Imaging prices at Rady Children's Hospital Orange County
Orange, CA · every code in this section with a posted price and a Medicare benchmark.
413 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) | $15,105 | $15,105 | 8.5× |
| Abdomen 1 View (74018) | $846 | $846 | 7.6× |
| Abdomen 2 views (74019) | $1,302 | $1,302 | 9.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 5 matching MRF lines |
$4,168–$6,198 | $4,168–$6,198 | varies |
| Adrenal Cortex & Medulla Img (78075) | $4,355 | $4,355 | 2.6× |
| Angio internal mammary (75756) range across 10 matching MRF lines |
$2,726–$5,561 | $2,726–$5,561 | varies |
| Angio pulmonary bilat (75743) range across 6 matching MRF lines |
$10,442–$14,752 | $10,442–$14,752 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 5 matching MRF lines |
$10,442–$13,227 | $10,442–$13,227 | varies |
| Angiography extremity bilateral rs&i (75716) range across 7 matching MRF lines |
$10,508–$11,034 | $10,508–$11,034 | varies |
| Angiography extremity unilateral rs&i (75710) range across 15 matching MRF lines |
$8,182–$9,451 | $8,182–$9,451 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 11 matching MRF lines |
$6,048–$6,445 | $6,048–$6,445 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 6 matching MRF lines |
$4,339–$5,561 | $4,339–$5,561 | varies |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$476–$590 | $476–$590 | varies |
| Aortography thoracic serialography rs&i (75605) range across 6 matching MRF lines |
$11,161–$11,720 | $11,161–$11,720 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $3,291 | $3,291 | 0.8× |
| Artery X-Rays Abdomen (75726) range across 6 matching MRF lines |
$6,101–$6,414 | $6,101–$6,414 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 9 matching MRF lines |
$5,634–$6,745 | $5,634–$6,745 | varies |
| Artery X-Rays Pelvis (75736) range across 7 matching MRF lines |
$8,433–$8,855 | $8,433–$8,855 | varies |
| Artery X-Rays Spine (75705) range across 7 matching MRF lines |
$7,966–$8,365 | $7,966–$8,365 | varies |
| Arthrogram ankle (73615) | $880 | $880 | 2.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$899–$961 | $899–$961 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$899–$944 | $899–$944 | varies |
| Basic radiation dosimetry calculation (77300) | $955 | $955 | 5.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$565–$1,645 | $565–$1,645 | varies |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$4,168–$4,728 | $4,168–$4,728 | varies |
| Bone Imaging Limited Area (78300) range across 4 matching MRF lines |
$2,791–$4,728 | $2,791–$4,728 | varies |
| Bone Imaging Multiple Areas (78305) range across 4 matching MRF lines |
$3,179–$4,728 | $3,179–$4,728 | varies |
| Bone Imaging Whole Body (78306) range across 5 matching MRF lines |
$4,168–$5,374 | $4,168–$5,374 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$2,077–$2,181 | $2,077–$2,181 | varies |
| Bone marrow imaging; multiple areas (78103) range across 2 matching MRF lines |
$1,714–$1,800 | $1,714–$1,800 | varies |
| Bone marrow imaging; whole body (78104) | $1,579 | $1,579 | 3.1× |
| Bone survey infant (77076) | $1,645 | $1,645 | 12.2× |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$4,477–$4,862 | $4,477–$4,862 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 4 matching MRF lines |
$4,656–$5,054 | $4,656–$5,054 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$8,392–$14,498 | $8,392–$14,498 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$3,376–$4,275 | $3,376–$4,275 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,231 | $4,231 | 4.2× |
| Cardiac Shunt Detection (78428) | $5,514 | $5,514 | 10.7× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$1,841–$2,130 | $1,841–$2,130 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 4 matching MRF lines |
$4,984–$5,409 | $4,984–$5,409 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $4,984 | $4,984 | 7.1× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$5,652–$5,935 | $5,652–$5,935 | varies |
| Chest 1 view (71045) range across 6 matching MRF lines |
$1,105–$2,718 | $1,105–$2,718 | varies |
| Chest 2 views (71046) | $1,523 | $1,523 | 13.6× |
| Chest 3 views (71047) | $2,298 | $2,298 | 20.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$779–$2,630 | $779–$2,630 | varies |
