Imaging prices at Regional Medical Center of San Jose
San Jose, CA · every code in this section with a posted price and a Medicare benchmark.
469 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) | $7,831.60 | $11,188 | 3.8× |
| Abdomen 1 View (74018) | $408.10 | $583 | 3.2× |
| Abdomen 2 views (74019) | $575.40 | $822 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,321.90 | $3,317 | 3.9× |
| Adrenal Cortex & Medulla Img (78075) | $6,461.70 | $9,231 | 3.4× |
| Angio internal mammary (75756) | $13,350.40 | $19,072 | 2.9× |
| Angio pulmonary bilat (75743) | $13,350.40 | $19,072 | 2.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $13,884.50 | $19,835 | 3.0× |
| Angiography extremity bilateral rs&i (75716) | $13,350.40 | $19,072 | 2.9× |
| Angiography extremity unilateral rs&i (75710) | $13,350.40 | $19,072 | 2.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $13,350.40 | $19,072 | 2.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,749.10 | $8,213 | 1.2× |
| Ankle 2 views (73600) | $408.10 | $583 | 3.2× |
| Aortography thoracic serialography rs&i (75605) | $22,117.90 | $31,597 | 2.7× |
| Artery X-Rays Abdomen (75726) | $22,117.90 | $31,597 | 2.7× |
| Artery X-Rays Adrenal Gland (75731) | $5,749.10 | $8,213 | 1.2× |
| Artery X-Rays Pelvis (75736) | $22,117.90 | $31,597 | 2.7× |
| Artery X-Rays Spine (75705) | $22,117.90 | $31,597 | 2.7× |
| Arthrogram ankle (73615) | $2,027.20 | $2,896 | 4.0× |
| Arthrogram hip (73525) | $1,949.50 | $2,785 | 3.8× |
| Arthrogram Wrist (73115) | $2,027.20 | $2,896 | 4.0× |
| Basic radiation dosimetry calculation (77300) | $815.50 | $1,165 | 4.1× |
| Bone age studies (77072) | $568.40 | $812 | 3.7× |
| Bone Imaging 3 Phase (78315) | $2,321.90 | $3,317 | 3.9× |
| Bone Imaging Limited Area (78300) | $1,857.80 | $2,654 | 3.2× |
| Bone Imaging Multiple Areas (78305) | $1,857.80 | $2,654 | 3.2× |
| Bone Imaging Whole Body (78306) | $2,321.90 | $3,317 | 3.9× |
| Bone marrow imaging limited area (78102) | $1,786.40 | $2,552 | 3.0× |
| Bone marrow imaging; multiple areas (78103) | $1,857.80 | $2,654 | 3.2× |
| Bone marrow imaging; whole body (78104) | $1,857.80 | $2,654 | 3.2× |
| Bone survey infant (77076) | $739.20 | $1,056 | 4.8× |
| Brachytx isodose complex (77318) | $1,690.50 | $2,415 | 3.1× |
| Brachytx isodose intermed (77317) | $1,690.50 | $2,415 | 3.1× |
| Brachytx Isodose Plan Simple (77316) | $1,690.50 | $2,415 | 3.1× |
| Brain Flow Imaging Only (78610) | $2,394 | $3,420 | 3.0× |
| Brain Image W/Flow < 4 Views (78601) | $1,857.80 | $2,654 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,993.20 | $4,276 | 3.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,692.20 | $3,846 | 3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,229.60 | $10,328 | 3.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,053.80 | $2,934 | 3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $5,735.80 | $8,194 | 11.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,545.80 | $6,494 | 3.9× |
| Cardiac Shunt Detection (78428) | $1,857.80 | $2,654 | 3.2× |
| Cat Scan Follow-Up Study (76380) | $408.10 | $583 | 3.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,394 | $3,420 | 3.0× |
| Cerebrospinal Fluid Scan (78630) | $2,728.60 | $3,898 | 3.4× |
| Chest 1 view (71045) | $408.10 | $583 | 3.2× |
| Chest 2 views (71046) | $408.10 | $583 | 3.2× |
| Chest 3 views (71047) | $408.10 | $583 | 3.2× |
| Chest 4 or more views (71048) | $623 | $890 | 4.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $523.60 | $748 | 3.4× |
| Cholecystography Oral Contrast (74290) | $1,061.90 | $1,517 | 4.1× |
| Clavicle complete (73000) | $408.10 | $583 | 3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $402.50 | $575 | 2.6× |
| Continuing medical physics consltj pr wk (77336) | $815.50 | $1,165 | 4.1× |
| Contrast Exam Abdominl Aorta (75625) | $13,350.40 | $19,072 | 2.9× |
| Contrast X-Ray Bladder (74430) | $1,949.50 | $2,785 | 3.8× |
| Contrast X-Ray Of Elbow (73085) | $2,027.20 | $2,896 | 4.0× |
