Imaging prices at Parkview Regional Medical Center
Fort Wayne, IN · every code in this section with a posted price and a Medicare benchmark.
330 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) | $6,552.50 | $13,105 | 4.5× |
| Abdomen 1 View (74018) | $204 | $408 | 2.2× |
| Abdomen 2 views (74019) | $296 | $592 | 2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,254.50 | $2,509 | 3.0× |
| Angio internal mammary (75756) | $2,185 | $4,370 | 0.7× |
| Angio pulmonary bilat (75743) | $3,496 | $6,992 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,959 | $5,918 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $2,824.50 | $5,649 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,959 | $5,918 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,127 | $6,254 | 0.9× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$162.50–$252.50 | $325–$505 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,959 | $5,918 | 0.5× |
| Artery X-Rays Abdomen (75726) | $3,082 | $6,164 | 0.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,573 | $5,146 | 0.4× |
| Artery X-Rays Spine (75705) | $2,959 | $5,918 | 0.5× |
| Arthrogram hip (73525) | $1,051 | $2,102 | 2.8× |
| Basic radiation dosimetry calculation (77300) | $584 | $1,168 | 4.1× |
| Bone age studies (77072) | $111 | $222 | 1.0× |
| Bone Imaging 3 Phase (78315) | $1,582.50 | $3,165 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,096 | $2,192 | 2.6× |
| Bone Imaging Multiple Areas (78305) | $1,354 | $2,708 | 3.2× |
| Bone Imaging Whole Body (78306) | $1,673.50 | $3,347 | 4.0× |
| Bone survey infant (77076) | $446.50 | $893 | 4.0× |
| Brain Flow Imaging Only (78610) | $1,140.50 | $2,281 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,079 | $2,158 | 2.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,295 | $2,590 | 1.6× |
| Cat Scan Follow-Up Study (76380) range across 5 matching MRF lines |
$291.50–$291.65 | $583–$583.30 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,177 | $2,354 | 2.0× |
| Cerebrospinal Fluid Scan (78630) | $1,281 | $2,562 | 2.2× |
| Chest 1 view (71045) | $163 | $326 | 1.8× |
| Chest 2 views (71046) | $215.50 | $431 | 2.3× |
| Chest 3 views (71047) | $268 | $536 | 2.9× |
| Chest 4 or more views (71048) | $349 | $698 | 3.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$166.50–$250 | $333–$500 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $49.50 | $99 | 0.4× |
| Continuing medical physics consltj pr wk (77336) | $904.50 | $1,809 | 6.4× |
| Contrast Exam Abdominl Aorta (75625) | $2,959 | $5,918 | 0.9× |
| Contrast X-Ray Bladder (74430) | $508 | $1,016 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $998.50 | $1,997 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,706 | $3,412 | 4.6× |
| CT abdomen and pelvis without contrast (74176) | $879 | $1,758 | 3.5× |
| CT abdomen w contrast (74160) | $812 | $1,624 | 4.4× |
| CT abdomen w wo contrast (74170) | $942.50 | $1,885 | 5.1× |
| CT abdomen w/o contrast (74150) | $671.50 | $1,343 | 6.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,985 | $3,970 | 5.4× |
| CT Angio Chest (71275) | $983 | $1,966 | 5.3× |
| CT Angio Head (70496) | $823.50 | $1,647 | 4.4× |
| CT angio hrt w/3d image (75574) | $858.50 | $1,717 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$786.50–$1,180 | $1,573–$2,360 | varies |
| CT Angio Neck (70498) | $823 | $1,646 | 4.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$889–$1,245 | $1,778–$2,490 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $481.50 | $963 | 2.6× |
| CT cervical spine w/ contrast (72126) | $779 | $1,558 | 2.1× |
| CT cervical spine w/o contrast (72125) | $571 | $1,142 | 5.2× |
| CT cervical spine w/wo cont (72127) | $814 | $1,628 | 4.4× |
| CT chest w contrast (71260) | $797 | $1,594 | 4.3× |
| CT chest w/wo contrast (71270) | $1,004 | $2,008 | 5.4× |
| CT colonography screening (74263) | $521 | $1,042 | 2.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,089.50 | $2,179 | 5.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $521 | $1,042 | 4.7× |
| CT head/brain with contrast (70460) | $642.50 | $1,285 | 3.5× |
| CT head/brain without and with contrast (70470) | $753 | $1,506 | 4.1× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$49.50–$297 | $99–$594 | varies |
| CT hrt w/3d image congen (75573) | $830.50 | $1,661 | 2.3× |
| CT iac w contrast (70481) | $763.50 | $1,527 | 4.1× |
| CT l-spine w&w/o contrast (72133) | $1,031.50 | $2,063 | 5.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$574–$860.50 | $1,148–$1,721 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$812–$1,137.50 | $1,624–$2,275 | varies |
