Imaging prices at Novant Health Presbyterian Medical Center
Charlotte, NC · every code in this section with a posted price and a Medicare benchmark.
459 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $4,527.50 | $9,055 | 3.4× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $910 | $1,820 | 2.3× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,301.52 | $2,603.04 | 1.0× |
| Angio internal mammary (75756) range across 5 matching MRF lines |
$1,867.50–$2,334.50 | $3,735–$4,669 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$2,498–$2,566.50 | $4,996–$5,133 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$2,469–$2,683.50 | $4,938–$5,367 | varies |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$2,846–$3,093.50 | $5,692–$6,187 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$2,586.50–$2,811 | $5,173–$5,622 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$1,764–$1,917 | $3,528–$3,834 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,637 | $3,274 | 0.5× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$106–$232.50 | $212–$465 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$2,937.50–$7,027.50 | $5,875–$14,055 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$2,846–$3,093.50 | $5,692–$6,187 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$2,002.50–$2,176.50 | $4,005–$4,353 | varies |
| Artery X-Rays Pelvis (75736) | $2,811 | $5,622 | 0.5× |
| Artery X-Rays Spine (75705) | $2,811 | $5,622 | 0.5× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$399–$537.50 | $798–$1,075 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$463.50–$625 | $927–$1,250 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$463.50–$625 | $927–$1,250 | varies |
| Basic radiation dosimetry calculation (77300) | $434.50 | $869 | 3.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$96–$129.50 | $192–$259 | varies |
| Bone Imaging 3 Phase (78315) | $1,242.50 | $2,485 | 3.2× |
| Bone Imaging Limited Area (78300) | $431 | $862 | 1.1× |
| Bone Imaging Whole Body (78306) | $1,102 | $2,204 | 2.8× |
| Bone marrow imaging limited area (78102) | $823 | $1,646 | 2.1× |
| Bone marrow imaging; multiple areas (78103) | $823 | $1,646 | 2.1× |
| Bone marrow imaging; whole body (78104) | $435 | $870 | 1.1× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Brachytx isodose complex (77318) | $1,484.50 | $2,969 | 4.1× |
| Brachytx Isodose Plan Simple (77316) | $1,156.50 | $2,313 | 3.2× |
| Brain Flow Imaging Only (78610) | $1,091.50 | $2,183 | 2.1× |
| Brain Image W/Flow < 4 Views (78601) | $946.50 | $1,893 | 2.4× |
| Brain imaging < 4 static views (78600) | $450 | $900 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,014.50 | $2,029 | 1.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $728 | $1,456 | 1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,525 | $7,050 | 2.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $770 | $1,540 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,517 | $3,034 | 4.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,853 | $3,706 | 2.4× |
| Cardiac Shunt Detection (78428) | $816.50 | $1,633 | 2.1× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$391.50–$495 | $783–$990 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,014.50 | $2,029 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $1,014.50 | $2,029 | 1.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$172–$1,308 | $344–$2,616 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$204.50–$222 | $409–$444 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 2 matching MRF lines |
$188–$261 | $376–$522 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $183 | $366 | 1.8× |
| Continuing medical physics consltj pr wk (77336) | $555 | $1,110 | 4.2× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,777.50–$1,932 | $3,555–$3,864 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$463.50–$625 | $927–$1,250 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$463.50–$625 | $927–$1,250 | varies |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$347–$377 | $694–$754 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,569–$3,248.50 | $5,138–$6,497 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,813–$2,292.50 | $3,626–$4,585 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,271.50–$1,608 | $2,543–$3,216 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$1,459–$1,851.50 | $2,918–$3,703 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$984–$1,244 | $1,968–$2,488 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,107.50–$2,665 | $4,215–$5,330 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,369.50–$1,731.50 | $2,739–$3,463 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,363–$1,724 | $2,726–$3,448 | varies |
| CT angio hrt w/3d image (75574) range across 6 matching MRF lines |
