Imaging prices at O'connor Hospital
Delhi, NY · 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) | $204.17 | $756.18 | 0.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$12.78–$112.73 | $47.35–$417.52 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$15.78–$194.24 | $58.46–$719.40 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $137.78 | $510.30 | 0.3× |
| Angio internal mammary (75756) | $68.70 | $254.43 | 0.0× |
| Angio pulmonary bilat (75743) | $70.88 | $262.50 | 0.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $72.17 | $267.31 | 0.0× |
| Angiography extremity bilateral rs&i (75716) | $113.40 | $420 | 0.0× |
| Angiography extremity unilateral rs&i (75710) | $99.23 | $367.50 | 0.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $56.70 | $210 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $57.58 | $213.26 | 0.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$13.90–$104.78 | $51.47–$388.08 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$99.23 | $367.50 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $78.31 | $290.03 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$113.40 | $420 | 0.0× |
| Artery X-Rays Adrenal Gland (75731) | $85.05 | $315 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$85.05 | $315 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$105.20 | $389.64 | 0.0× |
| Arthrogram ankle (73615) | $55.33 | $204.92 | 0.1× |
| Arthrogram hip (73525) | $55.76 | $206.50 | 0.1× |
| Arthrogram Wrist (73115) | $57.87 | $214.35 | 0.1× |
| Basic radiation dosimetry calculation (77300) | $28.12 | $104.15 | 0.2× |
| Bone age studies (77072) range across 2 matching MRF lines |
$11.09–$94.50 | $41.09–$350 | varies |
| Bone Imaging 3 Phase (78315) | $136.96 | $507.25 | 0.3× |
| Bone Imaging Limited Area (78300) | $89.90 | $332.98 | 0.2× |
| Bone Imaging Multiple Areas (78305) | $109.41 | $405.22 | 0.2× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$116.92–$339.77 | $433.04–$1,258.42 | varies |
| Bone marrow imaging limited area (78102) | $68.87 | $255.06 | 0.1× |
| Bone marrow imaging; multiple areas (78103) | $74.13 | $274.56 | 0.1× |
| Bone marrow imaging; whole body (78104) | $99.50 | $368.52 | 0.2× |
| Bone survey infant (77076) | $45.94 | $170.16 | 0.4× |
| Brachytx isodose complex (77318) | $194.01 | $718.56 | 0.4× |
| Brachytx isodose intermed (77317) | $136.50 | $505.54 | 0.3× |
| Brachytx Isodose Plan Simple (77316) | $103.82 | $384.53 | 0.2× |
| Brain Flow Imaging Only (78610) | $69.85 | $258.71 | 0.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $129.06 | $477.99 | 0.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $80.10 | $296.65 | 0.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $91.16 | $337.64 | 0.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $162.23 | $600.84 | 0.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $188.62 | $698.58 | 0.2× |
| Cat Scan Follow-Up Study (76380) | $58.84 | $217.91 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $133.04 | $492.75 | 0.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$11.08–$93.96 | $41.05–$348 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$14.36–$114.48 | $53.20–$424 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$18.07–$86.23 | $66.94–$319.37 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$19.79–$128.10 | $73.31–$474.44 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $37.80 | $140 | 0.3× |
| Cholecystography Oral Contrast (74290) | $37.15 | $137.59 | 0.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $49.85 | $184.62 | 0.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$13.76–$111.36 | $50.95–$412.46 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$66.15–$784.89 | $245–$2,907 | varies |
| Contrast Exam Abdominl Aorta (75625) | $99.23 | $367.50 | 0.0× |
| Contrast X-Ray Bladder (74430) | $17.65 | $65.38 | 0.0× |
| Contrast X-Ray Of Elbow (73085) | $47.70 | $176.67 | 0.1× |
| Contrast X-Ray Of Knee Joint (73580) | $54.45 | $201.68 | 0.1× |
| Contrast Xray Throat/Cerv Esopha (74210) | $41.52 | $153.78 | 0.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$160.15–$1,566 | $593.15–$5,800 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$135–$1,134 | $500–$4,200 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$106.88–$833.65 | $395.85–$3,087.58 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$116.71–$904.50 | $432.26–$3,350 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$66.62–$678.05 | $246.75–$2,511.30 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$178.07–$1,593 | $659.50–$5,900 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$124.48–$945 | $461.04–$3,500 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$122.17–$796.50 | $452.49–$2,950 | varies |
| CT angio hrt w/3d image (75574) | $141.53 | $524.20 | 0.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$143.33–$787.05 | $530.85–$2,915 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$122.03–$1,003.44 | $451.97–$3,716.44 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$131.82–$918 | $488.22–$3,400 | varies |
