Imaging prices at OhioHealth Mansfield Hospital
Mansfield, OH · every code in this section with a posted price and a Medicare benchmark.
436 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) | $7,637.50 | $11,750 | 5.8× |
| Abdomen 1 View (74018) | $268.45 | $413 | 3.2× |
| Abdomen 2 views (74019) | $325.65 | $501 | 3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,264.90 | $1,946 | 3.3× |
| Adrenal Cortex & Medulla Img (78075) | $2,239.25 | $3,445 | 1.8× |
| Angio internal mammary (75756) | $2,304.90 | $3,546 | 0.8× |
| Angio pulmonary bilat (75743) | $5,703.10 | $8,774 | 1.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,838.30 | $8,982 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $5,950.10 | $9,154 | 2.0× |
| Angiography extremity unilateral rs&i (75710) | $5,562.05 | $8,557 | 1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,135.60 | $4,824 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,605.90 | $7,086 | 1.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$206.05–$412.10 | $317–$634 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,382 | $8,280 | 1.0× |
| Artery X-Rays Abdomen (75726) | $6,407.70 | $9,858 | 1.2× |
| Artery X-Rays Adrenal Gland (75731) | $4,865.25 | $7,485 | 1.6× |
| Artery X-Rays Pelvis (75736) | $5,703.10 | $8,774 | 1.1× |
| Artery X-Rays Spine (75705) | $5,382 | $8,280 | 1.0× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$630.50–$1,261 | $970–$1,940 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,517.10–$3,034.20 | $2,334–$4,668 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$863.20–$1,726.40 | $1,328–$2,656 | varies |
| Basic radiation dosimetry calculation (77300) | $2,165.80 | $3,332 | 16.9× |
| Bone age studies (77072) | $284.05 | $437 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,537.25 | $2,365 | 4.0× |
| Bone Imaging Limited Area (78300) | $1,194.70 | $1,838 | 3.1× |
| Bone Imaging Multiple Areas (78305) | $1,328.60 | $2,044 | 3.5× |
| Bone Imaging Whole Body (78306) | $1,464.45 | $2,253 | 3.8× |
| Bone marrow imaging limited area (78102) | $1,330.55 | $2,047 | 3.5× |
| Bone marrow imaging; multiple areas (78103) | $1,397.50 | $2,150 | 3.7× |
| Bone marrow imaging; whole body (78104) | $1,467.70 | $2,258 | 3.8× |
| Bone survey infant (77076) | $449.15 | $691 | 4.5× |
| Brachytx isodose complex (77318) | $8,170.50 | $12,570 | 22.9× |
| Brachytx isodose intermed (77317) | $8,170.50 | $12,570 | 22.9× |
| Brachytx Isodose Plan Simple (77316) | $4,686.50 | $7,210 | 13.1× |
| Brain Flow Imaging Only (78610) | $728 | $1,120 | 1.4× |
| Brain Image W/Flow < 4 Views (78601) | $884.65 | $1,361 | 2.3× |
| Brain imaging < 4 static views (78600) | $884.65 | $1,361 | 2.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,394.90 | $2,146 | 2.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,140.10 | $1,754 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,926 | $6,040 | 2.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,352.65 | $2,081 | 3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,850.60 | $5,924 | 11.6× |
| Cardiac Shunt Detection (78428) | $1,352.65 | $2,081 | 3.5× |
| Cat Scan Follow-Up Study (76380) | $1,375.40 | $2,116 | 16.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $728 | $1,120 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $794.30 | $1,222 | 1.5× |
| Chest 1 view (71045) | $215.15 | $331 | 2.6× |
| Chest 2 views (71046) | $236.60 | $364 | 2.8× |
| Chest 3 views (71047) | $259.35 | $399 | 3.1× |
| Chest 4 or more views (71048) | $286.65 | $441 | 2.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$318.50–$637 | $490–$980 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $640.90 | $986 | 6.4× |
| Continuing medical physics consltj pr wk (77336) | $2,375.75 | $3,655 | 18.5× |
| Contrast Exam Abdominl Aorta (75625) | $5,464.55 | $8,407 | 1.8× |
| Contrast X-Ray Bladder (74430) | $564.85 | $869 | 1.7× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,623.70–$3,247.40 | $2,498–$4,996 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$902.20–$1,804.40 | $1,388–$2,776 | varies |
| Corpora cavernosography (74445) | $971.75 | $1,495 | 9.7× |
| CT abdomen and pelvis without and with contrast (74178) | $3,249.35 | $4,999 | 9.8× |
| CT abdomen and pelvis without contrast (74176) | $2,559.70 | $3,938 | 11.2× |
| CT abdomen w contrast (74160) | $2,037.10 | $3,134 | 12.2× |