| CT lumbar spine w contrast (72132) | $844 | $1,688 | 2.3× |
| CT lumbar spine w/o contrast (72131) | $723.50 | $1,447 | 6.5× |
| CT maxillofacial w contrast (70487) | $656 | $1,312 | 3.5× |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$411.50–$536.50 | $823–$1,073 | varies |
| CT neck tissue combo (70492) | $812 | $1,624 | 4.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $888 | $1,776 | 4.8× |
| CT orbits w/o contrast (70480) | $633 | $1,266 | 5.7× |
| CT pelvis w&w/o contrast (72194) | $1,004 | $2,008 | 5.4× |
| CT pelvis w/o contrast (72192) | $594 | $1,188 | 5.4× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,022.50–$1,076.50 | $2,045–$2,153 | varies |
| CT scans face/jaw combo (70488) | $774.50 | $1,549 | 4.2× |
| CT soft tissue neck w contrast (70491) | $643.50 | $1,287 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $545 | $1,090 | 4.9× |
| CT thoracic spine w contrast (72129) | $868 | $1,736 | 4.7× |
| CT thoracic spine w/o contrast (72128) | $742.50 | $1,485 | 6.7× |
| CT thoracic spine w/wo cont (72130) | $1,093 | $2,186 | 5.9× |
| CT thorax w/o contrast (71250) | $571 | $1,142 | 5.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$690.50–$1,036 | $1,381–$2,072 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$817–$1,137.50 | $1,634–$2,275 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,273.50 | $2,547 | 6.9× |
| Cta Abdomen (74175) | $880.50 | $1,761 | 4.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,204 | $2,408 | 3.3× |
| CTA pelvis (72191) | $928 | $1,856 | 5.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$137.15–$394.50 | $274.30–$789 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$138.12–$415.50 | $276.25–$831 | varies |
| Dxa Bone Density Axial (77080) | $287.50 | $575 | 2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $150.50 | $301 | 1.6× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$260–$394.50 | $520–$789 | varies |
| Echo exam uterus (76831) | $475.50 | $951 | 1.9× |
| Echo Guide For Artery Repair (76936) | $664 | $1,328 | 2.9× |
| Esophagram (74220) | $483.50 | $967 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$178.10–$486 | $356.20–$972 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$177.78–$423 | $355.55–$846 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $764.50 | $1,529 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $640 | $1,280 | 2.5× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$135–$252.50 | $270–$505 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$163.50–$250.50 | $327–$501 | varies |
| Gastric emptying imaging study (78264) | $1,383.50 | $2,767 | 3.3× |
| Gated Heart Planar Single (78472) | $1,749 | $3,498 | 4.1× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$160.50–$241.50 | $321–$483 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,310.50 | $12,621 | 8.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,509 | $11,018 | 7.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,506.50 | $9,013 | 6.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,184 | $2,368 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,735 | $3,470 | 3.0× |
| Hepatobiliary System Imaging (78226) | $1,382 | $2,764 | 3.3× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$739.50–$3,273 | $1,479–$6,546 | varies |
| Hysterosalpingogram (74740) | $754 | $1,508 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $618 | $1,236 | 6.7× |
| Joint Survey Single View (77077) | $250.50 | $501 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $1,104.50 | $2,209 | 1.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,506 | $3,012 | 2.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$208–$298.50 | $416–$597 | varies |
| Leveen/Shunt Patency Exam (78291) | $980 | $1,960 | 2.3× |
| Liver imaging static only (78201) | $950.50 | $1,901 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $2,149 | $4,298 | 3.7× |
| Lung perfusion differential (78597) | $1,177 | $2,354 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,149 | $4,298 | 3.7× |
| Lung Ventilation Imaging (78579) | $588.50 | $1,177 | 1.4× |
| Lymph System Imaging (78195) | $1,324.50 | $2,649 | 2.3× |
| Magnetic Image Jaw Joint (70336) | $693 | $1,386 | 2.7× |
| Meckels Divert Exam (78290) | $959 | $1,918 | 2.3× |
| Mlc imrt design & construction per imrt plan (77338) | $2,407 | $4,814 | 6.1× |
| Mr safety determination physician/other qhp (76016) | $130 | $260 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.50 | $75 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,078 | $2,156 | 2.9× |
