Imaging prices at Orlando Health St. Cloud Hospital
Saint Cloud, FL · every code in this section with a posted price and a Medicare benchmark.
409 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $4,868 | $12,170 | 3.4× |
| Abdomen 1 View (74018) | $230 | $575 | 2.5× |
| Abdomen 2 views (74019) | $275.60 | $689 | 2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $790.40 | $1,976 | 1.9× |
| Angio internal mammary (75756) | $5,234 | $13,085 | 1.6× |
| Angio pulmonary bilat (75743) | $5,234 | $13,085 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $6,281.60 | $15,704 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $5,234 | $13,085 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,234 | $13,085 | 1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,234 | $13,085 | 1.6× |
| Ankle 2 views (73600) | $308.40 | $771 | 3.4× |
| Aortography thoracic serialography rs&i (75605) | $5,234 | $13,085 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,234 | $13,085 | 1.6× |
| Artery X-Rays Abdomen (75726) | $8,542.40 | $21,356 | 1.5× |
| Artery X-Rays Adrenal Gland (75731) | $5,234 | $13,085 | 1.6× |
| Artery X-Rays Pelvis (75736) | $5,234 | $13,085 | 0.9× |
| Artery X-Rays Spine (75705) | $8,542.40 | $21,356 | 1.5× |
| Arthrogram ankle (73615) | $1,217.20 | $3,043 | 3.3× |
| Arthrogram hip (73525) | $676.80 | $1,692 | 1.9× |
| Arthrogram Wrist (73115) | $979.20 | $2,448 | 2.7× |
| Basic radiation dosimetry calculation (77300) | $535.20 | $1,338 | 3.8× |
| Bone age studies (77072) | $422.80 | $1,057 | 3.9× |
| Bone Imaging 3 Phase (78315) | $790.40 | $1,976 | 1.9× |
| Bone Imaging Limited Area (78300) | $790.40 | $1,976 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $790.40 | $1,976 | 1.9× |
| Bone Imaging Whole Body (78306) | $790.40 | $1,976 | 1.9× |
| Bone marrow imaging limited area (78102) | $790.40 | $1,976 | 1.9× |
| Bone marrow imaging; whole body (78104) | $790.40 | $1,976 | 1.9× |
| Bone survey infant (77076) | $554.80 | $1,387 | 5.1× |
| Brachytx isodose complex (77318) | $1,354 | $3,385 | 3.5× |
| Brachytx isodose intermed (77317) | $1,231.20 | $3,078 | 3.1× |
| Brachytx Isodose Plan Simple (77316) | $477.20 | $1,193 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,013.60 | $2,534 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,522.40 | $13,806 | 3.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$2,210.80–$3,692.40 | $5,527–$9,231 | varies |
| Cardiac Shunt Detection (78428) | $790.40 | $1,976 | 1.9× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$282.80–$634.40 | $707–$1,586 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,013.60 | $2,534 | 1.8× |
| Cerebrospinal Fluid Scan (78630) | $1,013.60 | $2,534 | 1.8× |
| Chest 1 view (71045) | $259.60 | $649 | 2.9× |
| Chest 2 views (71046) | $298.40 | $746 | 3.3× |
| Chest 3 views (71047) | $326.40 | $816 | 3.6× |
| Chest 4 or more views (71048) | $550.80 | $1,377 | 5.0× |
| Cisternography Positive Contrast Rs&I (70015) | $1,680 | $4,200 | 2.1× |
| Clavicle complete (73000) | $281.60 | $704 | 3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $443.20 | $1,108 | 4.1× |
| Continuing medical physics consltj pr wk (77336) | $535.20 | $1,338 | 3.8× |
| Contrast Exam Abdominl Aorta (75625) | $5,234 | $13,085 | 1.6× |
| Contrast X-Ray Bladder (74430) | $833.60 | $2,084 | 2.3× |
| Contrast X-Ray Of Elbow (73085) | $676.80 | $1,692 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $1,217.20 | $3,043 | 3.3× |
| Contrast Xray Throat/Cerv Esopha (74210) | $559.60 | $1,399 | 3.1× |
| Corpora cavernosography (74445) | $410 | $1,025 | 3.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,854.40–$4,757.20 | $7,136–$11,893 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,752.80–$2,921.20 | $4,382–$7,303 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,854.40–$4,757.20 | $7,136–$11,893 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$2,031.60–$5,258 | $5,079–$13,145 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$680.80–$1,528.40 | $1,702–$3,821 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$20–$443.20 | $50–$1,108 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$1,196.80–$5,903.60 | $2,992–$14,759 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$1,095.20–$1,824.80 | $2,738–$4,562 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$1,804.80–$3,008.40 | $4,512–$7,521 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,510–$3,387.20 | $3,775–$8,468 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,031.60–$3,387.20 | $5,079–$8,468 | varies |
| Dilation ureters/urethra rs&i (74485) | $5,684.80 | $14,212 | 2.6× |
