Imaging prices at Sentara Halifax Regional Hospital
South Boston, VA · every code in this section with a posted price and a Medicare benchmark.
436 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) | $4,340 | $8,680 | 3.2× |
| Abdomen 1 View (74018) | $167 | $334 | 2.0× |
| Abdomen 2 views (74019) | $265 | $530 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $590.50 | $1,181 | 1.5× |
| Adrenal Cortex & Medulla Img (78075) | $1,350 | $2,700 | 1.1× |
| Angio internal mammary (75756) | $2,083 | $4,166 | 0.7× |
| Angio pulmonary bilat (75743) | $5,878 | $11,756 | 1.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,703 | $9,406 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $3,487 | $6,974 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,378.50 | $6,757 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,878 | $11,756 | 1.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,912.50 | $5,825 | 0.9× |
| Ankle 2 views (73600) | $184.50 | $369 | 2.2× |
| Aortography thoracic serialography rs&i (75605) | $3,661.50 | $7,323 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,526.50 | $7,053 | 1.1× |
| Artery X-Rays Abdomen (75726) | $5,878 | $11,756 | 1.1× |
| Artery X-Rays Adrenal Gland (75731) | $3,358 | $6,716 | 1.1× |
| Artery X-Rays Pelvis (75736) | $5,878 | $11,756 | 1.1× |
| Artery X-Rays Spine (75705) | $3,661.50 | $7,323 | 0.7× |
| Arthrogram ankle (73615) | $592 | $1,184 | 1.7× |
| Arthrogram hip (73525) | $957 | $1,914 | 2.8× |
| Arthrogram Wrist (73115) | $775.50 | $1,551 | 2.3× |
| Basic radiation dosimetry calculation (77300) | $413.50 | $827 | 3.1× |
| Bone age studies (77072) | $118.50 | $237 | 1.2× |
| Bone Imaging 3 Phase (78315) | $1,177.50 | $2,355 | 3.0× |
| Bone Imaging Limited Area (78300) | $1,013.50 | $2,027 | 2.6× |
| Bone Imaging Multiple Areas (78305) | $1,043 | $2,086 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,132 | $2,264 | 2.9× |
| Bone marrow imaging limited area (78102) | $867.50 | $1,735 | 2.2× |
| Bone marrow imaging; multiple areas (78103) | $999.50 | $1,999 | 2.5× |
| Bone marrow imaging; whole body (78104) | $1,247 | $2,494 | 3.2× |
| Bone survey infant (77076) | $201.50 | $403 | 2.0× |
| Brachytx isodose complex (77318) | $2,544.50 | $5,089 | 6.9× |
| Brachytx isodose intermed (77317) | $2,105 | $4,210 | 5.7× |
| Brachytx Isodose Plan Simple (77316) | $1,664 | $3,328 | 4.5× |
| Brain Flow Imaging Only (78610) | $467 | $934 | 0.9× |
| Brain Image W/Flow < 4 Views (78601) | $2,774 | $5,548 | 7.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,667.50 | $7,335 | 6.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,189.50 | $6,379 | 6.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,923 | $3,846 | 5.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,187.50 | $4,375 | 2.8× |
| Cardiac Shunt Detection (78428) | $717 | $1,434 | 1.8× |
| Cat Scan Follow-Up Study (76380) | $533.50 | $1,067 | 6.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,004 | $2,008 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $916 | $1,832 | 1.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$117.50–$197 | $235–$394 | varies |
| Chest 2 views (71046) | $143 | $286 | 1.7× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$198.50–$355 | $397–$710 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$215.50–$444 | $431–$888 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $377.50 | $755 | 3.7× |
| Cisternography Positive Contrast Rs&I (70015) | $1,245 | $2,490 | 1.6× |
| Clavicle complete (73000) | $244 | $488 | 2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$188–$446.50 | $376–$893 | varies |
| Continuing medical physics consltj pr wk (77336) | $554.50 | $1,109 | 4.2× |
| Contrast Exam Abdominl Aorta (75625) | $3,378.50 | $6,757 | 1.1× |
| Contrast X-Ray Bladder (74430) | $276.50 | $553 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $957 | $1,914 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $307.50 | $615 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,259 | $4,518 | 6.6× |
| CT abdomen and pelvis without contrast (74176) | $1,541.50 | $3,083 | 6.6× |
| CT abdomen w contrast (74160) | $1,054.50 | $2,109 | 6.1× |
| CT abdomen w wo contrast (74170) | $1,130 | $2,260 | 6.6× |
| CT abdomen w/o contrast (74150) | $754 | $1,508 | 7.3× |
