Imaging prices at Sibley Memorial Hospital
Washington, DC · every code in this section with a posted price and a Medicare benchmark.
408 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) | $6,897 | $6,897 | 4.2× |
| Abdomen 1 View (74018) | $531 | $531 | 5.2× |
| Abdomen 2 views (74019) | $807 | $807 | 6.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,725 | $1,725 | 3.7× |
| Adrenal Cortex & Medulla Img (78075) | $5,330 | $5,330 | 3.5× |
| Angio internal mammary (75756) | $3,194 | $3,194 | 0.9× |
| Angio pulmonary bilat (75743) | $3,368 | $3,368 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,792 | $3,792 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $3,055 | $3,055 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,814 | $2,814 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,729 | $2,729 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,869 | $2,869 | 0.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$457–$676 | $457–$676 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,493 | $5,493 | 0.8× |
| Artery X-Rays Abdomen (75726) | $5,027 | $5,027 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $2,471 | $2,471 | 0.7× |
| Artery X-Rays Pelvis (75736) | $4,925 | $4,925 | 0.7× |
| Artery X-Rays Spine (75705) | $6,241 | $6,241 | 0.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,751–$2,892 | $1,751–$2,892 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,537–$2,538 | $1,537–$2,538 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,448–$2,399 | $1,448–$2,399 | varies |
| Basic radiation dosimetry calculation (77300) | $1,201 | $1,201 | 7.6× |
| Bone age studies (77072) | $576 | $576 | 4.7× |
| Bone Imaging 3 Phase (78315) | $1,737 | $1,737 | 3.7× |
| Bone Imaging Limited Area (78300) | $3,213 | $3,213 | 6.8× |
| Bone Imaging Multiple Areas (78305) | $3,213 | $3,213 | 6.8× |
| Bone Imaging Whole Body (78306) | $2,949 | $2,949 | 6.2× |
| Bone marrow imaging; multiple areas (78103) | $5,330 | $5,330 | 11.3× |
| Bone marrow imaging; whole body (78104) | $5,330 | $5,330 | 11.3× |
| Bone survey infant (77076) | $806 | $806 | 6.5× |
| Brachytx isodose complex (77318) | $3,361 | $3,361 | 7.6× |
| Brachytx isodose intermed (77317) | $2,837 | $2,837 | 6.4× |
| Brachytx Isodose Plan Simple (77316) | $2,387 | $2,387 | 5.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,251 | $2,251 | 3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,878 | $8,878 | 5.3× |
| Cat Scan Follow-Up Study (76380) | $1,128 | $1,128 | 11.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,018 | $2,018 | 3.1× |
| Cerebrospinal Fluid Scan (78630) | $2,579 | $2,579 | 4.0× |
| Chest 1 view (71045) | $661 | $661 | 6.4× |
| Chest 2 views (71046) | $698 | $698 | 6.8× |
| Chest 3 views (71047) | $773 | $773 | 7.5× |
| Chest 4 or more views (71048) | $827 | $827 | 6.7× |
| Cisternography Positive Contrast Rs&I (70015) | $857 | $857 | 0.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$473–$705 | $473–$705 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,128 | $1,128 | 9.1× |
| Continuing medical physics consltj pr wk (77336) | $1,840 | $1,840 | 11.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,116 | $3,116 | 0.8× |
| Contrast X-Ray Bladder (74430) | $902 | $902 | 2.2× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,714–$2,840 | $1,714–$2,840 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$2,020–$3,348 | $2,020–$3,348 | varies |
| Corpora cavernosography (74445) | $1,539 | $1,539 | 12.5× |
| CT abdomen and pelvis without and with contrast (74178) | $8,244 | $8,244 | 20.0× |
| CT abdomen and pelvis without contrast (74176) | $4,523 | $4,523 | 16.0× |
| CT abdomen w contrast (74160) | $3,256 | $3,256 | 15.7× |
| CT abdomen w wo contrast (74170) | $4,036 | $4,036 | 19.5× |
| CT abdomen w/o contrast (74150) | $1,727 | $1,727 | 14.0× |
| CT Angio Abdomen and Pelvis (74174) | $8,244 | $8,244 | 20.0× |
| CT Angio Chest (71275) | $2,798 | $2,798 | 13.5× |
| CT Angio Head (70496) | $3,357 | $3,357 | 16.2× |
| CT angio hrt w/3d image (75574) | $1,534 | $1,534 | 3.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$4,210–$6,979 | $4,210–$6,979 | varies |
| CT Angio Neck (70498) | $3,340 | $3,340 | 16.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$4,210–$6,979 | $4,210–$6,979 | varies |
| CT cervical spine w/ contrast (72126) | $2,488 | $2,488 | 6.0× |
| CT cervical spine w/o contrast (72125) | $2,564 | $2,564 | 20.8× |
| CT cervical spine w/wo cont (72127) | $4,210 | $4,210 | 20.3× |
| CT chest w contrast (71260) | $3,359 | $3,359 | 16.2× |
| CT chest w/wo contrast (71270) | $4,210 | $4,210 | 20.3× |