| Discography Cerv/Thor Spine (72285) | $9,660.40 | $24,151 | 4.7× |
| Diskography lumbar (72295) | $3,317.60 | $8,294 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $754.80 | $1,887 | 6.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $754.80 | $1,887 | 6.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $250 | $625 | 2.3× |
| Dxa Bone Density Axial (77080) | $494 | $1,235 | 4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $255.60 | $639 | 2.8× |
| Echo exam of fetal heart (76825) | $2,048 | $5,120 | 3.6× |
| Echo exam uterus (76831) | $1,314.80 | $3,287 | 5.3× |
| Echo Guide For Artery Repair (76936) | $494.80 | $1,237 | 2.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,048 | $5,120 | 8.2× |
| Echograp Trans R Pros Study (76873) | $754.80 | $1,887 | 6.9× |
| Esophagram (74220) | $547.20 | $1,368 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $858 | $2,145 | 7.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $714.80 | $1,787 | 6.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| Fluoroscopy up to 1 hr (76000) | $369.60 | $924 | 1.5× |
| Follow-Up Angiography (75898) | $1,327.20 | $3,318 | 0.4× |
| Foot 2 views (73620) | $263.60 | $659 | 2.9× |
| Forearm 2 views (73090) | $266.40 | $666 | 2.9× |
| Gastric emptying imaging study (78264) | $790.40 | $1,976 | 1.9× |
| Gated Heart Planar Single (78472) | $790.40 | $1,976 | 1.9× |
| Hand 2 views (73120) | $368 | $920 | 3.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,459.60 | $8,649 | 4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,454 | $8,635 | 4.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,454 | $8,635 | 4.7× |
| Heart Image (Pet) Multiple (78492) | $5,020.40 | $12,551 | 3.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,234 | $13,085 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,234 | $13,085 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $790.40 | $1,976 | 1.4× |
| Hepatobiliary System Imaging (78226) | $790.40 | $1,976 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $2,731.20 | $6,828 | 2.0× |
| Hysterosalpingogram (74740) | $1,326.80 | $3,317 | 5.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $775.60 | $1,939 | 8.5× |
| Infant hip ultrasound, limited static exam (76886) | $754.80 | $1,887 | 8.3× |
| Interstitial radiation source applic complex (77778) | $3,079.20 | $7,698 | 4.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,936.80 | $7,342 | 4.0× |
| Joint Survey Single View (77077) | $422.80 | $1,057 | 3.9× |
| K Flow/Funct Image Multiple (78709) | $1,013.60 | $2,534 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,013.60 | $2,534 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,013.60 | $2,534 | 1.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $790.40 | $1,976 | 1.9× |
| Kidney Imaging Morphol (78700) | $790.40 | $1,976 | 1.9× |
| Knee 3 Views (73562) | $321.60 | $804 | 3.5× |
| Leveen/Shunt Patency Exam (78291) | $790.40 | $1,976 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $790.40 | $1,976 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,013.60 | $2,534 | 1.8× |
| Lung perfusion differential (78597) | $790.40 | $1,976 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,013.20 | $2,533 | 1.8× |
| Lung Ventilation Imaging (78579) | $790.40 | $1,976 | 1.9× |
| Lymph System Imaging (78195) | $1,013.60 | $2,534 | 1.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,592.40 | $3,981 | 1.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,327.20 | $3,318 | 2.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,234 | $13,085 | 1.6× |
| Magnetic Image Jaw Joint (70336) range across 4 matching MRF lines |
$1,360–$3,210.80 | $3,400–$8,027 | varies |
| Mammary ductogram or galactogram multiple (77054) | $1,149.20 | $2,873 | 4.6× |
| Mammary ductogram or galactogram single (77053) | $1,149.20 | $2,873 | 4.6× |
| Meckels Divert Exam (78290) | $790.40 | $1,976 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,380.80 | $3,452 | 3.5× |
| Mr safety determination physician/other qhp (76016) | $146 | $365 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $40.40 | $101 | 1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $152 | $380 | 1.5× |
| Mr safety implt pos&/immoblj (76019) | $98 | $245 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $399.60 | $999 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI cardiac w/o cont stress (75559) range across 2 matching MRF lines |
