Imaging prices at Santa Ynez Valley Cottage Hospital
Solvang, CA · every code in this section with a posted price and a Medicare benchmark.
338 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) | $959 | $1,370 | 0.5× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$268.80–$371 | $384–$530 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$280–$609.70 | $400–$871 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,048.60 | $1,498 | 2.0× |
| Angio pulmonary bilat (75743) | $3,551.10 | $5,073 | 0.9× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,057.90–$4,463.90 | $5,797–$6,377 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,583.30–$3,612.70 | $5,119–$5,161 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,340.80 | $3,344 | 0.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$172.20–$329 | $246–$470 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,784.20 | $5,406 | 0.5× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$9,456.30–$10,402 | $13,509–$14,860 | varies |
| Artery X-Rays Pelvis (75736) | $3,784.20 | $5,406 | 0.5× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$2,546.60–$3,784.20 | $3,638–$5,406 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$432.60–$567.70 | $618–$811 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$541.10–$1,379.70 | $773–$1,971 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$432.60–$644.70 | $618–$921 | varies |
| Basic radiation dosimetry calculation (77300) | $1,103.20 | $1,576 | 6.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$172.20–$357 | $246–$510 | varies |
| Bone Imaging 3 Phase (78315) | $3,593.80 | $5,134 | 7.0× |
| Bone Imaging Whole Body (78306) | $3,094 | $4,420 | 6.0× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$172.20–$369.60 | $246–$528 | varies |
| Brachytx isodose complex (77318) | $868 | $1,240 | 1.8× |
| Brachytx isodose intermed (77317) | $868 | $1,240 | 1.8× |
| Brachytx Isodose Plan Simple (77316) | $5,835.20 | $8,336 | 12.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $951.30 | $1,359 | 1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,255.50 | $10,365 | 3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$3,221.40–$4,754.40 | $4,602–$6,792 | varies |
| Cardiac Shunt Detection (78428) | $1,192.10 | $1,703 | 2.3× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$268.80–$427 | $384–$610 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$280–$483 | $400–$690 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$290.50–$490 | $415–$700 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$301–$525 | $430–$750 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$172.20–$316.40 | $246–$452 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$1,640.80–$1,804.60 | $2,344–$2,578 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,199.80 | $1,714 | 6.9× |
| Contrast Exam Abdominl Aorta (75625) | $3,147.90 | $4,497 | 0.8× |
| Contrast X-Ray Bladder (74430) range across 4 matching MRF lines |
$676.20–$1,804.60 | $966–$2,578 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$432.60–$837.20 | $618–$1,196 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$432.60–$909.30 | $618–$1,299 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,990.80–$5,791.10 | $2,844–$8,273 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$1,312.50–$4,212.60 | $1,875–$6,018 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,815.80–$2,460.50 | $2,594–$3,515 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,990.80–$3,535 | $2,844–$5,050 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$1,640.80–$2,072.70 | $2,344–$2,961 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,990.80–$4,329.50 | $2,844–$6,185 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$1,815.80–$4,124.40 | $2,594–$5,892 | varies |
| CT Angio Head (70496) range across 4 matching MRF lines |
$1,487.50–$2,887.50 | $2,125–$4,125 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$2,226–$3,636.50 | $3,180–$5,195 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,225–$6,274.80 | $1,750–$8,964 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,662.50–$2,887.50 | $2,375–$4,125 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,225–$6,093.50 | $1,750–$8,705 | varies |
| CT cervical spine w/ contrast (72126) range across 4 matching MRF lines |
$1,487.50–$2,053.10 | $2,125–$2,933 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$1,312.50–$1,444.10 | $1,875–$2,063 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,662.50–$2,256.80 | $2,375–$3,224 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,815.80–$3,481.80 | $2,594–$4,974 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,990.80–$3,231.90 | $2,844–$4,617 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,487.50–$2,086 | $2,125–$2,980 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,662.50–$2,422 | $2,375–$3,460 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$2,226–$2,448.60 | $3,180–$3,498 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $150 | $214.29 | 1.3× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,487.50–$2,587.90 | $2,125–$3,697 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,662.50–$2,256.80 | $2,375–$3,224 | varies |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,050–$3,171 | $1,500–$4,530 | varies |
| CT lower extremity w/contrast material (73701) range across 5 matching MRF lines |
