Imaging prices at Palmetto General Hospital
Hialeah, FL · every code in this section with a posted price and a Medicare benchmark.
312 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $815.32 | $815.32 | 7.5× |
| Acute gi blood loss imaging (78278) | $3,526.15 | $3,526.15 | 8.4× |
| Angiography extremity bilateral rs&i (75716) | $12,260.32 | $12,260.32 | 3.7× |
| Angiography extremity unilateral rs&i (75710) | $8,825.73 | $8,825.73 | 2.7× |
| Angiography internal mammary rs&i (75756) | $9,008.74 | $9,008.74 | 2.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $14,247.39 | $14,247.39 | 2.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $12,444.53 | $12,444.53 | 3.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $9,169.07 | $9,169.07 | 2.8× |
| Angiography Spinal Selective Rs&I (75705) | $7,064.29 | $7,064.29 | 1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $14,247.39 | $14,247.39 | 2.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) | $3,308.15 | $3,308.15 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $9,169.07 | $9,169.07 | 2.8× |
| Ankle 2 views (73600) | $1,227.34 | $1,227.34 | 13.5× |
| Aortogram thoracic (75605) | $14,348.76 | $14,348.76 | 2.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $10,584.44 | $10,584.44 | 3.2× |
| Aortography abdominal serialography rs&i (75625) | $6,783.06 | $6,783.06 | 2.1× |
| Artery X-Rays Adrenal Gland (75731) | $9,169.07 | $9,169.07 | 2.8× |
| Arthrogram ankle (73615) | $1,179.49 | $1,179.49 | 3.2× |
| Arthrogram elbow (73085) | $1,179.49 | $1,179.49 | 3.2× |
| Arthrogram hip (73525) | $1,179.49 | $1,179.49 | 3.2× |
| Arthrogram knee (73580) | $1,179.49 | $1,179.49 | 3.2× |
| Arthrogram shoulder (73040) | $1,179.49 | $1,179.49 | 3.2× |
| Arthrogram wrist (73115) | $1,179.49 | $1,179.49 | 3.2× |
| Bone &/joint imaging whole body (78306) | $4,987.84 | $4,987.84 | 11.9× |
| Bone age studies (77072) | $1,241.51 | $1,241.51 | 11.4× |
| Bone Imaging 3 Phase (78315) | $2,515.72 | $2,515.72 | 6.0× |
| Bone survey complete (77075) | $1,580.50 | $1,580.50 | 14.5× |
| Bone survey infant (77076) | $348.71 | $348.71 | 3.2× |
| Bowel imaging (78290) | $1,207.40 | $1,207.40 | 2.9× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) | $1,207.40 | $1,207.40 | 2.9× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) | $1,567.41 | $1,567.41 | 2.8× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $3,044.37 | $3,044.37 | 7.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,179.49 | $1,179.49 | 3.2× |
| Cervical spine 2 or 3 views (72040) | $2,087.35 | $2,087.35 | 23.0× |
| Chest 1 view (71045) | $1,243.69 | $1,243.69 | 13.7× |
| Chest xray 3 views (71047) | $259.08 | $259.08 | 2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,436.62 | $1,436.62 | 7.8× |
| Clavicle complete (73000) | $922.14 | $922.14 | 10.1× |
| CT abdomen and pelvis without and with contrast (74178) | $18,223.07 | $18,223.07 | 50.0× |
| CT abdomen and pelvis without contrast (74176) | $16,191.81 | $16,191.81 | 65.0× |
| CT abdomen w contrast (74160) | $8,534.33 | $8,534.33 | 46.6× |
| CT abdomen w wo contrast (74170) | $11,461.62 | $11,461.62 | 62.6× |
| CT abdomen w/o contrast (74150) | $6,851.03 | $6,851.03 | 62.8× |
| CT angio hrt w/3d image (75574) | $4,620.51 | $4,620.51 | 12.7× |
| CT angio lwr extr w/o&w/dye (73706) | $5,295.22 | $5,295.22 | 28.9× |
| CT angiography upper extremity lt (73206) | $6,864.12 | $6,864.12 | 37.5× |
| CT c-spine w/contrast (72126) | $7,667.06 | $7,667.06 | 21.0× |
| CT c-spine w/o contrast (72125) | $8,908.59 | $8,908.59 | 81.6× |
| CT cervical spine w&w/o contrast (72127) | $572.13 | $572.13 | 3.1× |
| CT chest w contrast (71260) | $9,061.58 | $9,061.58 | 49.5× |
| CT chest w/wo contrast (71270) | $7,768.43 | $7,768.43 | 42.4× |