| Cholecystography Oral Contrast (74290) | $1,886 | $1,886 | 8.4× |
| Clavicle complete (73000) | $648 | $648 | 5.8× |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$1,005–$1,183 | $1,005–$1,183 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 8 matching MRF lines |
$6,820–$7,528 | $6,820–$7,528 | varies |
| Contrast X-Ray Bladder (74430) range across 5 matching MRF lines |
$1,304–$3,785 | $1,304–$3,785 | varies |
| Contrast X-Ray Of Elbow (73085) | $880 | $880 | 2.0× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,031–$1,083 | $1,031–$1,083 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $1,475 | $1,475 | 6.5× |
| Corpora cavernosography (74445) | $1,182 | $1,182 | 8.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$8,507–$9,161 | $8,507–$9,161 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$6,867–$7,395 | $6,867–$7,395 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$4,074–$5,531 | $4,074–$5,531 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$4,668–$5,531 | $4,668–$5,531 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$3,771–$5,498 | $3,771–$5,498 | varies |
| CT Angio Abdomen and Pelvis (74174) | $7,165 | $7,165 | 16.0× |
| CT Angio Chest (71275) | $5,550 | $5,550 | 24.6× |
| CT Angio Head (70496) range across 4 matching MRF lines |
$5,186–$5,471 | $5,186–$5,471 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$1,106–$1,584 | $1,106–$1,584 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$4,302–$5,186 | $4,302–$5,186 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$4,847–$5,186 | $4,847–$5,186 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$4,302–$5,186 | $4,302–$5,186 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$4,074–$4,157 | $4,074–$4,157 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$3,294–$4,681 | $3,294–$4,681 | varies |
| CT cervical spine w/wo cont (72127) | $4,079 | $4,079 | 18.1× |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$4,074–$5,918 | $4,074–$5,918 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$4,069–$5,467 | $4,069–$5,467 | varies |
| CT head/brain with contrast (70460) range across 5 matching MRF lines |
$3,810–$4,609 | $3,810–$4,609 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$4,362–$4,742 | $4,362–$4,742 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$1,216–$1,371 | $1,216–$1,371 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $407 | $407 | 3.6× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$1,313–$1,481 | $1,313–$1,481 | varies |
| CT iac w contrast (70481) range across 5 matching MRF lines |
$3,561–$4,077 | $3,561–$4,077 | varies |
| CT l-spine w&w/o contrast (72133) | $3,469 | $3,469 | 15.4× |
| CT lower ext w/o (73700) range across 14 matching MRF lines |
$3,294–$3,525 | $3,294–$3,525 | varies |
| CT lower extremity w/contrast material (73701) range across 18 matching MRF lines |
$3,561–$4,290 | $3,561–$4,290 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$3,810–$3,907 | $3,810–$3,907 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$958–$3,709 | $958–$3,709 | varies |
| CT maxillofacial w contrast (70487) range across 6 matching MRF lines |
$2,275–$3,810 | $2,275–$3,810 | varies |
| CT maxillofacial wo contrast (70486) range across 8 matching MRF lines |
$1,096–$3,525 | $1,096–$3,525 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$3,860–$4,362 | $3,860–$4,362 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 5 matching MRF lines |
$4,079–$4,668 | $4,079–$4,668 | varies |
| CT orbits w/o contrast (70480) range across 6 matching MRF lines |
$2,105–$3,525 | $2,105–$3,525 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$4,079–$5,467 | $4,079–$5,467 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$3,771–$4,229 | $3,771–$4,229 | varies |
| CT scan of leg combo (73702) range across 16 matching MRF lines |
$4,079–$4,765 | $4,079–$4,765 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$1,987–$4,362 | $1,987–$4,362 | varies |
| CT soft tissue neck w contrast (70491) range across 7 matching MRF lines |
$2,912–$4,813 | $2,912–$4,813 | varies |
| CT soft tissue neck w/o contrast (70490) range across 5 matching MRF lines |
$3,294–$4,080 | $3,294–$4,080 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$3,810–$4,109 | $3,810–$4,109 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$634–$3,970 | $634–$3,970 | varies |