| Contrast X-Ray Of Knee Joint (73580) | $2,027.20 | $2,896 | 4.0× |
| Corpora cavernosography (74445) | $591.50 | $845 | 3.8× |
| CT abdomen and pelvis without and with contrast (74178) | $2,534.70 | $3,621 | 4.9× |
| CT abdomen and pelvis without contrast (74176) | $1,516.20 | $2,166 | 4.3× |
| CT abdomen w contrast (74160) | $1,326.50 | $1,895 | 5.1× |
| CT abdomen w wo contrast (74170) | $1,326.50 | $1,895 | 5.1× |
| CT abdomen w/o contrast (74150) | $739.20 | $1,056 | 4.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,534.70 | $3,621 | 4.9× |
| CT Angio Chest (71275) | $1,326.50 | $1,895 | 5.1× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT angio hrt w/3d image (75574) | $1,326.50 | $1,895 | 2.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,955.30 | $7,079 | 19.2× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,326.50 | $1,895 | 5.1× |
| CT bone density (77078) | $326.90 | $467 | 2.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,063.60 | $2,948 | 8.0× |
| CT cervical spine w/ contrast (72126) | $2,534.70 | $3,621 | 4.9× |
| CT cervical spine w/o contrast (72125) | $3,738.70 | $5,341 | 24.3× |
| CT cervical spine w/wo cont (72127) | $5,059.60 | $7,228 | 19.6× |
| CT chest w contrast (71260) | $4,393.90 | $6,277 | 17.0× |
| CT chest w/wo contrast (71270) | $4,957.40 | $7,082 | 19.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,061.90 | $1,517 | 4.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $591.50 | $845 | 3.8× |
| CT head/brain with contrast (70460) | $1,326.50 | $1,895 | 5.1× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,061.90 | $1,517 | 2.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $408.10 | $583 | 3.2× |
| CT hrt w/3d image congen (75573) | $915.60 | $1,308 | 1.8× |
| CT iac w contrast (70481) | $1,326.50 | $1,895 | 5.1× |
| CT l-spine w&w/o contrast (72133) | $4,477.20 | $6,396 | 17.4× |
| CT lower ext w/o (73700) | $739.20 | $1,056 | 4.8× |
| CT lower extremity w/contrast material (73701) | $1,326.50 | $1,895 | 5.1× |
| CT lumbar spine w contrast (72132) | $2,534.70 | $3,621 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $739.20 | $1,056 | 4.8× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$591.50–$739.20 | $845–$1,056 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT orbits w/o contrast (70480) | $739.20 | $1,056 | 4.8× |
| CT pelvis w&w/o contrast (72194) | $1,061.90 | $1,517 | 4.1× |
| CT pelvis w/o contrast (72192) | $739.20 | $1,056 | 4.8× |
| CT scan of leg combo (73702) | $1,326.50 | $1,895 | 5.1× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,061.90–$1,326.50 | $1,517–$1,895 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$591.50–$739.20 | $845–$1,056 | varies |
| CT thoracic spine w contrast (72129) | $1,326.50 | $1,895 | 5.1× |
| CT thoracic spine w/o contrast (72128) | $739.20 | $1,056 | 4.8× |
| CT thoracic spine w/wo cont (72130) | $4,686.50 | $6,695 | 18.2× |
| CT thorax w/o contrast (71250) | $739.20 | $1,056 | 4.8× |
| CT upper ext wo (73200) | $739.20 | $1,056 | 4.8× |
| CT upper extremity w/o & w/contrast material (73202) | $1,326.50 | $1,895 | 5.1× |
| CT upper extremity with contrast (73201) | $2,534.70 | $3,621 | 4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,394.20 | $7,706 | 20.9× |
| Cta Abdomen (74175) | $1,326.50 | $1,895 | 5.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,063.60 | $2,948 | 4.0× |
| CTA pelvis (72191) | $1,326.50 | $1,895 | 5.1× |
| Dilation ureters/urethra rs&i (74485) | $9,145.50 | $13,065 | 3.0× |
| Discography Cerv/Thor Spine (72285) | $8,575.70 | $12,251 | 3.0× |
| Diskography lumbar (72295) | $8,575.70 | $12,251 | 3.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $591.50 | $845 | 3.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $591.50 | $845 | 3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $591.50 | $845 | 3.8× |
| Dxa Bone Density Axial (77080) | $568.40 | $812 | 3.7× |
| Dxa bone density study (77085) | $591.50 | $845 | 3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $314.30 | $449 | 2.5× |
