Imaging prices at St. Francis Hospital

Federal Way, 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) $278.19 $886.45 2.3×
Acute gi blood loss imaging (78278) $957.99 $3,052.64 2.1×
Angio Adrenal Bilat Select (75733) $2,773.16 $8,836.67 0.8×
Angiography extremity bilateral rs&i (75716) $2,766.87 $8,816.65 0.8×
Angiography pulmonary bilateral slctv rs&i (75743) $2,761.23 $8,798.67 0.8×
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure
$3,044.57 $9,701.54 0.5×
Angiography visceral slctv/supraslctv rs&i (75726) $3,644.23 $11,612.34 0.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,315.98 $7,379.87 0.6×
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure
$2,426.68 $7,732.62 0.4×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $2,926.13 $9,324.12 0.8×
Aortography abdominal serialography rs&i (75625) $2,831.74 $9,023.34 0.8×
Aortography Thoracic W/O Serialography Rs&I (75600) $2,824.06 $8,998.87 0.8×
Basic dosimetry (77300) $491.54 $1,566.29 3.1×
Bone &/Joint Imaging Limited Area (78300) $819 $2,609.73 1.8×
Bone &/Joint Imaging Multiple Areas (78305) $852.83 $2,717.55 1.8×
Bone &/joint imaging whole body (78306) $1,489.09 $4,744.97 3.2×
Bone age studies (77072) $211.99 $675.48 1.7×
Bone Imaging 3 Phase (78315) $1,563.54 $4,982.22 3.4×
Bone Marrow Imaging Limited Area (78102) $498.36 $1,588.01 1.1×
Bone survey complete (77075) $451.55 $1,438.85 3.7×
Bone survey infant (77076) $252.12 $803.36 2.1×
Bowel imaging (78290) $652.02 $2,077.66 1.4×
Brachytx isodose complex (77318) $1,610.74 $5,132.63 3.7×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $599.69 $1,910.89 1.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $839.56 $2,675.25 1.3×
Brain Imaging Pet Metabolic Evaluation (78608) $2,852.77 $9,090.36 1.7×
Brain Imaging Vascular Flow Only (78610) $642.11 $2,046.07 1.0×
Brain imaging, minimum 4 static views; Non-Facility (78605) $599.69 $1,910.89 1.0×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,287.75 $4,103.42 2.8×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $1,159.52 $3,694.80 2.5×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $1,560 $4,970.95 1.7×
Cardiac MRI w/w/o contrast & further seq (75561) $1,560 $4,970.95 3.9×
Cardiac shunt detection (78428) $835.83 $2,663.37 1.8×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $863.16 $2,750.46 1.4×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $920.15 $2,932.06 1.5×
Cervical spine 2 or 3 views (72040) $279.87 $891.78 2.8×
Chest 1 view (71045) $208.59 $664.66 2.1×
Chest xray 3 views (71047) $273.25 $870.70 2.7×
Cholecystography, oral contrast Non-Facility (74290) $211.55 $674.10 1.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $606.53 $1,932.70 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $68.10 $217 0.6×
Continuing medical physics consltj pr wk (77336) $702.41 $2,238.22 4.5×
Contrast Xray Throat/Cerv Esopha (74210) $530.04 $1,688.97 2.6×
Corpora cavernosography (74445) $342.77 $1,092.21 2.8×
CT abdomen and pelvis without and with contrast (74178) $4,251.39 $13,547.07 10.5×
CT abdomen and pelvis without contrast (74176) $3,221.76 $10,266.14 11.6×
CT abdomen w contrast (74160) $1,932.20 $6,156.96 9.5×
CT abdomen w wo contrast (74170) $2,077.12 $6,618.73 10.2×
CT abdomen w/o contrast (74150) $1,577.96 $5,028.18 13.0×
CT angio hrt w/3d image (75574) $1,035.83 $3,300.66 2.6×
