Imaging prices at St. Joseph Medical Center

Tacoma, 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) $293.60 $886.45 2.4×
Acute gi blood loss imaging (78278) $1,011.03 $3,052.64 2.2×
Angio Adrenal Bilat Select (75733) $2,926.69 $8,836.67 0.8×
Angiography extremity bilateral rs&i (75716) $2,920.06 $8,816.65 0.8×
Angiography pulmonary bilateral slctv rs&i (75743) $2,914.10 $8,798.67 0.8×
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure
$3,213.13 $9,701.54 0.5×
Angiography visceral slctv/supraslctv rs&i (75726) $3,845.98 $11,612.34 0.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,444.20 $7,379.87 0.7×
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure
$2,561.03 $7,732.62 0.4×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $3,088.13 $9,324.12 0.8×
Aortography abdominal serialography rs&i (75625) $2,988.51 $9,023.34 0.8×
Aortography Thoracic W/O Serialography Rs&I (75600) $2,980.41 $8,998.87 0.8×
Basic dosimetry (77300) $518.76 $1,566.29 3.3×
Bone &/Joint Imaging Limited Area (78300) $864.34 $2,609.73 1.9×
Bone &/Joint Imaging Multiple Areas (78305) $900.05 $2,717.55 1.9×
Bone &/joint imaging whole body (78306) $1,571.53 $4,744.97 3.4×
Bone age studies (77072) $223.72 $675.48 1.8×
Bone Imaging 3 Phase (78315) $1,650.10 $4,982.22 3.5×
Bone Marrow Imaging Limited Area (78102) $525.95 $1,588.01 1.1×
Bone survey complete (77075) $476.55 $1,438.85 3.9×
Bone survey infant (77076) $266.08 $803.36 2.2×
Bowel imaging (78290) $688.12 $2,077.66 1.5×
Brachytx isodose complex (77318) $1,699.92 $5,132.63 3.9×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $632.89 $1,910.89 1.4×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $886.04 $2,675.25 1.4×
Brain Imaging Pet Metabolic Evaluation (78608) $3,010.71 $9,090.36 1.8×
Brain Imaging Vascular Flow Only (78610) $677.66 $2,046.07 1.1×
Brain imaging, minimum 4 static views; Non-Facility (78605) $632.89 $1,910.89 1.0×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,359.05 $4,103.42 2.9×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $1,223.71 $3,694.80 2.6×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $1,646.37 $4,970.95 1.8×
Cardiac MRI w/w/o contrast & further seq (75561) $1,646.37 $4,970.95 4.0×
Cardiac shunt detection (78428) $882.11 $2,663.37 1.9×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $910.95 $2,750.46 1.4×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $971.10 $2,932.06 1.5×
Cervical spine 2 or 3 views (72040) $295.36 $891.78 2.9×
Chest 1 view (71045) $220.14 $664.66 2.2×
Chest xray 3 views (71047) $288.38 $870.70 2.8×
Cholecystography, oral contrast Non-Facility (74290) $223.27 $674.10 1.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $640.11 $1,932.70 3.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $71.87 $217 0.6×
Continuing medical physics consltj pr wk (77336) $741.30 $2,238.22 4.7×
Contrast Xray Throat/Cerv Esopha (74210) $559.39 $1,688.97 2.7×
Corpora cavernosography (74445) $361.74 $1,092.21 3.0×
CT abdomen and pelvis without and with contrast (74178) $4,486.76 $13,547.07 11.0×
CT abdomen and pelvis without contrast (74176) $3,400.12 $10,266.14 12.2×
CT abdomen w contrast (74160) $2,039.17 $6,156.96 10.0×
CT abdomen w wo contrast (74170) $2,192.11 $6,618.73 10.7×
CT abdomen w/o contrast (74150) $1,665.33 $5,028.18 13.6×
CT angio hrt w/3d image (75574) $1,093.18 $3,300.66 2.7×