| Echo exam of fetal heart (76825) | $2,614.50 | $3,735 | 3.3× |
| Echo exam uterus (76831) | $1,212.40 | $1,732 | 3.5× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$1,326.50–$1,561.70 | $1,895–$2,231 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,212.40 | $1,732 | 3.5× |
| Esophageal Motility Study (78258) | $1,857.80 | $2,654 | 3.2× |
| Esophagram (74220) | $1,020.60 | $1,458 | 4.0× |
| Fetal Biophys Profile W/Nst (76818) | $739.20 | $1,056 | 4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $591.50 | $845 | 3.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,212.40 | $1,732 | 3.5× |
| Fluoroscopy up to 1 hr (76000) | $1,213.10 | $1,733 | 3.5× |
| Follow-Up Angiography (75898) | $5,749.10 | $8,213 | 1.2× |
| Foot 2 views (73620) | $408.10 | $583 | 3.2× |
| Forearm 2 views (73090) | $408.10 | $583 | 3.2× |
| Gastric emptying imaging study (78264) | $2,321.90 | $3,317 | 3.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,857.80 | $2,654 | 3.2× |
| Gastroesophageal Reflux Exam (78262) | $1,857.80 | $2,654 | 3.2× |
| Gated Heart Planar Single (78472) | $1,786.40 | $2,552 | 3.0× |
| Gated Heart, Multiple (78473) | $1,857.80 | $2,654 | 3.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,394 | $3,420 | 3.0× |
| Hand 2 views (73120) | $595 | $850 | 3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,630.50 | $6,615 | 4.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,630.50 | $6,615 | 4.5× |
| Heart first pass single,planar (78481) | $2,394 | $3,420 | 3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $13,350.40 | $19,072 | 2.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $13,884.50 | $19,835 | 3.0× |
| Hepatobil Syst Image W/Drug (78227) | $2,891 | $4,130 | 3.6× |
| Hepatobiliary System Imaging (78226) | $2,071.30 | $2,959 | 3.5× |
| Ht Muscle Image Spect Sing (78451) | $6,213.20 | $8,876 | 3.3× |
| Hysterosalpingogram (74740) | $1,313.20 | $1,876 | 3.7× |
| Image fusion (77399) | $627.20 | $896 | 3.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $408.10 | $583 | 3.2× |
| Infant hip ultrasound, limited static exam (76886) | $408.10 | $583 | 3.2× |
| Infusion Ivp (74410) | $1,061.90 | $1,517 | 4.1× |
| Interstitial radiation source applic complex (77778) | $4,444.30 | $6,349 | 4.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,704.40 | $5,292 | 3.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,732.10 | $3,903 | 3.4× |
| Intracavitary radiation source applic simple (77761) | $2,732.10 | $3,903 | 3.4× |
| K Flow/Funct Image Multiple (78709) | $2,394 | $3,420 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $2,993.20 | $4,276 | 3.7× |
| K Flow/Funct Image W/O Drug (78707) | $2,394 | $3,420 | 3.0× |
| Knee 3 Views (73562) | $408.10 | $583 | 3.2× |
| Leveen/Shunt Patency Exam (78291) | $1,857.80 | $2,654 | 3.2× |
| Liver & Spleen Imaging Static Only (78215) | $1,857.80 | $2,654 | 3.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,053.80 | $2,934 | 3.5× |
| Liver imaging w/vascular flow (78202) | $2,692.20 | $3,846 | 3.4× |
| Lung Perf&Ventilat Diferentl (78598) | $2,993.20 | $4,276 | 3.7× |
| Lung perfusion differential (78597) | $2,101.40 | $3,002 | 3.6× |
| Lung Ventilat&Perfus Imaging (78582) | $2,993.20 | $4,276 | 3.7× |
| Lung Ventilation Imaging (78579) | $1,857.80 | $2,654 | 3.2× |
| Lymph System Imaging (78195) | $2,993.20 | $4,276 | 3.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $3,259.20 | $4,656 | 3.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $13,884.50 | $19,835 | 3.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $5,749.10 | $8,213 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,516.20 | $2,166 | 4.3× |
| Magnetic Resonance Elastography (76391) | $1,212.40 | $1,732 | 3.5× |
| Mammary ductogram or galactogram single (77053) | $1,212.40 | $1,732 | 3.5× |
