Imaging prices at NYU Langone Hospitals
New York, NY · every code in this section with a posted price and a Medicare benchmark.
474 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) | $2,541.80 | $13,377.89 | 1.5× |
| Abdomen 1 View (74018) | $50.47 | $265.65 | 0.5× |
| Abdomen 2 views (74019) | $78.69 | $414.18 | 0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $427.40 | $2,249.47 | 0.9× |
| Adrenal Cortex & Medulla Img (78075) | $902.77 | $4,751.44 | 0.6× |
| Angio internal mammary (75756) | $736.16 | $3,874.54 | 0.2× |
| Angio pulmonary bilat (75743) | $1,053.06 | $5,542.43 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $789.80 | $4,156.82 | 0.2× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$679.21–$1,358.43 | $3,574.81–$7,149.61 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,106.12 | $11,084.85 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $736.16 | $3,874.54 | 0.2× |
| Ankle 2 views (73600) | $64.70 | $340.52 | 0.6× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,057.97 | $5,568.28 | 0.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,099.05 | $5,784.46 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,079.22 | $5,680.08 | 0.2× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$649.62 | $3,419.04 | 0.1× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$683.46 | $3,597.15 | 0.1× |
| Arthrogram ankle (73615) | $233.56 | $1,229.24 | 0.5× |
| Arthrogram hip (73525) | $353.77 | $1,861.97 | 0.8× |
| Arthrogram Wrist (73115) | $156.01 | $821.10 | 0.4× |
| Basic radiation dosimetry calculation (77300) | $177.80 | $935.80 | 1.1× |
| Bone age studies (77072) | $52.88 | $278.33 | 0.4× |
| Bone Imaging 3 Phase (78315) | $939.56 | $4,945.07 | 1.9× |
| Bone Imaging Limited Area (78300) | $490.35 | $2,580.79 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $626.38 | $3,296.72 | 1.3× |
| Bone Imaging Whole Body (78306) | $680.89 | $3,583.62 | 1.4× |
| Bone marrow imaging limited area (78102) | $85.63 | $450.71 | 0.2× |
| Bone marrow imaging; whole body (78104) | $535.02 | $2,815.89 | 1.1× |
| Bone survey infant (77076) | $122.63 | $645.41 | 0.9× |
| Brachytx isodose complex (77318) | $382.68 | $2,014.11 | 0.8× |
| Brachytx isodose intermed (77317) | $264.07 | $1,389.83 | 0.6× |
| Brachytx Isodose Plan Simple (77316) | $202.81 | $1,067.43 | 0.4× |
| Brain Flow Imaging Only (78610) | $296.53 | $1,560.69 | 0.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,050.10 | $5,526.85 | 1.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $696.28 | $3,664.64 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,899.32 | $9,996.42 | 1.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $352.28 | $1,854.12 | 0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,067.12 | $10,879.57 | 4.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,067.12 | $10,879.57 | 2.1× |
| Cardiac Shunt Detection (78428) | $296.53 | $1,560.69 | 0.6× |
| Cardiovasc nucl exam unlisted (78499) | $296.53 | $1,560.69 | 0.6× |
| Cat Scan Follow-Up Study (76380) | $231.13 | $1,216.46 | 2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $743.22 | $3,911.70 | 1.1× |
| Cerebrospinal Fluid Scan (78630) | $656.91 | $3,457.43 | 1.0× |
| Chest 1 view (71045) | $37.51 | $197.43 | 0.3× |
| Chest 2 views (71046) | $46.46 | $244.52 | 0.4× |
| Chest 3 views (71047) | $56.67 | $298.26 | 0.5× |
| Chest 4 or more views (71048) | $65.08 | $342.50 | 0.5× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $74.63 | $392.79 | 0.6× |
| Cholecystography Oral Contrast (74290) | $90.64 | $477.06 | 0.4× |
| Cisternography Positive Contrast Rs&I (70015) | $488.45 | $2,570.77 | 0.5× |
| Clavicle complete (73000) | $62.18 | $327.24 | 0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $111.80 | $588.44 | 0.9× |
| Continuing medical physics consltj pr wk (77336) | $238.14 | $1,253.39 | 1.4× |
| Contrast Exam Abdominl Aorta (75625) | $713.74 | $3,756.54 | 0.2× |
| Contrast X-Ray Bladder (74430) | $131.80 | $693.71 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $233.56 | $1,229.24 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $239.75 | $1,261.84 | 0.6× |
