Imaging prices at OhioHealth O'Bleness Hospital
Athens, 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) | $5,120.05 | $7,877 | 3.9× |
| Abdomen 1 View (74018) | $275.60 | $424 | 3.3× |
| Abdomen 2 views (74019) | $323.70 | $498 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,427.40 | $2,196 | 3.7× |
| Adrenal Cortex & Medulla Img (78075) | $2,596.10 | $3,994 | 2.1× |
| Angio internal mammary (75756) | $1,524.25 | $2,345 | 0.5× |
| Angio pulmonary bilat (75743) | $6,676.15 | $10,271 | 2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,617.30 | $8,642 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $10,261.55 | $15,787 | 3.4× |
| Angiography extremity unilateral rs&i (75710) | $9,144.85 | $14,069 | 3.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,018.60 | $4,644 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,430.40 | $6,816 | 1.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$184.60–$369.20 | $284–$568 | varies |
| Aortography thoracic serialography rs&i (75605) | $7,944.30 | $12,222 | 1.5× |
| Artery X-Rays Abdomen (75726) | $6,053.45 | $9,313 | 1.1× |
| Artery X-Rays Adrenal Gland (75731) | $5,617.30 | $8,642 | 1.9× |
| Artery X-Rays Pelvis (75736) | $5,390.45 | $8,293 | 1.0× |
| Artery X-Rays Spine (75705) | $9,989.20 | $15,368 | 1.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$663–$1,326 | $1,020–$2,040 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,119.30–$2,238.60 | $1,722–$3,444 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$873.60–$1,747.20 | $1,344–$2,688 | varies |
| Basic radiation dosimetry calculation (77300) | $1,763.45 | $2,713 | 13.7× |
| Bone age studies (77072) | $286 | $440 | 2.9× |
| Bone Imaging 3 Phase (78315) | $2,015.65 | $3,101 | 5.3× |
| Bone Imaging Limited Area (78300) | $1,511.90 | $2,326 | 4.0× |
| Bone Imaging Multiple Areas (78305) | $1,665.95 | $2,563 | 4.4× |
| Bone Imaging Whole Body (78306) | $1,833 | $2,820 | 4.8× |
| Bone marrow imaging limited area (78102) | $1,513.85 | $2,329 | 4.0× |
| Bone marrow imaging; multiple areas (78103) | $1,665.30 | $2,562 | 4.4× |
| Bone marrow imaging; whole body (78104) | $1,831.70 | $2,818 | 4.8× |
| Bone survey infant (77076) | $576.55 | $887 | 5.8× |
| Brachytx isodose complex (77318) | $5,579.60 | $8,584 | 15.6× |
| Brachytx isodose intermed (77317) | $5,579.60 | $8,584 | 15.6× |
| Brachytx Isodose Plan Simple (77316) | $3,199.30 | $4,922 | 8.9× |
| Brain Flow Imaging Only (78610) | $843.70 | $1,298 | 1.6× |
| Brain Image W/Flow < 4 Views (78601) | $1,025.70 | $1,578 | 2.7× |
| Brain imaging < 4 static views (78600) | $1,025.70 | $1,578 | 2.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,321.45 | $2,033 | 2.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,321.45 | $2,033 | 2.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,969.90 | $7,646 | 3.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,567.80 | $2,412 | 4.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,229.20 | $4,968 | 9.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,229.20 | $4,968 | 4.3× |
| Cardiac Shunt Detection (78428) | $1,567.80 | $2,412 | 4.1× |
| Cat Scan Follow-Up Study (76380) | $1,615.90 | $2,486 | 19.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $843.70 | $1,298 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $920.40 | $1,416 | 1.8× |
| Chest 1 view (71045) | $294.45 | $453 | 3.5× |
| Chest 2 views (71046) | $323.70 | $498 | 3.9× |
| Chest 3 views (71047) | $356.20 | $548 | 4.3× |
| Chest 4 or more views (71048) | $444.60 | $684 | 4.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$283.40–$566.80 | $436–$872 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,076.40 | $1,656 | 10.8× |
| Continuing medical physics consltj pr wk (77336) | $1,589.90 | $2,446 | 12.4× |
| Contrast Exam Abdominl Aorta (75625) | $9,537.45 | $14,673 | 3.2× |
| Contrast X-Ray Bladder (74430) | $955.50 | $1,470 | 2.9× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,168.70–$2,337.40 | $1,798–$3,596 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$914.55–$1,829.10 | $1,407–$2,814 | varies |
| Corpora cavernosography (74445) | $1,056.25 | $1,625 | 10.6× |
| CT abdomen and pelvis without and with contrast (74178) | $2,977.65 | $4,581 | 8.9× |
| CT abdomen and pelvis without contrast (74176) | $2,460.90 | $3,786 | 10.8× |
