Imaging prices at St. Anthony North Health Campus
Westminster, CO · every code in this section with a posted price and a Medicare benchmark.
449 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $6,386.18 | $15,965.43 | 4.4× |
| Abdomen 1 View (74018) | $284.41 | $711.02 | 3.1× |
| Abdomen 2 views (74019) | $413.94 | $1,034.84 | 3.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,308.80 | $3,271.98 | 3.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,954.38 | $4,885.94 | 1.4× |
| Angio internal mammary (75756) | $1,720.06 | $4,300.15 | 0.5× |
| Angio pulmonary bilat (75743) | $4,117.86 | $10,294.64 | 1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,094.52 | $12,736.30 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $4,384.86 | $10,962.14 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $2,330.60 | $5,826.50 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,079.66 | $5,199.13 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,332.18 | $3,330.44 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$296.91–$385.97 | $742.26–$964.92 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,817.90 | $7,044.75 | 0.5× |
| Artery X-Rays Abdomen (75726) | $3,486.04 | $8,715.08 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $2,547.26 | $6,368.15 | 0.8× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$2,774.56–$4,161.85 | $6,936.38–$10,404.61 | varies |
| Artery X-Rays Spine (75705) | $3,670.64 | $9,176.60 | 0.6× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$389.94–$779.87 | $974.83–$1,949.66 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$486.42–$632.34 | $1,216.03–$1,580.84 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$716.32–$1,432.64 | $1,790.79–$3,581.60 | varies |
| Basic radiation dosimetry calculation (77300) | $839.96 | $2,099.88 | 5.9× |
| Bone age studies (77072) | $262.04 | $655.09 | 2.4× |
| Bone Imaging 3 Phase (78315) | $2,060.36 | $5,150.88 | 4.9× |
| Bone Imaging Limited Area (78300) | $1,519.18 | $3,797.95 | 3.6× |
| Bone Imaging Multiple Areas (78305) | $1,823.02 | $4,557.55 | 4.3× |
| Bone Imaging Whole Body (78306) | $2,443.25 | $6,108.12 | 5.8× |
| Bone marrow imaging limited area (78102) | $411.87 | $1,029.67 | 1.0× |
| Bone marrow imaging; multiple areas (78103) | $1,398.77 | $3,496.91 | 3.3× |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$1,487.70–$1,678.52 | $3,719.24–$4,196.29 | varies |
| Bone survey infant (77076) | $548.58 | $1,371.45 | 5.0× |
| Brachytx isodose complex (77318) | $4,074.54 | $10,186.34 | 10.3× |
| Brachytx isodose intermed (77317) | $3,159.26 | $7,898.13 | 8.0× |
| Brachytx Isodose Plan Simple (77316) | $2,919.60 | $7,299 | 7.4× |
| Brain Image W/Flow < 4 Views (78601) | $625.77 | $1,564.41 | 1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,176.92 | $2,942.29 | 2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,338.42 | $13,346.05 | 3.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $184.60 | $461.49 | 0.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,480.20 | $3,700.50 | 4.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,776.24 | $4,440.60 | 2.1× |
| Cardiac Shunt Detection (78428) | $1,274.56 | $3,186.38 | 3.0× |
| Cardiovasc nucl exam unlisted (78499) | $921.30 | $2,303.23 | 2.2× |
| Cat Scan Follow-Up Study (76380) | $1,200.14 | $3,000.35 | 13.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,011.90 | $2,529.75 | 1.8× |
| Cerebrospinal Fluid Scan (78630) | $2,430.50 | $6,076.24 | 4.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$293.46–$351.17 | $733.63–$877.92 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$392.38–$392.74 | $980.93–$981.83 | varies |
| Chest 3 views (71047) | $470.60 | $1,176.49 | 5.1× |
| Chest 4 or more views (71048) | $550.91 | $1,377.26 | 5.0× |
| Cholecystography Oral Contrast (74290) | $338.73 | $846.81 | 1.8× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $977.87 | $2,444.67 | 8.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$393.62–$511.69 | $984.04–$1,279.22 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $379.49 | $948.71 | 3.4× |
| Continuing medical physics consltj pr wk (77336) | $1,024.47 | $2,561.17 | 7.2× |
| Contrast Exam Abdominl Aorta (75625) | $3,659.44 | $9,148.60 | 1.1× |