| Contrast Xray Throat/Cerv Esopha (74210) | $101.56 | $534.53 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,771.71 | $9,324.81 | 4.1× |
| CT abdomen and pelvis without contrast (74176) | $1,003.43 | $5,281.19 | 3.4× |
| CT abdomen w contrast (74160) | $1,160.19 | $6,106.25 | 5.3× |
| CT abdomen w wo contrast (74170) | $1,316.95 | $6,931.31 | 6.0× |
| CT abdomen w/o contrast (74150) | $752.50 | $3,960.55 | 5.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,984.12 | $10,442.73 | 4.6× |
| CT Angio Chest (71275) | $1,265.85 | $6,662.39 | 5.8× |
| CT Angio Head (70496) | $1,369.92 | $7,210.08 | 6.3× |
| CT angio hrt w/3d image (75574) | $1,029.11 | $5,416.36 | 2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $786.74 | $4,140.76 | 3.6× |
| CT Angio Neck (70498) | $1,405.23 | $7,395.94 | 6.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $533.33 | $2,807.02 | 2.4× |
| CT bone density (77078) | $231.13 | $1,216.46 | 2.1× |
| CT cervical spine w/ contrast (72126) | $1,477.46 | $7,776.08 | 3.4× |
| CT cervical spine w/o contrast (72125) | $735.12 | $3,869.03 | 5.6× |
| CT cervical spine w/wo cont (72127) | $1,654.01 | $8,705.31 | 7.6× |
| CT chest w contrast (71260) | $1,614.15 | $8,495.54 | 7.4× |
| CT chest w/wo contrast (71270) | $1,807.03 | $9,510.66 | 8.3× |
| CT colonography screening (74263) | $366.21 | $1,927.40 | 1.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $453.49 | $2,386.80 | 2.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $339.47 | $1,786.68 | 2.6× |
| CT head/brain with contrast (70460) | $877.16 | $4,616.65 | 4.0× |
| CT head/brain without and with contrast (70470) | $1,033.66 | $5,440.29 | 4.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,029.11 | $5,416.36 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $96.69 | $4,603.98 | 0.9× |
| CT hrt w/3d image congen (75573) | $135.73 | $714.35 | 0.3× |
| CT iac w contrast (70481) | $870.48 | $4,581.46 | 4.0× |
| CT l-spine w&w/o contrast (72133) | $1,704.04 | $8,968.61 | 7.8× |
| CT lower ext w/o (73700) | $646.30 | $3,401.59 | 5.0× |
| CT lower extremity w/contrast material (73701) | $814.30 | $4,285.78 | 3.7× |
| CT lumbar spine w contrast (72132) | $1,522.13 | $8,011.21 | 3.5× |
| CT lumbar spine w/o contrast (72131) | $757.32 | $3,985.88 | 5.8× |
| CT maxillofacial w contrast (70487) | $938.42 | $4,939.07 | 4.3× |
| CT maxillofacial wo contrast (70486) | $775.51 | $4,081.63 | 5.9× |
| CT neck tissue combo (70492) | $1,164.47 | $6,128.78 | 5.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $951.80 | $5,009.47 | 4.3× |
| CT orbits w/o contrast (70480) | $737.79 | $3,883.11 | 5.7× |
| CT pelvis w&w/o contrast (72194) | $1,152.43 | $6,065.42 | 5.3× |
| CT pelvis w/o contrast (72192) | $514.42 | $2,707.47 | 3.9× |
| CT scan of leg combo (73702) | $988.71 | $5,203.76 | 4.5× |
| CT scans face/jaw combo (70488) | $1,140.13 | $6,000.67 | 5.2× |
| CT soft tissue neck w contrast (70491) | $986.84 | $5,193.90 | 4.5× |
| CT soft tissue neck w/o contrast (70490) | $809.22 | $4,259.04 | 6.2× |
| CT thoracic spine w contrast (72129) | $1,477.46 | $7,776.08 | 6.7× |
| CT thoracic spine w/o contrast (72128) | $735.12 | $3,869.03 | 5.6× |
| CT thoracic spine w/wo cont (72130) | $1,654.01 | $8,705.31 | 7.6× |
| CT thorax w/o contrast (71250) | $803.06 | $4,226.65 | 6.2× |
| CT unlisted procedure (76497) | $231.13 | $1,216.46 | 2.1× |
| CT upper ext wo (73200) | $736.45 | $3,876.07 | 5.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,141.46 | $6,007.69 | 5.2× |
| CT upper extremity with contrast (73201) | $913.28 | $4,806.73 | 2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $651.12 | $3,426.94 | 3.0× |
| Cta Abdomen (74175) | $1,567.34 | $8,249.14 | 7.2× |
| CTA pelvis (72191) | $874.76 | $4,603.98 | 4.0× |
| Dilation ureters/urethra rs&i (74485) | $407.99 | $2,147.30 | 0.2× |
| Discography Cerv/Thor Spine (72285) | $677.92 | $3,568 | 0.3× |
| Diskography lumbar (72295) | $900.60 | $4,739.98 | 0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $99.22 | $522.21 | 0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $141.78 | $746.20 | 1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $109.93 | $578.57 | 0.8× |