| CT colonography screening (74263) | $761 | $761 | 2.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,798 | $2,798 | 13.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,798 | $2,798 | 22.7× |
| CT head/brain with contrast (70460) | $2,480 | $2,480 | 12.0× |
| CT head/brain without and with contrast (70470) | $3,357 | $3,357 | 16.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,534 | $1,534 | 3.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $688 | $688 | 6.7× |
| CT iac w contrast (70481) | $2,696 | $2,696 | 13.0× |
| CT l-spine w&w/o contrast (72133) | $4,686 | $4,686 | 22.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,805–$4,655 | $2,805–$4,655 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,357–$5,562 | $3,357–$5,562 | varies |
| CT lumbar spine w contrast (72132) | $3,357 | $3,357 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $2,891 | $2,891 | 23.4× |
| CT maxillofacial w contrast (70487) | $2,696 | $2,696 | 13.0× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$791–$2,250 | $791–$2,250 | varies |
| CT neck tissue combo (70492) | $3,340 | $3,340 | 16.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,357 | $3,357 | 16.2× |
| CT orbits w/o contrast (70480) | $2,541 | $2,541 | 20.6× |
| CT pelvis w&w/o contrast (72194) | $4,210 | $4,210 | 20.3× |
| CT pelvis w/o contrast (72192) | $2,798 | $2,798 | 22.7× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$4,210–$6,979 | $4,210–$6,979 | varies |
| CT scans face/jaw combo (70488) | $3,357 | $3,357 | 16.2× |
| CT soft tissue neck w contrast (70491) | $2,776 | $2,776 | 13.4× |
| CT soft tissue neck w/o contrast (70490) | $2,324 | $2,324 | 18.8× |
| CT thoracic spine w contrast (72129) | $3,357 | $3,357 | 16.2× |
| CT thoracic spine w/o contrast (72128) | $2,798 | $2,798 | 22.7× |
| CT thoracic spine w/wo cont (72130) | $4,210 | $4,210 | 20.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,402–$2,798 | $1,402–$2,798 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,805–$4,350 | $2,805–$4,350 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$4,210–$6,979 | $4,210–$6,979 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$3,357–$5,562 | $3,357–$5,562 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,557 | $3,557 | 17.2× |
| Cta Abdomen (74175) | $5,012 | $5,012 | 24.2× |
| CTA pelvis (72191) | $4,210 | $4,210 | 20.3× |
| Dilation ureters/urethra rs&i (74485) | $1,871 | $1,871 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $2,284 | $2,284 | 1.0× |
| Diskography lumbar (72295) | $3,828 | $3,828 | 1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $684 | $684 | 5.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $684 | $684 | 5.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $661 | $661 | 5.4× |
| Dxa Bone Density Axial (77080) | $808 | $808 | 6.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $808 | $808 | 7.9× |
| Echo exam of fetal heart (76825) | $2,253 | $2,253 | 3.5× |
| Echo exam uterus (76831) | $518 | $518 | 1.8× |
| Echo Guide For Artery Repair (76936) | $1,507 | $1,507 | 5.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,253 | $2,253 | 8.0× |
| Echograp Trans R Pros Study (76873) | $1,719 | $1,719 | 13.9× |
| Esophageal Motility Study (78258) | $1,268 | $1,268 | 2.7× |
| Esophagram (74220) | $1,040 | $1,040 | 5.0× |
| Fetal Biophys Profile W/Nst (76818) | $1,823 | $1,823 | 14.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,823 | $1,823 | 14.8× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,112–$1,731 | $1,112–$1,731 | varies |
| Follow-Up Angiography (75898) | $1,614 | $1,614 | 0.4× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$726–$1,090 | $726–$1,090 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$499–$715 | $499–$715 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,274–$1,709 | $1,274–$1,709 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,709 | $1,709 | 3.6× |
| Gastroesophageal Reflux Exam (78262) | $1,191 | $1,191 | 2.5× |
| Gated Heart Planar Single (78472) | $1,831 | $1,831 | 3.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,562 | $2,562 | 4.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$457–$676 | $457–$676 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,902 | $7,902 | 9.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $7,155 | $7,155 | 8.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $7,155 | $7,155 | 8.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,053 | $3,053 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,073 | $3,073 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $2,250 | $2,250 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,896 | $1,896 | 4.0× |