| CT thoracic spine w/wo cont (72130) | $3,839 | $3,839 | 17.0× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$3,771–$4,441 | $3,771–$4,441 | varies |
| CT unlisted procedure (76497) | $269 | $269 | 2.4× |
| CT upper ext wo (73200) range across 14 matching MRF lines |
$3,294–$3,525 | $3,294–$3,525 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 17 matching MRF lines |
$3,619–$4,572 | $3,619–$4,572 | varies |
| CT upper extremity with contrast (73201) range across 21 matching MRF lines |
$2,724–$4,273 | $2,724–$4,273 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $7,161 | $7,161 | 31.7× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$4,362–$4,668 | $4,362–$4,668 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$4,847–$5,186 | $4,847–$5,186 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,007–$1,058 | $1,007–$1,058 | varies |
| Discography Cerv/Thor Spine (72285) | $3,936 | $3,936 | 1.6× |
| Diskography lumbar (72295) | $3,936 | $3,936 | 1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$283–$672 | $283–$672 | varies |
| Dxa Bone Density Axial (77080) | $1,176 | $1,176 | 8.7× |
| Dxa bone density study (77085) | $727 | $727 | 5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$554–$774 | $554–$774 | varies |
| Echo exam of fetal heart (76825) | $3,514 | $3,514 | 5.0× |
| Echo Guide For Artery Repair (76936) range across 5 matching MRF lines |
$481–$1,449 | $481–$1,449 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,551 | $2,551 | 8.3× |
| Esophageal Motility Study (78258) range across 3 matching MRF lines |
$4,758–$4,996 | $4,758–$4,996 | varies |
| Esophagram (74220) | $1,763 | $1,763 | 7.8× |
| Fetal Biophys Profile W/Nst (76818) | $1,531 | $1,531 | 11.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $5,633 | $5,633 | 18.4× |
| Fluoroscopy up to 1 hr (76000) range across 15 matching MRF lines |
$2,013–$3,366 | $2,013–$3,366 | varies |
| Follow-Up Angiography (75898) range across 4 matching MRF lines |
$2,327–$2,377 | $2,327–$2,377 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$279–$536 | $279–$536 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$529–$648 | $529–$648 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$5,927–$6,224 | $5,927–$6,224 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $6,653 | $6,653 | 12.9× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$4,212–$6,224 | $4,212–$6,224 | varies |
| Gated Heart Planar Single (78472) | $11,060 | $11,060 | 21.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $6,653 | $6,653 | 9.5× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$409–$536 | $409–$536 | varies |
| Heart first pass single,planar (78481) | $3,829 | $3,829 | 5.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$9,756–$10,244 | $9,756–$10,244 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$9,756–$10,244 | $9,756–$10,244 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$4,728–$10,533 | $4,728–$10,533 | varies |
| Hepatobiliary System Imaging (78226) range across 4 matching MRF lines |
$4,168–$10,567 | $4,168–$10,567 | varies |
| Ht Muscle Image Spect Sing (78451) | $7,361 | $7,361 | 4.4× |
| Hysterosalpingogram (74740) | $1,298 | $1,298 | 4.2× |
| Image fusion (77399) range across 3 matching MRF lines |
$514–$1,675 | $514–$1,675 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $3,577 | $3,577 | 32.0× |
| Infant hip ultrasound, limited static exam (76886) | $1,669 | $1,669 | 14.9× |
| Joint Survey Single View (77077) | $1,538 | $1,538 | 11.4× |
| K Flow/Funct Image Multiple (78709) | $7,531 | $7,531 | 10.8× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$6,938–$7,531 | $6,938–$7,531 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$6,938–$7,531 | $6,938–$7,531 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $3,417 | $3,417 | 6.6× |
| Kidney Imaging Morphol (78700) range across 4 matching MRF lines |
$2,223–$6,676 | $2,223–$6,676 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $4,079 | $4,079 | 7.9× |
| Knee 3 Views (73562) | $828 | $828 | 7.4× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $4,130 | $4,130 | 8.0× |
| Leveen/Shunt Patency Exam (78291) | $2,386 | $2,386 | 4.6× |
| Liver & Spleen Imaging Static Only (78215) range across 4 matching MRF lines |