| CT abdomen w contrast (74160) | $1,929.85 | $2,969 | 11.5× |
| CT abdomen w wo contrast (74170) | $2,122.90 | $3,266 | 12.7× |
| CT abdomen w/o contrast (74150) | $1,755 | $2,700 | 17.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,373.15 | $3,651 | 7.1× |
| CT Angio Chest (71275) | $1,855.10 | $2,854 | 11.1× |
| CT Angio Head (70496) | $2,447.25 | $3,765 | 14.6× |
| CT angio hrt w/3d image (75574) | $2,165.80 | $3,332 | 6.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,760.85–$3,521.70 | $2,709–$5,418 | varies |
| CT Angio Neck (70498) | $2,202.20 | $3,388 | 13.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,874.60 | $2,884 | 11.2× |
| CT cervical spine w/ contrast (72126) | $1,921.40 | $2,956 | 5.8× |
| CT cervical spine w/o contrast (72125) | $1,747.20 | $2,688 | 17.5× |
| CT cervical spine w/wo cont (72127) | $2,113.15 | $3,251 | 12.6× |
| CT chest w contrast (71260) | $1,894.10 | $2,914 | 11.3× |
| CT chest w/wo contrast (71270) | $2,083.25 | $3,205 | 12.4× |
| CT colonography screening (74263) | $1,173.25 | $1,805 | 5.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,466.40 | $2,256 | 14.7× |
| CT head/brain with contrast (70460) | $1,015.95 | $1,563 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,118 | $1,720 | 6.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,613.30 | $2,482 | 4.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $260.65 | $401 | 3.1× |
| CT hrt w/3d image congen (75573) | $2,009.15 | $3,091 | 6.0× |
| CT iac w contrast (70481) | $1,859.65 | $2,861 | 11.1× |
| CT l-spine w&w/o contrast (72133) | $1,274 | $1,960 | 7.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,253.20–$2,506.40 | $1,928–$3,856 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,378.65–$2,756.65 | $2,121–$4,241 | varies |
| CT lumbar spine w contrast (72132) | $1,158.30 | $1,782 | 3.5× |
| CT lumbar spine w/o contrast (72131) | $1,053 | $1,620 | 10.5× |
| CT maxillofacial w contrast (70487) | $1,259.70 | $1,938 | 7.5× |
| CT maxillofacial wo contrast (70486) | $1,145.30 | $1,762 | 11.5× |
| CT neck tissue combo (70492) | $1,878.50 | $2,890 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,046.20 | $3,148 | 12.2× |
| CT orbits w/o contrast (70480) | $1,691.30 | $2,602 | 16.9× |
| CT pelvis w&w/o contrast (72194) | $1,838.85 | $2,829 | 11.0× |
| CT pelvis w/o contrast (72192) | $1,612 | $2,480 | 16.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,516.45–$3,032.25 | $2,333–$4,665 | varies |
| CT scans face/jaw combo (70488) | $1,385.80 | $2,132 | 8.3× |
| CT soft tissue neck w contrast (70491) | $1,706.90 | $2,626 | 10.2× |
| CT soft tissue neck w/o contrast (70490) | $1,551.55 | $2,387 | 15.5× |
| CT thoracic spine w contrast (72129) | $1,916.20 | $2,948 | 11.4× |
| CT thoracic spine w/o contrast (72128) | $1,569.10 | $2,414 | 15.7× |
| CT thoracic spine w/wo cont (72130) | $2,109.25 | $3,245 | 12.6× |
| CT thorax w/o contrast (71250) | $1,722.50 | $2,650 | 17.3× |
| CT unlisted procedure (76497) | $2,067.65 | $3,181 | 24.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,255.80–$2,511.60 | $1,932–$3,864 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,518.40–$3,036.80 | $2,336–$4,672 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,380.60–$2,760.55 | $2,124–$4,247 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,139.80 | $3,292 | 12.8× |
| Cta Abdomen (74175) | $2,163.85 | $3,329 | 12.9× |
| CTA pelvis (72191) | $1,854.45 | $2,853 | 11.1× |
| Dilation ureters/urethra rs&i (74485) | $5,015.40 | $7,716 | 2.5× |
| Discography Cerv/Thor Spine (72285) | $2,418 | $3,720 | 1.3× |
| Diskography lumbar (72295) | $2,405.65 | $3,701 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $646.75 | $995 | 6.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $844.35 | $1,299 | 8.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $392.60 | $604 | 3.9× |
| Dxa Bone Density Axial (77080) | $558.35 | $859 | 5.6× |
| Dxa bone density study (77085) | $967.20 | $1,488 | 9.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $503.10 | $774 | 6.1× |
| Echo exam of fetal heart (76825) | $1,131.65 | $1,741 | 2.2× |
| Echo exam uterus (76831) | $1,261.65 | $1,941 | 5.5× |
| Echo Guide For Artery Repair (76936) | $3,511.30 | $5,402 | 17.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $744.90 | $1,146 | 3.3× |
