Imaging prices at Piedmont Medical Center
Rock Hill, SC · every code in this section with a posted price and a Medicare benchmark.
335 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) | $5,113.50 | $6,818 | 3.8× |
| Abdomen 1 View (74018) | $773.25 | $1,031 | 9.1× |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$630.75–$868.50 | $841–$1,158 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,548.50 | $3,398 | 6.6× |
| Angio internal mammary (75756) | $3,694.50 | $4,926 | 1.2× |
| Angio pulmonary bilat (75743) | $4,996.50 | $6,662 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $7,177.50 | $9,570 | 2.3× |
| Angiography extremity unilateral rs&i (75710) | $6,433.50 | $8,578 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,158.25 | $4,211 | 1.0× |
| Ankle 2 views (73600) | $683.25 | $911 | 8.1× |
| Aortography thoracic serialography rs&i (75605) | $6,790.50 | $9,054 | 1.3× |
| Artery X-Rays Abdomen (75726) | $10,755 | $14,340 | 2.0× |
| Artery X-Rays Spine (75705) | $8,781 | $11,708 | 1.6× |
| Arthrogram ankle (73615) | $1,791 | $2,388 | 5.3× |
| Arthrogram hip (73525) | $1,935 | $2,580 | 5.7× |
| Arthrogram Wrist (73115) | $1,645.50 | $2,194 | 4.9× |
| Basic radiation dosimetry calculation (77300) | $478.50 | $638 | 3.7× |
| Bone age studies (77072) | $819.75 | $1,093 | 8.1× |
| Bone Imaging 3 Phase (78315) | $2,297.25 | $3,063 | 5.9× |
| Bone Imaging Limited Area (78300) | $1,797.75 | $2,397 | 4.6× |
| Bone Imaging Multiple Areas (78305) | $3,528 | $4,704 | 9.1× |
| Bone Imaging Whole Body (78306) | $2,653.50 | $3,538 | 6.8× |
| Bone survey infant (77076) | $1,244.25 | $1,659 | 12.2× |
| Brain Flow Imaging Only (78610) | $1,215 | $1,620 | 2.3× |
| Brain Image W/Flow < 4 Views (78601) | $2,114.25 | $2,819 | 5.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,771.50 | $6,362 | 14.1× |
| Cat Scan Follow-Up Study (76380) | $1,617.75 | $2,157 | 19.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,524.50 | $3,366 | 4.8× |
| Cerebrospinal Fluid Scan (78630) | $1,501.50 | $2,002 | 2.8× |
| Chest 1 view (71045) | $503.25 | $671 | 6.0× |
| Chest 2 views (71046) | $725.25 | $967 | 8.6× |
| Chest 3 views (71047) | $366 | $488 | 4.3× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$618–$732 | $824–$976 | varies |
| Clavicle complete (73000) | $969 | $1,292 | 11.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,617.75 | $2,157 | 15.9× |
| Continuing medical physics consltj pr wk (77336) | $750 | $1,000 | 5.7× |
| Contrast Exam Abdominl Aorta (75625) | $6,386.25 | $8,515 | 2.1× |
| Contrast X-Ray Bladder (74430) | $850.50 | $1,134 | 2.5× |
| Contrast X-Ray Of Elbow (73085) | $1,801.50 | $2,402 | 5.3× |
| Contrast X-Ray Of Knee Joint (73580) | $1,738.50 | $2,318 | 5.1× |
| CT abdomen and pelvis without and with contrast (74178) | $11,587.50 | $15,450 | 34.2× |
| CT abdomen and pelvis without contrast (74176) | $4,665 | $6,220 | 20.1× |
| CT abdomen w contrast (74160) | $3,935.25 | $5,247 | 23.1× |
| CT abdomen w wo contrast (74170) | $4,014.75 | $5,353 | 23.6× |
| CT abdomen w/o contrast (74150) | $3,008.25 | $4,011 | 29.6× |
| CT Angio Abdomen and Pelvis (74174) range across 5 matching MRF lines |
$5,628.75–$6,998.25 | $7,505–$9,331 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$5,764.50–$6,456 | $7,686–$8,608 | varies |
| CT Angio Head (70496) | $5,860.50 | $7,814 | 34.4× |
| CT angio hrt w/3d image (75574) | $5,085 | $6,780 | 15.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,780.25 | $7,707 | 33.9× |
| CT Angio Neck (70498) | $5,643.75 | $7,525 | 33.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $6,897 | $9,196 | 40.5× |
| CT cervical spine w/ contrast (72126) | $3,524.25 | $4,699 | 10.4× |
| CT cervical spine w/o contrast (72125) | $3,217.50 | $4,290 | 31.7× |
| CT cervical spine w/wo cont (72127) | $5,032.50 | $6,710 | 29.5× |
| CT chest w contrast (71260) | $3,376.50 | $4,502 | 19.8× |