| CT Angio Abdomen and Pelvis (74174) | $6,390.50 | $12,781 | 18.6× |
| CT Angio Chest (71275) | $1,513.78 | $3,027.57 | 8.8× |
| CT Angio Head (70496) | $2,691.50 | $5,383 | 15.6× |
| CT angio hrt w/3d image (75574) | $375 | $750 | 1.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,782 | $5,564 | 16.1× |
| CT Angio Neck (70498) | $2,637.50 | $5,275 | 15.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,789.50 | $5,579 | 16.2× |
| CT bone density (77078) | $507 | $1,014 | 5.9× |
| CT cervical spine w/ contrast (72126) | $1,518 | $3,036 | 4.4× |
| CT cervical spine w/o contrast (72125) | $1,265 | $2,530 | 12.3× |
| CT cervical spine w/wo cont (72127) | $1,736.50 | $3,473 | 10.1× |
| CT chest w contrast (71260) | $1,497.10 | $2,994.20 | 8.7× |
| CT chest w/wo contrast (71270) | $1,963.50 | $3,927 | 11.4× |
| CT colonography screening (74263) | $433 | $866 | 1.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $536.50 | $1,073 | 3.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $433 | $866 | 4.2× |
| CT head/brain with contrast (70460) | $1,503.50 | $3,007 | 8.7× |
| CT head/brain without and with contrast (70470) | $1,618.50 | $3,237 | 9.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,068 | $2,136 | 3.1× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$45–$51.50 | $90–$103 | varies |
| CT hrt w/3d image congen (75573) | $1,068 | $2,136 | 3.1× |
| CT iac w contrast (70481) | $1,145.50 | $2,291 | 6.6× |
| CT l-spine w&w/o contrast (72133) | $1,955 | $3,910 | 11.3× |
| CT lower ext w/o (73700) | $1,002.88 | $2,005.76 | 9.8× |
| CT lower extremity w/contrast material (73701) | $1,393 | $2,786 | 8.1× |
| CT lumbar spine w contrast (72132) | $1,722.50 | $3,445 | 5.0× |
| CT lumbar spine w/o contrast (72131) | $1,574.50 | $3,149 | 15.3× |
| CT maxillofacial w contrast (70487) | $802.50 | $1,605 | 4.7× |
| CT maxillofacial wo contrast (70486) | $670 | $1,340 | 6.5× |
| CT neck tissue combo (70492) | $1,585 | $3,170 | 9.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,776.50 | $3,553 | 10.3× |
| CT orbits w/o contrast (70480) | $670 | $1,340 | 6.5× |
| CT pelvis w&w/o contrast (72194) | $2,008.50 | $4,017 | 11.6× |
| CT pelvis w/o contrast (72192) | $1,078.92 | $2,157.83 | 10.5× |
| CT scan of leg combo (73702) | $1,504 | $3,008 | 8.7× |
| CT scans face/jaw combo (70488) | $1,796.50 | $3,593 | 10.4× |
| CT soft tissue neck w contrast (70491) | $1,379 | $2,758 | 8.0× |
| CT soft tissue neck w/o contrast (70490) | $848.50 | $1,697 | 8.3× |
| CT thoracic spine w contrast (72129) | $1,810.50 | $3,621 | 10.5× |
| CT thoracic spine w/o contrast (72128) | $1,262.50 | $2,525 | 12.3× |
| CT thoracic spine w/wo cont (72130) | $1,776.50 | $3,553 | 10.3× |
| CT thorax w/o contrast (71250) | $993.12 | $1,986.23 | 9.7× |
| CT upper ext wo (73200) | $1,353.50 | $2,707 | 13.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,681 | $3,362 | 9.7× |
| CT upper extremity with contrast (73201) | $1,520 | $3,040 | 4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,567.50 | $7,135 | 20.7× |
| Cta Abdomen (74175) | $3,308.50 | $6,617 | 19.2× |
| CTA pelvis (72191) | $3,082.50 | $6,165 | 17.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $375.50 | $751 | 1.6× |
| Dilation ureters/urethra rs&i (74485) | $2,347 | $4,694 | 1.1× |
| Discography Cerv/Thor Spine (72285) | $1,771 | $3,542 | 0.9× |
| Diskography lumbar (72295) | $1,859.50 | $3,719 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $132.50 | $265 | 1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $132.50 | $265 | 1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $426 | $852 | 4.1× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$112.50–$578.50 | $225–$1,157 | varies |
| Dxa bone density study (77085) | $1,002 | $2,004 | 9.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$295.50–$326.50 | $591–$653 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$950–$1,016.50 | $1,900–$2,033 | varies |
| Echo exam uterus (76831) | $560.50 | $1,121 | 2.4× |
| Echo Guide For Artery Repair (76936) | $525 | $1,050 | 2.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $280 | $560 | 1.2× |
