40 $5,442 14.9×
MRI upper extremity oth than jt w/contr matrl (73219) $3,628.10 $5,183 9.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,502.10 $5,003 13.7×
Mri Uppr Extremity W/O&W/Dye (73220) $4,088 $5,840 10.9×
MRI, abdomen, combo (74183) $4,385.50 $6,265 11.7×
MRI, dorsal spine combo (72157) $4,696.30 $6,709 12.6×
MRI, dorsal spine contrast (72147) $4,101.30 $5,859 11.0×
MRI, joint upper extrem (73221) $3,591.70 $5,131 14.0×
MRI, joint upper extrem combo (73223) $4,323.90 $6,177 11.6×
MRI, lumbar spine combo (72158) $4,706.80 $6,724 12.6×
Myocardial Imaging Pet Metabolic Evaluation (78459) $1,990.10 $2,843 1.4×
Myocardial Spect Multiple Studies (78452) $5,866.70 $8,381 4.2×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $2,254.70 $3,221 1.5×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $3,881.50 $5,545 2.5×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $6,054.30 $8,649 2.6×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $7,398.30 $10,569 3.1×
N-invas est c ffr sw aly CTA (75580) $3,235.40 $4,622 3.5×
Neck soft tissue (70360) $378 $540 4.1×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $544.60 $778 1.3×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $862.40 $1,232 2.0×
Nm csf leak detection (78650) $4,918.90 $7,027 3.5×
Nonvascular Shunt X-Ray (75809) $523.60 $748 4.7×
Ntsty modul radthx pln dose-vol histos (77301)
range across 2 matching MRF lines
$12,994.80–$51,104.20 $18,564–$73,006 varies
Nuclear Rx Intra-Arterial (79445) $1,193.50 $1,705 4.8×
Nuclear Rx Oral Admin (79005) $2,259.60 $3,228 9.0×
Ob us nuchal meas 1 gest (76813) $940.80 $1,344 8.4×
Panoramic X-ray of jaws (70355) $692.30 $989 7.4×
Parathyroid imaging w/tomographic spect & CT (78072) $2,671.20 $3,816 4.6×
Parathyroid Planar Imaging (78070) $2,422.70 $3,461 5.7×
Pelvis 1 or 2 views (72170) $576.10 $823 5.1×
Peritoneogram Rs&I (74190) $739.90 $1,057 1.3×
Pet Image Skull-Thigh (78812) $5,630.10 $8,043 3.7×
Pet Image W/Ct Lmtd (78814) $5,609.80 $8,014 3.7×
PET image w/CT, full body (78816) $5,905.20 $8,436 3.9×
PET imaging CT attenuation skull base mid-thigh (78815) $5,905.20 $8,436 3.9×
Pet Imaging Limited Area Chest Head/Neck (78811) $5,712 $8,160 4.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $3,871 $5,530 1.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,829.10 $2,613 4.3×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $2,093.70 $2,991 2.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $620.20 $886 5.5×
Radex abscess/fistula/sinus tract rs&i (76080) $1,332.10 $1,903 2.3×
Radex Ankle Complete Minimum 3 Views (73610) $541.80 $774 5.8×
Radex Calcaneus Minimum 2 Views (73650) $468.30 $669 5.0×
Radex elbow complete minimum 3 views (73080) $577.50 $825 6.2×
Radex Facial Bones Complete Minimum 3 Views (70150) $897.40 $1,282 8.0×
Radex fingr minimum 2 views (73140) $458.50 $655 4.9×
Radex foot complete minimum 3 views (73630) $594.30 $849 6.4×
Radex Hand Minimum 3 Views (73130) $547.40 $782 5.9×
Radex lower extremity infant minimum 2 views (73592) $478.80 $684 5.1×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $531.30 $759 4.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $716.10 $1,023 7.7×
Radex Ribs Unilateral 2 Views (71100) $659.40 $942 7.1×
Radex shoulder complete minimum 2 views (73030) $623 $890 6.7×
Radex Sinuses Paransl < 3 Views (70210) $266.70 $381 2.9×
Radex Spine 1 View Specify Level (72020) $450.10 $643 4.8×
