Imaging prices at St. Elizabeth Hospital

Enumclaw, 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.

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $313.24 $886.45 2.6×
Acute gi blood loss imaging (78278) $1,078.70 $3,052.64 2.3×
Angio Adrenal Bilat Select (75733) $3,122.57 $8,836.67 0.9×
Angiography extremity bilateral rs&i (75716) $3,115.49 $8,816.65 0.8×
Angiography pulmonary bilateral slctv rs&i (75743) $3,109.14 $8,798.67 0.8×
Angiography Spinal Selective Rs&I (75705) $3,428.18 $9,701.54 0.5×
Angiography visceral slctv/supraslctv rs&i (75726) $4,103.39 $11,612.34 0.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,607.79 $7,379.87 0.7×
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure
$2,732.44 $7,732.62 0.4×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $3,294.82 $9,324.12 0.9×
Aortography abdominal serialography rs&i (75625) $3,188.53 $9,023.34 0.9×
Aortography Thoracic W/O Serialography Rs&I (75600) $3,179.88 $8,998.87 0.9×
Basic dosimetry (77300) $553.48 $1,566.29 3.5×
Bone &/Joint Imaging Limited Area (78300) $922.19 $2,609.73 2.0×
Bone &/Joint Imaging Multiple Areas (78305) $960.29 $2,717.55 2.1×
Bone &/joint imaging whole body (78306) $1,676.71 $4,744.97 3.6×
Bone age studies (77072) $238.70 $675.48 2.0×
Bone Imaging 3 Phase (78315) $1,760.54 $4,982.22 3.8×
Bone Marrow Imaging Limited Area (78102) $561.15 $1,588.01 1.2×
Bone survey complete (77075) $508.44 $1,438.85 4.2×
Bone survey infant (77076) $283.88 $803.36 2.3×
Bowel imaging (78290) $734.18 $2,077.66 1.6×
Brachytx isodose complex (77318) $1,813.69 $5,132.63 4.2×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $675.25 $1,910.89 1.5×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $945.34 $2,675.25 1.5×
Brain Imaging Pet Metabolic Evaluation (78608) $3,212.21 $9,090.36 1.9×
Brain Imaging Vascular Flow Only (78610) $723.01 $2,046.07 1.1×
Brain imaging, minimum 4 static views; Non-Facility (78605) $675.25 $1,910.89 1.1×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,450.01 $4,103.42 3.1×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $1,305.62 $3,694.80 2.8×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $1,756.56 $4,970.95 1.9×
Cardiac MRI w/w/o contrast & further seq (75561) $1,756.56 $4,970.95 4.3×
Cardiac shunt detection (78428) $941.15 $2,663.37 2.0×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $971.92 $2,750.46 1.5×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $1,036.09 $2,932.06 1.6×
Cervical spine 2 or 3 views (72040) $315.13 $891.78 3.1×
Chest 1 view (71045) $234.87 $664.66 2.3×
Chest xray 3 views (71047) $307.68 $870.70 3.0×
Cholecystography, oral contrast Non-Facility (74290) $238.21 $674.10 1.2×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $682.95 $1,932.70 3.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $76.69 $217 0.6×
Continuing medical physics consltj pr wk (77336) $790.91 $2,238.22 5.1×
Contrast Xray Throat/Cerv Esopha (74210) $596.83 $1,688.97 2.9×
Corpora cavernosography (74445) $385.95 $1,092.21 3.2×
CT abdomen and pelvis without and with contrast (74178) $4,787.06 $13,547.07 11.8×
CT abdomen and pelvis without contrast (74176) $3,627.69 $10,266.14 13.1×
CT abdomen w contrast (74160) $2,175.66 $6,156.96 10.7×
CT abdomen w wo contrast (74170) $2,338.83 $6,618.73 11.5×
CT abdomen w/o contrast (74150) $1,776.78 $5,028.18 14.6×
CT angio hrt w/3d image (75574) $1,166.34 $3,300.66 2.9×