| Echograp Trans R Pros Study (76873) | $224.25 | $345 | 2.2× |
| Esophagram (74220) | $498.55 | $767 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $757.90 | $1,166 | 7.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $682.50 | $1,050 | 6.8× |
| Fluoroscopy up to 1 hr (76000) | $598 | $920 | 2.6× |
| Follow-Up Angiography (75898) | $1,680.25 | $2,585 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$189.15–$378.30 | $291–$582 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$208–$416 | $320–$640 | varies |
| Gastric emptying imaging study (78264) | $2,184 | $3,360 | 5.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,902.25 | $4,465 | 7.6× |
| Gated Heart Planar Single (78472) | $2,369.90 | $3,646 | 6.2× |
| Gated Heart, Multiple (78473) | $2,369.90 | $3,646 | 6.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $3,192.15 | $4,911 | 6.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$198.90–$397.80 | $306–$612 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,721 | $10,340 | 10.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,721 | $10,340 | 10.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,721 | $10,340 | 10.1× |
| Heart first pass single,planar (78481) | $1,756.30 | $2,702 | 3.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,456.40 | $6,856 | 1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,081.95 | $3,203 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,912.65 | $4,481 | 5.6× |
| Hepatobiliary System Imaging (78226) | $2,057.25 | $3,165 | 5.4× |
| Ht Musc Image Planar Mult (78454) | $2,975.05 | $4,577 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $2,328.95 | $3,583 | 1.9× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $3,972.15 | $6,111 | 6.0× |
| Hysterosalpingogram (74740) | $1,101.75 | $1,695 | 4.8× |
| Interstitial radiation source applic complex (77778) | $3,238.95 | $4,983 | 4.9× |
| Joint Survey Single View (77077) | $221.65 | $341 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $2,936.05 | $4,517 | 5.7× |
| K Flow/Funct Image W/Drug (78708) | $1,948.70 | $2,998 | 3.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,851.20 | $2,848 | 3.6× |
| Kidney Imaging Morphol (78700) | $1,645.80 | $2,532 | 4.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,645.80 | $2,532 | 4.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$390–$779.35 | $600–$1,199 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $971.75 | $1,495 | 2.5× |
| Leveen/Shunt Patency Exam (78291) | $998.40 | $1,536 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,826.50 | $2,810 | 4.8× |
| Liver imaging static only (78201) | $1,934.40 | $2,976 | 3.7× |
| Liver imaging w/vascular flow (78202) | $1,934.40 | $2,976 | 3.7× |
| Lung perfusion differential (78597) | $1,797.90 | $2,766 | 4.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,881.75 | $2,895 | 3.6× |
| Lung Ventilation Imaging (78579) | $909.35 | $1,399 | 2.4× |
| Lymph System Imaging (78195) | $1,448.85 | $2,229 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $6,009.90 | $9,246 | 4.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $2,002 | $3,080 | 3.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $7,584.85 | $11,669 | 2.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $7,584.85 | $11,669 | 2.5× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,147.60–$4,295.20 | $3,304–$6,608 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $2,637.05 | $4,057 | 15.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,511.60 | $3,864 | 4.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $2,761.85 | $4,249 | 16.5× |
| Mammary ductogram or galactogram multiple (77054) | $1,220.05 | $1,877 | 5.4× |
| Mammary ductogram or galactogram single (77053) | $663 | $1,020 | 2.9× |
| Meckels Divert Exam (78290) | $2,836.60 | $4,364 | 7.4× |
| Medical physics dose eval radiation expos w/rprt (76145) | $2,067.65 | $3,181 | 5.8× |
| Mlc imrt design & construction per imrt plan (77338) | $1,118 | $1,720 | 3.1× |
| 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) | $2,534.35 | $3,899 | 7.6× |
| MRA head w/o contrast (70544) | $2,093 | $3,220 | 9.2× |
| MRA head with contrast (70545) | $2,303.60 | $3,544 | 6.9× |
| MRA neck w contrast (70548) | $2,503.80 | $3,852 | 7.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,754.05 | $4,237 | 8.3× |