$1,225–$5,646.90 | $1,750–$8,067 | varies |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$1,487.50–$2,053.10 | $2,125–$2,933 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$1,312.50–$1,444.10 | $1,875–$2,063 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$1,225–$2,086 | $1,750–$2,980 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$1,050–$1,822.10 | $1,500–$2,603 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,662.50–$2,352.70 | $2,375–$3,361 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,662.50–$2,590 | $2,375–$3,700 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,312.50–$2,282 | $1,875–$3,260 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,662.50–$3,231.90 | $2,375–$4,617 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$1,312.50–$2,303 | $1,875–$3,290 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,400–$3,850 | $2,000–$5,500 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,400–$2,352.70 | $2,000–$3,361 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,487.50–$2,216.90 | $2,125–$3,167 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,312.50–$1,733.90 | $1,875–$2,477 | varies |
| CT thoracic spine w contrast (72129) range across 4 matching MRF lines |
$1,487.50–$2,053.10 | $2,125–$2,933 | varies |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$1,312.50–$1,444.10 | $1,875–$2,063 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,662.50–$2,170 | $2,375–$3,100 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$1,640.80–$2,592.10 | $2,344–$3,703 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,050–$2,297.40 | $1,500–$3,282 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$1,400–$2,549.40 | $2,000–$3,642 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$1,225–$2,340.10 | $1,750–$3,343 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,226–$3,026.10 | $3,180–$4,323 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,815.80–$2,625 | $2,594–$3,750 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,487.50–$1,890.70 | $2,125–$2,701 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$268.80–$1,434.30 | $384–$2,049 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $413 | $590 | 3.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $569.10 | $813 | 4.2× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$172.20–$608.30 | $246–$869 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$172.20–$237.30 | $246–$339 | varies |
| Echo exam of fetal heart (76825) | $1,926.40 | $2,752 | 2.7× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$285.60–$602 | $408–$860 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $674.80 | $964 | 2.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$268.80–$402.50 | $384–$575 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$285.60–$314.30 | $408–$449 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) range across 2 matching MRF lines |
$1,837.50–$2,021.60 | $2,625–$2,888 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$538.30–$804.30 | $769–$1,149 | varies |
| Follow-Up Angiography (75898) | $2,986.20 | $4,266 | 0.7× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$172.20–$302.40 | $246–$432 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$172.20–$329 | $246–$470 | varies |
| Gastric emptying imaging study (78264) | $2,640.40 | $3,772 | 5.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$172.20–$203.70 | $246–$291 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $8,554 | $12,220 | 9.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $9,644.60 | $13,778 | 10.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,868.50 | $6,955 | 5.4× |
| Heart Image (Pet) Multiple (78492) | $5,635.70 | $8,051 | 3.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$5,599.30–$6,159.30 | $7,999–$8,799 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $8,509.20 | $12,156 | 2.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,422.70 | $3,461 | 3.5× |
| Hepatobiliary System Imaging (78226) | $2,132.90 | $3,047 | 4.1× |
| Ht Musc Image Planar Mult (78454) | $3,894.10 | $5,563 | 2.3× |
| Ht Muscle Image Spect Sing (78451) | $4,274.20 | $6,106 | 2.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$344.40–$935.20 | $492–$1,336 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$228.20–$471.10 | $326–$673 | varies |
| Interstitial radiation source applic complex (77778) | $1,899.80 | $2,714 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $1,351.70 | $1,931 | 1.9× |
| K Flow/Funct Image W/O Drug (78707) | $973 | $1,390 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$182–$329 | $260–$470 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $953.40 | $1,362 | 1.9× |
| Lung perfusion differential (78597) | $3,811.50 | $5,445 | 7.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,943.90 | $2,777 | 2.8× |
| Lymph System Imaging (78195) | $2,212.70 | $3,161 | 3.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,470–$1,964.90 | $2,100–$2,807 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) range across 2 matching MRF lines |
$2,012.50–$2,870 | $2,875–$4,100 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) range across 2 matching MRF lines |
$1,837.50–$2,617.30 | $2,625–$3,739 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) range across 2 matching MRF lines |
$2,187.50–$3,192.70 | $3,125–$4,561 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$275.80–$704.90 | $394–$1,007 | varies |
| Meckels Divert Exam (78290) | $953.40 | $1,362 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $4,871.30 | $6,959 | 10.1× |
| Mr safety determination physician/other qhp (76016) | $154 | $220 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $58.10 | $83 | 1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $218.40 | $312 | 1.8× |