$2,130–$2,941.60 | $5,325–$7,354 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,958.40–$3,264.40 | $4,896–$8,161 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,360–$2,266.80 | $3,400–$5,667 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,214.80–$3,692.40 | $5,537–$9,231 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,522.40 | $13,806 | 4.1× |
| Myocardial Spect Multiple Studies (78452) | $2,731.20 | $6,828 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$1,781.20–$3,209.20 | $4,453–$8,023 | varies |
| Neck soft tissue (70360) | $263.20 | $658 | 2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $790.40 | $1,976 | 1.9× |
| Nm csf leak detection (78650) | $2,731.20 | $6,828 | 2.0× |
| Nonvascular Shunt X-Ray (75809) | $380 | $950 | 3.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,868 | $12,170 | 3.4× |
| Nuclear Rx Intra-Arterial (79445) | $935.20 | $2,338 | 3.8× |
| Nuclear Rx Oral Admin (79005) | $1,257.60 | $3,144 | 5.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $754.80 | $1,887 | 6.9× |
| Panoramic X-ray of jaws (70355) | $255.60 | $639 | 2.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,013.60 | $2,534 | 1.8× |
| Parathyroid Planar Imaging (78070) | $790.40 | $1,976 | 1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $790.40 | $1,976 | 1.9× |
| Pelvis 1 or 2 views (72170) | $422.80 | $1,057 | 3.9× |
| Peritoneogram Rs&I (74190) | $1,818.40 | $4,546 | 3.2× |
| Pet Image W/Ct Lmtd (78814) | $6,718.40 | $16,796 | 4.5× |
| PET image w/CT, full body (78816) | $6,718.40 | $16,796 | 4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,718.40 | $16,796 | 4.5× |
| Proton trmt simple w/comp (77522) | $5,446.40 | $13,616 | 4.2× |
| Proton tx delivery complex (77525) | $5,446.40 | $13,616 | 4.2× |
| Proton tx delivery intermediate (77523) | $5,446.40 | $13,616 | 4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,234 | $13,085 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $790.40 | $1,976 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $380 | $950 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,326.80 | $3,317 | 2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $369.60 | $924 | 4.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $272.80 | $682 | 3.0× |
| Radex elbow complete minimum 3 views (73080) | $307.60 | $769 | 3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $472.40 | $1,181 | 4.3× |
| Radex fingr minimum 2 views (73140) | $248.80 | $622 | 2.7× |
| Radex foot complete minimum 3 views (73630) | $266.40 | $666 | 2.9× |
| Radex Hand Minimum 3 Views (73130) | $441.60 | $1,104 | 4.9× |
| Radex lower extremity infant minimum 2 views (73592) | $289.20 | $723 | 3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $422.80 | $1,057 | 3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $288.40 | $721 | 3.2× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $502.40 | $1,256 | 5.5× |
| Radex Ribs Unilateral 2 Views (71100) | $306 | $765 | 3.4× |
| Radex shoulder complete minimum 2 views (73030) | $727.60 | $1,819 | 8.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $289.20 | $723 | 3.2× |
| Radex Spine 1 View Specify Level (72020) | $311.20 | $778 | 3.4× |
| Radex Sternum Minimum 2 Views (71120) | $341.20 | $853 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $353.60 | $884 | 3.9× |
| Radex Toe Minimum 2 Views (73660) | $227.60 | $569 | 2.5× |
| Radex upper extremity infant minimum 2 views (73092) | $368 | $920 | 3.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $300.40 | $751 | 3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $807.20 | $2,018 | 7.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $34,551.20 | $86,378 | 4.5× |
| Radiation treatment delivery level 1 (77402) | $521.60 | $1,304 | 4.9× |
| Radiation treatment delivery level 2 (77407) | $521.60 | $1,304 | 1.3× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$919.20–$1,195.20 | $2,298–$2,988 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $470.80 | $1,177 | 4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $343.60 | $859 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $813.20 | $2,033 | 4.4× |
| Radiologic exam colon single contrast study (74270) | $813.20 | $2,033 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $737.60 | $1,844 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) | $368 | $920 | 3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $422.80 | $1,057 | 3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $547.20 | $1,368 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $547.20 | $1,368 | 3.0× |
| Radiologic exam teeth complete full mouth (70320) | $807.20 | $2,018 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $813.20 | $2,033 | 4.4× |