| CT chest w/wo contrast (71270) | $4,616.25 | $6,155 | 27.1× |
| CT head/brain with contrast (70460) | $2,572.50 | $3,430 | 15.1× |
| CT head/brain without and with contrast (70470) | $4,705.50 | $6,274 | 27.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,488.50 | $3,318 | 7.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,087.25 | $2,783 | 24.7× |
| CT hrt w/3d image congen (75573) | $4,308.75 | $5,745 | 12.7× |
| CT iac w contrast (70481) | $4,492.50 | $5,990 | 26.4× |
| CT l-spine w&w/o contrast (72133) | $4,122.75 | $5,497 | 24.2× |
| CT lower ext w/o (73700) | $3,285 | $4,380 | 32.3× |
| CT lower extremity w/contrast material (73701) | $2,572.50 | $3,430 | 15.1× |
| CT lumbar spine w contrast (72132) | $3,524.25 | $4,699 | 10.4× |
| CT lumbar spine w/o contrast (72131) | $3,217.50 | $4,290 | 31.7× |
| CT maxillofacial w contrast (70487) | $2,871 | $3,828 | 16.8× |
| CT maxillofacial wo contrast (70486) | $3,155.25 | $4,207 | 31.1× |
| CT neck tissue combo (70492) | $3,573.75 | $4,765 | 21.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,551.25 | $8,735 | 38.4× |
| CT orbits w/o contrast (70480) | $4,300.50 | $5,734 | 42.3× |
| CT pelvis w&w/o contrast (72194) | $4,491 | $5,988 | 26.3× |
| CT pelvis w/o contrast (72192) | $2,697.75 | $3,597 | 26.6× |
| CT scan of leg combo (73702) | $3,416.25 | $4,555 | 20.0× |
| CT scans face/jaw combo (70488) | $3,961.50 | $5,282 | 23.2× |
| CT soft tissue neck w contrast (70491) | $3,747.75 | $4,997 | 22.0× |
| CT soft tissue neck w/o contrast (70490) | $2,451.75 | $3,269 | 24.1× |
| CT thoracic spine w contrast (72129) | $3,210 | $4,280 | 18.8× |
| CT thoracic spine w/o contrast (72128) | $2,572.50 | $3,430 | 25.3× |
| CT thoracic spine w/wo cont (72130) | $5,032.50 | $6,710 | 29.5× |
| CT thorax w/o contrast (71250) | $3,668.25 | $4,891 | 36.1× |
| CT upper ext wo (73200) | $3,213.75 | $4,285 | 31.6× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$5,605.50–$6,100.50 | $7,474–$8,134 | varies |
| CT upper extremity with contrast (73201) | $4,317 | $5,756 | 12.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,815.75 | $6,421 | 28.3× |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$4,627.50–$6,465.75 | $6,170–$8,621 | varies |
| CTA pelvis (72191) range across 4 matching MRF lines |
$4,627.50–$6,465.75 | $6,170–$8,621 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,508.25 | $6,011 | 2.2× |
| Diskography lumbar (72295) | $3,705.75 | $4,941 | 2.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $819 | $1,092 | 8.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,287 | $1,716 | 12.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $906 | $1,208 | 8.9× |
| Dxa Bone Density Axial (77080) | $798.75 | $1,065 | 7.9× |
| Dxa bone density study (77085) | $1,136.25 | $1,515 | 11.2× |
| Echo exam of fetal heart (76825) | $1,770.75 | $2,361 | 3.3× |
| Echo Guide For Artery Repair (76936) | $2,443.50 | $3,258 | 11.6× |
| Esophagram (74220) | $942 | $1,256 | 5.5× |
| Fetal Biophys Profile W/Nst (76818) | $701.25 | $935 | 6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $942.75 | $1,257 | 9.3× |
| Fluoroscopy up to 1 hr (76000) | $927 | $1,236 | 4.0× |
| Follow-Up Angiography (75898) | $4,039.50 | $5,386 | 1.3× |
| Foot 2 views (73620) | $522.75 | $697 | 6.2× |
| Forearm 2 views (73090) | $1,086.75 | $1,449 | 12.9× |
| Gastric emptying imaging study (78264) | $3,236.25 | $4,315 | 8.3× |
| Gated Heart Planar Single (78472) | $2,572.50 | $3,430 | 6.6× |
| Hand 2 views (73120) | $521.25 | $695 | 5.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,913.50 | $5,218 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $3,566.25 | $4,755 | 6.8× |
| Hepatobiliary System Imaging (78226) | $2,937 | $3,916 | 7.6× |
| Ht Muscle Image Spect Sing (78451) | $3,754.50 | $5,006 | 3.0× |
| Hysterosalpingogram (74740) | $2,295.75 | $3,061 | 9.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$464.25–$506.25 | $619–$675 | varies |