CT c-spine w/contrast (72126) $1,678.82 $5,068.91 4.1×
CT c-spine w/o contrast (72125) $1,526.20 $4,608.10 12.5×
CT cervical spine w&w/o contrast (72127) $1,831.43 $5,529.72 8.9×
CT chest w contrast (71260) $2,025.34 $6,115.19 9.9×
CT chest w/wo contrast (71270) $2,187.37 $6,604.41 10.7×
CT colonography screening (74263) $1,070.77 $3,233 3.8×
CT colonography w/dye (74262) $877.65 $2,649.90 4.3×
CT colonography w/o cntrst (74261) $797.86 $2,409 6.5×
CT head/brain with contrast (70460) $1,587.11 $4,792.01 7.8×
CT head/brain without and with contrast (70470) $1,777.56 $5,367.05 8.7×
CT heart contrast eval cardiac structure&morph (75572) $1,093.18 $3,300.66 2.7×
CT heart w/o contrast quant eval coronary calcium (75571) $86.25 $260.40 0.8×
CT hrt w/3d image congen (75573) $1,093.18 $3,300.66 2.7×
CT iac w contrast (70481) $1,564.51 $4,723.77 7.6×
CT limited/localized follow up study (76380) $671.79 $2,028.36 6.6×
CT lumbar spine w & w/o contrast (72133) $1,661.17 $5,015.62 8.1×
CT lumbar spine w/contrast (72132) $1,522.74 $4,597.65 3.7×
CT lumbar spine w/o contrast (72131) $1,384.30 $4,179.68 11.3×
CT maxillofacial w contrast (70487) $1,415.74 $4,274.58 6.9×
CT maxillofacial w/wo contrast (70488) $1,589.80 $4,800.14 7.8×
CT maxillofacial wo contrast (70486) $389.91 $1,177.26 3.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,588.39 $4,795.89 7.8×
CT orbits w/o contrast (70480) $1,433.14 $4,327.12 11.7×
CT pelvis w/o contrast (72192) $1,501.34 $4,533.05 12.3×
CT pelvis w/wo contrast (72194) $2,001.78 $6,044.06 9.8×
CT soft tissue neck w contrast (70491) $1,565.63 $4,727.15 7.6×
CT soft tissue neck w/o & w/contrast material (70492) $1,904.84 $5,751.36 9.3×
CT soft tissue neck w/o contrast (70490) $1,396.02 $4,215.04 11.4×
CT thoracic spine w/contrast (72129) $1,598.87 $4,827.54 7.8×
CT thoracic spine w/o contrast (72128) $1,453.52 $4,388.67 11.9×
CT thoracic spine w/wo contrast (72130) $1,744.22 $5,266.40 8.5×
CT thorax w/o contrast (71250) $1,802.55 $5,442.52 14.8×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $2,015.64 $6,085.91 9.8×
Cta Abdomen (74175) $2,124.39 $6,414.26 10.4×
CTA abdomen pelvis (74174) $4,425.81 $13,363.05 10.9×
CTA chest (71275) $2,609.68 $7,879.51 12.7×
Cta Head (70496) $2,006.94 $6,059.64 9.8×
Cta Neck (70498) $2,107.29 $6,362.62 10.3×
Cta Pelvis (72191) $1,907.23 $5,758.56 9.3×
Cystography minimum 3 views rs&i (74430) $485.98 $1,467.34 1.2×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $1,193.25 $3,602.83 0.5×
Diskogram cervical (72285) $2,311.95 $6,980.56 1.0×
Diskography lumbar (72295) $2,201.85 $6,648.14 1.0×
Doppler Fetal Mid Cerebral Artery (76821) $283.69 $856.53 2.3×
Dxa bone density study 1/> sites axial skel (77080) $394.65 $1,191.56 3.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $169.71 $512.39 1.7×
Dxa bone density study axial skeleton (77085) $634.72 $1,916.43 5.2×
Esophageal motility (78258) $517.62 $1,562.87 1.1×
Esophagus (74220) $611.85 $1,847.38 3.0×
Facial bones min 3 views (70150) $270.78 $817.57 2.2×
Fetal biophysical profile non-stress testing (76818) $410.47 $1,239.35 3.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $384.82 $1,161.89 3.2×
Fetal Echo (76825) $619.58 $1,870.72 1.0×
Fluoroscopy up to 1 hr (76000) $441.29 $1,332.38 1.6×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,506.79 $4,549.51 3.2×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $1,803.36 $5,444.94 2.8×
