Imaging prices at Sierra Medical Center
El Paso, TX · every code in this section with a posted price and a Medicare benchmark.
387 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) | $17,888.25 | $23,851 | 12.9× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$582.75–$1,116 | $777–$1,488 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$654–$1,766.25 | $872–$2,355 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$3,342–$4,326 | $4,456–$5,768 | varies |
| Adrenal Cortex & Medulla Img (78075) | $4,093.50 | $5,458 | 3.1× |
| Angio internal mammary (75756) | $15,372.75 | $20,497 | 4.8× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$3,929.25–$9,447.75 | $5,239–$12,597 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,968 | $6,624 | 1.6× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$6,870.75–$12,981 | $9,161–$17,308 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$5,187.75–$8,997.75 | $6,917–$11,997 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$9,447.75–$14,116.50 | $12,597–$18,822 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 3 matching MRF lines |
$2,710.50–$3,600 | $3,614–$4,800 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$473.25–$1,081.50 | $631–$1,442 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$9,447.75–$26,300.25 | $12,597–$35,067 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 2 matching MRF lines |
$3,171–$9,447.75 | $4,228–$12,597 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$14,303.25–$26,300.25 | $19,071–$35,067 | varies |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$7,593.75–$9,447.75 | $10,125–$12,597 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$15,762–$16,551.75 | $21,016–$22,069 | varies |
| Arthrogram ankle (73615) | $2,026.50 | $2,702 | 5.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$623.25–$843.75 | $831–$1,125 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$738.75–$1,133.25 | $985–$1,511 | varies |
| Basic radiation dosimetry calculation (77300) | $465.75 | $621 | 3.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$706.50–$1,786.50 | $942–$2,382 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,674–$3,651.75 | $2,232–$4,869 | varies |
| Bone Imaging Limited Area (78300) range across 3 matching MRF lines |
$1,963.50–$4,256.25 | $2,618–$5,675 | varies |
| Bone Imaging Multiple Areas (78305) | $1,963.50 | $2,618 | 4.9× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$4,371.75–$7,330.50 | $5,829–$9,774 | varies |
| Bone marrow imaging limited area (78102) | $1,856.25 | $2,475 | 4.6× |
| Bone marrow imaging; multiple areas (78103) | $1,856.25 | $2,475 | 4.6× |
| Bone marrow imaging; whole body (78104) | $1,856.25 | $2,475 | 4.6× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$2,686.50–$3,787.50 | $3,582–$5,050 | varies |
| Brain Flow Imaging Only (78610) | $3,302.25 | $4,403 | 6.1× |
| Brain Image W/Flow < 4 Views (78601) | $1,452.75 | $1,937 | 3.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $4,348.50 | $5,798 | 8.0× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,536.50 | $3,382 | 4.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,901.25 | $10,535 | 5.5× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $2,499 | $3,332 | 4.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $5,390.25 | $7,187 | 15.4× |
| Cardiac Shunt Detection (78428) | $2,106 | $2,808 | 5.2× |
| Cat Scan Follow-Up Study (76380) range across 11 matching MRF lines |
$1,120.50–$5,146.50 | $1,494–$6,862 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,709.75 | $3,613 | 5.0× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$2,336.25–$2,709.75 | $3,115–$3,613 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$434.25–$1,214.25 | $579–$1,619 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$633–$1,398.75 | $844–$1,865 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$654.75–$1,563 | $873–$2,084 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$783–$1,700.25 | $1,044–$2,267 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $1,275.75 | $1,701 | 1.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$438–$1,526.25 | $584–$2,035 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$352.50–$417 | $470–$556 | varies |
| Continuing medical physics consltj pr wk (77336) | $813.75 | $1,085 | 6.0× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$4,914–$10,872 | $6,552–$14,496 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$986.25–$2,457.75 | $1,315–$3,277 | varies |
| Contrast X-Ray Of Elbow (73085) | $2,154.75 | $2,873 | 6.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,320.75 | $1,761 | 3.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$4,769.25–$23,668.50 | $6,359–$31,558 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$2,065.50–$16,917 | $2,754–$22,556 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$3,398.25–$9,297.75 | $4,531–$12,397 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$4,769.25–$11,823.75 | $6,359–$15,765 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$2,065.50–$7,560 | $2,754–$10,080 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 5 matching MRF lines |
$6,855–$7,558.50 | $9,140–$10,078 | varies |
| CT Angio Chest (71275) range across 6 matching MRF lines |
