Imaging prices at Norwalk Hospital

Norwalk, CT · every code in this section with a posted price and a Medicare benchmark.

391 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) $8,721 $8,721 5.3×
Abdomen 1 View (74018) $248 $248 2.4×
Abdomen 2 views (74019) $301 $301 2.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $967 $967 2.0×
Angio internal mammary (75756) $9,924 $9,924 2.6×
Angio pulmonary bilat (75743) $9,924 $9,924 2.6×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $9,924 $9,924 2.6×
Angiography extremity bilateral rs&i (75716) $9,924 $9,924 2.6×
Angiography extremity unilateral rs&i (75710) $9,924 $9,924 2.6×
Angiography pulmonary unilateral slctv rs&i (75741) $9,924 $9,924 2.6×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $9,924 $9,924 2.6×
Ankle 2 views (73600) $203 $203 1.9×
Aortography thoracic serialography rs&i (75605) $17,110 $17,110 2.6×
Artery X-Rays Abdomen (75726) $17,110 $17,110 2.6×
Artery X-Rays Adrenal Gland (75731) $9,924 $9,924 2.6×
Artery X-Rays Pelvis (75736) $17,110 $17,110 2.6×
Artery X-Rays Spine (75705) $17,110 $17,110 2.6×
Arthrogram ankle (73615) $858 $858 2.1×
Arthrogram hip (73525) $1,197 $1,197 2.9×
Arthrogram Wrist (73115) $858 $858 2.1×
Basic radiation dosimetry calculation (77300) $973 $973 6.0×
Bone age studies (77072) $246 $246 2.0×
Bone Imaging 3 Phase (78315) $967 $967 2.0×
Bone Imaging Limited Area (78300) $967 $967 2.0×
Bone Imaging Multiple Areas (78305) $967 $967 2.0×
Bone Imaging Whole Body (78306) $967 $967 2.0×
Bone marrow imaging limited area (78102) $830 $830 1.7×
Bone marrow imaging; multiple areas (78103) $967 $967 2.0×
Bone marrow imaging; whole body (78104) $967 $967 2.0×
Bone survey infant (77076) $246 $246 2.0×
Brachytx isodose complex (77318) $1,824 $1,824 4.1×
Brachytx isodose intermed (77317) $1,192 $1,192 2.7×
Brachytx Isodose Plan Simple (77316) $666 $666 1.5×
Brain Image W/Flow < 4 Views (78601) $967 $967 2.0×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,268 $1,268 1.9×
Brain Imaging Pet Metabolic Evaluation (78608) $3,669 $3,669 2.1×
Cardiac MRI w/w/o contrast & further seq (75561) $1,701 $1,701 4.1×
Cat Scan Follow-Up Study (76380) $891 $891 8.5×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,268 $1,268 1.9×
Cerebrospinal Fluid Scan (78630) $1,268 $1,268 1.9×
Chest 1 view (71045) $374 $374 3.6×
Chest 2 views (71046) $374 $374 3.6×
Chest 3 views (71047) $374 $374 3.6×
Chest 4 or more views (71048) $454 $454 3.6×
Clavicle complete (73000) $203 $203 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $306 $306 2.4×
Continuing medical physics consltj pr wk (77336) $973 $973 6.0×
Contrast Exam Abdominl Aorta (75625) $9,924 $9,924 2.6×
Contrast X-Ray Bladder (74430) $1,053 $1,053 2.5×
Contrast X-Ray Of Knee Joint (73580) $858 $858 2.1×
CT abdomen and pelvis without and with contrast (74178) $3,770 $3,770 9.0×
CT abdomen and pelvis without contrast (74176) $2,402 $2,402 8.4×
CT abdomen w contrast (74160) $1,801 $1,801 8.6×
CT abdomen w wo contrast (74170) $1,801 $1,801 8.6×
CT abdomen w/o contrast (74150) $1,078 $1,078 8.6×
CT Angio Abdomen and Pelvis (74174) $3,770 $3,770 9.0×
CT Angio Chest (71275) $1,801 $1,801 8.6×
CT Angio Head (70496) $1,974 $1,974 9.4×
CT angio hrt w/3d image (75574) $1,801 $1,801 4.3×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,801 $1,801 8.6×
CT Angio Neck (70498) $1,974 $1,974 9.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,801 $1,801 8.6×
CT cervical spine w/ contrast (72126) $4,134 $4,134 9.9×
CT cervical spine w/o contrast (72125) $1,181 $1,181 9.4×
CT cervical spine w/wo cont (72127) $1,974 $1,974 9.4×
CT chest w contrast (71260) $1,801 $1,801 8.6×
CT chest w/wo contrast (71270) $1,801 $1,801 8.6×
CT colonography screening (74263) $2,578 $2,578 9.0×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,801 $1,801 8.6×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,078 $1,078 8.6×