$1,295–$4,324 | $1,295–$4,324 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 4 matching MRF lines |
$2,424–$4,324 | $2,424–$4,324 | varies |
| Liver imaging static only (78201) | $20,780 | $20,780 | 29.8× |
| Liver imaging w/vascular flow (78202) | $1,725 | $1,725 | 2.5× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$2,388–$2,593 | $2,388–$2,593 | varies |
| Lung perfusion differential (78597) range across 3 matching MRF lines |
$2,761–$4,324 | $2,761–$4,324 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$3,439–$3,732 | $3,439–$3,732 | varies |
| Lung Ventilation Imaging (78579) | $5,557 | $5,557 | 10.8× |
| Lymph System Imaging (78195) range across 4 matching MRF lines |
$5,076–$10,178 | $5,076–$10,178 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,519 | $1,519 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $761 | $761 | 0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,563 | $1,563 | 0.4× |
| Magnetic Image Jaw Joint (70336) range across 6 matching MRF lines |
$2,229–$5,848 | $2,229–$5,848 | varies |
| Magnetic Resonance Elastography (76391) | $428 | $428 | 1.4× |
| Mammary ductogram or galactogram multiple (77054) | $959 | $959 | 3.1× |
| Meckels Divert Exam (78290) range across 4 matching MRF lines |
$3,185–$4,212 | $3,185–$4,212 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $1,129 | $1,129 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $7,125 | $7,125 | 15.9× |
| MRA head w/o contrast (70544) range across 6 matching MRF lines |
$2,259–$6,479 | $2,259–$6,479 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$2,774–$3,126 | $2,774–$3,126 | varies |
| MRA neck w contrast (70548) range across 5 matching MRF lines |
$2,919–$4,464 | $2,919–$4,464 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 5 matching MRF lines |
$4,787–$5,632 | $4,787–$5,632 | varies |
| MRA neck w/o contrast (70547) range across 6 matching MRF lines |
$2,848–$3,685 | $2,848–$3,685 | varies |
| MRI abdomen w contrast (74182) | $5,094 | $5,094 | 11.4× |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$5,532–$7,161 | $5,532–$7,161 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 18 matching MRF lines |
$3,061–$6,140 | $3,061–$6,140 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$3,925–$6,101 | $3,925–$6,101 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 20 matching MRF lines |
$3,890–$6,140 | $3,890–$6,140 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$2,823–$3,414 | $2,823–$3,414 | varies |
| MRI brain functional w/o physician admnistration (70554) | $3,245 | $3,245 | 10.6× |
| MRI brain functional w/physician admnistration (70555) | $3,747 | $3,747 | 12.2× |
| MRI cardiac w/o cont stress (75559) | $2,266 | $2,266 | 3.2× |
| MRI cardiac w/o contrast (75557) | $3,376 | $3,376 | 11.0× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$3,973–$4,170 | $3,973–$4,170 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$4,190–$5,422 | $4,190–$5,422 | varies |
| MRI chest w/o contrast (71550) range across 8 matching MRF lines |
$3,964–$5,489 | $3,964–$5,489 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$5,751–$6,076 | $5,751–$6,076 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 8 matching MRF lines |
$4,178–$6,018 | $4,178–$6,018 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$4,713–$6,101 | $4,713–$6,101 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 10 matching MRF lines |
$4,542–$10,000 | $4,542–$10,000 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$5,884–$6,176 | $5,884–$6,176 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$8,254–$10,684 | $8,254–$10,684 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 8 matching MRF lines |
$3,657–$6,048 | $3,657–$6,048 | varies |
| MRI orbit face neck w contrast (70542) range across 4 matching MRF lines |
$3,973–$5,147 | $3,973–$5,147 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 5 matching MRF lines |
$5,020–$7,828 | $5,020–$7,828 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$4,568–$6,241 | $4,568–$6,241 | varies |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$6,068–$6,818 | $6,068–$6,818 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$5,287–$6,306 | $5,287–$6,306 | varies |
| MRI spectroscopy (76390) range across 3 matching MRF lines |