Radex Sternum Minimum 2 Views (71120) $538.30 $769 5.8×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $803.60 $1,148 8.6×
Radex Toe Minimum 2 Views (73660) $436.10 $623 4.7×
Radex upper extremity infant minimum 2 views (73092) $451.50 $645 4.0×
Radex Wrist Complete Minimum 3 Views (73110) $492.80 $704 5.3×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $2,067.10 $2,953 18.5×
Radiation Delivery Stereotactic Cranial Linear (77372) $25,706.80 $36,724 3.3×
Radiation treatment delivery level 1 (77402)
range across 2 matching MRF lines
$807.80–$4,378.50 $1,154–$6,255 varies
Radiation treatment delivery level 2 (77407) $1,054.20 $1,506 2.6×
Radiation treatment delivery level 3 (77412)
range across 2 matching MRF lines
$3,561.60–$32,584.30 $5,088–$46,549 varies
Radiolog exam mandible compl minimum 4 views (70110) $719.60 $1,028 6.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $574 $820 5.1×
Radiologic exam colon double contrast study (74280) $1,260 $1,800 6.7×
Radiologic exam colon single contrast study (74270) $1,225.70 $1,751 6.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $855.40 $1,222 4.6×
Radiologic exam knee complete 4/more views (73564) $724.50 $1,035 6.5×
Radiologic exam pelvis compl minimum 3 views (72190) $687.40 $982 6.1×
Radiologic Exam Small Int Single Contrast Study (74250) $790.30 $1,129 4.2×
Radiologic exam swallow function contrast study (74230) $666.40 $952 3.5×
Radiologic exam upr gi trc double contrast study (74246) $1,048.60 $1,498 5.6×
Radiologic examination femur 1 view (73551) $426.30 $609 4.6×
Radiologic examination femur minimum 2 views (73552) $566.30 $809 6.1×
Radiologic examination knee 1/2 views (73560) $556.50 $795 6.0×
Radiologic Examination Osseous Survey Limited (77074) $1,142.40 $1,632 10.2×
Radiologic examination tibia & fibula 2 views (73590) $536.90 $767 5.8×
Renal Cyst Study (74470) $940.80 $1,344 1.6×
Ribs bilateral 3 views (71110) $787.50 $1,125 7.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,706.20 $3,866 6.3×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,998.80 $4,284 5.2×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,370.90 $3,387 4.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,627.10 $3,753 4.5×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,576 $3,680 1.9×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $2,765.70 $3,951 2.0×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $2,400.30 $3,429 9.6×
Rp Therapy Intravenous Administration (79101) $1,403.50 $2,005 5.6×
Rp Therapy Unlisted Procedure (79999) $549.50 $785 2.2×
Salivary Gland Imaging (78230) $975.10 $1,393 2.3×
Scapula (73010) $500.50 $715 4.5×
Screening Digital Breast Tomosynthesis Bi (77063) $125.30 $179 5.4×
Shoulder 1 view (73020) $415.10 $593 4.5×
Shoulder Arthrography (73040) $1,299.20 $1,856 3.5×
Sialogram (70390) $1,460.20 $2,086 5.7×
Skull less than 4 views (70250) $484.40 $692 4.3×
Special dosimetry (77331)
range across 2 matching MRF lines
$753.20–$26,872.30 $1,076–$38,389 varies
Special Physics Consult (77370)
range across 2 matching MRF lines
$1,398.60–$49,199.50 $1,998–$70,285 varies
Special teletherapy port plan (77321)
range across 2 matching MRF lines
$1,821.40–$28,321.82 $2,602–$40,459.74 varies
Special treatment procedure (77470)
range across 2 matching MRF lines
$3,416.70–$44,673.30 $4,881–$63,819 varies
Srs Multisource (77371)