| Infant hip ultrasound, limited static exam (76886) | $624.75 | $833 | 7.4× |
| K Flow/Funct Image Multiple (78709) | $3,218.25 | $4,291 | 6.1× |
| K Flow/Funct Image W/Drug (78708) | $2,361 | $3,148 | 4.5× |
| K Flow/Funct Image W/O Drug (78707) | $2,569.50 | $3,426 | 4.9× |
| Knee 3 Views (73562) | $1,167.75 | $1,557 | 13.8× |
| Liver & Spleen Imaging Static Only (78215) | $2,280.75 | $3,041 | 5.9× |
| Liver imaging static only (78201) | $1,893 | $2,524 | 3.6× |
| Lung Perf&Ventilat Diferentl (78598) | $1,455.75 | $1,941 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $3,694.50 | $4,926 | 7.0× |
| Lung Ventilation Imaging (78579) | $1,995.75 | $2,661 | 5.1× |
| Lymph System Imaging (78195) | $2,769 | $3,692 | 5.2× |
| Magnetic Image Jaw Joint (70336) | $4,718.25 | $6,291 | 20.3× |
| Mammary ductogram or galactogram single (77053) | $2,440.50 | $3,254 | 10.5× |
| Meckels Divert Exam (78290) | $1,872 | $2,496 | 4.8× |
| Mlc imrt design & construction per imrt plan (77338) | $6,200.25 | $8,267 | 17.0× |
| Mr safety determination physician/other qhp (76016) | $342 | $456 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $95.25 | $127 | 3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $357 | $476 | 3.9× |
| Mr safety implt pos&/immoblj (76019) | $231 | $308 | 4.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $939.75 | $1,253 | 4.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$5,504.25–$5,986.50 | $7,339–$7,982 | varies |
| MRA head w/o contrast (70544) | $5,621.25 | $7,495 | 24.2× |
| MRA head with contrast (70545) | $4,731.75 | $6,309 | 14.0× |
| MRA neck w contrast (70548) | $5,031 | $6,708 | 14.8× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$4,866–$6,625.50 | $6,488–$8,834 | varies |
| MRA neck w/o contrast (70547) | $4,978.50 | $6,638 | 21.5× |
| MRI abdomen w contrast (74182) | $6,784.50 | $9,046 | 20.0× |
| MRI abdomen w/o contrast (74181) | $5,709.75 | $7,613 | 24.6× |
| MRI any jt lower extrem w/contrast material (73722) | $7,655.25 | $10,207 | 10.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,902 | $10,536 | 23.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,747.75 | $8,997 | 8.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,176.75 | $5,569 | 18.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $5,088 | $6,784 | 21.9× |
| MRI cardiac w/o contrast (75557) | $3,916.50 | $5,222 | 16.9× |
| MRI cervical spine w contrast (72142) | $4,846.50 | $6,462 | 14.3× |
| MRI cervical spine w/o cont (72141) | $6,805.50 | $9,074 | 29.4× |
| MRI chest w/o contrast (71550) | $6,332.25 | $8,443 | 27.3× |
| MRI chest wo w contrast (71552) | $5,721.75 | $7,629 | 16.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $7,131.75 | $9,509 | 21.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $6,213 | $8,284 | 18.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,658.50 | $8,878 | 28.7× |
| MRI lumbar spine w contrast (72149) | $4,846.50 | $6,462 | 14.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,721.75 | $7,629 | 16.9× |
| MRI orbit face &/neck w/o contrast (70540) | $5,284.50 | $7,046 | 22.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,721.75 | $7,629 | 16.9× |
| MRI pelvis w contrast (72196) | $6,504.75 | $8,673 | 19.2× |
| MRI pelvis w/o & w contrast (72197) | $4,851 | $6,468 | 14.3× |
| MRI pelvis w/o contrast (72195) | $4,688.25 | $6,251 | 20.2× |
| MRI thoracic spine w/o contrast (72146) | $5,709.75 | $7,613 | 24.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,476.25 | $8,635 | 19.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,996 | $5,328 | 17.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,429.50 | $5,906 | 13.1× |
| MRI, abdomen, combo (74183) | $8,019 | $10,692 | 23.7× |
| MRI, dorsal spine combo (72157) | $5,721.75 | $7,629 | 16.9× |
| MRI, dorsal spine contrast (72147) | $5,223.75 | $6,965 | 15.4× |