Heart first pass single,planar (78481) $919.55 $2,776.43 1.5×
Heart Infarct Image (78466) $882.11 $2,663.37 1.9×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $2,452.10 $7,403.71 0.7×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $1,584.74 $4,784.86 0.4×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,346.58 $4,065.77 2.1×
Hepatobiliary syst imaging including gallbladder (78226) $1,279.25 $3,862.48 2.7×
Hysterosalpingogram (74740) $432.04 $1,304.45 1.6×
Image fusion (77399) $680.86 $2,055.75 4.3×
Interstitial radiation source applic complex (77778) $2,555.33 $7,715.41 3.1×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $181.97 $549.42 1.5×
Kidney imaging morphology (78700) $760.59 $2,296.48 1.6×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,094.51 $3,304.70 1.7×
Kidney img morphology vascular flow 1 w/rx (78708) $1,113.06 $3,360.71 1.8×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,168.71 $3,528.74 1.8×
Liver & spleen imaging static only (78215) $817.11 $2,467.11 1.8×
Liver & Spleen Imaging W/Vascular Flow (78216) $878.57 $2,652.70 1.9×
Liver imaging static only (78201) $847.74 $2,559.61 1.3×
Liver imaging w/vascular flow (78202) $817.65 $2,468.75 1.3×
Lung perf&ventilat diferentl (78598) $1,318.73 $3,981.69 2.1×
Lung perfusion differential (78597) $875.93 $2,644.72 1.9×
Lung ventilation imaging (78579) $605.08 $1,826.92 1.3×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,068 $6,244 0.6×
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) $843.89 $2,547.98 0.5×
Lymphoscintigraphy (78195) $1,300.32 $3,926.10 2.1×
Mammary ductogram or galactogram multiple (77054) $526.65 $1,590.13 1.9×
Mammary ductogram or galactogram single (77053) $490.15 $1,479.92 1.8×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $258.46 $780.36 2.5×
Mlc imrt design & construction per imrt plan (77338) $2,295.37 $6,930.50 5.3×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $20.28 $61.23 0.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $76.01 $229.48 0.7×
Mr safety implt pos&/immoblj (76019) $49.19 $148.50 0.7×
Mr safety med physics xm customization plng&mntr (76017) $200.15 $604.30 0.7×
MRA head w & w/o contrast (70546) $2,437.63 $7,360.03 6.0×
MRA head w/o contrast (70544) $1,658.25 $5,006.82 6.0×
MRA head with contrast (70545) $1,807.49 $5,457.43 4.4×
MRA neck w contrast (70548) $1,756.56 $5,303.64 4.3×
Mra Neck W/O &W/Contrast Material (70549) $2,788.19 $8,418.49 6.8×
MRA neck w/o contrast (70547) $1,617.15 $4,882.73 5.8×
MRI abdomen w contrast (74182) $2,087.38 $6,302.52 5.1×
MRI abdomen w/o & w/contrast material (74183) $2,846.43 $8,594.35 7.0×
MRI abdomen w/o contrast (74181) $1,480.15 $4,469.06 5.3×
MRI bone marrow blood supply (77084) $1,441.89 $4,353.55 5.2×
MRI breast w/o contrast bilateral (77047) $1,626.84 $4,911.97 5.8×
MRI c-spine with contrast (72142) $2,203 $6,651.60 5.4×
MRI cardiac w/o cont stress (75559) $1,330.82 $4,018.19 2.1×
MRI cardiac w/o contrast (75557) $1,166.18 $3,521.09 4.2×
MRI cervical spine w/o contrast (72141) $2,166.88 $6,542.56 7.8×
MRI chest w/o & w/contrast material (71552) $2,850.99 $8,608.12 7.0×
MRI chest w/o contrast (71550) $1,734.35 $5,236.60 6.2×
MRI chest with contrast (71551) $2,090.73 $6,312.62 2.3×
MRI orbit face &/neck w/o contrast (70540) $1,469.13 $4,435.79 5.3×
MRI orbit face neck w contrast (70542) $1,989.44 $6,006.80 4.9×