| MRA neck w/o contrast (70547) | $2,276.30 | $3,502 | 10.0× |
| MRI abdomen w contrast (74182) | $2,501.85 | $3,849 | 7.5× |
| MRI abdomen w/o contrast (74181) | $2,273.70 | $3,498 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,474.55–$4,949.10 | $3,807–$7,614 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,722.85–$5,445.70 | $4,189–$8,378 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,570.10–$5,140.20 | $3,954–$7,908 | varies |
| MRI bone marrow blood supply (77084) | $2,328.95 | $3,583 | 10.2× |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$3,414.45–$6,828.90 | $5,253–$10,506 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,971.80 | $4,572 | 13.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,718.30 | $4,182 | 11.9× |
| MRI cardiac w/o contrast (75557) | $3,229.20 | $4,968 | 14.2× |
| MRI cervical spine w contrast (72142) | $2,399.15 | $3,691 | 7.2× |
| MRI cervical spine w/o cont (72141) | $2,170.35 | $3,339 | 9.5× |
| MRI chest w/o contrast (71550) | $2,555.80 | $3,932 | 11.2× |
| MRI chest with contrast (71551) | $2,683.85 | $4,129 | 3.6× |
| MRI chest wo w contrast (71552) | $2,811.90 | $4,326 | 8.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,317.90–$4,635.80 | $3,566–$7,132 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,551.25–$5,102.50 | $3,925–$7,850 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,107.30–$4,214.60 | $3,242–$6,484 | varies |
| MRI lumbar spine w contrast (72149) | $2,575.30 | $3,962 | 7.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,626.65 | $4,041 | 7.9× |
| MRI orbit face &/neck w/o contrast (70540) | $2,235.35 | $3,439 | 9.8× |
| MRI orbit face neck w contrast (70542) | $2,469.35 | $3,799 | 7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,703.35 | $4,159 | 8.1× |
| MRI pelvis w contrast (72196) | $2,598.70 | $3,998 | 7.8× |
| MRI pelvis w/o & w contrast (72197) | $2,845.70 | $4,378 | 8.5× |
| MRI pelvis w/o contrast (72195) | $2,351.70 | $3,618 | 10.3× |
| MRI spectroscopy (76390) | $2,029.30 | $3,122 | 24.4× |
| MRI thoracic spine w/o contrast (72146) | $2,364.05 | $3,637 | 10.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,494.05–$4,988.10 | $3,837–$7,674 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,257.45–$4,514.25 | $3,473–$6,945 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,668.25–$5,336.50 | $4,105–$8,210 | varies |
| MRI, abdomen, combo (74183) | $2,752.10 | $4,234 | 8.3× |
| MRI, dorsal spine combo (72157) | $2,860 | $4,400 | 8.6× |
| MRI, dorsal spine contrast (72147) | $2,599.35 | $3,999 | 7.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,335.45–$4,670.90 | $3,593–$7,186 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,826.85–$5,653.70 | $4,349–$8,698 | varies |
| MRI, lumbar spine combo (72158) | $2,832.70 | $4,358 | 8.5× |
| Myelogram cervical (72240) | $910.65 | $1,401 | 1.2× |
| Myelogram Lumbar (72265) | $916.50 | $1,410 | 1.2× |
| Myelography thoracic (72255) | $832.65 | $1,281 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,007.50 | $1,550 | 1.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,539.85 | $2,369 | 4.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,539.85 | $2,369 | 3.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,860.95 | $2,863 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $3,804.45 | $5,853 | 3.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,242.15 | $1,911 | 0.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,928.55 | $2,967 | 1.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,953.90 | $3,006 | 0.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,626.35 | $5,579 | 1.7× |
| Neck soft tissue (70360) | $253.50 | $390 | 3.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $708.50 | $1,090 | 1.9× |
| Nm csf leak detection (78650) | $2,041.65 | $3,141 | 1.7× |
| Nm myocard infarct spect (78469) | $1,539.85 | $2,369 | 3.0× |
| Nonvascular Shunt X-Ray (75809) | $917.15 | $1,411 | 9.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $13,117.65 | $20,181 | 9.9× |
| Nuclear Rx Intra-Arterial (79445) | $1,613.95 | $2,483 | 7.2× |
| Nuclear Rx Oral Admin (79005) | $1,997.45 | $3,073 | 9.0× |
| Ob us nuchal meas 1 gest (76813) | $678.60 | $1,044 | 6.8× |
| Optic foramina (70190) range across 2 matching MRF lines |
$139.75–$278.85 | $215–$429 | varies |