$2,940–$8,811 | $3,920–$11,748 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$3,564.75–$10,583.25 | $4,753–$14,111 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,979.25–$3,507.75 | $2,639–$4,677 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$3,277.50–$7,659 | $4,370–$10,212 | varies |
| CT Angio Neck (70498) range across 6 matching MRF lines |
$3,384–$10,793.25 | $4,512–$14,391 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 6 matching MRF lines |
$3,306.75–$8,116.50 | $4,409–$10,822 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$2,820.75–$5,241.75 | $3,761–$6,989 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$3,410.25–$5,201.25 | $4,547–$6,935 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$4,212–$4,780.50 | $5,616–$6,374 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$3,132.75–$8,689.50 | $4,177–$11,586 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$2,821.50–$8,713.50 | $3,762–$11,618 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$3,344.25–$9,822 | $4,459–$13,096 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$3,441.75–$10,438.50 | $4,589–$13,918 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,853.75 | $3,805 | 8.1× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$134.25–$2,105.25 | $179–$2,807 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$4,030.50–$5,433 | $5,374–$7,244 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$3,144–$9,393 | $4,192–$12,524 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,497.75–$5,053.50 | $1,997–$6,738 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,190–$6,522 | $2,920–$8,696 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$2,816.25–$9,098.25 | $3,755–$12,131 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$3,176.25–$8,360.25 | $4,235–$11,147 | varies |
| CT maxillofacial w contrast (70487) range across 5 matching MRF lines |
$2,894.25–$10,298.25 | $3,859–$13,731 | varies |
| CT maxillofacial wo contrast (70486) range across 5 matching MRF lines |
$3,255–$8,365.50 | $4,340–$11,154 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$3,153.75–$11,499.75 | $4,205–$15,333 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$4,057.50–$5,505 | $5,410–$7,340 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$4,043.25–$4,245 | $5,391–$5,660 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$4,009.50–$8,923.50 | $5,346–$11,898 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,600.50–$6,080.25 | $2,134–$8,107 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,954.25–$7,770 | $3,939–$10,360 | varies |
| CT scans face/jaw combo (70488) range across 5 matching MRF lines |
$2,773.50–$13,226.25 | $3,698–$17,635 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$3,358.50–$9,666 | $4,478–$12,888 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$2,826.75–$7,203 | $3,769–$9,604 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$2,395.50–$3,427.50 | $3,194–$4,570 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$3,159.75–$3,612.75 | $4,213–$4,817 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$2,950.50–$4,218.75 | $3,934–$5,625 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,732.25–$6,493.50 | $3,643–$8,658 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,418–$3,672.75 | $3,224–$4,897 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,841–$4,929.75 | $3,788–$6,573 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,415.75–$4,181.25 | $3,221–$5,575 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$3,201–$10,564.50 | $4,268–$14,086 | varies |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$3,477.75–$11,199.75 | $4,637–$14,933 | varies |
| CTA pelvis (72191) range across 6 matching MRF lines |
$3,497.25–$11,038.50 | $4,663–$14,718 | varies |
| Dilation ureters/urethra rs&i (74485) | $2,029.50 | $2,706 | 1.0× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$9,377.25–$10,126.50 | $12,503–$13,502 | varies |
| Diskography lumbar (72295) range across 3 matching MRF lines |
$8,090.25–$10,126.50 | $10,787–$13,502 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $3,849.75 | $5,133 | 36.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$918–$7,699.50 | $1,224–$10,266 | varies |
| Dxa Bone Density Axial (77080) | $1,146.75 | $1,529 | 10.9× |
| Dxa bone density study (77085) | $1,017.75 | $1,357 | 9.7× |
| Echo exam of fetal heart (76825) | $6,398.25 | $8,531 | 11.7× |
| Echo exam uterus (76831) | $1,064.25 | $1,419 | 4.4× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$763.50–$2,742 | $1,018–$3,656 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $3,123 | $4,164 | 13.0× |
| Esophagram (74220) range across 3 matching MRF lines |
$1,062.75–$2,278.50 | $1,417–$3,038 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$857.25–$2,431.50 | $1,143–$3,242 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$657–$2,034 | $876–$2,712 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,842 | $6,456 | 20.2× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$443.25–$1,680.75 | $591–$2,241 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$2,888.25–$5,566.50 | $3,851–$7,422 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$378.75–$1,095.75 | $505–$1,461 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$492.75–$1,255.50 | $657–$1,674 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$5,044.50–$5,086.50 | $6,726–$6,782 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $5,896.50 | $7,862 | 14.7× |