| Dxa Bone Density Axial (77080) | $106.45 | $560.28 | 0.8× |
| Dxa bone density study (77085) | $106.45 | $560.28 | 0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $65.96 | $347.16 | 0.6× |
| Echo exam of fetal heart (76825) | $350.54 | $1,844.94 | 0.5× |
| Echo exam uterus (76831) | $164.55 | $866.04 | 0.6× |
| Echo Guide For Artery Repair (76936) | $412.78 | $2,172.50 | 1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $371.57 | $1,955.64 | 1.2× |
| Echograp Trans R Pros Study (76873) | $171.76 | $903.99 | 1.3× |
| Esophageal Motility Study (78258) | $739.44 | $3,891.78 | 1.5× |
| Esophagram (74220) | $105.42 | $554.85 | 0.5× |
| Fetal Biophys Profile W/Nst (76818) | $794.20 | $4,180 | 6.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $566.99 | $2,984.16 | 4.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $235.38 | $1,238.84 | 0.8× |
| Fluoroscopy up to 1 hr (76000) | $337.76 | $1,777.66 | 1.1× |
| Follow-Up Angiography (75898) | $265.54 | $1,397.59 | 0.1× |
| Foot 2 views (73620) | $66.07 | $347.76 | 0.6× |
| Forearm 2 views (73090) | $64.35 | $338.71 | 0.6× |
| Gastric emptying imaging study (78264) | $822.21 | $4,327.44 | 1.6× |
| Gastroesophageal Reflux Exam (78262) | $376.79 | $1,983.11 | 0.8× |
| Gated Heart Planar Single (78472) | $582.97 | $3,068.26 | 1.2× |
| Gated Heart, Multiple (78473) | $728.59 | $3,834.66 | 1.5× |
| Hand 2 views (73120) | $71.12 | $374.33 | 0.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,524.55 | $8,023.96 | 1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,397.36 | $7,354.52 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,270.42 | $6,686.42 | 1.5× |
| Heart first pass single,planar (78481) | $294.26 | $1,548.75 | 0.4× |
| Heart Image (Pet) Multiple (78492) | $2,149.67 | $11,314.04 | 1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $736.16 | $3,874.54 | 0.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,112.14 | $11,116.52 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $1,275.97 | $6,715.63 | 1.9× |
| Hepatobiliary System Imaging (78226) | $931.49 | $4,902.57 | 1.9× |
| Ht Musc Image Planar Mult (78454) | $1,157.86 | $6,094.01 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $961.02 | $5,057.98 | 0.6× |
| Hyperthermia external generated superficial (77600) | $587.05 | $3,089.72 | 1.2× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $1,611.94 | $8,483.90 | 2.3× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $1,611.94 | $8,483.90 | 2.3× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $847.88 | $4,462.54 | 1.2× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $1,016.14 | $5,348.10 | 1.2× |
| Hysterosalpingogram (74740) | $98.29 | $517.31 | 0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $288.30 | $1,517.38 | 2.7× |
| Infant hip ultrasound, limited static exam (76886) | $288.30 | $1,517.38 | 2.7× |
| Infusion Ivp (74410) | $957.16 | $5,037.69 | 4.4× |
| Interstitial radiation source applic complex (77778) | $486.16 | $2,558.76 | 0.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $573.61 | $3,018.98 | 0.7× |
| Intracavitary Radiation Source Applic Intermed (77762) | $404.90 | $2,131.05 | 0.6× |
| Intracavitary radiation source applic simple (77761) | $320.69 | $1,687.84 | 0.5× |
| Joint Survey Single View (77077) | $39.89 | $209.97 | 0.3× |
| K Flow/Funct Image Multiple (78709) | $982.21 | $5,169.55 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $471.42 | $2,481.17 | 0.7× |
| K Flow/Funct Image W/O Drug (78707) | $628.65 | $3,308.67 | 0.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $296.53 | $1,560.69 | 0.6× |
| Kidney Imaging Morphol (78700) | $471.42 | $2,481.17 | 0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $569.59 | $2,997.86 | 1.1× |
| Knee 3 Views (73562) | $81.79 | $430.48 | 0.8× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $337.92 | $1,778.52 | 0.7× |
| Leveen/Shunt Patency Exam (78291) | $85.63 | $450.71 | 0.2× |
| Liver & Spleen Imaging Static Only (78215) | $296.53 | $1,560.69 | 0.6× |
| Liver imaging static only (78201) | $470.16 | $2,474.53 | 0.7× |
| Liver imaging w/vascular flow (78202) | $496.41 | $2,612.67 | 0.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,654.77 | $8,709.34 | 2.4× |
