Imaging prices at Osf Little Company of Mary Medical Center
Evergreen Park, IL · every code in this section with a posted price and a Medicare benchmark.
465 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) | $6,498 | $10,830 | 4.4× |
| Abdomen 1 View (74018) | $277.20 | $462 | 3.0× |
| Abdomen 2 views (74019) | $337.80 | $563 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,657.20 | $2,762 | 3.9× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,246.80 | $2,078 | 0.9× |
| Angio internal mammary (75756) | $5,460.60 | $9,101 | 1.6× |
| Angio pulmonary bilat (75743) | $4,897.20 | $8,162 | 1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,348.60 | $5,581 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $5,460.60 | $9,101 | 1.6× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$4,612.20–$5,460.60 | $7,687–$9,101 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,460.60 | $9,101 | 1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,772.40 | $7,954 | 1.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$271.20–$407.40 | $452–$679 | varies |
| Aortography thoracic serialography rs&i (75605) | $7,098 | $11,830 | 1.2× |
| Artery X-Rays Abdomen (75726) | $7,747.80 | $12,913 | 1.3× |
| Artery X-Rays Adrenal Gland (75731) | $2,457 | $4,095 | 0.7× |
| Artery X-Rays Pelvis (75736) | $7,747.80 | $12,913 | 1.3× |
| Artery X-Rays Spine (75705) | $7,747.80 | $12,913 | 1.3× |
| Arthrogram ankle (73615) | $1,021.80 | $1,703 | 2.7× |
| Arthrogram hip (73525) | $888.60 | $1,481 | 2.4× |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$699.60–$1,021.80 | $1,166–$1,703 | varies |
| Basic radiation dosimetry calculation (77300) | $613.20 | $1,022 | 4.3× |
| Bone age studies (77072) | $211.80 | $353 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,845 | $3,075 | 4.3× |
| Bone Imaging Limited Area (78300) | $792.60 | $1,321 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $1,314.60 | $2,191 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,839 | $3,065 | 4.3× |
| Bone marrow imaging; whole body (78104) | $1,357.80 | $2,263 | 3.2× |
| Bone survey infant (77076) | $729 | $1,215 | 6.5× |
| Brachytx isodose complex (77318) | $1,208.40 | $2,014 | 3.0× |
| Brachytx isodose intermed (77317) | $814.80 | $1,358 | 2.0× |
| Brachytx Isodose Plan Simple (77316) | $925.20 | $1,542 | 2.3× |
| Brain Flow Imaging Only (78610) | $991.20 | $1,652 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) | $1,182 | $1,970 | 2.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $777 | $1,295 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,837.20 | $8,062 | 3.2× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $2,121.60 | $3,536 | 3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,179.40 | $5,299 | 8.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,106.40 | $6,844 | 4.9× |
| Cardiac Shunt Detection (78428) | $1,078.20 | $1,797 | 2.5× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$861–$1,697.40 | $1,435–$2,829 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $989.40 | $1,649 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $1,655.40 | $2,759 | 2.8× |
| Chest 1 view (71045) | $236.40 | $394 | 2.5× |
| Chest 2 views (71046) | $279.60 | $466 | 3.0× |
| Chest 3 views (71047) | $332.40 | $554 | 3.6× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$375.60–$521.40 | $626–$869 | varies |
| Cholecystography Oral Contrast (74290) | $373.80 | $623 | 2.0× |
| Cisternography Positive Contrast Rs&I (70015) | $1,090.20 | $1,817 | 1.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$286.80–$429.60 | $478–$716 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $176.40 | $294 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $613.20 | $1,022 | 4.3× |
| Contrast Exam Abdominl Aorta (75625) | $5,460.60 | $9,101 | 1.6× |
| Contrast X-Ray Bladder (74430) | $596.40 | $994 | 1.6× |
| Contrast X-Ray Of Elbow (73085) | $888.60 | $1,481 | 2.4× |
| Contrast X-Ray Of Knee Joint (73580) | $1,021.80 | $1,703 | 2.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $575.40 | $959 | 3.1× |
| Corpora cavernosography (74445) | $1,798.20 | $2,997 | 16.1× |
| CT abdomen and pelvis without and with contrast (74178) | $4,380 | $7,300 | 11.7× |
| CT abdomen and pelvis without contrast (74176) | $3,079.20 | $5,132 | 12.0× |
| CT abdomen w contrast (74160) | $2,355 | $3,925 | 12.5× |
| CT abdomen w wo contrast (74170) | $2,681.40 | $4,469 | 14.3× |
| CT abdomen w/o contrast (74150) | $2,176.20 | $3,627 | 19.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,504.40 | $4,174 | 6.7× |