CT c-spine w/contrast (72126) $1,791.18 $5,068.91 4.4×
CT c-spine w/o contrast (72125) $1,628.34 $4,608.10 13.4×
CT cervical spine w&w/o contrast (72127) $1,954.01 $5,529.72 9.6×
CT chest w contrast (71260) $2,160.90 $6,115.19 10.6×
CT chest w/wo contrast (71270) $2,333.77 $6,604.41 11.5×
CT colonography screening (74263) $1,142.43 $3,233 4.1×
CT colonography w/dye (74262) $936.39 $2,649.90 4.6×
CT colonography w/o cntrst (74261) $851.26 $2,409 7.0×
CT head/brain with contrast (70460) $1,693.33 $4,792.01 8.3×
CT head/brain without and with contrast (70470) $1,896.53 $5,367.05 9.3×
CT heart contrast eval cardiac structure&morph (75572) $1,166.34 $3,300.66 2.9×
CT heart w/o contrast quant eval coronary calcium (75571) $92.02 $260.40 0.9×
CT hrt w/3d image congen (75573) $1,166.34 $3,300.66 2.9×
CT iac w contrast (70481) $1,669.22 $4,723.77 8.2×
CT limited/localized follow up study (76380) $716.76 $2,028.36 7.1×
CT lumbar spine w & w/o contrast (72133) $1,772.35 $5,015.62 8.7×
CT lumbar spine w/contrast (72132) $1,624.65 $4,597.65 4.0×
CT lumbar spine w/o contrast (72131) $1,476.95 $4,179.68 12.2×
CT maxillofacial w contrast (70487) $1,510.49 $4,274.58 7.4×
CT maxillofacial w/wo contrast (70488) $1,696.20 $4,800.14 8.3×
CT maxillofacial wo contrast (70486) $416.01 $1,177.26 3.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,694.70 $4,795.89 8.3×
CT orbits w/o contrast (70480) $1,529.05 $4,327.12 12.6×
CT pelvis w/o contrast (72192) $1,601.82 $4,533.05 13.2×
CT pelvis w/wo contrast (72194) $2,135.76 $6,044.06 10.5×
CT soft tissue neck w contrast (70491) $1,670.41 $4,727.15 8.2×
CT soft tissue neck w/o & w/contrast material (70492) $2,032.33 $5,751.36 10.0×
CT soft tissue neck w/o contrast (70490) $1,489.45 $4,215.04 12.3×
CT thoracic spine w/contrast (72129) $1,705.89 $4,827.54 8.4×
CT thoracic spine w/o contrast (72128) $1,550.80 $4,388.67 12.8×
CT thoracic spine w/wo contrast (72130) $1,860.96 $5,266.40 9.1×
CT thorax w/o contrast (71250) $1,923.20 $5,442.52 15.8×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $2,150.55 $6,085.91 10.6×
Cta Abdomen (74175) $2,266.58 $6,414.26 11.1×
CTA abdomen pelvis (74174) $4,722.03 $13,363.05 11.7×
CTA chest (71275) $2,784.34 $7,879.51 13.7×
Cta Head (70496) $2,141.27 $6,059.64 10.5×
Cta Neck (70498) $2,248.33 $6,362.62 11.0×
Cta Pelvis (72191) $2,034.87 $5,758.56 10.0×
Cystography minimum 3 views rs&i (74430) $518.51 $1,467.34 1.3×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $1,273.12 $3,602.83 0.5×
Diskogram cervical (72285) $2,466.69 $6,980.56 1.1×
Diskography lumbar (72295) $2,349.22 $6,648.14 1.0×
Doppler Fetal Mid Cerebral Artery (76821) $302.67 $856.53 2.5×
Dxa bone density study 1/> sites axial skel (77080) $421.06 $1,191.56 3.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $181.07 $512.39 1.8×
Dxa bone density study axial skeleton (77085) $677.20 $1,916.43 5.6×
Esophageal motility (78258) $552.27 $1,562.87 1.2×
Esophagus (74220) $652.80 $1,847.38 3.2×
Facial bones min 3 views (70150) $288.91 $817.57 2.4×
Fetal biophysical profile non-stress testing (76818) $437.95 $1,239.35 3.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $410.58 $1,161.89 3.4×
Fetal Echo (76825) $661.05 $1,870.72 1.0×
Fluoroscopy up to 1 hr (76000) $470.82 $1,332.38 1.7×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,607.64 $4,549.51 3.5×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $1,924.05 $5,444.94 3.1×