| CT bone density (77078) | $44.62 | $165.27 | 0.4× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$78.83–$702.22 | $291.96–$2,600.83 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$66.62–$648 | $246.75–$2,400 | varies |
| CT cervical spine w/wo cont (72127) | $92.26 | $341.70 | 0.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$77.89–$796.50 | $288.47–$2,950 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$91.83–$650.03 | $340.11–$2,407.50 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $208.97 | $773.95 | 1.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $185.58 | $687.35 | 1.4× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$69.10–$837 | $255.91–$3,100 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$81.22–$1,081.13 | $300.82–$4,004.17 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $105.80 | $391.85 | 0.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $46.37 | $171.74 | 0.4× |
| CT hrt w/3d image congen (75573) | $134.17 | $496.92 | 0.3× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$84.43–$661.50 | $312.70–$2,450 | varies |
| CT l-spine w&w/o contrast (72133) | $92.56 | $342.81 | 0.4× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$60.41–$634.50 | $223.75–$2,350 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$90.72–$715.50 | $336–$2,650 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$78.98–$729 | $292.51–$2,700 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$66.62–$702 | $246.75–$2,600 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$90.72–$693.50 | $336–$2,568.52 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$90.72–$654.54 | $336–$2,424.21 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$103.83–$756 | $384.55–$2,800 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$98.53–$1,080 | $364.91–$4,000 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$74.10–$641.87 | $274.44–$2,377.29 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$112.65–$575.49 | $417.24–$2,131.44 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$66.62–$705.47 | $246.75–$2,612.85 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$91.21–$945 | $337.82–$3,500 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$90.72–$702 | $336–$2,600 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$86.38–$727.65 | $319.91–$2,695 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$70.22–$655.97 | $260.08–$2,429.52 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$79.39–$717.82 | $294.05–$2,658.61 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$60.56–$673.88 | $224.30–$2,495.84 | varies |
| CT thoracic spine w/wo cont (72130) | $93.16 | $345.02 | 0.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$66.62–$688.50 | $246.75–$2,550 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$71.62–$678.05 | $265.26–$2,511.30 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $110.68 | $409.93 | 0.5× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$94.30–$635.44 | $349.25–$2,353.47 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$181.06–$877.50 | $670.60–$3,250 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$135.93–$946.08 | $503.44–$3,503.99 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$135.21–$621 | $500.79–$2,300 | varies |
| Dilation ureters/urethra rs&i (74485) | $51.02 | $188.95 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $55.21 | $204.47 | 0.0× |
| Diskography lumbar (72295) | $47.48 | $175.86 | 0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $21.60 | $80 | 0.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $29.85 | $110.56 | 0.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $37.99 | $140.69 | 0.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$20.52–$199.57 | $76–$739.16 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$25.11–$243 | $93–$900 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$13.36–$96.76 | $49.49–$358.37 | varies |
| Echo exam of fetal heart (76825) | $112.13 | $415.30 | 0.2× |
| Echo exam uterus (76831) | $49.87 | $184.70 | 0.2× |
| Echo Guide For Artery Repair (76936) | $110.24 | $408.31 | 0.4× |
| Echograp Trans R Pros Study (76873) | $74.75 | $276.84 | 0.6× |
| Esophagram (74220) | $42.51 | $157.46 | 0.2× |
| Fetal Biophys Profile W/Nst (76818) | $50.01 | $185.22 | 0.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$36.06–$182.25 | $133.56–$675 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $182.61 | $676.33 | 0.6× |
| Fluoroscopy up to 1 hr (76000) | $18.42 | $68.24 | 0.1× |
| Follow-Up Angiography (75898) | $56.70 | $210 | 0.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$12.06–$100.48 | $44.67–$372.16 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$12.48–$108.28 | $46.24–$401.03 | varies |
| Gastric emptying imaging study (78264) | $130.58 | $483.62 | 0.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $154.53 | $572.32 | 0.3× |
| Gated Heart Planar Single (78472) | $90.45 | $334.99 | 0.2× |