| MRA head w/o contrast (70544) | $807 | $1,614 | 3.2× |
| MRA head with contrast (70545) | $1,043.50 | $2,087 | 2.8× |
| MRA neck w contrast (70548) | $967.50 | $1,935 | 2.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $978 | $1,956 | 2.6× |
| MRA neck w/o contrast (70547) | $533 | $1,066 | 2.1× |
| MRI abdomen w contrast (74182) | $926 | $1,852 | 2.5× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$515.50–$868 | $1,031–$1,736 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$820–$1,192 | $1,640–$2,384 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$953–$1,429.50 | $1,906–$2,859 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$802–$1,192 | $1,604–$2,384 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,125.50 | $2,251 | 4.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $790 | $1,580 | 3.1× |
| MRI cardiac w/o contrast (75557) | $824.50 | $1,649 | 3.3× |
| MRI cervical spine w contrast (72142) | $968.50 | $1,937 | 2.6× |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$248–$786 | $496–$1,572 | varies |
| MRI chest w/o contrast (71550) | $753.50 | $1,507 | 3.0× |
| MRI chest wo w contrast (71552) | $984.50 | $1,969 | 2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $907 | $1,814 | 2.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$979.50–$1,390.50 | $1,959–$2,781 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$689–$993 | $1,378–$1,986 | varies |
| MRI lumbar spine w contrast (72149) | $917.50 | $1,835 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$347.50–$1,388 | $695–$2,776 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $675 | $1,350 | 2.7× |
| MRI orbit face neck w contrast (70542) | $800 | $1,600 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $927 | $1,854 | 2.5× |
| MRI pelvis w contrast (72196) | $937.50 | $1,875 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,106 | $2,212 | 3.0× |
| MRI pelvis w/o contrast (72195) | $764.50 | $1,529 | 3.0× |
| MRI spectroscopy (76390) | $853 | $1,706 | 9.3× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$275.50–$850 | $551–$1,700 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $825 | $1,650 | 2.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$701.50–$993 | $1,403–$1,986 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$949–$1,390.50 | $1,898–$2,781 | varies |
| MRI, abdomen, combo (74183) | $1,070.50 | $2,141 | 2.9× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$347.50–$1,072 | $695–$2,144 | varies |
| MRI, dorsal spine contrast (72147) | $947.50 | $1,895 | 2.6× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$680.50–$993 | $1,361–$1,986 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$929.50–$1,390.50 | $1,859–$2,781 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$347.50–$1,034.50 | $695–$2,069 | varies |
| Myelogram cervical (72240) | $1,648 | $3,296 | 2.0× |
| Myelogram Lumbar (72265) | $967.50 | $1,935 | 1.2× |
| Myelograpy 2/more regions rs&i (72270) | $2,153 | $4,306 | 2.6× |
| Myocardial Spect Multiple Studies (78452) | $4,463 | $8,926 | 3.3× |
| N-invas est c ffr sw aly CTA (75580) | $2,790.50 | $5,581 | 3.1× |
| Neck soft tissue (70360) | $166 | $332 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $10,380.50 | $20,761 | 7.1× |
| Nuclear Rx Intra-Arterial (79445) | $1,079 | $2,158 | 4.4× |
| Nuclear Rx Oral Admin (79005) | $2,147.50 | $4,295 | 8.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$235–$352.50 | $470–$705 | varies |
| Parathyroid Planar Imaging (78070) | $908 | $1,816 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $953 | $1,906 | 2.3× |
| Pelvis 1 or 2 views (72170) | $201.50 | $403 | 1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,191.50 | $4,383 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,173 | $2,346 | 2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $396.50 | $793 | 3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $569 | $1,138 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$199.50–$285 | $399–$570 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$177–$265 | $354–$530 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$208–$275 | $416–$550 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $248.50 | $497 | 2.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$110.50–$161 | $221–$322 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$205.50–$308.50 | $411–$617 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$200–$275 | $400–$550 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$153.50–$253.50 | $307–$507 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $208.50 | $417 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $202 | $404 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$209–$289.50 | $418–$579 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $194.50 | $389 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $165.50 | $331 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $201 | $402 | 2.2× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$110.50–$159.50 | $221–$319 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$153.50–$253.50 | $307–$507 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 8 matching MRF lines |
