Imaging prices at St. Clare Hospital
Lakewood, WA · every code in this section with a posted price and a Medicare benchmark.
364 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $201.98 | $700.70 | 2.0× |
| Abdomen 2 views (74019) | $255.52 | $886.45 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $879.90 | $3,052.64 | 1.9× |
| Angio pulmonary bilat (75743) | $2,536.14 | $8,798.67 | 0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,547.09 | $8,836.67 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $2,541.32 | $8,816.65 | 0.7× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,228.86 | $7,732.62 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,593.85 | $8,998.87 | 0.7× |
| Artery X-Rays Abdomen (75726) | $3,347.16 | $11,612.34 | 0.5× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,796.38 | $9,701.54 | 0.4× |
| Basic radiation dosimetry calculation (77300) | $451.47 | $1,566.29 | 2.9× |
| Bone age studies (77072) | $194.71 | $675.48 | 1.6× |
| Bone Imaging 3 Phase (78315) | $1,436.08 | $4,982.22 | 3.1× |
| Bone Imaging Limited Area (78300) | $752.24 | $2,609.73 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $783.31 | $2,717.55 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,367.70 | $4,744.97 | 2.9× |
| Bone marrow imaging limited area (78102) | $457.73 | $1,588.01 | 1.0× |
| Bone marrow imaging; multiple areas (78103) | $489.78 | $1,699.17 | 1.0× |
| Bone marrow imaging; whole body (78104) | $553.86 | $1,921.49 | 1.2× |
| Bone survey infant (77076) | $231.57 | $803.36 | 1.9× |
| Brachytx isodose complex (77318) | $1,479.44 | $5,132.63 | 3.4× |
| Brain Flow Imaging Only (78610) | $589.77 | $2,046.07 | 0.9× |
| Brain Image W/Flow < 4 Views (78601) | $550.80 | $1,910.89 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $771.12 | $2,675.25 | 1.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $550.80 | $1,910.89 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,620.22 | $9,090.36 | 1.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,182.78 | $4,103.42 | 2.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,432.84 | $4,970.95 | 3.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,432.84 | $4,970.95 | 1.6× |
| Cardiac Shunt Detection (78428) | $767.70 | $2,663.37 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $584.66 | $2,028.36 | 5.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $792.80 | $2,750.46 | 1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $845.14 | $2,932.06 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $897.13 | $3,112.43 | 1.4× |
| Chest 1 view (71045) | $191.59 | $664.66 | 1.9× |
| Chest 2 views (71046) | $249.06 | $864.06 | 2.5× |
| Chest 3 views (71047) | $250.98 | $870.70 | 2.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$249.06–$250.98 | $864.06–$870.70 | varies |
| Cholecystography Oral Contrast (74290) | $194.31 | $674.10 | 0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $62.55 | $217 | 0.5× |
| Continuing medical physics consltj pr wk (77336) | $645.15 | $2,238.22 | 4.1× |
| Contrast Exam Abdominl Aorta (75625) | $2,600.90 | $9,023.34 | 0.7× |
| Contrast X-Ray Bladder (74430) | $422.95 | $1,467.34 | 1.0× |
| Contrast Xray Throat/Cerv Esopha (74210) | $486.84 | $1,688.97 | 2.4× |
| Corpora cavernosography (74445) | $314.82 | $1,092.21 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) | $3,904.82 | $13,547.07 | 9.6× |
| CT abdomen and pelvis without contrast (74176) | $2,959.13 | $10,266.14 | 10.6× |
| CT abdomen w contrast (74160) | $1,774.69 | $6,156.96 | 8.7× |
| CT abdomen w wo contrast (74170) | $1,907.79 | $6,618.73 | 9.3× |
| CT abdomen w/o contrast (74150) | $1,449.33 | $5,028.18 | 11.9× |
| CT Angio Abdomen and Pelvis (74174) | $3,851.78 | $13,363.05 | 9.5× |
| CT Angio Chest (71275) | $2,271.20 | $7,879.51 | 11.1× |
| CT Angio Head (70496) | $1,746.64 | $6,059.64 | 8.5× |
| CT angio hrt w/3d image (75574) | $951.39 | $3,300.66 | 2.3× |
| CT Angio Neck (70498) | $1,833.97 | $6,362.62 | 9.0× |
| CT cervical spine w/ contrast (72126) | $1,461.07 | $5,068.91 | 3.6× |
| CT cervical spine w/o contrast (72125) | $1,328.25 | $4,608.10 | 10.9× |
| CT cervical spine w/wo cont (72127) | $1,593.90 | $5,529.72 | 7.8× |
| CT chest w contrast (71260) | $1,762.65 | $6,115.19 | 8.6× |
| CT chest w/wo contrast (71270) | $1,903.67 | $6,604.41 | 9.3× |