| CT Angio Chest (71275) | $2,476.80 | $4,128 | 13.2× |
| CT Angio Head (70496) | $2,340.60 | $3,901 | 12.5× |
| CT angio hrt w/3d image (75574) | $1,582.20 | $2,637 | 4.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,439–$3,658.20 | $4,065–$6,097 | varies |
| CT Angio Neck (70498) | $2,439 | $4,065 | 13.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,439–$3,658.20 | $4,065–$6,097 | varies |
| CT bone density (77078) | $1,437 | $2,395 | 15.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,115.60 | $3,526 | 11.3× |
| CT cervical spine w/ contrast (72126) | $2,256 | $3,760 | 6.0× |
| CT cervical spine w/o contrast (72125) | $2,157.60 | $3,596 | 19.3× |
| CT cervical spine w/wo cont (72127) | $2,999.40 | $4,999 | 16.0× |
| CT chest w contrast (71260) | $2,220.60 | $3,701 | 11.8× |
| CT chest w/wo contrast (71270) | $2,293.20 | $3,822 | 12.2× |
| CT colonography screening (74263) | $2,487 | $4,145 | 9.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,440.20 | $4,067 | 13.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,090.40 | $3,484 | 18.7× |
| CT head/brain with contrast (70460) | $2,153.40 | $3,589 | 11.5× |
| CT head/brain without and with contrast (70470) | $2,505.60 | $4,176 | 13.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,969.80 | $3,283 | 5.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $117 | $195 | 1.3× |
| CT hrt w/3d image congen (75573) | $1,858.80 | $3,098 | 5.0× |
| CT iac w contrast (70481) | $2,153.40 | $3,589 | 11.5× |
| CT l-spine w&w/o contrast (72133) | $2,717.40 | $4,529 | 14.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,085–$3,127.80 | $3,475–$5,213 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,133.60–$3,199.80 | $3,556–$5,333 | varies |
| CT lumbar spine w contrast (72132) | $2,515.20 | $4,192 | 6.7× |
| CT lumbar spine w/o contrast (72131) | $2,157.60 | $3,596 | 19.3× |
| CT maxillofacial w contrast (70487) | $2,245.20 | $3,742 | 11.9× |
| CT maxillofacial wo contrast (70486) | $2,101.20 | $3,502 | 18.8× |
| CT neck tissue combo (70492) | $2,505.60 | $4,176 | 13.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,532 | $4,220 | 13.5× |
| CT orbits w/o contrast (70480) | $2,133.60 | $3,556 | 19.0× |
| CT pelvis w&w/o contrast (72194) | $2,439 | $4,065 | 13.0× |
| CT pelvis w/o contrast (72192) | $2,067.60 | $3,446 | 18.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,505.60–$3,758.40 | $4,176–$6,264 | varies |
| CT scans face/jaw combo (70488) | $2,675.40 | $4,459 | 14.2× |
| CT soft tissue neck w contrast (70491) | $2,254.20 | $3,757 | 12.0× |
| CT soft tissue neck w/o contrast (70490) | $2,196 | $3,660 | 19.6× |
| CT thoracic spine w contrast (72129) | $2,503.80 | $4,173 | 13.3× |
| CT thoracic spine w/o contrast (72128) | $2,109.60 | $3,516 | 18.8× |
| CT thoracic spine w/wo cont (72130) | $2,717.40 | $4,529 | 14.5× |
| CT thorax w/o contrast (71250) | $2,088 | $3,480 | 18.6× |
| CT unlisted procedure (76497) | $1,756.80 | $2,928 | 18.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$2,133–$3,199.20 | $3,555–$5,332 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,532–$3,798 | $4,220–$6,330 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,190.60–$3,286.20 | $3,651–$5,477 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,274.60 | $3,791 | 12.1× |
| Cta Abdomen (74175) | $2,504.40 | $4,174 | 13.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,247 | $3,745 | 6.0× |
| CTA pelvis (72191) | $2,505.60 | $4,176 | 13.3× |
| Dilation ureters/urethra rs&i (74485) | $3,467.40 | $5,779 | 1.5× |
| Discography Cerv/Thor Spine (72285) | $2,118.60 | $3,531 | 1.0× |
| Diskography lumbar (72295) | $2,124.60 | $3,541 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $784.80 | $1,308 | 7.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$73.80–$729 | $123–$1,215 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $481.20 | $802 | 4.3× |
| Dxa Bone Density Axial (77080) | $216.60 | $361 | 1.9× |
| Dxa bone density study (77085) | $390.60 | $651 | 3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $240 | $400 | 2.6× |
| Echo exam of fetal heart (76825) | $1,868.40 | $3,114 | 3.2× |
| Echo exam uterus (76831) | $1,146 | $1,910 | 4.5× |
| Echo Guide For Artery Repair (76936) | $1,962.60 | $3,271 | 8.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,308.60 | $2,181 | 5.1× |
| Echograp Trans R Pros Study (76873) | $2,306.40 | $3,844 | 20.6× |
| Esophageal Motility Study (78258) | $1,293 | $2,155 | 3.0× |