| Meckels Divert Exam (78290) | $2,105.60 | $3,008 | 3.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,690.50 | $2,415 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $449.40 | $642 | 3.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $125.30 | $179 | 2.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $469 | $670 | 3.4× |
| Mr safety implt pos&/immoblj (76019) | $303.10 | $433 | 3.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,233.40 | $1,762 | 3.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,534.70 | $3,621 | 4.9× |
| MRA head w/o contrast (70544) | $1,516.20 | $2,166 | 4.3× |
| MRA head with contrast (70545) | $2,027.20 | $2,896 | 4.0× |
| MRA neck w contrast (70548) | $2,534.70 | $3,621 | 4.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,534.70 | $3,621 | 4.9× |
| MRA neck w/o contrast (70547) | $1,516.20 | $2,166 | 4.3× |
| MRI abdomen w contrast (74182) | $2,534.70 | $3,621 | 4.9× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,212.40–$1,516.20 | $1,732–$2,166 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $4,509.40 | $6,442 | 3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,953.50 | $8,505 | 11.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,509.40 | $6,442 | 3.9× |
| MRI bone marrow blood supply (77084) | $1,212.40 | $1,732 | 3.5× |
| MRI brain functional w/o physician admnistration (70554) | $1,212.40 | $1,732 | 3.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,212.40 | $1,732 | 3.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,212.40 | $1,732 | 3.5× |
| MRI cardiac w/o cont stress (75559) | $3,138.10 | $4,483 | 3.9× |
| MRI cardiac w/o contrast (75557) | $1,516.20 | $2,166 | 4.3× |
| MRI cervical spine w contrast (72142) | $2,534.70 | $3,621 | 4.9× |
| MRI cervical spine w/o cont (72141) | $1,516.20 | $2,166 | 4.3× |
| MRI chest w/o contrast (71550) | $1,516.20 | $2,166 | 4.3× |
| MRI chest with contrast (71551) | $3,636.50 | $5,195 | 3.2× |
| MRI chest wo w contrast (71552) | $6,196.40 | $8,852 | 12.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,534.70 | $3,621 | 4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,751.90 | $8,217 | 11.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,516.20 | $2,166 | 4.3× |
| MRI lumbar spine w contrast (72149) | $2,534.70 | $3,621 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,961.20 | $8,516 | 11.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,516.20 | $2,166 | 4.3× |
| MRI orbit face neck w contrast (70542) | $2,534.70 | $3,621 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,958.40 | $8,512 | 11.6× |
| MRI pelvis w contrast (72196) | $2,534.70 | $3,621 | 4.9× |
| MRI pelvis w/o & w contrast (72197) | $2,534.70 | $3,621 | 4.9× |
| MRI pelvis w/o contrast (72195) | $1,516.20 | $2,166 | 4.3× |
| MRI spectroscopy (76390) | $4,297.30 | $6,139 | 33.6× |
| MRI thoracic spine w/o contrast (72146) | $1,516.20 | $2,166 | 4.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,027.20 | $2,896 | 4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,516.20 | $2,166 | 4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,534.70 | $3,621 | 4.9× |
| MRI, abdomen, combo (74183) | $6,196.40 | $8,852 | 12.1× |
| MRI, dorsal spine combo (72157) | $5,849.90 | $8,357 | 11.4× |
| MRI, dorsal spine contrast (72147) | $2,534.70 | $3,621 | 4.9× |
| MRI, joint upper extrem (73221) | $1,516.20 | $2,166 | 4.3× |
| MRI, joint upper extrem combo (73223) | $6,416.20 | $9,166 | 12.5× |
| MRI, lumbar spine combo (72158) | $5,747.70 | $8,211 | 11.2× |
| Myelogram cervical (72240) | $3,636.50 | $5,195 | 3.2× |
| Myelogram Lumbar (72265) | $3,636.50 | $5,195 | 3.2× |
| Myelography thoracic (72255) | $3,636.50 | $5,195 | 3.2× |
| Myelograpy 2/more regions rs&i (72270) | $3,636.50 | $5,195 | 3.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,130.10 | $3,043 | 3.6× |
| Myocardial Spect Multiple Studies (78452) | $6,320.30 | $9,029 | 3.3× |
| Neck soft tissue (70360) | $408.10 | $583 | 3.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,857.80 | $2,654 | 3.2× |
| Nm csf leak detection (78650) | $6,461.70 | $9,231 | 3.4× |