| Mr safety implt pos&/immoblj (76019) | $141.40 | $202 | 1.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $575.40 | $822 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,187.50–$4,085.90 | $3,125–$5,837 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,837.50–$2,050.30 | $2,625–$2,929 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,012.50–$2,526.30 | $2,875–$3,609 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,012.50–$3,223.50 | $2,875–$4,605 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,187.50–$3,714.20 | $3,125–$5,306 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,837.50–$2,021.60 | $2,625–$2,888 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,471.70–$2,718.80 | $3,531–$3,884 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,296.70–$2,526.30 | $3,281–$3,609 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,645–$2,222.50 | $2,350–$3,175 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,820–$2,582.30 | $2,600–$3,689 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,645–$2,226.70 | $2,350–$3,181 | varies |
| MRI brain functional w/o physician admnistration (70554) | $2,555.70 | $3,651 | 8.3× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,470–$1,617 | $2,100–$2,310 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$1,470–$1,617 | $2,100–$2,310 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$2,871.40–$3,366.30 | $4,102–$4,809 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$2,012.50–$2,237.90 | $2,875–$3,197 | varies |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$1,837.50–$3,389.40 | $2,625–$4,842 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,296.70–$2,473.10 | $3,281–$3,533 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,646.70–$3,114.30 | $3,781–$4,449 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,820–$4,865.70 | $2,600–$6,951 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,470–$3,132.50 | $2,100–$4,475 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,012.50–$2,767.10 | $2,875–$3,953 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$2,187.50–$3,691.10 | $3,125–$5,273 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,837.50–$2,617.30 | $2,625–$3,739 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,012.50–$2,617.30 | $2,875–$3,739 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,187.50–$3,264.80 | $3,125–$4,664 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,012.50–$2,819.60 | $2,875–$4,028 | varies |
| MRI pelvis w/o & w contrast (72197) range across 6 matching MRF lines |
$2,187.50–$6,343.40 | $3,125–$9,062 | varies |
| MRI pelvis w/o contrast (72195) range across 6 matching MRF lines |
$1,837.50–$2,734.90 | $2,625–$3,907 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$1,837.50–$2,021.60 | $2,625–$2,888 | varies |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$1,837.50–$2,526.30 | $2,625–$3,609 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,470–$1,642.90 | $2,100–$2,347 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,820–$2,480.10 | $2,600–$3,543 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,646.70–$2,911.30 | $3,781–$4,159 | varies |
| MRI, dorsal spine combo (72157) range across 4 matching MRF lines |
$2,187.50–$3,691.10 | $3,125–$5,273 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,471.70–$2,695 | $3,531–$3,850 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,470–$1,727.60 | $2,100–$2,468 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,820–$2,620.10 | $2,600–$3,743 | varies |
| MRI, lumbar spine combo (72158) range across 4 matching MRF lines |
$2,187.50–$3,691.10 | $3,125–$5,273 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,559.80 | $6,514 | 2.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,848.30 | $4,069 | 1.7× |
| Myocardial Spect Multiple Studies (78452) | $5,053.30 | $7,219 | 3.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $10,995.60 | $15,708 | 6.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $11,609.50 | $16,585 | 6.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $6,001.10 | $8,573 | 2.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $6,701.10 | $9,573 | 2.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $6,342.70 | $9,061 | 3.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$215.60–$298.90 | $308–$427 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$336–$357 | $480–$510 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,145.50 | $13,065 | 5.1× |
| Nuclear Rx Intra-Arterial (79445) | $555.80 | $794 | 1.9× |
| Nuclear Rx Oral Admin (79005) | $1,253 | $1,790 | 4.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,145.40 | $5,922 | 5.9× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$215.60–$480.90 | $308–$687 | varies |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$970.20–$1,066.80 | $1,386–$1,524 | varies |
| Pet Image W/Ct Lmtd (78814) | $7,529.20 | $10,756 | 4.1× |
| PET image w/CT, full body (78816) | $6,516.30 | $9,309 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,776 | $9,680 | 3.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,414 | $2,020 | 0.8× |