MRI orbit/face/neck w&w/o cont (70543) $3,060.68 $9,241.24 7.5×
MRI pelvis w/contrast (72196) $1,847.93 $5,579.52 4.5×
MRI pelvis w/o & w/contrast material (72197) $3,079.88 $9,299.20 7.6×
MRI pelvis w/o contrast (72195) $1,693.93 $5,114.56 6.1×
MRI spectroscopy (76390) $826.47 $2,495.39 8.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,485.07 $10,522.61 8.6×
MRI spinal canal lumbar w/contrast material (72149) $2,302.95 $6,953.40 5.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,492.18 $10,544.09 8.6×
MRI spinal canal thoracic w/contrast matrl (72147) $2,302.54 $6,952.16 5.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,488.70 $10,533.58 8.6×
MRI temporomandibular joint (70336) $1,449.29 $4,375.90 5.2×
MRI thoracic spine w/o contrast (72146) $2,267.66 $6,846.83 8.1×
Myelogram Cervical (72240) $1,154.83 $3,486.81 1.3×
Myelogram Lumbar (72265) $1,154.83 $3,486.81 1.3×
Myelogram thoracic (72255) $1,154.83 $3,486.81 1.3×
Myelography 2 or more regions (72270) $1,318.77 $3,981.82 1.4×
Myocardial Imaging Pet Metabolic Evaluation (78459) $3,029.12 $9,145.94 2.0×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $933.42 $2,818.29 1.5×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) $3,320.89 $10,026.90 2.0×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) $5,371.31 $16,217.83 2.1×
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) $3,410.37 $10,297.06 2.0×
Myocardial infarct spect (78469) $1,072.22 $3,237.39 1.7×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,061.44 $3,204.85 0.7×
Myocardial Perfusion Planar Multiple Studies (78454) $1,392.21 $4,203.55 0.9×
Myocardial Spect Multiple Studies (78452) $2,962.16 $8,943.76 2.0×
Myocardial spect single study at rest or stress (78451) $2,270.99 $6,856.88 1.5×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $3,465.36 $10,463.11 2.1×
N-invas est c ffr sw aly CTA (75580) $1,647.05 $4,973 1.6×
Neck soft tissue (70360) $192.02 $579.77 1.9×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $331.34 $1,000.43 0.7×
Nm bone marrow multi (78103) $562.77 $1,699.17 1.2×
Nm bone marrow wb (78104) $636.40 $1,921.49 1.4×
Nm cardiac blood pool multiple (78473) $1,519.44 $4,587.71 3.3×
Nm cisternogram (78630) $1,030.83 $3,112.43 1.6×
Nm csf leak detection (78650) $976.66 $2,948.86 0.6×
Nm gastric emptying study (78264) $1,161.97 $3,508.36 2.5×
Nm gastroesophageal reflux study (78262) $887.72 $2,680.31 1.9×
Nm peritoneal-venous shunt patency (78291) $621.47 $1,876.42 1.3×
Noncardiac Vascular Flow Imaging (78445) $349.37 $1,054.85 0.7×
Nonvascular shunt X-ray (75809) $304.90 $920.59 2.5×
Ntsty modul radthx pln dose-vol histos (77301) $4,188.28 $12,645.84 2.6×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $656.33 $1,981.68 1.4×
Nuclear Rx Oral Admin (79005) $773.99 $2,336.94 2.8×
Ob us nuchal meas 1 gest (76813) $373.07 $1,126.41 3.1×
Osseous survey limited (77074) $333.58 $1,007.19 2.7×
Parathyroid Planar Imaging (78070) $956.56 $2,888.18 2.1×
Parathyroid planar imaging w/wo subtraction (78071) $2,334.80 $7,049.54 5.0×
Pelvis 1 or 2 views (72170) $274.78 $829.63 2.3×
Perineogram (74775) $359.22 $1,084.60 1.3×
Peritoneogram after injection (74190) $324.37 $979.36 0.5×
PET image w/CT, skull-thigh (78815) $3,406.08 $10,284.12 2.0×
PET imaging CT for attenuation limited area (78814) $3,264.16 $9,855.62 2.0×
