Imaging prices at St. Luke's Hospital
Chesterfield, MO · every code in this section with a posted price and a Medicare benchmark.
428 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) | $4,404.24 | $7,340.40 | 3.2× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$19.20–$153 | $32–$255 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$24.60–$245.40 | $41–$409 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $667.68 | $1,112.80 | 1.7× |
| Angio internal mammary (75756) | $854.34 | $1,423.90 | 0.3× |
| Angio pulmonary bilat (75743) | $1,817.40 | $3,029 | 0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,183.98 | $1,973.30 | 0.4× |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$1,817.40–$4,032 | $3,029–$6,720 | varies |
| Angiography extremity unilateral rs&i (75710) range across 8 matching MRF lines |
$854.34–$2,640 | $1,423.90–$4,400 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $948.54 | $1,580.90 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $854.34 | $1,423.90 | 0.3× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$15.60–$233.28 | $26–$388.80 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,817.40 | $3,029 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,817.40 | $3,029 | 0.6× |
| Artery X-Rays Abdomen (75726) | $4,112.40 | $6,854 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $1,817.40 | $3,029 | 0.6× |
| Artery X-Rays Pelvis (75736) | $4,112.40 | $6,854 | 0.7× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$862.56 | $1,437.60 | 0.2× |
| Arthrogram ankle (73615) range across 6 matching MRF lines |
$57–$997.56 | $95–$1,662.60 | varies |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$57–$1,298.28 | $95–$2,163.80 | varies |
| Arthrogram Wrist (73115) range across 6 matching MRF lines |
$57–$1,127.76 | $95–$1,879.60 | varies |
| Basic radiation dosimetry calculation (77300) | $486 | $810 | 3.6× |
| Bone age studies (77072) range across 3 matching MRF lines |
$18–$249.36 | $30–$415.60 | varies |
| Bone Imaging 3 Phase (78315) | $920.22 | $1,533.70 | 2.3× |
| Bone Imaging Limited Area (78300) | $610.92 | $1,018.20 | 1.5× |
| Bone Imaging Multiple Areas (78305) | $783.30 | $1,305.50 | 2.0× |
| Bone Imaging Whole Body (78306) | $821.10 | $1,368.50 | 2.1× |
| Bone survey infant (77076) | $187.14 | $311.90 | 1.8× |
| Brachytx isodose complex (77318) | $1,174.80 | $1,958 | 3.1× |
| Brachytx isodose intermed (77317) | $704.28 | $1,173.80 | 1.9× |
| Brachytx Isodose Plan Simple (77316) | $629.70 | $1,049.50 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) | $447.18 | $745.30 | 1.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $601.44 | $1,002.40 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 4 matching MRF lines |
$148.20–$2,868 | $247–$4,780 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 4 matching MRF lines |
$232.20–$1,668.60 | $387–$2,781 | varies |
| Cat Scan Follow-Up Study (76380) | $589.50 | $982.50 | 6.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $458.46 | $764.10 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $793.50 | $1,322.50 | 1.5× |
| Chest 1 view (71045) range across 7 matching MRF lines |
$19.20–$244.80 | $32–$408 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$22.80–$232.56 | $38–$387.60 | varies |
| Chest 3 views (71047) range across 9 matching MRF lines |
$29.40–$244.80 | $49–$408 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$34.20–$198 | $57–$330 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$30–$76.38 | $50–$127.30 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $591.90 | $986.50 | 0.8× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$15–$261.96 | $25–$436.60 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$93.60–$1,080.84 | $156–$1,801.40 | varies |
| Continuing medical physics consltj pr wk (77336) | $617.76 | $1,029.60 | 4.6× |
| Contrast Exam Abdominl Aorta (75625) | $1,817.40 | $3,029 | 0.6× |
| Contrast X-Ray Bladder (74430) | $256.98 | $428.30 | 0.7× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$469.92–$939.84 | $783.20–$1,566.40 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 6 matching MRF lines |
$57–$753.72 | $95–$1,256.20 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 3 matching MRF lines |
$32.40–$196.86 | $54–$328.10 | varies |
| Corpora cavernosography (74445) | $680.70 | $1,134.50 | 6.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$222–$2,998.98 | $370–$4,998.30 | varies |
| CT abdomen and pelvis without contrast (74176) range across 5 matching MRF lines |
$179.40–$2,178.24 | $299–$3,630.40 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$117–$1,240.32 | $195–$2,067.20 | varies |
| CT abdomen w wo contrast (74170) range across 7 matching MRF lines |
$129.60–$1,596.78 | $216–$2,661.30 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$109.80–$1,164.30 | $183–$1,940.50 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 6 matching MRF lines |
$220.80–$3,407.76 | $368–$5,679.60 | varies |
| CT Angio Chest (71275) range across 6 matching MRF lines |
$117–$1,304.04 | $195–$2,173.40 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$169.20–$1,287.60 | $282–$2,146 | varies |
| CT angio hrt w/3d image (75574) | $1,500 | $2,500 | 4.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$117–$1,764.96 | $195–$2,941.60 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$169.20–$1,485.30 | $282–$2,475.50 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$117–$1,764.96 | $195–$2,941.60 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$36–$277.62 | $60–$462.70 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$112.20–$1,245 | $187–$2,075 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$107.40–$1,226.34 | $179–$2,043.90 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$115.80–$1,509.48 | $193–$2,515.80 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$114.60–$1,285.80 | $191–$2,143 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$126.60–$1,535.58 | $211–$2,559.30 | varies |