| Pet Myocardial Sngl Study (78491) | $5,252.80 | $7,504 | 2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$5,599.30–$6,159.30 | $7,999–$8,799 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $953.40 | $1,362 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$268.80–$693.70 | $384–$991 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$620.90–$1,178.10 | $887–$1,683 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$182–$404.60 | $260–$578 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$172.20–$279.30 | $246–$399 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$172.20–$392 | $246–$560 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$172.20–$555.10 | $246–$793 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$172.20–$298.90 | $246–$427 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$182–$417.90 | $260–$597 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$172.20–$487.90 | $246–$697 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$172.20–$276.50 | $246–$395 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$172.20–$402.50 | $246–$575 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$268.80–$329 | $384–$470 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$182–$453.60 | $260–$648 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$172.20–$300.30 | $246–$429 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$215.60–$338.10 | $308–$483 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$268.80–$375.20 | $384–$536 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$172.20–$392.70 | $246–$561 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$172.20–$314.30 | $246–$449 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$172.20–$457.80 | $246–$654 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$182–$377.30 | $260–$539 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,991.30 | $18,559 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $1,463 | $2,090 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$215.60–$573.30 | $308–$819 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$290.50–$630 | $415–$900 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$268.80–$790.30 | $384–$1,129 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$268.80–$597.80 | $384–$854 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$172.20–$495.60 | $246–$708 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$224–$686.70 | $320–$981 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$268.80–$791 | $384–$1,130 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$215.60–$546 | $308–$780 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$268.80–$961.10 | $384–$1,373 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$172.20–$369.60 | $246–$528 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$172.20–$329 | $246–$470 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$172.20–$401.80 | $246–$574 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $527.10 | $753 | 1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $570.50 | $815 | 1.2× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$268.80–$545.30 | $384–$779 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,951.20 | $4,216 | 5.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $949.20 | $1,356 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,309.30 | $3,299 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,943.80 | $5,634 | 5.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,278.80 | $4,684 | 4.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,719.10 | $5,313 | 2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,606.40 | $5,152 | 2.2× |
| Scapula (73010) range across 2 matching MRF lines |
$172.20–$377.30 | $246–$539 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $68.60 | $98 | 2.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$172.20–$412.30 | $246–$589 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$432.60–$898.10 | $618–$1,283 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$215.60–$495.60 | $308–$708 | varies |
| Special dosimetry (77331) | $326.90 | $467 | 1.9× |
| Special Physics Consult (77370) | $2,160.20 | $3,086 | 12.5× |
| Special teletherapy port plan (77321) | $2,183.30 | $3,119 | 4.5× |
| Special treatment procedure (77470) | $2,696.40 | $3,852 | 3.8× |
| Stereotactic Body Radiation Delivery (77373) | $9,146.20 | $13,066 | 4.0× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$172.20–$255.50 | $246–$365 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$172.20–$2,203.60 | $246–$3,148 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $316.40 | $452 | 2.4× |
| Tbs technical calculation only (77091) | $177.10 | $253 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,959.20 | $5,656 | 8.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $868 | $1,240 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,759.30 | $6,799 | 9.9× |
| Ther rad simulaj-aided field setting simple (77280) | $3,109.40 | $4,442 | 18.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$268.80–$746.20 | $384–$1,066 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$215.60–$437.50 | $308–$625 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$215.60–$495.60 | $308–$708 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$215.60–$395.50 | $308–$565 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,992.90 | $2,847 | 3.9× |
| Tx Devices Design & Construction Complex (77334) | $1,377.60 | $1,968 | 2.9× |
| Tx devices design & construction intermediate (77333) | $333.90 | $477 | 1.9× |
| Tx devices design & construction simple (77332) | $653.10 | $933 | 3.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$228.20–$492.10 | $326–$703 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$446.60–$753.20 | $638–$1,076 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$357–$753.20 | $510–$1,076 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$172.20–$741.30 | $246–$1,059 | varies |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$336–$375.20 | $480–$536 | varies |