| CT colonography screening (74263) | $931.89 | $3,233 | 3.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $763.81 | $2,649.90 | 3.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $694.38 | $2,409 | 5.7× |
| CT head/brain with contrast (70460) | $1,381.26 | $4,792.01 | 6.7× |
| CT head/brain without and with contrast (70470) | $1,547.01 | $5,367.05 | 7.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $951.39 | $3,300.66 | 2.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $75.06 | $260.40 | 0.7× |
| CT hrt w/3d image congen (75573) | $951.39 | $3,300.66 | 2.3× |
| CT iac w contrast (70481) | $1,361.59 | $4,723.77 | 6.7× |
| CT l-spine w&w/o contrast (72133) | $1,445.71 | $5,015.62 | 7.1× |
| CT lumbar spine w contrast (72132) | $1,325.24 | $4,597.65 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $1,204.76 | $4,179.68 | 9.9× |
| CT maxillofacial w contrast (70487) | $1,232.11 | $4,274.58 | 6.0× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$242.39–$1,211.91 | $840.90–$4,204.50 | varies |
| CT neck tissue combo (70492) | $1,657.78 | $5,751.36 | 8.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,382.38 | $4,795.89 | 6.8× |
| CT orbits w/o contrast (70480) | $1,247.26 | $4,327.12 | 10.2× |
| CT pelvis w&w/o contrast (72194) | $1,742.15 | $6,044.06 | 8.5× |
| CT pelvis w/o contrast (72192) | $1,306.62 | $4,533.05 | 10.7× |
| CT scans face/jaw combo (70488) | $1,383.60 | $4,800.14 | 6.8× |
| CT soft tissue neck w contrast (70491) | $1,362.56 | $4,727.15 | 6.7× |
| CT soft tissue neck w/o contrast (70490) | $1,214.95 | $4,215.04 | 10.0× |
| CT thoracic spine w contrast (72129) | $1,391.50 | $4,827.54 | 6.8× |
| CT thoracic spine w/o contrast (72128) | $1,265 | $4,388.67 | 10.4× |
| CT thoracic spine w/wo cont (72130) | $1,518 | $5,266.40 | 7.4× |
| CT thorax w/o contrast (71250) | $1,568.76 | $5,442.52 | 12.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,754.21 | $6,085.91 | 8.6× |
| Cta Abdomen (74175) | $1,848.86 | $6,414.26 | 9.0× |
| CTA pelvis (72191) | $1,659.86 | $5,758.56 | 8.1× |
| Dilation ureters/urethra rs&i (74485) | $1,038.49 | $3,602.83 | 0.4× |
| Discography Cerv/Thor Spine (72285) | $2,012.09 | $6,980.56 | 0.9× |
| Diskography lumbar (72295) | $1,916.27 | $6,648.14 | 0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $246.89 | $856.53 | 2.0× |
| Dxa Bone Density Axial (77080) | $343.46 | $1,191.56 | 2.8× |
| Dxa bone density study (77085) | $552.40 | $1,916.43 | 4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $147.70 | $512.39 | 1.5× |
| Echo exam of fetal heart (76825) | $539.22 | $1,870.72 | 0.8× |
| Echo exam uterus (76831) | $440.26 | $1,527.38 | 1.6× |
| Echo Guide For Artery Repair (76936) | $480.81 | $1,668.07 | 1.9× |
| Echograp Trans R Pros Study (76873) | $490.83 | $1,702.84 | 4.0× |
| Esophageal Motility Study (78258) | $450.49 | $1,562.87 | 1.0× |
| Esophagram (74220) | $532.50 | $1,847.38 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $357.24 | $1,239.35 | 2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $334.91 | $1,161.89 | 2.7× |
| Fluoroscopy up to 1 hr (76000) | $384.05 | $1,332.38 | 1.4× |
| Follow-Up Angiography (75898) | $2,127.18 | $7,379.87 | 0.6× |
| Gastric emptying imaging study (78264) | $1,011.26 | $3,508.36 | 2.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,311.36 | $4,549.51 | 2.8× |
| Gastroesophageal Reflux Exam (78262) | $772.58 | $2,680.31 | 1.7× |
| Gated Heart Planar Single (78472) | $1,065 | $3,694.80 | 2.3× |
| Gated Heart, Multiple (78473) | $1,322.37 | $4,587.71 | 2.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,569.46 | $5,444.94 | 2.5× |
| Heart first pass single,planar (78481) | $800.29 | $2,776.43 | 1.3× |
| Heart Image (Pet) Multiple (78492) | $2,968.04 | $10,297.06 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,134.06 | $7,403.71 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,379.20 | $4,784.86 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,171.93 | $4,065.77 | 1.8× |
| Hepatobiliary System Imaging (78226) | $1,113.33 | $3,862.48 | 2.4× |
| Ht Musc Image Planar Mult (78454) | $1,211.64 | $4,203.55 | 0.8× |
| Ht Muscle Image Spect Sing (78451) | $1,976.44 | $6,856.88 | 1.3× |
| Hysterosalpingogram (74740) | $376 | $1,304.45 | 1.4× |