CT head/brain with contrast (70460) $1,974 $1,974 9.4×
CT head/brain without and with contrast (70470) $1,974 $1,974 9.4×
CT heart contrast eval cardiac structure&morph (75572) $1,801 $1,801 4.3×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 0.9×
CT iac w contrast (70481) $1,974 $1,974 9.4×
CT l-spine w&w/o contrast (72133) $1,801 $1,801 8.6×
CT lower ext w/o (73700) $1,078 $1,078 8.6×
CT lower extremity w/contrast material (73701) $1,801 $1,801 8.6×
CT lumbar spine w contrast (72132) $3,770 $3,770 9.0×
CT lumbar spine w/o contrast (72131) $1,078 $1,078 8.6×
CT maxillofacial w contrast (70487) $1,974 $1,974 9.4×
CT maxillofacial wo contrast (70486) $1,181 $1,181 9.4×
CT neck tissue combo (70492) $1,974 $1,974 9.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,974 $1,974 9.4×
CT orbits w/o contrast (70480) $1,181 $1,181 9.4×
CT pelvis w&w/o contrast (72194) $1,801 $1,801 8.6×
CT pelvis w/o contrast (72192) $1,078 $1,078 8.6×
CT scan of leg combo (73702) $1,801 $1,801 8.6×
CT scans face/jaw combo (70488) $1,974 $1,974 9.4×
CT soft tissue neck w contrast (70491) $1,974 $1,974 9.4×
CT soft tissue neck w/o contrast (70490) $1,181 $1,181 9.4×
CT thoracic spine w contrast (72129) $1,801 $1,801 8.6×
CT thoracic spine w/o contrast (72128) $1,078 $1,078 8.6×
CT thoracic spine w/wo cont (72130) $1,801 $1,801 8.6×
CT thorax w/o contrast (71250) $1,078 $1,078 8.6×
CT unlisted procedure (76497) $891 $891 8.5×
CT upper ext wo (73200) $1,078 $1,078 8.6×
CT upper extremity w/o & w/contrast material (73202) $1,801 $1,801 8.6×
CT upper extremity with contrast (73201) $3,770 $3,770 9.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,801 $1,801 8.6×
Cta Abdomen (74175) $1,801 $1,801 8.6×
CTA pelvis (72191) $1,801 $1,801 8.6×
Dilation ureters/urethra rs&i (74485) $5,575 $5,575 2.2×
Diskography lumbar (72295) $4,311 $4,311 1.8×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $518 $518 4.1×
Doppler Echo Fetal Spectral Display Complete (76827) $518 $518 4.1×
Doppler Fetal Mid Cerebral Artery (76821) $342 $342 2.7×
Dxa Bone Density Axial (77080) $246 $246 2.0×
Dxa bone density study (77085) $342 $342 2.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $203 $203 1.9×
Echo exam of fetal heart (76825) $2,604 $2,604 4.0×
Echo exam uterus (76831) $1,156 $1,156 4.0×
Echo Guide For Artery Repair (76936) $976 $976 3.8×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,156 $1,156 4.0×
Echograp Trans R Pros Study (76873) $518 $518 4.1×
Esophagram (74220) $503 $503 2.4×
Fetal Biophys Profile W/Nst (76818) $518 $518 4.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $518 $518 4.1×
Fluoroscopy up to 1 hr (76000) $761 $761 2.7×
Follow-Up Angiography (75898) $9,924 $9,924 2.6×
Foot 2 views (73620) $203 $203 1.9×
Forearm 2 views (73090) $203 $203 1.9×
Gastric emptying imaging study (78264) $967 $967 2.0×
Gastroesophageal Reflux Exam (78262) $967 $967 2.0×
Gated Heart Planar Single (78472) $967 $967 2.0×
Gated Heart, Multiple (78473) $967 $967 2.0×
Hand 2 views (73120) $246 $246 2.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $5,126 $5,126 6.1×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,877 $4,877 5.8×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $4,845 $4,845 5.8×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $9,924 $9,924 2.6×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $9,924 $9,924 2.6×
Hepatobil Syst Image W/Drug (78227) $1,268 $1,268 1.9×
Hepatobiliary System Imaging (78226) $967 $967 2.0×
Ht Muscle Image Spect Sing (78451) $3,330 $3,330 2.1×
Hysterosalpingogram (74740) $671 $671 2.3×
Infant hip ultrasound with hip movement (dynamic) (76885) $427 $427 4.1×
Interstitial radiation source applic complex (77778) $7,756 $7,756 9.3×
K Flow/Funct Image Multiple (78709) $1,268 $1,268 1.9×
