Imaging prices at St. Joseph Medical Center
Bloomington, IL · every code in this section with a posted price and a Medicare benchmark.
359 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$1,207.20–$9,318.60 | $2,012–$15,531 | varies |
| Abdomen 1 View (74018) | $277.20 | $462 | 3.0× |
| Abdomen 2 views (74019) | $337.80 | $563 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,057.20 | $1,762 | 2.5× |
| Angio pulmonary bilat (75743) | $2,148.60 | $3,581 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $8,965.20 | $14,942 | 2.6× |
| Angiography extremity unilateral rs&i (75710) | $5,977.80 | $9,963 | 1.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$420–$630.60 | $700–$1,051 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,405.60 | $5,676 | 0.6× |
| Artery X-Rays Abdomen (75726) | $5,324.40 | $8,874 | 0.9× |
| Artery X-Rays Pelvis (75736) | $5,899.20 | $9,832 | 1.0× |
| Artery X-Rays Spine (75705) | $6,811.80 | $11,353 | 1.1× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,063.80–$1,596 | $1,773–$2,660 | varies |
| Arthrogram Wrist (73115) | $1,287 | $2,145 | 3.4× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$175.20–$475.20 | $292–$792 | varies |
| Bone age studies (77072) | $448.20 | $747 | 4.0× |
| Bone Imaging 3 Phase (78315) | $1,366.80 | $2,278 | 3.2× |
| Bone Imaging Multiple Areas (78305) | $1,353 | $2,255 | 3.2× |
| Bone Imaging Whole Body (78306) | $1,237.20 | $2,062 | 2.9× |
| Bone survey infant (77076) | $556.80 | $928 | 5.0× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$673.80–$1,908 | $1,123–$3,180 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$443.40–$1,477.80 | $739–$2,463 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$334.80–$1,045.80 | $558–$1,743 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,002.60 | $1,671 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,262.60 | $13,771 | 5.4× |
| Cat Scan Follow-Up Study (76380) | $1,694.40 | $2,824 | 18.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,110.60 | $1,851 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $2,799.60 | $4,666 | 4.8× |
| Chest 1 view (71045) | $236.40 | $394 | 2.5× |
| Chest 2 views (71046) | $279.60 | $466 | 3.0× |
| Chest 3 views (71047) | $332.40 | $554 | 3.6× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$375.60–$616.80 | $626–$1,028 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $1,445.40 | $2,409 | 1.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$378–$563.40 | $630–$939 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $176.40 | $294 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $1,028.40 | $1,714 | 7.1× |
| Contrast Exam Abdominl Aorta (75625) | $5,536.20 | $9,227 | 1.6× |
| Contrast X-Ray Bladder (74430) | $307.80 | $513 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $872.40 | $1,454 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,115.20 | $5,192 | 8.3× |
| CT abdomen and pelvis without contrast (74176) | $2,578.20 | $4,297 | 10.1× |
| CT abdomen w contrast (74160) | $2,119.20 | $3,532 | 11.3× |
| CT abdomen w wo contrast (74170) | $2,626.80 | $4,378 | 14.0× |
| CT abdomen w/o contrast (74150) | $1,814.40 | $3,024 | 16.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,337.80 | $5,563 | 8.9× |
| CT Angio Chest (71275) | $1,908.60 | $3,181 | 10.2× |
| CT Angio Head (70496) | $2,293.20 | $3,822 | 12.2× |
| CT angio hrt w/3d image (75574) | $1,921.20 | $3,202 | 5.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,118–$3,177.60 | $3,530–$5,296 | varies |
| CT Angio Neck (70498) | $2,227.80 | $3,713 | 11.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,175–$3,262.80 | $3,625–$5,438 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,599.60 | $2,666 | 8.5× |
| CT cervical spine w/ contrast (72126) | $1,909.20 | $3,182 | 5.1× |
| CT cervical spine w/o contrast (72125) | $1,791.60 | $2,986 | 16.0× |
| CT cervical spine w/wo cont (72127) | $2,001 | $3,335 | 10.6× |
| CT chest w contrast (71260) | $2,075.40 | $3,459 | 11.0× |
| CT chest w/wo contrast (71270) | $2,230.20 | $3,717 | 11.9× |
| CT head/brain with contrast (70460) | $1,694.40 | $2,824 | 9.0× |
| CT head/brain without and with contrast (70470) | $1,968.60 | $3,281 | 10.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,821 | $3,035 | 4.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $117 | $195 | 1.3× |