| Gated Heart Planar Single (78472) | $5,020.50 | $6,694 | 12.5× |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$4,780.50–$5,789.25 | $6,374–$7,719 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $5,896.50 | $7,862 | 10.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$412.50–$1,071.75 | $550–$1,429 | varies |
| Heart Image (Pet) Multiple (78492) | $7,878 | $10,504 | 5.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $9,447.75 | $12,597 | 3.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $9,447.75 | $12,597 | 3.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,898.25–$2,650.50 | $2,531–$3,534 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$6,948.75–$7,641.75 | $9,265–$10,189 | varies |
| Ht Musc Image Planar Mult (78454) | $15,351.75 | $20,469 | 11.8× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$7,788–$10,197.75 | $10,384–$13,597 | varies |
| Hysterosalpingogram (74740) | $1,944.75 | $2,593 | 8.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$940.50–$1,002 | $1,254–$1,336 | varies |
| Infusion Ivp (74410) | $789.75 | $1,053 | 4.5× |
| K Flow/Funct Image W/Drug (78708) | $5,080.50 | $6,774 | 9.3× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$3,369–$4,380.75 | $4,492–$5,841 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $3,687.75 | $4,917 | 9.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,649.75 | $3,533 | 6.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$642–$863.25 | $856–$1,151 | varies |
| Leveen/Shunt Patency Exam (78291) | $3,480 | $4,640 | 8.7× |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$2,471.25–$4,888.50 | $3,295–$6,518 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,307.75 | $3,077 | 5.7× |
| Liver imaging static only (78201) | $5,477.25 | $7,303 | 10.0× |
| Liver imaging w/vascular flow (78202) | $4,065.75 | $5,421 | 7.5× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$4,242.75–$4,515.75 | $5,657–$6,021 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$1,493.25–$1,797 | $1,991–$2,396 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$3,971.25–$5,694 | $5,295–$7,592 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,094.75–$2,769 | $2,793–$3,692 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$1,777.50–$1,959.75 | $2,370–$2,613 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$1,302–$1,537.50 | $1,736–$2,050 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,976.25–$4,235.25 | $2,635–$5,647 | varies |
| Mr safety determination physician/other qhp (76016) | $338.25 | $451 | 3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $93.75 | $125 | 3.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $352.50 | $470 | 3.7× |
| Mr safety implt pos&/immoblj (76019) | $228 | $304 | 3.8× |
| Mr safety med physics xm customization plng&mntr (76017) | $927.75 | $1,237 | 3.9× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$5,247–$8,214.75 | $6,996–$10,953 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$5,157.75–$5,652 | $6,877–$7,536 | varies |
| MRA head with contrast (70545) | $6,650.25 | $8,867 | 19.0× |
| MRA neck w contrast (70548) | $5,974.50 | $7,966 | 17.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,824 | $10,432 | 22.3× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$3,897.75–$5,565.75 | $5,197–$7,421 | varies |
| MRI abdomen w contrast (74182) | $3,711.75 | $4,949 | 10.6× |
| MRI abdomen w/o contrast (74181) | $5,312.25 | $7,083 | 22.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$4,477.50–$5,362.50 | $5,970–$7,150 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,308.75 | $9,745 | 20.9× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,971.50–$3,276 | $3,962–$4,368 | varies |
| MRI brain functional w/physician admnistration (70555) | $1,107.75 | $1,477 | 4.6× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$3,276–$4,827 | $4,368–$6,436 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$3,276–$4,443 | $4,368–$5,924 | varies |
| MRI cardiac w/o cont stress (75559) | $3,742.50 | $4,990 | 6.8× |
| MRI cardiac w/o contrast (75557) | $4,004.25 | $5,339 | 16.7× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$3,731.25–$5,529.75 | $4,975–$7,373 | varies |
| MRI cervical spine w/o cont (72141) | $5,289 | $7,052 | 22.1× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$3,939–$4,209 | $5,252–$5,612 | varies |
| MRI chest with contrast (71551) | $3,939 | $5,252 | 5.0× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$4,720.50–$4,864.50 | $6,294–$6,486 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$5,106.75–$7,028.25 | $6,809–$9,371 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,249.50 | $13,666 | 29.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,173 | $5,564 | 17.4× |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$5,387.25–$5,996.25 | $7,183–$7,995 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $7,075.50 | $9,434 | 20.2× |
| MRI orbit face &/neck w/o contrast (70540) | $5,157.75 | $6,877 | 21.5× |
| MRI orbit face neck w contrast (70542) | $3,731.25 | $4,975 | 10.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$4,224–$7,011.75 | $5,632–$9,349 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$3,711.75–$3,731.25 | $4,949–$4,975 | varies |