| CT abdomen w wo contrast (74170) | $2,343.25 | $3,605 | 14.0× |
| CT abdomen w/o contrast (74150) | $1,771.25 | $2,725 | 17.7× |
| CT Angio Abdomen and Pelvis (74174) | $3,411.85 | $5,249 | 10.2× |
| CT Angio Chest (71275) | $2,165.80 | $3,332 | 12.9× |
| CT Angio Head (70496) | $2,300.35 | $3,539 | 13.7× |
| CT angio hrt w/3d image (75574) | $2,372.50 | $3,650 | 7.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,636.70–$3,273.40 | $2,518–$5,036 | varies |
| CT Angio Neck (70498) | $2,300.35 | $3,539 | 13.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,691.30 | $2,602 | 10.1× |
| CT cervical spine w/ contrast (72126) | $1,766.05 | $2,717 | 5.3× |
| CT cervical spine w/o contrast (72125) | $1,605.50 | $2,470 | 16.1× |
| CT cervical spine w/wo cont (72127) | $1,942.20 | $2,988 | 11.6× |
| CT chest w contrast (71260) | $1,762.15 | $2,711 | 10.5× |
| CT chest w/wo contrast (71270) | $1,938.30 | $2,982 | 11.6× |
| CT colonography screening (74263) | $1,197.30 | $1,842 | 5.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,197.30 | $1,842 | 12.0× |
| CT head/brain with contrast (70460) | $1,370.20 | $2,108 | 8.2× |
| CT head/brain without and with contrast (70470) | $1,654.25 | $2,545 | 9.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,371.50 | $2,110 | 4.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $380.25 | $585 | 4.6× |
| CT hrt w/3d image congen (75573) | $1,371.50 | $2,110 | 4.1× |
| CT iac w contrast (70481) | $1,749.15 | $2,691 | 10.4× |
| CT l-spine w&w/o contrast (72133) | $2,561 | $3,940 | 15.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,184.95–$2,369.90 | $1,823–$3,646 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,303.25–$2,606.50 | $2,005–$4,010 | varies |
| CT lumbar spine w contrast (72132) | $2,328.30 | $3,582 | 7.0× |
| CT lumbar spine w/o contrast (72131) | $2,116.40 | $3,256 | 21.2× |
| CT maxillofacial w contrast (70487) | $1,738.75 | $2,675 | 10.4× |
| CT maxillofacial wo contrast (70486) | $1,502.15 | $2,311 | 15.0× |
| CT neck tissue combo (70492) | $2,437.50 | $3,750 | 14.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,923.35 | $2,959 | 11.5× |
| CT orbits w/o contrast (70480) | $1,589.25 | $2,445 | 15.9× |
| CT pelvis w&w/o contrast (72194) | $2,206.10 | $3,394 | 13.2× |
| CT pelvis w/o contrast (72192) | $1,823.25 | $2,805 | 18.3× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,433.90–$2,867.80 | $2,206–$4,412 | varies |
| CT scans face/jaw combo (70488) | $1,916.85 | $2,949 | 11.4× |
| CT soft tissue neck w contrast (70491) | $2,215.85 | $3,409 | 13.2× |
| CT soft tissue neck w/o contrast (70490) | $2,013.70 | $3,098 | 20.2× |
| CT thoracic spine w contrast (72129) | $2,328.30 | $3,582 | 13.9× |
| CT thoracic spine w/o contrast (72128) | $2,116.40 | $3,256 | 21.2× |
| CT thoracic spine w/wo cont (72130) | $2,561 | $3,940 | 15.3× |
| CT thorax w/o contrast (71250) | $1,602.25 | $2,465 | 16.1× |
| CT unlisted procedure (76497) | $2,150.20 | $3,308 | 25.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,303.90–$2,607.80 | $2,006–$4,012 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,577.55–$3,155.10 | $2,427–$4,854 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,434.55–$2,869.10 | $2,207–$4,414 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,468.70 | $3,798 | 14.7× |
| Cta Abdomen (74175) | $2,497.95 | $3,843 | 14.9× |
| CTA pelvis (72191) | $2,298.40 | $3,536 | 13.7× |
| Dilation ureters/urethra rs&i (74485) | $4,607.20 | $7,088 | 2.3× |
| Discography Cerv/Thor Spine (72285) | $2,252.90 | $3,466 | 1.2× |
| Diskography lumbar (72295) | $2,373.80 | $3,652 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $654.55 | $1,007 | 6.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $776.10 | $1,194 | 7.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $408.85 | $629 | 4.1× |
| Dxa Bone Density Axial (77080) | $351 | $540 | 3.5× |
| Dxa bone density study (77085) | $1,684.15 | $2,591 | 16.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $300.95 | $463 | 3.6× |
| Echo exam of fetal heart (76825) | $1,036.75 | $1,595 | 2.0× |
| Echo exam uterus (76831) | $962.65 | $1,481 | 4.2× |
| Echo Guide For Artery Repair (76936) | $3,555.50 | $5,470 | 17.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $683.15 | $1,051 | 3.0× |
| Echograp Trans R Pros Study (76873) | $498.55 | $767 | 5.0× |
| Esophagram (74220) | $464.75 | $715 | 2.8× |
