Imaging prices at DMC Sinai-Grace Hospital
Detroit, MI · every code in this section with a posted price and a Medicare benchmark.
340 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) | $8,067.75 | $10,757 | 5.8× |
| Abdomen 1 View (74018) | $522.75 | $697 | 6.0× |
| Abdomen 2 views (74019) | $687 | $916 | 6.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,578.50 | $3,438 | 6.5× |
| Angio internal mammary (75756) | $9,300.75 | $12,401 | 3.0× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$5,283.75–$7,517.25 | $7,045–$10,023 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$5,535–$6,642 | $7,380–$8,856 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$5,631–$5,839.50 | $7,508–$7,786 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$7,248.75–$8,304 | $9,665–$11,072 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,070.75 | $6,761 | 1.6× |
| Ankle 2 views (73600) | $442.50 | $590 | 5.1× |
| Aortography thoracic serialography rs&i (75605) | $8,512.50 | $11,350 | 1.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $7,993.50 | $10,658 | 2.5× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$10,990.50–$11,182.50 | $14,654–$14,910 | varies |
| Artery X-Rays Pelvis (75736) | $9,167.25 | $12,223 | 1.7× |
| Artery X-Rays Spine (75705) | $10,279.50 | $13,706 | 1.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,626.75–$1,952.25 | $2,169–$2,603 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,145.25–$1,462.50 | $1,527–$1,950 | varies |
| Arthrogram Wrist (73115) | $1,145.25 | $1,527 | 3.3× |
| Basic radiation dosimetry calculation (77300) | $1,024.50 | $1,366 | 7.6× |
| Bone age studies (77072) | $707.25 | $943 | 6.8× |
| Bone Imaging 3 Phase (78315) | $2,490 | $3,320 | 6.3× |
| Bone Imaging Limited Area (78300) | $2,673 | $3,564 | 6.7× |
| Bone Imaging Multiple Areas (78305) | $2,673 | $3,564 | 6.7× |
| Bone Imaging Whole Body (78306) | $2,490 | $3,320 | 6.3× |
| Bone survey infant (77076) | $811.50 | $1,082 | 7.8× |
| Brain Flow Imaging Only (78610) | $1,519.50 | $2,026 | 2.8× |
| Cerebrospinal Fluid Scan (78630) | $3,272.25 | $4,363 | 6.0× |
| Chest 1 view (71045) | $293.25 | $391 | 3.4× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$564–$1,461 | $752–$1,948 | varies |
| Chest 3 views (71047) | $775.50 | $1,034 | 8.9× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$817.50–$1,215.75 | $1,090–$1,621 | varies |
| Cholecystography Oral Contrast (74290) | $847.50 | $1,130 | 4.8× |
| Clavicle complete (73000) | $750 | $1,000 | 8.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $392.25 | $523 | 3.8× |
| Continuing medical physics consltj pr wk (77336) | $1,081.50 | $1,442 | 8.1× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,424.75–$5,887.50 | $7,233–$7,850 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$990–$1,255.50 | $1,320–$1,674 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,145.25–$1,462.50 | $1,527–$1,950 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,174.50–$1,536 | $1,566–$2,048 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $381 | $508 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) | $5,284.50 | $7,046 | 15.2× |
| CT abdomen and pelvis without contrast (74176) | $3,485.25 | $4,647 | 14.7× |
| CT abdomen w contrast (74160) | $3,747.75 | $4,997 | 21.4× |
| CT abdomen w wo contrast (74170) | $5,720.25 | $7,627 | 32.7× |
| CT abdomen w/o contrast (74150) | $2,607 | $3,476 | 25.0× |
| CT Angio Abdomen and Pelvis (74174) | $6,507.75 | $8,677 | 18.7× |
| CT Angio Chest (71275) | $7,178.25 | $9,571 | 41.1× |
| CT Angio Head (70496) | $10,870.50 | $14,494 | 62.2× |
| CT angio hrt w/3d image (75574) | $2,904.75 | $3,873 | 8.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $8,254.50 | $11,006 | 47.2× |
| CT Angio Neck (70498) | $7,218.75 | $9,625 | 41.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $8,599.50 | $11,466 | 49.2× |
| CT cervical spine w/ contrast (72126) | $4,789.50 | $6,386 | 13.8× |
| CT cervical spine w/o contrast (72125) | $3,534 | $4,712 | 33.9× |