| Echograp Trans R Pros Study (76873) | $536.50 | $1,073 | 5.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$294–$467 | $588–$934 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$316.50–$338.50 | $633–$677 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $252 | $504 | 2.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $568.50 | $1,137 | 2.4× |
| Fluoroscopy up to 1 hr (76000) | $779.50 | $1,559 | 3.3× |
| Follow-Up Angiography (75898) | $1,862.50 | $3,725 | 0.6× |
| Foot 2 views (73620) | $186 | $372 | 2.2× |
| Forearm 2 views (73090) | $214 | $428 | 2.5× |
| Gastric emptying imaging study (78264) | $846.50 | $1,693 | 2.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,098 | $2,196 | 2.8× |
| Gastroesophageal Reflux Exam (78262) | $696.50 | $1,393 | 1.8× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$925–$1,348 | $1,850–$2,696 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,313.50 | $2,627 | 2.5× |
| Hand 2 views (73120) | $129 | $258 | 1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,957 | $5,914 | 4.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,729 | $5,458 | 4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,374 | $4,748 | 3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,703 | $9,406 | 1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,526.50 | $7,053 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,495.50 | $2,991 | 2.8× |
| Hepatobiliary System Imaging (78226) | $1,495.50 | $2,991 | 3.8× |
| Ht Musc Image Planar Mult (78454) | $1,811 | $3,622 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $1,811 | $3,622 | 1.4× |
| Hysterosalpingogram (74740) | $366 | $732 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $249.50 | $499 | 2.9× |
| Infant hip ultrasound, limited static exam (76886) | $151 | $302 | 1.8× |
| Infusion Ivp (74410) | $361 | $722 | 2.1× |
| Interstitial radiation source applic complex (77778) | $2,957 | $5,914 | 4.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,813.50 | $3,627 | 2.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,592 | $3,184 | 2.9× |
| Intracavitary radiation source applic simple (77761) | $1,376 | $2,752 | 2.5× |
| Joint Survey Single View (77077) | $343.50 | $687 | 3.3× |
| K Flow/Funct Image Multiple (78709) | $1,598 | $3,196 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $1,389 | $2,778 | 2.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,207.50 | $2,415 | 2.3× |
| Kidney Imaging Morphol (78700) | $913.50 | $1,827 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,050 | $2,100 | 2.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$226–$329.50 | $452–$659 | varies |
| Leveen/Shunt Patency Exam (78291) | $696.50 | $1,393 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,202 | $2,404 | 3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,381 | $2,762 | 3.5× |
| Liver imaging static only (78201) | $1,223 | $2,446 | 2.3× |
| Liver imaging w/vascular flow (78202) | $1,223 | $2,446 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $1,356.50 | $2,713 | 2.5× |
| Lung perfusion differential (78597) | $1,356.50 | $2,713 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,141 | $2,282 | 2.1× |
| Lymph System Imaging (78195) | $482 | $964 | 0.9× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,315.50 | $2,631 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,315.50 | $2,631 | 2.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,140 | $4,280 | 0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,140 | $4,280 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $2,034.50 | $4,069 | 8.7× |
| Magnetic Resonance Elastography (76391) | $1,192 | $2,384 | 5.1× |
| Mammary ductogram or galactogram multiple (77054) | $651.50 | $1,303 | 2.8× |
| Mammary ductogram or galactogram single (77053) | $413 | $826 | 1.8× |
| Meckels Divert Exam (78290) | $1,043 | $2,086 | 2.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,906 | $5,812 | 8.5× |
| MRA head w/o contrast (70544) | $2,356 | $4,712 | 10.0× |
| MRA head with contrast (70545) | $2,708 | $5,416 | 7.9× |
| MRA neck w contrast (70548) | $2,704.50 | $5,409 | 7.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,007.50 | $6,015 | 8.8× |
| MRA neck w/o contrast (70547) | $2,504.50 | $5,009 | 10.7× |
| MRI abdomen w contrast (74182) | $1,997.50 | $3,995 | 5.8× |
| MRI abdomen w/o contrast (74181) | $1,905 | $3,810 | 8.1× |
