Imaging prices at Riverside Medical Center
Kankakee, IL · every code in this section with a posted price and a Medicare benchmark.
364 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) | $2,258.15 | $8,482.92 | 1.5× |
| Abdomen 1 View (74018) | $139.76 | $525 | 1.5× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$149.07–$153.60 | $560–$577 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $492.47 | $1,850 | 1.1× |
| Adrenal Cortex & Medulla Img (78075) | $399.03 | $1,499 | 0.3× |
| Angio internal mammary (75756) | $869.14 | $3,265 | 0.3× |
| Angio pulmonary bilat (75743) | $2,183.64 | $8,203 | 0.6× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$1,994.64–$3,989.27 | $7,493–$14,986 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$1,928.62–$2,183.64 | $7,245–$8,203 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,183.64 | $8,203 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,183.64 | $8,203 | 0.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$119.79–$239.58 | $450–$900 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,928.62 | $7,245 | 0.3× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$1,928.62–$3,750.23 | $7,245–$14,088 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$1,900.40–$3,750.23 | $7,139–$14,088 | varies |
| Artery X-Rays Spine (75705) | $4,791.60 | $18,000 | 0.8× |
| Arthrogram ankle (73615) | $285.90 | $1,074 | 0.8× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$345–$369.22 | $1,296–$1,387 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$300.81–$369.22 | $1,130–$1,387 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$276.85–$2,491.63 | $1,040–$9,360 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$101.16–$109.14 | $380–$410 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$841.19–$866.48 | $3,160–$3,255 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$769.32–$792.48 | $2,890–$2,977 | varies |
| Bone survey infant (77076) | $82.52 | $310 | 0.7× |
| Brachytx isodose complex (77318) | $420.86 | $1,581 | 1.0× |
| Brachytx isodose intermed (77317) | $323.43 | $1,215 | 0.8× |
| Brachytx Isodose Plan Simple (77316) | $350.32 | $1,316 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $476.50 | $1,790 | 0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,227.18 | $4,610 | 0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,224.52 | $4,600 | 3.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$1,011.56–$1,092.48 | $3,800–$4,104 | varies |
| Cat Scan Follow-Up Study (76380) | $313.58 | $1,178 | 3.4× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $337.54 | $1,268 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $354.05 | $1,330 | 0.6× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$109.94–$226.27 | $413–$850 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$146.41–$158.12 | $550–$594 | varies |
| Chest 3 views (71047) | $135.50 | $509 | 1.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$157.06–$161.85 | $590–$608 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $103.02 | $387 | 0.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$114.47–$123.52 | $430–$464 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$66.55–$79.86 | $250–$300 | varies |
| Continuing medical physics consltj pr wk (77336) | $287.50 | $1,080 | 2.0× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,994.64–$2,183.64 | $7,493–$8,203 | varies |
| Contrast X-Ray Bladder (74430) | $380.67 | $1,430 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $369.22 | $1,387 | 1.0× |
| Contrast X-Ray Of Knee Joint (73580) | $369.22 | $1,387 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,784.45 | $10,460 | 7.4× |
| CT abdomen and pelvis without contrast (74176) | $1,969.88 | $7,400 | 7.7× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,155.57–$1,301.72 | $4,341–$4,890 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,392.23–$1,410.86 | $5,230–$5,300 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$959.12–$1,221.86 | $3,603–$4,590 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,251.14–$1,288.67 | $4,700–$4,841 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$1,024.87–$2,049.74 | $3,850–$7,700 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$605.61–$1,050.69 | $2,275–$3,947 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$364.69–$1,050.69 | $1,370–$3,947 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$614.92–$1,050.69 | $2,310–$3,947 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$825.22–$1,050.69 | $3,100–$3,947 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$409.95–$1,050.69 | $1,540–$3,947 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $133.10 | $500 | 0.7× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,098.87–$1,155.57 | $4,128–$4,341 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$959.12–$1,112.72 | $3,603–$4,180 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$946.07–$1,392.23 | $3,554–$5,230 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,050.69–$1,118.04 | $3,947–$4,200 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$947.67–$1,272.17 | $3,560–$4,779 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,050.69 | $3,947 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $829.48 | $3,116 | 7.4× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$897.09–$1,050.69 | $3,370–$3,947 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,235.17–$1,272.17 | $4,640–$4,779 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$276.85–$1,050.69 | $1,040–$3,947 | varies |