| Contrast X-Ray Bladder (74430) | $747.24 | $1,868.09 | 2.0× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$681.29–$885.68 | $1,703.22–$2,214.18 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$619.72–$1,239.44 | $1,549.28–$3,098.59 | varies |
| Corpora cavernosography (74445) | $238.83 | $597.07 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) | $6,185.93 | $15,464.82 | 16.8× |
| CT abdomen and pelvis without contrast (74176) | $4,120.54 | $10,301.33 | 16.4× |
| CT abdomen w contrast (74160) | $2,828.88 | $7,072.20 | 15.3× |
| CT abdomen w wo contrast (74170) | $3,240.24 | $8,100.60 | 17.5× |
| CT abdomen w/o contrast (74150) | $2,167.09 | $5,417.71 | 19.7× |
| CT Angio Abdomen and Pelvis (74174) | $6,456.04 | $16,140.08 | 17.5× |
| CT Angio Chest (71275) | $3,306.60 | $8,266.49 | 17.9× |
| CT Angio Head (70496) | $3,283.26 | $8,208.15 | 17.7× |
| CT angio hrt w/3d image (75574) | $673.50 | $1,683.73 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$4,703.68–$6,114.77 | $11,759.18–$15,286.91 | varies |
| CT Angio Neck (70498) | $3,479.72 | $8,699.29 | 18.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$2,157.98–$2,805.38 | $5,394.94–$7,013.43 | varies |
| CT cervical spine w/ contrast (72126) | $2,580.72 | $6,451.79 | 7.0× |
| CT cervical spine w/o contrast (72125) | $2,306.88 | $5,767.18 | 20.9× |
| CT cervical spine w/wo cont (72127) | $2,672.23 | $6,680.56 | 14.4× |
| CT chest w contrast (71260) | $2,957.21 | $7,393.02 | 16.0× |
| CT chest w/wo contrast (71270) | $3,012.54 | $7,531.33 | 16.3× |
| CT head/brain with contrast (70460) | $2,604.33 | $6,510.82 | 14.1× |
| CT head/brain without and with contrast (70470) | $3,105.14 | $7,762.83 | 16.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,924.26 | $4,810.64 | 5.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,043.12 | $5,107.80 | 22.3× |
| CT hrt w/3d image congen (75573) | $1,306.41 | $3,266.01 | 3.5× |
| CT iac w contrast (70481) | $2,511.25 | $6,278.11 | 13.6× |
| CT l-spine w&w/o contrast (72133) | $2,546.41 | $6,366.01 | 13.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,954.80–$2,541.24 | $4,886.99–$6,353.08 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,049.50–$3,964.34 | $7,623.74–$9,910.84 | varies |
| CT lumbar spine w contrast (72132) | $2,519.43 | $6,298.56 | 6.8× |
| CT lumbar spine w/o contrast (72131) | $2,302.23 | $5,755.57 | 20.9× |
| CT maxillofacial w contrast (70487) | $2,687.42 | $6,718.54 | 14.5× |
| CT maxillofacial wo contrast (70486) | $2,055.55 | $5,138.87 | 18.6× |
| CT neck tissue combo (70492) | $3,341.86 | $8,354.65 | 18.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,973.41 | $7,433.52 | 16.1× |
| CT orbits w/o contrast (70480) | $2,373.70 | $5,934.24 | 21.5× |
| CT pelvis w&w/o contrast (72194) | $2,945.70 | $7,364.24 | 15.9× |
| CT pelvis w/o contrast (72192) | $1,953.47 | $4,883.67 | 17.7× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$3,659.39–$4,757.21 | $9,148.46–$11,893.01 | varies |
| CT scans face/jaw combo (70488) | $3,224.90 | $8,062.23 | 17.4× |
| CT soft tissue neck w contrast (70491) | $2,978.33 | $7,445.81 | 16.1× |
| CT soft tissue neck w/o contrast (70490) | $2,224.42 | $5,561.03 | 20.2× |
| CT thoracic spine w contrast (72129) | $2,451.16 | $6,127.89 | 13.2× |
| CT thoracic spine w/o contrast (72128) | $2,354.46 | $5,886.13 | 21.3× |
| CT thoracic spine w/wo cont (72130) | $2,941.40 | $7,353.49 | 15.9× |
| CT thorax w/o contrast (71250) | $2,099 | $5,247.48 | 19.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,111.83–$2,745.38 | $5,279.57–$6,863.43 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,055.40–$3,972.02 | $7,638.49–$9,930.04 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,511.43–$3,264.86 | $6,278.57–$8,162.13 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,378.56 | $8,446.38 | 18.3× |
| Cta Abdomen (74175) | $3,160.88 | $7,902.20 | 17.1× |
| CTA pelvis (72191) | $3,295.16 | $8,237.90 | 17.8× |
| Dilation ureters/urethra rs&i (74485) | $1,087.55 | $2,718.86 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $2,632.15 | $6,580.37 | 1.3× |