| CT head/brain with contrast (70460) | $9,374 | $9,374 | 51.2× |
| CT head/brain without and with contrast (70470) | $11,690.56 | $11,690.56 | 63.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $1,226.44 | $1,226.44 | 13.5× |
| CT iac w contrast (70481) | $8,873.37 | $8,873.37 | 48.4× |
| CT lower ext w/o (73700) | $6,382.67 | $6,382.67 | 58.5× |
| CT lower extremity w wo contrast (73702) | $858.20 | $858.20 | 4.7× |
| CT lower extremity w/contrast material (73701) | $5,126.27 | $5,126.27 | 28.0× |
| CT lumbar spine w & w/o contrast (72133) | $11,222.64 | $11,222.64 | 61.3× |
| CT lumbar spine w/contrast (72132) | $6,777.88 | $6,777.88 | 18.6× |
| CT lumbar spine w/o contrast (72131) | $8,125.30 | $8,125.30 | 74.4× |
| CT maxillofacial w contrast (70487) | $8,274.33 | $8,274.33 | 45.2× |
| CT maxillofacial w/wo contrast (70488) | $13,672.96 | $13,672.96 | 74.6× |
| CT maxillofacial wo contrast (70486) | $8,200.16 | $8,200.16 | 75.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $14,227.40 | $14,227.40 | 77.7× |
| CT orbits w/o contrast (70480) | $8,605.15 | $8,605.15 | 78.8× |
| CT pelvis w/o contrast (72192) | $7,633.43 | $7,633.43 | 69.9× |
| CT pelvis w/wo contrast (72194) | $17,023.62 | $17,023.62 | 92.9× |
| CT scan of arm combo (73202) | $10,740.86 | $10,740.86 | 58.6× |
| CT soft tissue neck w contrast (70491) | $9,277.18 | $9,277.18 | 50.6× |
| CT soft tissue neck w/o & w/contrast material (70492) | $9,896.91 | $9,896.91 | 54.0× |
| CT soft tissue neck w/o contrast (70490) | $8,103.70 | $8,103.70 | 74.2× |
| CT thoracic spine w/contrast (72129) | $10,751.76 | $10,751.76 | 58.7× |
| CT thoracic spine w/o contrast (72128) | $7,432.08 | $7,432.08 | 68.1× |
| CT thoracic spine w/wo contrast (72130) | $13,154.12 | $13,154.12 | 71.8× |
| CT thorax w/o contrast (71250) | $6,306.61 | $6,306.61 | 57.8× |
| CT unlisted procedure (76497) | $259.08 | $259.08 | 2.9× |
| CT upper ext wo (73200) | $3,431.87 | $3,431.87 | 31.4× |
| CT upper extremity with contrast (73201) | $5,439.25 | $5,439.25 | 14.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $7,807.14 | $7,807.14 | 42.6× |
| Cta Abdomen (74175) | $7,861.85 | $7,861.85 | 42.9× |
| CTA abdomen pelvis (74174) | $5,820.45 | $5,820.45 | 16.0× |
| CTA chest (71275) | $8,828 | $8,828 | 48.2× |
| Cta Head (70496) | $6,118.78 | $6,118.78 | 33.4× |
| Cta Neck (70498) | $6,782.25 | $6,782.25 | 37.0× |
| Cta Pelvis (72191) | $9,550.80 | $9,550.80 | 52.1× |
| Cystography minimum 3 views rs&i (74430) | $1,641.54 | $1,641.54 | 4.5× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) | $2,974.61 | $2,974.61 | 1.4× |
| Dxa bone density study 1/> sites axial skel (77080) | $1,914.04 | $1,914.04 | 17.5× |
| Esophagus (74220) | $1,478.04 | $1,478.04 | 8.1× |
| Facial bones min 3 views (70150) | $1,072.56 | $1,072.56 | 9.8× |
| Fetal biophysical profile non-stress testing (76818) | $1,985.98 | $1,985.98 | 18.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,294.92 | $1,294.92 | 11.9× |
| Fluoroscopy up to 1 hr (76000) | $737 | $737 | 3.0× |
| Foot 2 views (73620) | $1,324.35 | $1,324.35 | 14.6× |
| Forearm 2 views (73090) | $1,822.48 | $1,822.48 | 20.1× |
| Hand 2 views (73120) | $893.80 | $893.80 | 8.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $9,169.07 | $9,169.07 | 2.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) | $9,169.07 | $9,169.07 | 2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $2,423.07 | $2,423.07 | 4.3× |
| Hepatobiliary syst imaging including gallbladder (78226) | $2,760.97 | $2,760.97 | 6.6× |
| Hysterosalpingogram (74740) | $3,303.79 | $3,303.79 | 13.3× |
| Kidney imaging morphology (78700) | $1,207.40 | $1,207.40 | 2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $5,109.92 | $5,109.92 | 9.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $3,467.29 | $3,467.29 | 6.1× |