| Panoramic X-ray of jaws (70355) | $254.80 | $392 | 3.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,054.35 | $4,699 | 5.9× |
| Parathyroid Planar Imaging (78070) | $2,431.65 | $3,741 | 6.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,901.60 | $4,464 | 7.6× |
| Pelvis 1 or 2 views (72170) | $248.30 | $382 | 2.5× |
| Perineogram (74775) | $1,230.45 | $1,893 | 5.4× |
| Peritoneogram Rs&I (74190) | $1,473.55 | $2,267 | 2.8× |
| Pet Image W/Ct Lmtd (78814) | $4,631.25 | $7,125 | 3.4× |
| PET image w/CT, full body (78816) | $5,687.50 | $8,750 | 4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,148.65 | $7,921 | 3.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,607.20 | $7,088 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,069.25 | $1,645 | 2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $437.45 | $673 | 4.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,409.20 | $2,168 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$260–$520 | $400–$800 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$282.75–$565.50 | $435–$870 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$315.90–$631.80 | $486–$972 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $417.95 | $643 | 4.2× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$252.20–$504.40 | $388–$776 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$306.15–$612.30 | $471–$942 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$290.55–$581.10 | $447–$894 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$412.75–$825.50 | $635–$1,270 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$364–$728 | $560–$1,120 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $326.30 | $502 | 3.9× |
| Radex Ribs Unilateral 2 Views (71100) | $304.20 | $468 | 3.7× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$349.70–$700.05 | $538–$1,077 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $174.20 | $268 | 2.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $962 | $1,480 | 5.7× |
| Radex Spine 1 View Specify Level (72020) | $202.15 | $311 | 2.4× |
| Radex Sternum Minimum 2 Views (71120) | $339.30 | $522 | 4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $411.45 | $633 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$228.15–$456.30 | $351–$702 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$358.80–$717.60 | $552–$1,104 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$320.45–$640.90 | $493–$986 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $545.35 | $839 | 5.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $4,807.40 | $7,396 | 0.7× |
| Radiation treatment delivery level 1 (77402) | $1,105 | $1,700 | 11.3× |
| Radiation treatment delivery level 2 (77407) | $1,222 | $1,880 | 3.3× |
| Radiation treatment delivery level 3 (77412) | $1,339 | $2,060 | 2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $386.75 | $595 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $367.90 | $566 | 3.7× |
| Radiologic exam colon double contrast study (74280) | $967.20 | $1,488 | 5.8× |
| Radiologic exam colon single contrast study (74270) | $716.95 | $1,103 | 4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $612.95 | $943 | 3.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$416.65–$833.30 | $641–$1,282 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $299.65 | $461 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $817.70 | $1,258 | 4.9× |
| Radiologic exam swallow function contrast study (74230) | $587.60 | $904 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $772.20 | $1,188 | 4.6× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$251.55–$503.10 | $387–$774 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$301.60–$603.20 | $464–$928 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$231.40–$462.80 | $356–$712 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $390 | $600 | 3.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$226.85–$453.70 | $349–$698 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $341.25 | $525 | 0.7× |
| Renal Cyst Study (74470) | $1,550.90 | $2,386 | 3.0× |