| Hysterosalpingogram (74740) | $1,363 | $1,363 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,139 | $1,139 | 11.1× |
| Infant hip ultrasound, limited static exam (76886) | $1,021 | $1,021 | 9.9× |
| Infusion Ivp (74410) | $1,616 | $1,616 | 7.8× |
| Interstitial radiation source applic complex (77778) | $6,829 | $6,829 | 8.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $7,228 | $7,228 | 8.8× |
| K Flow/Funct Image Multiple (78709) | $2,636 | $2,636 | 4.1× |
| K Flow/Funct Image W/Drug (78708) | $2,636 | $2,636 | 4.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,710 | $1,710 | 2.7× |
| Kidney Imaging Morphol (78700) | $1,477 | $1,477 | 3.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$513–$748 | $513–$748 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,409 | $1,409 | 3.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,652 | $1,652 | 3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,567 | $2,567 | 5.4× |
| Liver imaging static only (78201) | $2,567 | $2,567 | 4.0× |
| Liver imaging w/vascular flow (78202) | $2,567 | $2,567 | 4.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,829 | $2,829 | 4.4× |
| Lung perfusion differential (78597) | $2,168 | $2,168 | 4.6× |
| Lung Ventilat&Perfus Imaging (78582) | $2,251 | $2,251 | 3.5× |
| Lung Ventilation Imaging (78579) | $1,911 | $1,911 | 4.0× |
| Lymph System Imaging (78195) | $1,954 | $1,954 | 3.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,679 | $2,679 | 0.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| Mammary ductogram or galactogram multiple (77054) | $1,697 | $1,697 | 6.0× |
| Mammary ductogram or galactogram single (77053) | $1,366 | $1,366 | 4.8× |
| Meckels Divert Exam (78290) | $1,889 | $1,889 | 4.0× |
| Mlc imrt design & construction per imrt plan (77338) | $2,570 | $2,570 | 5.8× |
| Mra Head W/O & W/Contrast Material (70546) | $4,946 | $4,946 | 12.0× |
| MRA head w/o contrast (70544) | $4,328 | $4,328 | 15.4× |
| MRA head with contrast (70545) | $4,328 | $4,328 | 10.5× |
| MRA neck w contrast (70548) | $4,328 | $4,328 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,946 | $4,946 | 12.0× |
| MRA neck w/o contrast (70547) | $4,328 | $4,328 | 15.4× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,102–$6,140 | $3,102–$6,140 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$4,135–$9,021 | $4,135–$9,021 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,702–$7,016 | $3,702–$7,016 | varies |
| MRI bone marrow blood supply (77084) | $1,682 | $1,682 | 6.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $5,317 | $5,317 | 18.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,054 | $3,054 | 10.8× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| MRI cervical spine w contrast (72142) | $4,616 | $4,616 | 11.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$3,364–$3,850 | $3,364–$3,850 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$4,453–$4,604 | $4,453–$4,604 | varies |
| MRI chest with contrast (71551) | $4,604 | $4,604 | 5.0× |
| MRI chest wo w contrast (71552) | $4,604 | $4,604 | 11.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,102–$6,140 | $3,102–$6,140 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,135–$9,021 | $4,135–$9,021 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,102–$6,140 | $3,102–$6,140 | varies |
| MRI lumbar spine w contrast (72149) | $5,080 | $5,080 | 12.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,814 | $5,814 | 14.1× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,633–$3,850 | $2,633–$3,850 | varies |
| MRI orbit face neck w contrast (70542) | $3,850 | $3,850 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,946 | $4,946 | 12.0× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| MRI pelvis w/o & w contrast (72197) | $4,763 | $4,763 | 11.6× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$4,161–$4,763 | $4,161–$4,763 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$3,702–$4,237 | $3,702–$4,237 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$4,237–$7,016 | $4,237–$7,016 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$4,237–$7,016 | $4,237–$7,016 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,702–$9,021 | $3,702–$9,021 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$5,080–$6,398 | $5,080–$6,398 | varies |
| MRI, dorsal spine combo (72157) | $6,398 | $6,398 | 15.5× |
| MRI, dorsal spine contrast (72147) | $5,080 | $5,080 | 12.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,702–$7,016 | $3,702–$7,016 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$5,443–$9,021 | $5,443–$9,021 | varies |