| Knee 3 views (73562) | $2,081.90 | $2,081.90 | 22.9× |
| Liver & spleen imaging static only (78215) | $2,472.12 | $2,472.12 | 5.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,207.40 | $1,207.40 | 2.9× |
| Liver imaging static only (78201) | $1,567.41 | $1,567.41 | 2.8× |
| Lymphoscintigraphy (78195) | $1,741.82 | $1,741.82 | 3.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) | $7,056.66 | $7,056.66 | 8.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) | $9,229.03 | $9,229.03 | 25.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $9,229.03 | $9,229.03 | 25.3× |
| Mammary ductogram or galactogram multiple (77054) | $737 | $737 | 3.0× |
| Mammary ductogram or galactogram single (77053) | $1,863.90 | $1,863.90 | 7.5× |
| MRA head w & w/o contrast (70546) | $5,739.94 | $5,739.94 | 15.8× |
| MRA head w/o contrast (70544) | $4,274.98 | $4,274.98 | 17.2× |
| MRA head with contrast (70545) | $1,179.49 | $1,179.49 | 3.2× |
| MRA neck w contrast (70548) | $6,874.63 | $6,874.63 | 18.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,215.18 | $6,215.18 | 17.1× |
| MRA neck w/o contrast (70547) | $6,732.93 | $6,732.93 | 27.0× |
| MRI abdomen w contrast (74182) | $1,179.49 | $1,179.49 | 3.2× |
| MRI abdomen w/o & w/contrast material (74183) | $5,070.68 | $5,070.68 | 13.9× |
| MRI abdomen w/o contrast (74181) | $7,309.54 | $7,309.54 | 29.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,291.52 | $2,291.52 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $10,841.14 | $10,841.14 | 29.8× |
| MRI breast w/o contrast bilateral (77047) | $1,105.51 | $1,105.51 | 4.4× |
| MRI breast wo contrast unilateral (77046) | $737 | $737 | 3.0× |
| MRI c-spine with contrast (72142) | $9,481.91 | $9,481.91 | 26.0× |
| MRI cardiac w/o contrast (75557) | $737 | $737 | 3.0× |
| MRI cervical spine w/o contrast (72141) | $11,484.24 | $11,484.24 | 46.1× |
| MRI chest w/o & w/contrast material (71552) | $1,179.49 | $1,179.49 | 3.2× |
| MRI chest w/o contrast (71550) | $737 | $737 | 3.0× |
| MRI chest with contrast (71551) | $2,291.52 | $2,291.52 | 2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,179.49 | $1,179.49 | 3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,947.96 | $10,947.96 | 30.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $8,240.40 | $8,240.40 | 33.1× |
| MRI orbit face &/neck w/o contrast (70540) | $7,622.37 | $7,622.37 | 30.6× |
| MRI orbit face neck w contrast (70542) | $1,179.49 | $1,179.49 | 3.2× |
| MRI orbit/face/neck w&w/o cont (70543) | $5,972.11 | $5,972.11 | 16.4× |
| MRI pelvis w/contrast (72196) | $1,179.49 | $1,179.49 | 3.2× |
| MRI pelvis w/o & w/contrast material (72197) | $8,621.90 | $8,621.90 | 23.7× |
| MRI pelvis w/o contrast (72195) | $7,866.53 | $7,866.53 | 31.6× |
| MRI spectroscopy (76390) | $5,319.20 | $5,319.20 | 58.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $20,258.74 | $20,258.74 | 55.6× |
| MRI spinal canal lumbar w/contrast material (72149) | $12,059.76 | $12,059.76 | 33.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $15,575.01 | $15,575.01 | 42.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $5,945.95 | $5,945.95 | 16.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $9,581.10 | $9,581.10 | 26.3× |
| MRI temporomandibular joint (70336) | $8,304.71 | $8,304.71 | 33.3× |
| MRI thoracic spine w/o contrast (72146) | $9,013.21 | $9,013.21 | 36.2× |
| MRI up ext w/o contrast (73218) | $6,560.71 | $6,560.71 | 26.3× |
| MRI upper ext joint w/o contrast (73221) | $9,229.03 | $9,229.03 | 37.0× |
| MRI, joint upper extrem combo (73223) | $7,056.66 | $7,056.66 | 19.4× |
| Myelogram Cervical (72240) | $4,811.26 | $4,811.26 | 5.9× |
| Myocardial Spect Multiple Studies (78452) | $12,064.12 | $12,064.12 | 8.9× |