| CT hrt w/3d image congen (75573) | $1,050.69 | $3,947 | 2.8× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$934.36–$1,050.69 | $3,510–$3,947 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$966.31–$1,392.23 | $3,630–$5,230 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$829.48–$1,847.43 | $3,116–$6,940 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,050.69–$2,182.84 | $3,947–$8,200 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,110.05–$1,155.57 | $4,170–$4,341 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$959.12–$1,118.04 | $3,603–$4,200 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,050.69–$1,088.76 | $3,947–$4,090 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$829.48–$939.69 | $3,116–$3,530 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,267.11–$1,272.17 | $4,760–$4,779 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,195.24–$1,272.17 | $4,490–$4,779 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$829.48–$982.28 | $3,116–$3,690 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,195.24–$1,392.23 | $4,490–$5,230 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$769.32–$1,598.80 | $2,890–$6,006 | varies |
| CT scan of leg combo (73702) | $1,272.17 | $4,779 | 6.8× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,099.41–$1,272.17 | $4,130–$4,779 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,050.69–$1,099.41 | $3,947–$4,130 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$829.48–$865.15 | $3,116–$3,250 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,155.57–$1,272.44 | $4,341–$4,780 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$959.12–$1,224.52 | $3,603–$4,600 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$953–$1,392.23 | $3,580–$5,230 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$745.36–$829.48 | $2,800–$3,116 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$829.48–$1,003.57 | $3,116–$3,770 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,272.17 | $4,779 | 6.8× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,022.21–$1,050.69 | $3,840–$3,947 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$412.61–$1,050.69 | $1,550–$3,947 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$822.56–$1,392.23 | $3,090–$5,230 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $239.58 | $900 | 0.6× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$383.33–$1,155.57 | $1,440–$4,341 | varies |
| Dilation ureters/urethra rs&i (74485) | $1,214.67 | $4,563 | 0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $93.44 | $351 | 0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $137.89 | $518 | 1.2× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$292.82–$322.10 | $1,100–$1,210 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$42.59–$43.92 | $160–$165 | varies |
| Echo exam of fetal heart (76825) | $193 | $725 | 0.3× |
| Echo exam uterus (76831) | $149.34 | $561 | 0.6× |
| Echo Guide For Artery Repair (76936) | $347.39 | $1,305 | 1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $102.75 | $386 | 0.4× |
| Esophagram (74220) | $266.20 | $1,000 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) | $271.52 | $1,020 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$159.72–$172.50 | $600–$648 | varies |
| Fluoroscopy up to 1 hr (76000) | $167.71 | $630 | 0.7× |
| Follow-Up Angiography (75898) | $879.52 | $3,304 | 0.3× |
| Foot 2 views (73620) | $167.71 | $630 | 1.8× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$181.02–$362.03 | $680–$1,360 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$633.56–$652.46 | $2,380–$2,451 | varies |
| Gastroesophageal Reflux Exam (78262) | $584.58 | $2,196 | 1.4× |
| Gated Heart Planar Single (78472) | $914.93 | $3,437 | 2.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$111.80–$115.26 | $420–$433 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $496.73 | $1,866 | 0.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$481.29–$496.73 | $1,808–$1,866 | varies |
| Heart first pass single,planar (78481) | $456 | $1,713 | 0.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,183.64 | $8,203 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$894.43–$966.04 | $3,360–$3,629 | varies |
| Hepatobiliary System Imaging (78226) | $452.54 | $1,700 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $849.18 | $3,190 | 0.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$290.16–$348.19 | $1,090–$1,308 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$167.71–$181.02 | $630–$680 | varies |
| Interstitial radiation source applic complex (77778) | $3,147.82 | $11,825 | 4.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $674.55 | $2,534 | 0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) | $515.90 | $1,938 | 0.9× |
| Intracavitary radiation source applic simple (77761) | $506.58 | $1,903 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $346.59 | $1,302 | 0.6× |
| K Flow/Funct Image W/Drug (78708) | $865.15 | $3,250 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $865.15 | $3,250 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $784.76 | $2,948 | 1.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$151.73–$156.26 | $570–$587 | varies |
| Leveen/Shunt Patency Exam (78291) | $263.54 | $990 | 0.6× |
| Liver & Spleen Imaging Static Only (78215) | $436.57 | $1,640 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $947.67 | $3,560 | 1.6× |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$210.30–$216.69 | $790–$814 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,078.11 | $4,050 | 1.9× |
| Lung Ventilation Imaging (78579) | $351.38 | $1,320 | 0.8× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$762.66–$823.62 | $2,865–$3,094 | varies |
| Magnetic Image Jaw Joint (70336) | $266.20 | $1,000 | 1.0× |