| Lung perfusion differential (78597) | $1,074.58 | $5,655.69 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $670.04 | $3,526.50 | 1.0× |
| Lung Ventilation Imaging (78579) | $368.46 | $1,939.25 | 0.7× |
| Lymph System Imaging (78195) | $941.08 | $4,953.05 | 1.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $516.89 | $2,720.48 | 0.3× |
| Lymphangiography extremity only unilateral rs&i (75801) | $258.45 | $1,360.24 | 0.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $748.31 | $3,938.46 | 0.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $516.89 | $2,720.48 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $502.77 | $2,646.18 | 1.7× |
| Magnetic Resonance Elastography (76391) | $163.15 | $858.69 | 0.5× |
| Mammary ductogram or galactogram multiple (77054) | $350.92 | $1,846.93 | 1.2× |
| Mammary ductogram or galactogram single (77053) | $212.61 | $1,119 | 0.7× |
| Meckels Divert Exam (78290) | $637.73 | $3,356.49 | 1.3× |
| Medical physics dose eval radiation expos w/rprt (76145) | $87.61 | $461.10 | 0.2× |
| Mlc imrt design & construction per imrt plan (77338) | $952.80 | $5,014.75 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,133.51 | $11,229 | 4.9× |
| MRA head w/o contrast (70544) | $1,262.40 | $6,644.21 | 4.2× |
| MRA head with contrast (70545) | $1,881.08 | $9,900.41 | 4.3× |
| MRA neck w contrast (70548) | $1,197 | $6,300 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,861.62 | $9,798.01 | 4.3× |
| MRA neck w/o contrast (70547) | $1,098.25 | $5,780.25 | 3.7× |
| MRI abdomen w contrast (74182) | $1,632.05 | $8,589.74 | 3.7× |
| MRI abdomen w/o contrast (74181) | $1,094.11 | $5,758.49 | 3.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,790.85 | $9,425.55 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,031.13 | $10,690.14 | 4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,790.85 | $9,425.55 | 1.8× |
| MRI bone marrow blood supply (77084) | $870.85 | $4,583.44 | 2.9× |
| MRI brain functional w/o physician admnistration (70554) | $671.71 | $3,535.32 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,458.39 | $7,675.75 | 4.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $868.43 | $4,570.69 | 2.9× |
| MRI cardiac w/o cont stress (75559) | $1,798.39 | $9,465.22 | 2.6× |
| MRI cardiac w/o contrast (75557) | $1,798.39 | $9,465.22 | 6.0× |
| MRI cervical spine w contrast (72142) | $1,427.77 | $7,514.58 | 3.3× |
| MRI cervical spine w/o cont (72141) | $958.17 | $5,043 | 3.2× |
| MRI chest w/o contrast (71550) | $1,097.27 | $5,775.13 | 3.7× |
| MRI chest with contrast (71551) | $1,197 | $6,300 | 1.2× |
| MRI chest wo w contrast (71552) | $1,859.92 | $9,789.05 | 4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,830.09 | $9,632.07 | 4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,075.72 | $10,924.82 | 4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,228.23 | $6,464.38 | 4.1× |
| MRI lumbar spine w contrast (72149) | $1,689.20 | $8,890.53 | 3.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,619.40 | $8,523.18 | 3.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,094.84 | $5,762.34 | 3.7× |
| MRI orbit face neck w contrast (70542) | $1,197 | $6,300 | 2.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,855.79 | $9,767.29 | 4.3× |
| MRI pelvis w contrast (72196) | $1,150.05 | $6,052.88 | 2.6× |
| MRI pelvis w/o & w contrast (72197) | $1,306.91 | $6,878.45 | 3.0× |
| MRI pelvis w/o contrast (72195) | $771.15 | $4,058.71 | 2.6× |
| MRI spectroscopy (76390) | $563.92 | $2,968 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $892.26 | $4,696.13 | 3.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,418.29 | $7,464.66 | 3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $951.85 | $5,009.72 | 3.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,608.70 | $8,466.86 | 3.7× |
| MRI, abdomen, combo (74183) | $1,854.57 | $9,760.90 | 4.3× |
| MRI, dorsal spine combo (72157) | $1,512.16 | $7,958.73 | 3.5× |
| MRI, dorsal spine contrast (72147) | $1,330.74 | $7,003.88 | 3.1× |
| MRI, joint upper extrem (73221) | $1,201.85 | $6,325.51 | 4.0× |
| MRI, joint upper extrem combo (73223) | $2,031.13 | $10,690.14 | 4.7× |