| Nm myocard infarct spect (78469) | $6,213.20 | $8,876 | 7.8× |
| Nm red cell survival study (78130) | $1,857.80 | $2,654 | 3.2× |
| Nm unlisted gi procedure (78299) | $1,857.80 | $2,654 | 3.2× |
| Nm whole blood volume (78122) | $2,394 | $3,420 | 3.0× |
| Nonvascular Shunt X-Ray (75809) | $672.70 | $961 | 4.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $17,441.90 | $24,917 | 8.6× |
| Nuclear Rx Intra-Arterial (79445) | $1,335.60 | $1,908 | 3.9× |
| Nuclear Rx Oral Admin (79005) | $1,167.60 | $1,668 | 3.4× |
| Ob us nuchal meas 1 gest (76813) | $739.20 | $1,056 | 4.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $568.40 | $812 | 3.7× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$568.40–$591.50 | $812–$845 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $560 | $800 | 2.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 2 matching MRF lines |
$568.40–$591.50 | $812–$845 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $568.40 | $812 | 3.7× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $86.80 | $124 | 2.0× |
| Optic foramina (70190) | $326.90 | $467 | 2.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$2,394–$2,993.20 | $3,420–$4,276 | varies |
| Parathyroid Planar Imaging (78070) | $1,957.20 | $2,796 | 3.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,857.80 | $2,654 | 3.2× |
| Pelvis 1 or 2 views (72170) | $568.40 | $812 | 3.7× |
| Peritoneogram Rs&I (74190) | $2,614.50 | $3,735 | 3.3× |
| Pet Image Skull-Thigh (78812) | $7,740.60 | $11,058 | 3.7× |
| Pet Image W/Ct Lmtd (78814) | $6,951.70 | $9,931 | 3.3× |
| PET image w/CT, full body (78816) | $9,037 | $12,910 | 4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,286.60 | $11,838 | 3.9× |
| Pet Myocardial Sngl Study (78491) | $7,229.60 | $10,328 | 3.4× |
| PET whole body (78813) | $7,229.60 | $10,328 | 3.4× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $6,461.70 | $9,231 | 3.4× |
| Platelet survival study Non-Facility (78191) | $1,857.80 | $2,654 | 3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $13,884.50 | $19,835 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,156 | $3,080 | 3.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $659.40 | $942 | 4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,513.70 | $3,591 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $408.10 | $583 | 3.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $408.10 | $583 | 3.2× |
| Radex elbow complete minimum 3 views (73080) | $408.10 | $583 | 3.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $568.40 | $812 | 3.7× |
| Radex fingr minimum 2 views (73140) | $408.10 | $583 | 3.2× |
| Radex foot complete minimum 3 views (73630) | $408.10 | $583 | 3.2× |
| Radex Hand Minimum 3 Views (73130) | $408.10 | $583 | 3.2× |
| Radex lower extremity infant minimum 2 views (73592) | $408.10 | $583 | 3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $717.50 | $1,025 | 4.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $408.10 | $583 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $408.10 | $583 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) | $408.10 | $583 | 3.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $314.30 | $449 | 2.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,212.40 | $1,732 | 4.7× |
| Radex Spine 1 View Specify Level (72020) | $394.10 | $563 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $408.10 | $583 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $408.10 | $583 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $408.10 | $583 | 3.2× |
| Radex upper extremity infant minimum 2 views (73092) | $568.40 | $812 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $408.10 | $583 | 3.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $591.50 | $845 | 3.8× |
| Radiation treatment delivery level 1 (77402) | $615.30 | $879 | 4.1× |
| Radiation treatment delivery level 2 (77407) | $1,135.40 | $1,622 | 2.0× |
