Imaging prices at Portsmouth Regional Hospital
Portsmouth, NH · every code in this section with a posted price and a Medicare benchmark.
385 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) | $15,517 | $15,517 | 10.4× |
| Abdomen 1 View (74018) | $335 | $335 | 3.6× |
| Abdomen 2 views (74019) | $642 | $642 | 5.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,317 | $2,317 | 5.4× |
| Adrenal Cortex & Medulla Img (78075) | $5,977 | $5,977 | 4.3× |
| Angio internal mammary (75756) | $8,702 | $8,702 | 2.6× |
| Angio pulmonary bilat (75743) | $11,666 | $11,666 | 3.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,529 | $6,529 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $6,520 | $6,520 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $5,880 | $5,880 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,880 | $5,880 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $8,702 | $8,702 | 2.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$289–$729 | $289–$729 | varies |
| Aortography thoracic serialography rs&i (75605) | $14,962 | $14,962 | 2.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $12,192 | $12,192 | 3.6× |
| Artery X-Rays Abdomen (75726) | $12,628 | $12,628 | 2.1× |
| Artery X-Rays Adrenal Gland (75731) | $12,628 | $12,628 | 3.7× |
| Artery X-Rays Pelvis (75736) | $7,922 | $7,922 | 1.3× |
| Artery X-Rays Spine (75705) | $20,310 | $20,310 | 3.4× |
| Arthrogram ankle (73615) | $8,005 | $8,005 | 21.3× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$2,571–$2,728 | $2,571–$2,728 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$4,048–$8,084 | $4,048–$8,084 | varies |
| Basic radiation dosimetry calculation (77300) | $1,341 | $1,341 | 9.3× |
| Bone age studies (77072) | $1,058 | $1,058 | 9.4× |
| Bone Imaging 3 Phase (78315) | $4,625 | $4,625 | 10.7× |
| Bone Imaging Multiple Areas (78305) | $3,520 | $3,520 | 8.2× |
| Bone Imaging Whole Body (78306) | $3,064 | $3,064 | 7.1× |
| Bone survey infant (77076) | $462 | $462 | 4.1× |
| Brachytx isodose complex (77318) | $3,519 | $3,519 | 8.7× |
| Brachytx isodose intermed (77317) | $2,860 | $2,860 | 7.1× |
| Brachytx Isodose Plan Simple (77316) | $2,008 | $2,008 | 5.0× |
| Brain Image W/Flow < 4 Views (78601) | $1,766 | $1,766 | 4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,948 | $1,948 | 3.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,548 | $1,548 | 2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $16,286 | $16,286 | 10.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $6,807 | $6,807 | 18.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $6,807 | $6,807 | 8.1× |
| Cat Scan Follow-Up Study (76380) | $4,870 | $4,870 | 51.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,548 | $1,548 | 2.6× |
| Cerebrospinal Fluid Scan (78630) | $2,225 | $2,225 | 3.8× |
| Chest 1 view (71045) | $335 | $335 | 3.6× |
| Chest 2 views (71046) | $335 | $335 | 3.6× |
| Chest 3 views (71047) | $335 | $335 | 3.6× |
| Chest 4 or more views (71048) | $642 | $642 | 5.7× |
| Cholecystography Oral Contrast (74290) | $1,732 | $1,732 | 9.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$1,074–$2,138 | $1,074–$2,138 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $577 | $577 | 5.1× |
| Continuing medical physics consltj pr wk (77336) | $2,177 | $2,177 | 15.0× |
| Contrast Exam Abdominl Aorta (75625) | $14,962 | $14,962 | 4.4× |
| Contrast X-Ray Bladder (74430) | $915 | $915 | 2.4× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$3,566–$7,124 | $3,566–$7,124 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$3,943–$7,875 | $3,943–$7,875 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $14,436 | $14,436 | 38.4× |
| CT abdomen and pelvis without contrast (74176) | $8,838 | $8,838 | 34.4× |
| CT abdomen w contrast (74160) | $9,869 | $9,869 | 52.2× |
