Imaging prices at Osf Heart of Mary Medical Center
Urbana, IL · every code in this section with a posted price and a Medicare benchmark.
374 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) | $12,312 | $20,520 | 8.3× |
| Abdomen 1 View (74018) | $277.20 | $462 | 3.0× |
| Abdomen 2 views (74019) | $337.80 | $563 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,885.80 | $3,143 | 4.4× |
| Angio pulmonary bilat (75743) | $2,220.60 | $3,701 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $7,285.20 | $12,142 | 2.2× |
| Angiography extremity unilateral rs&i (75710) | $4,857 | $8,095 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,764.60 | $7,941 | 1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,507 | $5,845 | 1.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$426.60–$640.20 | $711–$1,067 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,607.60 | $4,346 | 0.4× |
| Artery X-Rays Abdomen (75726) | $4,324.80 | $7,208 | 0.7× |
| Artery X-Rays Pelvis (75736) | $4,792.20 | $7,987 | 0.8× |
| Arthrogram ankle (73615) | $797.40 | $1,329 | 2.1× |
| Arthrogram hip (73525) | $1,054.20 | $1,757 | 2.8× |
| Arthrogram Wrist (73115) | $909 | $1,515 | 2.4× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$854.40–$1,321.20 | $1,424–$2,202 | varies |
| Bone age studies (77072) | $354.60 | $591 | 3.2× |
| Bone Imaging 3 Phase (78315) | $1,852.20 | $3,087 | 4.3× |
| Bone Imaging Limited Area (78300) | $964.20 | $1,607 | 2.3× |
| Bone Imaging Multiple Areas (78305) | $1,282.20 | $2,137 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,522.80 | $2,538 | 3.6× |
| Bone survey infant (77076) | $382.80 | $638 | 3.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $940.80 | $1,568 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,005 | $11,675 | 4.6× |
| Cat Scan Follow-Up Study (76380) | $3,577.20 | $5,962 | 38.4× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$210.60–$236.40 | $351–$394 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$279.60–$349.20 | $466–$582 | varies |
| Chest 3 views (71047) | $332.40 | $554 | 3.6× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$375.60–$616.20 | $626–$1,027 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$304.20–$456.60 | $507–$761 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $176.40 | $294 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $1,359 | $2,265 | 9.4× |
| Contrast Exam Abdominl Aorta (75625) | $4,498.20 | $7,497 | 1.3× |
| Contrast X-Ray Bladder (74430) | $493.80 | $823 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $1,054.20 | $1,757 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $916.80 | $1,528 | 2.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $799.20 | $1,332 | 4.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,577.20 | $5,962 | 9.6× |
| CT abdomen and pelvis without contrast (74176) | $3,577.20 | $5,962 | 14.0× |
| CT abdomen w contrast (74160) | $3,577.20 | $5,962 | 19.0× |
| CT abdomen w wo contrast (74170) | $3,577.20 | $5,962 | 19.0× |
| CT abdomen w/o contrast (74150) | $3,577.20 | $5,962 | 31.9× |
| CT Angio Abdomen and Pelvis (74174) | $3,577.20 | $5,962 | 9.6× |
| CT Angio Chest (71275) | $3,577.20 | $5,962 | 19.0× |
| CT Angio Head (70496) | $3,491.40 | $5,819 | 18.6× |
| CT angio hrt w/3d image (75574) | $3,577.20 | $5,962 | 9.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT Angio Neck (70498) | $3,491.40 | $5,819 | 18.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $3,577.20 | $5,962 | 19.0× |
| CT cervical spine w/ contrast (72126) | $3,491.40 | $5,819 | 9.3× |
| CT cervical spine w/o contrast (72125) | $3,491.40 | $5,819 | 31.2× |
| CT cervical spine w/wo cont (72127) | $3,491.40 | $5,819 | 18.6× |
| CT chest w contrast (71260) | $3,577.20 | $5,962 | 19.0× |
| CT chest w/wo contrast (71270) | $3,577.20 | $5,962 | 19.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $3,577.20 | $5,962 | 19.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $3,577.20 | $5,962 | 31.9× |
| CT head/brain with contrast (70460) | $3,491.40 | $5,819 | 18.6× |
| CT head/brain without and with contrast (70470) | $3,491.40 | $5,819 | 18.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,577.20 | $5,962 | 9.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $117 | $195 | 1.3× |