Heart first pass single,planar (78481) $981.10 $2,776.43 1.6×
Heart Infarct Image (78466) $941.15 $2,663.37 2.0×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $2,616.21 $7,403.71 0.7×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $1,690.80 $4,784.86 0.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,436.70 $4,065.77 2.3×
Hepatobiliary syst imaging including gallbladder (78226) $1,364.87 $3,862.48 2.9×
Hysterosalpingogram (74740) $460.95 $1,304.45 1.7×
Image fusion (77399) $726.43 $2,055.75 4.7×
Interstitial radiation source applic complex (77778) $2,726.36 $7,715.41 3.4×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $194.15 $549.42 1.6×
Kidney imaging morphology (78700) $811.50 $2,296.48 1.7×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,167.77 $3,304.70 1.9×
Kidney img morphology vascular flow 1 w/rx (78708) $1,187.56 $3,360.71 1.9×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,246.94 $3,528.74 2.0×
Liver & spleen imaging static only (78215) $871.79 $2,467.11 1.9×
Liver & Spleen Imaging W/Vascular Flow (78216) $937.37 $2,652.70 2.0×
Liver imaging static only (78201) $904.48 $2,559.61 1.4×
Liver imaging w/vascular flow (78202) $872.37 $2,468.75 1.4×
Lung perf&ventilat diferentl (78598) $1,406.99 $3,981.69 2.2×
Lung perfusion differential (78597) $934.55 $2,644.72 2.0×
Lung ventilation imaging (78579) $645.58 $1,826.92 1.4×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,206.41 $6,244 0.6×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) $900.37 $2,547.98 0.5×
Lymphoscintigraphy (78195) $1,387.35 $3,926.10 2.2×
Mammary ductogram or galactogram multiple (77054) $561.90 $1,590.13 2.0×
Mammary ductogram or galactogram single (77053) $522.96 $1,479.92 1.9×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $275.76 $780.36 2.7×
Mlc imrt design & construction per imrt plan (77338) $2,449 $6,930.50 5.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $21.64 $61.23 0.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $81.10 $229.48 0.7×
Mr safety implt pos&/immoblj (76019) $52.48 $148.50 0.8×
Mr safety med physics xm customization plng&mntr (76017) $213.54 $604.30 0.8×
MRA head w & w/o contrast (70546) $2,600.78 $7,360.03 6.4×
MRA head w/o contrast (70544) $1,769.24 $5,006.82 6.4×
MRA head with contrast (70545) $1,928.47 $5,457.43 4.8×
MRA neck w contrast (70548) $1,874.12 $5,303.64 4.6×
Mra Neck W/O &W/Contrast Material (70549) $2,974.80 $8,418.49 7.3×
MRA neck w/o contrast (70547) $1,725.39 $4,882.73 6.2×
MRI abdomen w contrast (74182) $2,227.09 $6,302.52 5.5×
MRI abdomen w/o & w/contrast material (74183) $3,036.94 $8,594.35 7.5×
MRI abdomen w/o contrast (74181) $1,579.21 $4,469.06 5.7×
MRI bone marrow blood supply (77084) $1,538.39 $4,353.55 5.6×
MRI breast w/o contrast bilateral (77047) $1,735.72 $4,911.97 6.3×
MRI c-spine with contrast (72142) $2,350.44 $6,651.60 5.8×
MRI cardiac w/o cont stress (75559) $1,419.89 $4,018.19 2.2×
MRI cardiac w/o contrast (75557) $1,244.23 $3,521.09 4.5×
MRI cervical spine w/o contrast (72141) $2,311.91 $6,542.56 8.3×
MRI chest w/o & w/contrast material (71552) $3,041.81 $8,608.12 7.5×
MRI chest w/o contrast (71550) $1,850.43 $5,236.60 6.7×
MRI chest with contrast (71551) $2,230.66 $6,312.62 2.5×
MRI orbit face &/neck w/o contrast (70540) $1,567.46 $4,435.79 5.7×
MRI orbit face neck w contrast (70542) $2,122.59 $6,006.80 5.2×