K Flow/Funct Image W/Drug (78708) $1,268 $1,268 1.9×
K Flow/Funct Image W/O Drug (78707) $1,268 $1,268 1.9×
Kidney Imaging Morphol (78700) $1,308 $1,308 2.7×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $967 $967 2.0×
Knee 3 Views (73562) $203 $203 1.9×
Leveen/Shunt Patency Exam (78291) $967 $967 2.0×
Liver & Spleen Imaging Static Only (78215) $967 $967 2.0×
Liver & Spleen Imaging W/Vascular Flow (78216) $967 $967 2.0×
Liver imaging static only (78201) $1,268 $1,268 1.9×
Lung Perf&Ventilat Diferentl (78598) $1,268 $1,268 1.9×
Lung Ventilat&Perfus Imaging (78582) $1,268 $1,268 1.9×
Lymph System Imaging (78195) $1,268 $1,268 1.9×
Lymphangiography extremity only unilateral rs&i (75801) $1,955 $1,955 2.6×
Lymphangiography, pelvic/abdominal, unilateral (75805) $9,924 $9,924 2.6×
Magnetic Image Jaw Joint (70336) $1,083 $1,083 3.8×
Magnetic Resonance Elastography (76391) $1,083 $1,083 3.8×
Mammary ductogram or galactogram single (77053) $1,011 $1,011 3.5×
Meckels Divert Exam (78290) $967 $967 2.0×
Mlc imrt design & construction per imrt plan (77338) $2,574 $2,574 5.7×
Mra Head W/O & W/Contrast Material (70546) $1,678 $1,678 4.0×
MRA head w/o contrast (70544) $1,069 $1,069 3.7×
MRA head with contrast (70545) $1,678 $1,678 4.0×
MRA neck w contrast (70548) $1,678 $1,678 4.0×
Mra Neck W/O &W/Contrast Material (70549) $1,678 $1,678 4.0×
MRA neck w/o contrast (70547) $1,069 $1,069 3.7×
MRI abdomen w contrast (74182) $1,701 $1,701 4.1×
MRI abdomen w/o contrast (74181) $1,083 $1,083 3.8×
MRI any jt lower extrem w/contrast material (73722) $3,540 $3,540 3.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,540 $3,540 8.5×
MRI any jt upper extremity w/contrast matrl (73222) $3,540 $3,540 3.8×
MRI Breast W/O Contrast Bilateral (77047) $1,083 $1,083 3.8×
MRI Breast Without Contrast Material Unilateral (77046) $1,083 $1,083 3.8×
MRI cardiac w/o contrast (75557) $1,083 $1,083 3.8×
MRI cervical spine w contrast (72142) $1,678 $1,678 4.0×
MRI cervical spine w/o cont (72141) $1,069 $1,069 3.7×
MRI chest w/o contrast (71550) $1,083 $1,083 3.8×
MRI chest with contrast (71551) $3,540 $3,540 3.8×
MRI chest wo w contrast (71552) $1,701 $1,701 4.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,701 $1,701 4.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,701 $1,701 4.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,083 $1,083 3.8×
MRI lumbar spine w contrast (72149) $1,701 $1,701 4.1×
Mri Neck Spine W/O & W/Dye (72156) $1,678 $1,678 4.0×
MRI orbit face &/neck w/o contrast (70540) $1,069 $1,069 3.7×
MRI orbit face neck w contrast (70542) $1,678 $1,678 4.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,678 $1,678 4.0×
MRI pelvis w contrast (72196) $1,701 $1,701 4.1×
MRI pelvis w/o & w contrast (72197) $1,701 $1,701 4.1×
MRI pelvis w/o contrast (72195) $1,083 $1,083 3.8×
MRI spectroscopy (76390) $401 $401 3.8×
MRI thoracic spine w/o contrast (72146) $1,083 $1,083 3.8×
MRI upper extremity oth than jt w/contr matrl (73219) $1,701 $1,701 4.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,083 $1,083 3.8×
Mri Uppr Extremity W/O&W/Dye (73220) $1,701 $1,701 4.1×
MRI, abdomen, combo (74183) $1,701 $1,701 4.1×
MRI, dorsal spine combo (72157) $1,701 $1,701 4.1×
MRI, dorsal spine contrast (72147) $1,701 $1,701 4.1×
MRI, joint upper extrem (73221) $1,083 $1,083 3.8×
MRI, joint upper extrem combo (73223) $1,701 $1,701 4.1×
MRI, lumbar spine combo (72158) $1,701 $1,701 4.1×
Myelogram cervical (72240) $2,492 $2,492 2.7×
Myelogram Lumbar (72265) $2,492 $2,492 2.7×
Myelography thoracic (72255) $2,492 $2,492 2.7×
Myelograpy 2/more regions rs&i (72270) $3,096 $3,096 3.3×
Myocardial Imaging Pet Metabolic Evaluation (78459)
range across 2 matching MRF lines		 $3,330–$7,938 $3,330–$7,938 varies
Myocardial Spect Multiple Studies (78452) $3,330 $3,330 2.1×