| CT abdomen w wo contrast (74170) | $10,399 | $10,399 | 55.0× |
| CT abdomen w/o contrast (74150) | $6,395 | $6,395 | 56.8× |
| CT Angio Abdomen and Pelvis (74174) | $15,358 | $15,358 | 40.9× |
| CT Angio Chest (71275) | $11,214 | $11,214 | 59.3× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$4,748–$11,214 | $4,748–$11,214 | varies |
| CT angio hrt w/3d image (75574) | $12,827 | $12,827 | 34.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$11,541–$16,815 | $11,541–$16,815 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,748–$11,214 | $4,748–$11,214 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $11,541 | $11,541 | 61.1× |
| CT cervical spine w/ contrast (72126) | $9,869 | $9,869 | 26.3× |
| CT cervical spine w/o contrast (72125) | $8,182 | $8,182 | 72.6× |
| CT cervical spine w/wo cont (72127) | $10,399 | $10,399 | 55.0× |
| CT chest w contrast (71260) | $9,328 | $9,328 | 49.4× |
| CT chest w/wo contrast (71270) | $10,048 | $10,048 | 53.2× |
| CT colonography screening (74263) | $6,093 | $6,093 | 23.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $7,390 | $7,390 | 39.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $5,919 | $5,919 | 52.5× |
| CT head/brain with contrast (70460) | $10,036 | $10,036 | 53.1× |
| CT head/brain without and with contrast (70470) | $11,206 | $11,206 | 59.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $12,461 | $12,461 | 33.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $12,827 | $12,827 | 136.8× |
| CT hrt w/3d image congen (75573) | $12,827 | $12,827 | 34.1× |
| CT iac w contrast (70481) | $8,851 | $8,851 | 46.8× |
| CT l-spine w&w/o contrast (72133) | $10,703 | $10,703 | 56.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$6,707–$10,353 | $6,707–$10,353 | varies |
| CT lower extremity w/contrast material (73701) | $9,789 | $9,789 | 51.8× |
| CT lumbar spine w contrast (72132) | $9,869 | $9,869 | 26.3× |
| CT lumbar spine w/o contrast (72131) | $7,983 | $7,983 | 70.9× |
| CT maxillofacial w contrast (70487) | $9,552 | $9,552 | 50.5× |
| CT maxillofacial wo contrast (70486) | $7,415 | $7,415 | 65.8× |
| CT neck tissue combo (70492) | $10,399 | $10,399 | 55.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $10,703 | $10,703 | 56.6× |
| CT orbits w/o contrast (70480) | $5,829 | $5,829 | 51.7× |
| CT pelvis w&w/o contrast (72194) | $10,399 | $10,399 | 55.0× |
| CT pelvis w/o contrast (72192) | $6,162 | $6,162 | 54.7× |
| CT scan of leg combo (73702) | $10,279 | $10,279 | 54.4× |
| CT scans face/jaw combo (70488) | $10,399 | $10,399 | 55.0× |
| CT soft tissue neck w contrast (70491) | $9,552 | $9,552 | 50.5× |
| CT soft tissue neck w/o contrast (70490) | $6,191 | $6,191 | 55.0× |
| CT thoracic spine w contrast (72129) | $7,464 | $7,464 | 39.5× |
| CT thoracic spine w/o contrast (72128) | $7,464 | $7,464 | 66.3× |
| CT thoracic spine w/wo cont (72130) | $10,703 | $10,703 | 56.6× |
| CT thorax w/o contrast (71250) | $6,690 | $6,690 | 59.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$6,575–$10,353 | $6,575–$10,353 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$11,541–$17,308 | $11,541–$17,308 | varies |
| CT upper extremity with contrast (73201) | $9,095 | $9,095 | 24.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $10,194 | $10,194 | 53.9× |
| Cta Abdomen (74175) | $11,214 | $11,214 | 59.3× |
| CTA pelvis (72191) | $11,214 | $11,214 | 59.3× |
| Diskography lumbar (72295) | $16,493 | $16,493 | 7.8× |
| Dxa Bone Density Axial (77080) | $1,414 | $1,414 | 12.6× |
| Echo exam uterus (76831) | $1,974 | $1,974 | 7.7× |
| Echo Guide For Artery Repair (76936) | $1,875 | $1,875 | 8.1× |
| Echograp Trans R Pros Study (76873) | $382 | $382 | 3.4× |
| Esophagram (74220) | $1,662 | $1,662 | 8.8× |
| Fetal Biophys Profile W/Nst (76818) | $2,211 | $2,211 | 19.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,686 | $1,686 | 15.0× |