| Gated Heart, Multiple (78473) | $114.96 | $425.76 | 0.2× |
| GI Endoscopic US S&I (76975) | $40.29 | $149.21 | 0.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $175.62 | $650.44 | 0.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$13.33–$83.70 | $49.37–$310 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $380.56 | $1,409.49 | 0.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $255.75 | $947.22 | 0.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $147.10 | $544.81 | 0.2× |
| Heart first pass single,planar (78481) | $70.95 | $262.78 | 0.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $179.74 | $665.70 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $53.23 | $197.15 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) | $172.52 | $638.97 | 0.3× |
| Hepatobiliary System Imaging (78226) | $128.42 | $475.64 | 0.3× |
| Ht Musc Image Planar Mult (78454) | $172.46 | $638.74 | 0.1× |
| Ht Muscle Image Spect Sing (78451) | $134.25 | $497.21 | 0.1× |
| Hysterosalpingogram (74740) | $40.87 | $151.37 | 0.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $58.55 | $216.85 | 0.5× |
| Infant hip ultrasound, limited static exam (76886) | $43.24 | $160.14 | 0.4× |
| Infusion Ivp (74410) | $60.27 | $223.22 | 0.3× |
| Interstitial radiation source applic complex (77778) | $389.60 | $1,442.95 | 0.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $331.49 | $1,227.74 | 0.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $234.78 | $869.55 | 0.3× |
| Intracavitary radiation source applic simple (77761) | $178.46 | $660.95 | 0.3× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$20.06–$108 | $74.30–$400 | varies |
| K Flow/Funct Image Multiple (78709) | $146.72 | $543.39 | 0.2× |
| K Flow/Funct Image W/Drug (78708) | $74.08 | $274.36 | 0.1× |
| K Flow/Funct Image W/O Drug (78707) | $92.83 | $343.83 | 0.1× |
| Kidney Imaging Morphol (78700) | $68.09 | $252.19 | 0.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $89.45 | $331.31 | 0.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$17.30–$128.04 | $64.09–$474.22 | varies |
| Leveen/Shunt Patency Exam (78291) | $133.65 | $495 | 0.3× |
| Liver & Spleen Imaging Static Only (78215) | $78.15 | $289.45 | 0.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $54.55 | $202.04 | 0.1× |
| Lung Perf&Ventilat Diferentl (78598) | $119.60 | $442.95 | 0.2× |
| Lung perfusion differential (78597) | $79.83 | $295.66 | 0.2× |
| Lung Ventilat&Perfus Imaging (78582) | $131.34 | $486.44 | 0.2× |
| Lung Ventilation Imaging (78579) | $74.76 | $276.89 | 0.1× |
| Lymph System Imaging (78195) | $139.99 | $518.47 | 0.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $106.22 | $393.42 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $100.63 | $372.71 | 0.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $111.19 | $411.82 | 0.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $109.84 | $406.81 | 0.0× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$118.15–$594 | $437.58–$2,200 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $181.44 | $672 | 0.8× |
| Mammary ductogram or galactogram multiple (77054) | $29.47 | $109.16 | 0.1× |
| Mammary ductogram or galactogram single (77053) | $22.77 | $84.33 | 0.1× |
| Meckels Divert Exam (78290) | $130.36 | $482.80 | 0.3× |
| Medical physics dose eval radiation expos w/rprt (76145) | $413.91 | $1,533 | 0.9× |
| Mlc imrt design & construction per imrt plan (77338) | $198.06 | $733.57 | 0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $30.78 | $114 | 0.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $302.67 | $1,121 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$146.06–$952.65 | $540.97–$3,528.33 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$95.54–$955.84 | $353.87–$3,540.16 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$100.85–$538.25 | $373.53–$1,993.51 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$109.20–$640.10 | $404.45–$2,370.75 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$153.29–$1,175.83 | $567.73–$4,354.94 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$95.69–$756 | $354.41–$2,800 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$135.01–$918 | $500.05–$3,400 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$90.72–$1,034.61 | $336–$3,831.90 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$139.87–$520.03 | $518.02–$1,926.02 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$172.44–$1,175.85 | $638.66–$4,354.99 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $139.73 | $517.50 | 0.1× |
| MRI bone marrow blood supply (77084) | $141.63 | $524.54 | 0.5× |
| MRI brain functional w/o physician admnistration (70554) | $168.56 | $624.31 | 0.6× |
| MRI brain functional w/physician admnistration (70555) | $260.13 | $963.45 | 0.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $97.89 | $362.55 | 0.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $94.42 | $349.72 | 0.3× |
| MRI cardiac w/o cont stress (75559) | $166.32 | $616 | 0.2× |