$2,327–$2,805 | $2,327–$2,805 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$4,519–$5,848 | $4,519–$5,848 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 10 matching MRF lines |
$4,644–$5,726 | $4,644–$5,726 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 10 matching MRF lines |
$4,568–$6,328 | $4,568–$6,328 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 10 matching MRF lines |
$4,713–$6,101 | $4,713–$6,101 | varies |
| MRI, abdomen, combo (74183) range across 5 matching MRF lines |
$5,700–$7,377 | $5,700–$7,377 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$6,877–$8,901 | $6,877–$8,901 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$4,299–$4,512 | $4,299–$4,512 | varies |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$4,568–$5,914 | $4,568–$5,914 | varies |
| MRI, joint upper extrem combo (73223) range across 13 matching MRF lines |
$4,027–$6,101 | $4,027–$6,101 | varies |
| MRI, lumbar spine combo (72158) | $9,950 | $9,950 | 22.2× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,653–$1,736 | $1,653–$1,736 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$2,447–$2,570 | $2,447–$2,570 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$1,796–$2,447 | $1,796–$2,447 | varies |
| Myelograpy 2/more regions rs&i (72270) | $2,199 | $2,199 | 2.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $4,671 | $4,671 | 9.1× |
| Myocardial Spect Multiple Studies (78452) | $9,159 | $9,159 | 5.5× |
| Neck soft tissue (70360) | $972 | $972 | 8.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $864 | $864 | 1.7× |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$5,206–$5,652 | $5,206–$5,652 | varies |
| Nm myocard infarct spect (78469) | $3,698 | $3,698 | 5.3× |
| Nm whole blood volume (78122) | $2,206 | $2,206 | 3.2× |
| Nonvascular Shunt X-Ray (75809) | $858 | $858 | 6.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $18,755 | $18,755 | 10.5× |
| Nuclear Rx Oral Admin (79005) range across 6 matching MRF lines |
$6,502–$6,828 | $6,502–$6,828 | varies |
| Optic foramina (70190) | $953 | $953 | 8.5× |
| Panoramic X-ray of jaws (70355) | $444 | $444 | 4.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $5,406 | $5,406 | 7.7× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$6,690–$7,025 | $6,690–$7,025 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $5,406 | $5,406 | 10.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$590–$1,130 | $590–$1,130 | varies |
| Perineogram (74775) | $2,226 | $2,226 | 7.3× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$6,050–$8,067 | $6,050–$8,067 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$6,399–$8,678 | $6,399–$8,678 | varies |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$8,180–$9,967 | $8,180–$9,967 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$9,140–$9,814 | $9,140–$9,814 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$4,731–$8,119 | $4,731–$8,119 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$6,050–$7,731 | $6,050–$7,731 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$8,337–$8,754 | $8,337–$8,754 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$4,367–$4,741 | $4,367–$4,741 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $2,435 | $2,435 | 18.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$350–$368 | $350–$368 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $770 | $770 | 6.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $542 | $542 | 4.8× |
| Radex elbow complete minimum 3 views (73080) | $748 | $748 | 6.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$1,096–$1,173 | $1,096–$1,173 | varies |
| Radex fingr minimum 2 views (73140) | $510 | $510 | 4.6× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$536–$542 | $536–$542 | varies |
| Radex Hand Minimum 3 Views (73130) | $722 | $722 | 6.5× |
| Radex lower extremity infant minimum 2 views (73592) | $780 | $780 | 7.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,259 | $1,259 | 9.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$680–$727 | $680–$727 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $614 | $614 | 5.5× |
| Radex Ribs Unilateral 2 Views (71100) | $748 | $748 | 6.7× |
| Radex shoulder complete minimum 2 views (73030) | $748 | $748 | 6.7× |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$751–$805 | $751–$805 | varies |