$177–$265 | $354–$530 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,728 | $41,456 | 2.7× |
| Radiation treatment delivery level 1 (77402) | $635 | $1,270 | 5.9× |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$762–$4,214 | $1,524–$8,428 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$928.50–$4,701.50 | $1,857–$9,403 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $273.50 | $547 | 2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $325.50 | $651 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $914 | $1,828 | 4.9× |
| Radiologic exam colon single contrast study (74270) | $547 | $1,094 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $534.50 | $1,069 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$226.50–$331.50 | $453–$663 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $252 | $504 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $557.50 | $1,115 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $461 | $922 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $600 | $1,200 | 3.2× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$71–$107 | $142–$214 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$207.50–$330 | $415–$660 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$174–$251.50 | $348–$503 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $409.50 | $819 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$201.50–$298.50 | $403–$597 | varies |
| Ribs bilateral 3 views (71110) | $237 | $474 | 2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $727 | $1,454 | 1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,567.50 | $3,135 | 3.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,249.50 | $4,499 | 3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,695.50 | $3,391 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,752.50 | $5,505 | 1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,074.50 | $4,149 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $1,352 | $2,704 | 5.5× |
| Scapula (73010) range across 3 matching MRF lines |
$198.50–$284 | $397–$568 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $41 | $82 | 1.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$136–$206 | $272–$412 | varies |
| Shoulder Arthrography (73040) | $949 | $1,898 | 2.6× |
| Skull less than 4 views (70250) | $203 | $406 | 1.8× |
| Special dosimetry (77331) | $563 | $1,126 | 4.0× |
| Special Physics Consult (77370) | $1,149 | $2,298 | 8.1× |
| Special teletherapy port plan (77321) | $1,081 | $2,162 | 2.7× |
| Special treatment procedure (77470) | $2,819.50 | $5,639 | 4.8× |
| Stereotactic Body Radiation Delivery (77373) | $6,486.50 | $12,973 | 3.4× |
| Sternoclavicular joints (71130) | $167.50 | $335 | 1.8× |
| Superior sagittal sinus venogram (75870) | $1,500 | $3,000 | 0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,231 | $4,462 | 5.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,182 | $2,364 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,026 | $4,052 | 5.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,533 | $3,066 | 3.9× |
| Ther rad simulaj-aided field setting simple (77280) | $995 | $1,990 | 7.0× |
| Thoracic spine 2 views (72070) | $224 | $448 | 2.0× |
| Thoracic spine 3 views (72072) | $270 | $540 | 2.4× |
| Thoracolumbar 2 views (72080) | $239 | $478 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $624 | $1,248 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,620 | $3,240 | 2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $976.50 | $1,953 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $1,130.50 | $2,261 | 2.9× |
| Tx devices design & construction intermediate (77333) | $772.50 | $1,545 | 5.4× |
| Tx devices design & construction simple (77332) | $595.50 | $1,191 | 4.2× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$83.85–$503.50 | $167.70–$1,007 | varies |
| Ultrasound Elastography Parenchyma (76981) | $214.50 | $429 | 1.9× |