| MRI, lumbar spine combo (72158) | $1,916.10 | $10,084.72 | 4.4× |
| Myelogram cervical (72240) | $418.01 | $2,200.07 | 0.4× |
| Myelogram Lumbar (72265) | $444.85 | $2,341.34 | 0.5× |
| Myelography thoracic (72255) | $181.03 | $952.77 | 0.2× |
| Myelograpy 2/more regions rs&i (72270) | $521.25 | $2,743.44 | 0.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,863.51 | $9,807.95 | 1.2× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $294.26 | $1,548.75 | 0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $961.02 | $5,057.98 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $1,157.86 | $6,094.01 | 0.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,149.67 | $11,314.04 | 1.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,149.67 | $11,314.04 | 1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,149.67 | $11,314.04 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $2,090.86 | $11,004.54 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $682.86 | $3,594 | 0.6× |
| Neck soft tissue (70360) | $51.74 | $272.29 | 0.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $187.16 | $985.05 | 0.4× |
| Nm myocard infarct spect (78469) | $315.62 | $1,661.18 | 0.5× |
| Nm red cell survival study (78130) | $344.48 | $1,813.06 | 0.7× |
| Nm whole blood volume (78122) | $362.15 | $1,906.04 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $133.07 | $700.35 | 1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,537.90 | $13,357.37 | 1.5× |
| Nuclear Rx Intra-Arterial (79445) | $281.64 | $1,482.33 | 1.0× |
| Nuclear Rx Oral Admin (79005) | $558.74 | $2,940.75 | 1.9× |
| Ob us nuchal meas 1 gest (76813) | $116.52 | $613.24 | 0.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $99.11 | $521.65 | 0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $71.73 | $377.55 | 0.5× |
| Optic foramina (70190) | $61.95 | $326.03 | 0.6× |
| Panoramic X-ray of jaws (70355) | $41.52 | $218.52 | 0.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $592.06 | $3,116.08 | 0.9× |
| Parathyroid Planar Imaging (78070) | $514.83 | $2,709.63 | 1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $540.57 | $2,845.12 | 1.1× |
| Pelvis 1 or 2 views (72170) | $55.18 | $290.41 | 0.4× |
| Peritoneogram Rs&I (74190) | $603.85 | $3,178.14 | 0.9× |
| Pet Image Skull-Thigh (78812) | $1,863.51 | $9,807.95 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $1,863.51 | $9,807.95 | 1.0× |
| PET image w/CT, full body (78816) | $2,108.28 | $11,096.21 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,060.33 | $10,843.83 | 1.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,863.51 | $9,807.95 | 1.2× |
| Pet Myocardial Sngl Study (78491) | $1,063.24 | $5,595.98 | 0.6× |
| PET whole body (78813) | $1,863.51 | $9,807.95 | 1.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $902.77 | $4,751.44 | 0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $866.08 | $4,558.31 | 0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $475.71 | $2,503.75 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $188.82 | $993.77 | 1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $120.79 | $635.75 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $75.25 | $396.06 | 0.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $52.08 | $274.11 | 0.5× |
| Radex elbow complete minimum 3 views (73080) | $75.37 | $396.67 | 0.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $65.27 | $343.54 | 0.5× |
| Radex fingr minimum 2 views (73140) | $95.90 | $504.74 | 0.9× |
| Radex foot complete minimum 3 views (73630) | $74.22 | $390.63 | 0.7× |
| Radex Hand Minimum 3 Views (73130) | $164.96 | $868.19 | 1.5× |
| Radex lower extremity infant minimum 2 views (73592) | $41.30 | $217.35 | 0.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $70.46 | $370.84 | 0.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $44.51 | $234.26 | 0.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $109.75 | $577.62 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $52.19 | $274.71 | 0.5× |