N-invas est c ffr sw aly CTA (75580) $13,129 $13,129 12.8×
Neck soft tissue (70360) $248 $248 2.4×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $1,588 $1,588 3.4×
Nm csf leak detection (78650) $3,330 $3,330 2.1×
Nm myocard infarct spect (78469) $1,268 $1,268 1.9×
Nonvascular Shunt X-Ray (75809) $301 $301 2.4×
Ntsty modul radthx pln dose-vol histos (77301) $8,721 $8,721 5.3×
Nuclear Rx Intra-Arterial (79445) $584 $584 2.1×
Nuclear Rx Oral Admin (79005) $584 $584 2.1×
Ob us nuchal meas 1 gest (76813) $518 $518 4.1×
Ophthalmic Ultrasonic Foreign Body Localization (76529)
range across 2 matching MRF lines		 $123–$427 $123–$427 varies
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 2 matching MRF lines		 $117–$518 $117–$518 varies
Ophthalmic us dx quantitative a-scan only (76511)
range across 2 matching MRF lines		 $137–$524 $137–$524 varies
Panoramic X-ray of jaws (70355) $203 $203 1.9×
Parathyroid Planar Imaging (78070) $967 $967 2.0×
Parathyroid planar imaging w/wo subtraction (78071) $967 $967 2.0×
Pelvis 1 or 2 views (72170) $246 $246 2.0×
Pet Image W/Ct Lmtd (78814) $3,669 $3,669 2.1×
PET image w/CT, full body (78816) $3,669 $3,669 2.1×
PET imaging CT attenuation skull base mid-thigh (78815)
range across 3 matching MRF lines		 $3,669–$6,766 $3,669–$6,766 varies
Pet Myocardial Sngl Study (78491) $3,669 $3,669 2.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $9,924 $9,924 2.6×
Pulmonary Perfusion Imaging Particulate (78580) $967 $967 2.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $301 $301 2.4×
Radex abscess/fistula/sinus tract rs&i (76080) $1,510 $1,510 2.3×
Radex Ankle Complete Minimum 3 Views (73610) $203 $203 1.9×
Radex Calcaneus Minimum 2 Views (73650) $203 $203 1.9×
Radex elbow complete minimum 3 views (73080) $203 $203 1.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $246 $246 2.0×
Radex fingr minimum 2 views (73140) $203 $203 1.9×
Radex foot complete minimum 3 views (73630) $203 $203 1.9×
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $246–$304 $246–$304 varies
Radex lower extremity infant minimum 2 views (73592) $203 $203 1.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $203 $203 1.9×
Radex Ribs Unilateral 2 Views (71100)
range across 3 matching MRF lines		 $203–$307 $203–$307 varies
Radex shoulder complete minimum 2 views (73030) $203 $203 1.9×
Radex Sinuses Paransl < 3 Views (70210) $203 $203 1.9×
Radex Spine 1 View Specify Level (72020) $203 $203 1.9×
Radex Sternum Minimum 2 Views (71120) $203 $203 1.9×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $203 $203 1.9×
Radex Toe Minimum 2 Views (73660) $203 $203 1.9×
Radex upper extremity infant minimum 2 views (73092) $246 $246 2.0×
Radex Wrist Complete Minimum 3 Views (73110) $203 $203 1.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $246 $246 2.0×
Radiation Delivery Stereotactic Cranial Linear (77372) $29,234 $29,234 3.3×
Radiation treatment delivery level 1 (77402) $991 $991 8.1×
Radiation treatment delivery level 2 (77407) $1,261 $1,261 2.7×
Radiation treatment delivery level 3 (77412) $1,684 $1,684 2.5×
Radiolog exam mandible compl minimum 4 views (70110) $246 $246 2.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $301 $301 2.4×
Radiologic exam colon double contrast study (74280) $503 $503 2.4×
Radiologic exam colon single contrast study (74270) $503 $503 2.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $503 $503 2.4×
Radiologic exam knee complete 4/more views (73564) $246 $246 2.0×
Radiologic exam pelvis compl minimum 3 views (72190) $246 $246 2.0×
Radiologic Exam Small Int Single Contrast Study (74250) $503 $503 2.4×
Radiologic exam swallow function contrast study (74230) $503 $503 2.4×
Radiologic exam upr gi trc double contrast study (74246) $503 $503 2.4×
Radiologic examination femur 1 view (73551) $203 $203 1.9×