CT c-spine w/contrast (72126) $1,590.75 $5,068.91 3.9×
CT c-spine w/o contrast (72125) $1,446.13 $4,608.10 11.9×
CT cervical spine w&w/o contrast (72127) $1,735.36 $5,529.72 8.5×
CT chest w contrast (71260) $1,919.09 $6,115.19 9.4×
CT chest w/wo contrast (71270) $2,072.62 $6,604.41 10.2×
CT colonography screening (74263) $1,014.59 $3,233 3.7×
CT colonography w/dye (74262) $831.60 $2,649.90 4.1×
CT colonography w/o cntrst (74261) $756 $2,409 6.2×
CT head/brain with contrast (70460) $1,503.85 $4,792.01 7.4×
CT head/brain without and with contrast (70470) $1,684.31 $5,367.05 8.3×
CT heart contrast eval cardiac structure&morph (75572) $1,035.83 $3,300.66 2.6×
CT heart w/o contrast quant eval coronary calcium (75571) $81.72 $260.40 0.8×
CT hrt w/3d image congen (75573) $1,035.83 $3,300.66 2.6×
CT iac w contrast (70481) $1,482.43 $4,723.77 7.3×
CT limited/localized follow up study (76380) $636.55 $2,028.36 6.3×
CT lumbar spine w & w/o contrast (72133) $1,574.02 $5,015.62 7.7×
CT lumbar spine w/contrast (72132) $1,442.85 $4,597.65 3.6×
CT lumbar spine w/o contrast (72131) $1,311.68 $4,179.68 10.8×
CT maxillofacial w contrast (70487) $1,341.47 $4,274.58 6.6×
CT maxillofacial w/wo contrast (70488) $1,506.40 $4,800.14 7.4×
CT maxillofacial wo contrast (70486) $369.46 $1,177.26 3.0×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,505.07 $4,795.89 7.4×
CT orbits w/o contrast (70480) $1,357.96 $4,327.12 11.2×
CT pelvis w/o contrast (72192) $1,422.58 $4,533.05 11.7×
CT pelvis w/wo contrast (72194) $1,896.77 $6,044.06 9.3×
CT soft tissue neck w contrast (70491) $1,483.49 $4,727.15 7.3×
CT soft tissue neck w/o & w/contrast material (70492) $1,804.91 $5,751.36 8.9×
CT soft tissue neck w/o contrast (70490) $1,322.78 $4,215.04 10.9×
CT thoracic spine w/contrast (72129) $1,515 $4,827.54 7.4×
CT thoracic spine w/o contrast (72128) $1,377.27 $4,388.67 11.3×
CT thoracic spine w/wo contrast (72130) $1,652.72 $5,266.40 8.1×
CT thorax w/o contrast (71250) $1,707.99 $5,442.52 14.1×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,909.90 $6,085.91 9.4×
Cta Abdomen (74175) $2,012.95 $6,414.26 9.9×
CTA abdomen pelvis (74174) $4,193.64 $13,363.05 10.4×
CTA chest (71275) $2,472.78 $7,879.51 12.1×
Cta Head (70496) $1,901.66 $6,059.64 9.3×
Cta Neck (70498) $1,996.74 $6,362.62 9.8×
Cta Pelvis (72191) $1,807.17 $5,758.56 8.9×
Cystography minimum 3 views rs&i (74430) $460.49 $1,467.34 1.1×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $1,130.66 $3,602.83 0.5×
Diskogram cervical (72285) $2,190.67 $6,980.56 1.0×
Diskography lumbar (72295) $2,086.34 $6,648.14 0.9×
Doppler Fetal Mid Cerebral Artery (76821) $268.80 $856.53 2.2×
Dxa bone density study 1/> sites axial skel (77080) $373.94 $1,191.56 3.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $160.80 $512.39 1.6×
Dxa bone density study axial skeleton (77085) $601.42 $1,916.43 5.0×
Esophageal motility (78258) $490.47 $1,562.87 1.1×
Esophagus (74220) $579.76 $1,847.38 2.8×
Facial bones min 3 views (70150) $256.58 $817.57 2.1×
Fetal biophysical profile non-stress testing (76818) $388.94 $1,239.35 3.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $364.63 $1,161.89 3.0×
Fetal Echo (76825) $587.08 $1,870.72 0.9×
Fluoroscopy up to 1 hr (76000) $418.14 $1,332.38 1.5×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,427.75 $4,549.51 3.1×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $1,708.75 $5,444.94 2.7×
