Imaging prices at Our Lady of Lourdes Memorial Hospital, Inc
Binghamton, NY · every code in this section with a posted price and a Medicare benchmark.
382 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) | $4,324.12 | $8,648.23 | 2.5× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$78.19–$99.29 | $156.37–$198.57 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$147.54–$184.55 | $295.08–$369.09 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,280.21 | $2,560.41 | 2.6× |
| Angio internal mammary (75756) | $2,438 | $4,876 | 0.6× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$3,311–$3,623.50 | $6,622–$7,247 | varies |
| Angiography extremity bilateral rs&i (75716) | $2,468.48 | $4,936.95 | 0.6× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$1,234.24–$2,558 | $2,468.48–$5,116 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$909.77–$2,979 | $1,819.53–$5,958 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$1,689–$3,037.01 | $3,378–$6,074.02 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$294.89–$382.06 | $589.78–$764.11 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,711.50 | $5,423 | 0.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,404 | $8,808 | 1.1× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,558.13 | $5,116.25 | 0.4× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,605.81 | $3,211.61 | 0.2× |
| Artery X-Rays Spine (75705) | $6,948.50 | $13,897 | 1.0× |
| Arthrogram hip (73525) | $959.50 | $1,919 | 2.2× |
| Arthrogram Wrist (73115) | $420 | $840 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $121.94 | $243.87 | 0.7× |
| Bone age studies (77072) range across 2 matching MRF lines |
$256.65–$342.74 | $513.30–$685.48 | varies |
| Bone Imaging 3 Phase (78315) | $3,535.58 | $7,071.16 | 7.1× |
| Bone Imaging Limited Area (78300) | $1,406.71 | $2,813.42 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $807 | $1,614 | 1.6× |
| Bone Imaging Whole Body (78306) | $2,907.89 | $5,815.77 | 5.8× |
| Bone marrow imaging limited area (78102) | $548.58 | $1,097.16 | 1.1× |
| Bone marrow imaging; multiple areas (78103) | $1,080.50 | $2,161 | 2.2× |
| Bone marrow imaging; whole body (78104) | $925 | $1,850 | 1.9× |
| Bone survey infant (77076) | $261.87 | $523.74 | 2.0× |
| Brachytx isodose complex (77318) | $482.73 | $965.45 | 1.0× |
| Brachytx isodose intermed (77317) | $723.50 | $1,447 | 1.5× |
| Brachytx Isodose Plan Simple (77316) | $322.83 | $645.66 | 0.7× |
| Brain Image W/Flow < 4 Views (78601) | $560.50 | $1,121 | 1.1× |
| Brain imaging < 4 static views (78600) | $925 | $1,850 | 1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,252.50 | $6,505 | 1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,238.50 | $6,477 | 7.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,238.50 | $6,477 | 3.3× |
| Cat Scan Follow-Up Study (76380) | $766 | $1,532 | 7.1× |
| Cerebrospinal Fluid Scan (78630) | $1,589 | $3,178 | 2.3× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$52.18–$82.87 | $104.35–$165.73 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$52.18–$74.32 | $104.35–$148.63 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$53–$98.48 | $106–$196.96 | varies |
| Chest 4 or more views (71048) | $140.81 | $281.61 | 1.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$146.58–$184.72 | $293.15–$369.43 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $75 | $150 | 0.6× |
| Continuing medical physics consltj pr wk (77336) | $532.49 | $1,064.98 | 3.2× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,583.55–$4,154.75 | $3,167.10–$8,309.50 | varies |
| Contrast X-Ray Bladder (74430) | $193.23 | $386.45 | 0.4× |
| Contrast X-Ray Of Elbow (73085) | $546.50 | $1,093 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $546.50 | $1,093 | 1.3× |
| Contrast Xray Throat/Cerv Esopha (74210) | $267.48 | $534.96 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $4,143.63 | $8,287.25 | 9.5× |
| CT abdomen and pelvis without contrast (74176) | $2,268.21 | $4,536.41 | 7.6× |
| CT abdomen w contrast (74160) | $1,409.16 | $2,818.31 | 6.4× |
| CT abdomen w wo contrast (74170) | $2,253.20 | $4,506.39 | 10.3× |
| CT abdomen w/o contrast (74150) | $949.62 | $1,899.23 | 7.3× |
| CT Angio Abdomen and Pelvis (74174) | $3,285.09 | $6,570.18 | 7.5× |
| CT Angio Chest (71275) | $853.88 | $1,707.75 | 3.9× |
| CT Angio Head (70496) | $2,692.17 | $5,384.34 | 12.3× |
| CT angio hrt w/3d image (75574) | $2,086.56 | $4,173.12 | 4.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,309.80 | $2,619.59 | 6.0× |
| CT Angio Neck (70498) | $2,099.92 | $4,199.84 | 9.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $376.22 | $752.43 | 1.7× |
| CT cervical spine w/ contrast (72126) | $1,453.59 | $2,907.17 | 3.3× |