MRI orbit/face/neck w&w/o cont (70543) $3,265.53 $9,241.24 8.1×
MRI pelvis w/contrast (72196) $1,971.61 $5,579.52 4.9×
MRI pelvis w/o & w/contrast material (72197) $3,286.01 $9,299.20 8.1×
MRI pelvis w/o contrast (72195) $1,807.31 $5,114.56 6.5×
MRI spectroscopy (76390) $881.79 $2,495.39 8.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,718.32 $10,522.61 9.2×
MRI spinal canal lumbar w/contrast material (72149) $2,457.09 $6,953.40 6.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,725.91 $10,544.09 9.2×
MRI spinal canal thoracic w/contrast matrl (72147) $2,456.65 $6,952.16 6.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,722.20 $10,533.58 9.2×
MRI temporomandibular joint (70336) $1,546.29 $4,375.90 5.6×
MRI thoracic spine w/o contrast (72146) $2,419.43 $6,846.83 8.7×
Myelogram Cervical (72240) $1,232.12 $3,486.81 1.4×
Myelogram Lumbar (72265) $1,232.12 $3,486.81 1.4×
Myelogram thoracic (72255) $1,232.12 $3,486.81 1.4×
Myelography 2 or more regions (72270) $1,407.04 $3,981.82 1.5×
Myocardial Imaging Pet Metabolic Evaluation (78459) $3,231.85 $9,145.94 2.1×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $995.89 $2,818.29 1.6×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) $3,543.15 $10,026.90 2.1×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) $5,730.81 $16,217.83 2.2×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) $3,638.62 $10,297.06 2.2×
Myocardial infarct spect (78469) $1,143.98 $3,237.39 1.8×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,132.48 $3,204.85 0.8×
Myocardial Perfusion Planar Multiple Studies (78454) $1,485.39 $4,203.55 1.0×
Myocardial Spect Multiple Studies (78452) $3,160.41 $8,943.76 2.1×
Myocardial spect single study at rest or stress (78451) $2,422.98 $6,856.88 1.6×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $3,697.30 $10,463.11 2.2×
N-invas est c ffr sw aly CTA (75580) $1,757.29 $4,973 1.8×
Neck soft tissue (70360) $204.88 $579.77 2.0×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $353.52 $1,000.43 0.8×
Nm bone marrow multi (78103) $600.43 $1,699.17 1.3×
Nm bone marrow wb (78104) $678.99 $1,921.49 1.5×
Nm cardiac blood pool multiple (78473) $1,621.14 $4,587.71 3.5×
Nm cisternogram (78630) $1,099.83 $3,112.43 1.7×
Nm csf leak detection (78650) $1,042.03 $2,948.86 0.7×
Nm gastric emptying study (78264) $1,239.73 $3,508.36 2.7×
Nm gastroesophageal reflux study (78262) $947.13 $2,680.31 2.0×
Nm peritoneal-venous shunt patency (78291) $663.06 $1,876.42 1.4×
Noncardiac Vascular Flow Imaging (78445) $372.75 $1,054.85 0.8×
Nonvascular shunt X-ray (75809) $325.31 $920.59 2.7×
Ntsty modul radthx pln dose-vol histos (77301) $4,468.59 $12,645.84 2.8×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $700.26 $1,981.68 1.5×
Nuclear Rx Oral Admin (79005) $825.80 $2,336.94 3.0×
Ob us nuchal meas 1 gest (76813) $398.04 $1,126.41 3.3×
Osseous survey limited (77074) $355.91 $1,007.19 2.9×
Parathyroid Planar Imaging (78070) $1,020.58 $2,888.18 2.2×
Parathyroid planar imaging w/wo subtraction (78071) $2,491.06 $7,049.54 5.4×
Pelvis 1 or 2 views (72170) $293.17 $829.63 2.4×
Perineogram (74775) $383.26 $1,084.60 1.4×
Peritoneogram after injection (74190) $346.08 $979.36 0.5×
PET image w/CT, skull-thigh (78815) $3,634.05 $10,284.12 2.2×
PET imaging CT for attenuation limited area (78814) $3,482.63 $9,855.62 2.1×