| Radiation treatment delivery level 3 (77412) | $1,180.90 | $1,687 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $628.60 | $898 | 4.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $591.50 | $845 | 3.8× |
| Radiologic exam colon double contrast study (74280) | $1,243.20 | $1,776 | 4.8× |
| Radiologic exam colon single contrast study (74270) | $1,036 | $1,480 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) | $710.50 | $1,015 | 4.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $686.70 | $981 | 4.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $672.70 | $961 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $739.20 | $1,056 | 2.9× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $1,212.40 | $1,732 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,020.60 | $1,458 | 4.0× |
| Radiologic examination femur 1 view (73551) | $326.90 | $467 | 2.6× |
| Radiologic examination femur minimum 2 views (73552) | $408.10 | $583 | 3.2× |
| Radiologic examination knee 1/2 views (73560) | $408.10 | $583 | 3.2× |
| Radiologic Examination Osseous Survey Limited (77074) | $655.90 | $937 | 4.3× |
| Radiologic Examination Salivary Gland Calculus (70380) | $326.90 | $467 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $408.10 | $583 | 3.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $326.90 | $467 | 2.6× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,167.60 | $1,668 | 3.4× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,167.60 | $1,668 | 3.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $2,394 | $3,420 | 3.0× |
| Renal Cyst Study (74470) | $2,614.50 | $3,735 | 3.3× |
| Ribs bilateral 3 views (71110) | $676.20 | $966 | 4.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,786.40 | $2,552 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,007.60 | $2,868 | 3.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,461.70 | $9,231 | 8.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $6,213.20 | $8,876 | 7.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,993.20–$6,883.80 | $4,276–$9,834 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $6,461.70 | $9,231 | 3.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,213.20 | $8,876 | 3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $6,461.70 | $9,231 | 3.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,167.60 | $1,668 | 3.4× |
| Rp Therapy Intravenous Administration (79101) | $1,167.60 | $1,668 | 3.4× |
| Salivary Gland Imaging (78230) | $1,857.80 | $2,654 | 3.2× |
| Salivary Gland Imaging Serial Images (78231) | $2,053.80 | $2,934 | 3.5× |
| Scapula (73010) | $739.20 | $1,056 | 4.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $205.80 | $294 | 8.8× |
| Sella turcica (70240) | $326.90 | $467 | 2.6× |
| Shoulder 1 view (73020) | $408.10 | $583 | 3.2× |
| Shoulder Arthrography (73040) | $1,949.50 | $2,785 | 3.8× |
| Sialogram (70390) | $1,233.40 | $1,762 | 3.5× |
| Skull less than 4 views (70250) | $568.40 | $812 | 3.7× |
| Special dosimetry (77331) | $652.40 | $932 | 3.3× |
| Special Physics Consult (77370) | $815.50 | $1,165 | 4.1× |
| Special teletherapy port plan (77321) | $1,668.10 | $2,383 | 3.0× |
| Special treatment procedure (77470) | $2,732.10 | $3,903 | 3.4× |
| Speech evaluation, complex (70371) | $1,220.10 | $1,743 | 3.5× |
| Spleen Imaging (78185) | $1,857.80 | $2,654 | 3.2× |
| Srs Multisource (77371) | $40,177.90 | $57,397 | 3.7× |
| Stereotactic Body Radiation Delivery (77373) | $11,106.90 | $15,867 | 4.2× |
| Sternoclavicular joints (71130) | $408.10 | $583 | 3.2× |
| Superior sagittal sinus venogram (75870) | $5,749.10 | $8,213 | 1.2× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $490 | $700 | 3.3× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $490 | $700 | 3.3× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $179.20 | $256 | 3.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $615.30 | $879 | 4.1× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $420 | $600 | 3.3× |