| Myocardial spect single study at rest or stress (78451) | $4,185.62 | $4,185.62 | 3.1× |
| Neck soft tissue (70360) | $1,106.35 | $1,106.35 | 12.2× |
| Nm cisternogram (78630) | $1,706.94 | $1,706.94 | 3.0× |
| Nm gastric emptying study (78264) | $2,515.72 | $2,515.72 | 6.0× |
| Nm gastroesophageal reflux study (78262) | $1,207.40 | $1,207.40 | 2.9× |
| Nm kidney scan w/flow (78701) | $1,207.40 | $1,207.40 | 2.9× |
| Noncardiac Vascular Flow Imaging (78445) | $1,207.40 | $1,207.40 | 2.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) | $1,207.40 | $1,207.40 | 2.9× |
| Nuclear Rx Oral Admin (79005) | $3,974.14 | $3,974.14 | 16.3× |
| Osseous survey limited (77074) | $456.71 | $456.71 | 4.2× |
| Parathyroid Planar Imaging (78070) | $2,418.71 | $2,418.71 | 5.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $15,443.12 | $15,443.12 | 37.0× |
| Pelvis 1 or 2 views (72170) | $1,290.56 | $1,290.56 | 11.8× |
| PET image w/CT, skull-thigh (78815) | $4,740.54 | $4,740.54 | 3.2× |
| PET imaging CT for attenuation limited area (78814) | $4,740.54 | $4,740.54 | 3.2× |
| PET imaging for CT attenuation whole body (78816) | $4,740.54 | $4,740.54 | 3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $9,169.07 | $9,169.07 | 2.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) | $9,169.07 | $9,169.07 | 2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,949.54 | $2,949.54 | 7.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $3,577.38 | $3,577.38 | 6.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,547.65 | $1,547.65 | 2.7× |
| Radex Ankle Compl Minimum 3 Views (73610) | $1,981.62 | $1,981.62 | 21.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $1,111.80 | $1,111.80 | 12.2× |
| Radex Elbw Compl Minimum 3 Views (73080) | $1,965.27 | $1,965.27 | 21.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $259.08 | $259.08 | 2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $348.71 | $348.71 | 3.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) | $348.71 | $348.71 | 3.2× |
| Radex fingr minimum 2 views (73140) | $1,584.86 | $1,584.86 | 17.4× |
| Radex Foot Compl Minimum 3 Views (73630) | $2,019.77 | $2,019.77 | 22.2× |
| Radex Hand Minimum 3 Views (73130) | $2,012.14 | $2,012.14 | 22.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $638.74 | $638.74 | 7.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) | $348.71 | $348.71 | 3.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $2,047.02 | $2,047.02 | 18.8× |
| Radex Humerus Minimum 2 Views (73060) | $1,931.48 | $1,931.48 | 21.3× |
| Radex Kne 1/2 Views (73560) | $1,254.59 | $1,254.59 | 13.8× |
| Radex Kne Compl 4/More Views (73564) | $1,782.15 | $1,782.15 | 16.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $1,006.07 | $1,006.07 | 9.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,486.76 | $1,486.76 | 16.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $1,582.68 | $1,582.68 | 14.5× |
| Radex Sho Compl Minimum 2 Views (73030) | $2,101.52 | $2,101.52 | 23.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $259.08 | $259.08 | 2.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) | $348.71 | $348.71 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $259.08 | $259.08 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $966.83 | $966.83 | 10.6× |
| Radex Wrst Compl Minimum 3 Views (73110) | $2,084.08 | $2,084.08 | 22.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $348.71 | $348.71 | 3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $948.30 | $948.30 | 10.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $348.71 | $348.71 | 3.2× |
| Radiologic exam chest 2 views (71046) | $1,337.80 | $1,337.80 | 14.7× |
| Radiologic exam colon single contrast study (74270) | $1,385.39 | $1,385.39 | 7.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $3,526.15 | $3,526.15 | 19.3× |