| CT cervical spine w/wo cont (72127) | $6,449.25 | $8,599 | 36.9× |
| CT chest w contrast (71260) | $3,747.75 | $4,997 | 21.4× |
| CT chest w/wo contrast (71270) | $4,642.50 | $6,190 | 26.6× |
| CT head/brain with contrast (70460) | $4,779.75 | $6,373 | 27.3× |
| CT head/brain without and with contrast (70470) | $4,444.50 | $5,926 | 25.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,904.75 | $3,873 | 8.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $164.25 | $219 | 1.9× |
| CT iac w contrast (70481) | $3,509.25 | $4,679 | 20.1× |
| CT l-spine w&w/o contrast (72133) | $8,040.75 | $10,721 | 46.0× |
| CT lower ext w/o (73700) | $4,579.50 | $6,106 | 44.0× |
| CT lower extremity w/contrast material (73701) | $5,613.75 | $7,485 | 32.1× |
| CT lumbar spine w contrast (72132) | $5,736.75 | $7,649 | 16.5× |
| CT lumbar spine w/o contrast (72131) | $4,821.75 | $6,429 | 46.3× |
| CT maxillofacial w contrast (70487) | $3,509.25 | $4,679 | 20.1× |
| CT maxillofacial wo contrast (70486) | $2,607 | $3,476 | 25.0× |
| CT neck tissue combo (70492) | $7,116 | $9,488 | 40.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,104.75 | $5,473 | 23.5× |
| CT orbits w/o contrast (70480) | $2,607 | $3,476 | 25.0× |
| CT pelvis w&w/o contrast (72194) | $7,823.25 | $10,431 | 44.8× |
| CT pelvis w/o contrast (72192) | $4,592.25 | $6,123 | 44.1× |
| CT scan of leg combo (73702) | $7,563 | $10,084 | 43.3× |
| CT scans face/jaw combo (70488) | $4,104.75 | $5,473 | 23.5× |
| CT soft tissue neck w contrast (70491) | $5,103 | $6,804 | 29.2× |
| CT soft tissue neck w/o contrast (70490) | $4,003.50 | $5,338 | 38.4× |
| CT thoracic spine w contrast (72129) | $6,348.75 | $8,465 | 36.3× |
| CT thoracic spine w/o contrast (72128) | $4,598.25 | $6,131 | 44.1× |
| CT thoracic spine w/wo cont (72130) | $7,413 | $9,884 | 42.4× |
| CT thorax w/o contrast (71250) | $2,773.50 | $3,698 | 26.6× |
| CT upper ext wo (73200) | $4,134.75 | $5,513 | 39.7× |
| CT upper extremity w/o & w/contrast material (73202) | $8,393.25 | $11,191 | 48.0× |
| CT upper extremity with contrast (73201) | $6,116.25 | $8,155 | 17.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,009.50 | $5,346 | 22.9× |
| Cta Abdomen (74175) | $5,208 | $6,944 | 29.8× |
| CTA pelvis (72191) | $8,899.50 | $11,866 | 50.9× |
| Dilation ureters/urethra rs&i (74485) | $4,422.75 | $5,897 | 2.1× |
| Diskography lumbar (72295) | $7,114.50 | $9,486 | 3.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,368.75 | $1,825 | 13.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,368.75 | $1,825 | 13.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $811.50 | $1,082 | 7.8× |
| Dxa Bone Density Axial (77080) | $1,409.25 | $1,879 | 13.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $595.50 | $794 | 6.9× |
| Echo exam of fetal heart (76825) | $4,660.50 | $6,214 | 8.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $3,651.75 | $4,869 | 15.4× |
| Esophagram (74220) | $962.25 | $1,283 | 5.5× |
| Fetal Biophys Profile W/Nst (76818) | $1,055.25 | $1,407 | 10.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $811.50 | $1,082 | 7.8× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$750.75–$1,152.75 | $1,001–$1,537 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,358.50–$4,504.50 | $4,478–$6,006 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$243–$342.75 | $324–$457 | varies |
| Forearm 2 views (73090) | $465.75 | $621 | 5.4× |
| Gastric emptying imaging study (78264) | $2,201.25 | $2,935 | 5.5× |
| Gastroesophageal Reflux Exam (78262) | $621 | $828 | 1.6× |
| Gated Heart Planar Single (78472) | $2,242.50 | $2,990 | 5.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$411–$414.75 | $548–$553 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,800.50 | $7,734 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $2,424 | $3,232 | 4.5× |
| Hepatobiliary System Imaging (78226) | $2,424 | $3,232 | 6.1× |
| Ht Musc Image Planar Mult (78454) | $6,387.75 | $8,517 | 5.0× |