| Fetal Biophys Profile W/Nst (76818) | $537.55 | $827 | 5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $497.90 | $766 | 5.0× |
| Fluoroscopy up to 1 hr (76000) | $608.40 | $936 | 2.7× |
| Follow-Up Angiography (75898) | $5,427.50 | $8,350 | 1.8× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$223.60–$447.20 | $344–$688 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$209.95–$419.90 | $323–$646 | varies |
| Gastric emptying imaging study (78264) | $2,062.45 | $3,173 | 5.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,233.40 | $3,436 | 5.9× |
| Gated Heart Planar Single (78472) | $1,576.25 | $2,425 | 4.1× |
| Gated Heart, Multiple (78473) | $2,083.25 | $3,205 | 5.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,404.35 | $3,699 | 4.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$201.50–$403 | $310–$620 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $9,842.30 | $15,142 | 14.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $9,842.30 | $15,142 | 14.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $9,842.30 | $15,142 | 14.8× |
| Heart first pass single,planar (78481) | $1,513.85 | $2,329 | 2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,051.45 | $6,233 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,893.80 | $4,452 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) | $2,401.75 | $3,695 | 4.6× |
| Hepatobiliary System Imaging (78226) | $1,943.50 | $2,990 | 5.1× |
| Ht Musc Image Planar Mult (78454) | $2,566.85 | $3,949 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $2,254.85 | $3,469 | 1.8× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $3,223.35 | $4,959 | 4.8× |
| Hysterosalpingogram (74740) | $929.50 | $1,430 | 4.1× |
| Interstitial radiation source applic complex (77778) | $4,743.70 | $7,298 | 7.1× |
| Joint Survey Single View (77077) | $222.95 | $343 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $1,940.25 | $2,985 | 3.7× |
| K Flow/Funct Image W/Drug (78708) | $1,712.75 | $2,635 | 3.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,539.85 | $2,369 | 3.0× |
| Kidney Imaging Morphol (78700) | $1,420.25 | $2,185 | 3.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,420.25 | $2,185 | 3.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$322.40–$644.80 | $496–$992 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $853.45 | $1,313 | 2.2× |
| Leveen/Shunt Patency Exam (78291) | $861.25 | $1,325 | 2.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,605.50 | $2,470 | 4.2× |
| Liver imaging static only (78201) | $1,665.95 | $2,563 | 3.2× |
| Liver imaging w/vascular flow (78202) | $1,665.95 | $2,563 | 3.2× |
| Lung perfusion differential (78597) | $889.20 | $1,368 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,031.55 | $1,587 | 2.0× |
| Lung Ventilation Imaging (78579) | $717.60 | $1,104 | 1.9× |
| Lymph System Imaging (78195) | $1,275.30 | $1,962 | 2.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $3,998.15 | $6,151 | 2.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $2,785.90 | $4,286 | 4.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $8,139.95 | $12,523 | 2.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $8,139.95 | $12,523 | 2.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,803.75–$3,607.50 | $2,775–$5,550 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $2,456.35 | $3,779 | 14.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,232.75 | $3,435 | 4.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $2,702.05 | $4,157 | 16.1× |
| Mammary ductogram or galactogram multiple (77054) | $1,133.60 | $1,744 | 5.0× |
| Mammary ductogram or galactogram single (77053) | $567.45 | $873 | 2.5× |
| Meckels Divert Exam (78290) | $2,490.15 | $3,831 | 6.5× |
| Medical physics dose eval radiation expos w/rprt (76145) | $2,843.10 | $4,374 | 8.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,669.85 | $2,569 | 4.7× |
| Mr safety determination physician/other qhp (76016) | $172.25 | $265 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $48.75 | $75 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $178.75 | $275 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $117 | $180 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,794.35 | $4,299 | 8.4× |
| MRA head w/o contrast (70544) | $2,308.80 | $3,552 | 10.1× |
| MRA head with contrast (70545) | $2,539.55 | $3,907 | 7.6× |