| MRI cardiac w/o contrast (75557) | $124.07 | $459.53 | 0.4× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$122.54–$842.73 | $453.85–$3,121.23 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$90.72–$929.68 | $336–$3,443.25 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$150.85–$639.41 | $558.70–$2,368.19 | varies |
| MRI chest with contrast (71551) | $166.80 | $617.79 | 0.2× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$210.78–$1,175.83 | $780.65–$4,354.94 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$116.98–$629.21 | $433.25–$2,330.42 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$150.54–$1,175.85 | $557.56–$4,354.99 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$99.58–$935.52 | $368.81–$3,464.90 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$120.42–$972 | $446–$3,600 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$142.56–$1,278.17 | $527.99–$4,733.95 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$100.71–$742.50 | $373–$2,750 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$119.66–$574.03 | $443.20–$2,126.05 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$151.11–$1,213.31 | $559.65–$4,493.75 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$119.82–$945 | $443.76–$3,500 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$150.44–$1,175.85 | $557.17–$4,354.99 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$102.03–$876.15 | $377.88–$3,245 | varies |
| MRI spectroscopy (76390) | $148.55 | $550.20 | 1.4× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$90.72–$877.50 | $336–$3,250 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$148.14–$715.50 | $548.66–$2,650 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$135.54–$988.96 | $502.01–$3,662.83 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$183.18–$1,175.85 | $678.43–$4,354.99 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$151–$1,214.98 | $559.27–$4,499.94 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$142.84–$1,243.65 | $529.03–$4,606.12 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$121.55–$770.66 | $450.19–$2,854.31 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$90.72–$891 | $336–$3,300 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$173–$1,175.85 | $640.75–$4,354.99 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$142.27–$1,232.24 | $526.94–$4,563.85 | varies |
| Myelogram cervical (72240) | $49.14 | $182 | 0.1× |
| Myelogram Lumbar (72265) | $46.92 | $173.76 | 0.0× |
| Myelography thoracic (72255) | $51.31 | $190.03 | 0.1× |
| Myelograpy 2/more regions rs&i (72270) | $70.49 | $261.08 | 0.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $73.85 | $273.52 | 0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $415.85 | $1,540.18 | 0.3× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $77.80 | $288.16 | 0.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $115.75 | $428.69 | 0.1× |
| Myocardial Spect Multiple Studies (78452) | $185.97 | $688.78 | 0.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $469.41 | $1,738.57 | 0.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $467.80 | $1,732.61 | 0.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $613.61 | $2,272.63 | 0.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $732.69 | $2,713.65 | 0.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $711 | $2,633.32 | 0.4× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$13.49–$120.80 | $49.96–$447.42 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $167.97 | $622.12 | 0.3× |
| Nm csf leak detection (78650) | $107.09 | $396.63 | 0.1× |
| Nm myocard infarct spect (78469) | $88.43 | $327.50 | 0.1× |
| Nm red cell survival study (78130) | $52.35 | $193.89 | 0.1× |
| Nonvascular Shunt X-Ray (75809) | $35.08 | $129.91 | 0.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $779.87 | $2,888.41 | 0.5× |
| Nuclear Rx Intra-Arterial (79445) | $82.48 | $305.47 | 0.3× |
| Nuclear Rx Oral Admin (79005) | $57.80 | $214.07 | 0.2× |
| Ob us nuchal meas 1 gest (76813) | $50.41 | $186.72 | 0.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$34.16–$94.50 | $126.50–$350 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $67.50 | $250 | 0.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $45.09 | $167 | 0.3× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $51.17 | $189.50 | 0.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $67.50 | $250 | 0.5× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$5.40–$31.65 | $20–$117.24 | varies |
| Optic foramina (70190) | $16.05 | $59.45 | 0.1× |
| Panoramic X-ray of jaws (70355) | $10.35 | $38.33 | 0.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $173.05 | $640.93 | 0.3× |
| Parathyroid Planar Imaging (78070) | $116.03 | $429.75 | 0.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $138.72 | $513.77 | 0.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$11.93–$129.99 | $44.17–$481.44 | varies |
| Peritoneogram Rs&I (74190) | $85.05 | $315 | 0.1× |
| Pet Image W/Ct Lmtd (78814) | $582.43 | $2,157.13 | 0.3× |