| Ultrasound Exam Aaa Screen (76706) | $271 | $542 | 2.5× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$377–$459 | $754–$918 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$129.35–$391 | $258.70–$782 | varies |
| Unlis px ther radiol clinical tx planning (77299) | $1,339 | $2,678 | 9.4× |
| Unlisted Dx Radiographic Procedure (76499) | $1,235 | $2,470 | 13.4× |
| Unlisted us procedure (76999) | $427.50 | $855 | 4.6× |
| Upper gi w/o kub (74240) | $537 | $1,074 | 2.9× |
| Urethrocystogram voiding (74455) | $599 | $1,198 | 2.4× |
| Urethrocystography retrograde (74450) | $646 | $1,292 | 2.6× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$449.50–$631 | $899–$1,262 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$119.60–$379 | $239.20–$758 | varies |
| Us exam, pelvic, limited (76857) | $423 | $846 | 3.8× |
| Us head (76506) | $584 | $1,168 | 5.3× |
| Us kidney transplant (76776) | $522 | $1,044 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$52.98–$462.50 | $105.95–$925 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$390.98–$840.50 | $781.95–$1,681 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$131.95–$539.50 | $263.90–$1,079 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$149.82–$458.50 | $299.65–$917 | varies |
| Us pelvic non ob complete (76856) | $453 | $906 | 4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$255.12–$616 | $510.25–$1,232 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$126.75–$561 | $253.50–$1,122 | varies |
| Us retroperitoneal complete (76770) | $501 | $1,002 | 4.5× |
| Us retroperitoneal limited (76775) | $356 | $712 | 3.2× |
| Us scrotum and contents (76870) | $423 | $846 | 3.8× |
| Us spinal canal and contents (76800) | $422.50 | $845 | 3.8× |
| Us thyroid (76536) range across 3 matching MRF lines |
$51.80–$450 | $103.60–$900 | varies |
| Vein X-Ray Chest (75827) | $2,415.50 | $4,831 | 1.5× |
| Venogram Sinus/Jugular (75860) | $1,212 | $2,424 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,959 | $5,918 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,278 | $2,556 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,007.50 | $2,015 | 0.6× |
| Venography Renal Bilateral (75833) | $2,848 | $5,696 | 0.9× |
| Venography Renal Unilateral (75831) | $2,661 | $5,322 | 0.8× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$157.50–$250.50 | $315–$501 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $213.50 | $427 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $488 | $976 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $250 | $500 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$167.50–$251.50 | $335–$503 | varies |
| X-Ray Exam Breast Specimen (76098) | $445 | $890 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $337.50 | $675 | 3.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $391 | $782 | 3.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $160.50 | $321 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $207.50 | $415 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $243 | $486 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $296.50 | $593 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $377 | $754 | 3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $217.50 | $435 | 2.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $319.50 | $639 | 2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $245.50 | $491 | 2.2× |
| X-ray eye for foreign body (70030) | $220 | $440 | 2.4× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$199.50–$275 | $399–$550 | varies |
| X-ray IV pyelogram (ivp) (74400) | $508 | $1,016 | 2.7× |
| X-ray IV pyelogram+tomography (74415) | $666 | $1,332 | 3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $149.50 | $299 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $246 | $492 | 2.2× |
| X-ray nose-rectum child f.b. (76010) | $185 | $370 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $321 | $642 | 2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $202 | $404 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $208 | $416 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $274.50 | $549 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $312 | $624 | 2.8× |
| X-ray thoracic spine 4 vw (72074) | $295 | $590 | 2.7× |
| X-Ray Tmj Unilat (70328) | $178 | $356 | 1.9× |
| X-Rays Bone Length Studies (77073) | $278.50 | $557 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $444 | $888 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $302 | $604 | 2.7× |
| Xr facial bones less than 3 views (70140) | $210.50 | $421 | 2.3× |
| Xr orbits complete 4 views (70200) | $235.50 | $471 | 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.