| MRA neck w contrast (70548) | $2,532.40 | $3,896 | 7.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,785.90 | $4,286 | 8.4× |
| MRA neck w/o contrast (70547) | $2,302.95 | $3,543 | 10.1× |
| MRI abdomen w contrast (74182) | $2,976.35 | $4,579 | 8.9× |
| MRI abdomen w/o contrast (74181) | $2,705.95 | $4,163 | 11.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,494.70–$4,989.40 | $3,838–$7,676 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,744.95–$5,489.90 | $4,223–$8,446 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,589.60–$5,179.20 | $3,984–$7,968 | varies |
| MRI bone marrow blood supply (77084) | $1,840.80 | $2,832 | 8.1× |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$2,432.95–$4,865.90 | $3,743–$7,486 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,397.85 | $3,689 | 10.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,192.45 | $3,373 | 9.6× |
| MRI cardiac w/o contrast (75557) | $3,542.50 | $5,450 | 15.5× |
| MRI cervical spine w contrast (72142) | $2,708.55 | $4,167 | 8.1× |
| MRI cervical spine w/o cont (72141) | $2,462.20 | $3,788 | 10.8× |
| MRI chest w/o contrast (71550) | $2,573.35 | $3,959 | 11.3× |
| MRI chest with contrast (71551) | $2,830.75 | $4,355 | 3.8× |
| MRI chest wo w contrast (71552) | $3,113.50 | $4,790 | 9.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,754.70–$5,509.40 | $4,238–$8,476 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,030.30–$6,060.60 | $4,662–$9,324 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,505.10–$5,010.20 | $3,854–$7,708 | varies |
| MRI lumbar spine w contrast (72149) | $3,240.90 | $4,986 | 9.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,979.60 | $4,584 | 8.9× |
| MRI orbit face &/neck w/o contrast (70540) | $2,260.05 | $3,477 | 9.9× |
| MRI orbit face neck w contrast (70542) | $2,486.25 | $3,825 | 7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,733.90 | $4,206 | 8.2× |
| MRI pelvis w contrast (72196) | $2,705.95 | $4,163 | 8.1× |
| MRI pelvis w/o & w contrast (72197) | $2,976.35 | $4,579 | 8.9× |
| MRI pelvis w/o contrast (72195) | $2,460.25 | $3,785 | 10.8× |
| MRI spectroscopy (76390) | $2,176.20 | $3,348 | 26.2× |
| MRI thoracic spine w/o contrast (72146) | $2,975.70 | $4,578 | 13.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,710.50–$5,421 | $4,170–$8,340 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,464.15–$4,928.30 | $3,791–$7,582 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,982.20–$5,964.40 | $4,588–$9,176 | varies |
| MRI, abdomen, combo (74183) | $3,274.70 | $5,038 | 9.8× |
| MRI, dorsal spine combo (72157) | $3,600.35 | $5,539 | 10.8× |
| MRI, dorsal spine contrast (72147) | $3,272.75 | $5,035 | 9.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,354.30–$4,708.60 | $3,622–$7,244 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,848.30–$5,696.60 | $4,382–$8,764 | varies |
| MRI, lumbar spine combo (72158) | $3,564.60 | $5,484 | 10.7× |
| Myelogram cervical (72240) | $1,233.05 | $1,897 | 1.6× |
| Myelogram Lumbar (72265) | $1,239.55 | $1,907 | 1.7× |
| Myelography thoracic (72255) | $1,158.30 | $1,782 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,366.30 | $2,102 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,231.75 | $1,895 | 3.2× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,327.95 | $2,043 | 2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,605.50 | $2,470 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $3,343.60 | $5,144 | 2.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,063.40 | $1,636 | 0.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,651.65 | $2,541 | 1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,740.05 | $2,677 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,103.75 | $4,775 | 1.5× |
| N-invas est c ffr sw aly CTA (75580) | $2,446.60 | $3,764 | 3.0× |
| Neck soft tissue (70360) | $280.15 | $431 | 3.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $612.30 | $942 | 1.6× |
| Nm csf leak detection (78650) | $1,760.85 | $2,709 | 1.4× |
| Nm myocard infarct spect (78469) | $1,327.95 | $2,043 | 2.6× |
| Nonvascular Shunt X-Ray (75809) | $1,009.45 | $1,553 | 10.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $14,203.80 | $21,852 | 10.7× |
| Nuclear Rx Intra-Arterial (79445) | $1,290.25 | $1,985 | 5.8× |
| Nuclear Rx Oral Admin (79005) | $1,290.25 | $1,985 | 5.8× |
| Ob us nuchal meas 1 gest (76813) | $579.80 | $892 | 5.8× |