| CT hrt w/3d image congen (75573) | $3,577.20 | $5,962 | 9.6× |
| CT iac w contrast (70481) | $3,491.40 | $5,819 | 18.6× |
| CT l-spine w&w/o contrast (72133) | $3,577.20 | $5,962 | 19.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT lumbar spine w contrast (72132) | $3,577.20 | $5,962 | 9.6× |
| CT lumbar spine w/o contrast (72131) | $3,577.20 | $5,962 | 31.9× |
| CT maxillofacial w contrast (70487) | $3,491.40 | $5,819 | 18.6× |
| CT maxillofacial wo contrast (70486) | $3,491.40 | $5,819 | 31.2× |
| CT neck tissue combo (70492) | $3,491.40 | $5,819 | 18.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,491.40 | $5,819 | 18.6× |
| CT orbits w/o contrast (70480) | $3,491.40 | $5,819 | 31.2× |
| CT pelvis w&w/o contrast (72194) | $3,577.20 | $5,962 | 19.0× |
| CT pelvis w/o contrast (72192) | $3,577.20 | $5,962 | 31.9× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT scans face/jaw combo (70488) | $3,491.40 | $5,819 | 18.6× |
| CT soft tissue neck w contrast (70491) | $3,491.40 | $5,819 | 18.6× |
| CT soft tissue neck w/o contrast (70490) | $3,491.40 | $5,819 | 31.2× |
| CT thoracic spine w contrast (72129) | $3,577.20 | $5,962 | 19.0× |
| CT thoracic spine w/o contrast (72128) | $3,577.20 | $5,962 | 31.9× |
| CT thoracic spine w/wo cont (72130) | $3,577.20 | $5,962 | 19.0× |
| CT thorax w/o contrast (71250) | $3,577.20 | $5,962 | 31.9× |
| CT unlisted procedure (76497) | $3,577.20 | $5,962 | 38.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$3,577.20–$5,365.80 | $5,962–$8,943 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,577.20 | $5,962 | 19.0× |
| Cta Abdomen (74175) | $3,577.20 | $5,962 | 19.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,577.20 | $5,962 | 9.6× |
| CTA pelvis (72191) | $3,577.20 | $5,962 | 19.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $376.80 | $628 | 3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $492.60 | $821 | 4.4× |
| Dxa Bone Density Axial (77080) | $532.80 | $888 | 4.8× |
| Dxa bone density study (77085) | $346.20 | $577 | 3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $426 | $710 | 4.6× |
| Echo exam of fetal heart (76825) | $1,072.80 | $1,788 | 1.8× |
| Echo Guide For Artery Repair (76936) | $1,081.20 | $1,802 | 4.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $432 | $720 | 1.7× |
| Esophagram (74220) | $532.20 | $887 | 2.8× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$448.20–$780 | $747–$1,300 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $658.80 | $1,098 | 5.9× |
| Fluoroscopy up to 1 hr (76000) | $676.20 | $1,127 | 2.6× |
| Follow-Up Angiography (75898) | $2,220.60 | $3,701 | 0.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$340.20–$510.60 | $567–$851 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$388.20–$582.60 | $647–$971 | varies |
| Gastric emptying imaging study (78264) | $1,471.80 | $2,453 | 3.4× |
| Gated Heart Planar Single (78472) | $2,133.60 | $3,556 | 5.0× |
| Gated Heart, Multiple (78473) | $3,190.80 | $5,318 | 7.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$391.80–$588 | $653–$980 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,189 | $5,315 | 5.5× |
| Hepatobiliary System Imaging (78226) | $1,506.60 | $2,511 | 3.5× |
| Ht Musc Image Planar Mult (78454) | $4,204.20 | $7,007 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $3,884.40 | $6,474 | 2.8× |
| Hysterosalpingogram (74740) | $612.60 | $1,021 | 2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $619.20 | $1,032 | 6.6× |
| Infant hip ultrasound, limited static exam (76886) | $597.60 | $996 | 6.4× |
| Interstitial radiation source applic complex (77778) | $3,033.60 | $5,056 | 4.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,076 | $3,460 | 2.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,736.40 | $2,894 | 2.9× |
| Intracavitary radiation source applic simple (77761) | $1,396.20 | $2,327 | 2.4× |
| Joint Survey Single View (77077) | $478.20 | $797 | 4.3× |
| K Flow/Funct Image Multiple (78709) | $2,223.60 | $3,706 | 3.8× |