| Ribs bilateral 3 views (71110) | $355.55 | $547 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,400.45 | $3,693 | 6.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,523.95 | $3,883 | 6.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,779.40 | $4,276 | 5.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,646.80 | $4,072 | 5.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,013.40 | $4,636 | 5.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,571.75 | $5,495 | 2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,936.40 | $6,056 | 2.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,246.75 | $4,995 | 2.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,289 | $5,060 | 14.8× |
| Rp Therapy Intravenous Administration (79101) | $1,990.30 | $3,062 | 8.9× |
| Salivary Gland Imaging (78230) | $2,315.30 | $3,562 | 6.1× |
| Scapula (73010) range across 2 matching MRF lines |
$323.70–$647.40 | $498–$996 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $61.75 | $95 | 2.6× |
| Sella turcica (70240) | $196.95 | $303 | 2.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$182.65–$365.30 | $281–$562 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,082.25–$2,164.50 | $1,665–$3,330 | varies |
| Sialogram (70390) | $1,008.15 | $1,551 | 4.4× |
| Skull less than 4 views (70250) | $210.60 | $324 | 2.1× |
| Special dosimetry (77331) | $709.15 | $1,091 | 5.5× |
| Special Physics Consult (77370) | $2,115.10 | $3,254 | 16.5× |
| Special teletherapy port plan (77321) | $5,073.25 | $7,805 | 14.2× |
| Special treatment procedure (77470) | $2,769.65 | $4,261 | 5.2× |
| Stereotactic Body Radiation Delivery (77373) | $3,295.50 | $5,070 | 1.9× |
| Sternoclavicular joints (71130) | $421.20 | $648 | 5.1× |
| Superior sagittal sinus venogram (75870) | $2,342.60 | $3,604 | 0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,534.40 | $6,976 | 12.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $3,250 | $5,000 | 9.1× |
| Testicular Imaging W/Flow (78761) | $1,319.50 | $2,030 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,923.40 | $6,036 | 11.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,931.15 | $2,971 | 5.4× |
| Ther rad simulaj-aided field setting simple (77280) | $1,059.50 | $1,630 | 8.3× |
| Thoracic spine 2 views (72070) | $320.45 | $493 | 3.2× |
| Thoracic spine 3 views (72072) | $359.45 | $553 | 3.6× |
| Thoracolumbar 2 views (72080) | $317.20 | $488 | 3.8× |
| Thyroid Imaging With Vascular Flow (78013) | $891.80 | $1,372 | 2.3× |
| Thyroid Met Imaging Body (78018) | $2,254.85 | $3,469 | 4.3× |
| Thyroid Uptake Measurement (78012) | $1,322.10 | $2,034 | 3.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,721.85 | $2,649 | 4.5× |
| Tx Devices Design & Construction Complex (77334) | $1,396.20 | $2,148 | 3.9× |
| Tx devices design & construction intermediate (77333) | $1,269.45 | $1,953 | 9.9× |
| Tx devices design & construction simple (77332) | $1,154.40 | $1,776 | 9.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$473.85–$947.70 | $729–$1,458 | varies |
| Ultrasound Elastography Parenchyma (76981) | $572 | $880 | 5.7× |
| Ultrasound Exam Aaa Screen (76706) | $356.85 | $549 | 3.6× |
| Ultrasound, abdomen limited (76705) | $581.10 | $894 | 5.8× |
| Umbilical-artery Doppler (OB) (76820) | $382.85 | $589 | 3.8× |
| Unlisted fluoroscopic procedure (76496) | $957.45 | $1,473 | 11.5× |
| Unlisted magnetic resonance procedure (76498) | $490.10 | $754 | 5.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,066 | $1,640 | 10.9× |
| Unlisted us procedure (76999) | $1,030.90 | $1,586 | 12.4× |
| Upper gi w/o kub (74240) | $659.75 | $1,015 | 3.9× |
| Ureteral Reflux Study (78740) | $3,077.10 | $4,734 | 8.1× |
| Urethrocystogram voiding (74455) | $986.05 | $1,517 | 4.3× |
| Urethrocystography retrograde (74450) | $951.60 | $1,464 | 4.2× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$146.25–$1,235 | $225–$1,900 | varies |
| Us chest (76604) | $460.85 | $709 | 4.6× |
| Us complete joint (76881) | $608.40 | $936 | 6.1× |
| Us exam, pelvic, limited (76857) | $488.15 | $751 | 4.9× |
| Us head (76506) | $496.60 | $764 | 5.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $507 | $780 | 5.1× |
| Us ob detailed single fetus (76811) | $708.50 | $1,090 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $427.05 | $657 | 4.3× |
| Us ob transvaginal (76817) | $571.35 | $879 | 5.7× |
| Us pelvic non ob complete (76856) | $621.40 | $956 | 6.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $535.60 | $824 | 5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $480.35 | $739 | 4.8× |