| PET image w/CT, full body (78816) | $586.94 | $2,173.86 | 0.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $586.63 | $2,172.70 | 0.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $30.94 | $114.59 | 0.0× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $29.08 | $107.72 | 0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $179.74 | $665.70 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $93.81 | $347.43 | 0.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$21.33–$115.77 | $78.99–$428.78 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $32.60 | $120.75 | 0.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$15.74–$131.94 | $58.29–$488.65 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$12.20–$90.59 | $45.19–$335.53 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$13.91–$113.06 | $51.50–$418.74 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$20.04–$97.71 | $74.24–$361.90 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$16.14–$86.40 | $59.77–$320 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$14.61–$131.66 | $54.11–$487.62 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$15.74–$113.06 | $58.29–$418.74 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$13.48–$48.56 | $49.91–$179.85 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $26.71 | $98.93 | 0.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$16.31–$104.82 | $60.39–$388.23 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $43.36 | $160.61 | 0.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$15.78–$145.48 | $58.44–$538.83 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$14.76–$204.10 | $54.66–$755.92 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$13.76–$76.95 | $50.98–$285 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $159.28 | $589.91 | 0.7× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$10.51–$160.65 | $38.91–$595 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$14.35–$99.99 | $53.15–$370.32 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$22.57–$124.52 | $83.60–$461.18 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$12.46–$79.65 | $46.16–$295 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$13.48–$59.45 | $49.91–$220.18 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$17.44–$113.06 | $64.59–$418.74 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$42.27–$140.35 | $156.56–$519.81 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$18.48–$105.19 | $68.45–$389.60 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$18.35–$141.85 | $67.98–$525.38 | varies |
| Radiologic exam colon double contrast study (74280) | $95.70 | $354.44 | 0.4× |
| Radiologic exam colon single contrast study (74270) | $66.56 | $246.53 | 0.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $47.81 | $177.09 | 0.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$19.87–$157.86 | $73.61–$584.65 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$18.06–$171.02 | $66.89–$633.42 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $52.98 | $196.21 | 0.2× |
| Radiologic exam swallow function contrast study (74230) | $54.19 | $200.71 | 0.2× |
| Radiologic exam teeth complete full mouth (70320) | $22.42 | $83.03 | 0.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $16.72 | $61.94 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $60.39 | $223.66 | 0.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$12.48–$67.39 | $46.24–$249.61 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$15.18–$120.42 | $56.23–$445.99 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$14.60–$96.33 | $54.09–$356.77 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $27.77 | $102.85 | 0.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $16.02 | $59.35 | 0.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$13.48–$108.28 | $49.91–$401.03 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $26.32 | $97.47 | 0.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $5.52 | $20.44 | 0.1× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $457.47 | $1,694.35 | 1.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $70.88 | $262.50 | 0.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $29.82 | $110.44 | 0.1× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $32.56 | $120.61 | 0.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $154.17 | $570.99 | 0.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $105.61 | $391.16 | 0.2× |
| Renal Cyst Study (74470) | $29.62 | $109.70 | 0.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$18.79–$140.30 | $69.60–$519.64 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $99.81 | $369.67 | 0.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $108.35 | $401.30 | 0.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $255.08 | $944.73 | 0.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $122.39 | $453.28 | 0.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $150.71 | $558.18 | 0.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $280.19 | $1,037.74 | 0.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $358.90 | $1,329.25 | 0.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $189.86 | $703.20 | 0.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $121.50 | $450 | 0.4× |