range across 3 matching MRF lines
$28,596.40–$65,189.60 $40,852–$93,128 varies
Stereotactic Body Radiation Delivery (77373)
range across 2 matching MRF lines
$7,599.20–$42,926.80 $10,856–$61,324 varies
Sternoclavicular joints (71130) $706.30 $1,009 7.6×
Superior sagittal sinus venogram (75870) $1,862 $2,660 0.6×
Surface Applic Low Dose Rate Radionuclide Source (77789) $282.80 $404 2.6×
Tbs technical calculation only (77091) $196 $280 2.1×
Telethx isodose pln cplx w/basic dosimetry (77307)
range across 2 matching MRF lines
$2,722.30–$23,879.80 $3,889–$34,114 varies
Telethx isodose pln smpl w/dosimetry calculation (77306)
range across 2 matching MRF lines
$1,719.20–$2,608.90 $2,456–$3,727 varies
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines
$4,291.70–$26,740 $6,131–$38,200 varies
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $3,812.90 $5,447 9.5×
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines
$2,430.40–$29,229.20 $3,472–$41,756 varies
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $519.40 $742 2.8×
Thoracic spine 2 views (72070) $697.90 $997 6.2×
Thoracic spine 3 views (72072) $778.40 $1,112 6.9×
Thoracolumbar 2 views (72080) $649.60 $928 7.0×
Thyroid Imaging With Vascular Flow (78013) $865.20 $1,236 2.0×
Thyroid Met Imaging Body (78018) $1,532.30 $2,189 2.6×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,107.40 $1,582 2.6×
Tx Devices Design & Construction Complex (77334)
range across 2 matching MRF lines
$1,754.90–$27,477.10 $2,507–$39,253 varies
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines
$1,134.70–$4,935.70 $1,621–$7,051 varies
Tx devices design & construction simple (77332)
range across 2 matching MRF lines
$889.70–$22,254.40 $1,271–$31,792 varies
Ultrasound Breast Limited (76642) $438.90 $627 4.7×
Ultrasound elastography first target lesion (76982) $482.30 $689 4.3×
Ultrasound Elastography Parenchyma (76981) $482.30 $689 4.3×
Ultrasound Exam Aaa Screen (76706) $852.60 $1,218 7.6×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $3,213 $4,590 8.6×
Ultrasound, abdomen limited (76705) $1,604.40 $2,292 14.3×
Umbilical-artery Doppler (OB) (76820) $969.50 $1,385 8.7×
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines
$76.30–$5,055.40 $109–$7,222 varies
Unlisted fluoroscopic procedure (76496)
range across 9 matching MRF lines
$877.80–$26,511.80 $1,254–$37,874 varies
Unlisted magnetic resonance procedure (76498) $2,110.50 $3,015 22.6×
Unlisted us procedure (76999) $105 $150 1.1×
Upper gi w/o kub (74240) $822.50 $1,175 4.4×
Urethrocystogram voiding (74455) $897.40 $1,282 3.5×
Urethrocystography retrograde (74450) $839.30 $1,199 3.3×
Us breast unilateral complete (76641) $532 $760 4.7×
Us chest (76604) $1,039.50 $1,485 9.3×
Us complete joint (76881) $1,269.80 $1,814 11.3×
Us exam, pelvic, limited (76857) $862.40 $1,232 7.7×
Us head (76506) $1,406.30 $2,009 12.6×
Us kidney transplant (76776) $1,237.60 $1,768 11.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $774.90 $1,107 6.9×
Us ob detailed single fetus (76811) $1,360.80 $1,944 5.3×
Us ob limited 1 or more fetuses (76815) $718.90 $1,027 6.4×
Us ob transvaginal (76817) $749 $1,070 6.7×
Us pelvic non ob complete (76856) $1,509.90 $2,157 13.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $940.80 $1,344 8.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $830.90 $1,187 7.4×
Us retroperitoneal complete (76770) $1,474.20 $2,106 13.2×