| Esophagram (74220) | $630 | $1,050 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $397.80 | $663 | 3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $621 | $1,035 | 5.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,460.60 | $4,101 | 9.6× |
| Fluoroscopy up to 1 hr (76000) | $883.80 | $1,473 | 3.5× |
| Follow-Up Angiography (75898) | $1,983 | $3,305 | 0.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$266.40–$400.80 | $444–$668 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$249.60–$375 | $416–$625 | varies |
| Gastric emptying imaging study (78264) | $1,431 | $2,385 | 3.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,138.20 | $1,897 | 2.7× |
| Gastroesophageal Reflux Exam (78262) | $851.40 | $1,419 | 2.0× |
| Gated Heart Planar Single (78472) | $1,812.60 | $3,021 | 4.2× |
| Gated Heart, Multiple (78473) | $1,494.60 | $2,491 | 3.5× |
| GI Endoscopic US S&I (76975) | $531.60 | $886 | 2.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,138.20 | $1,897 | 2.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$269.40–$402.60 | $449–$671 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,079.20 | $10,132 | 8.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,079.20 | $10,132 | 8.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,079.20 | $10,132 | 8.1× |
| Heart first pass single,planar (78481) | $1,078.20 | $1,797 | 1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,460.60 | $9,101 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,460.60 | $9,101 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,722 | $2,870 | 3.0× |
| Hepatobiliary System Imaging (78226) | $1,722 | $2,870 | 4.0× |
| Ht Musc Image Planar Mult (78454) | $2,689.20 | $4,482 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $2,426.40 | $4,044 | 1.7× |
| Hysterosalpingogram (74740) | $868.80 | $1,448 | 3.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $592.80 | $988 | 6.4× |
| Infant hip ultrasound, limited static exam (76886) | $630 | $1,050 | 6.8× |
| Interstitial radiation source applic complex (77778) | $1,875 | $3,125 | 2.5× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,226.40 | $2,044 | 1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,353 | $2,255 | 2.3× |
| Intracavitary radiation source applic simple (77761) | $863.40 | $1,439 | 1.5× |
| Joint Survey Single View (77077) | $214.20 | $357 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $1,909.20 | $3,182 | 3.3× |
| K Flow/Funct Image W/Drug (78708) | $1,873.80 | $3,123 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,873.80 | $3,123 | 3.2× |
| Kidney Imaging Morphol (78700) | $868.80 | $1,448 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,102.80 | $1,838 | 2.6× |
| Knee 3 Views (73562) | $457.20 | $762 | 4.9× |
| Leveen/Shunt Patency Exam (78291) | $783 | $1,305 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $972 | $1,620 | 2.3× |
| Liver imaging w/vascular flow (78202) | $1,881 | $3,135 | 3.2× |
| Lung Perf&Ventilat Diferentl (78598) | $2,242.20 | $3,737 | 3.9× |
| Lung perfusion differential (78597) | $1,711.80 | $2,853 | 4.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,859.60 | $4,766 | 4.9× |
| Lung Ventilation Imaging (78579) | $1,257 | $2,095 | 2.9× |
| Lymph System Imaging (78195) | $339 | $565 | 0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,694.40 | $7,824 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $3,139.80 | $5,233 | 12.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $3,564.60 | $5,941 | 19.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,982 | $4,970 | 5.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $4,440.60 | $7,401 | 23.6× |
| Magnetic Resonance Elastography (76391) | $3,703.20 | $6,172 | 14.5× |
| Mammary ductogram or galactogram multiple (77054) | $880.80 | $1,468 | 3.4× |
| Mammary ductogram or galactogram single (77053) | $880.80 | $1,468 | 3.4× |
| Meckels Divert Exam (78290) | $2,838 | $4,730 | 6.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,119 | $1,865 | 2.8× |
| 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) | $3,253.20 | $5,422 | 8.7× |
| MRA head w/o contrast (70544) | $2,871 | $4,785 | 11.2× |
| MRA head with contrast (70545) | $2,955 | $4,925 | 7.9× |
| MRA neck w contrast (70548) | $2,955 | $4,925 | 7.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,324.60 | $5,541 | 8.9× |
| MRA neck w/o contrast (70547) | $2,871 | $4,785 | 11.2× |
| MRI abdomen w contrast (74182) | $2,955 | $4,925 | 7.9× |