| MRI, joint upper extrem (73221) | $7,138.50 | $9,518 | 30.8× |
| MRI, joint upper extrem combo (73223) | $5,094 | $6,792 | 15.0× |
| MRI, lumbar spine combo (72158) | $5,721.75 | $7,629 | 16.9× |
| Myelogram cervical (72240) | $2,851.50 | $3,802 | 3.7× |
| Myelogram Lumbar (72265) | $2,851.50 | $3,802 | 3.7× |
| Myelography thoracic (72255) | $2,851.50 | $3,802 | 3.7× |
| Myelograpy 2/more regions rs&i (72270) | $5,007 | $6,676 | 6.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,722.50 | $3,630 | 7.0× |
| Myocardial Spect Multiple Studies (78452) | $5,847.75 | $7,797 | 4.6× |
| Neck soft tissue (70360) | $819.75 | $1,093 | 9.7× |
| Nm myocard infarct spect (78469) | $3,667.50 | $4,890 | 7.0× |
| Nonvascular Shunt X-Ray (75809) | $754.50 | $1,006 | 7.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,564.75 | $4,753 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $1,124.25 | $1,499 | 5.0× |
| Ob us nuchal meas 1 gest (76813) | $681.75 | $909 | 6.7× |
| Panoramic X-ray of jaws (70355) | $348 | $464 | 4.1× |
| Parathyroid Planar Imaging (78070) | $1,327.50 | $1,770 | 3.4× |
| Pelvis 1 or 2 views (72170) | $605.25 | $807 | 6.0× |
| Peritoneogram Rs&I (74190) | $1,819.50 | $2,426 | 3.4× |
| Pet Image W/Ct Lmtd (78814) | $10,167 | $13,556 | 7.3× |
| PET image w/CT, full body (78816) | $10,567.50 | $14,090 | 7.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $10,567.50 | $14,090 | 7.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,160.50 | $8,214 | 2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,534.50 | $2,046 | 4.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,494.75 | $1,993 | 14.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,408.50 | $1,878 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $1,028.25 | $1,371 | 12.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $537.75 | $717 | 6.4× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,006.50–$1,008.75 | $1,342–$1,345 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$831.75–$915 | $1,109–$1,220 | varies |
| Radex fingr minimum 2 views (73140) | $783 | $1,044 | 9.3× |
| Radex foot complete minimum 3 views (73630) | $1,023 | $1,364 | 12.1× |
| Radex Hand Minimum 3 Views (73130) | $1,083 | $1,444 | 12.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,033.50 | $1,378 | 12.2× |
| Radex Ribs Unilateral 2 Views (71100) | $755.25 | $1,007 | 8.9× |
| Radex shoulder complete minimum 2 views (73030) | $1,130.25 | $1,507 | 13.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $488.25 | $651 | 5.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,792.50 | $2,390 | 10.5× |
| Radex Spine 1 View Specify Level (72020) | $621.75 | $829 | 7.4× |
| Radex Sternum Minimum 2 Views (71120) | $620.25 | $827 | 7.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $434.25 | $579 | 5.1× |
| Radex Toe Minimum 2 Views (73660) | $754.50 | $1,006 | 8.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $1,070.25 | $1,427 | 12.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,818.75 | $2,425 | 17.9× |
| Radiation treatment delivery level 1 (77402) | $420 | $560 | 4.2× |
| Radiation treatment delivery level 2 (77407) | $519 | $692 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $681.75 | $909 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,108.50 | $1,478 | 10.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $735.75 | $981 | 7.2× |
| Radiologic exam colon double contrast study (74280) | $2,067 | $2,756 | 12.1× |
| Radiologic exam colon single contrast study (74270) | $1,491 | $1,988 | 8.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,140.75 | $1,521 | 6.7× |
| Radiologic exam knee complete 4/more views (73564) | $1,026.75 | $1,369 | 10.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,052.25 | $1,403 | 10.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,180.50 | $1,574 | 6.9× |