Us retroperitoneal limited (76775) $1,313.20 $1,876 11.7×
Us scrotum and contents (76870) $1,376.90 $1,967 12.3×
Us spinal canal and contents (76800) $1,559.60 $2,228 13.9×
Us thyroid (76536) $1,343.30 $1,919 12.0×
Us transrectal (76872) $1,085 $1,550 9.7×
Vein X-Ray Chest (75827) $2,644.60 $3,778 1.6×
Vein X-Ray Liver W/O Hemodyn (75887) $2,452.80 $3,504 0.7×
Vein X-Ray Spleen/Liver (75810) $1,512.70 $2,161 0.4×
Venogram Sinus/Jugular (75860) $2,597 $3,710 0.8×
Venography caval inferior serialography rs&i (75825) $3,923.50 $5,605 1.2×
Venography extremity bilateral rs&i (75822) $2,265.20 $3,236 1.3×
Venography extremity unilateral rs&i (75820) $1,736 $2,480 1.0×
Venography Orbital Rs&I (75880) $1,353.10 $1,933 2.0×
Venography Renal Bilateral (75833) $3,885 $5,550 1.1×
Venography Renal Unilateral (75831) $3,749.20 $5,356 1.1×
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure
$2,668.40 $3,812 0.4×
Vertebral fracture assessment via dxa (77086) $411.60 $588 4.4×
Wrist 2 views (73100) $399.70 $571 4.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $764.40 $1,092 8.2×
X-ray antegrade pyelogram tube (74425) $1,262.80 $1,804 3.4×
X-Ray Aorta Leg Arteries (75630) $4,862.90 $6,947 1.4×
X-Ray Bend Only L-S Spine (72120) $637 $910 5.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $367.50 $525 3.9×
X-Ray Exam Breast Specimen (76098) $790.30 $1,129 1.3×
X-Ray Exam Entire Spi 1 Vw (72081) $613.20 $876 6.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $746.90 $1,067 6.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $823.20 $1,176 7.3×
X-Ray Exam Hip Uni 1 View (73501) $497 $710 5.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $522.90 $747 5.6×
X-Ray Exam Hip Uni 4/> Views (73503) $1,071 $1,530 9.6×
X-Ray Exam Hips Bi 2 Views (73521) $896 $1,280 8.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $940.80 $1,344 8.4×
X-Ray Exam Hips Bi 5/> Views (73523) $987.70 $1,411 8.8×
X-Ray Exam L-S Spine Bending (72114) $1,169 $1,670 10.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $665.70 $951 7.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $985.60 $1,408 8.8×
X-Ray Exam Unilat Ribs/Chest (71101) $782.60 $1,118 7.0×
X-ray eye for foreign body (70030) $379.40 $542 4.1×
X-ray humerus (73060) $619.50 $885 6.6×
X-ray IV pyelogram (ivp) (74400) $1,164.80 $1,664 6.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $524.30 $749 5.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $481.60 $688 5.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $651.70 $931 5.8×
X-ray nose-rectum child f.b. (76010) $406 $580 4.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $988.40 $1,412 8.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $690.90 $987 6.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $744.10 $1,063 8.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $840.70 $1,201 9.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $812 $1,160 7.2×
X-Ray Stress View (77071) $367.50 $525 3.9×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,158.50 $1,655 3.1×
X-Rays Bone Length Studies (77073) $770.70 $1,101 6.9×
X-Rays Bone Survey Complete (77075) $1,484 $2,120 13.2×
Xr c-spine 4 or 5 views (72050) $943.60 $1,348 8.4×
Xr facial bones less than 3 views (70140) $408.10 $583 4.4×
Xr orbits complete 4 views (70200) $828.10 $1,183 7.4×

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.