| Radex shoulder complete minimum 2 views (73030) | $131.92 | $694.31 | 1.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $81.74 | $430.22 | 0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $138.40 | $728.44 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $85.58 | $450.40 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $36.94 | $194.41 | 0.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $41.64 | $219.16 | 0.4× |
| Radex Toe Minimum 2 Views (73660) | $63.55 | $334.48 | 0.6× |
| Radex upper extremity infant minimum 2 views (73092) | $62.63 | $329.65 | 0.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $73.88 | $388.82 | 0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $178.25 | $938.15 | 1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $29,152.74 | $153,435.45 | 3.2× |
| Radiation treatment delivery level 1 (77402) | $332.44 | $1,749.67 | 2.6× |
| Radiation treatment delivery level 2 (77407) | $416.57 | $2,192.46 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $571.96 | $3,010.30 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $36.13 | $190.18 | 0.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $86.56 | $455.60 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $422.14 | $2,221.80 | 1.9× |
| Radiologic exam colon single contrast study (74270) | $150.73 | $793.33 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) | $94.87 | $499.30 | 0.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $77.20 | $406.33 | 0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $142.82 | $751.67 | 0.7× |
| Radiologic exam swallow function contrast study (74230) | $94.41 | $496.89 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $62.91 | $331.11 | 0.3× |
| Radiologic examination femur 1 view (73551) | $68.14 | $358.63 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) | $79.54 | $418.61 | 0.7× |
| Radiologic examination knee 1/2 views (73560) | $69.52 | $365.88 | 0.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $164.27 | $864.57 | 1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) | $50.26 | $264.54 | 0.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $87.99 | $463.08 | 0.8× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $55.43 | $291.72 | 0.1× |
| Radiopharm Dacryocystography (78660) | $259.58 | $1,366.20 | 0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $334.50 | $1,760.55 | 0.5× |
| Renal Cyst Study (74470) | $659.25 | $3,469.74 | 1.0× |
| Ribs bilateral 3 views (71110) | $63.67 | $335.08 | 0.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $461.07 | $2,426.71 | 0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $631.68 | $3,324.61 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,383.23 | $7,280.14 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $783.85 | $4,125.55 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $966.26 | $5,085.60 | 1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,062.89 | $5,594.16 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,352.77 | $7,119.84 | 0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $966.26 | $5,085.60 | 0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $405.05 | $2,131.84 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $429.78 | $2,262.01 | 1.5× |
| Salivary Gland Function Study (78232) | $85.63 | $450.71 | 0.2× |
| Salivary Gland Imaging Serial Images (78231) | $296.53 | $1,560.69 | 0.6× |
| Scapula (73010) | $68.71 | $361.65 | 0.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $30.72 | $161.68 | 1.3× |
| Sella turcica (70240) | $35.10 | $184.75 | 0.3× |
| Shoulder 1 view (73020) | $52.77 | $277.73 | 0.5× |
| Shoulder Arthrography (73040) | $267.05 | $1,405.53 | 0.6× |
| Sialogram (70390) | $137.58 | $724.09 | 0.5× |
| Skull less than 4 views (70250) | $59.65 | $313.95 | 0.5× |
| Special dosimetry (77331) | $35.23 | $185.42 | 0.2× |
| Special Physics Consult (77370) | $362.03 | $1,905.44 | 2.2× |
| Special teletherapy port plan (77321) | $127.68 | $671.98 | 0.3× |
| Special treatment procedure (77470) | $15,351.31 | $80,796.35 | 22.3× |
| Spleen Imaging (78185) | $332.04 | $1,747.58 | 0.7× |
| Srs Multisource (77371) | $29,152.74 | $153,435.45 | 3.2× |
| Stereotactic Body Radiation Delivery (77373) | $29,152.74 | $153,435.45 | 13.1× |
| Sternoclavicular joints (71130) | $45.66 | $240.30 | 0.4× |