| MRI, lumbar spine combo (72158) | $6,398 | $6,398 | 15.5× |
| Myelogram cervical (72240) | $1,989 | $1,989 | 2.1× |
| Myelogram Lumbar (72265) | $1,829 | $1,829 | 2.0× |
| Myelography thoracic (72255) | $2,890 | $2,890 | 3.1× |
| Myelograpy 2/more regions rs&i (72270) | $2,670 | $2,670 | 2.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,938 | $1,938 | 4.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,394 | $1,394 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $5,860 | $5,860 | 3.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $6,715 | $6,715 | 4.0× |
| Neck soft tissue (70360) | $399 | $399 | 3.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,726 | $1,726 | 3.8× |
| Nm csf leak detection (78650) | $2,841 | $2,841 | 1.9× |
| Nm unlisted gi procedure (78299) | $1,673 | $1,673 | 3.5× |
| Nonvascular Shunt X-Ray (75809) | $1,358 | $1,358 | 11.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $13,830 | $13,830 | 8.5× |
| Nuclear Rx Oral Admin (79005) | $2,244 | $2,244 | 8.1× |
| Ob us nuchal meas 1 gest (76813) | $684 | $684 | 5.5× |
| Parathyroid Planar Imaging (78070) | $800 | $800 | 1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,066 | $2,066 | 4.4× |
| Pelvis 1 or 2 views (72170) | $539 | $539 | 4.4× |
| Pet Image W/Ct Lmtd (78814) | $8,878 | $8,878 | 5.3× |
| PET image w/CT, full body (78816) | $8,878 | $8,878 | 5.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,878 | $8,878 | 5.3× |
| Proton trmt simple w/comp (77522) | $7,423 | $7,423 | 5.0× |
| Proton tx delivery complex (77525) | $7,555 | $7,555 | 5.1× |
| Proton tx delivery intermediate (77523) | $7,548 | $7,548 | 5.1× |
| Proton tx delivery simple w/o compensation (77520) | $4,472 | $4,472 | 6.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,026 | $3,026 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,971 | $1,971 | 4.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,198 | $1,198 | 9.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$902–$1,286 | $902–$1,286 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$715–$1,054 | $715–$1,054 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$452–$665 | $452–$665 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$645–$1,061 | $645–$1,061 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $726 | $726 | 5.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$186–$367 | $186–$367 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$895–$1,462 | $895–$1,462 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$530–$764 | $530–$764 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$396–$645 | $396–$645 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $814 | $814 | 6.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $500 | $500 | 4.9× |
| Radex Ribs Unilateral 2 Views (71100) | $584 | $584 | 5.7× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$609–$895 | $609–$895 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $609 | $609 | 5.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $947 | $947 | 4.6× |
| Radex Spine 1 View Specify Level (72020) | $376 | $376 | 3.7× |
| Radex Sternum Minimum 2 Views (71120) | $571 | $571 | 5.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $701 | $701 | 6.8× |
| Radex Toe Minimum 2 Views (73660) | $412 | $412 | 4.0× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$806–$1,311 | $806–$1,311 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$513–$1,281 | $513–$1,281 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $2,289 | $2,289 | 18.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $46,308 | $46,308 | 5.3× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$658–$1,257 | $658–$1,257 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$769–$1,817 | $769–$1,817 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$860–$1,537 | $860–$1,537 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $634 | $634 | 5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,198 | $1,198 | 9.7× |
| Radiologic exam colon double contrast study (74280) | $2,032 | $2,032 | 9.8× |
| Radiologic exam colon single contrast study (74270) | $1,499 | $1,499 | 7.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$513–$748 | $513–$748 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $705 | $705 | 5.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,097 | $1,097 | 5.3× |
| Radiologic exam swallow function contrast study (74230) | $1,068 | $1,068 | 5.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $838 | $838 | 4.0× |
| Radiologic examination femur 1 view (73551) | $544 | $544 | 5.3× |