| MRI abdomen w/o contrast (74181) | $2,871 | $4,785 | 11.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,109.80–$4,664.40 | $5,183–$7,774 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,605.40–$5,408.40 | $6,009–$9,014 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,085.20–$4,628.40 | $5,142–$7,714 | varies |
| MRI bone marrow blood supply (77084) | $4,609.80 | $7,683 | 18.0× |
| MRI brain functional w/o physician admnistration (70554) | $3,397.20 | $5,662 | 13.3× |
| MRI brain functional w/physician admnistration (70555) | $3,192.60 | $5,321 | 12.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,307.40 | $7,179 | 16.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,871 | $4,785 | 11.2× |
| MRI cardiac w/o cont stress (75559) | $4,086 | $6,810 | 7.0× |
| MRI cardiac w/o contrast (75557) | $2,871 | $4,785 | 11.2× |
| MRI cervical spine w contrast (72142) | $3,658.80 | $6,098 | 9.8× |
| MRI cervical spine w/o cont (72141) | $2,871 | $4,785 | 11.2× |
| MRI chest w/o contrast (71550) | $2,871 | $4,785 | 11.2× |
| MRI chest with contrast (71551) | $2,955 | $4,925 | 3.5× |
| MRI chest wo w contrast (71552) | $3,324.60 | $5,541 | 8.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,006–$4,509 | $5,010–$7,515 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,439.80–$5,159.40 | $5,733–$8,599 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,871–$4,307.40 | $4,785–$7,179 | varies |
| MRI lumbar spine w contrast (72149) | $3,496.80 | $5,828 | 9.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,754.80 | $6,258 | 10.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,871 | $4,785 | 11.2× |
| MRI orbit face neck w contrast (70542) | $2,955 | $4,925 | 7.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,369.60 | $5,616 | 9.0× |
| MRI pelvis w contrast (72196) | $2,955 | $4,925 | 7.9× |
| MRI pelvis w/o & w contrast (72197) | $3,324.60 | $5,541 | 8.9× |
| MRI pelvis w/o contrast (72195) | $2,871 | $4,785 | 11.2× |
| MRI spectroscopy (76390) | $4,106.40 | $6,844 | 44.0× |
| MRI thoracic spine w/o contrast (72146) | $2,871 | $4,785 | 11.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$2,955–$4,432.80 | $4,925–$7,388 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,871–$4,307.40 | $4,785–$7,179 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,324.60–$4,986 | $5,541–$8,310 | varies |
| MRI, abdomen, combo (74183) | $3,576.60 | $5,961 | 9.6× |
| MRI, dorsal spine combo (72157) | $3,592.20 | $5,987 | 9.6× |
| MRI, dorsal spine contrast (72147) | $3,346.80 | $5,578 | 9.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,871–$4,307.40 | $4,785–$7,179 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,324.60–$4,986 | $5,541–$8,310 | varies |
| MRI, lumbar spine combo (72158) | $3,879 | $6,465 | 10.4× |
| Myelogram cervical (72240) | $888.60 | $1,481 | 1.1× |
| Myelogram Lumbar (72265) | $1,114.80 | $1,858 | 1.3× |
| Myelography thoracic (72255) | $1,114.80 | $1,858 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,114.80 | $1,858 | 1.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,243.20 | $2,072 | 2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$6,004.20–$9,651 | $10,007–$16,085 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,172 | $3,620 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $5,697.60 | $9,496 | 4.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,236.40 | $5,394 | 2.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,236.40 | $5,394 | 2.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $5,388.60 | $8,981 | 2.3× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $6,168 | $10,280 | 2.6× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $6,168 | $10,280 | 3.8× |
| Neck soft tissue (70360) | $325.80 | $543 | 3.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $732.60 | $1,221 | 1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $550.80 | $918 | 1.3× |
| Nm csf leak detection (78650) | $958.80 | $1,598 | 0.7× |
| Nm unlisted gi procedure (78299) | $940.20 | $1,567 | 2.2× |
| Nm whole blood volume (78122) | $859.20 | $1,432 | 1.5× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$1,035–$2,083.20 | $1,725–$3,472 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,498 | $10,830 | 4.4× |
| Nuclear medicine study of endocrine organs (78099) | $749.40 | $1,249 | 1.7× |
| Nuclear Rx Intra-Arterial (79445) | $501.60 | $836 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $1,928.40 | $3,214 | 7.7× |
| Ob us nuchal meas 1 gest (76813) | $802.80 | $1,338 | 7.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$94.80–$406.80 | $158–$678 | varies |