| Radiologic examination femur 1 view (73551) | $193.20 | $483 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) | $307.60 | $769 | 3.4× |
| Radiologic examination knee 1/2 views (73560) | $307.60 | $769 | 3.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $565.60 | $1,414 | 5.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $307.60 | $769 | 3.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $919.20 | $2,298 | 2.3× |
| Renal Cyst Study (74470) | $2,557.60 | $6,394 | 4.5× |
| Ribs bilateral 3 views (71110) | $520.80 | $1,302 | 4.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $790.40 | $1,976 | 1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $790.40 | $1,976 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,731.20 | $6,828 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,731.20 | $6,828 | 4.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,731.20 | $6,828 | 4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,731.20 | $6,828 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,165.20 | $7,913 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,165.20 | $7,913 | 2.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,453.20 | $3,633 | 6.0× |
| Rp Therapy Intravenous Administration (79101) | $1,005.60 | $2,514 | 4.1× |
| Salivary Gland Function Study (78232) | $790.40 | $1,976 | 1.9× |
| Salivary Gland Imaging Serial Images (78231) | $790.40 | $1,976 | 1.9× |
| Scapula (73010) | $307.60 | $769 | 2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $54.40 | $136 | 2.3× |
| Shoulder 1 view (73020) | $303.20 | $758 | 3.3× |
| Shoulder Arthrography (73040) | $676.80 | $1,692 | 1.9× |
| Skull less than 4 views (70250) | $422.80 | $1,057 | 3.9× |
| Special dosimetry (77331) | $788.80 | $1,972 | 5.6× |
| Special Physics Consult (77370) | $788.80 | $1,972 | 5.6× |
| Special teletherapy port plan (77321) | $1,380.80 | $3,452 | 3.5× |
| Special treatment procedure (77470) | $2,392.80 | $5,982 | 4.1× |
| Speech evaluation, complex (70371) | $502.40 | $1,256 | 2.0× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$7,912.40–$10,288 | $19,781–$25,720 | varies |
| Sternoclavicular joints (71130) | $353.60 | $884 | 3.9× |
| Superior sagittal sinus venogram (75870) | $1,286 | $3,215 | 0.4× |
| Tbs technical calculation only (77091) | $251.20 | $628 | 2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,380.80 | $3,452 | 3.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $788.80 | $1,972 | 2.0× |
| Testicular Imaging W/Flow (78761) | $790.40 | $1,976 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,511.60–$1,966 | $3,779–$4,915 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,380.80 | $3,452 | 3.5× |
| Ther rad simulaj-aided field setting simple (77280) | $788.80 | $1,972 | 5.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $414.80 | $1,037 | 2.3× |
| Thoracic spine 2 views (72070) | $422.80 | $1,057 | 3.9× |
| Thoracic spine 3 views (72072) | $470.80 | $1,177 | 4.3× |
| Thoracolumbar 2 views (72080) | $353.60 | $884 | 3.9× |
| Thyroid Imaging With Vascular Flow (78013) | $790.40 | $1,976 | 1.9× |
| Thyroid Met Imaging Body (78018) | $1,013.60 | $2,534 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $790.40 | $1,976 | 1.9× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,380.80–$1,795.20 | $3,452–$4,488 | varies |
| Tx devices design & construction intermediate (77333) | $794.80 | $1,987 | 5.7× |
| Tx devices design & construction simple (77332) | $721.60 | $1,804 | 5.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$376.80–$754 | $942–$1,885 | varies |
| Ultrasound Elastography Parenchyma (76981) | $1,143.20 | $2,858 | 10.5× |
| Ultrasound Exam Aaa Screen (76706) | $553.60 | $1,384 | 5.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,342 | $3,355 | 3.7× |
| Ultrasound, abdomen limited (76705) | $754.80 | $1,887 | 6.9× |
| Umbilical-artery Doppler (OB) (76820) | $250 | $625 | 2.3× |
| Unlisted Dx Radiographic Procedure (76499) | $494 | $1,235 | 5.4× |
| Unlisted fluoroscopic procedure (76496) | $5,234 | $13,085 | 57.6× |
| Unlisted magnetic resonance procedure (76498) | $5,791.20 | $14,478 | 63.7× |
| Upper gi w/o kub (74240) | $806.80 | $2,017 | 4.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $1,368.80 | $3,422 | 123.8× |
| Ureteral Reflux Study (78740) | $790.40 | $1,976 | 1.9× |
| Urethrocystogram voiding (74455) | $1,326.80 | $3,317 | 5.3× |
| Urethrocystography retrograde (74450) | $833.60 | $2,084 | 3.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$376.80–$754 | $942–$1,885 | varies |
| Us chest (76604) | $472.80 | $1,182 | 4.3× |