| CT hrt w/3d image congen (75573) | $1,821 | $3,035 | 4.9× |
| CT iac w contrast (70481) | $1,882.80 | $3,138 | 10.0× |
| CT l-spine w&w/o contrast (72133) | $2,172.60 | $3,621 | 11.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,694.40–$2,542.20 | $2,824–$4,237 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,808.40–$2,712.60 | $3,014–$4,521 | varies |
| CT lumbar spine w contrast (72132) | $1,900.20 | $3,167 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,759.80 | $2,933 | 15.7× |
| CT maxillofacial w contrast (70487) | $2,053.20 | $3,422 | 10.9× |
| CT maxillofacial wo contrast (70486) | $1,725.60 | $2,876 | 15.4× |
| CT neck tissue combo (70492) | $1,991.40 | $3,319 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,034.60 | $3,391 | 10.8× |
| CT orbits w/o contrast (70480) | $1,818 | $3,030 | 16.2× |
| CT pelvis w&w/o contrast (72194) | $2,296.80 | $3,828 | 12.2× |
| CT pelvis w/o contrast (72192) | $1,694.40 | $2,824 | 15.1× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,069.40–$3,104.40 | $3,449–$5,174 | varies |
| CT scans face/jaw combo (70488) | $2,287.80 | $3,813 | 12.2× |
| CT soft tissue neck w contrast (70491) | $1,948.80 | $3,248 | 10.4× |
| CT soft tissue neck w/o contrast (70490) | $1,694.40 | $2,824 | 15.1× |
| CT thoracic spine w contrast (72129) | $1,900.20 | $3,167 | 10.1× |
| CT thoracic spine w/o contrast (72128) | $1,759.80 | $2,933 | 15.7× |
| CT thoracic spine w/wo cont (72130) | $2,172.60 | $3,621 | 11.6× |
| CT thorax w/o contrast (71250) | $1,694.40 | $2,824 | 15.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,694.40–$2,542.20 | $2,824–$4,237 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,172.60–$3,258.60 | $3,621–$5,431 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,809.60–$2,713.80 | $3,016–$4,523 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,181.60 | $3,636 | 11.6× |
| Cta Abdomen (74175) | $1,933.80 | $3,223 | 10.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,624.80 | $2,708 | 4.3× |
| CTA pelvis (72191) | $2,265 | $3,775 | 12.1× |
| Dilation ureters/urethra rs&i (74485) | $1,923.60 | $3,206 | 0.9× |
| Discography Cerv/Thor Spine (72285) | $1,230 | $2,050 | 0.6× |
| Diskography lumbar (72295) | $1,230 | $2,050 | 0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $426.60 | $711 | 3.8× |
| Dxa Bone Density Axial (77080) | $360.60 | $601 | 3.2× |
| Dxa bone density study (77085) | $425.40 | $709 | 3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $214.80 | $358 | 2.3× |
| Echo Guide For Artery Repair (76936) | $1,331.40 | $2,219 | 5.8× |
| Esophagram (74220) | $498 | $830 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$463.20–$702.60 | $772–$1,171 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $705 | $1,175 | 6.3× |
| Fluoroscopy up to 1 hr (76000) | $336 | $560 | 1.3× |
| Follow-Up Angiography (75898) | $1,957.20 | $3,262 | 0.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$387.60–$580.80 | $646–$968 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$442.20–$656.40 | $737–$1,094 | varies |
| Gastric emptying imaging study (78264) | $1,081.20 | $1,802 | 2.5× |
| Gated Heart Planar Single (78472) | $1,539 | $2,565 | 3.6× |
| Gated Heart, Multiple (78473) | $2,103.60 | $3,506 | 4.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$315.60–$628.20 | $526–$1,047 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$1,050–$3,427.20 | $1,750–$5,712 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$762–$2,978.40 | $1,270–$4,964 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$512.40–$2,590.80 | $854–$4,318 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,784.20 | $6,307 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,656 | $2,760 | 2.8× |
| Hepatobiliary System Imaging (78226) | $1,656 | $2,760 | 3.9× |
| Ht Muscle Image Spect Sing (78451) | $4,269.60 | $7,116 | 3.1× |
| Hysterosalpingogram (74740) | $472.20 | $787 | 1.8× |
| Image fusion (77399) | $498.60 | $831 | 3.5× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,321.80–$2,296.20 | $2,203–$3,827 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 2 matching MRF lines |