Radiologic examination femur minimum 2 views (73552) $203 $203 1.9×
Radiologic examination knee 1/2 views (73560) $203 $203 1.9×
Radiologic Examination Osseous Survey Limited (77074) $246 $246 2.0×
Radiologic examination tibia & fibula 2 views (73590) $203 $203 1.9×
Radiopharm Dacryocystography (78660) $967 $967 2.0×
Ribs bilateral 3 views (71110) $246 $246 2.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $967 $967 2.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,330 $3,330 5.1×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,330 $3,330 5.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,330 $3,330 5.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,330 $3,330 2.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,669 $3,669 2.1×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,330 $3,330 2.1×
Rp Therapy Intravenous Administration (79101) $584 $584 2.1×
Scapula (73010) $246 $246 2.0×
Screening Digital Breast Tomosynthesis Bi (77063) $92 $92 3.9×
Shoulder 1 view (73020) $203 $203 1.9×
Shoulder Arthrography (73040)
range across 3 matching MRF lines		 $1,197–$1,821 $1,197–$1,821 varies
Skull less than 4 views (70250) $246 $246 2.0×
Special dosimetry (77331) $973 $973 6.0×
Special Physics Consult (77370) $973 $973 6.0×
Special teletherapy port plan (77321) $2,574 $2,574 5.7×
Special treatment procedure (77470) $3,474 $3,474 5.2×
Stereotactic Body Radiation Delivery (77373) $7,789 $7,789 3.6×
Sternoclavicular joints (71130) $203 $203 1.9×
Superior sagittal sinus venogram (75870) $9,924 $9,924 2.6×
Tbs technical calculation only (77091) $130 $130 1.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,824 $1,824 4.1×
Telethx isodose pln smpl w/dosimetry calculation (77306) $666 $666 1.5×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,574 $2,574 5.7×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,574 $2,574 5.7×
Ther rad simulaj-aided field setting simple (77280) $973 $973 6.0×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $571 $571 2.7×
Thoracic spine 2 views (72070) $246 $246 2.0×
Thoracic spine 3 views (72072) $246 $246 2.0×
Thoracolumbar 2 views (72080) $203 $203 1.9×
Thyroid Imaging With Vascular Flow (78013) $967 $967 2.0×
Thyroid Met Imaging Body (78018) $1,268 $1,268 1.9×
Thyroid Uptake Measurement (78012) $967 $967 2.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $967 $967 2.0×
Tx Devices Design & Construction Complex (77334) $1,954 $1,954 4.4×
Tx devices design & construction intermediate (77333) $1,787 $1,787 11.1×
Tx devices design & construction simple (77332) $1,626 $1,626 10.1×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $126–$434 $126–$434 varies
Ultrasound Elastography Parenchyma (76981) $518 $518 4.1×
Ultrasound Exam Aaa Screen (76706) $518 $518 4.1×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines		 $104–$518 $104–$518 varies
Umbilical-artery Doppler (OB) (76820) $342 $342 2.7×
Unlisted Dx Radiographic Procedure (76499) $283 $283 2.7×
Unlisted fluoroscopic procedure (76496) $283 $283 2.7×
Unlisted us procedure (76999)
range across 3 matching MRF lines		 $297–$427 $297–$427 varies
Upper gi w/o kub (74240) $503 $503 2.4×
Urethrocystogram voiding (74455) $671 $671 2.3×
Urethrocystography retrograde (74450) $671 $671 2.3×
Us breast unilateral complete (76641) $518 $518 4.1×
Us chest (76604)
range across 3 matching MRF lines		 $101–$518 $101–$518 varies
Us complete joint (76881) $518 $518 4.1×
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines		 $86–$518 $86–$518 varies
Us head (76506) $518 $518 4.1×
Us kidney transplant (76776) $518 $518 4.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 5 matching MRF lines		 $127–$518 $127–$518 varies
Us ob detailed single fetus (76811) $1,156 $1,156 4.0×
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines		 $140–$518 $140–$518 varies