| MRI pelvis w/o & w contrast (72197) | $5,179.50 | $6,906 | 14.8× |
| MRI pelvis w/o contrast (72195) | $4,621.50 | $6,162 | 19.3× |
| MRI spectroscopy (76390) | $2,872.50 | $3,830 | 32.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$4,962.75–$5,820 | $6,617–$7,760 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$6,390.75–$8,113.50 | $8,521–$10,818 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,459.50 | $5,946 | 18.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$5,122.50–$5,780.25 | $6,830–$7,707 | varies |
| MRI, abdomen, combo (74183) | $8,331.75 | $11,109 | 23.8× |
| MRI, dorsal spine combo (72157) | $7,068 | $9,424 | 20.2× |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$4,092.75–$5,661.75 | $5,457–$7,549 | varies |
| MRI, joint upper extrem (73221) | $5,780.25 | $7,707 | 24.1× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$6,942–$7,290.75 | $9,256–$9,721 | varies |
| MRI, lumbar spine combo (72158) | $7,259.25 | $9,679 | 20.7× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$3,781.50–$5,372.25 | $5,042–$7,163 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$3,971.25–$5,372.25 | $5,295–$7,163 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$4,429.50–$5,706 | $5,906–$7,608 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$4,610.25–$4,966.50 | $6,147–$6,622 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $7,197.75 | $9,597 | 5.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $16,107.75 | $21,477 | 12.4× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$10,652.25–$11,678.25 | $14,203–$15,571 | varies |
| N-invas est c ffr sw aly CTA (75580) | $4,848.75 | $6,465 | 5.6× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$618.75–$1,340.25 | $825–$1,787 | varies |
| Nonvascular Shunt X-Ray (75809) | $595.50 | $794 | 5.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $15,405 | $20,540 | 11.1× |
| Nuclear Rx Intra-Arterial (79445) | $1,302.75 | $1,737 | 5.6× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$2,814–$5,285.25 | $3,752–$7,047 | varies |
| Panoramic X-ray of jaws (70355) | $1,078.50 | $1,438 | 12.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$2,077.50–$3,198.75 | $2,770–$4,265 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,951.25 | $3,935 | 7.3× |
| Pelvis 1 or 2 views (72170) range across 5 matching MRF lines |
$547.50–$2,062.50 | $730–$2,750 | varies |
| Perineogram (74775) | $1,365.75 | $1,821 | 5.7× |
| Pet Image Skull-Thigh (78812) | $7,901.25 | $10,535 | 5.5× |
| Pet Image W/Ct Lmtd (78814) | $7,878 | $10,504 | 5.5× |
| PET image w/CT, full body (78816) | $7,901.25 | $10,535 | 5.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,901.25 | $10,535 | 5.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $6,791.25 | $9,055 | 5.2× |
| Pet Myocardial Sngl Study (78491) | $8,352.75 | $11,137 | 5.8× |
| PET whole body (78813) | $7,901.25 | $10,535 | 5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $9,447.75 | $12,597 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$3,422.25–$3,494.25 | $4,563–$4,659 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,278–$1,545 | $1,704–$2,060 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,699.50–$3,130.50 | $2,266–$4,174 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$595.50–$1,443.75 | $794–$1,925 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$635.25–$1,290.75 | $847–$1,721 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$368.25–$1,332 | $491–$1,776 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$701.25–$2,254.50 | $935–$3,006 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$460.50–$1,229.25 | $614–$1,639 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$517.50–$1,445.25 | $690–$1,927 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$537.75–$1,458.75 | $717–$1,945 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$570.75–$2,034 | $761–$2,712 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,923.75 | $2,565 | 18.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$853.50–$1,342.50 | $1,138–$1,790 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$473.25–$1,132.50 | $631–$1,510 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$639.75–$1,533 | $853–$2,044 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$1,064.25–$2,261.25 | $1,419–$3,015 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $4,525.50 | $6,034 | 25.7× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$591–$1,063.50 | $788–$1,418 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$562.50–$1,202.25 | $750–$1,603 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$550.50–$1,425.75 | $734–$1,901 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$621–$1,081.50 | $828–$1,442 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$354.75–$987 | $473–$1,316 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$561.75–$1,254.75 | $749–$1,673 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $3,024.75 | $4,033 | 28.8× |