| Radiologic exam upr gi trc single contrast study (74240) | $1,778.88 | $1,778.88 | 9.7× |
| Radiologic examination femur 1 view (73551) | $259.08 | $259.08 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,413.73 | $1,413.73 | 15.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) | $348.71 | $348.71 | 3.2× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) | $348.71 | $348.71 | 3.2× |
| Radiological examination surgical specimen (76098) | $1,117.25 | $1,117.25 | 2.0× |
| Ribs bilateral 3 views (71110) | $2,463.40 | $2,463.40 | 22.6× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) | $2,653.06 | $2,653.06 | 6.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,827.14 | $5,827.14 | 10.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $4,185.62 | $4,185.62 | 7.4× |
| Rp therapy intra-arterial particulate admn (79445) | $2,048.11 | $2,048.11 | 8.4× |
| Sacroiliac Joints < 3 Views (72200) | $348.71 | $348.71 | 3.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) | $737 | $737 | 3.0× |
| Scapula (73010) | $1,900.96 | $1,900.96 | 17.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $138.43 | $138.43 | 5.9× |
| Sella turcica (70240) | $259.08 | $259.08 | 2.9× |
| Shoulder 1 view (73020) | $1,963.09 | $1,963.09 | 21.6× |
| Sialogram (70390) | $737 | $737 | 3.0× |
| Small bowel series (74250) | $2,067.73 | $2,067.73 | 11.3× |
| Spine thoracic 3 views (72072) | $1,738.55 | $1,738.55 | 15.9× |
| Splenoportograpy rs&i (75810) | $7,996.24 | $7,996.24 | 2.4× |
| Superior sagittal sinus venogram (75870) | $9,169.07 | $9,169.07 | 2.8× |
| Testicular Imaging With Vascular Flow (78761) | $1,207.40 | $1,207.40 | 2.9× |
| Thoracolumbar 2 views (72080) | $568.98 | $568.98 | 6.3× |
| Thyroid carcinoma metastases img whole body (78018) | $4,826.52 | $4,826.52 | 8.5× |
| Thyroid imaging w/blood flow (78013) | $1,207.40 | $1,207.40 | 2.9× |
| Thyroid uptake measurement (78012) | $2,798.03 | $2,798.03 | 6.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,207.40 | $1,207.40 | 2.9× |
| Tmj unilateral (70328) | $259.08 | $259.08 | 2.9× |
| Ultrasound breast complete (76641) | $2,294.45 | $2,294.45 | 21.0× |
| Ultrasound elastography first target lesion (76982) | $686.70 | $686.70 | 6.3× |
| Ultrasound Exam Aaa Screen (76706) | $858.92 | $858.92 | 7.9× |
| Ultrasound, abdomen limited (76705) | $3,110.86 | $3,110.86 | 28.5× |
| Umbilical-artery Doppler (OB) (76820) | $348.71 | $348.71 | 3.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) | $248.91 | $248.91 | 2.7× |
| Urethrocystogram voiding (74455) | $2,140.76 | $2,140.76 | 8.6× |
| Urethrocystography retrograde rs&i (74450) | $737 | $737 | 3.0× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) | $572.13 | $572.13 | 3.1× |
| Us breast unilateral limited (76642) | $839.30 | $839.30 | 9.2× |
| Us chest (76604) | $1,850.82 | $1,850.82 | 17.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) | $847.68 | $847.68 | 3.8× |
| Us compl joint r-t w/image documentation (76881) | $1,451.88 | $1,451.88 | 13.3× |
| Us elastography parenchyma (76981) | $348.71 | $348.71 | 3.2× |
| Us encephalogram (76506) | $1,486.76 | $1,486.76 | 13.6× |
| Us infant hips w manipulation (76885) | $1,189.19 | $1,189.19 | 13.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,421.36 | $1,421.36 | 13.0× |
| Us ob detailed single fetus (76811) | $737 | $737 | 3.0× |
| Us ob limited (76815) | $1,051.85 | $1,051.85 | 9.6× |
| Us ob transvaginal (76817) | $1,024.60 | $1,024.60 | 9.4× |
| Us pelvic non ob complete (76856) | $3,337.58 | $3,337.58 | 30.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $348.71 | $348.71 | 3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,227.96 | $2,227.96 | 20.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $1,346.15 | $1,346.15 | 12.3× |