$2,501.40–$2,719.80 | $4,169–$4,533 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$1,971–$2,463 | $3,285–$4,105 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$1,117.20–$2,203.20 | $1,862–$3,672 | varies |
| Joint Survey Single View (77077) | $415.80 | $693 | 3.7× |
| K Flow/Funct Image Multiple (78709) | $1,338.60 | $2,231 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $1,224.60 | $2,041 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,032 | $1,720 | 1.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$387.60–$580.80 | $646–$968 | varies |
| Liver & Spleen Imaging Static Only (78215) | $931.80 | $1,553 | 2.2× |
| Lung Perf&Ventilat Diferentl (78598) | $2,371.80 | $3,953 | 4.1× |
| Lung perfusion differential (78597) | $1,252.80 | $2,088 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $2,178.60 | $3,631 | 3.7× |
| Lung Ventilation Imaging (78579) | $1,152 | $1,920 | 2.7× |
| Lymph System Imaging (78195) | $1,392 | $2,320 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $3,060.60 | $5,101 | 12.0× |
| Meckels Divert Exam (78290) | $2,921.40 | $4,869 | 6.8× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$675.60–$901.20 | $1,126–$1,502 | varies |
| Mr safety determination physician/other qhp (76016) | $134.40 | $224 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.80 | $63 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $140.40 | $234 | 1.4× |
| Mr safety implt pos&/immoblj (76019) | $90.60 | $151 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $369.60 | $616 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,908.20 | $4,847 | 7.8× |
| MRA head w/o contrast (70544) | $2,405.40 | $4,009 | 9.4× |
| MRA head with contrast (70545) | $2,721 | $4,535 | 7.3× |
| MRA neck w contrast (70548) | $2,721 | $4,535 | 7.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,758.80 | $4,598 | 7.4× |
| MRA neck w/o contrast (70547) | $2,405.40 | $4,009 | 9.4× |
| MRI abdomen w contrast (74182) | $2,685 | $4,475 | 7.2× |
| MRI abdomen w/o contrast (74181) | $2,405.40 | $4,009 | 9.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,820–$4,230 | $4,700–$7,050 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,272.40–$4,908.60 | $5,454–$8,181 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,908.20–$4,363.20 | $4,847–$7,272 | varies |
| MRI brain functional w/o physician admnistration (70554) | $3,328.20 | $5,547 | 13.0× |
| MRI brain functional w/physician admnistration (70555) | $2,392.20 | $3,987 | 9.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,664.20 | $6,107 | 14.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,442.60 | $4,071 | 9.6× |
| MRI cervical spine w contrast (72142) | $2,994 | $4,990 | 8.0× |
| MRI cervical spine w/o cont (72141) | $2,509.20 | $4,182 | 9.8× |
| MRI chest w/o contrast (71550) | $2,484.60 | $4,141 | 9.7× |
| MRI chest with contrast (71551) | $2,683.20 | $4,472 | 3.2× |
| MRI chest wo w contrast (71552) | $3,000 | $5,000 | 8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,908.20–$4,360.20 | $4,847–$7,267 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,369.60–$5,055 | $5,616–$8,425 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,676.60–$4,015.20 | $4,461–$6,692 | varies |
| MRI lumbar spine w contrast (72149) | $2,994 | $4,990 | 8.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,058.80 | $5,098 | 8.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,458.20 | $4,097 | 9.6× |
| MRI orbit face neck w contrast (70542) | $2,661 | $4,435 | 7.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,301.20 | $5,502 | 8.8× |
| MRI pelvis w contrast (72196) | $2,889.60 | $4,816 | 7.7× |
| MRI pelvis w/o & w contrast (72197) | $2,908.20 | $4,847 | 7.8× |
| MRI pelvis w/o contrast (72195) | $2,458.20 | $4,097 | 9.6× |
| MRI spectroscopy (76390) | $2,392.20 | $3,987 | 25.7× |
| MRI thoracic spine w/o contrast (72146) | $2,425.80 | $4,043 | 9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,598.60–$3,897.60 | $4,331–$6,496 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,836.20–$4,254 | $4,727–$7,090 | varies |
| MRI, abdomen, combo (74183) | $2,839.20 | $4,732 | 7.6× |
| MRI, dorsal spine combo (72157) | $3,022.80 | $5,038 | 8.1× |
| MRI, dorsal spine contrast (72147) | $2,643 | $4,405 | 7.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,499–$3,748.80 | $4,165–$6,248 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,836.20–$4,254 | $4,727–$7,090 | varies |