Heart first pass single,planar (78481) $871.31 $2,776.43 1.4×
Heart Infarct Image (78466) $835.83 $2,663.37 1.8×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $2,323.46 $7,403.71 0.6×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $1,501.60 $4,784.86 0.4×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,275.94 $4,065.77 2.0×
Hepatobiliary syst imaging including gallbladder (78226) $1,212.14 $3,862.48 2.6×
Hysterosalpingogram (74740) $409.37 $1,304.45 1.5×
Image fusion (77399) $645.15 $2,055.75 4.1×
Interstitial radiation source applic complex (77778) $2,421.28 $7,715.41 3.0×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $172.43 $549.42 1.4×
Kidney imaging morphology (78700) $720.69 $2,296.48 1.6×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,037.10 $3,304.70 1.6×
Kidney img morphology vascular flow 1 w/rx (78708) $1,054.67 $3,360.71 1.7×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,107.40 $3,528.74 1.8×
Liver & spleen imaging static only (78215) $774.24 $2,467.11 1.7×
Liver & Spleen Imaging W/Vascular Flow (78216) $832.48 $2,652.70 1.8×
Liver imaging static only (78201) $803.27 $2,559.61 1.3×
Liver imaging w/vascular flow (78202) $774.76 $2,468.75 1.2×
Lung perf&ventilat diferentl (78598) $1,249.55 $3,981.69 2.0×
Lung perfusion differential (78597) $829.98 $2,644.72 1.8×
Lung ventilation imaging (78579) $573.34 $1,826.92 1.2×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $1,959.52 $6,244 0.5×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) $799.62 $2,547.98 0.4×
Lymphoscintigraphy (78195) $1,232.11 $3,926.10 2.0×
Mammary ductogram or galactogram multiple (77054) $499.02 $1,590.13 1.8×
Mammary ductogram or galactogram single (77053) $464.44 $1,479.92 1.7×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $244.90 $780.36 2.4×
Mlc imrt design & construction per imrt plan (77338) $2,174.96 $6,930.50 5.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $19.22 $61.23 0.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $72.02 $229.48 0.7×
Mr safety implt pos&/immoblj (76019) $46.61 $148.50 0.7×
Mr safety med physics xm customization plng&mntr (76017) $189.65 $604.30 0.7×
MRA head w & w/o contrast (70546) $2,309.75 $7,360.03 5.7×
MRA head w/o contrast (70544) $1,571.26 $5,006.82 5.7×
MRA head with contrast (70545) $1,712.67 $5,457.43 4.2×
MRA neck w contrast (70548) $1,664.41 $5,303.64 4.1×
Mra Neck W/O &W/Contrast Material (70549) $2,641.92 $8,418.49 6.5×
MRA neck w/o contrast (70547) $1,532.32 $4,882.73 5.5×
MRI abdomen w contrast (74182) $1,977.88 $6,302.52 4.9×
MRI abdomen w/o & w/contrast material (74183) $2,697.11 $8,594.35 6.7×
MRI abdomen w/o contrast (74181) $1,402.50 $4,469.06 5.1×
MRI bone marrow blood supply (77084) $1,366.25 $4,353.55 4.9×
MRI breast w/o contrast bilateral (77047) $1,541.49 $4,911.97 5.6×
MRI c-spine with contrast (72142) $2,087.43 $6,651.60 5.2×
MRI cardiac w/o cont stress (75559) $1,261.01 $4,018.19 2.0×
MRI cardiac w/o contrast (75557) $1,105 $3,521.09 4.0×
MRI cervical spine w/o contrast (72141) $2,053.21 $6,542.56 7.4×
MRI chest w/o & w/contrast material (71552) $2,701.43 $8,608.12 6.7×
MRI chest w/o contrast (71550) $1,643.37 $5,236.60 5.9×
MRI chest with contrast (71551) $1,981.05 $6,312.62 2.2×
MRI orbit face &/neck w/o contrast (70540) $1,392.06 $4,435.79 5.0×
MRI orbit face neck w contrast (70542) $1,885.08 $6,006.80 4.7×