$779–$985.50 | $1,558–$1,971 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,348–$1,514 | $2,696–$3,028 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,442–$1,823 | $2,884–$3,646 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,250–$1,499 | $2,500–$2,998 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$218.50–$245.50 | $437–$491 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,271.50–$1,608 | $2,543–$3,216 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$1,028–$1,300 | $2,056–$2,600 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,513–$1,913.50 | $3,026–$3,827 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,133–$1,432.50 | $2,266–$2,865 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,385–$1,752 | $2,770–$3,504 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$942–$1,191.50 | $1,884–$2,383 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$962.50–$1,178.50 | $1,925–$2,357 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,008.50–$1,275.50 | $2,017–$2,551 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$1,158–$1,464.50 | $2,316–$2,929 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$391–$494.50 | $782–$989 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $125 | $250 | 1.5× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$423–$535 | $846–$1,070 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,133–$1,432.50 | $2,266–$2,865 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,691–$2,138 | $3,382–$4,276 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$920–$1,164 | $1,840–$2,328 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,204.50–$1,523 | $2,409–$3,046 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,356–$1,715 | $2,712–$3,430 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,095–$1,384 | $2,190–$2,768 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$865–$1,094 | $1,730–$2,188 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$779.50–$1,107.50 | $1,559–$2,215 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,300.50–$1,644 | $2,601–$3,288 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,229.50–$1,555 | $2,459–$3,110 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,003–$1,268.50 | $2,006–$2,537 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$1,127.50–$1,593 | $2,255–$3,186 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$899–$1,188.50 | $1,798–$2,377 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,332.50–$1,685 | $2,665–$3,370 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,362–$1,723 | $2,724–$3,446 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,177–$1,489 | $2,354–$2,978 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$957–$1,210 | $1,914–$2,420 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$1,136–$1,437 | $2,272–$2,874 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$883–$1,117 | $1,766–$2,234 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,265.50–$1,600 | $2,531–$3,200 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$713.50–$1,061.50 | $1,427–$2,123 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$320.50–$405.50 | $641–$811 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,055–$1,334.50 | $2,110–$2,669 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,290.50–$1,632.50 | $2,581–$3,265 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,185.50–$1,499 | $2,371–$2,998 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,430–$1,808 | $2,860–$3,616 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,088.50–$1,377 | $2,177–$2,754 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,411–$1,784 | $2,822–$3,568 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 2 matching MRF lines |
$327–$355.50 | $654–$711 | varies |
| Dilation ureters/urethra rs&i (74485) range across 4 matching MRF lines |
$1,183.50–$1,928.50 | $2,367–$3,857 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$1,736.50–$1,887 | $3,473–$3,774 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$2,317–$2,519 | $4,634–$5,038 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$177.50–$201 | $355–$402 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) | $383 | $766 | 3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$181–$206 | $362–$412 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$184–$205 | $368–$410 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$109.50–$147.50 | $219–$295 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$184–$210.50 | $368–$421 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$1,067–$1,212.50 | $2,134–$2,425 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$317–$401 | $634–$802 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$317–$360.50 | $634–$721 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $553 | $1,106 | 2.4× |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$877–$997 | $1,754–$1,994 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$213.50–$287.50 | $427–$575 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 5 matching MRF lines |
$306.50–$467.50 | $613–$935 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 5 matching MRF lines |
$280–$360.50 | $560–$721 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $465 | $930 | 2.0× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$353–$476.50 | $706–$953 | varies |
| Follow-Up Angiography (75898) | $2,045.50 | $4,091 | 0.7× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$106–$232.50 | $212–$465 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$66.50–$232.50 | $133–$465 | varies |
| Gastric emptying imaging study (78264) | $1,321.50 | $2,643 | 3.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $928 | $1,856 | 2.4× |
| Gastroesophageal Reflux Exam (78262) | $483.50 | $967 | 1.2× |
| Gated Heart Planar Single (78472) | $1,276.50 | $2,553 | 3.3× |