| MRI, lumbar spine combo (72158) | $3,053.40 | $5,089 | 8.2× |
| Myelogram cervical (72240) | $1,494 | $2,490 | 1.8× |
| Myelogram Lumbar (72265) | $1,979.40 | $3,299 | 2.4× |
| Myelography thoracic (72255) | $1,881 | $3,135 | 2.2× |
| Myelograpy 2/more regions rs&i (72270) | $2,434.80 | $4,058 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $7,188 | $11,980 | 5.2× |
| N-invas est c ffr sw aly CTA (75580) | $1,933.80 | $3,223 | 2.1× |
| Neck soft tissue (70360) | $520.20 | $867 | 5.6× |
| Nm csf leak detection (78650) | $1,497.60 | $2,496 | 1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$1,496.40–$6,723 | $2,494–$11,205 | varies |
| Ob us nuchal meas 1 gest (76813) | $589.20 | $982 | 5.3× |
| Panoramic X-ray of jaws (70355) | $195 | $325 | 2.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,593.60 | $2,656 | 2.7× |
| Parathyroid Planar Imaging (78070) | $1,102.20 | $1,837 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,488 | $2,480 | 3.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$280.80–$327.60 | $468–$546 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,989.40 | $11,649 | 4.6× |
| PET image w/CT, full body (78816) | $6,587.40 | $10,979 | 4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,587.40 | $10,979 | 4.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,957.20 | $3,262 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,120.80 | $1,868 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $535.80 | $893 | 4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $793.20 | $1,322 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$354–$531 | $590–$885 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$327.60–$489.60 | $546–$816 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$354–$531 | $590–$885 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $532.20 | $887 | 4.8× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$315.60–$474 | $526–$790 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$315.60–$473.40 | $526–$789 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$432.60–$861 | $721–$1,435 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$412.80–$615.60 | $688–$1,026 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$537.60–$805.20 | $896–$1,342 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $442.20 | $737 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $431.40 | $719 | 4.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$367.20–$550.80 | $612–$918 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $132.60 | $221 | 1.4× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$301.80–$324 | $503–$540 | varies |
| Radex Sternum Minimum 2 Views (71120) | $414 | $690 | 4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $556.80 | $928 | 6.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$297.60–$447 | $496–$745 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$435–$649.20 | $725–$1,082 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$432.60–$861 | $721–$1,435 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $385.20 | $642 | 3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,914.20 | $29,857 | 2.3× |
| Radiation treatment delivery level 1 (77402) | $844.20 | $1,407 | 7.7× |
| Radiation treatment delivery level 2 (77407) | $3,191.40 | $5,319 | 7.7× |
| Radiation treatment delivery level 3 (77412) | $4,308.60 | $7,181 | 7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $493.80 | $823 | 4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $389.40 | $649 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $871.20 | $1,452 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $703.80 | $1,173 | 3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $717.60 | $1,196 | 3.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$535.20–$802.80 | $892–$1,338 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $342 | $570 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $484.20 | $807 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $514.20 | $857 | 2.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $718.80 | $1,198 | 3.8× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$465.60–$700.20 | $776–$1,167 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$431.40–$644.40 | $719–$1,074 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$397.80–$595.20 | $663–$992 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $555.60 | $926 | 5.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$456–$679.20 | $760–$1,132 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) range across 2 matching MRF lines |