MRI orbit/face/neck w&w/o cont (70543) $2,900.12 $9,241.24 7.2×
MRI pelvis w/contrast (72196) $1,750.99 $5,579.52 4.3×
MRI pelvis w/o & w/contrast material (72197) $2,918.31 $9,299.20 7.2×
MRI pelvis w/o contrast (72195) $1,605.07 $5,114.56 5.8×
MRI spectroscopy (76390) $783.12 $2,495.39 7.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,302.24 $10,522.61 8.2×
MRI spinal canal lumbar w/contrast material (72149) $2,182.14 $6,953.40 5.4×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,308.98 $10,544.09 8.2×
MRI spinal canal thoracic w/contrast matrl (72147) $2,181.75 $6,952.16 5.4×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,305.69 $10,533.58 8.2×
MRI temporomandibular joint (70336) $1,373.26 $4,375.90 5.0×
MRI thoracic spine w/o contrast (72146) $2,148.70 $6,846.83 7.8×
Myelogram Cervical (72240) $1,094.25 $3,486.81 1.2×
Myelogram Lumbar (72265) $1,094.25 $3,486.81 1.2×
Myelogram thoracic (72255) $1,094.25 $3,486.81 1.2×
Myelography 2 or more regions (72270) $1,249.59 $3,981.82 1.4×
Myocardial Imaging Pet Metabolic Evaluation (78459) $2,870.21 $9,145.94 1.9×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $884.45 $2,818.29 1.4×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) $3,146.68 $10,026.90 1.9×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) $5,089.53 $16,217.83 2.0×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) $3,231.46 $10,297.06 1.9×
Myocardial infarct spect (78469) $1,015.97 $3,237.39 1.6×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,005.76 $3,204.85 0.7×
Myocardial Perfusion Planar Multiple Studies (78454) $1,319.18 $4,203.55 0.9×
Myocardial Spect Multiple Studies (78452) $2,806.76 $8,943.76 1.9×
Myocardial spect single study at rest or stress (78451) $2,151.85 $6,856.88 1.4×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $3,283.57 $10,463.11 2.0×
N-invas est c ffr sw aly CTA (75580) $1,560.65 $4,973 1.6×
Neck soft tissue (70360) $181.95 $579.77 1.8×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $313.96 $1,000.43 0.7×
Nm bone marrow multi (78103) $533.24 $1,699.17 1.1×
Nm bone marrow wb (78104) $603.01 $1,921.49 1.3×
Nm cardiac blood pool multiple (78473) $1,439.73 $4,587.71 3.1×
Nm cisternogram (78630) $976.76 $3,112.43 1.5×
Nm csf leak detection (78650) $925.43 $2,948.86 0.6×
Nm gastric emptying study (78264) $1,101.01 $3,508.36 2.4×
Nm gastroesophageal reflux study (78262) $841.15 $2,680.31 1.8×
Nm peritoneal-venous shunt patency (78291) $588.87 $1,876.42 1.3×
Noncardiac Vascular Flow Imaging (78445) $331.04 $1,054.85 0.7×
Nonvascular shunt X-ray (75809) $288.91 $920.59 2.4×
Ntsty modul radthx pln dose-vol histos (77301) $3,968.56 $12,645.84 2.5×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $621.90 $1,981.68 1.3×
Nuclear Rx Oral Admin (79005) $733.39 $2,336.94 2.7×
Ob us nuchal meas 1 gest (76813) $353.50 $1,126.41 2.9×
Osseous survey limited (77074) $316.08 $1,007.19 2.6×
Parathyroid Planar Imaging (78070) $906.38 $2,888.18 2.0×
Parathyroid planar imaging w/wo subtraction (78071) $2,212.31 $7,049.54 4.8×
Pelvis 1 or 2 views (72170) $260.36 $829.63 2.1×
Perineogram (74775) $340.38 $1,084.60 1.2×
Peritoneogram after injection (74190) $307.35 $979.36 0.5×
PET image w/CT, skull-thigh (78815) $3,227.40 $10,284.12 1.9×
PET imaging CT for attenuation limited area (78814) $3,092.93 $9,855.62 1.9×
PET imaging for CT attenuation whole body (78816) $3,415.66 $10,884.03 2.1×
Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) $3,172 $10,107.60 1.9×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $2,468.40 $7,865.55 0.7×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $1,506.37 $4,800.06 0.4×
Pulmonary Perfusion Imaging Particulate (78580) $722.77 $2,303.10 1.6×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,225.03 $3,903.56 1.9×
Radex abscess/fistula/sinus tract rs&i (76080) $356.26 $1,135.21 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $696.59 $2,219.69 6.9×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $949.90 $3,026.84 7.8×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $1,100.30 $3,506.09 9.1×
Radex Hips Bilateral With Pelvis 2 Views (73521) $217.31 $692.45 1.8×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $266.33 $848.64 2.2×
Radex Mndbl Compl Minimum 4 Views (70110) $292.93 $933.40 2.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $241.81 $770.52 2.4×
Radex Pelvis Compl Minimum 3 Views (72190) $294.21 $937.48 2.4×
Radex Sinuses Paransl < 3 Views (70210) $204.34 $651.13 2.0×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $310.18 $988.39 2.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $267.94 $853.78 2.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,179.46 $3,758.33 9.7×
Radiation Delivery Stereotactic Cranial Cobalt (77371) $35,975.48 $114,636.17 4.2×
Radiation Delivery Stereotactic Cranial Linear (77372) $6,455.44 $20,570.30 0.8×
Radiation treatment delivery level 1 (77402) $413.74 $1,318.38 3.5×
Radiation treatment delivery level 2 (77407) $490.08 $1,561.63 1.1×
Radiation treatment delivery level 3 (77412) $657.13 $2,093.92 1.0×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $219.90 $700.70 2.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $314.46 $1,002 2.6×
Radiologic exam chest 2 views (71046) $271.17 $864.06 2.7×
Radiologic exam colon single contrast study (74270) $480.76 $1,531.93 2.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $575.45 $1,833.65 2.8×
Radiologic exam upr gi trc double contrast study (74246) $570.69 $1,818.49 2.8×
Radiologic exam upr gi trc single contrast study (74240) $657.72 $2,095.80 3.2×
Radiologic Examination Salivary Gland Calculus (70380) $142.36 $453.63 1.4×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $267.65 $852.84 2.2×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $192.76 $614.20 1.6×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) $131.21 $418.09 1.3×
Radiological examination surgical specimen (76098) $312.68 $996.35 0.5×
Radiopharm Dacryocystography (78660) $666.01 $2,122.23 1.4×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $777.38 $2,477.11 2.9×
Renal Cyst Study (74470) $527.66 $1,681.37 0.8×
Ribs bilateral 3 views (71110) $250.60 $798.51 2.1×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $719.71 $2,293.34 1.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $923.80 $2,943.69 2.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,675.73 $5,339.71 2.7×
Rp loclzj tum plnr whole body single day imaging (78802) $1,224.57 $3,902.09 1.9×
Rp loclzj tum spect 1 area single day imaging (78803) $1,289.02 $4,107.47 2.0×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,675.73 $5,339.71 1.1×
Rp therapy intra-arterial particulate admn (79445) $539.18 $1,718.10 2.0×
Rp Therapy Intravenous Administration (79101) $770.06 $2,453.78 2.8×