PET imaging for CT attenuation whole body (78816) $3,846.03 $10,884.03 2.3×
Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) $3,571.67 $10,107.60 2.2×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $2,779.41 $7,865.55 0.8×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $1,696.18 $4,800.06 0.5×
Pulmonary Perfusion Imaging Particulate (78580) $813.84 $2,303.10 1.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,379.38 $3,903.56 2.2×
Radex abscess/fistula/sinus tract rs&i (76080) $401.15 $1,135.21 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $784.36 $2,219.69 7.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $1,069.58 $3,026.84 8.8×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $1,238.93 $3,506.09 10.2×
Radex Hips Bilateral With Pelvis 2 Views (73521) $244.69 $692.45 2.0×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $299.88 $848.64 2.5×
Radex Mndbl Compl Minimum 4 Views (70110) $329.84 $933.40 2.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $272.28 $770.52 2.7×
Radex Pelvis Compl Minimum 3 Views (72190) $331.28 $937.48 2.7×
Radex Sinuses Paransl < 3 Views (70210) $230.09 $651.13 2.3×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $349.27 $988.39 2.9×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $301.70 $853.78 3.0×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,328.06 $3,758.33 10.9×
Radiation Delivery Stereotactic Cranial Cobalt (77371) $40,508.34 $114,636.17 4.7×
Radiation Delivery Stereotactic Cranial Linear (77372) $7,268.82 $20,570.30 0.8×
Radiation treatment delivery level 1 (77402) $465.87 $1,318.38 3.9×
Radiation treatment delivery level 2 (77407) $551.83 $1,561.63 1.2×
Radiation treatment delivery level 3 (77412) $739.92 $2,093.92 1.2×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $247.61 $700.70 2.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $354.08 $1,002 2.9×
Radiologic exam chest 2 views (71046) $305.33 $864.06 3.0×
Radiologic exam colon single contrast study (74270) $541.33 $1,531.93 2.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $647.95 $1,833.65 3.2×
Radiologic exam upr gi trc double contrast study (74246) $642.59 $1,818.49 3.2×
Radiologic exam upr gi trc single contrast study (74240) $740.59 $2,095.80 3.6×
Radiologic Examination Salivary Gland Calculus (70380) $160.30 $453.63 1.6×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $301.37 $852.84 2.5×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $217.04 $614.20 1.8×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) $147.74 $418.09 1.5×
Radiological examination surgical specimen (76098) $352.08 $996.35 0.6×
Radiopharm Dacryocystography (78660) $749.93 $2,122.23 1.6×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $875.33 $2,477.11 3.2×
Renal Cyst Study (74470) $594.14 $1,681.37 0.9×
Ribs bilateral 3 views (71110) $282.17 $798.51 2.3×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $810.39 $2,293.34 1.7×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,040.20 $2,943.69 2.2×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,886.87 $5,339.71 3.0×
Rp loclzj tum plnr whole body single day imaging (78802) $1,378.86 $3,902.09 2.2×
Rp loclzj tum spect 1 area single day imaging (78803) $1,451.44 $4,107.47 2.3×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,886.87 $5,339.71 1.3×
Rp therapy intra-arterial particulate admn (79445) $607.12 $1,718.10 2.2×