| Image fusion (77399) | $592.56 | $2,055.75 | 3.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $295.13 | $1,023.90 | 2.9× |
| Infant hip ultrasound, limited static exam (76886) | $263.16 | $912.98 | 2.6× |
| Interstitial radiation source applic complex (77778) | $2,223.90 | $7,715.41 | 2.7× |
| Joint Survey Single View (77077) | $158.37 | $549.42 | 1.3× |
| K Flow/Funct Image Multiple (78709) | $1,017.13 | $3,528.74 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $968.70 | $3,360.71 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $952.55 | $3,304.70 | 1.5× |
| Kidney Imaging Morphol (78700) | $661.94 | $2,296.48 | 1.4× |
| Leveen/Shunt Patency Exam (78291) | $540.87 | $1,876.42 | 1.2× |
| Liver & Spleen Imaging Static Only (78215) | $711.13 | $2,467.11 | 1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $764.62 | $2,652.70 | 1.6× |
| Liver imaging static only (78201) | $737.79 | $2,559.61 | 1.2× |
| Liver imaging w/vascular flow (78202) | $711.60 | $2,468.75 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,147.69 | $3,981.69 | 1.8× |
| Lung perfusion differential (78597) | $762.32 | $2,644.72 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,125.17 | $3,903.56 | 1.8× |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$483.83–$569.37 | $1,678.53–$1,975.30 | varies |
| Lymph System Imaging (78195) | $1,131.67 | $3,926.10 | 1.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $734.44 | $2,547.98 | 0.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,799.78 | $6,244 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $1,261.32 | $4,375.90 | 4.5× |
| Mammary ductogram or galactogram multiple (77054) | $458.35 | $1,590.13 | 1.6× |
| Mammary ductogram or galactogram single (77053) | $426.58 | $1,479.92 | 1.5× |
| Meckels Divert Exam (78290) | $598.87 | $2,077.66 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) | $1,997.66 | $6,930.50 | 4.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $17.65 | $61.23 | 0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $66.15 | $229.48 | 0.6× |
| Mr safety implt pos&/immoblj (76019) | $42.81 | $148.50 | 0.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $174.19 | $604.30 | 0.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,121.47 | $7,360.03 | 5.2× |
| MRA head w/o contrast (70544) | $1,443.17 | $5,006.82 | 5.2× |
| MRA head with contrast (70545) | $1,573.06 | $5,457.43 | 3.9× |
| MRA neck w contrast (70548) | $1,528.73 | $5,303.64 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,426.56 | $8,418.49 | 6.0× |
| MRA neck w/o contrast (70547) | $1,407.41 | $4,882.73 | 5.1× |
| MRI abdomen w contrast (74182) | $1,816.65 | $6,302.52 | 4.5× |
| MRI abdomen w/o contrast (74181) | $1,288.17 | $4,469.06 | 4.6× |
| MRI bone marrow blood supply (77084) | $1,254.88 | $4,353.55 | 4.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,415.84 | $4,911.97 | 5.1× |
| MRI cardiac w/o cont stress (75559) | $1,158.21 | $4,018.19 | 1.8× |
| MRI cardiac w/o contrast (75557) | $1,014.93 | $3,521.09 | 3.6× |
| MRI cervical spine w contrast (72142) | $1,917.27 | $6,651.60 | 4.7× |
| MRI cervical spine w/o cont (72141) | $1,885.84 | $6,542.56 | 6.8× |
| MRI chest w/o contrast (71550) | $1,509.41 | $5,236.60 | 5.4× |
| MRI chest with contrast (71551) | $1,819.56 | $6,312.62 | 2.0× |
| MRI chest wo w contrast (71552) | $2,481.22 | $8,608.12 | 6.1× |
| MRI lumbar spine w contrast (72149) | $2,004.26 | $6,953.40 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,033.05 | $10,522.61 | 7.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,278.58 | $4,435.79 | 4.6× |
| MRI orbit face neck w contrast (70542) | $1,731.41 | $6,006.80 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,663.71 | $9,241.24 | 6.5× |
| MRI pelvis w contrast (72196) | $1,608.25 | $5,579.52 | 3.9× |
| MRI pelvis w/o & w contrast (72197) | $2,680.41 | $9,299.20 | 6.6× |
| MRI pelvis w/o contrast (72195) | $1,474.23 | $5,114.56 | 5.3× |
| MRI spectroscopy (76390) | $719.28 | $2,495.39 | 7.1× |
| MRI thoracic spine w/o contrast (72146) | $1,973.54 | $6,846.83 | 7.1× |
| MRI, abdomen, combo (74183) | $2,477.25 | $8,594.35 | 6.1× |
| MRI, dorsal spine combo (72157) | $3,036.21 | $10,533.58 | 7.5× |
| MRI, dorsal spine contrast (72147) | $2,003.90 | $6,952.16 | 4.9× |
| MRI, lumbar spine combo (72158) | $3,039.24 | $10,544.09 | 7.5× |