$304.80–$461.40 | $508–$769 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) range across 2 matching MRF lines |
$461.40–$540.60 | $769–$901 | varies |
| Ribs bilateral 3 views (71110) | $540 | $900 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,325.80 | $5,543 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,217 | $3,695 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,525.80 | $2,543 | 2.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,288.40 | $3,814 | 1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,051.60 | $5,086 | 2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,034 | $3,390 | 1.5× |
| Salivary Gland Imaging Serial Images (78231) | $691.20 | $1,152 | 1.6× |
| Scapula (73010) range across 3 matching MRF lines |
$391.80–$588.60 | $653–$981 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $90 | $150 | 3.8× |
| Shoulder 1 view (73020) | $265.20 | $442 | 2.8× |
| Shoulder Arthrography (73040) | $952.80 | $1,588 | 2.5× |
| Skull less than 4 views (70250) | $396.60 | $661 | 3.5× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$240–$495.60 | $400–$826 | varies |
| Special Physics Consult (77370) | $1,344 | $2,240 | 9.3× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$297–$1,239 | $495–$2,065 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$567–$2,245.80 | $945–$3,743 | varies |
| Srs Multisource (77371) | $37,210.80 | $62,018 | 4.7× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$7,025.40–$12,090 | $11,709–$20,150 | varies |
| Sternoclavicular joints (71130) | $356.40 | $594 | 3.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 2 matching MRF lines |
$214.80–$297 | $358–$495 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$489–$1,202.40 | $815–$2,004 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$334.80–$889.80 | $558–$1,483 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$693–$2,139.60 | $1,155–$3,566 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$494.40–$2,635.80 | $824–$4,393 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$304.80–$1,195.20 | $508–$1,992 | varies |
| Thoracic spine 2 views (72070) | $405 | $675 | 3.6× |
| Thoracic spine 3 views (72072) | $465.60 | $776 | 4.2× |
| Thoracolumbar 2 views (72080) | $198 | $330 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $783 | $1,305 | 1.8× |
| Thyroid Met Imaging Body (78018) | $870.60 | $1,451 | 1.5× |
| Thyroid Uptake Measurement (78012) | $578.40 | $964 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,263.60 | $2,106 | 2.9× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$334.80–$1,122.60 | $558–$1,871 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$231.60–$693.60 | $386–$1,156 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$148.20–$535.80 | $247–$893 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$487.20–$728.40 | $812–$1,214 | varies |
| Ultrasound elastography first target lesion (76982) | $268.20 | $447 | 2.4× |
| Ultrasound Elastography Parenchyma (76981) | $338.40 | $564 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $782.40 | $1,304 | 7.0× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$733.80–$952.20 | $1,223–$1,587 | varies |
| Umbilical-artery Doppler (OB) (76820) | $456.60 | $761 | 4.1× |
| Unlisted magnetic resonance procedure (76498) | $2,694.60 | $4,491 | 28.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$1,822.80–$2,272.20 | $3,038–$3,787 | varies |
| Unlisted us procedure (76999) | $550.80 | $918 | 5.9× |
| Upper gi w/o kub (74240) | $771 | $1,285 | 4.1× |
| Ureteral Reflux Study (78740) | $738.60 | $1,231 | 1.7× |
| Urethrocystogram voiding (74455) | $693.60 | $1,156 | 2.7× |
| Urethrocystography retrograde (74450) | $750.60 | $1,251 | 2.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$540–$808.20 | $900–$1,347 | varies |
| Us chest (76604) | $531 | $885 | 4.7× |
| Us complete joint (76881) range across 3 matching MRF lines |