| K Flow/Funct Image W/Drug (78708) | $1,594.80 | $2,658 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,733.40 | $2,889 | 3.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,381.80 | $2,303 | 3.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$306.60–$460.20 | $511–$767 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,012.20 | $1,687 | 2.4× |
| Liver & Spleen Imaging Static Only (78215) | $1,141.80 | $1,903 | 2.7× |
| Liver imaging w/vascular flow (78202) | $937.20 | $1,562 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $2,736 | $4,560 | 4.7× |
| Lung perfusion differential (78597) | $3,952.80 | $6,588 | 9.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,982.40 | $3,304 | 3.4× |
| Lymph System Imaging (78195) | $1,411.80 | $2,353 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $4,771.20 | $7,952 | 18.7× |
| Mammary ductogram or galactogram multiple (77054) | $1,041.60 | $1,736 | 4.1× |
| Mammary ductogram or galactogram single (77053) | $598.80 | $998 | 2.3× |
| Meckels Divert Exam (78290) | $2,637.60 | $4,396 | 6.2× |
| Mlc imrt design & construction per imrt plan (77338) | $4,136.40 | $6,894 | 10.3× |
| Mr safety determination physician/other qhp (76016) | $134.40 | $224 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.80 | $63 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $140.40 | $234 | 1.4× |
| Mr safety implt pos&/immoblj (76019) | $90.60 | $151 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $369.60 | $616 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $4,532.40 | $7,554 | 12.1× |
| MRA head w/o contrast (70544) | $4,532.40 | $7,554 | 17.7× |
| MRA head with contrast (70545) | $4,532.40 | $7,554 | 12.1× |
| MRA neck w contrast (70548) | $4,532.40 | $7,554 | 12.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,532.40 | $7,554 | 12.1× |
| MRA neck w/o contrast (70547) | $4,532.40 | $7,554 | 17.7× |
| MRI abdomen w contrast (74182) | $4,771.20 | $7,952 | 12.8× |
| MRI abdomen w/o contrast (74181) | $4,771.20 | $7,952 | 18.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI bone marrow blood supply (77084) | $4,771.20 | $7,952 | 18.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $7,156.80 | $11,928 | 28.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,771.20 | $7,952 | 18.7× |
| MRI cervical spine w contrast (72142) | $4,532.40 | $7,554 | 12.1× |
| MRI cervical spine w/o cont (72141) | $4,532.40 | $7,554 | 17.7× |
| MRI chest w/o contrast (71550) | $4,771.20 | $7,952 | 18.7× |
| MRI chest with contrast (71551) | $4,771.20 | $7,952 | 5.7× |
| MRI chest wo w contrast (71552) | $4,771.20 | $7,952 | 12.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI lumbar spine w contrast (72149) | $4,771.20 | $7,952 | 12.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,532.40 | $7,554 | 12.1× |
| MRI orbit face &/neck w/o contrast (70540) | $4,532.40 | $7,554 | 17.7× |
| MRI orbit face neck w contrast (70542) | $4,532.40 | $7,554 | 12.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,532.40 | $7,554 | 12.1× |
| MRI pelvis w contrast (72196) | $4,771.20 | $7,952 | 12.8× |
| MRI pelvis w/o & w contrast (72197) | $4,771.80 | $7,953 | 12.8× |
| MRI pelvis w/o contrast (72195) | $4,771.20 | $7,952 | 18.7× |
| MRI thoracic spine w/o contrast (72146) | $4,771.20 | $7,952 | 18.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI, abdomen, combo (74183) | $4,771.20 | $7,952 | 12.8× |
| MRI, dorsal spine combo (72157) | $4,771.20 | $7,952 | 12.8× |
| MRI, dorsal spine contrast (72147) | $4,771.20 | $7,952 | 12.8× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$4,771.20–$7,156.80 | $7,952–$11,928 | varies |
| MRI, lumbar spine combo (72158) | $4,771.20 | $7,952 | 12.8× |
| Myelogram cervical (72240) | $1,213.80 | $2,023 | 1.4× |
| Myelogram Lumbar (72265) | $1,608 | $2,680 | 1.9× |
| Myelography thoracic (72255) | $1,528.20 | $2,547 | 1.8× |
| Myelograpy 2/more regions rs&i (72270) | $1,977.60 | $3,296 | 2.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,181 | $3,635 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $6,540.60 | $10,901 | 4.7× |
| Neck soft tissue (70360) | $321.60 | $536 | 3.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $811.80 | $1,353 | 2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,883 | $14,805 | 6.0× |
| Nuclear Rx Oral Admin (79005) | $1,057.20 | $1,762 | 4.2× |