| CT cervical spine w/o contrast (72125) | $1,135.10 | $2,270.19 | 8.7× |
| CT cervical spine w/wo cont (72127) | $2,066 | $4,132 | 9.4× |
| CT chest w contrast (71260) | $991.53 | $1,983.06 | 4.5× |
| CT chest w/wo contrast (71270) | $1,192.32 | $2,384.64 | 5.4× |
| CT colonography screening (74263) | $1,421.06 | $2,842.11 | 4.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,783.31 | $3,566.61 | 8.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,421.06 | $2,842.11 | 10.9× |
| CT head/brain with contrast (70460) | $1,223.95 | $2,447.90 | 5.6× |
| CT head/brain without and with contrast (70470) | $1,591.13 | $3,182.26 | 7.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,627.54 | $3,255.08 | 3.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $100 | $200 | 0.9× |
| CT iac w contrast (70481) | $2,710.87 | $5,421.73 | 12.4× |
| CT l-spine w&w/o contrast (72133) | $2,276.49 | $4,552.97 | 10.4× |
| CT lower ext w/o (73700) | $1,227.51 | $2,455.02 | 9.4× |
| CT lower extremity w/contrast material (73701) | $1,309.80 | $2,619.59 | 6.0× |
| CT lumbar spine w contrast (72132) | $964.11 | $1,928.21 | 2.2× |
| CT lumbar spine w/o contrast (72131) | $659.82 | $1,319.63 | 5.1× |
| CT maxillofacial w contrast (70487) | $1,772.75 | $3,545.49 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,772.75 | $3,545.49 | 13.6× |
| CT neck tissue combo (70492) | $2,692.17 | $5,384.34 | 12.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,299.78 | $6,599.55 | 15.1× |
| CT orbits w/o contrast (70480) | $1,772.75 | $3,545.49 | 13.6× |
| CT pelvis w&w/o contrast (72194) | $1,890.95 | $3,781.89 | 8.6× |
| CT pelvis w/o contrast (72192) | $1,319.11 | $2,638.22 | 10.1× |
| CT scan of leg combo (73702) | $2,105 | $4,210 | 9.6× |
| CT scans face/jaw combo (70488) | $1,902.95 | $3,805.89 | 8.7× |
| CT soft tissue neck w contrast (70491) | $2,209.42 | $4,418.84 | 10.1× |
| CT soft tissue neck w/o contrast (70490) | $1,444.91 | $2,889.81 | 11.1× |
| CT thoracic spine w contrast (72129) | $1,992.38 | $3,984.75 | 9.1× |
| CT thoracic spine w/o contrast (72128) | $1,556.13 | $3,112.25 | 11.9× |
| CT thoracic spine w/wo cont (72130) | $2,093.50 | $4,187 | 9.6× |
| CT thorax w/o contrast (71250) | $677.93 | $1,355.85 | 5.2× |
| CT unlisted procedure (76497) | $202.50 | $405 | 1.9× |
| CT upper ext wo (73200) | $1,227.51 | $2,455.02 | 9.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,304.50 | $2,609 | 6.0× |
| CT upper extremity with contrast (73201) | $1,850.58 | $3,701.16 | 4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,803.49 | $3,606.98 | 8.2× |
| Cta Abdomen (74175) | $1,207.85 | $2,415.69 | 5.5× |
| CTA pelvis (72191) | $892.69 | $1,785.38 | 4.1× |
| Dilation ureters/urethra rs&i (74485) | $1,387 | $2,774 | 0.5× |
| Dxa Bone Density Axial (77080) | $671.38 | $1,342.75 | 5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $346 | $692 | 3.2× |
| Echo exam of fetal heart (76825) | $470 | $940 | 0.7× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$237–$431.50 | $474–$863 | varies |
| Echograp Trans R Pros Study (76873) | $494.50 | $989 | 3.8× |
| Esophagram (74220) | $951.12 | $1,902.23 | 4.3× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$162.50–$441 | $325–$882 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$200–$867.36 | $400–$1,734.72 | varies |
| Fluoroscopy up to 1 hr (76000) | $232.88 | $465.75 | 0.8× |
| Follow-Up Angiography (75898) | $1,748 | $3,496 | 0.4× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$234.87–$296 | $469.74–$592 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$146.58–$184.72 | $293.15–$369.43 | varies |
| Gastric emptying imaging study (78264) | $1,382.69 | $2,765.38 | 2.8× |
| Gated Heart Planar Single (78472) | $2,138.49 | $4,276.97 | 4.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$173.30–$173.59 | $346.59–$347.18 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $713.28 | $1,426.56 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $713.28 | $1,426.56 | 0.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,711.50 | $5,423 | 0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,439.50 | $4,879 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,473.95 | $4,947.89 | 3.7× |
| Hepatobiliary System Imaging (78226) | $2,473.95 | $4,947.89 | 5.0× |
| Ht Muscle Image Spect Sing (78451) | $1,895.82 | $3,791.64 | 1.2× |
| Hysterosalpingogram (74740) | $732.66 | $1,465.31 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $467.25 | $934.50 | 4.3× |
| Infant hip ultrasound, limited static exam (76886) | $479.86 | $959.72 | 4.4× |
| Interstitial radiation source applic complex (77778) | $4,301.93 | $8,603.86 | 4.9× |