| Diskography lumbar (72295) | $2,632.15 | $6,580.37 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $663.70 | $1,659.25 | 6.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $865.70 | $2,164.25 | 7.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $450.02 | $1,125.04 | 4.1× |
| Dxa Bone Density Axial (77080) | $391.08 | $977.68 | 3.5× |
| Dxa bone density study (77085) | $550.54 | $1,376.34 | 5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $462.40 | $1,156 | 5.0× |
| Echo exam of fetal heart (76825) | $1,962.25 | $4,905.62 | 3.4× |
| Echo exam uterus (76831) | $865.70 | $2,164.25 | 3.4× |
| Echo Guide For Artery Repair (76936) | $761.25 | $1,903.12 | 3.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $865.70 | $2,164.25 | 3.4× |
| Echograp Trans R Pros Study (76873) | $663.70 | $1,659.25 | 6.0× |
| Esophagram (74220) | $635.05 | $1,587.62 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $818 | $2,045 | 7.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $681.67 | $1,704.16 | 6.2× |
| Fluoroscopy up to 1 hr (76000) | $614.30 | $1,535.74 | 2.4× |
| Follow-Up Angiography (75898) | $1,824.20 | $4,560.49 | 0.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$338.90–$356.58 | $847.24–$891.44 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$348.56–$454.30 | $871.38–$1,135.73 | varies |
| Gastric emptying imaging study (78264) | $1,668.34 | $4,170.85 | 4.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,924.27 | $4,810.67 | 4.6× |
| Gated Heart Planar Single (78472) | $1,970.10 | $4,925.23 | 4.7× |
| Gated Heart, Multiple (78473) | $2,364.10 | $5,910.25 | 5.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,405.34 | $6,013.34 | 4.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$347.97–$452.36 | $869.92–$1,130.88 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,405.59 | $13,513.96 | 7.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,694.91 | $16,737.27 | 9.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,723.22 | $4,308.03 | 2.3× |
| Heart Image (Pet) Multiple (78492) | $4,273.78 | $10,684.45 | 2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,904.78 | $7,261.95 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,420.66 | $6,051.63 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,141.90 | $5,354.74 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,987.21 | $4,968.01 | 4.7× |
| Ht Muscle Image Spect Sing (78451) | $4,383.98 | $10,959.95 | 3.2× |
| Hysterosalpingogram (74740) | $750.81 | $1,877.02 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $346.28 | $865.68 | 3.8× |
| Interstitial radiation source applic complex (77778) | $7,965.74 | $19,914.33 | 10.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,335.69 | $10,839.22 | 5.9× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $4,830.29 | $12,075.71 | 0.6× |
| Intraop radiaj tx deliver xray single tx session (77424) | $5,034.26 | $12,585.64 | 0.6× |
| Joint Survey Single View (77077) | $287.75 | $719.37 | 2.6× |
| K Flow/Funct Image Multiple (78709) | $1,466.50 | $3,666.24 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $2,839.65 | $7,099.12 | 5.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,906.86 | $4,767.14 | 3.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $817.80 | $2,044.50 | 1.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $694.70 | $1,736.74 | 1.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$414.87–$539.50 | $1,037.16–$1,348.75 | varies |
| Leveen/Shunt Patency Exam (78291) | $830.15 | $2,075.37 | 2.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,159.24 | $2,898.10 | 2.7× |
| Liver imaging static only (78201) | $1,190.20 | $2,975.50 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,735.29 | $4,338.22 | 3.0× |
| Lung perfusion differential (78597) | $1,735.29 | $4,338.22 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,482.46 | $6,206.13 | 4.3× |
| Lung Ventilation Imaging (78579) | $1,637.44 | $4,093.58 | 3.9× |
| Lymph System Imaging (78195) | $1,714.89 | $4,287.21 | 3.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,686.99 | $4,217.46 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,401.74–$4,803.48 | $6,004.35–$12,008.70 | varies |
| Mammary ductogram or galactogram multiple (77054) | $732.70 | $1,831.75 | 2.9× |
| Mammary ductogram or galactogram single (77053) | $610.59 | $1,526.46 | 2.4× |