| Panoramic X-ray of jaws (70355) | $212.40 | $354 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,196 | $3,660 | 3.8× |
| Parathyroid Planar Imaging (78070) | $1,087.20 | $1,812 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,253.40 | $2,089 | 2.9× |
| Pelvis 1 or 2 views (72170) | $265.80 | $443 | 2.4× |
| Peritoneogram Rs&I (74190) | $1,017.60 | $1,696 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $4,837.20 | $8,062 | 3.2× |
| PET image w/CT, full body (78816) | $4,837.20 | $8,062 | 3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,837.20 | $8,062 | 3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,897.20 | $8,162 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,603.80 | $2,673 | 3.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $549.60 | $916 | 4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,017.60 | $1,696 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$328.80–$493.20 | $548–$822 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$246–$370.20 | $410–$617 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$322.80–$485.40 | $538–$809 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $717 | $1,195 | 6.4× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$187.20–$279 | $312–$465 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$327–$489.60 | $545–$816 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$317.40–$475.20 | $529–$792 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$535.20–$1,173.60 | $892–$1,956 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$347.40–$580.80 | $579–$968 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $258.60 | $431 | 2.8× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $321.60 | $536 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $433.20 | $722 | 4.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$321–$481.80 | $535–$803 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $376.20 | $627 | 4.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $967.80 | $1,613 | 5.1× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$301.80–$324 | $503–$540 | varies |
| Radex Sternum Minimum 2 Views (71120) | $288 | $480 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $514.20 | $857 | 5.5× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$201.60–$301.80 | $336–$503 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$568.20–$1,129.80 | $947–$1,883 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$320.40–$480.60 | $534–$801 | 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) | $10,795.20 | $17,992 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $735 | $1,225 | 6.7× |
| Radiation treatment delivery level 2 (77407) | $2,778.60 | $4,631 | 6.7× |
| Radiation treatment delivery level 3 (77412) | $2,778.60 | $4,631 | 4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $402.60 | $671 | 3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $389.40 | $649 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $1,319.40 | $2,199 | 7.0× |
| Radiologic exam colon single contrast study (74270) | $834 | $1,390 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $863.40 | $1,439 | 4.6× |
| Radiologic exam knee complete 4/more views (73564) | $343.20 | $572 | 3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $585.60 | $976 | 5.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $598.20 | $997 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $435 | $725 | 2.3× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $306 | $510 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$771–$897 | $1,285–$1,495 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$339–$481.80 | $565–$803 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$284.40–$424.80 | $474–$708 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$267.60–$402 | $446–$670 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $912.60 | $1,521 | 8.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $260.40 | $434 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$284.40–$424.80 | $474–$708 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $244.20 | $407 | 2.6× |
| Radiopharm Dacryocystography (78660) | $550.80 | $918 | 1.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,201.80 | $2,003 | 4.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $384 | $640 | 0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $384 | $640 | 0.9× |
| Renal Cyst Study (74470) | $4,042.20 | $6,737 | 6.9× |