| Joint Survey Single View (77077) | $309 | $618 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $2,445.93 | $4,891.86 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $2,445.93 | $4,891.86 | 3.6× |
| Kidney Imaging Morphol (78700) | $1,074.50 | $2,149 | 2.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$187.19–$235.92 | $374.37–$471.84 | varies |
| Leveen/Shunt Patency Exam (78291) | $925 | $1,850 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,121.50 | $2,243 | 2.2× |
| Lung perfusion differential (78597) | $785.50 | $1,571 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $2,473.95 | $4,947.89 | 3.7× |
| Lung Ventilation Imaging (78579) | $728.50 | $1,457 | 1.5× |
| Lymph System Imaging (78195) | $932.38 | $1,864.75 | 1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,106.50 | $4,213 | 0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,882.50 | $3,765 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $2,640.13 | $5,280.26 | 8.9× |
| Meckels Divert Exam (78290) | $1,018.40 | $2,036.80 | 2.0× |
| Mlc imrt design & construction per imrt plan (77338) | $322.83 | $645.66 | 0.7× |
| Mr safety determination physician/other qhp (76016) | $132.13 | $264.25 | 1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $44.25 | $88.50 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $137.63 | $275.25 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $89.13 | $178.25 | 1.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $362.63 | $725.25 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,337.71 | $4,675.42 | 5.4× |
| MRA head w/o contrast (70544) | $1,232.88 | $2,465.75 | 4.1× |
| MRA head with contrast (70545) | $2,214.50 | $4,429 | 5.1× |
| MRA neck w contrast (70548) | $2,010.50 | $4,021 | 4.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,337.71 | $4,675.42 | 5.4× |
| MRA neck w/o contrast (70547) | $1,232.88 | $2,465.75 | 4.1× |
| MRI abdomen w contrast (74182) | $2,961 | $5,922 | 6.8× |
| MRI abdomen w/o contrast (74181) | $1,177.94 | $2,355.87 | 4.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,792.65 | $5,585.29 | 2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,020.02 | $10,040.03 | 11.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,642.73 | $5,285.46 | 2.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,277.39 | $2,554.77 | 4.3× |
| MRI cardiac w/o cont stress (75559) | $2,817.50 | $5,635 | 4.1× |
| MRI cardiac w/o contrast (75557) | $2,817.50 | $5,635 | 9.5× |
| MRI cervical spine w contrast (72142) | $2,350.63 | $4,701.26 | 5.4× |
| MRI cervical spine w/o cont (72141) | $2,232.57 | $4,465.14 | 7.5× |
| MRI chest w/o contrast (71550) | $1,206.49 | $2,412.98 | 4.1× |
| MRI chest with contrast (71551) | $2,322.50 | $4,645 | 2.4× |
| MRI chest wo w contrast (71552) | $2,343.54 | $4,687.08 | 5.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,603 | $5,206 | 6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,018.07 | $10,036.14 | 11.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$750.48–$2,330.56 | $1,500.96–$4,661.12 | varies |
| MRI lumbar spine w contrast (72149) | $2,857.55 | $5,715.09 | 6.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,148.27 | $6,296.54 | 7.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,317.46 | $2,634.92 | 4.4× |
| MRI orbit face neck w contrast (70542) | $2,691.50 | $5,383 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,556.21 | $5,112.42 | 5.9× |
| MRI pelvis w contrast (72196) | $1,521.26 | $3,042.51 | 3.5× |
| MRI pelvis w/o & w contrast (72197) | $2,050.19 | $4,100.38 | 4.7× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$750.48–$959.22 | $1,500.96–$1,918.44 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$750.48–$1,432.35 | $1,500.96–$2,864.69 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,617.42 | $5,234.83 | 6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$750.48–$2,183.89 | $1,500.96–$4,367.77 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,887.40 | $5,774.80 | 6.6× |
| MRI, abdomen, combo (74183) | $2,305.90 | $4,611.79 | 5.3× |
| MRI, dorsal spine combo (72157) | $2,020.34 | $4,040.67 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,508.28 | $3,016.55 | 3.5× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$750.48–$2,424.67 | $1,500.96–$4,849.33 | varies |
| MRI, joint upper extrem combo (73223) | $4,704.60 | $9,409.20 | 10.8× |
| MRI, lumbar spine combo (72158) | $3,826.51 | $7,653.01 | 8.8× |
| Myelogram cervical (72240) | $2,062 | $4,124 | 2.1× |
| Myelogram Lumbar (72265) | $1,530.75 | $3,061.50 | 1.6× |
| Myelograpy 2/more regions rs&i (72270) | $2,575.50 | $5,151 | 2.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,135.50 | $10,271 | 3.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,500 | $5,000 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $2,225.75 | $4,451.50 | 1.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,894 | $5,788 | 1.6× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$329.76–$417.20 | $659.52–$834.39 | varies |