$716.40–$1,071.60 | $1,194–$1,786 | varies |
| Us exam, pelvic, limited (76857) | $547.80 | $913 | 4.9× |
| Us kidney transplant (76776) | $1,095.60 | $1,826 | 9.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$406.20–$605.40 | $677–$1,009 | varies |
| Us ob detailed single fetus (76811) | $791.40 | $1,319 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $705 | $1,175 | 6.3× |
| Us ob transvaginal (76817) | $520.80 | $868 | 4.6× |
| Us pelvic non ob complete (76856) | $720.60 | $1,201 | 6.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $791.40 | $1,319 | 7.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$316.20–$630.60 | $527–$1,051 | varies |
| Us retroperitoneal complete (76770) | $894.60 | $1,491 | 8.0× |
| Us retroperitoneal limited (76775) | $810.60 | $1,351 | 7.2× |
| Us scrotum and contents (76870) | $564 | $940 | 5.0× |
| Us thyroid (76536) | $562.20 | $937 | 5.0× |
| Us transrectal (76872) | $1,463.40 | $2,439 | 13.1× |
| Vein X-Ray Chest (75827) | $2,624.40 | $4,374 | 1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,957.20 | $3,262 | 0.6× |
| Venogram Sinus/Jugular (75860) | $1,957.20 | $3,262 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $4,561.80 | $7,603 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $2,315.40 | $3,859 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $1,315.20 | $2,192 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$315.60–$628.20 | $526–$1,047 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $391.80 | $653 | 4.2× |
| X-Ray Aorta Leg Arteries (75630) | $3,640.80 | $6,068 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $415.80 | $693 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$387.60–$580.80 | $646–$968 | varies |
| X-Ray Exam Breast Specimen (76098) | $340.80 | $568 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $260.40 | $434 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $301.80 | $503 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $334.20 | $557 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $676.20 | $1,127 | 7.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $711 | $1,185 | 7.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $868.20 | $1,447 | 7.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $580.20 | $967 | 5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $614.40 | $1,024 | 5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $750 | $1,250 | 6.7× |
| X-Ray Exam L-S Spine Bending (72114) | $540.60 | $901 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $412.80 | $688 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $560.40 | $934 | 5.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $583.20 | $972 | 5.2× |
| X-ray eye for foreign body (70030) | $435 | $725 | 4.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$406.20–$610.20 | $677–$1,017 | varies |
| X-ray IV pyelogram (ivp) (74400) | $895.20 | $1,492 | 4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $327 | $545 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $681 | $1,135 | 7.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $415.80 | $693 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $332.40 | $554 | 3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $600.60 | $1,001 | 5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $483 | $805 | 4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $423 | $705 | 3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $286.80 | $478 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $526.20 | $877 | 5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $507.60 | $846 | 4.5× |
| X-Ray Stress View (77071) | $266.40 | $444 | 2.9× |
| X-ray thoracic spine 4 vw (72074) | $502.20 | $837 | 4.5× |
| X-Ray Tmj Unilat (70328) | $370.80 | $618 | 4.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $927 | $1,545 | 2.5× |
| X-Rays Bone Length Studies (77073) | $639 | $1,065 | 5.7× |
| X-Rays Bone Survey Complete (77075) | $870.60 | $1,451 | 7.8× |
| Xr c-spine 4 or 5 views (72050) | $510 | $850 | 4.6× |
| Xr facial bones less than 3 views (70140) | $456.60 | $761 | 4.9× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$406.80–$612 | $678–$1,020 | varies |
| Xr orbits complete 4 views (70200) | $526.20 | $877 | 4.7× |
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.