| Rp Therapy Intravenous Administration (79101) | $67.50 | $250 | 0.2× |
| Salivary Gland Function Study (78232) | $43.27 | $160.25 | 0.1× |
| Salivary Gland Imaging (78230) | $70.49 | $261.08 | 0.1× |
| Scapula (73010) range across 2 matching MRF lines |
$13.18–$104.82 | $48.83–$388.23 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$22.62–$139.81 | $83.79–$517.83 | varies |
| Sella turcica (70240) | $14.06 | $52.07 | 0.1× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$9.23–$141.51 | $34.18–$524.11 | varies |
| Shoulder Arthrography (73040) | $56.18 | $208.07 | 0.1× |
| Sialogram (70390) | $50.33 | $186.42 | 0.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$15.32–$90.45 | $56.75–$335 | varies |
| Special dosimetry (77331) | $37.80 | $140 | 0.2× |
| Special teletherapy port plan (77321) | $40.50 | $150 | 0.1× |
| Special treatment procedure (77470) | $59.71 | $221.13 | 0.1× |
| Spleen Imaging (78185) | $67.10 | $248.51 | 0.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$17.61–$114.85 | $65.24–$425.36 | varies |
| Superior sagittal sinus venogram (75870) | $66.59 | $246.64 | 0.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $56.15 | $207.96 | 0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $122.22 | $452.67 | 0.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $63.06 | $233.54 | 0.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $36.26 | $134.29 | 0.1× |
| Testicular Imaging W/Flow (78761) | $84.89 | $314.39 | 0.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $192.13 | $711.59 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $187.19 | $693.31 | 0.4× |
| Ther rad simulaj-aided field setting simple (77280) | $114.36 | $423.55 | 0.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $109.85 | $406.86 | 0.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$14.07–$111.06 | $52.10–$411.33 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$16.77–$152.81 | $62.12–$565.97 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$14.78–$113.20 | $54.74–$419.25 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $91.64 | $339.40 | 0.2× |
| Thyroid Imaging With Vascular Flow (78013) | $75.52 | $279.71 | 0.2× |
| Thyroid Met Imaging Body (78018) | $123.28 | $456.59 | 0.2× |
| Thyroid Uptake Measurement (78012) | $34.17 | $126.55 | 0.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $94.26 | $349.12 | 0.2× |
| Tx Devices Design & Construction Complex (77334) | $53.36 | $197.64 | 0.1× |
| Tx devices design & construction intermediate (77333) | $58.59 | $216.99 | 0.3× |
| Tx devices design & construction simple (77332) | $24.30 | $90 | 0.1× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$36.50–$202.50 | $135.18–$750 | varies |
| Ultrasound elastography first target lesion (76982) | $52.92 | $196 | 0.4× |
| Ultrasound Elastography Parenchyma (76981) | $44.49 | $164.76 | 0.3× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$45.59–$259.18 | $168.85–$959.94 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$37.70–$276.96 | $139.64–$1,025.76 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$19.23–$140.40 | $71.21–$520 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $9.45 | $35 | 0.1× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $9.45 | $35 | 0.0× |
| Upper gi w/o kub (74240) | $53.25 | $197.24 | 0.2× |
| Ureteral Reflux Study (78740) | $86.40 | $320 | 0.2× |
| Urethrocystogram voiding (74455) | $44.68 | $165.48 | 0.2× |
| Urethrocystography retrograde (74450) | $28.81 | $106.72 | 0.1× |
| Us bone density measurement (76977) | $4.05 | $15 | 0.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$44.30–$274.59 | $164.08–$1,017 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$30.05–$189 | $111.30–$700 | varies |
| Us complete joint (76881) | $24.84 | $92 | 0.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$20.89–$242.72 | $77.37–$898.96 | varies |
| Us head (76506) range across 2 matching MRF lines |
$48.47–$178.14 | $179.52–$659.77 | varies |
| Us kidney transplant (76776) | $63.37 | $234.69 | 0.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$25.61–$205.97 | $94.85–$762.86 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$75.56–$233.71 | $279.86–$865.58 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$34.92–$144.45 | $129.34–$535 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$39.80–$168.75 | $147.39–$625 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$45.27–$302.01 | $167.65–$1,118.54 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$50.57–$209.25 | $187.28–$775 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$47–$168.75 | $174.06–$625 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$46.57–$314.25 | $172.48–$1,163.90 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$25.26–$251.35 | $93.57–$930.91 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$43.25–$252.32 | $160.19–$934.52 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$69.22–$202.13 | $256.36–$748.63 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$47.57–$243 | $176.20–$900 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$85.56–$175.50 | $316.89–$650 | varies |