| Ht Muscle Image Spect Sing (78451) | $4,407.75 | $5,877 | 3.4× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$944.25–$1,514.25 | $1,259–$2,019 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$2,203.50–$2,319.75 | $2,938–$3,093 | varies |
| K Flow/Funct Image W/O Drug (78707) | $2,029.50 | $2,706 | 3.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,157.75 | $2,877 | 5.4× |
| Knee 3 Views (73562) | $557.25 | $743 | 6.4× |
| Liver & Spleen Imaging Static Only (78215) | $2,334 | $3,112 | 5.9× |
| Lung perfusion differential (78597) | $3,450.75 | $4,601 | 8.7× |
| Lung Ventilat&Perfus Imaging (78582) | $9,270.75 | $12,361 | 17.1× |
| Lung Ventilation Imaging (78579) | $2,817.75 | $3,757 | 7.1× |
| Lymph System Imaging (78195) | $2,454 | $3,272 | 4.5× |
| Magnetic Image Jaw Joint (70336) | $6,718.50 | $8,958 | 28.3× |
| Mammary ductogram or galactogram multiple (77054) | $483.75 | $645 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $531 | $708 | 2.2× |
| Meckels Divert Exam (78290) | $1,236.75 | $1,649 | 3.1× |
| Mlc imrt design & construction per imrt plan (77338) | $1,900.50 | $2,534 | 5.1× |
| Mr safety determination physician/other qhp (76016) | $352.50 | $470 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $98.25 | $131 | 3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $367.50 | $490 | 3.9× |
| Mr safety implt pos&/immoblj (76019) | $237.75 | $317 | 4.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $968.25 | $1,291 | 4.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$5,669.25–$13,128.75 | $7,559–$17,505 | varies |
| MRA head w/o contrast (70544) | $4,274.25 | $5,699 | 18.0× |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$4,541.25–$6,106.50 | $6,055–$8,142 | varies |
| MRA neck w contrast (70548) | $6,106.50 | $8,142 | 17.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,669.25 | $7,559 | 16.3× |
| MRA neck w/o contrast (70547) | $4,481.25 | $5,975 | 18.8× |
| MRI abdomen w contrast (74182) | $5,103.75 | $6,805 | 14.7× |
| MRI abdomen w/o contrast (74181) | $4,660.50 | $6,214 | 19.6× |
| MRI any jt lower extrem w/contrast material (73722) | $6,472.50 | $8,630 | 8.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $8,661.75 | $11,549 | 24.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $7,794 | $10,392 | 10.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $8,198.25 | $10,931 | 34.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,043.25 | $5,391 | 17.0× |
| MRI cardiac w/o contrast (75557) | $6,885 | $9,180 | 29.0× |
| MRI cervical spine w contrast (72142) | $8,994.75 | $11,993 | 25.9× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$6,570–$7,329 | $8,760–$9,772 | varies |
| MRI chest w/o contrast (71550) | $5,105.25 | $6,807 | 21.5× |
| MRI chest wo w contrast (71552) | $6,783 | $9,044 | 19.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $8,661.75 | $11,549 | 24.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,183.75 | $8,245 | 26.0× |
| MRI lumbar spine w contrast (72149) | $9,731.25 | $12,975 | 28.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $10,562.25 | $14,083 | 30.4× |
| MRI orbit face &/neck w/o contrast (70540) | $4,271.25 | $5,695 | 18.0× |
| MRI orbit face neck w contrast (70542) | $4,539 | $6,052 | 13.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,787.75 | $7,717 | 16.6× |
| MRI pelvis w contrast (72196) | $8,175 | $10,900 | 23.5× |
| MRI pelvis w/o & w contrast (72197) | $9,830.25 | $13,107 | 28.3× |
| MRI pelvis w/o contrast (72195) | $6,810.75 | $9,081 | 28.6× |
| MRI spectroscopy (76390) | $4,906.50 | $6,542 | 56.6× |
| MRI thoracic spine w/o contrast (72146) | $6,936 | $9,248 | 29.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $7,859.25 | $10,479 | 22.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $7,176.75 | $9,569 | 30.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $9,532.50 | $12,710 | 27.4× |
| MRI, abdomen, combo (74183) | $6,749.25 | $8,999 | 19.4× |
| MRI, dorsal spine combo (72157) | $9,244.50 | $12,326 | 26.6× |
| MRI, dorsal spine contrast (72147) | $9,247.50 | $12,330 | 26.6× |
| MRI, joint upper extrem (73221) | $7,176.75 | $9,569 | 30.2× |