| Nm unlisted gi procedure (78299) | $602.75 | $1,205.50 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $268.93 | $537.86 | 2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,617.50 | $5,235 | 1.5× |
| Nuclear Rx Intra-Arterial (79445) | $234.50 | $469 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $1,451.54 | $2,903.08 | 5.0× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $116.03 | $232.05 | 0.9× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $126.06 | $252.11 | 1.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$66.75–$276.50 | $133.50–$553 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $19.85 | $39.69 | 0.5× |
| Optic foramina (70190) | $422 | $844 | 3.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,181 | $6,362 | 4.7× |
| Parathyroid Planar Imaging (78070) | $1,292.22 | $2,584.44 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $872.63 | $1,745.25 | 1.7× |
| Pelvis 1 or 2 views (72170) | $173.30 | $346.59 | 1.3× |
| Peritoneogram Rs&I (74190) | $3,250.50 | $6,501 | 4.8× |
| Pet Image W/Ct Lmtd (78814) | $5,657.50 | $11,315 | 3.2× |
| PET image w/CT, full body (78816) | $2,161.70 | $4,323.40 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,161.70 | $4,323.40 | 1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,711.50 | $5,423 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $811.04 | $1,622.08 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $289.44 | $578.87 | 2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $313.89 | $627.77 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$329.05–$414.70 | $658.10–$829.40 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$128.75–$166.92 | $257.50–$333.83 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$160.12–$201.78 | $320.23–$403.56 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$157.76–$198.82 | $315.52–$397.64 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$264.89–$334.04 | $529.78–$668.08 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$333.17–$419.89 | $666.34–$839.78 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$149.52–$188.43 | $299.03–$376.86 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $327.91 | $655.81 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$324.93–$409.51 | $649.86–$819.01 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$97.51–$135.03 | $195.01–$270.05 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$157.17–$181.02 | $314.34–$362.03 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $208.84 | $417.68 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,766 | $3,532 | 8.1× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$117.22–$128.75 | $234.43–$257.50 | varies |
| Radex Sternum Minimum 2 Views (71120) | $129.82 | $259.64 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$416.76–$525.24 | $833.51–$1,050.47 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$118.91–$149.86 | $237.81–$299.71 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $327.91 | $655.81 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$156.15–$188.43 | $312.29–$376.86 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,003.50 | $2,007 | 7.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $9,705.43 | $19,410.86 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $288 | $576 | 2.3× |
| Radiation treatment delivery level 2 (77407) | $1,031 | $2,062 | 2.1× |
| Radiation treatment delivery level 3 (77412) | $546.29 | $1,092.58 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$383.21–$482.95 | $766.42–$965.89 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $190.07 | $380.13 | 1.5× |
| Radiologic exam colon double contrast study (74280) | $991.34 | $1,982.68 | 4.5× |
| Radiologic exam colon single contrast study (74270) | $756.32 | $1,512.64 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$167.77–$211.43 | $335.53–$422.86 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $329.63 | $659.25 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $414.84 | $829.67 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $485.02 | $970.04 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,235.04 | $2,470.07 | 5.6× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$83–$110.54 | $165.99–$221.07 | varies |
| Radiologic examination femur minimum 2 views (73552) | $110.54 | $221.07 | 1.0× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$114.72–$139.47 | $229.43–$278.93 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $457.50 | $915 | 4.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$146.58–$184.72 | $293.15–$369.43 | varies |