| Gated Heart, Multiple (78473) | $770 | $1,540 | 2.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $3,016.50 | $6,033 | 5.7× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$89.50–$232.50 | $179–$465 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$1,481.50–$5,780 | $2,963–$11,560 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$4,361–$4,436 | $8,722–$8,872 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,092.50 | $6,185 | 4.6× |
| Heart Image (Pet) Multiple (78492) | $2,478 | $4,956 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$2,201.50–$2,393 | $4,403–$4,786 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$2,645–$3,352.50 | $5,290–$6,705 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,620 | $3,240 | 3.1× |
| Hepatobiliary System Imaging (78226) | $1,591 | $3,182 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $1,906 | $3,812 | 1.5× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$442–$596 | $884–$1,192 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$219–$277 | $438–$554 | varies |
| Infant hip ultrasound, limited static exam (76886) | $219 | $438 | 2.6× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$364.50–$396 | $729–$792 | varies |
| Interstitial radiation source applic complex (77778) | $5,657 | $11,314 | 8.4× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| K Flow/Funct Image Multiple (78709) | $1,697 | $3,394 | 3.2× |
| K Flow/Funct Image W/Drug (78708) | $1,172 | $2,344 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,049.50 | $2,099 | 2.0× |
| Kidney Imaging Morphol (78700) | $612 | $1,224 | 1.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,453 | $2,906 | 3.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$201.50–$280 | $403–$560 | varies |
| Leveen/Shunt Patency Exam (78291) | $629.50 | $1,259 | 1.6× |
| Liver & Spleen Imaging Static Only (78215) | $699.50 | $1,399 | 1.8× |
| Liver imaging w/vascular flow (78202) | $783 | $1,566 | 1.5× |
| Lung Perf&Ventilat Diferentl (78598) | $1,294 | $2,588 | 2.5× |
| Lung perfusion differential (78597) | $987 | $1,974 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,276.50 | $2,553 | 2.4× |
| Lung Ventilation Imaging (78579) | $1,112.50 | $2,225 | 2.9× |
| Lymph System Imaging (78195) | $1,248.50 | $2,497 | 2.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $808 | $1,616 | 0.5× |
| Lymphangiography extremity only unilateral rs&i (75801) range across 4 matching MRF lines |
$555–$603 | $1,110–$1,206 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,672 | $3,344 | 0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,637 | $3,274 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$1,461.50–$1,951 | $2,923–$3,902 | varies |
| Magnetic Resonance Elastography (76391) | $255.50 | $511 | 1.1× |
| Mammary ductogram or galactogram multiple (77054) | $402.50 | $805 | 1.7× |
| Mammary ductogram or galactogram single (77053) | $251 | $502 | 1.1× |
| Meckels Divert Exam (78290) | $699.50 | $1,399 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $5,053.50 | $10,107 | 13.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$44–$56 | $88–$112 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$165–$208.50 | $330–$417 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$107–$135 | $214–$270 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$435–$550 | $870–$1,100 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,887.50–$2,387 | $3,775–$4,774 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,403–$1,775 | $2,806–$3,550 | varies |
| MRA head with contrast (70545) | $2,143.50 | $4,287 | 6.3× |
| MRA neck w contrast (70548) | $2,068.50 | $4,137 | 6.1× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,823.50–$2,306 | $3,647–$4,612 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,249–$1,580 | $2,498–$3,160 | varies |
| MRI abdomen w contrast (74182) | $1,969 | $3,938 | 5.8× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,398.50–$1,768.50 | $2,797–$3,537 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,298.50–$1,641.50 | $2,597–$3,283 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,631.50–$2,063 | $3,263–$4,126 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,536–$1,942 | $3,072–$3,884 | varies |
| MRI bone marrow blood supply (77084) | $275.50 | $551 | 1.2× |
| MRI brain functional w/o physician admnistration (70554) | $761 | $1,522 | 3.3× |
| MRI brain functional w/physician admnistration (70555) | $761 | $1,522 | 3.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,300 | $4,600 | 9.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,800 | $3,600 | 7.8× |
| MRI cardiac w/o cont stress (75559) | $1,189 | $2,378 | 2.2× |
| MRI cardiac w/o contrast (75557) | $898.50 | $1,797 | 3.9× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,689.50–$2,136.50 | $3,379–$4,273 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,550.50–$1,961 | $3,101–$3,922 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,270–$1,606.50 | $2,540–$3,213 | varies |