| MRI, joint upper extrem combo (73223) | $10,388.25 | $13,851 | 29.9× |
| MRI, lumbar spine combo (72158) | $10,299.75 | $13,733 | 29.6× |
| Myelogram cervical (72240) | $3,015 | $4,020 | 3.9× |
| Myelogram Lumbar (72265) | $3,053.25 | $4,071 | 3.9× |
| Myelograpy 2/more regions rs&i (72270) | $5,022 | $6,696 | 6.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,603.25 | $3,471 | 6.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,407.75 | $5,877 | 3.4× |
| Myocardial Spect Multiple Studies (78452) | $6,387.75 | $8,517 | 5.0× |
| Neck soft tissue (70360) | $441.75 | $589 | 5.1× |
| Nm myocard infarct spect (78469) | $2,543.25 | $3,391 | 4.7× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$512.25–$911.25 | $683–$1,215 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,106.50 | $12,142 | 6.6× |
| Nuclear Rx Intra-Arterial (79445) | $1,707.75 | $2,277 | 7.3× |
| Nuclear Rx Oral Admin (79005) | $1,564.50 | $2,086 | 6.7× |
| Ob us nuchal meas 1 gest (76813) | $1,179 | $1,572 | 11.3× |
| Panoramic X-ray of jaws (70355) | $529.50 | $706 | 6.1× |
| Parathyroid Planar Imaging (78070) | $1,561.50 | $2,082 | 3.9× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$564–$637.50 | $752–$850 | varies |
| Peritoneogram Rs&I (74190) | $1,395 | $1,860 | 2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$4,316.25–$7,051.50 | $5,755–$9,402 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,700.25 | $2,267 | 4.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $816 | $1,088 | 7.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $791.25 | $1,055 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $586.50 | $782 | 6.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $392.25 | $523 | 4.5× |
| Radex elbow complete minimum 3 views (73080) | $562.50 | $750 | 6.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $865.50 | $1,154 | 8.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$247.50–$348.75 | $330–$465 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$507–$655.50 | $676–$874 | varies |
| Radex Hand Minimum 3 Views (73130) | $516 | $688 | 6.0× |
| Radex lower extremity infant minimum 2 views (73592) | $414 | $552 | 4.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $972 | $1,296 | 9.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $525 | $700 | 6.1× |
| Radex Ribs Unilateral 2 Views (71100) | $684.75 | $913 | 7.9× |
| Radex shoulder complete minimum 2 views (73030) | $516 | $688 | 6.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $546.75 | $729 | 6.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $990 | $1,320 | 5.7× |
| Radex Spine 1 View Specify Level (72020) | $273 | $364 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$479.25–$809.25 | $639–$1,079 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $798.75 | $1,065 | 9.2× |
| Radex Toe Minimum 2 Views (73660) | $465.75 | $621 | 5.4× |
| Radex upper extremity infant minimum 2 views (73092) | $531 | $708 | 5.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $557.25 | $743 | 6.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $684.75 | $913 | 6.6× |
| Radiation treatment delivery level 1 (77402) | $642.75 | $857 | 6.3× |
| Radiation treatment delivery level 3 (77412) | $1,507.50 | $2,010 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $741.75 | $989 | 7.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $687 | $916 | 6.6× |
| Radiologic exam colon double contrast study (74280) | $1,709.25 | $2,279 | 9.8× |
| Radiologic exam colon single contrast study (74270) | $1,492.50 | $1,990 | 8.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,120.50 | $1,494 | 6.4× |
| Radiologic exam knee complete 4/more views (73564) | $655.50 | $874 | 6.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$620.25–$674.25 | $827–$899 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $800.25 | $1,067 | 4.6× |
| Radiologic exam swallow function contrast study (74230) | $870.75 | $1,161 | 5.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,090.50 | $1,454 | 6.2× |