| Radiologic exam swallow function contrast study (74230) | $834 | $1,112 | 4.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,357.50 | $1,810 | 8.0× |
| Radiologic examination femur 1 view (73551) | $543 | $724 | 6.4× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$741.75–$789.75 | $989–$1,053 | varies |
| Radiologic examination knee 1/2 views (73560) | $725.25 | $967 | 8.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $675 | $900 | 8.0× |
| Ribs bilateral 3 views (71110) | $1,062.75 | $1,417 | 10.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,303.25 | $3,071 | 5.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,440.25 | $4,587 | 8.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,014.25 | $4,019 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,794.25 | $5,059 | 7.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,921.25 | $3,895 | 5.5× |
| Scapula (73010) | $737.25 | $983 | 7.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $213 | $284 | 9.1× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$636–$803.25 | $848–$1,071 | varies |
| Shoulder Arthrography (73040) | $1,540.50 | $2,054 | 4.5× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$919.50–$1,180.50 | $1,226–$1,574 | varies |
| Special dosimetry (77331) | $458.25 | $611 | 3.5× |
| Special Physics Consult (77370) | $1,617.75 | $2,157 | 12.4× |
| Special teletherapy port plan (77321) | $1,974.75 | $2,633 | 5.4× |
| Special treatment procedure (77470) | $2,909.25 | $3,879 | 5.4× |
| Stereotactic Body Radiation Delivery (77373) | $8,438.25 | $11,251 | 4.9× |
| Sternoclavicular joints (71130) | $417 | $556 | 4.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,167.75 | $1,557 | 3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $897.75 | $1,197 | 2.5× |
| Testicular Imaging W/Flow (78761) | $2,857.50 | $3,810 | 7.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,995.75 | $2,661 | 5.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,796 | $3,728 | 7.7× |
| Ther rad simulaj-aided field setting simple (77280) | $1,110.75 | $1,481 | 8.5× |
| Thoracic spine 2 views (72070) | $1,147.50 | $1,530 | 11.3× |
| Thoracolumbar 2 views (72080) | $870.75 | $1,161 | 10.3× |
| Thyroid Imaging With Vascular Flow (78013) | $871.50 | $1,162 | 2.2× |
| Thyroid Met Imaging Body (78018) | $3,216 | $4,288 | 6.1× |
| Thyroid Uptake Measurement (78012) | $871.50 | $1,162 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,542.75 | $2,057 | 4.0× |
| Tx Devices Design & Construction Complex (77334) | $1,037.25 | $1,383 | 2.9× |
| Tx devices design & construction intermediate (77333) | $1,128 | $1,504 | 8.6× |
| Tx devices design & construction simple (77332) | $646.50 | $862 | 4.9× |
| Ultrasound Breast Limited (76642) | $873.75 | $1,165 | 10.3× |
| Ultrasound elastography first target lesion (76982) | $508.50 | $678 | 5.0× |
| Ultrasound Elastography Parenchyma (76981) | $735 | $980 | 7.2× |
| Ultrasound Exam Aaa Screen (76706) | $462 | $616 | 4.5× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$1,689.75–$1,951.50 | $2,253–$2,602 | varies |
| Umbilical-artery Doppler (OB) (76820) | $617.25 | $823 | 6.1× |
| Upper gi w/o kub (74240) | $1,605 | $2,140 | 9.4× |
| Ureteral Reflux Study (78740) | $1,644.75 | $2,193 | 4.2× |
| Urethrocystogram voiding (74455) | $1,589.25 | $2,119 | 6.9× |
| Urethrocystography retrograde (74450) | $1,549.50 | $2,066 | 6.7× |
| Us breast unilateral complete (76641) | $738 | $984 | 7.3× |
| Us chest (76604) | $1,110 | $1,480 | 10.9× |
| Us complete joint (76881) | $1,410 | $1,880 | 13.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$1,023.75–$1,359.75 | $1,365–$1,813 | varies |
| Us head (76506) | $915 | $1,220 | 9.0× |
| Us kidney transplant (76776) | $2,142.75 | $2,857 | 21.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,279.50 | $1,706 | 12.6× |
| Us ob detailed single fetus (76811) | $1,654.50 | $2,206 | 7.1× |