| MRI chest with contrast (71551) | $1,684.50 | $3,369 | 2.2× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,795–$2,270 | $3,590–$4,540 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,433–$1,812 | $2,866–$3,624 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,642.50–$2,077.50 | $3,285–$4,155 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,115.50–$1,411 | $2,231–$2,822 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,689.50–$2,136.50 | $3,379–$4,273 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,969.50–$2,491 | $3,939–$4,982 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,293–$1,635.50 | $2,586–$3,271 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,409–$1,781.50 | $2,818–$3,563 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,783–$2,254.50 | $3,566–$4,509 | varies |
| MRI pelvis w contrast (72196) | $1,765 | $3,530 | 5.2× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,954.50–$2,472 | $3,909–$4,944 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,293–$1,635.50 | $2,586–$3,271 | varies |
| MRI spectroscopy (76390) | $378.50 | $757 | 4.5× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,550.50–$1,961 | $3,101–$3,922 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,865 | $3,730 | 5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,177–$1,488 | $2,354–$2,976 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,629–$2,059.50 | $3,258–$4,119 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,125–$2,687.50 | $4,250–$5,375 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,969.50–$2,491 | $3,939–$4,982 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,725–$2,136.50 | $3,450–$4,273 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,339.50–$1,694 | $2,679–$3,388 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,931.50–$2,443 | $3,863–$4,886 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,969.50–$2,491 | $3,939–$4,982 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$584–$788 | $1,168–$1,576 | varies |
| Myelogram Lumbar (72265) range across 4 matching MRF lines |
$782.50–$1,027 | $1,565–$2,054 | varies |
| Myelography thoracic (72255) range across 3 matching MRF lines |
$739–$2,598.50 | $1,478–$5,197 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$833.50–$1,124 | $1,667–$2,248 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $615.50 | $1,231 | 1.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,825 | $5,650 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $3,165 | $6,330 | 2.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,896.50 | $3,793 | 1.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,925.50 | $5,851 | 1.4× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$2,321–$2,608 | $4,642–$5,216 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $266.30 | $532.60 | 0.7× |
| Nm csf leak detection (78650) | $1,301.52 | $2,603.04 | 1.0× |
| Nm whole blood volume (78122) | $1,102 | $2,204 | 2.1× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$140–$188 | $280–$376 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,727 | $9,454 | 3.5× |
| Nuclear Rx Intra-Arterial (79445) | $844.50 | $1,689 | 3.7× |
| Nuclear Rx Oral Admin (79005) | $764.50 | $1,529 | 3.4× |
| Ob us nuchal meas 1 gest (76813) | $290 | $580 | 2.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 2 matching MRF lines |
$249.50–$283.50 | $499–$567 | varies |
| Optic foramina (70190) range across 2 matching MRF lines |
$79.50–$122.50 | $159–$245 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$236–$256.50 | $472–$513 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,773.50 | $5,547 | 5.3× |
| Parathyroid Planar Imaging (78070) | $804.50 | $1,609 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,012 | $2,024 | 2.6× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Perineogram (74775) | $1,759 | $3,518 | 7.6× |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$290–$315 | $580–$630 | varies |
| Pet Image W/Ct Lmtd (78814) | $3,525 | $7,050 | 2.5× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$5,009–$5,261.50 | $10,018–$10,523 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 7 matching MRF lines |
$5,009–$5,261.50 | $10,018–$10,523 | varies |
| Pet Myocardial Sngl Study (78491) | $2,478 | $4,956 | 1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$2,003–$2,177 | $4,006–$4,354 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $629.50 | $1,259 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$240.50–$324.50 | $481–$649 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$337–$366 | $674–$732 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex fingr minimum 2 views (73140) range across 22 matching MRF lines |
$145.50–$232.50 | $291–$465 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$161.50–$196 | $323–$392 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $158 | $316 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$321.50–$546.50 | $643–$1,093 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$160–$215.50 | $320–$431 | varies |
| Radex Toe Minimum 2 Views (73660) range across 22 matching MRF lines |
$155–$196 | $310–$392 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $295 | $590 | 2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,267.50 | $24,535 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $485 | $970 | 4.9× |
| Radiation treatment delivery level 2 (77407) | $643 | $1,286 | 1.7× |
| Radiation treatment delivery level 3 (77412) | $777.50 | $1,555 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$456–$614.50 | $912–$1,229 | varies |
| Radiologic exam colon single contrast study (74270) range across 5 matching MRF lines |