PET imaging for CT attenuation whole body (78816) $3,604.77 $10,884.03 2.2×
Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) $3,347.62 $10,107.60 2.0×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $2,605.06 $7,865.55 0.7×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $1,589.77 $4,800.06 0.4×
Pulmonary Perfusion Imaging Particulate (78580) $762.79 $2,303.10 1.6×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,292.85 $3,903.56 2.0×
Radex abscess/fistula/sinus tract rs&i (76080) $375.98 $1,135.21 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $735.16 $2,219.69 7.2×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $1,002.49 $3,026.84 8.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $1,161.21 $3,506.09 9.5×
Radex Hips Bilateral With Pelvis 2 Views (73521) $229.34 $692.45 1.9×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $281.07 $848.64 2.3×
Radex Mndbl Compl Minimum 4 Views (70110) $309.14 $933.40 2.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $255.20 $770.52 2.5×
Radex Pelvis Compl Minimum 3 Views (72190) $310.50 $937.48 2.5×
Radex Sinuses Paransl < 3 Views (70210) $215.66 $651.13 2.1×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $327.36 $988.39 2.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $282.77 $853.78 2.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,244.75 $3,758.33 10.2×
Radiation Delivery Stereotactic Cranial Cobalt (77371) $37,967.22 $114,636.17 4.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $6,812.84 $20,570.30 0.8×
Radiation treatment delivery level 1 (77402) $436.65 $1,318.38 3.7×
Radiation treatment delivery level 2 (77407) $517.21 $1,561.63 1.1×
Radiation treatment delivery level 3 (77412) $693.51 $2,093.92 1.1×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $232.08 $700.70 2.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $331.86 $1,002 2.7×
Radiologic exam chest 2 views (71046) $286.18 $864.06 2.8×
Radiologic exam colon single contrast study (74270) $507.38 $1,531.93 2.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $607.31 $1,833.65 3.0×
Radiologic exam upr gi trc double contrast study (74246) $602.28 $1,818.49 2.9×
Radiologic exam upr gi trc single contrast study (74240) $694.13 $2,095.80 3.4×
Radiologic Examination Salivary Gland Calculus (70380) $150.25 $453.63 1.5×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $282.46 $852.84 2.3×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $203.43 $614.20 1.7×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) $138.48 $418.09 1.4×
Radiological examination surgical specimen (76098) $329.99 $996.35 0.5×
Radiopharm Dacryocystography (78660) $702.88 $2,122.23 1.5×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $820.42 $2,477.11 3.0×
Renal Cyst Study (74470) $556.87 $1,681.37 0.9×
Ribs bilateral 3 views (71110) $264.47 $798.51 2.2×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $759.55 $2,293.34 1.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $974.95 $2,943.69 2.1×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,768.50 $5,339.71 2.8×
Rp loclzj tum plnr whole body single day imaging (78802) $1,292.37 $3,902.09 2.0×
Rp loclzj tum spect 1 area single day imaging (78803) $1,360.39 $4,107.47 2.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,768.50 $5,339.71 1.2×
Rp therapy intra-arterial particulate admn (79445) $569.04 $1,718.10 2.1×
Rp Therapy Intravenous Administration (79101) $812.69 $2,453.78 3.0×