| Panoramic X-ray of jaws (70355) | $154.80 | $258 | 1.7× |
| Parathyroid Planar Imaging (78070) | $1,655.40 | $2,759 | 3.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,743 | $2,905 | 4.1× |
| Pelvis 1 or 2 views (72170) | $523.80 | $873 | 4.7× |
| Peritoneogram Rs&I (74190) | $514.20 | $857 | 0.9× |
| Pet Image W/Ct Lmtd (78814) | $5,411.40 | $9,019 | 3.5× |
| PET image w/CT, full body (78816) | $6,903.60 | $11,506 | 4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,313.80 | $10,523 | 4.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,220.60 | $3,701 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,332.60 | $2,221 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $551.40 | $919 | 4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $773.40 | $1,289 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$453–$679.80 | $755–$1,133 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$259.20–$388.80 | $432–$648 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$531–$796.80 | $885–$1,328 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $478.20 | $797 | 4.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$249.60–$374.40 | $416–$624 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$446.40–$669.60 | $744–$1,116 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$450.60–$676.20 | $751–$1,127 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$282.60–$424.20 | $471–$707 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$324.60–$487.20 | $541–$812 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $354 | $590 | 3.8× |
| Radex Ribs Unilateral 2 Views (71100) | $393 | $655 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$557.40–$836.40 | $929–$1,394 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $349.80 | $583 | 3.8× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$307.20–$330 | $512–$550 | varies |
| Radex Sternum Minimum 2 Views (71120) | $400.20 | $667 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $492 | $820 | 5.3× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$235.20–$356.40 | $392–$594 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$298.20–$447.60 | $497–$746 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$523.20–$784.80 | $872–$1,308 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $385.20 | $642 | 3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,355.60 | $28,926 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $1,116 | $1,860 | 10.2× |
| Radiation treatment delivery level 2 (77407) | $4,218 | $7,030 | 10.2× |
| Radiation treatment delivery level 3 (77412) | $5,693.40 | $9,489 | 9.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $384.60 | $641 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $389.40 | $649 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $850.20 | $1,417 | 4.5× |
| Radiologic exam colon single contrast study (74270) | $647.40 | $1,079 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $710.40 | $1,184 | 3.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$654.60–$982.20 | $1,091–$1,637 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $235.20 | $392 | 2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $583.80 | $973 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $615 | $1,025 | 3.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $721.80 | $1,203 | 3.8× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$218.40–$327.60 | $364–$546 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$349.80–$525 | $583–$875 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$375.60–$563.40 | $626–$939 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $382.20 | $637 | 3.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $346.80 | $578 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$388.20–$582.60 | $647–$971 | varies |
| Ribs bilateral 3 views (71110) | $478.20 | $797 | 4.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,548.60 | $2,581 | 3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,478.40 | $2,464 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,012.60 | $5,021 | 5.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,067.60 | $3,446 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,320.20 | $3,867 | 4.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,481.20 | $5,802 | 2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,641 | $7,735 | 3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,093.60 | $5,156 | 2.2× |