| Magnetic Resonance Elastography (76391) range across 2 matching MRF lines |
$189–$204.18 | $710–$767 | varies |
| Mammary ductogram or galactogram multiple (77054) | $214.56 | $806 | 0.8× |
| Mammary ductogram or galactogram single (77053) | $150.14 | $564 | 0.6× |
| Meckels Divert Exam (78290) | $306.13 | $1,150 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $905.88 | $3,403 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$1,488.06–$1,532.78 | $5,590–$5,758 | varies |
| MRA head w/o contrast (70544) | $1,232.51 | $4,630 | 4.8× |
| MRA neck w contrast (70548) | $1,380.25 | $5,185 | 3.7× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,216.53–$1,532.78 | $4,570–$5,758 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,232.51–$1,304.38 | $4,630–$4,900 | varies |
| MRI abdomen w contrast (74182) | $1,320.62 | $4,961 | 3.5× |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$1,179.27–$2,528.90 | $4,430–$9,500 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,320.62–$1,463.30 | $4,961–$5,497 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,479.01–$1,762.24 | $5,556–$6,620 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$745.36–$1,320.62 | $2,800–$4,961 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$785.29–$848.11 | $2,950–$3,186 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $487.15 | $1,830 | 1.9× |
| MRI cardiac w/o cont stress (75559) | $669.49 | $2,515 | 1.1× |
| MRI cardiac w/o contrast (75557) | $710.75 | $2,670 | 2.8× |
| MRI cervical spine w contrast (72142) | $1,320.62 | $4,961 | 3.5× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,179.27–$1,320.35 | $4,430–$4,960 | varies |
| MRI chest w/o contrast (71550) | $1,179.27 | $4,430 | 4.6× |
| MRI chest with contrast (71551) | $1,320.62 | $4,961 | 1.6× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,328.34–$1,479.01 | $4,990–$5,556 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,320.62 | $4,961 | 3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,173.94–$1,479.01 | $4,410–$5,556 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,179.27–$1,309.70 | $4,430–$4,920 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$718.74–$1,320.62 | $2,700–$4,961 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,479.01–$1,637.13 | $5,556–$6,150 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,408.20–$1,426.30 | $5,290–$5,358 | varies |
| MRI orbit face neck w contrast (70542) | $1,651.50 | $6,204 | 4.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,876.71 | $7,050 | 5.0× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,270.84–$1,320.62 | $4,774–$4,961 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,479.01–$1,484.60 | $5,556–$5,577 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,168.62–$1,179.27 | $4,390–$4,430 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,179.27–$1,315.03 | $4,430–$4,940 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,320.62 | $4,961 | 3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,165.96–$1,179.27 | $4,380–$4,430 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,173.94–$1,479.01 | $4,410–$5,556 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$1,479.01–$3,122.53 | $5,556–$11,730 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,479.01–$1,637.13 | $5,556–$6,150 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,320.62–$1,498.71 | $4,961–$5,630 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,179.27–$1,203.22 | $4,430–$4,520 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,426.83–$1,541.03 | $5,360–$5,789 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,479.01–$1,658.43 | $5,556–$6,230 | varies |
| Myelogram cervical (72240) | $1,570.85 | $5,901 | 1.9× |
| Myelogram Lumbar (72265) | $1,055.48 | $3,965 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,612.64 | $6,058 | 1.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $278.18 | $1,045 | 0.6× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,637.13–$1,686.38 | $6,150–$6,335 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$79.86–$133.10 | $300–$500 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $186.61 | $701 | 0.4× |
| Nonvascular Shunt X-Ray (75809) | $88.64 | $333 | 0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,502.13 | $13,156 | 2.4× |
| Nuclear Rx Intra-Arterial (79445) | $311.45 | $1,170 | 1.2× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$311.45–$342.33 | $1,170–$1,286 | varies |
| Optic foramina (70190) range across 2 matching MRF lines |
$189–$204.18 | $710–$767 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$138.42–$142.68 | $520–$536 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $729.39 | $2,740 | 1.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$729.39–$787.69 | $2,740–$2,959 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$79.86–$125.11 | $300–$470 | varies |
| Peritoneogram Rs&I (74190) | $353.51 | $1,328 | 0.6× |
| Pet Image W/Ct Lmtd (78814) | $1,014.22 | $3,810 | 0.7× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$1,599.86–$1,647.78 | $6,010–$6,190 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,730.30–$1,782.21 | $6,500–$6,695 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,183.64 | $8,203 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $343.40 | $1,290 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $218.02 | $819 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$196.99–$380.67 | $740–$1,430 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $186.34 | $700 | 2.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $122.45 | $460 | 1.3× |