| Fluoroscopy up to 1 hr (76000) | $1,629 | $1,629 | 6.3× |
| Follow-Up Angiography (75898) | $12,614 | $12,614 | 3.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$289–$368 | $289–$368 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$1,099–$2,171 | $1,099–$2,171 | varies |
| Gastric emptying imaging study (78264) | $2,468 | $2,468 | 5.7× |
| Gastroesophageal Reflux Exam (78262) | $2,596 | $2,596 | 6.0× |
| Gated Heart Planar Single (78472) | $4,993 | $4,993 | 11.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$289–$434 | $289–$434 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,268 | $4,268 | 5.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $9,495 | $9,495 | 12.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,417 | $6,417 | 8.6× |
| Heart Image (Pet) Multiple (78492) | $16,286 | $16,286 | 10.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $10,372 | $10,372 | 3.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,529 | $6,529 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,839 | $1,839 | 3.1× |
| Hepatobiliary System Imaging (78226) | $1,839 | $1,839 | 4.3× |
| Ht Musc Image Planar Mult (78454) | $5,642 | $5,642 | 4.0× |
| Ht Muscle Image Spect Sing (78451) | $5,642 | $5,642 | 4.0× |
| Hysterosalpingogram (74740) | $2,279 | $2,279 | 8.9× |
| Image fusion (77399) | $1,420 | $1,420 | 9.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,875 | $1,875 | 20.0× |
| Infant hip ultrasound, limited static exam (76886) | $1,875 | $1,875 | 20.0× |
| Interstitial radiation source applic complex (77778) | $23,290 | $23,290 | 31.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,580 | $2,580 | 3.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,047 | $2,047 | 3.4× |
| Intracavitary radiation source applic simple (77761) | $2,047 | $2,047 | 3.4× |
| Intraop radiaj tx deliver xray single tx session (77424) | $27,020 | $27,020 | 3.4× |
| K Flow/Funct Image Multiple (78709) | $3,084 | $3,084 | 5.3× |
| K Flow/Funct Image W/Drug (78708) | $2,162 | $2,162 | 3.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,948 | $1,948 | 3.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $2,041 | $2,041 | 4.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$500–$988 | $500–$988 | varies |
| Leveen/Shunt Patency Exam (78291) | $2,624 | $2,624 | 6.1× |
| Liver & Spleen Imaging Static Only (78215) | $4,317 | $4,317 | 10.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $4,317 | $4,317 | 10.0× |
| Liver imaging static only (78201) | $2,687 | $2,687 | 4.6× |
| Liver imaging w/vascular flow (78202) | $2,687 | $2,687 | 4.6× |
| Lung Perf&Ventilat Diferentl (78598) | $1,983 | $1,983 | 3.4× |
| Lung perfusion differential (78597) | $1,269 | $1,269 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,983 | $1,983 | 3.4× |
| Lung Ventilation Imaging (78579) | $1,269 | $1,269 | 2.9× |
| Lymph System Imaging (78195) | $2,776 | $2,776 | 4.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $5,990 | $5,990 | 3.5× |
| Lymphangiography extremity only unilateral rs&i (75801) | $2,303 | $2,303 | 3.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $12,192 | $12,192 | 3.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $12,192 | $12,192 | 3.6× |
| Magnetic Image Jaw Joint (70336) | $6,891 | $6,891 | 26.8× |
| Mammary ductogram or galactogram single (77053) | $1,296 | $1,296 | 5.0× |
| Meckels Divert Exam (78290) | $2,966 | $2,966 | 6.9× |
| Mlc imrt design & construction per imrt plan (77338) | $7,288 | $7,288 | 18.1× |
| Mr safety determination physician/other qhp (76016) | $290 | $290 | 3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $81 | $81 | 2.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $302 | $302 | 2.9× |