| Superior sagittal sinus venogram (75870) | $765.61 | $4,029.52 | 0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $101.44 | $533.88 | 0.8× |
| Tbs technical calculation only (77091) | $31.88 | $167.78 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $287.92 | $1,515.36 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $215.94 | $1,136.52 | 0.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $140.74 | $740.76 | 0.5× |
| Testicular Imaging W/Flow (78761) | $313.61 | $1,650.58 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,016.81 | $5,351.64 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $610.04 | $3,210.74 | 1.3× |
| Ther rad simulaj-aided field setting simple (77280) | $345.74 | $1,819.70 | 2.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $87.35 | $459.73 | 0.4× |
| Thoracic spine 2 views (72070) | $54.37 | $286.18 | 0.4× |
| Thoracic spine 3 views (72072) | $59.31 | $312.14 | 0.5× |
| Thoracolumbar 2 views (72080) | $39.23 | $206.49 | 0.4× |
| Thyroid Imaging With Vascular Flow (78013) | $468.90 | $2,467.89 | 0.9× |
| Thyroid Met Imaging Body (78018) | $997.86 | $5,251.91 | 1.5× |
| Thyroid Uptake Measurement (78012) | $296.78 | $1,562.02 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $593.56 | $3,124 | 1.2× |
| Tx Devices Design & Construction Complex (77334) | $472.16 | $2,485.04 | 1.0× |
| Tx devices design & construction intermediate (77333) | $165.19 | $869.40 | 1.0× |
| Tx devices design & construction simple (77332) | $254.89 | $1,341.53 | 1.5× |
| Ultrasound Breast Limited (76642) | $257.67 | $1,356.15 | 2.4× |
| Ultrasound elastography first target lesion (76982) | $82.62 | $434.84 | 0.6× |
| Ultrasound Elastography Parenchyma (76981) | $82.62 | $434.84 | 0.6× |
| Ultrasound Exam Aaa Screen (76706) | $84.15 | $442.89 | 0.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $148.14 | $779.69 | 0.3× |
| Ultrasound, abdomen limited (76705) | $307.13 | $1,616.48 | 2.4× |
| Umbilical-artery Doppler (OB) (76820) | $64.61 | $340.03 | 0.5× |
| Unlisted Dx Radiographic Procedure (76499) | $36.87 | $194.03 | 0.3× |
| Unlisted fluoroscopic procedure (76496) | $41.52 | $218.52 | 0.4× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $296.53 | $1,560.69 | 0.6× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $238.49 | $1,255.20 | 0.5× |
| Unlisted magnetic resonance procedure (76498) | $543.09 | $2,858.37 | 5.0× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $189.37 | $996.70 | 0.4× |
| Unlisted respiratory px dx nuclear medicine (78599) | $296.53 | $1,560.69 | 0.6× |
| Unlisted us procedure (76999) | $121.39 | $638.89 | 1.1× |
| Upper gi w/o kub (74240) | $62.91 | $331.11 | 0.3× |
| Ureteral Reflux Study (78740) | $351.31 | $1,848.99 | 0.7× |
| Urethrocystogram voiding (74455) | $308.02 | $1,621.14 | 1.0× |
| Urethrocystography retrograde (74450) | $336.24 | $1,769.70 | 1.1× |
| Us breast unilateral complete (76641) | $282.15 | $1,485 | 2.2× |
| Us chest (76604) | $220.06 | $1,158.23 | 1.7× |
| Us complete joint (76881) | $544.36 | $2,865.04 | 4.2× |
| Us exam, pelvic, limited (76857) | $271.55 | $1,429.20 | 2.1× |
| Us head (76506) | $261.45 | $1,376.07 | 2.0× |
| Us kidney transplant (76776) | $248.33 | $1,307 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $169.09 | $889.93 | 1.3× |
| Us ob detailed single fetus (76811) | $171.43 | $902.26 | 0.6× |
| Us ob limited 1 or more fetuses (76815) | $643.65 | $3,387.63 | 4.9× |
| Us ob transvaginal (76817) | $743.21 | $3,911.62 | 5.7× |
| Us pelvic non ob complete (76856) | $399.50 | $2,102.62 | 3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $549.40 | $2,891.60 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $880.40 | $4,633.70 | 6.7× |
| Us retroperitoneal complete (76770) | $359.88 | $1,894.09 | 2.8× |
| Us retroperitoneal limited (76775) | $183.47 | $965.64 | 1.4× |
| Us scrotum and contents (76870) | $352.56 | $1,855.57 | 2.7× |
| Us spinal canal and contents (76800) | $143.60 | $755.78 | 1.1× |
| Us thyroid (76536) | $374.51 | $1,971.12 | 2.9× |
| Us transrectal (76872) | $96.42 | $507.50 | 0.7× |