| MRI any jt lower extrem w/contrast material (73722) | $2,416.50 | $4,833 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,195.50 | $6,391 | 9.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,249.50 | $4,499 | 2.9× |
| MRI brain functional w/o physician admnistration (70554) | $2,034.50 | $4,069 | 8.7× |
| MRI brain functional w/physician admnistration (70555) | $1,639 | $3,278 | 7.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,752.50 | $5,505 | 11.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,300.50 | $4,601 | 9.8× |
| MRI cardiac w/o contrast (75557) | $1,362.50 | $2,725 | 5.8× |
| MRI cervical spine w contrast (72142) | $2,668 | $5,336 | 7.8× |
| MRI cervical spine w/o cont (72141) | $2,340.50 | $4,681 | 10.0× |
| MRI chest w/o contrast (71550) | $1,627.50 | $3,255 | 6.9× |
| MRI chest with contrast (71551) | $1,872 | $3,744 | 2.4× |
| MRI chest wo w contrast (71552) | $2,409.50 | $4,819 | 7.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,288 | $4,576 | 6.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,977 | $5,954 | 8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,241.50 | $4,483 | 9.6× |
| MRI lumbar spine w contrast (72149) | $2,862 | $5,724 | 8.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,526.50 | $7,053 | 10.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,938 | $3,876 | 8.3× |
| MRI orbit face neck w contrast (70542) | $2,313.50 | $4,627 | 6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,360 | $6,720 | 9.8× |
| MRI pelvis w contrast (72196) | $2,241.50 | $4,483 | 6.5× |
| MRI pelvis w/o & w contrast (72197) | $3,526 | $7,052 | 10.3× |
| MRI pelvis w/o contrast (72195) | $1,916.50 | $3,833 | 8.2× |
| MRI spectroscopy (76390) | $1,719.50 | $3,439 | 20.1× |
| MRI thoracic spine w/o contrast (72146) | $2,130 | $4,260 | 9.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,241.50 | $4,483 | 6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,976 | $3,952 | 8.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,977 | $5,954 | 8.7× |
| MRI, abdomen, combo (74183) | $3,339 | $6,678 | 9.7× |
| MRI, dorsal spine combo (72157) | $3,450 | $6,900 | 10.1× |
| MRI, dorsal spine contrast (72147) | $2,862 | $5,724 | 8.3× |
| MRI, joint upper extrem (73221) | $2,028.50 | $4,057 | 8.6× |
| MRI, joint upper extrem combo (73223) | $2,588.50 | $5,177 | 7.5× |
| MRI, lumbar spine combo (72158) | $3,593.50 | $7,187 | 10.5× |
| Myelogram cervical (72240) | $1,489.50 | $2,979 | 1.9× |
| Myelogram Lumbar (72265) | $1,847 | $3,694 | 2.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,449 | $2,898 | 1.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,002.50–$3,168 | $4,005–$6,336 | varies |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,263 | $4,526 | 1.0× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$244–$438 | $488–$876 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $931 | $1,862 | 2.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $227 | $454 | 0.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,123.50 | $8,247 | 3.0× |
| Nuclear Rx Intra-Arterial (79445) | $935.50 | $1,871 | 4.1× |
| Nuclear Rx Oral Admin (79005) | $1,269.50 | $2,539 | 5.5× |
| Ob us nuchal meas 1 gest (76813) | $509.50 | $1,019 | 5.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $228.50 | $457 | 2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $313 | $626 | 3.0× |
| Panoramic X-ray of jaws (70355) | $334.50 | $669 | 3.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,036 | $2,072 | 1.9× |
| Parathyroid Planar Imaging (78070) | $365.50 | $731 | 0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $965 | $1,930 | 2.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$174.50–$322.50 | $349–$645 | varies |
| Pet Image Skull-Thigh (78812) | $5,425 | $10,850 | 3.9× |
| PET image w/CT, full body (78816) | $4,409 | $8,818 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,409 | $8,818 | 3.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $5,425 | $10,850 | 4.3× |
| PET whole body (78813) | $5,425 | $10,850 | 3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,703 | $9,406 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $705 | $1,410 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$286–$494.50 | $572–$989 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $334.50 | $669 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $232 | $464 | 2.7× |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$162.50–$247 | $325–$494 | varies |