| Unlisted magnetic resonance procedure (76498) range across 5 matching MRF lines |
$1,572.90–$3,158.40 | $2,247–$4,512 | varies |
| Upper gi w/o kub (74240) range across 6 matching MRF lines |
$268.80–$870.10 | $384–$1,243 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$430.50–$967.40 | $615–$1,382 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$430.50–$764.40 | $615–$1,092 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$228.20–$547.40 | $326–$782 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$357–$707.70 | $510–$1,011 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$228.20–$828.80 | $326–$1,184 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$285.60–$487.90 | $408–$697 | varies |
| Us head (76506) range across 2 matching MRF lines |
$285.60–$643.30 | $408–$919 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$357–$828.80 | $510–$1,184 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$228.20–$515.20 | $326–$736 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$285.60–$529.90 | $408–$757 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$344.40–$417.20 | $492–$596 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$285.60–$870.10 | $408–$1,243 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$285.60–$849.10 | $408–$1,213 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$357–$991.90 | $510–$1,417 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$357–$828.80 | $510–$1,184 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$285.60–$828.80 | $408–$1,184 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$285.60–$589.40 | $408–$842 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$285.60–$828.80 | $408–$1,184 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$357–$498.40 | $510–$712 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$336–$2,078.30 | $480–$2,969 | varies |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$5,599.30–$6,159.30 | $7,999–$8,799 | varies |
| Venography Adrenal Unilateral (75840) | $5,464.20 | $7,806 | 1.3× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$336–$2,203.60 | $480–$3,148 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$3,517.50–$3,869.60 | $5,025–$5,528 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,801.10–$2,033.50 | $2,573–$2,905 | varies |
| Venography Renal Bilateral (75833) | $6,652.10 | $9,503 | 1.6× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$268.80–$2,203.60 | $384–$3,148 | varies |
| Venous sampling by catheter (75893) | $8,120 | $11,600 | 1.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$172.20–$371.70 | $246–$531 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$172.20–$412.30 | $246–$589 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$676.20–$1,918.70 | $966–$2,741 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,147.90 | $4,497 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$215.60–$499.80 | $308–$714 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$172.20–$358.40 | $246–$512 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$970.20–$1,066.80 | $1,386–$1,524 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$215.60–$788.20 | $308–$1,126 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$215.60–$910 | $308–$1,300 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 4 matching MRF lines |
$224–$1,085 | $320–$1,550 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$215.60–$275.80 | $308–$394 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$215.60–$320.60 | $308–$458 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$238–$1,203.30 | $340–$1,719 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$172.20–$683.20 | $246–$976 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$238–$683.20 | $340–$976 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$238–$831.60 | $340–$1,188 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$215.60–$495.60 | $308–$708 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$268.80–$476 | $384–$680 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$172.20–$329 | $246–$470 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$268.80–$737.10 | $384–$1,053 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$215.60–$343 | $308–$490 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$172.20–$268.80 | $246–$384 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$215.60–$495.60 | $308–$708 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$280–$619.50 | $400–$885 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$215.60–$396.90 | $308–$567 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$215.60–$408.10 | $308–$583 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$172.20–$546.70 | $246–$781 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$215.60–$695.80 | $308–$994 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$172.20–$231.70 | $246–$331 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$676.20–$1,363.60 | $966–$1,948 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$172.20–$451.50 | $246–$645 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$172.20–$554.40 | $246–$792 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$238–$573.30 | $340–$819 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$172.20–$308.70 | $246–$441 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$215.60–$495.60 | $308–$708 | 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.