| Radex Spine 1 View Specify Level (72020) | $542 | $542 | 4.8× |
| Radex Sternum Minimum 2 Views (71120) | $748 | $748 | 6.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$783–$915 | $783–$915 | varies |
| Radex Toe Minimum 2 Views (73660) | $510 | $510 | 4.6× |
| Radex upper extremity infant minimum 2 views (73092) | $780 | $780 | 5.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $802 | $802 | 7.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,396 | $1,396 | 10.4× |
| Radiation treatment delivery level 1 (77402) | $1,132 | $1,132 | 8.6× |
| Radiation treatment delivery level 3 (77412) | $2,029 | $2,029 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$1,024–$1,097 | $1,024–$1,097 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,302 | $1,302 | 9.7× |
| Radiologic exam colon double contrast study (74280) | $2,811 | $2,811 | 12.5× |
| Radiologic exam colon single contrast study (74270) range across 7 matching MRF lines |
$2,345–$2,463 | $2,345–$2,463 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$974–$1,067 | $974–$1,067 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,128 | $1,128 | 8.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,101 | $1,101 | 4.9× |
| Radiologic exam swallow function contrast study (74230) | $2,474 | $2,474 | 11.0× |
| Radiologic examination femur 1 view (73551) | $588 | $588 | 5.3× |
| Radiologic examination femur minimum 2 views (73552) | $789 | $789 | 7.0× |
| Radiologic examination knee 1/2 views (73560) | $529 | $529 | 4.7× |
| Radiologic Examination Osseous Survey Limited (77074) range across 10 matching MRF lines |
$1,041–$1,289 | $1,041–$1,289 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $1,094 | $1,094 | 9.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$486–$632 | $486–$632 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,058 | $1,058 | 1.5× |
| Radiopharm Dacryocystography (78660) | $5,168 | $5,168 | 10.1× |
| Renal Cyst Study (74470) | $1,298 | $1,298 | 1.8× |
| Ribs bilateral 3 views (71110) | $955 | $955 | 7.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 5 matching MRF lines |
$2,784–$4,728 | $2,784–$4,728 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 7 matching MRF lines |
$4,168–$7,147 | $4,168–$7,147 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 11 matching MRF lines |
$3,588–$7,780 | $3,588–$7,780 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$4,168–$6,748 | $4,168–$6,748 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,168 | $4,168 | 2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 3 matching MRF lines |
$4,728–$4,817 | $4,728–$4,817 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 5 matching MRF lines |
$4,168–$4,728 | $4,168–$4,728 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,281 | $1,281 | 4.3× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$773–$3,864 | $773–$3,864 | varies |
| Salivary Gland Function Study (78232) | $1,929 | $1,929 | 3.8× |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$2,263–$2,801 | $2,263–$2,801 | varies |
| Scapula (73010) | $789 | $789 | 5.9× |
| Sella turcica (70240) | $532 | $532 | 4.8× |
| Shoulder 1 view (73020) | $582 | $582 | 5.2× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$899–$944 | $899–$944 | varies |
| Sialogram (70390) | $606 | $606 | 2.0× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$737–$789 | $737–$789 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$1,967–$6,960 | $1,967–$6,960 | varies |
| Special Physics Consult (77370) range across 3 matching MRF lines |
$392–$2,532 | $392–$2,532 | varies |
| Special teletherapy port plan (77321) range across 3 matching MRF lines |
$615–$7,795 | $615–$7,795 | varies |
| Special treatment procedure (77470) range across 6 matching MRF lines |
$1,980–$4,975 | $1,980–$4,975 | varies |
| Speech evaluation, complex (70371) | $1,259 | $1,259 | 4.1× |
| Spleen Imaging (78185) | $2,868 | $2,868 | 5.6× |
| Stereotactic Body Radiation Delivery (77373) | $3,997 | $3,997 | 1.7× |
| Sternoclavicular joints (71130) | $615 | $615 | 5.5× |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$3,271–$3,435 | $3,271–$3,435 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $560 | $560 | 4.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$5,045–$8,160 | $5,045–$8,160 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$3,375–$5,437 | $3,375–$5,437 | varies |