Us ob transvaginal (76817)
range across 3 matching MRF lines		 $138–$524 $138–$524 varies
Us pelvic non ob complete (76856) $518 $518 4.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $518 $518 4.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $518 $518 4.1×
Us retroperitoneal complete (76770) $518 $518 4.1×
Us retroperitoneal limited (76775)
range across 3 matching MRF lines		 $101–$518 $101–$518 varies
Us scrotum and contents (76870) $518 $518 4.1×
Us spinal canal and contents (76800) $518 $518 4.1×
Us thyroid (76536)
range across 3 matching MRF lines		 $105–$518 $105–$518 varies
Us transrectal (76872)
range across 2 matching MRF lines		 $518–$766 $518–$766 varies
Vein X-Ray Chest (75827) $4,986 $4,986 2.6×
Vein X-Ray Liver W/O Hemodyn (75887) $9,924 $9,924 2.6×
Venogram Sinus/Jugular (75860) $9,924 $9,924 2.6×
Venography Adrenal Unilateral (75840) $9,924 $9,924 2.6×
Venography caval inferior serialography rs&i (75825) $9,924 $9,924 2.6×
Venography extremity bilateral rs&i (75822) $4,986 $4,986 2.6×
Venography extremity unilateral rs&i (75820) $4,986 $4,986 2.6×
Venography Orbital Rs&I (75880) $1,955 $1,955 2.6×
Venography Renal Bilateral (75833) $9,924 $9,924 2.6×
Venography Renal Unilateral (75831) $9,924 $9,924 2.6×
Venous sampling by catheter (75893) $17,110 $17,110 2.6×
Vertebral fracture assessment via dxa (77086) $283 $283 2.7×
Wrist 2 views (73100) $203 $203 1.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $203 $203 1.9×
X-ray antegrade pyelogram tube (74425) $1,053 $1,053 2.5×
X-Ray Aorta Leg Arteries (75630) $9,924 $9,924 2.6×
X-Ray Bend Only L-S Spine (72120) $246 $246 2.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $203 $203 1.9×
X-Ray Exam Breast Specimen (76098)
range across 3 matching MRF lines		 $1,975–$2,277 $1,975–$2,277 varies
X-Ray Exam Entire Spi 1 Vw (72081) $203 $203 1.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $246 $246 2.0×
X-Ray Exam Entire Spi 4/5 Vw (72083) $246 $246 2.0×
X-Ray Exam Hip Uni 1 View (73501) $203 $203 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $203 $203 1.9×
X-Ray Exam Hip Uni 4/> Views (73503) $246 $246 2.0×
X-Ray Exam Hips Bi 2 Views (73521) $246 $246 2.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $246 $246 2.0×
X-Ray Exam Hips Bi 5/> Views (73523) $246 $246 2.0×
X-Ray Exam L-S Spine Bending (72114) $246 $246 2.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $203 $203 1.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $246 $246 2.0×
X-Ray Exam Unilat Ribs/Chest (71101) $246 $246 2.0×
X-ray eye for foreign body (70030) $248 $248 2.4×
X-ray humerus (73060) $203 $203 1.9×
X-ray IV pyelogram (ivp) (74400) $503 $503 2.4×
X-ray IV pyelogram+tomography (74415) $1,278 $1,278 6.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $203 $203 1.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $203 $203 1.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $246 $246 2.0×
X-ray nose-rectum child f.b. (76010) $248 $248 2.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $246 $246 2.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $246 $246 2.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $246 $246 2.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $203 $203 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $203 $203 1.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $246 $246 2.0×
X-ray thoracic spine 4 vw (72074) $246 $246 2.0×
X-Ray Tmj Unilat (70328) $203 $203 1.9×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,053 $1,053 2.5×
X-Rays Bone Length Studies (77073) $246 $246 2.0×
X-Rays Bone Survey Complete (77075) $246 $246 2.0×
Xr c-spine 4 or 5 views (72050) $246 $246 2.0×
Xr facial bones less than 3 views (70140) $203 $203 1.9×
Xr orbits complete 4 views (70200) $246 $246 2.0×

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.