| Radex elbow complete minimum 3 views (73080) | $189 | $710 | 2.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $207.90 | $781 | 1.9× |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$111.80–$335.41 | $420–$1,260 | varies |
| Radex foot complete minimum 3 views (73630) | $186.34 | $700 | 2.0× |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$167.71–$335.41 | $630–$1,260 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $66.55 | $250 | 0.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $79.86 | $300 | 0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$178.35–$192.73 | $670–$724 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$171.70–$353.51 | $645–$1,328 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$79.86–$117.13 | $300–$440 | varies |
| Radex Spine 1 View Specify Level (72020) | $114.47 | $430 | 1.2× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$113.14–$146.41 | $425–$550 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $79.86 | $300 | 0.9× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$101.16–$202.31 | $380–$760 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$167.71–$335.41 | $630–$1,260 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$162.38–$239.58 | $610–$900 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,775.70 | $29,210 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $423.26 | $1,590 | 3.9× |
| Radiation treatment delivery level 2 (77407) | $445.62 | $1,674 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $469.04 | $1,762 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$79.86–$127.78 | $300–$480 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$162.38–$167.17 | $610–$628 | varies |
| Radiologic exam colon double contrast study (74280) | $347.12 | $1,304 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $271.52 | $1,020 | 1.4× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$195.92–$391.85 | $736–$1,472 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $93.17 | $350 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$231.59–$238.52 | $870–$896 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$242.24–$431.78 | $910–$1,622 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$388.65–$500.46 | $1,460–$1,880 | varies |
| Radiologic examination femur 1 view (73551) | $119.79 | $450 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$130.44–$134.43 | $490–$505 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$173.03–$346.06 | $650–$1,300 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$146.41–$150.94 | $550–$567 | varies |
| Radiopharm Dacryocystography (78660) | $362.56 | $1,362 | 0.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) range across 2 matching MRF lines |
$182.61–$274.98 | $686–$1,033 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $274.98 | $1,033 | 0.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $330.09 | $1,240 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,063.05 | $7,750 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$634.89–$654.05 | $2,385–$2,457 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$945.01–$973.49 | $3,550–$3,657 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,059.74 | $3,981 | 0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $934.36 | $3,510 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $240.38 | $903 | 1.0× |
| Scapula (73010) | $135.76 | $510 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$30.61–$33.01 | $115–$124 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$85.18–$175.69 | $320–$660 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$260.88–$369.22 | $980–$1,387 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$79.86–$134.43 | $300–$505 | varies |
| Special dosimetry (77331) | $243.04 | $913 | 1.7× |
| Special Physics Consult (77370) | $330.89 | $1,243 | 2.3× |
| Special teletherapy port plan (77321) | $449.88 | $1,690 | 1.1× |
| Special treatment procedure (77470) | $916.26 | $3,442 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $2,900.78 | $10,897 | 1.5× |
| Sternoclavicular joints (71130) | $124.05 | $466 | 1.3× |
| Superior sagittal sinus venogram (75870) | $4,054.76 | $15,232 | 1.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $106.48 | $400 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $744.30 | $2,796 | 1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $352.72 | $1,325 | 0.9× |
| Testicular Imaging W/Flow (78761) | $420.60 | $1,580 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $972.96 | $3,655 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $462.92 | $1,739 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $487.94 | $1,833 | 3.4× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$63.89–$165.58 | $240–$622 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$185.28–$191.66 | $696–$720 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $514.56 | $1,933 | 1.2× |
| Thyroid Met Imaging Body (78018) | $680.14 | $2,555 | 1.2× |
| Thyroid Uptake Measurement (78012) | $137.63 | $517 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$428.58–$462.92 | $1,610–$1,739 | varies |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$585.91–$5,273.16 | $2,201–$19,809 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$292.82–$585.64 | $1,100–$2,200 | varies |
| Tx devices design & construction simple (77332) | $207.64 | $780 | 1.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$185.28–$200.18 | $696–$752 | varies |
| Ultrasound elastography first target lesion (76982) | $85.98 | $323 | 0.8× |
| Ultrasound Elastography Parenchyma (76981) | $412.61 | $1,550 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$101.16–$104.08 | $380–$391 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$319.44–$849.18 | $1,200–$3,190 | varies |