| Rp Therapy Intravenous Administration (79101) | $1,318.20 | $2,197 | 5.3× |
| Scapula (73010) range across 3 matching MRF lines |
$335.40–$503.40 | $559–$839 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $93 | $155 | 4.0× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$235.80–$354 | $393–$590 | varies |
| Shoulder Arthrography (73040) | $773.40 | $1,289 | 2.1× |
| Sialogram (70390) | $829.80 | $1,383 | 3.2× |
| Skull less than 4 views (70250) | $313.20 | $522 | 2.8× |
| Special dosimetry (77331) | $289.80 | $483 | 2.0× |
| Special Physics Consult (77370) | $1,774.20 | $2,957 | 12.3× |
| Special teletherapy port plan (77321) | $2,311.20 | $3,852 | 5.8× |
| Special treatment procedure (77470) | $6,186.60 | $10,311 | 10.4× |
| Srs Multisource (77371) | $36,051 | $60,085 | 4.6× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$9,012.60–$11,713.80 | $15,021–$19,523 | varies |
| Sternoclavicular joints (71130) | $436.20 | $727 | 4.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,590 | $2,650 | 4.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,176 | $1,960 | 2.9× |
| Testicular Imaging W/Flow (78761) | $1,240.80 | $2,068 | 2.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,827.80 | $4,713 | 7.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,412 | $4,020 | 6.0× |
| Ther rad simulaj-aided field setting simple (77280) | $1,579.80 | $2,633 | 11.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,054.20 | $1,757 | 5.6× |
| Thoracic spine 2 views (72070) | $405 | $675 | 3.6× |
| Thoracic spine 3 views (72072) | $465.60 | $776 | 4.2× |
| Thoracolumbar 2 views (72080) | $198 | $330 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $884.40 | $1,474 | 2.1× |
| Thyroid Met Imaging Body (78018) | $2,098.80 | $3,498 | 3.6× |
| Thyroid Uptake Measurement (78012) | $493.20 | $822 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $950.40 | $1,584 | 2.2× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,511.40–$2,147.40 | $2,519–$3,579 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$531.60–$916.20 | $886–$1,527 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$343.20–$708 | $572–$1,180 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$454.80–$679.80 | $758–$1,133 | varies |
| Ultrasound elastography first target lesion (76982) | $366.60 | $611 | 3.3× |
| Ultrasound Elastography Parenchyma (76981) | $366.60 | $611 | 3.3× |
| Ultrasound Exam Aaa Screen (76706) | $730.20 | $1,217 | 6.5× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$816.60–$1,252.80 | $1,361–$2,088 | varies |
| Umbilical-artery Doppler (OB) (76820) | $585.60 | $976 | 5.2× |
| Unlisted Dx Radiographic Procedure (76499) | $284.40 | $474 | 3.0× |
| Unlisted fluoroscopic procedure (76496) | $253.80 | $423 | 2.7× |
| Unlisted magnetic resonance procedure (76498) | $4,771.20 | $7,952 | 51.2× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $982.80 | $1,638 | 2.3× |
| Unlisted us procedure (76999) | $430.20 | $717 | 4.6× |
| Upper gi w/o kub (74240) | $720.60 | $1,201 | 3.8× |
| Ureteral Reflux Study (78740) | $824.40 | $1,374 | 1.9× |
| Urethrocystogram voiding (74455) | $637.80 | $1,063 | 2.5× |
| Urethrocystography retrograde (74450) | $733.20 | $1,222 | 2.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$504.60–$1,274.40 | $841–$2,124 | varies |
| Us chest (76604) | $505.20 | $842 | 4.5× |
| Us complete joint (76881) range across 3 matching MRF lines |
$582–$834 | $970–$1,390 | varies |
| Us exam, pelvic, limited (76857) | $660.60 | $1,101 | 5.9× |
| Us head (76506) | $1,033.20 | $1,722 | 9.2× |
| Us kidney transplant (76776) | $753 | $1,255 | 6.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$547.80–$796.20 | $913–$1,327 | varies |
| Us ob detailed single fetus (76811) | $856.20 | $1,427 | 3.3× |
| Us ob limited 1 or more fetuses (76815) | $547.80 | $913 | 4.9× |
| Us ob transvaginal (76817) | $586.80 | $978 | 5.2× |