| Radiologic examination femur minimum 2 views (73552) | $673 | $673 | 6.5× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$488–$715 | $488–$715 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,442 | $1,442 | 11.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$488–$715 | $488–$715 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $983 | $983 | 2.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $657 | $657 | 1.4× |
| Renal Cyst Study (74470) | $1,069 | $1,069 | 1.7× |
| Ribs bilateral 3 views (71110) | $748 | $748 | 6.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,645 | $1,645 | 3.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,337 | $2,337 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,995 | $4,995 | 7.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,857 | $2,857 | 4.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,857 | $2,857 | 4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $5,918 | $5,918 | 3.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,715 | $6,715 | 4.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,918 | $5,918 | 3.9× |
| Rp Therapy Intravenous Administration (79101) | $2,870 | $2,870 | 10.4× |
| Salivary Gland Imaging Serial Images (78231) | $1,725 | $1,725 | 3.7× |
| Scapula (73010) | $500 | $500 | 4.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $172 | $172 | 7.4× |
| Sella turcica (70240) | $467 | $467 | 4.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$550–$824 | $550–$824 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,537–$2,538 | $1,537–$2,538 | varies |
| Sialogram (70390) | $1,230 | $1,230 | 4.4× |
| Skull less than 4 views (70250) | $961 | $961 | 7.8× |
| Special dosimetry (77331) | $999 | $999 | 6.3× |
| Special Physics Consult (77370) | $2,238 | $2,238 | 14.1× |
| Special teletherapy port plan (77321) | $2,512 | $2,512 | 5.7× |
| Special treatment procedure (77470) | $3,058 | $3,058 | 4.7× |
| Speech evaluation, complex (70371) | $1,035 | $1,035 | 3.7× |
| Stereotactic Body Radiation Delivery (77373) | $18,656 | $18,656 | 8.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$641–$1,051 | $641–$1,051 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,076 | $1,076 | 8.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,865 | $3,865 | 8.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,767 | $2,767 | 6.3× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$1,751–$2,892 | $1,751–$2,892 | varies |
| Testicular Imaging W/Flow (78761) | $1,407 | $1,407 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,086 | $5,086 | 11.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $4,353 | $4,353 | 9.8× |
| Ther rad simulaj-aided field setting simple (77280) | $2,823 | $2,823 | 17.8× |
| Thoracic spine 2 views (72070) | $630 | $630 | 5.1× |
| Thoracic spine 3 views (72072) | $705 | $705 | 5.7× |
| Thoracolumbar 2 views (72080) | $705 | $705 | 6.9× |
| Thyroid Imaging With Vascular Flow (78013) | $970 | $970 | 2.1× |
| Thyroid Met Imaging Body (78018) | $2,940 | $2,940 | 4.6× |
| Thyroid Uptake Measurement (78012) | $759 | $759 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,704 | $1,704 | 3.6× |
| Tx Devices Design & Construction Complex (77334) | $2,682 | $2,682 | 6.1× |
| Tx devices design & construction intermediate (77333) | $2,313 | $2,313 | 14.6× |
| Tx devices design & construction simple (77332) | $1,190 | $1,190 | 7.5× |
| Ultrasound Breast Limited (76642) | $1,187 | $1,187 | 11.5× |
| Ultrasound elastography first target lesion (76982) | $655 | $655 | 5.3× |
| Ultrasound Elastography Parenchyma (76981) | $1,265 | $1,265 | 10.2× |
| Ultrasound Exam Aaa Screen (76706) | $692 | $692 | 5.6× |
| Ultrasound, abdomen limited (76705) | $1,221 | $1,221 | 9.9× |
| Umbilical-artery Doppler (OB) (76820) | $1,472 | $1,472 | 11.9× |
| Unlisted Dx Radiographic Procedure (76499) | $111 | $111 | 1.1× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $2,636 | $2,636 | 5.6× |
| Unlisted magnetic resonance procedure (76498) | $2,792 | $2,792 | 27.2× |
| Unlisted us procedure (76999) | $586 | $586 | 5.7× |
| Upper gi w/o kub (74240) | $1,404 | $1,404 | 6.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $106 | $106 | 9.6× |
| Urea breath test c-14 isotopic analysis (78268) | $467 | $467 | 4.9× |
| Urethrocystogram voiding (74455) | $2,366 | $2,366 | 8.4× |
| Urethrocystography retrograde (74450) | $1,230 | $1,230 | 4.4× |
| Us breast unilateral complete (76641) | $1,187 | $1,187 | 9.6× |
| Us chest (76604) | $1,215 | $1,215 | 9.8× |
| Us complete joint (76881) range across 2 matching MRF lines |
$1,254–$2,064 | $1,254–$2,064 | varies |
| Us exam, pelvic, limited (76857) | $1,218 | $1,218 | 9.9× |