| Meckels Divert Exam (78290) | $1,197.15 | $2,992.86 | 2.8× |
| Medical physics dose eval radiation expos w/rprt (76145) | $966.36 | $2,415.89 | 2.5× |
| Mlc imrt design & construction per imrt plan (77338) | $12,138.33 | $30,345.82 | 30.7× |
| Mr safety determination physician/other qhp (76016) | $551.20 | $1,378 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $551.20 | $1,378 | 18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $551.20 | $1,378 | 5.5× |
| Mr safety implt pos&/immoblj (76019) | $551.20 | $1,378 | 8.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $551.20 | $1,378 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,630.77 | $9,076.92 | 9.9× |
| MRA head w/o contrast (70544) | $2,372.53 | $5,931.32 | 9.4× |
| MRA head with contrast (70545) | $2,514.59 | $6,286.47 | 6.8× |
| MRA neck w contrast (70548) | $2,832.46 | $7,081.15 | 7.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,206.25 | $8,015.61 | 8.7× |
| MRA neck w/o contrast (70547) | $2,458.68 | $6,146.70 | 9.8× |
| MRI abdomen w contrast (74182) | $2,838.09 | $7,095.22 | 7.7× |
| MRI abdomen w/o contrast (74181) | $2,520.89 | $6,302.22 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,617.82–$5,235.64 | $6,544.53–$13,089.10 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,141.38–$6,282.78 | $7,853.44–$15,706.93 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,820.57–$5,641.14 | $7,051.42–$14,102.83 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$3,561.92–$7,123.84 | $8,904.78–$17,809.58 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,371.18 | $5,927.94 | 9.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,839.94 | $4,599.84 | 7.3× |
| MRI cardiac w/o cont stress (75559) | $1,161.69 | $2,904.22 | 2.0× |
| MRI cardiac w/o contrast (75557) | $968.08 | $2,420.18 | 3.8× |
| MRI cervical spine w contrast (72142) | $2,802.96 | $7,007.38 | 7.6× |
| MRI cervical spine w/o cont (72141) | $2,562.31 | $6,405.76 | 10.2× |
| MRI chest w/o contrast (71550) | $2,131 | $5,327.49 | 8.5× |
| MRI chest with contrast (71551) | $2,663.74 | $6,659.35 | 3.2× |
| MRI chest wo w contrast (71552) | $3,329.68 | $8,324.20 | 9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,868.92–$5,737.86 | $7,172.29–$14,344.64 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,366.81–$6,733.62 | $8,417.02–$16,834.03 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,371.04–$4,742.06 | $5,927.59–$11,855.15 | varies |
| MRI lumbar spine w contrast (72149) | $3,078.86 | $7,697.15 | 8.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,096.78 | $7,741.93 | 8.4× |
| MRI orbit face &/neck w/o contrast (70540) | $2,732.12 | $6,830.30 | 10.9× |
| MRI orbit face neck w contrast (70542) | $2,841.66 | $7,104.14 | 7.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,519.55 | $8,798.87 | 9.6× |
| MRI pelvis w contrast (72196) | $2,291.94 | $5,729.83 | 6.2× |
| MRI pelvis w/o & w contrast (72197) | $3,132.46 | $7,831.14 | 8.5× |
| MRI pelvis w/o contrast (72195) | $1,451.40 | $3,628.48 | 5.8× |
| MRI spectroscopy (76390) | $3,289.91 | $8,224.76 | 35.8× |
| MRI thoracic spine w/o contrast (72146) | $2,446.03 | $6,115.07 | 9.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,698.65–$5,397.29 | $6,746.62–$13,493.22 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,342.82–$4,685.64 | $5,857.05–$11,714.09 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,238.37–$6,476.75 | $8,095.92–$16,191.87 | varies |
| MRI, abdomen, combo (74183) | $3,157.89 | $7,894.71 | 8.6× |
| MRI, dorsal spine combo (72157) | $3,267.86 | $8,169.63 | 8.9× |
| MRI, dorsal spine contrast (72147) | $2,735.66 | $6,839.13 | 7.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,364.23–$4,728.45 | $5,910.57–$11,821.12 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,109.19–$6,218.37 | $7,772.96–$15,545.92 | varies |
| MRI, lumbar spine combo (72158) | $3,475.08 | $8,687.70 | 9.4× |
| Musculoskeletal Nuclear Exam (78399) | $921.30 | $2,303.23 | 2.2× |
| Myelogram cervical (72240) | $1,151.42 | $2,878.53 | 1.4× |
| Myelogram Lumbar (72265) | $1,129.78 | $2,824.44 | 1.4× |
| Myelography thoracic (72255) | $885.96 | $2,214.88 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,309.33 | $3,273.31 | 1.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,186.40 | $2,965.98 | 2.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,265.71 | $8,164.26 | 2.4× |