$431–$614.50 | $862–$1,229 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$213.50–$287.50 | $427–$575 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$259.50–$350 | $519–$700 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$284–$383 | $568–$766 | varies |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) range across 2 matching MRF lines |
$140–$152 | $280–$304 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$259.50–$350 | $519–$700 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$126.50–$232.50 | $253–$465 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$134–$181 | $268–$362 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 2 matching MRF lines |
$56–$57.50 | $112–$115 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$66.50–$232.50 | $133–$465 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $341.50 | $683 | 0.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $47 | $94 | 0.6× |
| Radiopharm Dacryocystography (78660) | $378.04 | $756.07 | 1.0× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $463.50 | $927 | 2.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $571.50 | $1,143 | 2.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $3,122.50 | $6,245 | 8.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $3,122.50 | $6,245 | 8.3× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$424.50–$651 | $849–$1,302 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $768.50 | $1,537 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $768.50 | $1,537 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,767 | $3,534 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,407 | $2,814 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,301.52 | $2,603.04 | 2.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,231.17 | $2,462.33 | 1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,356.45 | $2,712.89 | 1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,231.17 | $2,462.33 | 1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $831 | $1,662 | 3.7× |
| Rp Therapy Intravenous Administration (79101) | $764.50 | $1,529 | 3.4× |
| Salivary Gland Imaging (78230) | $408.69 | $817.38 | 1.1× |
| Salivary Gland Imaging Serial Images (78231) | $423.50 | $847 | 1.1× |
| Scapula (73010) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $76 | $152 | 3.3× |
| Sella turcica (70240) range across 2 matching MRF lines |
$97.50–$131.50 | $195–$263 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$463.50–$625 | $927–$1,250 | varies |
| Sialogram (70390) range across 3 matching MRF lines |
$268–$300 | $536–$600 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Special dosimetry (77331) | $378.50 | $757 | 2.9× |
| Special Physics Consult (77370) | $637 | $1,274 | 4.9× |
| Special teletherapy port plan (77321) | $637 | $1,274 | 1.8× |
| Special treatment procedure (77470) | $1,803.50 | $3,607 | 3.4× |
| Spleen Imaging (78185) | $746 | $1,492 | 1.9× |
| Stereotactic Body Radiation Delivery (77373) | $4,925.50 | $9,851 | 2.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Superior sagittal sinus venogram (75870) | $2,045.50 | $4,091 | 0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,404.50 | $4,809 | 6.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,096 | $2,192 | 3.0× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 4 matching MRF lines |
$348–$724 | $696–$1,448 | varies |
| Testicular Imaging W/Flow (78761) | $837 | $1,674 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,837.50 | $3,675 | 5.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,131.50 | $2,263 | 8.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$291–$614.50 | $582–$1,229 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $787.50 | $1,575 | 2.0× |
| Thyroid Imaging With Vascular Flow (78013) | $595.50 | $1,191 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,364 | $2,728 | 2.6× |
| Thyroid Uptake Measurement (78012) | $420 | $840 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $643 | $1,286 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $920 | $1,840 | 2.5× |
| Tx devices design & construction intermediate (77333) | $703 | $1,406 | 5.4× |
| Tx devices design & construction simple (77332) | $693.50 | $1,387 | 5.3× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$241–$328.50 | $482–$657 | varies |
| Ultrasound elastography first target lesion (76982) | $140 | $280 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $140 | $280 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$235.50–$298 | $471–$596 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) range across 2 matching MRF lines |
$598–$679.50 | $1,196–$1,359 | varies |
| Ultrasound, abdomen limited (76705) range across 10 matching MRF lines |
$379.50–$479.50 | $759–$959 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$181–$206 | $362–$412 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$102.50–$785.50 | $205–$1,571 | varies |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$83–$519.50 | $166–$1,039 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$118.50–$150.50 | $237–$301 | varies |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$240.50–$324.50 | $481–$649 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $20.50 | $41 | 1.9× |