Sacroiliac Joints < 3 Views (72200) $179.72 $542.63 1.5×
Saline Infus Sonohysterography W/Color Doppler (76831) $505.87 $1,527.38 1.8×
Salivary gland imaging; with serial images Non-Facility (78231) $643.95 $1,944.30 1.4×
Screening Digital Breast Tomosynthesis Bi (77063) $94.53 $285.40 4.0×
Sella turcica (70240) $98 $295.88 1.0×
Sialogram (70390) $387.54 $1,170.11 1.4×
Simulation intermediate (77285) $1,280.28 $3,865.58 2.9×
Small bowel series (74250) $694.80 $2,097.83 3.4×
Spec telethx port pln parts hemibdy tot bdy (77321) $966.63 $2,918.58 2.2×
Special dosimetry (77331) $298.79 $902.15 1.9×
Special treatment procedure (77470) $2,532.66 $7,646.96 3.9×
Speech evaluation complex (70371) $490.62 $1,481.33 1.8×
Spine thoracic 3 views (72072) $308.80 $932.37 2.5×
Splenoportograpy rs&i (75810) $1,499.76 $4,528.28 0.4×
Stereotactic Body Radiation Delivery (77373) $4,398.32 $13,280.03 2.1×
Superior sagittal sinus venogram (75870) $1,271.88 $3,840.23 0.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,282.67 $3,872.82 2.9×
Telethx isodose pln smpl w/dosimetry calculation (77306) $951.32 $2,872.34 2.2×
Testicular Imaging With Vascular Flow (78761) $689.55 $2,081.99 1.5×
Ther rad simulaj-aided field setting complex (77290) $1,828.96 $5,522.26 4.2×
Ther rad simulaj-aided field setting simple (77280) $899.24 $2,715.11 5.7×
Thoracolumbar 2 views (72080) $231.22 $698.11 2.3×
Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) $719.78 $2,173.24 1.5×
Thyroid carcinoma metastases img whole body (78018) $1,216.52 $3,673.08 1.9×
Thyroid imaging w/blood flow (78013) $643.59 $1,943.22 1.4×
Thyroid uptake measurement (78012) $345.22 $1,042.31 0.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $757.17 $2,286.14 1.6×
Tomogram (76100) $370.56 $1,118.82 3.0×
Treatment device complex (77334) $962 $2,904.61 2.2×
Treatment device intermediate (77333) $594.50 $1,794.99 3.8×
Treatment devices simple (77332) $420.01 $1,268.15 2.7×
Ultrasound elastography first target lesion (76982) $178.16 $537.91 1.5×
Ultrasound Exam Aaa Screen (76706) $361.79 $1,092.36 3.0×
Ultrasound, abdomen limited (76705) $435.64 $1,315.32 3.6×
Umbilical-artery Doppler (OB) (76820) $256.29 $773.80 2.1×
Unlisted fluoroscopic procedure (76496) $516.40 $1,559.18 5.1×
Unlisted magnetic resonance procedure (76498) $1,622.50 $4,898.87 16.0×
Unlisted Procedure Clinical Brachytherapy (77799) $1,655.55 $4,998.67 13.9×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $135.96 $410.50 12.3×
Urea breath test, C-14 (isotopic); analysis Facility (78268) $251.59 $759.62 2.7×
Ureteral reflux study (78740) $694.43 $2,096.72 1.5×
Urethrocystogram voiding (74455) $626.32 $1,891.05 2.2×
Urethrocystography retrograde rs&i (74450) $481.78 $1,454.65 1.7×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $726.71 $2,194.17 3.6×
Us chest (76604) $406.43 $1,227.14 3.3×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $552.47 $1,668.07 2.2×
Us elastography parenchyma (76981) $178.16 $537.91 1.5×
Us encephalogram (76506) $346.71 $1,046.83 2.8×
Us hips infant static (76886) $302.38 $912.98 3.0×
Us infant hips w manipulation (76885) $339.12 $1,023.90 3.3×
Us ob detailed single fetus (76811) $713.60 $2,154.58 2.6×
Us ob limited (76815) $321.26 $969.99 2.6×
Us ob transvaginal (76817) $423.64 $1,279.10 3.5×