| Tbs technical calculation only (77091) | $420 | $600 | 3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,690.50 | $2,415 | 3.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,690.50 | $2,415 | 3.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $1,220.10 | $1,743 | 3.5× |
| Testicular Imaging W/Flow (78761) | $1,857.80 | $2,654 | 3.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,114 | $3,020 | 3.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,690.50 | $2,415 | 3.1× |
| Ther rad simulaj-aided field setting simple (77280) | $652.40 | $932 | 3.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,155 | $1,650 | 4.5× |
| Thoracic spine 2 views (72070) | $625.10 | $893 | 4.1× |
| Thoracic spine 3 views (72072) | $568.40 | $812 | 3.7× |
| Thoracolumbar 2 views (72080) | $408.10 | $583 | 3.2× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,857.80 | $2,654 | 3.2× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$1,786.40–$1,857.80 | $2,552–$2,654 | varies |
| Thyroid Met Imaging Body (78018) | $2,993.20 | $4,276 | 3.7× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$1,786.40–$1,857.80 | $2,552–$2,654 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,786.40–$1,857.80 | $2,552–$2,654 | varies |
| Tx Devices Design & Construction Complex (77334) | $2,114 | $3,020 | 3.8× |
| Tx devices design & construction intermediate (77333) | $815.50 | $1,165 | 4.1× |
| Tx devices design & construction simple (77332) | $815.50 | $1,165 | 4.1× |
| Ultrasound Breast Limited (76642) | $408.10 | $583 | 3.2× |
| Ultrasound elastography first target lesion (76982) | $568.40 | $812 | 3.7× |
| Ultrasound Elastography Parenchyma (76981) | $568.40 | $812 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $739.20 | $1,056 | 4.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,061.90 | $1,517 | 2.1× |
| Ultrasound, abdomen limited (76705) | $739.20 | $1,056 | 4.8× |
| Umbilical-artery Doppler (OB) (76820) | $591.50 | $845 | 3.8× |
| Unlis px ther radiol clinical tx planning (77299) | $652.40 | $932 | 3.3× |
| Unlisted Dx Radiographic Procedure (76499) | $326.90 | $467 | 2.6× |
| Unlisted fluoroscopic procedure (76496) | $408.10 | $583 | 3.2× |
| Unlisted magnetic resonance procedure (76498) | $326.90 | $467 | 2.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $829.50 | $1,185 | 5.5× |
| Unlisted us procedure (76999) | $418.60 | $598 | 3.3× |
| Upper gi w/o kub (74240) | $1,020.60 | $1,458 | 4.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $53.20 | $76 | 4.8× |
| Urea breath test c-14 isotopic analysis (78268) | $449.40 | $642 | 4.8× |
| Ureteral Reflux Study (78740) | $1,857.80 | $2,654 | 3.2× |
| Urethrocystogram voiding (74455) | $1,516.20 | $2,166 | 4.3× |
| Urethrocystography retrograde (74450) | $1,166.20 | $1,666 | 3.3× |
| Us bone density measurement (76977) | $606.90 | $867 | 3.9× |
| Us breast unilateral complete (76641) | $681.10 | $973 | 4.4× |
| Us chest (76604) | $739.20 | $1,056 | 4.8× |
| Us complete joint (76881) | $739.20 | $1,056 | 4.8× |
| Us exam, pelvic, limited (76857) | $713.30 | $1,019 | 4.6× |
| Us head (76506) | $739.20 | $1,056 | 4.8× |
| Us kidney transplant (76776) | $739.20 | $1,056 | 4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $568.40 | $812 | 3.7× |
| Us ob detailed single fetus (76811) | $1,212.40 | $1,732 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $696.50 | $995 | 4.5× |
| Us ob transvaginal (76817) | $739.20 | $1,056 | 4.8× |
| Us pelvic non ob complete (76856) | $739.20 | $1,056 | 4.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $739.20 | $1,056 | 4.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $627.90 | $897 | 4.1× |
| Us retroperitoneal complete (76770) | $739.20 | $1,056 | 4.8× |
| Us retroperitoneal limited (76775) | $739.20 | $1,056 | 4.8× |
| Us scrotum and contents (76870) | $739.20 | $1,056 | 4.8× |
| Us spinal canal and contents (76800) | $623 | $890 | 4.1× |
| Us thyroid (76536) | $739.20 | $1,056 | 4.8× |
| Us transrectal (76872) | $739.20 | $1,056 | 4.8× |