| Optic foramina (70190) range across 2 matching MRF lines |
$140.40–$280.80 | $216–$432 | varies |
| Panoramic X-ray of jaws (70355) | $258.05 | $397 | 3.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,356.90 | $3,626 | 4.5× |
| Parathyroid Planar Imaging (78070) | $2,136.55 | $3,287 | 5.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,243.80 | $3,452 | 5.9× |
| Pelvis 1 or 2 views (72170) | $174.20 | $268 | 1.7× |
| Perineogram (74775) | $1,391.65 | $2,141 | 6.1× |
| Peritoneogram Rs&I (74190) | $1,751.75 | $2,695 | 3.4× |
| Pet Image W/Ct Lmtd (78814) | $4,070.30 | $6,262 | 3.0× |
| PET image w/CT, full body (78816) | $5,372.25 | $8,265 | 3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,525.95 | $6,963 | 3.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,407.70 | $9,858 | 2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $825.50 | $1,270 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $404.30 | $622 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,390.35 | $2,139 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$256.75–$513.50 | $395–$790 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$277.55–$555.10 | $427–$854 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$313.30–$626.60 | $482–$964 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $449.15 | $691 | 4.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$193.70–$387.40 | $298–$596 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$329.55–$659.10 | $507–$1,014 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$293.80–$587.60 | $452–$904 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$228.80–$457.60 | $352–$704 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$581.10–$1,162.20 | $894–$1,788 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $323.05 | $497 | 3.9× |
| Radex Ribs Unilateral 2 Views (71100) | $301.60 | $464 | 3.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$345.15–$690.30 | $531–$1,062 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $193.70 | $298 | 2.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $580.45 | $893 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $200.85 | $309 | 2.4× |
| Radex Sternum Minimum 2 Views (71120) | $302.90 | $466 | 3.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $395.20 | $608 | 4.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$252.85–$505.70 | $389–$778 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$209.95–$419.90 | $323–$646 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$344.50–$689 | $530–$1,060 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $672.10 | $1,034 | 6.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,036.90 | $10,826 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $1,823.90 | $2,806 | 18.7× |
| Radiation treatment delivery level 2 (77407) | $1,916.20 | $2,948 | 5.2× |
| Radiation treatment delivery level 3 (77412) | $2,011.10 | $3,094 | 3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $416 | $640 | 4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $367.90 | $566 | 3.7× |
| Radiologic exam colon double contrast study (74280) | $715 | $1,100 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $566.80 | $872 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $674.05 | $1,037 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$378.30–$756.60 | $582–$1,164 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $269.10 | $414 | 2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $504.40 | $776 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $356.85 | $549 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $707.85 | $1,089 | 4.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$216.45–$432.90 | $333–$666 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$271.05–$542.10 | $417–$834 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$234–$468 | $360–$720 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $217.10 | $334 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$228.80–$457.60 | $352–$704 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $326.95 | $503 | 0.6× |
| Renal Cyst Study (74470) | $1,751.75 | $2,695 | 3.4× |