| Radiologic examination femur 1 view (73551) | $204 | $272 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $293.25 | $391 | 3.4× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$481.50–$527.25 | $642–$703 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,167.75 | $1,557 | 11.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $762.75 | $1,017 | 8.8× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$917.25–$929.25 | $1,223–$1,239 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,160.75 | $2,881 | 5.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,208.75 | $2,945 | 5.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,582.25 | $7,443 | 10.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,271.75 | $3,029 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,676.75 | $3,569 | 4.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $7,824 | $10,432 | 6.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,877.75 | $11,837 | 6.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $7,824 | $10,432 | 6.1× |
| Scapula (73010) | $520.50 | $694 | 5.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $121.50 | $162 | 5.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$498–$520.50 | $664–$694 | varies |
| Shoulder Arthrography (73040) | $1,947 | $2,596 | 5.6× |
| Skull less than 4 views (70250) | $670.50 | $894 | 6.4× |
| Special Physics Consult (77370) | $1,081.50 | $1,442 | 8.1× |
| Special teletherapy port plan (77321) | $2,540.25 | $3,387 | 6.8× |
| Special treatment procedure (77470) | $5,229.75 | $6,973 | 9.5× |
| Sternoclavicular joints (71130) | $537.75 | $717 | 6.2× |
| Superior sagittal sinus venogram (75870) | $4,150.50 | $5,534 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,927.75 | $5,237 | 10.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,403.75 | $3,205 | 6.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,425.50 | $3,234 | 6.5× |
| Ther rad simulaj-aided field setting simple (77280) | $615.75 | $821 | 4.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$606–$668.25 | $808–$891 | varies |
| Thoracic spine 3 views (72072) | $460.50 | $614 | 4.4× |
| Thoracolumbar 2 views (72080) | $668.25 | $891 | 7.7× |
| Thyroid Imaging With Vascular Flow (78013) | $910.50 | $1,214 | 2.3× |
| Thyroid Met Imaging Body (78018) | $2,758.50 | $3,678 | 5.1× |
| Thyroid Uptake Measurement (78012) | $1,272 | $1,696 | 3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,839.50 | $3,786 | 7.1× |
| Tx Devices Design & Construction Complex (77334) | $1,735.50 | $2,314 | 4.7× |
| Tx devices design & construction simple (77332) | $1,640.25 | $2,187 | 12.2× |
| Ultrasound Breast Limited (76642) | $362.25 | $483 | 4.2× |
| Ultrasound elastography first target lesion (76982) | $480.75 | $641 | 4.6× |
| Ultrasound Elastography Parenchyma (76981) | $631.50 | $842 | 6.1× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$814.50–$996 | $1,086–$1,328 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$963–$1,263.75 | $1,284–$1,685 | varies |
| Umbilical-artery Doppler (OB) (76820) | $811.50 | $1,082 | 7.8× |
| Upper gi w/o kub (74240) | $817.50 | $1,090 | 4.7× |
| Urethrocystogram voiding (74455) | $1,064.25 | $1,419 | 4.5× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,235.25–$1,346.25 | $1,647–$1,795 | varies |
| Us breast unilateral complete (76641) | $362.25 | $483 | 3.5× |
| Us chest (76604) range across 3 matching MRF lines |
$928.50–$1,715.25 | $1,238–$2,287 | varies |
| Us complete joint (76881) | $681 | $908 | 6.5× |
| Us exam, pelvic, limited (76857) | $822.75 | $1,097 | 7.9× |
| Us head (76506) | $1,198.50 | $1,598 | 11.5× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$681–$1,527.75 | $908–$2,037 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$366–$887.25 | $488–$1,183 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,410–$1,629 | $1,880–$2,172 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$773.25–$877.50 | $1,031–$1,170 | varies |
| Us ob transvaginal (76817) | $1,269 | $1,692 | 12.2× |