| Myelogram cervical (72240) | $1,005.05 | $3,486.81 | 1.1× |
| Myelogram Lumbar (72265) | $1,005.05 | $3,486.81 | 1.1× |
| Myelography thoracic (72255) | $1,005.05 | $3,486.81 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,147.73 | $3,981.82 | 1.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $767.70 | $2,663.37 | 1.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,636.24 | $9,145.94 | 1.7× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $812.35 | $2,818.29 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $923.77 | $3,204.85 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $2,577.96 | $8,943.76 | 1.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,015.90 | $10,463.11 | 1.8× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,674.65 | $16,217.83 | 1.8× |
| N-invas est c ffr sw aly CTA (75580) | $1,433.43 | $4,973 | 1.4× |
| Neck soft tissue (70360) | $167.12 | $579.77 | 1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $288.37 | $1,000.43 | 0.6× |
| Nm csf leak detection (78650) | $849.99 | $2,948.86 | 0.6× |
| Nm myocard infarct spect (78469) | $933.15 | $3,237.39 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $265.36 | $920.59 | 2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,645.05 | $12,645.84 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $495.23 | $1,718.10 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $673.61 | $2,336.94 | 2.5× |
| Ob us nuchal meas 1 gest (76813) | $324.68 | $1,126.41 | 2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $366.75 | $1,272.37 | 3.0× |
| Optic foramina (70190) | $110.54 | $383.47 | 1.1× |
| Parathyroid Planar Imaging (78070) | $832.50 | $2,888.18 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,031.97 | $7,049.54 | 4.4× |
| Pelvis 1 or 2 views (72170) | $239.14 | $829.63 | 2.0× |
| Perineogram (74775) | $312.63 | $1,084.60 | 1.1× |
| Peritoneogram Rs&I (74190) | $282.30 | $979.36 | 0.4× |
| Pet Image Skull-Thigh (78812) | $2,913.43 | $10,107.60 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $2,840.80 | $9,855.62 | 1.7× |
| PET image w/CT, full body (78816) | $3,137.23 | $10,884.03 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,964.31 | $10,284.12 | 1.8× |
| Pet Myocardial Sngl Study (78491) | $2,890.17 | $10,026.90 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,267.18 | $7,865.55 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $663.85 | $2,303.10 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $317.10 | $1,100.10 | 2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $327.22 | $1,135.21 | 0.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $235.66 | $817.57 | 1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $245.83 | $852.84 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $222.10 | $770.52 | 2.2× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $120.52 | $418.09 | 1.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $187.69 | $651.13 | 1.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $683.29 | $2,370.55 | 3.3× |
| Radex Spine 1 View Specify Level (72020) | $176.71 | $613.06 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $188.17 | $652.79 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $246.10 | $853.78 | 2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,083.31 | $3,758.33 | 8.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,929.21 | $20,570.30 | 0.7× |
| Radiation treatment delivery level 1 (77402) | $380.02 | $1,318.38 | 3.2× |
| Radiation treatment delivery level 2 (77407) | $450.13 | $1,561.63 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $603.56 | $2,093.92 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $269.05 | $933.40 | 2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $288.82 | $1,002 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $537.24 | $1,863.85 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $441.57 | $1,531.93 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $528.54 | $1,833.65 | 2.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $270.23 | $937.48 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $604.69 | $2,097.83 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $557.09 | $1,932.70 | 2.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $524.17 | $1,818.49 | 2.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $290.32 | $1,007.19 | 2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $130.76 | $453.63 | 1.3× |