Us pelvic non ob complete (76856) $530.35 $1,601.29 4.3×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $380.08 $1,147.59 3.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $500.37 $1,510.79 4.1×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $310.67 $938.01 2.5×
Us retroperitoneal complete (76770) $580.16 $1,751.68 4.8×
Us retroperitoneal limited (76775) $398.43 $1,202.97 3.3×
Us scrotum and contents (76870) $472.45 $1,426.49 3.9×
Us soft tissue head/neck (76536) $405.06 $1,222.99 3.3×
Us spinal canal and contents (76800) $398.87 $1,204.31 3.3×
Us transrectal (76872) $428.46 $1,293.66 3.5×
Us transrectal prostate volume (76873) $563.98 $1,702.84 4.6×
Us, eye b-scan (76512) $421.41 $1,272.37 3.5×
Venogram extremity bilateral (75822) $1,083.38 $3,271.07 0.6×
Venography caval inferior serialography rs&i (75825) $2,823.14 $8,524.02 0.8×
Venography caval superior serialography rs&i (75827) $2,681.98 $8,097.82 1.5×
Venography Renal Bilateral (75833) $1,802.70 $5,442.97 0.5×
Venography venous sinus/jugular cath rs&i (75860) $1,566.83 $4,730.78 0.4×
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure
$2,561.03 $7,732.62 0.4×
Vertebral fracture assessment via dxa (77086) $185.87 $561.18 1.8×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $364.36 $1,100.10 3.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $262.43 $792.35 2.6×
X-ray b.e. reductn intuss (74283) $263.75 $796.33 1.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $617.31 $1,863.85 3.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $255.21 $770.55 2.1×
X-ray eye for foreign body (70030) $190.45 $575.03 1.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $216.63 $654.06 2.1×
X-ray IV pyelogram (ivp) (74400) $669.84 $2,022.45 3.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $191.67 $578.70 1.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $210.80 $636.45 2.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $295.36 $891.78 2.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $445.50 $1,345.10 3.7×
X-ray nose-rectum child f.b. (76010) $179.10 $540.74 1.8×
X-ray optic foramen (70190) $127.01 $383.47 1.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $287.56 $868.24 2.4×
X-ray retrograde pyelogram (74420) $758.30 $2,289.56 1.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $333.19 $1,006 2.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $269.58 $813.95 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $240.38 $725.77 2.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $258.79 $781.36 2.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $383.45 $1,157.75 3.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $272.27 $822.07 2.2×
X-Ray Small Bowel Enteroclysis (74251) $785.13 $2,370.55 3.8×
X-Ray Spine One View - Xr Spine (72020) $203.05 $613.06 2.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $205.40 $620.15 2.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $216.21 $652.79 2.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $270.48 $816.67 2.2×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $340.36 $1,027.65 2.8×
Xr bone length studies (77073) $275.01 $830.33 2.3×
Xr c-spine 4 or 5 views (72050) $415.96 $1,255.92 3.4×
Xr c-spine 6 or more views (72052) $462.73 $1,397.12 3.8×
Xr chest 4+ views (71048) $287.28 $867.38 2.4×
Xr myelogram posterior fossa (70010) $981.11 $2,962.29 2.4×
Xr urogram antegrade (74425) $461.30 $1,392.82 1.1×