| Vascular Flow Imaging (78445) | $83.31 | $308.57 | 0.2× |
| Vasogram (74440) | $41.46 | $153.57 | 0.1× |
| Vein X-Ray Chest (75827) | $56.70 | $210 | 0.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $85.05 | $315 | 0.0× |
| Vein X-Ray Spleen/Liver (75810) | $213.18 | $789.54 | 0.1× |
| Venogram Sinus/Jugular (75860) | $56.70 | $210 | 0.0× |
| Venography Adrenal Unilateral (75840) | $55.38 | $205.12 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $56.70 | $210 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $56.70 | $210 | 0.0× |
| Venography extremity unilateral rs&i (75820) | $46.67 | $172.84 | 0.0× |
| Venography Renal Bilateral (75833) | $113.40 | $420 | 0.0× |
| Venography Renal Unilateral (75831) | $51.44 | $190.52 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$170.10 | $630 | 0.0× |
| Vertebral fracture assessment via dxa (77086) | $14.05 | $52.02 | 0.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$14.46–$89.10 | $53.56–$330 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$12.22–$120.95 | $45.25–$447.96 | varies |
| X-ray antegrade pyelogram tube (74425) | $58.48 | $216.59 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) | $113.40 | $420 | 0.0× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$17.33–$95.94 | $64.18–$355.34 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$12.48–$91.25 | $46.24–$337.96 | varies |
| X-Ray Exam Breast Specimen (76098) | $17.93 | $66.40 | 0.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$18.21–$126.93 | $67.43–$470.12 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$29.94–$184.05 | $110.88–$681.68 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$33.67–$124.58 | $124.72–$461.40 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$14.05–$76.38 | $52.05–$282.90 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$20.02–$165.89 | $74.13–$614.42 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$25.28–$114.75 | $93.62–$425 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$17.61–$239.38 | $65.24–$886.59 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$22.89–$240.85 | $84.78–$892.05 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$26.41–$242.33 | $97.81–$897.51 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$26.40–$325.39 | $97.77–$1,205.13 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$16.91–$129.17 | $62.63–$478.41 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$26.54–$256.91 | $98.29–$951.53 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$18.07–$186.54 | $66.94–$690.89 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$13.91–$222.10 | $51.53–$822.59 | varies |
| X-ray head for orthodontia (70350) | $6.98 | $25.85 | 0.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$13.76–$109.67 | $50.95–$406.18 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$58.09–$199.83 | $215.14–$740.11 | varies |
| X-ray IV pyelogram+tomography (74415) | $66.20 | $245.20 | 0.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$16.45–$75.14 | $60.94–$278.28 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$17–$99.57 | $62.98–$368.79 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$17.05–$145.02 | $63.14–$537.11 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$12.78–$98.61 | $47.35–$365.23 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$22.46–$195.95 | $83.18–$725.74 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$16.77–$107.81 | $62.12–$399.31 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $14.05 | $52.02 | 0.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$13.91–$96.33 | $51.50–$356.77 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$16.06–$129.43 | $59.48–$479.37 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$19.31–$162.55 | $71.51–$602.04 | varies |
| X-Ray Stress View (77071) | $23.25 | $86.10 | 0.2× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$18.91–$148.68 | $70.02–$550.66 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$14.76–$75.55 | $54.66–$279.83 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $43.19 | $159.97 | 0.1× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$19.16–$270.28 | $70.98–$1,001.02 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$42.59–$493.79 | $157.74–$1,828.84 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$22.73–$200.97 | $84.20–$744.32 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$13.78–$68.40 | $51.03–$253.32 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$20.48–$202.04 | $75.86–$748.28 | varies |
| Xr Tomogram Single Plane (76100) | $38.40 | $142.23 | 0.3× |
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.