Imaging prices at Southeast Health Medical Center
Dothan, AL · every code in this section with a posted price and a Medicare benchmark.
336 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) range across 2 matching MRF lines |
$2,852.32–$2,937.89 | $7,130.80–$7,344.72 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$78.48–$80.84 | $196.20–$202.09 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$141.72–$145.98 | $354.31–$364.94 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $619.28 | $1,548.21 | 1.6× |
| Angio internal mammary (75756) | $3,049.16 | $7,622.91 | 1.0× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$3,267.66–$3,365.69 | $8,169.16–$8,414.23 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,860.29–$2,946.10 | $7,150.72–$7,365.24 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,267.66–$3,365.69 | $8,169.16–$8,414.23 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,365.69 | $8,414.23 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,398.47 | $3,496.18 | 0.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$5,418.29–$5,580.84 | $13,545.72–$13,952.09 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $3,192.90 | $7,982.24 | 1.0× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$5,291.06–$5,449.79 | $13,227.64–$13,624.47 | varies |
| Artery X-Rays Adrenal Gland (75731) | $2,668.94 | $6,672.36 | 0.9× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$5,291.06–$5,449.79 | $13,227.64–$13,624.47 | varies |
| Artery X-Rays Spine (75705) | $5,449.79 | $13,624.47 | 1.0× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$480.26–$494.67 | $1,200.66–$1,236.68 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$484.51–$634.28 | $1,211.28–$1,585.71 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$305.26–$2,963.72 | $763.16–$7,409.30 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Bone Imaging Multiple Areas (78305) | $619.28 | $1,548.21 | 1.6× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Bone marrow imaging limited area (78102) | $318.57 | $796.43 | 0.8× |
| Bone survey infant (77076) | $145.24 | $363.11 | 1.4× |
| Brachytx isodose complex (77318) | $1,262.83 | $3,157.07 | 3.5× |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$770.55–$793.66 | $1,926.37–$1,984.16 | varies |
| Brachytx Isodose Plan Simple (77316) | $787.62 | $1,969.04 | 2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $798.38 | $1,995.95 | 1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$75.40–$77.66 | $188.49–$194.14 | varies |
| Cerebrospinal Fluid Scan (78630) | $2,106.78 | $5,266.96 | 4.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$78.48–$80.84 | $196.20–$202.09 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$78.48–$80.84 | $196.20–$202.09 | varies |
| Chest 3 views (71047) | $80.84 | $202.09 | 1.0× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$298.62–$307.58 | $746.56–$768.96 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $898.86 | $2,247.15 | 1.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$85.65–$88.22 | $214.13–$220.55 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$296.37–$305.26 | $740.93–$763.16 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,860.29–$2,946.10 | $7,150.72–$7,365.24 | varies |
| Contrast X-Ray Bladder (74430) | $499.05 | $1,247.62 | 1.5× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$480.26–$494.67 | $1,200.66–$1,236.68 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$615.81–$951.42 | $1,539.52–$2,378.56 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$872.68–$898.86 | $2,181.70–$2,247.15 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$522.26–$537.93 | $1,305.65–$1,344.82 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$863.69–$889.60 | $2,159.23–$2,224.01 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $168.97 | $422.43 | 1.0× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$874.80–$901.04 | $2,186.99–$2,252.60 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT cervical spine w/wo cont (72127) | $465.94 | $1,164.84 | 2.8× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$393.43–$405.24 | $983.58–$1,013.09 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$393.43–$405.24 | $983.58–$1,013.09 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$141.12–$145.36 | $352.81–$363.39 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT l-spine w&w/o contrast (72133) | $471.21 | $1,178.03 | 2.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$874.80–$901.04 | $2,186.99–$2,252.60 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$452.36–$2,006.96 | $1,130.91–$5,017.40 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,189.88–$1,225.57 | $2,974.69–$3,063.93 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT thoracic spine w/wo cont (72130) | $471.21 | $1,178.03 | 2.8× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$254.87–$262.52 | $637.17–$656.29 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,225.57 | $3,063.93 | 7.3× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$872.68–$898.86 | $2,181.70–$2,247.15 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$457.49–$471.21 | $1,143.72–$1,178.03 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $336.09 | $840.23 | 1.0× |
| CTA pelvis (72191) | $1,846.96 | $4,617.40 | 10.9× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$742.63–$2,054.72 | $1,856.58–$5,136.81 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$101.23–$104.26 | $253.07–$260.66 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$82.28–$84.75 | $205.70–$211.87 | varies |
| Echo exam uterus (76831) | $255.17 | $637.93 | 1.1× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$256.53–$264.23 | $641.33–$660.57 | varies |
| Echograp Trans R Pros Study (76873) | $944.10 | $2,360.26 | 9.4× |
| Esophagram (74220) range across 2 matching MRF lines |
$252.54–$260.12 | $631.36–$650.30 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$205.82–$297.65 | $514.54–$744.13 | varies |
| Follow-Up Angiography (75898) | $2,288.33 | $5,720.83 | 0.8× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Hand 2 views (73120) range across 5 matching MRF lines |