| Ureteral Reflux Study (78740) | $837 | $1,674 | 2.2× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$425–$573 | $850–$1,146 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$275–$371 | $550–$742 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$241–$328.50 | $482–$657 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$202.50–$256 | $405–$512 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$299–$378 | $598–$756 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$225–$242 | $450–$484 | varies |
| Us head (76506) range across 4 matching MRF lines |
$230–$290.50 | $460–$581 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$329.50–$416.50 | $659–$833 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$115.50–$179.50 | $231–$359 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$443.50–$561 | $887–$1,122 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$246–$311.50 | $492–$623 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$307–$388 | $614–$776 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$511.50–$647 | $1,023–$1,294 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$330–$395.50 | $660–$791 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$202.50–$256 | $405–$512 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$446–$564 | $892–$1,128 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$274–$346.50 | $548–$693 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$409–$517.50 | $818–$1,035 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$315–$398.50 | $630–$797 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$362.50–$458 | $725–$916 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$454–$574 | $908–$1,148 | varies |
| Vasogram (74440) | $217 | $434 | 0.9× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$919.50–$1,364 | $1,839–$2,728 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,045.50 | $4,091 | 0.7× |
| Vein X-Ray Skull Epidural (75872) range across 2 matching MRF lines |
$889–$966.50 | $1,778–$1,933 | varies |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$2,498–$2,566.50 | $4,996–$5,133 | varies |
| Venogram Sinus/Jugular (75860) | $1,672 | $3,344 | 0.5× |
| Venography Adrenal Unilateral (75840) range across 2 matching MRF lines |
$2,361–$2,566 | $4,722–$5,132 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$1,947–$2,116.50 | $3,894–$4,233 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$941.50–$1,024 | $1,883–$2,048 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$931–$941.50 | $1,862–$1,883 | varies |
| Venography Orbital Rs&I (75880) | $885.50 | $1,771 | 1.5× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$2,832–$3,078.50 | $5,664–$6,157 | varies |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$2,473–$2,688.50 | $4,946–$5,377 | varies |
| Venous sampling by catheter (75893) | $3,285 | $6,570 | 0.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $450 | $900 | 1.2× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$124.50–$167.50 | $249–$335 | varies |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$66.50–$232.50 | $133–$465 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$270–$307 | $540–$614 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$1,881.50–$2,045 | $3,763–$4,090 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$66.50–$232.50 | $133–$465 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$334.50–$451.50 | $669–$903 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$129–$174 | $258–$348 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $195 | $390 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $215 | $430 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$195–$249 | $390–$498 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$238.50–$321.50 | $477–$643 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$288.50–$389 | $577–$778 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$275.50–$372 | $551–$744 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$200–$232.50 | $400–$465 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| X-ray head for orthodontia (70350) range across 2 matching MRF lines |
$102.50–$138 | $205–$276 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$66.50–$232.50 | $133–$465 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$270–$364 | $540–$728 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$330–$445 | $660–$890 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$222.50–$280 | $445–$560 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$207–$280 | $414–$560 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$207.50–$280 | $415–$560 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$119.50–$129.50 | $239–$259 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$145.50–$196 | $291–$392 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$329.50–$444 | $659–$888 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$140–$188 | $280–$376 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$248.50–$335 | $497–$670 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$172–$232.50 | $344–$465 | varies |
| Xr myelogram posterior fossa (70010) range across 2 matching MRF lines |
$586.50–$637.50 | $1,173–$1,275 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$220.50–$297.50 | $441–$595 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$163–$219.50 | $326–$439 | varies |
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.