Rp Therapy Intravenous Administration (79101) $867.08 $2,453.78 3.2×
Sacroiliac Joints < 3 Views (72200) $191.75 $542.63 1.6×
Saline Infus Sonohysterography W/Color Doppler (76831) $539.73 $1,527.38 1.9×
Salivary gland imaging; with serial images Non-Facility (78231) $687.05 $1,944.30 1.5×
Screening Digital Breast Tomosynthesis Bi (77063) $100.86 $285.40 4.3×
Sella turcica (70240) $104.56 $295.88 1.0×
Sialogram (70390) $413.48 $1,170.11 1.5×
Simulation intermediate (77285) $1,365.96 $3,865.58 3.1×
Small bowel series (74250) $741.30 $2,097.83 3.6×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,031.33 $2,918.58 2.4×
Special dosimetry (77331) $318.79 $902.15 2.0×
Special treatment procedure (77470) $2,702.17 $7,646.96 4.2×
Speech evaluation complex (70371) $523.45 $1,481.33 1.9×
Spine thoracic 3 views (72072) $329.47 $932.37 2.7×
Splenoportograpy rs&i (75810) $1,600.14 $4,528.28 0.4×
Stereotactic Body Radiation Delivery (77373) $4,692.69 $13,280.03 2.3×
Superior sagittal sinus venogram (75870) $1,357.01 $3,840.23 0.4×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,368.52 $3,872.82 3.1×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,014.99 $2,872.34 2.3×
Testicular Imaging With Vascular Flow (78761) $735.71 $2,081.99 1.6×
Ther rad simulaj-aided field setting complex (77290) $1,951.37 $5,522.26 4.5×
Ther rad simulaj-aided field setting simple (77280) $959.43 $2,715.11 6.1×
Thoracolumbar 2 views (72080) $246.69 $698.11 2.4×
Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) $767.95 $2,173.24 1.7×
Thyroid carcinoma metastases img whole body (78018) $1,297.94 $3,673.08 2.1×
Thyroid imaging w/blood flow (78013) $686.67 $1,943.22 1.5×
Thyroid uptake measurement (78012) $368.32 $1,042.31 0.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $807.85 $2,286.14 1.7×
Tomogram (76100) $395.36 $1,118.82 3.3×
Treatment device complex (77334) $1,026.39 $2,904.61 2.4×
Treatment device intermediate (77333) $634.29 $1,794.99 4.1×
Treatment devices simple (77332) $448.12 $1,268.15 2.9×
Ultrasound elastography first target lesion (76982) $190.08 $537.91 1.6×
Ultrasound Exam Aaa Screen (76706) $386.01 $1,092.36 3.2×
Ultrasound, abdomen limited (76705) $464.79 $1,315.32 3.8×
Umbilical-artery Doppler (OB) (76820) $273.44 $773.80 2.3×
Unlisted fluoroscopic procedure (76496) $550.96 $1,559.18 5.5×
Unlisted magnetic resonance procedure (76498) $1,731.09 $4,898.87 17.1×
Unlisted Procedure Clinical Brachytherapy (77799) $1,766.36 $4,998.67 14.9×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $145.06 $410.50 13.1×
Urea breath test, C-14 (isotopic); analysis Facility (78268) $268.43 $759.62 2.8×
Ureteral reflux study (78740) $740.91 $2,096.72 1.6×
Urethrocystogram voiding (74455) $668.23 $1,891.05 2.4×
Urethrocystography retrograde rs&i (74450) $514.03 $1,454.65 1.9×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $775.35 $2,194.17 3.8×
Us chest (76604) $433.63 $1,227.14 3.6×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $589.44 $1,668.07 2.4×
Us elastography parenchyma (76981) $190.08 $537.91 1.6×
Us encephalogram (76506) $369.92 $1,046.83 3.0×
Us hips infant static (76886) $322.62 $912.98 3.2×
Us infant hips w manipulation (76885) $361.81 $1,023.90 3.6×
Us ob detailed single fetus (76811) $761.36 $2,154.58 2.7×
Us ob limited (76815) $342.76 $969.99 2.8×
Us ob transvaginal (76817) $451.99 $1,279.10 3.7×