Sacroiliac Joints < 3 Views (72200) $170.29 $542.63 1.4×
Saline Infus Sonohysterography W/Color Doppler (76831) $479.33 $1,527.38 1.7×
Salivary gland imaging; with serial images Non-Facility (78231) $610.17 $1,944.30 1.3×
Screening Digital Breast Tomosynthesis Bi (77063) $89.57 $285.40 3.8×
Sella turcica (70240) $92.86 $295.88 0.9×
Sialogram (70390) $367.21 $1,170.11 1.3×
Simulation intermediate (77285) $1,213.11 $3,865.58 2.8×
Small bowel series (74250) $658.35 $2,097.83 3.2×
Spec telethx port pln parts hemibdy tot bdy (77321) $915.92 $2,918.58 2.1×
Special dosimetry (77331) $283.12 $902.15 1.8×
Special treatment procedure (77470) $2,399.80 $7,646.96 3.7×
Speech evaluation complex (70371) $464.88 $1,481.33 1.7×
Spine thoracic 3 views (72072) $292.60 $932.37 2.4×
Splenoportograpy rs&i (75810) $1,421.08 $4,528.28 0.4×
Stereotactic Body Radiation Delivery (77373) $4,167.58 $13,280.03 2.0×
Superior sagittal sinus venogram (75870) $1,205.16 $3,840.23 0.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,215.39 $3,872.82 2.8×
Telethx isodose pln smpl w/dosimetry calculation (77306) $901.41 $2,872.34 2.1×
Testicular Imaging With Vascular Flow (78761) $653.38 $2,081.99 1.4×
Ther rad simulaj-aided field setting complex (77290) $1,733.02 $5,522.26 4.0×
Ther rad simulaj-aided field setting simple (77280) $852.07 $2,715.11 5.5×
Thoracolumbar 2 views (72080) $219.09 $698.11 2.2×
Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) $682.02 $2,173.24 1.5×
Thyroid carcinoma metastases img whole body (78018) $1,152.70 $3,673.08 1.8×
Thyroid imaging w/blood flow (78013) $609.83 $1,943.22 1.3×
Thyroid uptake measurement (78012) $327.11 $1,042.31 0.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $717.45 $2,286.14 1.5×
Tomogram (76100) $351.12 $1,118.82 2.9×
Treatment device complex (77334) $911.54 $2,904.61 2.1×
Treatment device intermediate (77333) $563.31 $1,794.99 3.6×
Treatment devices simple (77332) $397.98 $1,268.15 2.5×
Ultrasound elastography first target lesion (76982) $168.81 $537.91 1.4×
Ultrasound Exam Aaa Screen (76706) $342.81 $1,092.36 2.8×
Ultrasound, abdomen limited (76705) $412.78 $1,315.32 3.4×
Umbilical-artery Doppler (OB) (76820) $242.84 $773.80 2.0×
Unlisted fluoroscopic procedure (76496) $489.31 $1,559.18 4.8×
Unlisted magnetic resonance procedure (76498) $1,537.38 $4,898.87 15.2×
Unlisted Procedure Clinical Brachytherapy (77799) $1,568.70 $4,998.67 13.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $128.83 $410.50 11.6×
Urea breath test, C-14 (isotopic); analysis Facility (78268) $238.39 $759.62 2.5×
Ureteral reflux study (78740) $658 $2,096.72 1.4×
Urethrocystogram voiding (74455) $593.46 $1,891.05 2.1×
Urethrocystography retrograde rs&i (74450) $456.51 $1,454.65 1.6×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $688.59 $2,194.17 3.4×
Us chest (76604) $385.11 $1,227.14 3.2×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $523.48 $1,668.07 2.1×
Us elastography parenchyma (76981) $168.81 $537.91 1.4×
Us encephalogram (76506) $328.52 $1,046.83 2.7×
Us hips infant static (76886) $286.52 $912.98 2.8×
Us infant hips w manipulation (76885) $321.33 $1,023.90 3.2×
Us ob detailed single fetus (76811) $676.16 $2,154.58 2.4×
Us ob limited (76815) $304.41 $969.99 2.5×
Us ob transvaginal (76817) $401.42 $1,279.10 3.3×