| Mr safety implt pos&/immoblj (76019) | $196 | $196 | 3.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $796 | $796 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $8,286 | $8,286 | 22.0× |
| MRA head w/o contrast (70544) | $6,769 | $6,769 | 26.3× |
| MRA head with contrast (70545) | $8,286 | $8,286 | 22.0× |
| MRA neck w contrast (70548) | $7,613 | $7,613 | 20.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,286 | $8,286 | 22.0× |
| MRA neck w/o contrast (70547) | $6,769 | $6,769 | 26.3× |
| MRI abdomen w contrast (74182) | $9,630 | $9,630 | 25.6× |
| MRI abdomen w/o contrast (74181) | $8,172 | $8,172 | 31.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$6,891–$9,769 | $6,891–$9,769 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$8,458–$12,686 | $8,458–$12,686 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,891 | $6,891 | 8.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,083 | $4,083 | 15.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,328 | $3,328 | 12.9× |
| MRI cardiac w/o cont stress (75559) | $6,338 | $6,338 | 10.8× |
| MRI cardiac w/o contrast (75557) | $6,338 | $6,338 | 24.7× |
| MRI cervical spine w contrast (72142) | $7,613 | $7,613 | 20.3× |
| MRI cervical spine w/o cont (72141) | $7,613 | $7,613 | 29.6× |
| MRI chest w/o contrast (71550) | $8,172 | $8,172 | 31.8× |
| MRI chest wo w contrast (71552) | $9,630 | $9,630 | 25.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$6,891–$10,332 | $6,891–$10,332 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$8,458–$12,686 | $8,458–$12,686 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$6,891–$9,769 | $6,891–$9,769 | varies |
| MRI lumbar spine w contrast (72149) | $7,613 | $7,613 | 20.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $9,146 | $9,146 | 24.3× |
| MRI orbit face &/neck w/o contrast (70540) | $6,891 | $6,891 | 26.8× |
| MRI orbit face neck w contrast (70542) | $8,458 | $8,458 | 22.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $8,458 | $8,458 | 22.5× |
| MRI pelvis w/o & w contrast (72197) | $9,630 | $9,630 | 25.6× |
| MRI pelvis w/o contrast (72195) | $8,172 | $8,172 | 31.8× |
| MRI thoracic spine w/o contrast (72146) | $7,613 | $7,613 | 29.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,891 | $6,891 | 18.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,891 | $6,891 | 26.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$8,458–$12,688 | $8,458–$12,688 | varies |
| MRI, abdomen, combo (74183) | $9,630 | $9,630 | 25.6× |
| MRI, dorsal spine combo (72157) | $9,146 | $9,146 | 24.3× |
| MRI, dorsal spine contrast (72147) | $7,613 | $7,613 | 20.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$6,891–$10,332 | $6,891–$10,332 | varies |
| MRI, joint upper extrem combo (73223) | $8,458 | $8,458 | 22.5× |
| MRI, lumbar spine combo (72158) | $9,146 | $9,146 | 24.3× |
| Myelogram cervical (72240) | $5,327 | $5,327 | 6.3× |
| Myelogram Lumbar (72265) | $5,342 | $5,342 | 6.3× |
| Myelography thoracic (72255) | $5,342 | $5,342 | 6.3× |
| Myelograpy 2/more regions rs&i (72270) | $5,342 | $5,342 | 6.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $16,286 | $16,286 | 11.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,642 | $5,642 | 4.0× |
| Myocardial Spect Multiple Studies (78452) | $5,642 | $5,642 | 4.0× |
| Neck soft tissue (70360) | $1,025 | $1,025 | 10.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $940 | $940 | 2.3× |
| Nonvascular Shunt X-Ray (75809) | $1,922 | $1,922 | 17.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $23,125 | $23,125 | 15.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,572 | $1,572 | 6.3× |
| Nuclear Rx Oral Admin (79005) | $3,613 | $3,613 | 14.4× |
| Ob us nuchal meas 1 gest (76813) | $960 | $960 | 8.5× |
| Parathyroid Planar Imaging (78070) | $1,548 | $1,548 | 3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,605 | $1,605 | 3.7× |