| Radiopharm Dacryocystography (78660) | $925 | $1,850 | 1.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $925 | $1,850 | 1.9× |
| Renal Cyst Study (74470) | $788.50 | $1,577 | 1.2× |
| Ribs bilateral 3 views (71110) | $157.27 | $314.54 | 1.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,413.50 | $2,827 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,600.50 | $7,201 | 5.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,937.51 | $5,875.02 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,133.50 | $4,267 | 3.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $5,041 | $10,082 | 2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,667 | $5,334 | 1.7× |
| Rp Therapy Intravenous Administration (79101) | $237.04 | $474.08 | 0.8× |
| Scapula (73010) range across 2 matching MRF lines |
$135.98–$144.45 | $271.95–$288.90 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $140.02 | $280.04 | 6.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$128.34–$128.75 | $256.68–$257.50 | varies |
| Shoulder Arthrography (73040) | $595.50 | $1,191 | 1.4× |
| Sialogram (70390) | $617.50 | $1,235 | 2.1× |
| Skull less than 4 views (70250) | $332.35 | $664.70 | 2.5× |
| Special dosimetry (77331) | $121.94 | $243.87 | 0.7× |
| Special Physics Consult (77370) | $624.24 | $1,248.48 | 3.7× |
| Special teletherapy port plan (77321) | $331.61 | $663.22 | 0.7× |
| Special treatment procedure (77470) | $1,002.03 | $2,004.05 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $6,933.22 | $13,866.44 | 3.1× |
| Sternoclavicular joints (71130) | $380.57 | $761.13 | 3.5× |
| Tbs technical calculation only (77091) | $94.40 | $188.80 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $445.55 | $891.09 | 1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $207.50 | $415 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,574.10 | $3,148.19 | 3.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,502 | $3,004 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $817.33 | $1,634.66 | 4.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$173.30–$180.27 | $346.59–$360.53 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$191.90–$241.85 | $383.79–$483.70 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$188.95–$238.14 | $377.90–$476.27 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,837.45 | $3,674.90 | 3.7× |
| Thyroid Met Imaging Body (78018) | $2,719.74 | $5,439.48 | 4.0× |
| Thyroid Uptake Measurement (78012) | $925 | $1,850 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,837.45 | $3,674.90 | 3.7× |
| Tx Devices Design & Construction Complex (77334) | $618.25 | $1,236.49 | 1.3× |
| Tx devices design & construction intermediate (77333) | $939.50 | $1,879 | 5.6× |
| Tx devices design & construction simple (77332) | $121.94 | $243.87 | 0.7× |
| Ultrasound Breast Limited (76642) | $195.56 | $391.11 | 1.8× |
| Ultrasound elastography first target lesion (76982) | $351.63 | $703.26 | 2.7× |
| Ultrasound Elastography Parenchyma (76981) | $396.88 | $793.76 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$118.46–$347.82 | $236.92–$695.63 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$182–$1,223.83 | $364–$2,447.66 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$430–$446.39 | $860–$892.77 | varies |
| Unlisted fluoroscopic procedure (76496) | $695.50 | $1,391 | 6.4× |
| Unlisted magnetic resonance procedure (76498) | $276 | $552 | 2.5× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $572 | $1,144 | 1.1× |
| Unlisted respiratory px dx nuclear medicine (78599) | $63.27 | $126.53 | 0.1× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$132–$1,054.26 | $264–$2,108.51 | varies |
| Upper gi w/o kub (74240) | $1,235.04 | $2,470.07 | 5.6× |
| Urethrocystogram voiding (74455) | $399.06 | $798.12 | 1.3× |
| Urethrocystography retrograde (74450) | $557.50 | $1,115 | 1.9× |
| Us breast unilateral complete (76641) | $195.56 | $391.11 | 1.5× |
| Us chest (76604) range across 2 matching MRF lines |
$100.13–$755.52 | $200.25–$1,511.03 | varies |
| Us complete joint (76881) | $479.50 | $959 | 3.7× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$91.75–$453.17 | $183.50–$906.33 | varies |
| Us head (76506) | $127.58 | $255.15 | 1.0× |
| Us kidney transplant (76776) | $621.50 | $1,243 | 4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$73.13–$485.64 | $146.25–$971.27 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$263.50–$899.50 | $527–$1,799 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$138.63–$484.60 | $277.25–$969.19 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$150–$1,456.19 | $300–$2,912.37 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$450–$1,376.81 | $900–$2,753.62 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$312.50–$435.85 | $625–$871.69 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$200–$580.85 | $400–$1,161.70 | varies |