| Us complete joint (76881) | $754.80 | $1,887 | 6.9× |
| Us exam, pelvic, limited (76857) | $547.20 | $1,368 | 5.0× |
| Us head (76506) | $632 | $1,580 | 5.8× |
| Us kidney transplant (76776) | $807.20 | $2,018 | 7.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $494.80 | $1,237 | 4.5× |
| Us ob detailed single fetus (76811) | $922.80 | $2,307 | 3.7× |
| Us ob limited 1 or more fetuses (76815) | $646.40 | $1,616 | 5.9× |
| Us ob transvaginal (76817) | $646.40 | $1,616 | 5.9× |
| Us pelvic non ob complete (76856) | $754.80 | $1,887 | 6.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $754.80 | $1,887 | 6.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $547.20 | $1,368 | 5.0× |
| Us retroperitoneal complete (76770) | $804 | $2,010 | 7.4× |
| Us retroperitoneal limited (76775) | $754.80 | $1,887 | 6.9× |
| Us scrotum and contents (76870) | $754.80 | $1,887 | 6.9× |
| Us spinal canal and contents (76800) | $547.20 | $1,368 | 5.0× |
| Us thyroid (76536) | $754.80 | $1,887 | 6.9× |
| Us transrectal (76872) | $754.80 | $1,887 | 6.9× |
| Vein X-Ray Chest (75827) | $1,327.20 | $3,318 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,857.60 | $7,144 | 0.9× |
| Vein X-Ray Spleen/Liver (75810) | $5,234 | $13,085 | 1.6× |
| Venogram Sinus/Jugular (75860) | $5,234 | $13,085 | 1.6× |
| Venography Adrenal Unilateral (75840) | $5,234 | $13,085 | 1.6× |
| Venography caval inferior serialography rs&i (75825) | $5,234 | $13,085 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $1,592.40 | $3,981 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,327.20 | $3,318 | 0.8× |
| Venography Renal Bilateral (75833) | $5,234 | $13,085 | 1.6× |
| Venography Renal Unilateral (75831) | $5,234 | $13,085 | 1.6× |
| Venous sampling by catheter (75893) | $5,234 | $13,085 | 0.9× |
| Wrist 2 views (73100) | $288.80 | $722 | 3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $371.60 | $929 | 4.1× |
| X-ray antegrade pyelogram tube (74425) | $1,326.80 | $3,317 | 3.6× |
| X-Ray Aorta Leg Arteries (75630) | $5,234 | $13,085 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $389.20 | $973 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $278.40 | $696 | 3.1× |
| X-Ray Exam Breast Specimen (76098) | $1,679.20 | $4,198 | 2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $255.60 | $639 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $422.80 | $1,057 | 3.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $807.20 | $2,018 | 7.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $283.60 | $709 | 3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $353.60 | $884 | 3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $422.80 | $1,057 | 3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $422.80 | $1,057 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $422.80 | $1,057 | 3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $807.20 | $2,018 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) | $533.60 | $1,334 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $422.80 | $1,057 | 4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $504 | $1,260 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $422.80 | $1,057 | 3.9× |
| X-ray eye for foreign body (70030) | $230 | $575 | 2.5× |
| X-ray humerus (73060) | $307.60 | $769 | 3.4× |
| X-ray IV pyelogram (ivp) (74400) | $833.60 | $2,084 | 4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $297.20 | $743 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $337.20 | $843 | 3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $422.80 | $1,057 | 3.9× |
| X-ray nose-rectum child f.b. (76010) | $724 | $1,810 | 8.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $549.60 | $1,374 | 5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $422.80 | $1,057 | 3.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $422.80 | $1,057 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $313.60 | $784 | 3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $381.20 | $953 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $422.80 | $1,057 | 3.9× |
| X-ray thoracic spine 4 vw (72074) | $565.60 | $1,414 | 5.2× |
| X-Ray Tmj Unilat (70328) | $353.60 | $884 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,326.80 | $3,317 | 3.6× |
| X-Rays Bone Length Studies (77073) | $342 | $855 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $604 | $1,510 | 5.5× |
| Xr c-spine 4 or 5 views (72050) | $422.80 | $1,057 | 3.9× |
| Xr facial bones less than 3 views (70140) | $306 | $765 | 3.4× |
| Xr orbits complete 4 views (70200) | $422.80 | $1,057 | 3.9× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.