| Us pelvic non ob complete (76856) | $1,365.75 | $1,821 | 13.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$778.50–$931.50 | $1,038–$1,242 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $877.50 | $1,170 | 8.4× |
| Us retroperitoneal complete (76770) | $1,644.75 | $2,193 | 15.8× |
| Us retroperitoneal limited (76775) | $955.50 | $1,274 | 9.2× |
| Us scrotum and contents (76870) | $1,119 | $1,492 | 10.7× |
| Us spinal canal and contents (76800) | $1,326 | $1,768 | 12.7× |
| Us thyroid (76536) | $1,152.75 | $1,537 | 11.1× |
| Us transrectal (76872) | $1,152.75 | $1,537 | 11.1× |
| Vein X-Ray Chest (75827) | $5,751.75 | $7,669 | 3.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $7,381.50 | $9,842 | 2.3× |
| Venogram Sinus/Jugular (75860) | $4,770 | $6,360 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $4,794 | $6,392 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $2,007 | $2,676 | 1.3× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,466.25–$2,197.50 | $1,955–$2,930 | varies |
| Venography Renal Bilateral (75833) | $8,865.75 | $11,821 | 2.8× |
| Wrist 2 views (73100) | $414.75 | $553 | 4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$621.75–$1,029 | $829–$1,372 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,450.50–$1,509.75 | $1,934–$2,013 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$4,522.50–$5,912.25 | $6,030–$7,883 | varies |
| X-Ray Bend Only L-S Spine (72120) | $1,071.75 | $1,429 | 10.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$378.75–$600.75 | $505–$801 | varies |
| X-Ray Exam Breast Specimen (76098) | $762.75 | $1,017 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $204 | $272 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $293.25 | $391 | 2.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $204 | $272 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $293.25 | $391 | 3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $376.50 | $502 | 3.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $467.25 | $623 | 4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $563.25 | $751 | 5.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $775.50 | $1,034 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) | $1,667.25 | $2,223 | 16.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$684.75–$821.25 | $913–$1,095 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,137.75 | $1,517 | 10.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $917.25 | $1,223 | 8.8× |
| X-ray eye for foreign body (70030) | $293.25 | $391 | 3.4× |
| X-ray humerus (73060) | $750.75 | $1,001 | 8.7× |
| X-ray IV pyelogram (ivp) (74400) | $2,152.50 | $2,870 | 12.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $520.50 | $694 | 6.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $587.25 | $783 | 6.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$651.75–$863.25 | $869–$1,151 | varies |
| X-ray nose-rectum child f.b. (76010) | $600.75 | $801 | 6.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,075.50 | $1,434 | 10.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $587.25 | $783 | 5.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $527.25 | $703 | 5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$537.75–$787.50 | $717–$1,050 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $858 | $1,144 | 9.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $969.75 | $1,293 | 9.3× |
| X-ray thoracic spine 4 vw (72074) | $1,198.50 | $1,598 | 11.5× |
| X-Ray Tmj Unilat (70328) | $289.50 | $386 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$1,629.75–$1,778.25 | $2,173–$2,371 | varies |
| X-Rays Bone Length Studies (77073) | $1,002.75 | $1,337 | 9.6× |
| X-Rays Bone Survey Complete (77075) | $1,794.75 | $2,393 | 17.2× |
| Xr c-spine 4 or 5 views (72050) | $966 | $1,288 | 9.3× |
| Xr facial bones less than 3 views (70140) | $446.25 | $595 | 5.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $451.50 | $602 | 4.3× |
| Xr orbits complete 4 views (70200) | $763.50 | $1,018 | 7.3× |
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.