| Us retroperitoneal complete (76770) | $1,182.65 | $1,182.65 | 10.8× |
| Us retroperitoneal limited (76775) | $2,203.98 | $2,203.98 | 20.2× |
| Us scrotum and contents (76870) | $2,574.58 | $2,574.58 | 23.6× |
| Us soft tissue head/neck (76536) | $2,087.35 | $2,087.35 | 19.1× |
| Us spinal canal and contents (76800) | $907.97 | $907.97 | 8.3× |
| Us transrectal (76872) | $1,543.44 | $1,543.44 | 14.1× |
| Us transrectal prostate volume (76873) | $348.71 | $348.71 | 3.2× |
| Us,transplanted kidney, real time/ doppler (76776) | $348.71 | $348.71 | 3.2× |
| Venogram adrenal unilat (75840) | $9,169.07 | $9,169.07 | 2.8× |
| Venogram extremity bilateral (75822) | $4,751.31 | $4,751.31 | 2.9× |
| Venogram Extremity Unilateral (75820) | $3,087.97 | $3,087.97 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $3,154.46 | $3,154.46 | 1.0× |
| Venography caval superior serialography rs&i (75827) | $3,238.39 | $3,238.39 | 2.0× |
| Venography Orbital Rs&I (75880) | $1,657.40 | $1,657.40 | 2.5× |
| Venography Renal Bilateral (75833) | $9,169.07 | $9,169.07 | 2.8× |
| Venography renal unilateral selective rs&i (75831) | $9,169.07 | $9,169.07 | 2.8× |
| Venography venous sinus/jugular cath rs&i (75860) | $3,758.32 | $3,758.32 | 1.1× |
| Wrist 2 views (73100) | $1,500.93 | $1,500.93 | 16.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,502.02 | $1,502.02 | 16.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $572.13 | $572.13 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,654.62 | $1,654.62 | 18.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,948.92 | $1,948.92 | 21.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,678.60 | $1,678.60 | 15.4× |
| X-ray exam of femur 2/> (73552) | $1,917.31 | $1,917.31 | 21.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $681.25 | $681.25 | 7.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $259.08 | $259.08 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $810.96 | $810.96 | 8.9× |
| X-ray leg, infant (73592) | $259.08 | $259.08 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $2,375.11 | $2,375.11 | 21.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $348.71 | $348.71 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $259.08 | $259.08 | 2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $348.71 | $348.71 | 3.2× |
| X-ray retrograde pyelogram (74420) | $1,179.49 | $1,179.49 | 3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $2,759.88 | $2,759.88 | 30.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $1,469.32 | $1,469.32 | 13.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,718.46 | $2,718.46 | 24.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $802.24 | $802.24 | 7.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,611.02 | $1,611.02 | 17.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,893.33 | $1,893.33 | 20.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,056.83 | $2,056.83 | 18.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,093.27 | $1,093.27 | 10.0× |
| X-Ray Small Bowel Enteroclysis (74251) | $668.17 | $668.17 | 3.6× |
| X-Ray Spine One View - Xr Spine (72020) | $1,341.79 | $1,341.79 | 14.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $259.08 | $259.08 | 2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $1,423.54 | $1,423.54 | 15.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $1,600.12 | $1,600.12 | 14.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $348.71 | $348.71 | 3.2× |
| Xr bone length studies (77073) | $348.71 | $348.71 | 3.2× |
| Xr c-spine 4 or 5 views (72050) | $2,684.67 | $2,684.67 | 24.6× |
| Xr c-spine 6 or more views (72052) | $2,074.27 | $2,074.27 | 19.0× |
| Xr chest 4+ views (71048) | $2,751.16 | $2,751.16 | 25.2× |
| Xr urogram antegrade (74425) | $2,057.92 | $2,057.92 | 5.6× |