$141.01–$317.28 | $352.53–$793.20 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $576.01 | $1,440.02 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$1,689.21–$1,739.88 | $4,223.02–$4,349.71 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,739.88 | $4,349.71 | 2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,668.94 | $6,672.36 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,102.80 | $7,757.01 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$775.13–$798.38 | $1,937.82–$1,995.95 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Ht Muscle Image Spect Sing (78451) | $2,152.08 | $5,380.21 | 1.7× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$288.98–$297.65 | $722.46–$744.13 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$63.34–$65.24 | $158.36–$163.11 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$63.34–$65.24 | $158.36–$163.11 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$797.42–$821.34 | $1,993.54–$2,053.35 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$775.13–$798.38 | $1,937.82–$1,995.95 | varies |
| Kidney Imaging Morphol (78700) | $619.28 | $1,548.21 | 1.6× |
| Knee 3 Views (73562) range across 8 matching MRF lines |
$78.09–$249.80 | $195.23–$624.49 | varies |
| Liver & Spleen Imaging Static Only (78215) | $804.79 | $2,011.97 | 2.1× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$2,089.40–$2,152.08 | $5,223.50–$5,380.21 | varies |
| Lung perfusion differential (78597) | $619.28 | $1,548.21 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$775.13–$798.38 | $1,937.82–$1,995.95 | varies |
| Lung Ventilation Imaging (78579) | $619.28 | $1,548.21 | 1.6× |
| Lymph System Imaging (78195) | $591.29 | $1,478.23 | 1.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,451.49 | $3,628.72 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,906.17 | $7,265.42 | 1.0× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| Mammary ductogram or galactogram single (77053) | $575.38 | $1,438.45 | 2.5× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$771.21–$794.35 | $1,928.03–$1,985.87 | varies |
| Mr safety determination physician/other qhp (76016) | $85.41 | $213.52 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $23.72 | $59.31 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $88.92 | $222.30 | 1.0× |
| Mr safety implt pos&/immoblj (76019) | $57.55 | $143.87 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $234.17 | $585.43 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRA head with contrast (70545) | $1,199.39 | $2,998.48 | 3.6× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,164.46–$1,199.39 | $2,911.15–$2,998.48 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$3,081.35–$3,173.79 | $7,703.37–$7,934.47 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI abdomen w contrast (74182) | $2,241.95 | $5,604.87 | 6.7× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,088.96–$2,151.63 | $5,222.41–$5,379.08 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 5 matching MRF lines |
$696.29–$2,401.57 | $1,740.72–$6,003.92 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,088.96–$2,151.63 | $5,222.41–$5,379.08 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$392.72–$404.50 | $981.79–$1,011.24 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $269.66 | $674.16 | 1.2× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI cervical spine w contrast (72142) | $2,241.95 | $5,604.87 | 6.7× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI chest with contrast (71551) | $810.04 | $2,025.11 | 1.1× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,241.95 | $5,604.87 | 6.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,165.81–$2,331.62 | $2,914.52–$5,829.04 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$696.29–$1,392.58 | $1,740.72–$3,481.44 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI spectroscopy (76390) | $2,762.05 | $6,905.12 | 32.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,210.43 | $5,526.07 | 6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$696.29–$717.18 | $1,740.72–$1,792.94 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI, dorsal spine contrast (72147) | $1,200.78 | $3,001.96 | 3.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$696.29–$1,392.58 | $1,740.72–$3,481.44 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,165.81–$1,200.78 | $2,914.52–$3,001.96 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,089.40–$2,152.08 | $5,223.50–$5,380.21 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $636.85 | $1,592.12 | 1.7× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$78.51–$746.52 | $196.27–$1,866.31 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,852.32–$2,937.89 | $7,130.80–$7,344.72 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$279.84–$288.24 | $699.61–$720.60 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$394.02–$405.84 | $985.05–$1,014.60 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$2,687.76–$2,768.39 | $6,719.39–$6,920.97 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$2,687.76–$2,768.39 | $6,719.39–$6,920.97 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$3,160.39–$3,255.20 | $7,900.98–$8,138.01 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $351.53 | $878.82 | 0.9× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $896.26 | $2,240.65 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $557.26 | $1,393.16 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$78.09–$120.65 | $195.23–$301.63 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$207.67–$213.90 | $519.18–$534.76 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$193.83–$199.64 | $484.57–$499.11 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$180.38–$185.79 | $450.95–$464.48 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $120.65 | $301.63 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$18,391.25–$18,942.99 | $45,978.13–$47,357.47 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$118.58–$122.13 | $296.44–$305.33 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$233.82–$240.84 | $584.56–$602.10 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$537.04–$553.16 | $1,342.61–$1,382.89 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Radiologic exam colon double contrast study (74280) | $260.12 | $650.30 | 1.5× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$252.54–$260.12 | $631.36–$650.30 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $210.86 | $527.14 | 1.2× |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$141.01–$317.28 | $352.53–$793.20 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$252.54–$260.12 | $631.36–$650.30 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$78.09–$175.70 | $195.23–$439.26 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $145.24 | $363.11 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$117.14–$120.65 | $292.84–$301.63 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$2,089.40–$2,152.08 | $5,223.50–$5,380.21 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $384.34 | $960.86 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,152.08 | $5,380.21 | 4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,152.08 | $5,380.21 | 4.