| Pelvis 1 or 2 views (72170) | $1,085 | $1,085 | 9.6× |
| Pet Image W/Ct Lmtd (78814) | $16,286 | $16,286 | 10.6× |
| PET image w/CT, full body (78816) | $16,286 | $16,286 | 10.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $16,286 | $16,286 | 10.6× |
| Pet Myocardial Sngl Study (78491) | $16,286 | $16,286 | 10.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $10,372 | $10,372 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,238 | $3,238 | 7.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $2,091 | $2,091 | 18.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,120 | $2,120 | 3.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,041–$2,079 | $1,041–$2,079 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$883–$1,761 | $883–$1,761 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,024–$1,875 | $1,024–$1,875 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,109 | $1,109 | 9.8× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$819–$1,633 | $819–$1,633 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,104–$2,191 | $1,104–$2,191 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$1,085–$2,170 | $1,085–$2,170 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$429–$852 | $429–$852 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$348–$728 | $348–$728 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,076 | $1,076 | 11.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$948–$1,887 | $948–$1,887 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $1,172 | $1,172 | 12.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $2,239 | $2,239 | 11.8× |
| Radex Spine 1 View Specify Level (72020) | $943 | $943 | 10.1× |
| Radex Sternum Minimum 2 Views (71120) | $1,036 | $1,036 | 11.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,645 | $1,645 | 17.5× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$883–$1,761 | $883–$1,761 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$429–$852 | $429–$852 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,083–$2,156 | $1,083–$2,156 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,236 | $1,236 | 11.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $35,097 | $35,097 | 4.4× |
| Radiation treatment delivery level 1 (77402) | $1,782 | $1,782 | 16.2× |
| Radiation treatment delivery level 2 (77407) | $2,966 | $2,966 | 7.1× |
| Radiation treatment delivery level 3 (77412) | $2,834 | $2,834 | 4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,514 | $1,514 | 13.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $642 | $642 | 5.7× |
| Radiologic exam colon double contrast study (74280) | $3,009 | $3,009 | 15.9× |
| Radiologic exam colon single contrast study (74270) | $2,439 | $2,439 | 12.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$581–$872 | $581–$872 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,475 | $1,475 | 13.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $792 | $792 | 4.2× |
| Radiologic exam swallow function contrast study (74230) | $1,751 | $1,751 | 9.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,604 | $2,604 | 13.8× |
| Radiologic examination femur 1 view (73551) | $1,413 | $1,413 | 15.1× |
| Radiologic examination femur minimum 2 views (73552) | $1,413 | $1,413 | 15.1× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$1,099–$2,171 | $1,099–$2,171 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $463 | $463 | 4.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $1,192 | $1,192 | 12.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$1,104–$2,191 | $1,104–$2,191 | varies |
| Radiopharm Dacryocystography (78660) | $1,396 | $1,396 | 3.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $2,534 | $2,534 | 6.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,995 | $1,995 | 4.8× |