| Radex elbow complete minimum 3 views (73080) | $246.50 | $493 | 2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $322 | $644 | 3.1× |
| Radex fingr minimum 2 views (73140) | $143 | $286 | 1.7× |
| Radex foot complete minimum 3 views (73630) | $196 | $392 | 2.3× |
| Radex Hand Minimum 3 Views (73130) | $196 | $392 | 2.3× |
| Radex lower extremity infant minimum 2 views (73592) | $127 | $254 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $266.50 | $533 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$220.50–$293 | $441–$586 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $264.50 | $529 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $198 | $396 | 2.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $424.50 | $849 | 5.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $654.50 | $1,309 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $146.50 | $293 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $283 | $566 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$349–$359.50 | $698–$719 | varies |
| Radex Toe Minimum 2 Views (73660) | $191.50 | $383 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $120 | $240 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $214 | $428 | 2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$317–$353 | $634–$706 | varies |
| Radiation treatment delivery level 1 (77402) | $371 | $742 | 3.7× |
| Radiation treatment delivery level 2 (77407) | $371 | $742 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $564.50 | $1,129 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$322.50–$404 | $645–$808 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $273.50 | $547 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $1,146 | $2,292 | 6.6× |
| Radiologic exam colon single contrast study (74270) | $482.50 | $965 | 2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $294 | $588 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) | $242.50 | $485 | 2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$386.50–$427 | $773–$854 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $569 | $1,138 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $175 | $350 | 1.0× |
| Radiologic exam teeth complete full mouth (70320) | $147.50 | $295 | 0.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $147.50 | $295 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,056 | $2,112 | 6.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$127.50–$373.50 | $255–$747 | varies |
| Radiologic examination femur minimum 2 views (73552) | $129.50 | $259 | 1.5× |
| Radiologic examination knee 1/2 views (73560) | $185.50 | $371 | 2.2× |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$678–$749.50 | $1,356–$1,499 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $214 | $428 | 2.5× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $66 | $132 | 0.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $2,729 | $5,458 | 7.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $2,374 | $4,748 | 6.3× |
| Renal Cyst Study (74470) | $387 | $774 | 0.7× |
| Ribs bilateral 3 views (71110) | $545.50 | $1,091 | 5.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,169 | $2,338 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,285.50 | $2,571 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,414.50 | $2,829 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,556 | $3,112 | 2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,882.50 | $3,765 | 1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,071 | $4,142 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,712 | $3,424 | 1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $874.50 | $1,749 | 3.8× |
| Rp Therapy Intravenous Administration (79101) | $658.50 | $1,317 | 2.9× |
| Salivary Gland Imaging Serial Images (78231) | $696.50 | $1,393 | 1.8× |
| Scapula (73010) range across 2 matching MRF lines |
$198–$381.50 | $396–$763 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$49.50–$63.50 | $99–$127 | varies |
| Sella turcica (70240) | $141.50 | $283 | 1.7× |
| Shoulder 1 view (73020) | $198 | $396 | 2.3× |
| Shoulder Arthrography (73040) | $578 | $1,156 | 1.7× |