Us pelvic non ob complete (76856) $565.84 $1,601.29 4.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $405.52 $1,147.59 3.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $533.86 $1,510.79 4.4×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $331.46 $938.01 2.7×
Us retroperitoneal complete (76770) $618.99 $1,751.68 5.1×
Us retroperitoneal limited (76775) $425.09 $1,202.97 3.5×
Us scrotum and contents (76870) $504.08 $1,426.49 4.2×
Us soft tissue head/neck (76536) $432.17 $1,222.99 3.6×
Us spinal canal and contents (76800) $425.57 $1,204.31 3.5×
Us transrectal (76872) $457.14 $1,293.66 3.8×
Us transrectal prostate volume (76873) $601.73 $1,702.84 5.0×
Us, eye b-scan (76512) $449.62 $1,272.37 3.7×
Venogram extremity bilateral (75822) $1,155.88 $3,271.07 0.6×
Venography caval inferior serialography rs&i (75825) $3,012.09 $8,524.02 0.8×
Venography caval superior serialography rs&i (75827) $2,861.49 $8,097.82 1.6×
Venography Renal Bilateral (75833) $1,923.36 $5,442.97 0.5×
Venography venous sinus/jugular cath rs&i (75860) $1,671.69 $4,730.78 0.5×
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure
$2,732.44 $7,732.62 0.4×
Vertebral fracture assessment via dxa (77086) $198.31 $561.18 2.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $388.74 $1,100.10 3.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $279.99 $792.35 2.8×
X-ray b.e. reductn intuss (74283) $281.40 $796.33 1.4×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $658.62 $1,863.85 3.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $272.29 $770.55 2.2×
X-ray eye for foreign body (70030) $203.20 $575.03 2.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $231.13 $654.06 2.3×
X-ray IV pyelogram (ivp) (74400) $714.67 $2,022.45 3.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $204.50 $578.70 2.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $224.90 $636.45 2.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $315.13 $891.78 2.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $475.32 $1,345.10 3.9×
X-ray nose-rectum child f.b. (76010) $191.08 $540.74 1.9×
X-ray optic foramen (70190) $135.51 $383.47 1.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $306.81 $868.24 2.5×
X-ray retrograde pyelogram (74420) $809.05 $2,289.56 2.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $355.49 $1,006 2.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $287.63 $813.95 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $256.47 $725.77 2.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $276.11 $781.36 2.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $409.11 $1,157.75 3.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $290.50 $822.07 2.4×
X-Ray Small Bowel Enteroclysis (74251) $837.67 $2,370.55 4.1×
X-Ray Spine One View - Xr Spine (72020) $216.64 $613.06 2.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $219.14 $620.15 2.2×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $230.68 $652.79 2.3×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $288.59 $816.67 2.4×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $363.14 $1,027.65 3.0×
Xr bone length studies (77073) $293.41 $830.33 2.4×
Xr c-spine 4 or 5 views (72050) $443.80 $1,255.92 3.7×
Xr c-spine 6 or more views (72052) $493.70 $1,397.12 4.1×
Xr chest 4+ views (71048) $306.50 $867.38 2.5×
Xr myelogram posterior fossa (70010) $1,046.77 $2,962.29 2.6×
Xr urogram antegrade (74425) $492.18 $1,392.82 1.2×