| Us ob limited 1 or more fetuses (76815) | $834 | $1,112 | 8.2× |
| Us ob transvaginal (76817) | $1,797.75 | $2,397 | 17.7× |
| Us pelvic non ob complete (76856) | $2,164.50 | $2,886 | 21.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,938.75 | $2,585 | 19.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,613.25 | $2,151 | 15.9× |
| Us retroperitoneal complete (76770) | $1,688.25 | $2,251 | 16.6× |
| Us retroperitoneal limited (76775) | $1,524 | $2,032 | 15.0× |
| Us scrotum and contents (76870) | $1,570.50 | $2,094 | 15.5× |
| Us spinal canal and contents (76800) | $1,500.75 | $2,001 | 14.8× |
| Us thyroid (76536) range across 3 matching MRF lines |
$1,314.75–$1,432.50 | $1,753–$1,910 | varies |
| Vein X-Ray Chest (75827) | $5,141.25 | $6,855 | 3.4× |
| Venogram Sinus/Jugular (75860) | $5,013.15 | $6,684.20 | 1.6× |
| Venography caval inferior serialography rs&i (75825) | $3,069.75 | $4,093 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,698 | $2,264 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,686 | $2,248 | 1.1× |
| Venography Renal Bilateral (75833) | $8,620.50 | $11,494 | 2.8× |
| Wrist 2 views (73100) | $630.75 | $841 | 7.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $699.75 | $933 | 8.3× |
| X-ray antegrade pyelogram tube (74425) | $1,674 | $2,232 | 4.9× |
| X-Ray Aorta Leg Arteries (75630) | $8,565 | $11,420 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $913.50 | $1,218 | 9.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $564 | $752 | 6.7× |
| X-Ray Exam Breast Specimen (76098) | $730.50 | $974 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,736.25 | $2,315 | 20.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,747.50 | $2,330 | 17.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,747.50 | $2,330 | 17.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $773.25 | $1,031 | 9.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$1,125–$1,518 | $1,500–$2,024 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,673.25 | $2,231 | 16.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $916.50 | $1,222 | 9.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,147.50 | $1,530 | 11.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,181.25 | $1,575 | 11.6× |
| X-Ray Exam L-S Spine Bending (72114) | $1,177.50 | $1,570 | 11.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$1,024.50–$1,086 | $1,366–$1,448 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,380.75 | $1,841 | 13.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,180.50 | $1,574 | 11.6× |
| X-ray humerus (73060) | $1,047.75 | $1,397 | 12.4× |
| X-ray IV pyelogram (ivp) (74400) | $2,073 | $2,764 | 12.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $754.50 | $1,006 | 8.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $730.50 | $974 | 8.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,299 | $1,732 | 12.8× |
| X-ray nose-rectum child f.b. (76010) | $414.75 | $553 | 4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,788.75 | $2,385 | 17.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $768 | $1,024 | 7.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $903 | $1,204 | 10.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,273.50 | $1,698 | 15.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,093.50 | $1,458 | 10.8× |
| X-ray thoracic spine 4 vw (72074) | $679.50 | $906 | 6.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,115 | $2,820 | 6.2× |
| X-Rays Bone Length Studies (77073) | $686.25 | $915 | 6.8× |
| X-Rays Bone Survey Complete (77075) | $1,156.50 | $1,542 | 11.4× |
| Xr c-spine 4 or 5 views (72050) | $1,672.50 | $2,230 | 16.5× |
| Xr facial bones less than 3 views (70140) | $474.75 | $633 | 5.6× |
| Xr orbits complete 4 views (70200) | $1,093.50 | $1,458 | 10.8× |
| Xr Tomogram Single Plane (76100) | $1,086.75 | $1,449 | 10.7× |
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.