| Testicular Imaging W/Flow (78761) range across 3 matching MRF lines |
$3,301–$8,617 | $3,301–$8,617 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,205–$3,560 | $2,205–$3,560 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,587 | $2,587 | 5.4× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$1,340–$2,165 | $1,340–$2,165 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,314 | $2,314 | 10.3× |
| Thoracic spine 2 views (72070) | $851 | $851 | 6.3× |
| Thoracic spine 3 views (72072) | $1,233 | $1,233 | 9.2× |
| Thoracolumbar 2 views (72080) | $748 | $748 | 6.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 2 matching MRF lines |
$2,902–$3,048 | $2,902–$3,048 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 4 matching MRF lines |
$1,646–$6,254 | $1,646–$6,254 | varies |
| Thyroid Met Imaging Body (78018) range across 7 matching MRF lines |
$4,168–$10,097 | $4,168–$10,097 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 4 matching MRF lines |
$3,358–$3,526 | $3,358–$3,526 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$1,208–$3,312 | $1,208–$3,312 | varies |
| Tx devices design & construction intermediate (77333) | $1,304 | $1,304 | 7.5× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$545–$1,955 | $545–$1,955 | varies |
| Ultrasound Breast Limited (76642) | $1,155 | $1,155 | 10.3× |
| Ultrasound elastography first target lesion (76982) | $404 | $404 | 3.0× |
| Ultrasound Elastography Parenchyma (76981) range across 5 matching MRF lines |
$404–$428 | $404–$428 | varies |
| Ultrasound, abdomen limited (76705) range across 22 matching MRF lines |
$1,901–$1,997 | $1,901–$1,997 | varies |
| Umbilical-artery Doppler (OB) (76820) | $599 | $599 | 4.5× |
| Unlisted Dx Radiographic Procedure (76499) range across 6 matching MRF lines |
$235–$4,313 | $235–$4,313 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$348–$2,532 | $348–$2,532 | varies |
| Upper gi w/o kub (74240) | $3,085 | $3,085 | 13.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $1,767 | $1,767 | 159.8× |
| Urea breath test c-14 isotopic analysis (78268) | $1,205 | $1,205 | 12.8× |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$5,052–$5,486 | $5,052–$5,486 | varies |
| Urethrocystogram voiding (74455) range across 4 matching MRF lines |
$428–$2,830 | $428–$2,830 | varies |
| Urethrocystography retrograde (74450) range across 4 matching MRF lines |
$2,314–$2,771 | $2,314–$2,771 | varies |
| Us breast unilateral complete (76641) | $1,424 | $1,424 | 10.6× |
| Us chest (76604) range across 5 matching MRF lines |
$1,861–$2,884 | $1,861–$2,884 | varies |
| Us complete joint (76881) range across 7 matching MRF lines |
$1,481–$2,960 | $1,481–$2,960 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$1,462–$1,536 | $1,462–$1,536 | varies |
| Us head (76506) | $1,901 | $1,901 | 14.1× |
| Us kidney transplant (76776) | $3,269 | $3,269 | 24.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$1,997–$2,150 | $1,997–$2,150 | varies |
| Us ob limited 1 or more fetuses (76815) | $1,662 | $1,662 | 12.4× |
| Us ob transvaginal (76817) | $2,509 | $2,509 | 18.7× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$2,417–$2,918 | $2,417–$2,918 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $3,356 | $3,356 | 25.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,619 | $1,619 | 12.0× |
| Us retroperitoneal complete (76770) | $2,286 | $2,286 | 17.0× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$1,778–$1,867 | $1,778–$1,867 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,734–$2,691 | $1,734–$2,691 | varies |
| Us spinal canal and contents (76800) | $2,529 | $2,529 | 18.8× |
| Us thyroid (76536) range across 6 matching MRF lines |
$790–$3,755 | $790–$3,755 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$1,515–$3,912 | $1,515–$3,912 | varies |
| Vascular Flow Imaging (78445) | $1,403 | $1,403 | 2.7× |
| Vein X-Ray Chest (75827) range across 6 matching MRF lines |
$5,497–$9,949 | $5,497–$9,949 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$5,751–$6,039 | $5,751–$6,039 | varies |
| Vein X-Ray Skull Epidural (75872) range across 2 matching MRF lines |
$3,390–$3,560 | $3,390–$3,560 | varies |