| Us head (76506) | $1,288 | $1,288 | 10.4× |
| Us kidney transplant (76776) | $1,288 | $1,288 | 10.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,254 | $1,254 | 10.2× |
| Us ob detailed single fetus (76811) | $1,654 | $1,654 | 5.9× |
| Us ob limited 1 or more fetuses (76815) | $1,276 | $1,276 | 10.3× |
| Us ob transvaginal (76817) | $970 | $970 | 7.9× |
| Us pelvic non ob complete (76856) | $1,420 | $1,420 | 11.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,524 | $1,524 | 12.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $970 | $970 | 7.9× |
| Us retroperitoneal complete (76770) | $1,712 | $1,712 | 13.9× |
| Us retroperitoneal limited (76775) | $1,288 | $1,288 | 10.4× |
| Us scrotum and contents (76870) | $1,094 | $1,094 | 8.9× |
| Us spinal canal and contents (76800) | $1,524 | $1,524 | 12.3× |
| Us thyroid (76536) | $1,250 | $1,250 | 10.1× |
| Us transrectal (76872) | $1,606 | $1,606 | 13.0× |
| Vascular Flow Imaging (78445) | $1,159 | $1,159 | 2.5× |
| Vasogram (74440) | $966 | $966 | 3.4× |
| Vein X-Ray Chest (75827) | $1,771 | $1,771 | 1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,004 | $3,004 | 0.8× |
| Venogram Sinus/Jugular (75860) | $3,220 | $3,220 | 0.9× |
| Venography Adrenal Unilateral (75840) | $3,792 | $3,792 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $2,824 | $2,824 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,772 | $1,772 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,629 | $1,629 | 0.9× |
| Venography Renal Bilateral (75833) | $2,839 | $2,839 | 0.8× |
| Venography Renal Unilateral (75831) | $2,631 | $2,631 | 0.7× |
| Venous sampling by catheter (75893) | $5,509 | $5,509 | 0.8× |
| Vertebral fracture assessment via dxa (77086) | $706 | $706 | 6.9× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$438–$676 | $438–$676 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$571–$846 | $571–$846 | varies |
| X-ray antegrade pyelogram tube (74425) | $984 | $984 | 2.4× |
| X-Ray Aorta Leg Arteries (75630) | $4,790 | $4,790 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $850 | $850 | 6.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$535–$874 | $535–$874 | varies |
| X-Ray Exam Breast Specimen (76098) | $555 | $555 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $705 | $705 | 6.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,204 | $1,204 | 9.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $2,289 | $2,289 | 18.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $571 | $571 | 5.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $704 | $704 | 6.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,788 | $1,788 | 14.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $853 | $853 | 6.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,054 | $1,054 | 8.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,679 | $2,679 | 21.7× |
| X-Ray Exam L-S Spine Bending (72114) | $1,231 | $1,231 | 10.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $730 | $730 | 7.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,084 | $1,084 | 8.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $700 | $700 | 5.7× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$549–$774 | $549–$774 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,616 | $1,616 | 7.8× |
| X-ray IV pyelogram+tomography (74415) | $1,767 | $1,767 | 8.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $467 | $467 | 4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $473 | $473 | 4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $904 | $904 | 7.3× |
| X-ray nose-rectum child f.b. (76010) | $1,308 | $1,308 | 12.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $889 | $889 | 7.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $609 | $609 | 4.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $521 | $521 | 4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $834 | $834 | 8.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $906 | $906 | 8.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $945 | $945 | 7.7× |
| X-ray thoracic spine 4 vw (72074) | $705 | $705 | 5.7× |
| X-Ray Tmj Unilat (70328) | $609 | $609 | 5.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,285 | $1,285 | 3.1× |
| X-Rays Bone Length Studies (77073) | $834 | $834 | 6.8× |
| X-Rays Bone Survey Complete (77075) | $1,701 | $1,701 | 13.8× |
| Xr c-spine 4 or 5 views (72050) | $904 | $904 | 7.3× |
| Xr facial bones less than 3 views (70140) | $676 | $676 | 6.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $571 | $571 | 4.6× |
| Xr orbits complete 4 views (70200) | $806 | $806 | 6.5× |
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.