| Us pelvic non ob complete (76856) | $1,402.80 | $2,338 | 12.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $804.60 | $1,341 | 7.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $429 | $715 | 3.8× |
| Us retroperitoneal complete (76770) | $961.20 | $1,602 | 8.6× |
| Us retroperitoneal limited (76775) | $964.20 | $1,607 | 8.6× |
| Us scrotum and contents (76870) | $1,317 | $2,195 | 11.8× |
| Us spinal canal and contents (76800) | $684 | $1,140 | 6.1× |
| Us thyroid (76536) | $1,229.40 | $2,049 | 11.0× |
| Us transrectal (76872) | $997.20 | $1,662 | 8.9× |
| Vascular Flow Imaging (78445) | $1,356.60 | $2,261 | 3.2× |
| Vein X-Ray Chest (75827) | $2,132.40 | $3,554 | 1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,220.60 | $3,701 | 0.7× |
| Venogram Sinus/Jugular (75860) | $2,220.60 | $3,701 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $3,962.40 | $6,604 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,564.20 | $2,607 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,042.80 | $1,738 | 0.6× |
| Venography Renal Bilateral (75833) | $5,210.40 | $8,684 | 1.5× |
| Venography Renal Unilateral (75831) | $3,473.40 | $5,789 | 1.0× |
| Venous sampling by catheter (75893) | $5,668.20 | $9,447 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $377.40 | $629 | 4.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$304.20–$456.60 | $507–$761 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $415.20 | $692 | 4.5× |
| X-ray antegrade pyelogram tube (74425) | $1,251 | $2,085 | 3.3× |
| X-Ray Aorta Leg Arteries (75630) | $2,957.40 | $4,929 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $415.80 | $693 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$313.20–$469.80 | $522–$783 | varies |
| X-Ray Exam Breast Specimen (76098) | $387 | $645 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $260.40 | $434 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $301.80 | $503 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $334.20 | $557 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $291.60 | $486 | 3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $349.80 | $583 | 3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $468 | $780 | 4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $415.20 | $692 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $525 | $875 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $525 | $875 | 4.7× |
| X-Ray Exam L-S Spine Bending (72114) | $540.60 | $901 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $412.80 | $688 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $560.40 | $934 | 5.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $415.20 | $692 | 3.7× |
| X-ray eye for foreign body (70030) | $399.60 | $666 | 4.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$414.60–$622.20 | $691–$1,037 | varies |
| X-ray IV pyelogram (ivp) (74400) | $783.60 | $1,306 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $258.60 | $431 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $468.60 | $781 | 5.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $415.80 | $693 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $323.40 | $539 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $545.40 | $909 | 4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $477 | $795 | 4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $494.40 | $824 | 5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $361.80 | $603 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $349.20 | $582 | 3.1× |
| X-Ray Stress View (77071) | $183 | $305 | 2.0× |
| X-ray thoracic spine 4 vw (72074) | $502.20 | $837 | 4.5× |
| X-Ray Tmj Unilat (70328) | $328.20 | $547 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $852 | $1,420 | 2.3× |
| X-Rays Bone Length Studies (77073) | $506.40 | $844 | 4.5× |
| X-Rays Bone Survey Complete (77075) | $523.80 | $873 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $510 | $850 | 4.6× |
| Xr facial bones less than 3 views (70140) | $390.60 | $651 | 4.2× |
| Xr orbits complete 4 views (70200) | $361.80 | $603 | 3.2× |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$1,052.40–$2,487.60 | $1,754–$4,146 | varies |
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.