| Umbilical-artery Doppler (OB) (76820) | $143.48 | $539 | 1.3× |
| Unlisted Dx Radiographic Procedure (76499) | $796.74 | $2,993 | 8.5× |
| Unlisted fluoroscopic procedure (76496) | $91.57 | $344 | 1.0× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $277.38 | $1,042 | 2.5× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$250.23–$444.55 | $940–$1,670 | varies |
| Ureteral Reflux Study (78740) | $365.49 | $1,373 | 0.9× |
| Urethrocystogram voiding (74455) | $274.19 | $1,030 | 1.1× |
| Urethrocystography retrograde (74450) | $274.19 | $1,030 | 1.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$263.54–$316.25 | $990–$1,188 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$134.70–$138.69 | $506–$521 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$349.52–$699.04 | $1,313–$2,626 | varies |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$322.10–$766.66 | $1,210–$2,880 | varies |
| Us head (76506) range across 2 matching MRF lines |
$314.12–$339.14 | $1,180–$1,274 | varies |
| Us kidney transplant (76776) | $125.91 | $473 | 1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$196.46–$212.16 | $738–$797 | varies |
| Us ob detailed single fetus (76811) | $404.62 | $1,520 | 1.6× |
| Us ob limited 1 or more fetuses (76815) | $274.19 | $1,030 | 2.4× |
| Us ob transvaginal (76817) | $324.76 | $1,220 | 2.9× |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$389.45–$678.54 | $1,463–$2,549 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$356.71–$770.38 | $1,340–$2,894 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$137.89–$148.81 | $518–$559 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$359.37–$370.28 | $1,350–$1,391 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$306.13–$330.62 | $1,150–$1,242 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$351.38–$379.60 | $1,320–$1,426 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$120.06–$129.64 | $451–$487 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$329.02–$355.38 | $1,236–$1,335 | varies |
| Us transrectal (76872) | $91.04 | $342 | 0.8× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$966.84–$1,077.84 | $3,632–$4,049 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,183.64 | $8,203 | 0.6× |
| Venogram Sinus/Jugular (75860) | $4,054.76 | $15,232 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $2,183.64 | $8,203 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$695.05–$1,077.84 | $2,611–$4,049 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$684.40–$1,077.84 | $2,571–$4,049 | varies |
| Venography Renal Bilateral (75833) | $2,183.64 | $8,203 | 0.6× |
| Venography Renal Unilateral (75831) | $2,187.90 | $8,219 | 0.6× |
| Venous sampling by catheter (75893) | $4,791.60 | $18,000 | 0.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $298.14 | $1,120 | 0.7× |
| Vertebral fracture assessment via dxa (77086) | $55.90 | $210 | 0.6× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$106.48–$212.96 | $400–$800 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $158.12 | $594 | 1.7× |
| X-ray antegrade pyelogram tube (74425) | $285.90 | $1,074 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $1,994.64 | $7,493 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$113.14–$185.28 | $425–$696 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$117.13–$234.26 | $440–$880 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$151.73–$380.67 | $570–$1,430 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$53.24–$206.84 | $200–$777 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$90.51–$217.22 | $340–$816 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$189–$228.13 | $710–$857 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$58.56–$60.43 | $220–$227 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$137.09–$274.19 | $515–$1,030 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $115.26 | $433 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $146.41 | $550 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$173.03–$186.87 | $650–$702 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$173.03–$178.35 | $650–$670 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$232.66–$409.95 | $874–$1,540 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$143.75–$287.50 | $540–$1,080 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$185.28–$362.03 | $696–$1,360 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$212.96–$247.57 | $800–$930 | varies |
| X-ray humerus (73060) | $189 | $710 | 2.0× |
| X-ray IV pyelogram (ivp) (74400) | $377.47 | $1,418 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$66.55–$71.87 | $250–$270 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$165.58–$182.08 | $622–$684 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$239.58–$271.52 | $900–$1,020 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$143.75–$155.19 | $540–$583 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$79.86–$282.17 | $300–$1,060 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$79.86–$247.57 | $300–$930 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $298.14 | $1,120 | 2.7× |
| X-ray thoracic spine 4 vw (72074) | $196.19 | $737 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$295.48–$304.27 | $1,110–$1,143 | varies |
| X-Rays Bone Length Studies (77073) | $97.70 | $367 | 0.9× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$266.20–$274.19 | $1,000–$1,030 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$165.58–$204.97 | $622–$770 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$79.86–$115.53 | $300–$434 | varies |
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.