| Us retroperitoneal complete (76770) | $816.85 | $1,633.69 | 6.3× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$122.88–$606.14 | $245.75–$1,212.28 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$154.88–$832.73 | $309.75–$1,665.45 | varies |
| Us spinal canal and contents (76800) | $271.33 | $542.65 | 2.1× |
| Us thyroid (76536) range across 2 matching MRF lines |
$139.50–$733.83 | $279–$1,467.65 | varies |
| Us transrectal (76872) | $117 | $234 | 0.9× |
| Vascular Flow Imaging (78445) | $925 | $1,850 | 1.9× |
| Vein X-Ray Chest (75827) | $2,061 | $4,122 | 1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,571.50 | $3,143 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $8,068.50 | $16,137 | 2.0× |
| Venogram Sinus/Jugular (75860) | $2,127 | $4,254 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,156.10 | $2,312.19 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $1,716 | $3,432 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $876.65 | $1,753.29 | 0.4× |
| Venography Renal Bilateral (75833) | $1,379.66 | $2,759.31 | 0.4× |
| Venography Renal Unilateral (75831) | $8,136.50 | $16,273 | 2.1× |
| Venous sampling by catheter (75893) | $7,749.50 | $15,499 | 1.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$149.52–$344.04 | $299.03–$688.08 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $507.79 | $1,015.57 | 4.7× |
| X-ray antegrade pyelogram tube (74425) | $343.85 | $687.70 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $3,770 | $7,540 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$251.94–$317.52 | $503.88–$635.03 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$146.58–$184.72 | $293.15–$369.43 | varies |
| X-Ray Exam Breast Specimen (76098) | $594.22 | $1,188.43 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $128.75 | $257.50 | 1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $152.02 | $304.04 | 1.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $804.50 | $1,609 | 6.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$100.76–$110.54 | $201.52–$221.07 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $119.65 | $239.29 | 1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$145.99–$183.99 | $291.97–$367.97 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $219.57 | $439.13 | 1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$256.06–$322.71 | $512.12–$645.41 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$288.44–$363.51 | $576.87–$727.01 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $519.33 | $1,038.65 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$156.33–$210.69 | $312.65–$421.37 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$492.11–$620.19 | $984.21–$1,240.38 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$106.55–$144.45 | $213.09–$288.90 | varies |
| X-ray eye for foreign body (70030) | $362.79 | $725.57 | 3.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$160.12–$201.78 | $320.23–$403.56 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,618.32 | $3,236.63 | 7.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $118.70 | $237.39 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$191.82–$290.07 | $383.63–$580.13 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$188.95–$238.14 | $377.90–$476.27 | varies |
| X-ray nose-rectum child f.b. (76010) | $117.16 | $234.31 | 1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $195.11 | $390.21 | 1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$140.42–$158.76 | $280.84–$317.51 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $144.45 | $288.90 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$160.12–$201.78 | $320.23–$403.56 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$220.74–$278.19 | $441.48–$556.38 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$367.66–$477.75 | $735.32–$955.50 | varies |
| X-Ray Stress View (77071) | $127 | $254 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $442 | $884 | 3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,215.32 | $2,430.63 | 2.8× |
| X-Rays Bone Length Studies (77073) | $571.97 | $1,143.94 | 4.4× |
| X-Rays Bone Survey Complete (77075) | $398.38 | $796.75 | 3.1× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$388.51–$489.62 | $777.01–$979.23 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$132.31–$157.27 | $264.62–$314.54 | varies |
| Xr orbits complete 4 views (70200) | $278.19 | $556.38 | 2.1× |
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.