| Vein X-Ray Spleen/Liver (75810) | $5,497 | $5,497 | 1.4× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$8,337–$8,754 | $8,337–$8,754 | varies |
| Venography Adrenal Unilateral (75840) range across 4 matching MRF lines |
$1,369–$1,438 | $1,369–$1,438 | varies |
| Venography caval inferior serialography rs&i (75825) range across 7 matching MRF lines |
$5,497–$8,264 | $5,497–$8,264 | varies |
| Venography extremity bilateral rs&i (75822) range across 6 matching MRF lines |
$533–$6,445 | $533–$6,445 | varies |
| Venography extremity unilateral rs&i (75820) range across 13 matching MRF lines |
$2,838–$5,577 | $2,838–$5,577 | varies |
| Venography Orbital Rs&I (75880) range across 2 matching MRF lines |
$1,648–$1,731 | $1,648–$1,731 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$6,830–$7,172 | $6,830–$7,172 | varies |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$3,062–$3,216 | $3,062–$3,216 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$2,959–$3,107 | $2,959–$3,107 | varies |
| Venous thrombosis imaging (78457) | $6,119 | $6,119 | 8.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $6,119 | $6,119 | 11.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$481–$536 | $481–$536 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $699 | $699 | 6.2× |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$461–$2,380 | $461–$2,380 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 7 matching MRF lines |
$6,820–$7,528 | $6,820–$7,528 | varies |
| X-Ray Bend Only L-S Spine (72120) | $1,888 | $1,888 | 14.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$476–$590 | $476–$590 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,550 | $2,550 | 3.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$584–$795 | $584–$795 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$1,087–$1,963 | $1,087–$1,963 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,286 | $1,286 | 9.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $641 | $641 | 5.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$810–$955 | $810–$955 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$727–$1,041 | $727–$1,041 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $926 | $926 | 6.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,166 | $1,166 | 8.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$699–$748 | $699–$748 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$1,319–$1,437 | $1,319–$1,437 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $955 | $955 | 7.1× |
| X-ray eye for foreign body (70030) | $420 | $420 | 3.8× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$486–$632 | $486–$632 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,502–$2,644 | $1,502–$2,644 | varies |
| X-ray IV pyelogram+tomography (74415) | $3,621 | $3,621 | 16.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$481–$748 | $481–$748 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $931 | $931 | 6.9× |
| X-ray nose-rectum child f.b. (76010) | $1,592 | $1,592 | 14.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,041 | $1,041 | 7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,022 | $1,022 | 7.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $741 | $741 | 5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $727 | $727 | 6.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$955–$1,022 | $955–$1,022 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$1,174–$1,256 | $1,174–$1,256 | varies |
| X-Ray Stress View (77071) | $993 | $993 | 8.9× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$1,171–$1,286 | $1,171–$1,286 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$481–$699 | $481–$699 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$1,513–$8,333 | $1,513–$8,333 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$1,153–$1,244 | $1,153–$1,244 | varies |
| X-Rays Bone Survey Complete (77075) | $1,873 | $1,873 | 13.9× |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$982–$1,538 | $982–$1,538 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$702–$751 | $702–$751 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $1,096 | $1,096 | 8.2× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$1,699–$1,819 | $1,699–$1,819 | varies |
| Xr Tomogram Single Plane (76100) | $1,963 | $1,963 | 14.6× |
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.