| Radiation treatment delivery level 3 (77412) | $1,177.50 | $1,570 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$808.50–$1,801.50 | $1,078–$2,402 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$593.25–$1,642.50 | $791–$2,190 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$1,790.25–$5,025.75 | $2,387–$6,701 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$1,371–$3,530.25 | $1,828–$4,707 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,062.75 | $1,417 | 6.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$779.25–$1,371 | $1,039–$1,828 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$719.25–$2,589.75 | $959–$3,453 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$819–$2,085 | $1,092–$2,780 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$670.50–$1,570.50 | $894–$2,094 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$1,414.50–$4,596 | $1,886–$6,128 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$363–$432.75 | $484–$577 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$479.25–$1,309.50 | $639–$1,746 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$642–$1,172.25 | $856–$1,563 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$1,565.25–$7,107 | $2,087–$9,476 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $2,024.25 | $2,699 | 23.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$529.50–$1,264.50 | $706–$1,686 | varies |
| Renal Cyst Study (74470) | $2,565 | $3,420 | 4.7× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$645–$1,605 | $860–$2,140 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,629.75 | $2,173 | 4.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,260.25 | $4,347 | 8.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$4,758–$6,840.75 | $6,344–$9,121 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$2,634–$2,813.25 | $3,512–$3,751 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$3,150–$3,298.50 | $4,200–$4,398 | varies |
| Rp Therapy Intravenous Administration (79101) | $2,572.50 | $3,430 | 11.0× |
| Scapula (73010) range across 3 matching MRF lines |
$529.50–$1,132.50 | $706–$1,510 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $175.50 | $234 | 7.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$396.75–$1,132.50 | $529–$1,510 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$600.75–$1,689 | $801–$2,252 | varies |
| Sialogram (70390) | $1,135.50 | $1,514 | 4.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$748.50–$1,679.25 | $998–$2,239 | varies |
| Special dosimetry (77331) | $1,942.50 | $2,590 | 14.4× |
| Special Physics Consult (77370) | $1,001.25 | $1,335 | 7.4× |
| Special treatment procedure (77470) | $5,939.25 | $7,919 | 10.7× |
| Srs Multisource (77371) | $105,165 | $140,220 | 14.2× |
| Stereotactic Body Radiation Delivery (77373) | $8,445 | $11,260 | 4.7× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$653.25–$687 | $871–$916 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $785.25 | $1,047 | 2.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $534.75 | $713 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,660.25 | $3,547 | 7.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,596.75 | $2,129 | 4.2× |
| Ther rad simulaj-aided field setting simple (77280) | $996 | $1,328 | 7.4× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$909.75–$2,340.75 | $1,213–$3,121 | varies |
| Thoracic spine 3 views (72072) | $997.50 | $1,330 | 9.5× |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$585–$990.75 | $780–$1,321 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $2,238 | $2,984 | 5.6× |
| Thyroid Imaging With Vascular Flow (78013) | $1,167.75 | $1,557 | 2.9× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$5,213.25–$6,739.50 | $6,951–$8,986 | varies |
| Thyroid Uptake Measurement (78012) | $900.75 | $1,201 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,391.75 | $3,189 | 6.0× |
| Tx Devices Design & Construction Complex (77334) | $4,068 | $5,424 | 10.8× |
| Tx devices design & construction simple (77332) | $384 | $512 | 2.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$537.75–$725.25 | $717–$967 | varies |
| Ultrasound elastography first target lesion (76982) | $428.25 | $571 | 4.1× |
| Ultrasound Elastography Parenchyma (76981) | $428.25 | $571 | 4.1× |
| Ultrasound Exam Aaa Screen (76706) | $1,071 | $1,428 | 10.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $683.25 | $911 | 1.9× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$850.50–$2,241.75 | $1,134–$2,989 | varies |
| Umbilical-artery Doppler (OB) (76820) | $759.75 | $1,013 | 7.2× |
| Unlisted magnetic resonance procedure (76498) | $9,141.75 | $12,189 | 104.6× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$1,414.50–$3,027 | $1,886–$4,036 | varies |
| Ureteral Reflux Study (78740) | $2,960.25 | $3,947 | 7.4× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$1,224–$1,929.75 | $1,632–$2,573 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,237.50–$1,695.75 | $1,650–$2,261 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$595.50–$1,392 | $794–$1,856 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$450–$1,133.25 | $600–$1,511 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$725.25–$1,917.75 | $967–$2,557 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$603–$1,983.75 | $804–$2,645 | varies |
| Us head (76506) range across 2 matching MRF lines |