| Sialogram (70390) | $643 | $1,286 | 2.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$234–$520.50 | $468–$1,041 | varies |
| Special dosimetry (77331) | $378.50 | $757 | 2.9× |
| Special Physics Consult (77370) | $575.50 | $1,151 | 4.4× |
| Special teletherapy port plan (77321) | $919 | $1,838 | 2.5× |
| Special treatment procedure (77470) | $1,850 | $3,700 | 3.4× |
| Spleen Imaging (78185) | $727 | $1,454 | 1.8× |
| Srs Multisource (77371) | $14,869 | $29,738 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $10,508.50 | $21,017 | 6.0× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$356–$393 | $712–$786 | varies |
| Superior sagittal sinus venogram (75870) | $1,862.50 | $3,725 | 0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $905.50 | $1,811 | 2.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $788 | $1,576 | 2.1× |
| Testicular Imaging W/Flow (78761) | $828 | $1,656 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,275.50 | $2,551 | 3.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $946 | $1,892 | 2.6× |
| Ther rad simulaj-aided field setting simple (77280) | $636 | $1,272 | 4.8× |
| Thoracic spine 2 views (72070) | $264 | $528 | 2.6× |
| Thoracic spine 3 views (72072) | $362 | $724 | 3.5× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$282–$472 | $564–$944 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $813.50 | $1,627 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $613.50 | $1,227 | 1.6× |
| Thyroid Met Imaging Body (78018) | $1,869.50 | $3,739 | 3.5× |
| Thyroid Uptake Measurement (78012) | $1,342.50 | $2,685 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,129.50 | $2,259 | 2.9× |
| Tx Devices Design & Construction Complex (77334) | $514 | $1,028 | 1.4× |
| Tx devices design & construction intermediate (77333) | $448 | $896 | 3.4× |
| Tx devices design & construction simple (77332) | $389.50 | $779 | 2.9× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$241–$641.50 | $482–$1,283 | varies |
| Ultrasound elastography first target lesion (76982) | $307 | $614 | 3.0× |
| Ultrasound Elastography Parenchyma (76981) | $307 | $614 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$87.50–$607 | $175–$1,214 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $626.50 | $1,253 | 1.8× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$504–$634.50 | $1,008–$1,269 | varies |
| Umbilical-artery Doppler (OB) (76820) | $500 | $1,000 | 4.9× |
| Unlisted magnetic resonance procedure (76498) | $1,041 | $2,082 | 12.2× |
| Unlisted us procedure (76999) | $109.50 | $219 | 1.3× |
| Upper gi w/o kub (74240) | $686 | $1,372 | 4.0× |
| Ureteral Reflux Study (78740) | $913.50 | $1,827 | 2.3× |
| Urethrocystogram voiding (74455) | $525 | $1,050 | 2.2× |
| Urethrocystography retrograde (74450) | $271 | $542 | 1.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$299–$634 | $598–$1,268 | varies |
| Us chest (76604) range across 5 matching MRF lines |
$341.50–$359.50 | $683–$719 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$568.50–$688.50 | $1,137–$1,377 | varies |
| Us exam, pelvic, limited (76857) | $235 | $470 | 2.3× |
| Us head (76506) | $713 | $1,426 | 6.9× |
| Us kidney transplant (76776) | $550 | $1,100 | 5.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$85.50–$302.50 | $171–$605 | varies |
| Us ob detailed single fetus (76811) | $452.50 | $905 | 1.9× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$246.50–$264 | $493–$528 | varies |
| Us ob transvaginal (76817) | $330 | $660 | 3.2× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$461–$463 | $922–$926 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $323 | $646 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $180 | $360 | 1.8× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$440.50–$584 | $881–$1,168 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$424.50–$533 | $849–$1,066 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$622–$626 | $1,244–$1,252 | varies |
| Us spinal canal and contents (76800) | $504.50 | $1,009 | 4.9× |
| Us thyroid (76536) range across 4 matching MRF lines |
$502.50–$543.50 | $1,005–$1,087 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$218.50–$581 | $437–$1,162 | varies |
| Vascular Flow Imaging (78445) | $468.50 | $937 | 1.2× |
| Vasogram (74440) | $617 | $1,234 | 2.6× |