| Myocardial Spect Multiple Studies (78452) | $5,321.32 | $13,303.28 | 3.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,435.55 | $11,088.86 | 2.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,435.55 | $11,088.86 | 2.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,435.55 | $11,088.86 | 1.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,646.50 | $11,616.24 | 2.0× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,278.64 | $8,196.60 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) | $6,753.40 | $16,883.48 | 7.5× |
| Neck soft tissue (70360) | $361.47 | $903.66 | 3.9× |
| Nervous system nuclear exam (78699) | $921.30 | $2,303.23 | 2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $466.09 | $1,165.21 | 1.1× |
| Nm csf leak detection (78650) | $1,444.07 | $3,610.16 | 1.1× |
| Nm myocard infarct spect (78469) | $1,412.68 | $3,531.68 | 2.5× |
| Nm unlisted gi procedure (78299) | $922.86 | $2,307.15 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $313.18 | $782.95 | 2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $10,754.41 | $26,886.02 | 7.4× |
| Nuclear Rx Intra-Arterial (79445) | $1,187.38 | $2,968.45 | 4.8× |
| Nuclear Rx Oral Admin (79005) | $2,056.25 | $5,140.62 | 8.4× |
| Ob us nuchal meas 1 gest (76813) | $663.70 | $1,659.25 | 6.0× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $415.54 | $1,038.84 | 3.8× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$663.70–$1,269.69 | $1,659.25–$3,174.22 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 2 matching MRF lines |
$450.53–$901.02 | $1,126.32–$2,252.53 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $346.28 | $865.68 | 3.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$663.70–$1,269.69 | $1,659.25–$3,174.22 | varies |
| Panoramic X-ray of jaws (70355) | $291.33 | $728.32 | 3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,675.23 | $9,188.06 | 6.4× |
| Parathyroid Planar Imaging (78070) | $1,841.95 | $4,604.86 | 4.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,809.25 | $7,023.12 | 6.7× |
| Pelvis 1 or 2 views (72170) | $340.48 | $851.19 | 3.1× |
| Peritoneogram Rs&I (74190) | $1,250.50 | $3,126.24 | 2.2× |
| Pet Image Skull-Thigh (78812) | $3,606.51 | $9,016.27 | 2.4× |
| Pet Image W/Ct Lmtd (78814) | $4,879.11 | $12,197.76 | 3.2× |
| PET image w/CT, full body (78816) | $5,355.66 | $13,389.14 | 3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,111.14 | $12,777.85 | 3.4× |
| Pet Myocardial Sngl Study (78491) | $3,419.03 | $8,547.57 | 2.3× |
| PET whole body (78813) | $3,702.54 | $9,256.34 | 2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,806.58 | $7,016.44 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,363.22 | $3,408.04 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $507.63 | $1,269.07 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $820.17 | $2,050.42 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$444.41–$578.22 | $1,111.02–$1,445.55 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$350.18–$455.24 | $875.43–$1,138.09 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$378.13–$491.84 | $945.32–$1,229.59 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $578.90 | $1,447.25 | 5.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$343.80–$446.94 | $859.49–$1,117.33 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$403.04–$523.95 | $1,007.60–$1,309.87 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$372.02–$483.62 | $930.03–$1,209.04 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$430.93–$669.50 | $1,077.32–$1,673.73 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$487.95–$634.33 | $1,219.86–$1,585.81 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $446.36 | $1,115.89 | 4.9× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$564.56–$733.92 | $1,411.39–$1,834.80 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$456.68–$593.88 | $1,141.68–$1,484.68 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $365.79 | $914.46 | 4.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,227.62 | $3,069.03 | 6.6× |
| Radex Spine 1 View Specify Level (72020) | $356.07 | $890.16 | 3.9× |