| Ribs bilateral 3 views (71110) | $2,528 | $2,528 | 22.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,208 | $3,208 | 7.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,624 | $2,624 | 6.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,319 | $6,319 | 10.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $6,152 | $6,152 | 10.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,979 | $3,979 | 6.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,779 | $1,779 | 7.1× |
| Rp Therapy Intravenous Administration (79101) | $1,612 | $1,612 | 6.4× |
| Salivary Gland Imaging Serial Images (78231) | $1,853 | $1,853 | 4.3× |
| Scapula (73010) range across 3 matching MRF lines |
$1,074–$2,138 | $1,074–$2,138 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $52 | $52 | 2.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$515–$1,024 | $515–$1,024 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,293–$8,190 | $1,293–$8,190 | varies |
| Skull less than 4 views (70250) | $1,254 | $1,254 | 11.1× |
| Special dosimetry (77331) | $1,406 | $1,406 | 9.7× |
| Special Physics Consult (77370) | $2,012 | $2,012 | 13.9× |
| Special teletherapy port plan (77321) | $2,138 | $2,138 | 5.3× |
| Special treatment procedure (77470) | $7,239 | $7,239 | 12.2× |
| Srs Multisource (77371) | $28,006 | $28,006 | 3.5× |
| Stereotactic Body Radiation Delivery (77373) | $20,474 | $20,474 | 10.6× |
| Sternoclavicular joints (71130) | $1,200 | $1,200 | 12.8× |
| Superior sagittal sinus venogram (75870) | $12,192 | $12,192 | 3.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $971 | $971 | 8.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $7,685 | $7,685 | 19.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,965 | $2,965 | 7.3× |
| Temporomandble Jt Arthrography Rs&I (70332) | $5,986 | $5,986 | 23.3× |
| Testicular Imaging W/Flow (78761) | $2,041 | $2,041 | 4.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,484 | $5,484 | 13.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,297 | $3,297 | 8.2× |
| Ther rad simulaj-aided field setting simple (77280) | $2,642 | $2,642 | 18.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $760 | $760 | 4.0× |
| Thoracic spine 2 views (72070) | $691 | $691 | 6.1× |
| Thoracic spine 3 views (72072) | $1,434 | $1,434 | 12.7× |
| Thyroid Imaging With Vascular Flow (78013) | $2,831 | $2,831 | 6.6× |
| Thyroid Met Imaging Body (78018) | $4,930 | $4,930 | 8.4× |
| Thyroid Uptake Measurement (78012) | $2,010 | $2,010 | 4.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,084 | $3,084 | 7.2× |
| Tx Devices Design & Construction Complex (77334) | $4,038 | $4,038 | 10.0× |
| Tx devices design & construction intermediate (77333) | $1,685 | $1,685 | 11.6× |
| Tx devices design & construction simple (77332) | $1,349 | $1,349 | 9.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,247–$1,887 | $1,247–$1,887 | varies |
| Ultrasound Exam Aaa Screen (76706) | $646 | $646 | 5.7× |
| Ultrasound, abdomen limited (76705) | $801 | $801 | 7.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $437 | $437 | 4.0× |
| Upper gi w/o kub (74240) | $2,026 | $2,026 | 10.7× |
| Ureteral Reflux Study (78740) | $1,548 | $1,548 | 3.6× |
| Urethrocystogram voiding (74455) | $2,235 | $2,235 | 8.7× |
| Urethrocystography retrograde (74450) | $1,361 | $1,361 | 5.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,247–$1,887 | $1,247–$1,887 | varies |
| Us chest (76604) | $2,097 | $2,097 | 18.6× |
| Us complete joint (76881) | $1,555 | $1,555 | 13.8× |
| Us exam, pelvic, limited (76857) | $1,345 | $1,345 | 11.9× |
| Us head (76506) | $664 | $664 | 5.9× |
| Us kidney transplant (76776) | $463 | $463 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,243 | $1,243 | 11.0× |
| Us ob limited 1 or more fetuses (76815) | $542 | $542 | 4.8× |