| Vein X-Ray Chest (75827) | $2,083 | $4,166 | 1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,862.50 | $3,725 | 0.6× |
| Vein X-Ray Spleen/Liver (75810) | $3,358 | $6,716 | 1.1× |
| Venogram Sinus/Jugular (75860) | $2,140 | $4,280 | 0.7× |
| Venography Adrenal Unilateral (75840) | $4,703 | $9,406 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $4,703 | $9,406 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $2,495 | $4,990 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $1,665.50 | $3,331 | 1.1× |
| Venography Orbital Rs&I (75880) | $2,912.50 | $5,825 | 4.7× |
| Venography Renal Bilateral (75833) | $4,703 | $9,406 | 1.5× |
| Venography Renal Unilateral (75831) | $4,703 | $9,406 | 1.5× |
| Venous sampling by catheter (75893) | $4,703 | $9,406 | 0.9× |
| Venous thrombosis imaging (78457) | $852 | $1,704 | 1.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $979 | $1,958 | 2.5× |
| Vertebral fracture assessment via dxa (77086) | $192 | $384 | 2.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$182.50–$250.50 | $365–$501 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$222.50–$303.50 | $445–$607 | varies |
| X-ray antegrade pyelogram tube (74425) | $529.50 | $1,059 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $3,526.50 | $7,053 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$507.50–$561 | $1,015–$1,122 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $200 | $400 | 2.3× |
| X-Ray Exam Breast Specimen (76098) | $242 | $484 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $232 | $464 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $267 | $534 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $307 | $614 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$125.50–$172.50 | $251–$345 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$149–$207 | $298–$414 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$302.50–$334.50 | $605–$669 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $237.50 | $475 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$318.50–$351.50 | $637–$703 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$371.50–$410.50 | $743–$821 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $482.50 | $965 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $226.50 | $453 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$485.50–$588 | $971–$1,176 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $274.50 | $549 | 2.7× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$181.50–$186 | $363–$372 | varies |
| X-ray head for orthodontia (70350) | $141.50 | $283 | 1.7× |
| X-ray humerus (73060) | $220.50 | $441 | 2.6× |
| X-ray IV pyelogram (ivp) (74400) | $1,225.50 | $2,451 | 7.1× |
| X-ray IV pyelogram+tomography (74415) | $1,380.50 | $2,761 | 8.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $283 | $566 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $170 | $340 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $238.50 | $477 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $229 | $458 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$626.50–$693.50 | $1,253–$1,387 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$250–$413.50 | $500–$827 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $218 | $436 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $234 | $468 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$488–$790.50 | $976–$1,581 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$398–$693 | $796–$1,386 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$442–$579 | $884–$1,158 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$303.50–$336 | $607–$672 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $362.50 | $725 | 1.1× |
| X-Rays Bone Length Studies (77073) | $115.50 | $231 | 1.1× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$780–$882.50 | $1,560–$1,765 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$324–$437 | $648–$874 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$280.50–$309.50 | $561–$619 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $138 | $276 | 1.3× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$474.50–$524.50 | $949–$1,049 | varies |
| Xr Tomogram Single Plane (76100) | $158.50 | $317 | 1.5× |
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.