| Radex Sternum Minimum 2 Views (71120) | $447.70 | $1,119.24 | 4.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $701.72 | $1,754.29 | 7.6× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$319.08–$414.81 | $797.69–$1,037.01 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$779.48–$1,035.26 | $1,948.68–$2,588.13 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$391.93–$509.42 | $979.82–$1,273.55 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $742.56 | $1,856.39 | 6.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$7,749.26–$18,531.79 | $19,373.15–$46,329.46 | varies |
| Radiation treatment delivery level 1 (77402) | $527.78 | $1,319.45 | 4.9× |
| Radiation treatment delivery level 2 (77407) | $889.18 | $2,222.94 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $1,230.62 | $3,076.53 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $604.07 | $1,510.16 | 5.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $420.98 | $1,052.44 | 3.8× |
| Radiologic exam colon double contrast study (74280) | $1,100.23 | $2,750.56 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $998.44 | $2,496.10 | 5.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $607.95 | $1,519.87 | 3.3× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$582.40–$757.12 | $1,455.98–$1,892.78 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $395.16 | $987.88 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $683.67 | $1,709.17 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $725.62 | $1,814.03 | 3.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $333.90 | $834.73 | 1.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$93.38–$121.40 | $233.44–$303.50 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$112.06–$145.69 | $280.15–$364.22 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$394.85–$513.28 | $987.12–$1,283.18 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $303.72 | $759.30 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$382.23–$496.91 | $955.57–$1,242.26 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $6,694.91 | $16,737.27 | 16.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $5,169.65 | $12,924.11 | 12.7× |
| Renal Cyst Study (74470) | $1,002.21 | $2,505.51 | 1.7× |
| Ribs bilateral 3 views (71110) | $903.20 | $2,257.98 | 8.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $771.85 | $1,929.62 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,884.25 | $7,210.62 | 6.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,721.36 | $6,803.40 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,378 | $5,944.99 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,949.80 | $7,374.49 | 5.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,893.74 | $9,734.34 | 2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,283.11 | $10,707.77 | 2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,244.79 | $8,111.96 | 2.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,130.51 | $2,826.26 | 4.6× |
| Rp Therapy Intravenous Administration (79101) | $1,111.21 | $2,778.01 | 4.5× |
| Scapula (73010) range across 2 matching MRF lines |
$401.86–$522.42 | $1,004.64–$1,306.05 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Sella turcica (70240) | $323.82 | $809.53 | 3.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$264.94–$306.62 | $662.35–$766.53 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$623.05–$809.97 | $1,557.62–$2,024.91 | varies |
| Sialogram (70390) | $292.17 | $730.41 | 1.2× |
| Skull less than 4 views (70250) | $429.33 | $1,073.32 | 3.9× |
| Special dosimetry (77331) | $1,260.14 | $3,150.34 | 8.9× |
| Special Physics Consult (77370) | $1,541.63 | $3,854.06 | 10.9× |
| Special teletherapy port plan (77321) | $2,335.77 | $5,839.41 | 5.9× |
| Special treatment procedure (77470) | $6,869.44 | $17,173.60 | 11.8× |
| Speech evaluation, complex (70371) | $758.78 | $1,896.94 | 3.0× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$4,156.94–$18,531.79 | $10,392.33–$46,329.46 | varies |
| Sternoclavicular joints (71130) | $449.01 | $1,122.52 | 4.9× |
| Superior sagittal sinus venogram (75870) | $1,616.37 | $4,040.92 | 0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,526.12 | $3,815.28 | 14.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,503.58 | $11,258.93 | 11.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $4,041.62 | $10,104.04 | 10.2× |