| Ribs bilateral 3 views (71110) | $550.80 | $918 | 4.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $949.20 | $1,582 | 2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,074 | $1,790 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,810 | $6,350 | 6.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,250.60 | $3,751 | 3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,956 | $3,260 | 3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,934 | $4,890 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,912.60 | $6,521 | 2.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,608.20 | $4,347 | 1.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $3,019.20 | $5,032 | 12.1× |
| Rp Therapy Intravenous Administration (79101) | $811.20 | $1,352 | 3.2× |
| Rp Therapy Unlisted Procedure (79999) | $1,143 | $1,905 | 4.6× |
| Salivary Gland Function Study (78232) | $1,186.20 | $1,977 | 2.8× |
| Salivary Gland Imaging Serial Images (78231) | $1,186.20 | $1,977 | 2.8× |
| Scapula (73010) range across 3 matching MRF lines |
$349.20–$523.80 | $582–$873 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.20 | $62 | 1.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$258.60–$387.60 | $431–$646 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$553.80–$706.20 | $923–$1,177 | varies |
| Sialogram (70390) | $512.40 | $854 | 2.0× |
| Skull less than 4 views (70250) | $333 | $555 | 3.0× |
| Special dosimetry (77331) | $910.80 | $1,518 | 6.3× |
| Special Physics Consult (77370) | $780 | $1,300 | 5.4× |
| Special teletherapy port plan (77321) | $900 | $1,500 | 2.2× |
| Special treatment procedure (77470) | $2,306.40 | $3,844 | 3.9× |
| Speech evaluation, complex (70371) | $575.40 | $959 | 2.3× |
| Spleen Imaging (78185) | $730.20 | $1,217 | 1.7× |
| Srs Multisource (77371) | $56,264.40 | $93,774 | 7.1× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$6,014.40–$12,028.80 | $10,024–$20,048 | varies |
| Sternoclavicular joints (71130) | $544.20 | $907 | 5.8× |
| Superior sagittal sinus venogram (75870) | $1,983 | $3,305 | 0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $176.40 | $294 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,752.60 | $2,921 | 4.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,752.60 | $2,921 | 4.4× |
| Testicular Imaging W/Flow (78761) | $1,504.20 | $2,507 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,065.80 | $3,443 | 5.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,829.40 | $3,049 | 4.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$253.80–$909.60 | $423–$1,516 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $822 | $1,370 | 4.4× |
| 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 Carcinoma Metastases Img Lmtd Area (78015) | $1,010.40 | $1,684 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $721.80 | $1,203 | 1.7× |
| Thyroid Met Imaging Body (78018) | $1,782.60 | $2,971 | 3.1× |
| Thyroid Uptake Measurement (78012) | $550.80 | $918 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,306.80 | $2,178 | 3.1× |
| Tx Devices Design & Construction Complex (77334) | $1,119 | $1,865 | 2.8× |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$328.80–$804 | $548–$1,340 | varies |
| Tx devices design & construction simple (77332) | $546.60 | $911 | 3.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$325.80–$541.20 | $543–$902 | varies |
| Ultrasound elastography first target lesion (76982) | $327.60 | $546 | 2.9× |
| Ultrasound Elastography Parenchyma (76981) | $202.80 | $338 | 1.8× |
| Ultrasound Exam Aaa Screen (76706) | $585.60 | $976 | 5.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $615.60 | $1,026 | 1.6× |
| Ultrasound, abdomen limited (76705) | $729 | $1,215 | 6.5× |
| Umbilical-artery Doppler (OB) (76820) | $585.60 | $976 | 5.2× |
| Unlisted Dx Radiographic Procedure (76499) | $123 | $205 | 1.3× |
| Unlisted magnetic resonance procedure (76498) | $2,423.40 | $4,039 | 26.0× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $989.40 | $1,649 | 2.3× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$862.80–$1,488.60 | $1,438–$2,481 | varies |
| Unlisted respiratory px dx nuclear medicine (78599) | $989.40 | $1,649 | 2.3× |
| Unlisted us procedure (76999) | $1,188 | $1,980 | 12.7× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$579.60–$748.20 | $966–$1,247 | varies |
| Ureteral Reflux Study (78740) | $1,343.40 | $2,239 | 3.1× |
| Urethrocystogram voiding (74455) | $417.60 | $696 | 1.6× |
| Urethrocystography retrograde (74450) | $427.80 | $713 | 1.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$541.20–$649.80 | $902–$1,083 | varies |