$909–$998.25 | $1,212–$1,331 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$1,347–$4,689 | $1,796–$6,252 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$808.50–$1,917.75 | $1,078–$2,557 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,203–$4,125 | $1,604–$5,500 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$562.50–$1,997.25 | $750–$2,663 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$2,261.25–$2,515.50 | $3,015–$3,354 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$1,074–$2,861.25 | $1,432–$3,815 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$962.25–$4,131 | $1,283–$5,508 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$327–$759.75 | $436–$1,013 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$1,028.25–$2,409.75 | $1,371–$3,213 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$621–$2,409.75 | $828–$3,213 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$870–$2,716.50 | $1,160–$3,622 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$594–$1,806.75 | $792–$2,409 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,265.25–$2,190 | $1,687–$2,920 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$544.50–$2,418.75 | $726–$3,225 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$3,561–$4,520.25 | $4,748–$6,027 | varies |
| Vein X-Ray Skull Epidural (75872) | $5,838 | $7,784 | 9.3× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$2,936.25–$14,116.50 | $3,915–$18,822 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$3,807–$9,447.75 | $5,076–$12,597 | varies |
| Venography extremity bilateral rs&i (75822) range across 5 matching MRF lines |
$1,381.50–$5,566.50 | $1,842–$7,422 | varies |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$1,455.75–$5,962.50 | $1,941–$7,950 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$5,733.75–$9,447.75 | $7,645–$12,597 | varies |
| Venography Renal Unilateral (75831) | $9,447.75 | $12,597 | 3.0× |
| Venous sampling by catheter (75893) | $9,738.75 | $12,985 | 1.7× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$278.25–$373.50 | $371–$498 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$437.25–$1,077 | $583–$1,436 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$567–$1,480.50 | $756–$1,974 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,146.75–$2,015.25 | $1,529–$2,687 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$5,679–$9,447.75 | $7,572–$12,597 | varies |
| X-Ray Bend Only L-S Spine (72120) | $2,695.50 | $3,594 | 25.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$310.50–$882.75 | $414–$1,177 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$944.25–$1,824.75 | $1,259–$2,433 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$1,054.50–$1,277.25 | $1,406–$1,703 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$1,915.50–$2,315.25 | $2,554–$3,087 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $3,024.75 | $4,033 | 28.8× |
| X-Ray Exam Hip Uni 1 View (73501) range across 5 matching MRF lines |
$321–$893.25 | $428–$1,191 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$352.50–$1,332 | $470–$1,776 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$617.25–$705.75 | $823–$941 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$1,092–$1,506 | $1,456–$2,008 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$981.75–$1,038.75 | $1,309–$1,385 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$1,004.25–$1,215.75 | $1,339–$1,621 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $1,711.50 | $2,282 | 16.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$882.75–$1,911 | $1,177–$2,548 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$1,302–$1,479 | $1,736–$1,972 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$674.25–$2,096.25 | $899–$2,795 | varies |
| X-ray head for orthodontia (70350) | $1,236.75 | $1,649 | 14.1× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$474–$1,254.75 | $632–$1,673 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,846.50–$3,981.75 | $2,462–$5,309 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$1,846.50–$3,550.50 | $2,462–$4,734 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$768–$818.25 | $1,024–$1,091 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$845.25–$2,686.50 | $1,127–$3,582 | varies |
| X-ray nose-rectum child f.b. (76010) | $1,702.50 | $2,270 | 19.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$1,020–$2,222.25 | $1,360–$2,963 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$779.25–$1,709.25 | $1,039–$2,279 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $591 | $788 | 5.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$543–$1,809 | $724–$2,412 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$1,405.50–$3,818.25 | $1,874–$5,091 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$973.50–$2,810.25 | $1,298–$3,747 | varies |
| X-Ray Tmj Unilat (70328) | $299.25 | $399 | 3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$1,307.25–$1,938.75 | $1,743–$2,585 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$642.75–$1,311.75 | $857–$1,749 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,386.75–$4,492.50 | $1,849–$5,990 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$1,160.25–$3,169.50 | $1,547–$4,226 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$834.75–$996 | $1,113–$1,328 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $1,145.25 | $1,527 | 10.9× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$975.75–$1,193.25 | $1,301–$1,591 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$1,906.50–$2,826 | $2,542–$3,768 | 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.