| Testicular Imaging W/Flow (78761) | $849.04 | $2,122.58 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,351.70 | $5,879.25 | 6.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,687.63 | $4,219.06 | 4.3× |
| Ther rad simulaj-aided field setting simple (77280) | $1,197.50 | $2,993.73 | 8.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $565.28 | $1,413.18 | 3.1× |
| Thoracic spine 2 views (72070) | $471.07 | $1,177.67 | 4.3× |
| Thoracic spine 3 views (72072) | $565.28 | $1,413.19 | 5.1× |
| Thoracolumbar 2 views (72080) | $519.08 | $1,297.69 | 5.7× |
| Thyroid Imaging With Vascular Flow (78013) | $895.39 | $2,238.46 | 2.1× |
| Thyroid Met Imaging Body (78018) | $2,532.80 | $6,331.99 | 4.4× |
| Thyroid Uptake Measurement (78012) | $481.26 | $1,203.14 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,658.52 | $4,146.30 | 3.9× |
| Tx Devices Design & Construction Complex (77334) | $1,510.55 | $3,776.36 | 3.8× |
| Tx devices design & construction intermediate (77333) | $1,192.34 | $2,980.84 | 8.4× |
| Tx devices design & construction simple (77332) | $925.90 | $2,314.75 | 6.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$346.28–$692.56 | $865.68–$1,731.40 | varies |
| Ultrasound elastography first target lesion (76982) | $139.52 | $348.80 | 1.3× |
| Ultrasound Elastography Parenchyma (76981) | $139.52 | $348.80 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $577.13 | $1,442.82 | 5.2× |
| Ultrasound, abdomen limited (76705) | $617.54 | $1,543.83 | 5.6× |
| Umbilical-artery Doppler (OB) (76820) | $560.93 | $1,402.31 | 5.1× |
| Unlis px ther radiol clinical tx planning (77299) | $186.41 | $466.01 | 1.3× |
| Unlisted Dx Radiographic Procedure (76499) | $3,793.67 | $9,484.17 | 41.3× |
| Unlisted fluoroscopic procedure (76496) range across 3 matching MRF lines |
$664.83–$1,994.68 | $1,662.07–$4,986.68 | varies |
| Unlisted genitourinary px dx nuclear medicine (78799) | $921.30 | $2,303.23 | 2.2× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $922.86 | $2,307.15 | 2.2× |
| Unlisted magnetic resonance procedure (76498) | $2,224.56 | $5,561.39 | 24.2× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $896.92 | $2,242.29 | 2.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $3,610.73 | $9,026.81 | 33.5× |
| Unlisted respiratory px dx nuclear medicine (78599) | $921.30 | $2,303.23 | 2.2× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$346.28–$3,990.37 | $865.68–$9,975.92 | varies |
| Upper gi w/o kub (74240) | $701.14 | $1,752.85 | 3.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $218.15 | $545.37 | 19.7× |
| Urea breath test c-14 isotopic analysis (78268) | $546.14 | $1,365.33 | 5.8× |
| Ureteral Reflux Study (78740) | $992.87 | $2,482.16 | 2.4× |
| Urethrocystogram voiding (74455) | $901.15 | $2,252.87 | 3.6× |
| Urethrocystography retrograde (74450) | $866.64 | $2,166.59 | 3.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$577.13–$1,269.69 | $1,442.82–$3,174.22 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$663.70–$995.56 | $1,659.25–$2,488.88 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$663.70–$1,269.69 | $1,659.25–$3,174.22 | varies |
| Us exam, pelvic, limited (76857) | $617.54 | $1,543.83 | 5.6× |
| Us head (76506) | $577.13 | $1,442.82 | 5.2× |
| Us kidney transplant (76776) | $663.70 | $1,659.25 | 6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$346.28–$692.56 | $865.68–$1,731.40 | varies |
| Us ob detailed single fetus (76811) | $577.13 | $1,442.82 | 2.3× |
| Us ob limited 1 or more fetuses (76815) | $577.13 | $1,442.82 | 5.2× |
| Us ob transvaginal (76817) | $577.13 | $1,442.82 | 5.2× |
| Us pelvic non ob complete (76856) | $692.56 | $1,731.40 | 6.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $577.13 | $1,442.82 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $577.13 | $1,442.82 | 5.2× |
| Us retroperitoneal complete (76770) | $853.74 | $2,134.34 | 7.7× |
| Us retroperitoneal limited (76775) | $682.99 | $1,707.47 | 6.2× |
| Us scrotum and contents (76870) | $663.70 | $1,659.25 | 6.0× |
| Us spinal canal and contents (76800) | $346.28 | $865.68 | 3.1× |