| Us retroperitoneal complete (76770) | $749.45 | $1,153 | 7.5× |
| Us retroperitoneal limited (76775) | $542.10 | $834 | 5.4× |
| Us scrotum and contents (76870) | $588.90 | $906 | 5.9× |
| Us spinal canal and contents (76800) | $644.80 | $992 | 6.5× |
| Us thyroid (76536) | $599.95 | $923 | 6.0× |
| Us transrectal (76872) | $1,154.40 | $1,776 | 11.6× |
| Vascular Flow Imaging (78445) | $1,645.80 | $2,532 | 4.3× |
| Vein X-Ray Chest (75827) | $1,690 | $2,600 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,147.30 | $4,842 | 1.0× |
| Vein X-Ray Skull Epidural (75872) | $1,333.15 | $2,051 | 2.2× |
| Vein X-Ray Spleen/Liver (75810) | $3,034.85 | $4,669 | 1.0× |
| Venogram Sinus/Jugular (75860) | $3,471.65 | $5,341 | 1.2× |
| Venography Adrenal Unilateral (75840) | $1,129.70 | $1,738 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,327.65 | $3,581 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $4,298.45 | $6,613 | 2.9× |
| Venography extremity unilateral rs&i (75820) | $3,890.90 | $5,986 | 2.6× |
| Venography Renal Bilateral (75833) | $3,330.60 | $5,124 | 1.1× |
| Venography Renal Unilateral (75831) | $3,330.60 | $5,124 | 1.1× |
| Venous sampling by catheter (75893) | $4,607.20 | $7,088 | 0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,645.80 | $2,532 | 4.3× |
| Vertebral fracture assessment via dxa (77086) | $722.15 | $1,111 | 8.7× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$216.45–$432.90 | $333–$666 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $414.05 | $637 | 5.0× |
| X-ray antegrade pyelogram tube (74425) | $1,398.80 | $2,152 | 4.2× |
| X-Ray Aorta Leg Arteries (75630) | $12,774.45 | $19,653 | 4.2× |
| X-Ray Bend Only L-S Spine (72120) | $363.35 | $559 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$231.40–$462.80 | $356–$712 | varies |
| X-Ray Exam Breast Specimen (76098) | $572.65 | $881 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $222.95 | $343 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $286.65 | $441 | 2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $398.45 | $613 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $315.25 | $485 | 3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $419.90 | $646 | 5.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $526.50 | $810 | 5.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $397.15 | $611 | 4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $549.90 | $846 | 5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $659.75 | $1,015 | 6.6× |
| X-Ray Exam L-S Spine Bending (72114) | $583.05 | $897 | 5.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $349.05 | $537 | 4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $521.30 | $802 | 5.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $411.45 | $633 | 4.1× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$292.50–$585 | $450–$900 | varies |
| X-ray humerus (73060) | $231.40 | $356 | 2.8× |
| X-ray IV pyelogram (ivp) (74400) | $658.45 | $1,013 | 3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $254.80 | $392 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $276.25 | $425 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $367.25 | $565 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $450.45 | $693 | 5.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $438.75 | $675 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $448.50 | $690 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $356.20 | $548 | 3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $324.35 | $499 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $349.70 | $538 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $377 | $580 | 3.8× |
| X-Ray Stress View (77071) | $182.65 | $281 | 2.2× |
| X-ray thoracic spine 4 vw (72074) | $413.40 | $636 | 4.1× |
| X-Ray Tmj Unilat (70328) | $331.50 | $510 | 4.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $842.40 | $1,296 | 2.5× |
| X-Rays Bone Length Studies (77073) | $495.30 | $762 | 5.0× |
| X-Rays Bone Survey Complete (77075) | $607.75 | $935 | 6.1× |
| Xr c-spine 4 or 5 views (72050) | $455.65 | $701 | 4.6× |
| Xr facial bones less than 3 views (70140) | $294.45 | $453 | 3.5× |
| Xr orbits complete 4 views (70200) | $419.90 | $646 | 4.2× |
| Xr Tomogram Single Plane (76100) | $345.80 | $532 | 3.5× |
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.