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,387.62–$1,429.24 | $3,469.04–$3,573.11 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$394.02–$405.84 | $985.05–$1,014.60 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$24.44–$37.76 | $61.11–$94.41 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$78.09–$120.65 | $195.23–$301.63 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$480.26–$494.67 | $1,200.66–$1,236.68 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$220.72–$227.34 | $551.81–$568.36 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$305.26–$889.12 | $763.16–$2,222.79 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$296.37–$305.26 | $740.93–$763.16 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$771.21–$794.35 | $1,928.03–$1,985.87 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,245.78–$1,283.15 | $3,114.44–$3,207.87 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$4,059.20–$4,180.98 | $10,148.01–$10,452.45 | varies |
| Sternoclavicular joints (71130) | $208.24 | $520.59 | 2.5× |
| Superior sagittal sinus venogram (75870) | $1,966.10 | $4,915.24 | 0.6× |
| Tbs technical calculation only (77091) range across 2 matching MRF lines |
$82.28–$84.75 | $205.70–$211.87 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$770.55–$793.66 | $1,926.37–$1,984.16 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$766.56–$789.56 | $1,916.40–$1,973.89 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$771.21–$794.35 | $1,928.03–$1,985.87 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $556.43 | $1,391.07 | 1.5× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$296.37–$305.26 | $740.93–$763.16 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $619.28 | $1,548.21 | 1.6× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$775.13–$798.38 | $1,937.82–$1,995.95 | varies |
| Thyroid Uptake Measurement (78012) | $526.54 | $1,316.35 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$601.25–$619.28 | $1,503.12–$1,548.21 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$768.08–$791.12 | $1,920.19–$1,977.80 | varies |
| Tx devices design & construction intermediate (77333) | $308.60 | $771.51 | 2.4× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$299.62–$1,198.46 | $749.04–$2,996.16 | varies |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$63.34–$142.53 | $158.36–$356.33 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$216.21–$222.70 | $540.52–$556.74 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Umbilical-artery Doppler (OB) (76820) | $349.14 | $872.84 | 3.5× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$33.12–$434.15 | $82.81–$1,085.38 | varies |
| Unlisted fluoroscopic procedure (76496) | $91.24 | $228.09 | 1.1× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $375.41 | $938.53 | 1.0× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$252.54–$260.12 | $631.36–$650.30 | varies |
| Ureteral Reflux Study (78740) | $630.93 | $1,577.33 | 1.6× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$288.98–$297.65 | $722.46–$744.13 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$114.40–$176.75 | $286–$441.88 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$162.53–$167.40 | $406.32–$418.51 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us head (76506) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$211.16–$217.50 | $527.91–$543.75 | varies |
| Us retroperitoneal limited (76775) | $167.40 | $418.51 | 1.7× |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$162.53–$167.40 | $406.32–$418.51 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$114.40–$117.83 | $286–$294.58 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$750.02–$772.52 | $1,875.04–$1,931.29 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,120.59 | $7,801.48 | 1.0× |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$2,960.35–$3,049.16 | $7,400.88–$7,622.91 | varies |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$3,022.72–$3,113.40 | $7,556.80–$7,783.50 | varies |
| Venography Adrenal Unilateral (75840) | $3,128.12 | $7,820.31 | 1.0× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$3,189.21–$3,284.89 | $7,973.03–$8,212.22 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,317.79–$1,357.32 | $3,294.48–$3,393.31 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$781.02–$804.46 | $1,952.56–$2,011.14 | varies |
| Venography Renal Unilateral (75831) | $3,102.80 | $7,757.01 | 1.0× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$78.09–$287.22 | $195.23–$718.06 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $120.65 | $301.63 | 1.4× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$484.51–$499.05 | $1,211.28–$1,247.62 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,411.26 | $8,528.15 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$484.57–$499.11 | $1,211.43–$1,247.77 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $145.24 | $363.11 | 1.4× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$560.62–$577.44 | $1,401.56–$1,443.61 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$78.09–$156.18 | $195.23–$390.46 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$252.54–$260.12 | $631.36–$650.30 | varies |
| X-ray IV pyelogram+tomography (74415) | $260.12 | $650.30 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$220.72–$227.34 | $551.81–$568.36 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$82.47–$84.95 | $206.18–$212.37 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$120.16–$123.76 | $300.39–$309.40 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$483.24–$497.73 | $1,208.09–$1,244.33 | varies |
| X-Rays Bone Length Studies (77073) | $616.13 | $1,540.32 | 6.1× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,128.66–$1,162.52 | $2,821.66–$2,906.31 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$78.09–$80.44 | $195.23–$201.09 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$141.01–$145.24 | $352.53–$363.11 | 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.