| Us thyroid (76536) | $577.13 | $1,442.82 | 5.2× |
| Us transrectal (76872) | $577.13 | $1,442.82 | 5.2× |
| Vein X-Ray Chest (75827) | $2,297.17 | $5,742.91 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,172.37 | $2,930.92 | 0.4× |
| Venogram Sinus/Jugular (75860) | $11,509.58 | $28,773.93 | 3.5× |
| Venography Adrenal Unilateral (75840) | $3,734.82 | $9,337.04 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $2,302.01 | $5,755.01 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $2,216.15 | $5,540.37 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,100.47 | $2,751.17 | 0.7× |
| Venography Orbital Rs&I (75880) | $1,026.22 | $2,565.53 | 1.6× |
| Venography Renal Bilateral (75833) | $5,771.86 | $14,429.64 | 1.7× |
| Venography Renal Unilateral (75831) | $2,885.93 | $7,214.82 | 0.9× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,687.39 | $6,718.46 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $64.08 | $160.18 | 0.7× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$335.04–$435.54 | $837.59–$1,088.85 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $758.36 | $1,895.90 | 8.3× |
| X-ray antegrade pyelogram tube (74425) | $1,015 | $2,537.49 | 2.8× |
| X-Ray Aorta Leg Arteries (75630) | $3,118.36 | $7,795.88 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $764.76 | $1,911.89 | 6.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$335.94–$436.71 | $839.84–$1,091.76 | varies |
| X-Ray Exam Breast Specimen (76098) | $348.62 | $871.54 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $429.73 | $1,074.31 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $515.68 | $1,289.18 | 4.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $618.81 | $1,547.01 | 5.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $531.54 | $1,328.85 | 5.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $637.85 | $1,594.61 | 6.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $765.41 | $1,913.52 | 6.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $829.20 | $2,073 | 7.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $995.03 | $2,487.57 | 9.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,194.05 | $2,985.12 | 10.8× |
| X-Ray Exam L-S Spine Bending (72114) | $1,129.37 | $2,823.41 | 10.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $456.09 | $1,140.21 | 5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $850.32 | $2,125.80 | 7.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $813.41 | $2,033.52 | 7.4× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$541.23–$703.59 | $1,353.06–$1,758.97 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$395.04–$513.56 | $987.59–$1,283.89 | varies |
| X-ray IV pyelogram (ivp) (74400) | $217.37 | $543.42 | 1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $539.79 | $1,349.47 | 5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $483.49 | $1,208.72 | 5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $601.16 | $1,502.88 | 5.5× |
| X-ray nose-rectum child f.b. (76010) | $338.36 | $845.89 | 3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $944.40 | $2,361 | 8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $515.81 | $1,289.51 | 4.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $423.91 | $1,059.76 | 3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $443.31 | $1,108.27 | 4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $593.62 | $1,484.05 | 6.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $853.28 | $2,133.19 | 7.7× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$274.61–$357 | $686.52–$892.50 | varies |
| X-ray thoracic spine 4 vw (72074) | $678.34 | $1,695.85 | 6.2× |
| X-Ray Tmj Unilat (70328) | $539.79 | $1,349.47 | 5.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $606.56 | $1,516.38 | 1.6× |
| X-Rays Bone Length Studies (77073) | $105.17 | $262.91 | 1.0× |
| X-Rays Bone Survey Complete (77075) | $817.86 | $2,044.65 | 7.4× |
| Xr c-spine 4 or 5 views (72050) | $694.21 | $1,735.51 | 6.3× |
| Xr facial bones less than 3 views (70140) | $381.30 | $953.24 | 4.2× |
| Xr orbits complete 4 views (70200) | $669.82 | $1,674.55 | 6.1× |
| Xr Tomogram Single Plane (76100) | $614.66 | $1,536.65 | 5.6× |
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.