| Ribs bilateral 3 views (71110) | $382.85 | $589 | 3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,029.95 | $3,123 | 5.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,131.35 | $3,279 | 5.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,349.10 | $3,614 | 4.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,237.95 | $3,443 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,467.40 | $3,796 | 4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,720.25 | $4,185 | 2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,856.10 | $4,394 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,590.25 | $3,985 | 2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,854.50 | $5,930 | 17.3× |
| Rp Therapy Intravenous Administration (79101) | $1,290.25 | $1,985 | 5.8× |
| Salivary Gland Imaging (78230) | $1,796.60 | $2,764 | 4.7× |
| Scapula (73010) range across 2 matching MRF lines |
$327.60–$655.20 | $504–$1,008 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $52 | $80 | 2.2× |
| Sella turcica (70240) | $200.20 | $308 | 2.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$180.70–$361.40 | $278–$556 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,222.65–$2,445.30 | $1,881–$3,762 | varies |
| Sialogram (70390) | $684.45 | $1,053 | 3.0× |
| Skull less than 4 views (70250) | $206.70 | $318 | 2.1× |
| Special dosimetry (77331) | $1,058.20 | $1,628 | 8.2× |
| Special Physics Consult (77370) | $3,096.60 | $4,764 | 24.1× |
| Special teletherapy port plan (77321) | $7,567.30 | $11,642 | 21.2× |
| Special treatment procedure (77470) | $4,132.70 | $6,358 | 7.8× |
| Stereotactic Body Radiation Delivery (77373) | $4,824.30 | $7,422 | 2.8× |
| Sternoclavicular joints (71130) | $360.10 | $554 | 4.3× |
| Superior sagittal sinus venogram (75870) | $3,256.50 | $5,010 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $9,276.15 | $14,271 | 25.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $7,538.70 | $11,598 | 21.1× |
| Testicular Imaging W/Flow (78761) | $1,136.85 | $1,749 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,680.65 | $7,201 | 13.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,827.50 | $4,350 | 7.9× |
| Ther rad simulaj-aided field setting simple (77280) | $1,582.75 | $2,435 | 12.3× |
| Thoracic spine 2 views (72070) | $318.50 | $490 | 3.2× |
| Thoracic spine 3 views (72072) | $352.95 | $543 | 3.5× |
| Thoracolumbar 2 views (72080) | $338 | $520 | 4.1× |
| Thyroid Imaging With Vascular Flow (78013) | $769.60 | $1,184 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,944.80 | $2,992 | 3.8× |
| Thyroid Uptake Measurement (78012) | $1,161.55 | $1,787 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,627.60 | $2,504 | 4.3× |
| Tx Devices Design & Construction Complex (77334) | $1,898 | $2,920 | 5.3× |
| Tx devices design & construction intermediate (77333) | $1,807.65 | $2,781 | 14.1× |
| Tx devices design & construction simple (77332) | $1,721.85 | $2,649 | 13.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$315.25–$630.50 | $485–$970 | varies |
| Ultrasound Elastography Parenchyma (76981) | $720.20 | $1,108 | 7.2× |
| Ultrasound Exam Aaa Screen (76706) | $481 | $740 | 4.8× |
| Ultrasound, abdomen limited (76705) | $545.35 | $839 | 5.5× |
| Umbilical-artery Doppler (OB) (76820) | $397.15 | $611 | 4.0× |
| Unlisted fluoroscopic procedure (76496) | $2,466.10 | $3,794 | 29.7× |
| Unlisted magnetic resonance procedure (76498) | $442 | $680 | 5.3× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,560 | $2,400 | 16.0× |
| Unlisted us procedure (76999) | $689 | $1,060 | 8.3× |
| Upper gi w/o kub (74240) | $592.80 | $912 | 3.5× |
| Ureteral Reflux Study (78740) | $2,653.95 | $4,083 | 7.0× |
| Urethrocystogram voiding (74455) | $994.50 | $1,530 | 4.4× |
| Urethrocystography retrograde (74450) | $988.65 | $1,521 | 4.3× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$146.25–$1,043.90 | $225–$1,606 | varies |
| Us chest (76604) | $391.30 | $602 | 3.9× |
| Us complete joint (76881) | $663.65 | $1,021 | 6.6× |
| Us exam, pelvic, limited (76857) | $442.65 | $681 | 4.4× |
| Us head (76506) | $642.20 | $988 | 6.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $472.55 | $727 | 4.7× |
| Us ob detailed single fetus (76811) | $802.10 | $1,234 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $417.30 | $642 | 4.2× |
| Us ob transvaginal (76817) | $463.45 | $713 | 4.6× |
| Us pelvic non ob complete (76856) | $543.40 | $836 | 5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $488.15 | $751 | 4.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $475.80 | $732 | 4.8× |