| Vascular Flow Imaging (78445) | $1,857.80 | $2,654 | 3.2× |
| Vein X-Ray Chest (75827) | $3,259.20 | $4,656 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,749.10 | $8,213 | 1.2× |
| Vein X-Ray Skull Epidural (75872) | $3,128.30 | $4,469 | 3.4× |
| Vein X-Ray Spleen/Liver (75810) | $5,749.10 | $8,213 | 1.2× |
| Venogram Sinus/Jugular (75860) | $13,884.50 | $19,835 | 3.0× |
| Venography Adrenal Unilateral (75840) | $13,884.50 | $19,835 | 3.0× |
| Venography caval inferior serialography rs&i (75825) | $13,350.40 | $19,072 | 2.9× |
| Venography extremity bilateral rs&i (75822) | $5,527.20 | $7,896 | 2.4× |
| Venography extremity unilateral rs&i (75820) | $3,136 | $4,480 | 1.4× |
| Venography Orbital Rs&I (75880) | $3,128.30 | $4,469 | 3.4× |
| Venography Renal Bilateral (75833) | $13,884.50 | $19,835 | 3.0× |
| Venography Renal Unilateral (75831) | $13,350.40 | $19,072 | 2.9× |
| Venous sampling by catheter (75893) | $23,002.70 | $32,861 | 2.8× |
| Vertebral fracture assessment via dxa (77086) | $326.90 | $467 | 2.6× |
| Wrist 2 views (73100) | $408.10 | $583 | 3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $408.10 | $583 | 3.2× |
| X-ray antegrade pyelogram tube (74425) | $2,027.20 | $2,896 | 4.0× |
| X-Ray Aorta Leg Arteries (75630) | $13,350.40 | $19,072 | 2.9× |
| X-Ray Bend Only L-S Spine (72120) | $665.70 | $951 | 4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $408.10 | $583 | 3.2× |
| X-Ray Exam Breast Specimen (76098) | $2,513.70 | $3,591 | 3.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $314.30 | $449 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $568.40 | $812 | 3.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $591.50 | $845 | 3.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $408.10 | $583 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $408.10 | $583 | 3.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $591.50 | $845 | 3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $568.40 | $812 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $739.20 | $1,056 | 4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $739.20 | $1,056 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $739.20 | $1,056 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $408.10 | $583 | 3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $739.20 | $1,056 | 4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $645.40 | $922 | 4.2× |
| X-ray eye for foreign body (70030) | $326.90 | $467 | 2.6× |
| X-ray head for orthodontia (70350) | $326.90 | $467 | 2.6× |
| X-ray humerus (73060) | $408.10 | $583 | 3.2× |
| X-ray IV pyelogram (ivp) (74400) | $1,061.90 | $1,517 | 4.1× |
| X-ray IV pyelogram+tomography (74415) | $1,061.90 | $1,517 | 4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $408.10 | $583 | 3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $357 | $510 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $568.40 | $812 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $326.90 | $467 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $679.70 | $971 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $648.20 | $926 | 4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $408.10 | $583 | 3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $408.10 | $583 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $739.20 | $1,056 | 4.8× |
| X-Ray Stress View (77071) | $326.90 | $467 | 2.6× |
| X-ray thoracic spine 4 vw (72074) | $739.20 | $1,056 | 4.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,949.50 | $2,785 | 3.8× |
| X-Rays Bone Length Studies (77073) | $568.40 | $812 | 3.7× |
| X-Rays Bone Survey Complete (77075) | $739.20 | $1,056 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $739.20 | $1,056 | 4.8× |
| Xr facial bones less than 3 views (70140) | $408.10 | $583 | 3.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $591.50 | $845 | 3.8× |
| Xr orbits complete 4 views (70200) | $591.50 | $845 | 3.8× |
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.