| Vein X-Ray Chest (75827) | $117.81 | $620.05 | 0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $375.46 | $1,976.11 | 0.1× |
| Vein X-Ray Skull Epidural (75872) | $736.16 | $3,874.54 | 0.9× |
| Venogram Sinus/Jugular (75860) | $368.08 | $1,937.27 | 0.1× |
| Venography Adrenal Unilateral (75840) | $736.16 | $3,874.54 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $368.11 | $1,937.44 | 0.1× |
| Venography extremity bilateral rs&i (75822) | $377.75 | $1,988.15 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $320.16 | $1,685.07 | 0.2× |
| Venography Orbital Rs&I (75880) | $569.57 | $2,997.75 | 0.7× |
| Venography Renal Bilateral (75833) | $2,400.98 | $12,636.73 | 0.6× |
| Venography Renal Unilateral (75831) | $1,053.06 | $5,542.43 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,053.06 | $5,542.43 | 0.2× |
| Venous thrombosis imaging (78457) | $355.84 | $1,872.84 | 0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $296.53 | $1,560.69 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $48.12 | $253.28 | 0.4× |
| Wrist 2 views (73100) | $61.37 | $323.01 | 0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $58.85 | $309.73 | 0.5× |
| X-ray antegrade pyelogram tube (74425) | $457.93 | $2,410.17 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $885.01 | $4,657.93 | 0.2× |
| X-Ray Bend Only L-S Spine (72120) | $146.60 | $771.59 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $65.62 | $345.35 | 0.6× |
| X-Ray Exam Breast Specimen (76098) | $272.56 | $1,434.51 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $85.86 | $451.88 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $138.23 | $727.52 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $149.82 | $788.51 | 1.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $36.82 | $193.81 | 0.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $50.88 | $267.81 | 0.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $63.58 | $334.64 | 0.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $49.12 | $258.55 | 0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $60.07 | $316.14 | 0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $69.73 | $367.02 | 0.5× |
| X-Ray Exam L-S Spine Bending (72114) | $113.45 | $597.11 | 0.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $87.18 | $458.85 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $147.29 | $775.22 | 1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$62.06–$124.12 | $326.63–$653.26 | varies |
| X-ray eye for foreign body (70030) | $35.10 | $184.75 | 0.3× |
| X-ray humerus (73060) | $60.80 | $319.99 | 0.6× |
| X-ray IV pyelogram (ivp) (74400) | $256.88 | $1,352 | 1.2× |
| X-ray IV pyelogram+tomography (74415) | $1,117.30 | $5,880.53 | 5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $62.86 | $330.86 | 0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $78.46 | $412.97 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $64.35 | $338.71 | 0.5× |
| X-ray nose-rectum child f.b. (76010) | $129.20 | $680 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $80.87 | $425.65 | 0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $55.41 | $291.61 | 0.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $48.18 | $253.58 | 0.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $47.61 | $250.56 | 0.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $103.47 | $544.58 | 1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $150.27 | $790.91 | 1.2× |
| X-Ray Stress View (77071) | $82.48 | $434.12 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $67.45 | $355.01 | 0.5× |
| X-Ray Tmj Unilat (70328) | $54.13 | $284.91 | 0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $457.93 | $2,410.17 | 1.1× |
| X-Rays Bone Length Studies (77073) | $62.06 | $326.63 | 0.5× |
| X-Rays Bone Survey Complete (77075) | $112.53 | $592.28 | 0.9× |
| Xr c-spine 4 or 5 views (72050) | $117.81 | $620.05 | 0.9× |
| Xr facial bones less than 3 views (70140) | $45.69 | $240.48 | 0.4× |
| XR Mastoids < 3 Views Bilateral (70120) | $45.35 | $238.68 | 0.3× |
| Xr orbits complete 4 views (70200) | $36.94 | $194.41 | 0.3× |
| Xr Tomogram Single Plane (76100) | $113.57 | $597.74 | 0.9× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.