Us pelvic non ob complete (76856) $502.53 $1,601.29 4.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $360.15 $1,147.59 3.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $474.13 $1,510.79 3.9×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $294.37 $938.01 2.4×
Us retroperitoneal complete (76770) $549.72 $1,751.68 4.5×
Us retroperitoneal limited (76775) $377.52 $1,202.97 3.1×
Us scrotum and contents (76870) $447.67 $1,426.49 3.7×
Us soft tissue head/neck (76536) $383.81 $1,222.99 3.2×
Us spinal canal and contents (76800) $377.95 $1,204.31 3.1×
Us transrectal (76872) $405.99 $1,293.66 3.3×
Us transrectal prostate volume (76873) $534.40 $1,702.84 4.4×
Us, eye b-scan (76512) $399.30 $1,272.37 3.3×
Venogram extremity bilateral (75822) $1,026.54 $3,271.07 0.6×
Venography caval inferior serialography rs&i (75825) $2,675.04 $8,524.02 0.7×
Venography caval superior serialography rs&i (75827) $2,541.29 $8,097.82 1.4×
Venography Renal Bilateral (75833) $1,708.13 $5,442.97 0.5×
Venography venous sinus/jugular cath rs&i (75860) $1,484.63 $4,730.78 0.4×
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure
$2,426.68 $7,732.62 0.4×
Vertebral fracture assessment via dxa (77086) $176.12 $561.18 1.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $345.24 $1,100.10 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $248.66 $792.35 2.5×
X-ray b.e. reductn intuss (74283) $249.91 $796.33 1.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $584.92 $1,863.85 2.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $241.82 $770.55 2.0×
X-ray eye for foreign body (70030) $180.46 $575.03 1.8×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $205.26 $654.06 2.0×
X-ray IV pyelogram (ivp) (74400) $634.70 $2,022.45 3.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $181.61 $578.70 1.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $199.74 $636.45 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $279.87 $891.78 2.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $422.13 $1,345.10 3.5×
X-ray nose-rectum child f.b. (76010) $169.70 $540.74 1.7×
X-ray optic foramen (70190) $120.35 $383.47 1.2×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $272.48 $868.24 2.2×
X-ray retrograde pyelogram (74420) $718.52 $2,289.56 1.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $315.71 $1,006 2.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $255.44 $813.95 2.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $227.77 $725.77 2.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $245.21 $781.36 2.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $363.33 $1,157.75 3.0×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $257.99 $822.07 2.1×
X-Ray Small Bowel Enteroclysis (74251) $743.94 $2,370.55 3.7×
X-Ray Spine One View - Xr Spine (72020) $192.40 $613.06 1.9×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $194.62 $620.15 1.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $204.87 $652.79 2.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $256.29 $816.67 2.1×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $322.51 $1,027.65 2.7×
Xr bone length studies (77073) $260.58 $830.33 2.1×
Xr c-spine 4 or 5 views (72050) $394.14 $1,255.92 3.2×
Xr c-spine 6 or more views (72052) $438.45 $1,397.12 3.6×
Xr chest 4+ views (71048) $272.21 $867.38 2.2×
Xr myelogram posterior fossa (70010) $929.64 $2,962.29 2.3×
Xr urogram antegrade (74425) $437.10 $1,392.82 1.1×