| Radiopharm Dacryocystography (78660) | $611.72 | $2,122.23 | 1.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $714.01 | $2,477.11 | 2.6× |
| Renal Cyst Study (74470) | $484.64 | $1,681.37 | 0.8× |
| Ribs bilateral 3 views (71110) | $230.17 | $798.51 | 1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $661.04 | $2,293.34 | 1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $848.50 | $2,943.69 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,539.13 | $5,339.71 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,124.75 | $3,902.09 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,183.95 | $4,107.47 | 1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,539.13 | $5,339.71 | 1.0× |
| Rp Therapy Intravenous Administration (79101) | $707.28 | $2,453.78 | 2.6× |
| Salivary Gland Imaging Serial Images (78231) | $560.43 | $1,944.30 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $82.27 | $285.40 | 3.5× |
| Sella turcica (70240) | $85.29 | $295.88 | 0.8× |
| Sialogram (70390) | $337.28 | $1,170.11 | 1.2× |
| Skull less than 4 views (70250) | $236.96 | $822.07 | 1.9× |
| Special dosimetry (77331) | $260.04 | $902.15 | 1.7× |
| Special teletherapy port plan (77321) | $841.26 | $2,918.58 | 1.9× |
| Special treatment procedure (77470) | $2,204.17 | $7,646.96 | 3.4× |
| Speech evaluation, complex (70371) | $426.98 | $1,481.33 | 1.5× |
| Srs Multisource (77371) | $33,042.83 | $114,636.17 | 3.8× |
| Stereotactic Body Radiation Delivery (77373) | $3,827.85 | $13,280.03 | 1.8× |
| Sternoclavicular joints (71130) | $178.76 | $620.15 | 1.8× |
| Superior sagittal sinus venogram (75870) | $1,106.92 | $3,840.23 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,116.31 | $3,872.82 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $827.93 | $2,872.34 | 1.9× |
| Testicular Imaging W/Flow (78761) | $600.12 | $2,081.99 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,591.75 | $5,522.26 | 3.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,114.22 | $3,865.58 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $782.61 | $2,715.11 | 5.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $229.54 | $796.33 | 1.1× |
| Thoracic spine 2 views (72070) | $235.40 | $816.67 | 1.9× |
| Thoracic spine 3 views (72072) | $268.75 | $932.37 | 2.2× |
| Thoracolumbar 2 views (72080) | $201.23 | $698.11 | 2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $626.42 | $2,173.24 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $560.12 | $1,943.22 | 1.2× |
| Thyroid Met Imaging Body (78018) | $1,058.74 | $3,673.08 | 1.7× |
| Thyroid Uptake Measurement (78012) | $300.44 | $1,042.31 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $658.96 | $2,286.14 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $837.23 | $2,904.61 | 1.9× |
| Tx devices design & construction intermediate (77333) | $517.39 | $1,794.99 | 3.3× |
| Tx devices design & construction simple (77332) | $365.54 | $1,268.15 | 2.3× |
| Ultrasound elastography first target lesion (76982) | $155.05 | $537.91 | 1.3× |
| Ultrasound Elastography Parenchyma (76981) | $155.05 | $537.91 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $314.87 | $1,092.36 | 2.6× |
| Ultrasound, abdomen limited (76705) | $379.13 | $1,315.32 | 3.1× |
| Umbilical-artery Doppler (OB) (76820) | $223.05 | $773.80 | 1.8× |
| Unlisted fluoroscopic procedure (76496) | $449.42 | $1,559.18 | 4.4× |
| Unlisted magnetic resonance procedure (76498) | $1,412.06 | $4,898.87 | 13.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$799.63–$2,082.03 | $2,774.14–$7,223.20 | varies |
| Upper gi w/o kub (74240) | $604.10 | $2,095.80 | 3.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $118.33 | $410.50 | 10.7× |
| Urea breath test c-14 isotopic analysis (78268) | $218.96 | $759.62 | 2.3× |
| Ureteral Reflux Study (78740) | $604.37 | $2,096.72 | 1.3× |
| Urethrocystogram voiding (74455) | $545.08 | $1,891.05 | 2.0× |
| Urethrocystography retrograde (74450) | $419.29 | $1,454.65 | 1.5× |
| Us chest (76604) | $353.72 | $1,227.14 | 2.9× |
| Us exam, pelvic, limited (76857) | $330.79 | $1,147.59 | 2.7× |
| Us head (76506) | $301.74 | $1,046.83 | 2.5× |