| Us retroperitoneal complete (76770) | $586.30 | $902 | 5.9× |
| Us retroperitoneal limited (76775) | $506.35 | $779 | 5.1× |
| Us scrotum and contents (76870) | $503.75 | $775 | 5.0× |
| Us spinal canal and contents (76800) | $639.60 | $984 | 6.4× |
| Us thyroid (76536) | $551.20 | $848 | 5.5× |
| Us transrectal (76872) | $930.80 | $1,432 | 9.3× |
| Vascular Flow Imaging (78445) | $1,420.25 | $2,185 | 3.7× |
| Vein X-Ray Chest (75827) | $2,289.30 | $3,522 | 1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,375.80 | $6,732 | 1.5× |
| Vein X-Ray Skull Epidural (75872) | $1,855.10 | $2,854 | 3.1× |
| Vein X-Ray Spleen/Liver (75810) | $4,219.80 | $6,492 | 1.4× |
| Venogram Sinus/Jugular (75860) | $4,828.20 | $7,428 | 1.6× |
| Venography Adrenal Unilateral (75840) | $2,304.90 | $3,546 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $3,154.45 | $4,853 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $3,287.70 | $5,058 | 2.2× |
| Venography extremity unilateral rs&i (75820) | $2,959.45 | $4,553 | 2.0× |
| Venography Renal Bilateral (75833) | $4,633.20 | $7,128 | 1.5× |
| Venography Renal Unilateral (75831) | $3,474.90 | $5,346 | 1.2× |
| Venous sampling by catheter (75893) | $6,407.70 | $9,858 | 1.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,420.25 | $2,185 | 3.7× |
| Vertebral fracture assessment via dxa (77086) | $978.90 | $1,506 | 11.8× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$217.10–$434.20 | $334–$668 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $447.85 | $689 | 5.4× |
| X-ray antegrade pyelogram tube (74425) | $1,228.50 | $1,890 | 3.7× |
| X-Ray Aorta Leg Arteries (75630) | $5,562.05 | $8,557 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) | $357.50 | $550 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$234–$468 | $360–$720 | varies |
| X-Ray Exam Breast Specimen (76098) | $426.40 | $656 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $523.25 | $805 | 6.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $575.90 | $886 | 5.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $640.90 | $986 | 6.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $338.65 | $521 | 4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $397.15 | $611 | 4.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $455.65 | $701 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $423.15 | $651 | 4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $466.05 | $717 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $528.45 | $813 | 5.3× |
| X-Ray Exam L-S Spine Bending (72114) | $568.10 | $874 | 5.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $376.35 | $579 | 4.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $516.10 | $794 | 5.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $357.50 | $550 | 3.6× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$343.85–$687.70 | $529–$1,058 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$227.50–$455 | $350–$700 | varies |
| X-ray IV pyelogram (ivp) (74400) | $713.05 | $1,097 | 4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $258.05 | $397 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $278.85 | $429 | 3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $396.50 | $610 | 4.0× |
| X-ray nose-rectum child f.b. (76010) | $456.30 | $702 | 5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $440.05 | $677 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $380.90 | $586 | 3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $287.30 | $442 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $322.40 | $496 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $346.45 | $533 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $372.45 | $573 | 3.7× |
| X-Ray Stress View (77071) | $180.70 | $278 | 2.2× |
| X-ray thoracic spine 4 vw (72074) | $387.40 | $596 | 3.9× |
| X-Ray Tmj Unilat (70328) | $297.05 | $457 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $975 | $1,500 | 2.9× |
| X-Rays Bone Length Studies (77073) | $236.60 | $364 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $574.60 | $884 | 5.8× |
| Xr c-spine 4 or 5 views (72050) | $449.15 | $691 | 4.5× |
| Xr facial bones less than 3 views (70140) | $291.20 | $448 | 3.5× |
| Xr orbits complete 4 views (70200) | $377 | $580 | 3.8× |
| Xr Tomogram Single Plane (76100) | $358.15 | $551 | 3.6× |
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.