| Us ob transvaginal (76817) | $1,338 | $1,338 | 11.9× |
| Us pelvic non ob complete (76856) | $1,974 | $1,974 | 17.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $686 | $686 | 6.1× |
| Us retroperitoneal limited (76775) | $1,974 | $1,974 | 17.5× |
| Us scrotum and contents (76870) | $2,074 | $2,074 | 18.4× |
| Us spinal canal and contents (76800) | $693 | $693 | 6.2× |
| Us thyroid (76536) | $1,887 | $1,887 | 16.8× |
| Vein X-Ray Chest (75827) | $11,666 | $11,666 | 6.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,529 | $6,529 | 1.9× |
| Vein X-Ray Skull Epidural (75872) | $2,211 | $2,211 | 3.3× |
| Vein X-Ray Spleen/Liver (75810) | $10,372 | $10,372 | 3.0× |
| Venogram Sinus/Jugular (75860) | $6,110 | $6,110 | 1.8× |
| Venography Adrenal Unilateral (75840) | $12,628 | $12,628 | 3.7× |
| Venography caval inferior serialography rs&i (75825) | $11,666 | $11,666 | 3.4× |
| Venography extremity bilateral rs&i (75822) | $7,217 | $7,217 | 4.3× |
| Venography extremity unilateral rs&i (75820) | $4,507 | $4,507 | 2.7× |
| Venography Orbital Rs&I (75880) | $2,303 | $2,303 | 3.4× |
| Venography Renal Bilateral (75833) | $12,628 | $12,628 | 3.7× |
| Venous sampling by catheter (75893) | $22,458 | $22,458 | 3.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$337–$505 | $337–$505 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,143 | $1,143 | 12.2× |
| X-ray antegrade pyelogram tube (74425) | $2,571 | $2,571 | 6.8× |
| X-Ray Aorta Leg Arteries (75630) | $14,962 | $14,962 | 4.4× |
| X-Ray Bend Only L-S Spine (72120) | $1,209 | $1,209 | 10.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$954–$1,906 | $954–$1,906 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,571 | $2,571 | 4.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $391 | $391 | 4.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $647 | $647 | 5.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,236 | $1,236 | 11.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $704 | $704 | 7.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $850 | $850 | 9.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $850 | $850 | 7.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $850 | $850 | 7.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $850 | $850 | 7.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $997 | $997 | 8.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,024 | $1,024 | 9.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,177 | $1,177 | 12.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,904 | $1,904 | 16.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,817 | $1,817 | 16.1× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$788–$1,568 | $788–$1,568 | varies |
| X-ray humerus (73060) | $804 | $804 | 8.6× |
| X-ray IV pyelogram (ivp) (74400) | $4,346 | $4,346 | 23.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,418 | $1,418 | 15.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $933 | $933 | 9.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,209 | $1,209 | 10.7× |
| X-ray nose-rectum child f.b. (76010) | $2,439 | $2,439 | 26.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,293 | $1,293 | 11.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,164 | $1,164 | 12.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,542 | $1,542 | 16.4× |
| X-Ray Stress View (77071) | $948 | $948 | 10.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,074 | $2,074 | 5.5× |
| X-Rays Bone Length Studies (77073) | $1,153 | $1,153 | 10.2× |
| X-Rays Bone Survey Complete (77075) | $2,818 | $2,818 | 25.0× |
| Xr c-spine 4 or 5 views (72050) | $888 | $888 | 7.9× |
| Xr orbits complete 4 views (70200) | $1,238 | $1,238 | 11.0× |
| Xr Tomogram Single Plane (76100) | $943 | $943 | 8.4× |
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.