| Us ob detailed single fetus (76811) | $621.04 | $2,154.58 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $279.60 | $969.99 | 2.3× |
| Us ob transvaginal (76817) | $368.69 | $1,279.10 | 3.0× |
| Us pelvic non ob complete (76856) | $461.56 | $1,601.29 | 3.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $435.48 | $1,510.79 | 3.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $270.38 | $938.01 | 2.2× |
| Us retroperitoneal complete (76770) | $504.91 | $1,751.68 | 4.1× |
| Us retroperitoneal limited (76775) | $346.75 | $1,202.97 | 2.8× |
| Us scrotum and contents (76870) | $411.18 | $1,426.49 | 3.4× |
| Us spinal canal and contents (76800) | $347.14 | $1,204.31 | 2.8× |
| Us thyroid (76536) | $352.52 | $1,222.99 | 2.9× |
| Us transrectal (76872) | $372.89 | $1,293.66 | 3.1× |
| Vascular Flow Imaging (78445) | $304.06 | $1,054.85 | 0.7× |
| Vein X-Ray Chest (75827) | $2,334.13 | $8,097.82 | 1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,383.58 | $4,800.06 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $1,305.24 | $4,528.28 | 0.4× |
| Venogram Sinus/Jugular (75860) | $1,363.61 | $4,730.78 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,456.98 | $8,524.02 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $942.86 | $3,271.07 | 0.5× |
| Venography Renal Bilateral (75833) | $1,568.89 | $5,442.97 | 0.4× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,228.86 | $7,732.62 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $571.21 | $1,981.68 | 1.2× |
| Vertebral fracture assessment via dxa (77086) | $161.76 | $561.18 | 1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $228.39 | $792.35 | 2.2× |
| X-ray antegrade pyelogram tube (74425) | $401.47 | $1,392.82 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $2,687.60 | $9,324.12 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $284.90 | $988.39 | 2.3× |
| X-Ray Exam Breast Specimen (76098) | $287.19 | $996.35 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $639.81 | $2,219.69 | 6.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $872.46 | $3,026.84 | 7.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,010.60 | $3,506.09 | 8.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $199.60 | $692.45 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $222.11 | $770.55 | 1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $244.62 | $848.64 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $387.72 | $1,345.10 | 3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $257.05 | $891.78 | 2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $402.71 | $1,397.12 | 3.3× |
| X-ray eye for foreign body (70030) | $165.75 | $575.03 | 1.6× |
| X-ray IV pyelogram (ivp) (74400) | $582.96 | $2,022.45 | 2.8× |
| X-ray IV pyelogram+tomography (74415) | $632.45 | $2,194.17 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $166.81 | $578.70 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $183.46 | $636.45 | 1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $257.05 | $891.78 | 2.1× |
| X-ray nose-rectum child f.b. (76010) | $155.87 | $540.74 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $289.98 | $1,006 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $234.62 | $813.95 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $156.41 | $542.63 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $209.20 | $725.77 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $225.22 | $781.36 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $333.72 | $1,157.75 | 2.7× |
| X-Ray Stress View (77071) | $224.94 | $780.36 | 2.2× |
| X-ray thoracic spine 4 vw (72074) | $296.22 | $1,027.65 | 2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $659.95 | $2,289.56 | 1.6× |
| X-Rays Bone Length Studies (77073) | $239.34 | $830.33 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $414.74 | $1,438.85 | 3.4× |
| Xr c-spine 4 or 5 views (72050) | $362.01 | $1,255.92 | 3.0× |
| Xr facial bones less than 3 views (70140) | $188.53 | $654.06 | 1.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $177.04 | $614.20 | 1.5× |
| Xr myelogram posterior fossa (70010) | $853.86 | $2,962.29 | 2.1× |
| Xr orbits complete 4 views (70200) | $250.27 | $868.24 | 2.1× |
| Xr Tomogram Single Plane (76100) | $322.49 | $1,118.82 | 2.6× |
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.