| Us chest (76604) | $173.40 | $289 | 1.5× |
| Us complete joint (76881) range across 3 matching MRF lines |
$553.80–$831.60 | $923–$1,386 | varies |
| Us exam, pelvic, limited (76857) | $729 | $1,215 | 6.5× |
| Us head (76506) | $729 | $1,215 | 6.5× |
| Us kidney transplant (76776) | $729 | $1,215 | 6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$553.80–$831.60 | $923–$1,386 | varies |
| Us ob detailed single fetus (76811) | $1,179.60 | $1,966 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $651.60 | $1,086 | 5.8× |
| Us ob transvaginal (76817) | $496.80 | $828 | 4.4× |
| Us pelvic non ob complete (76856) | $729 | $1,215 | 6.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $802.80 | $1,338 | 7.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $580.20 | $967 | 5.2× |
| Us retroperitoneal complete (76770) | $729 | $1,215 | 6.5× |
| Us retroperitoneal limited (76775) | $585.60 | $976 | 5.2× |
| Us scrotum and contents (76870) | $775.20 | $1,292 | 6.9× |
| Us spinal canal and contents (76800) | $672.60 | $1,121 | 6.0× |
| Us thyroid (76536) | $742.20 | $1,237 | 6.6× |
| Us transrectal (76872) | $629.40 | $1,049 | 5.6× |
| Vascular Flow Imaging (78445) | $1,325.40 | $2,209 | 3.1× |
| Vein X-Ray Chest (75827) | $2,812.20 | $4,687 | 1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,983 | $3,305 | 0.6× |
| Venogram Sinus/Jugular (75860) | $4,897.20 | $8,162 | 1.4× |
| Venography Adrenal Unilateral (75840) | $1,983 | $3,305 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $5,002.80 | $8,338 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $1,350.60 | $2,251 | 0.8× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$1,230–$1,342.80 | $2,050–$2,238 | varies |
| Venography Renal Bilateral (75833) | $5,460.60 | $9,101 | 1.6× |
| Venography Renal Unilateral (75831) | $5,460.60 | $9,101 | 1.6× |
| Venous sampling by catheter (75893) | $7,098 | $11,830 | 1.2× |
| Vertebral fracture assessment via dxa (77086) | $366.60 | $611 | 3.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$263.40–$394.80 | $439–$658 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $240.60 | $401 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $5,460.60 | $9,101 | 1.6× |
| 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 |
$328.80–$493.20 | $548–$822 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$385.80–$787.20 | $643–$1,312 | varies |
| 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) | $294 | $490 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $394.20 | $657 | 4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $729 | $1,215 | 6.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $508.20 | $847 | 4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $462.60 | $771 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $531.60 | $886 | 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) | $553.80 | $923 | 4.9× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$286.20–$428.40 | $477–$714 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$272.40–$408 | $454–$680 | varies |
| X-ray IV pyelogram (ivp) (74400) | $710.40 | $1,184 | 3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $579 | $965 | 6.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $206.40 | $344 | 2.2× |
| 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) | $315 | $525 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $678.60 | $1,131 | 6.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $295.80 | $493 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $480.60 | $801 | 4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $288 | $480 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $372 | $620 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $453.60 | $756 | 4.0× |
| X-Ray Stress View (77071) | $429.60 | $716 | 4.6× |
| X-ray thoracic spine 4 vw (72074) | $502.20 | $837 | 4.5× |
| X-Ray Tmj Unilat (70328) | $427.80 | $713 | 4.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $735.60 | $1,226 | 2.0× |
| X-Rays Bone Length Studies (77073) | $453.60 | $756 | 4.0× |
| X-Rays Bone Survey Complete (77075) | $729 | $1,215 | 6.5× |
| 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 Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$142.80–$214.80 | $238–$358 | varies |
| Xr orbits complete 4 views (70200) | $580.80 | $968 | 5.2× |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$967.80–$2,288.40 | $1,613–$3,814 | 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.