| CT colonography screening (74263) range across 3 matching MRF lines |
$238.20–$748.62 | $397–$1,247.70 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 3 matching MRF lines |
$250.80–$1,497.18 | $418–$2,495.30 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 3 matching MRF lines |
$228.60–$748.62 | $381–$1,247.70 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$104.40–$1,019.70 | $174–$1,699.50 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$117–$1,206.36 | $195–$2,010.60 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $550.92 | $918.20 | 1.6× |
| CT heart no contrast quant eval coronry calcium (75571) range across 6 matching MRF lines |
$58.20–$75 | $97–$125 | varies |
| CT iac w contrast (70481) range across 5 matching MRF lines |
$126.60–$1,010.76 | $211–$1,684.60 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$117.60–$1,297.80 | $196–$2,163 | varies |
| CT lower ext w/o (73700) range across 9 matching MRF lines |
$100.20–$1,896 | $167–$3,160 | varies |
| CT lower extremity w/contrast material (73701) range across 7 matching MRF lines |
$107.40–$2,212.74 | $179–$3,687.90 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$112.20–$1,285.14 | $187–$2,141.90 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$107.40–$1,110.24 | $179–$1,850.40 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$119.40–$1,062.72 | $199–$1,771.20 | varies |
| CT maxillofacial wo contrast (70486) range across 8 matching MRF lines |
$105.60–$1,135.44 | $176–$1,892.40 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$133.20–$1,315.38 | $222–$2,192.30 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$133.80–$1,132.38 | $223–$1,887.30 | varies |
| CT orbits w/o contrast (70480) range across 7 matching MRF lines |
$118.20–$915.42 | $197–$1,525.70 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$119.40–$1,402.26 | $199–$2,337.10 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$100.80–$1,013.94 | $168–$1,689.90 | varies |
| CT scan of leg combo (73702) range across 7 matching MRF lines |
$115.80–$2,224.80 | $193–$3,708 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$131.40–$1,152.24 | $219–$1,920.40 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$126.60–$1,082.28 | $211–$1,803.80 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$118.20–$917.88 | $197–$1,529.80 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$112.20–$1,286.64 | $187–$2,144.40 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$107.40–$1,090.50 | $179–$1,817.50 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$117–$1,579.38 | $195–$2,632.30 | varies |
| CT thorax w/o contrast (71250) range across 5 matching MRF lines |
$107.40–$1,080.84 | $179–$1,801.40 | varies |
| CT upper ext wo (73200) range across 7 matching MRF lines |
$100.20–$1,893.24 | $167–$3,155.40 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 7 matching MRF lines |
$112.20–$2,101.20 | $187–$3,502 | varies |
| CT upper extremity with contrast (73201) range across 7 matching MRF lines |
$107.40–$2,015.82 | $179–$3,359.70 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$181.80–$1,723.74 | $303–$2,872.90 | varies |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$117–$2,044.98 | $195–$3,408.30 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,772.90 | $4,621.50 | 7.9× |
| CTA pelvis (72191) range across 4 matching MRF lines |
$164.40–$1,362.84 | $274–$2,271.40 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $308.04 | $513.40 | 1.3× |
| Dilation ureters/urethra rs&i (74485) | $1,380 | $2,300 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $1,059.12 | $1,765.20 | 0.5× |
| Diskography lumbar (72295) | $1,059.12 | $1,765.20 | 0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 4 matching MRF lines |
$30–$157.31 | $50–$262.18 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 4 matching MRF lines |
$31.20–$284.46 | $52–$474.10 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$37.80–$183.24 | $63–$305.40 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$27–$231.84 | $45–$386.40 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$22.80–$139.14 | $38–$231.90 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$90–$789.26 | $150–$1,315.43 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$39–$763.98 | $65–$1,273.30 | varies |
| Echo Guide For Artery Repair (76936) | $257.16 | $428.60 | 1.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$44.40–$350.57 | $74–$584.28 | varies |
| Echograp Trans R Pros Study (76873) | $566.82 | $944.70 | 5.4× |
| Esophagram (74220) range across 3 matching MRF lines |
$42.60–$270.42 | $71–$450.70 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 6 matching MRF lines |
$59.30–$304.80 | $98.84–$508 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$41.40–$157.31 | $69–$262.18 | varies |
| Fluoroscopy up to 1 hr (76000) range across 7 matching MRF lines |
$295.74–$349.56 | $492.90–$582.60 | varies |
| Follow-Up Angiography (75898) | $341.58 | $569.30 | 0.1× |
| Foot 2 views (73620) range across 10 matching MRF lines |
$15.60–$282.96 | $26–$471.60 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$15–$281.04 | $25–$468.40 | varies |
| Gastric emptying imaging study (78264) | $763.98 | $1,273.30 | 1.9× |
| Gastric Mucosa Imaging (78261) | $341.64 | $569.40 | 0.9× |
| Gastroesophageal Reflux Exam (78262) | $341.64 | $569.40 | 0.9× |
| Gated Heart Planar Single (78472) | $746.46 | $1,244.10 | 1.9× |
| Hand 2 views (73120) range across 8 matching MRF lines |
$15.60–$239.76 | $26–$399.60 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,579.92 | $7,633.20 | 6.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,117.20 | $6,862 | 5.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,817.40 | $3,029 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$909–$909.06 | $1,515–$1,515.10 | varies |
| Hepatobil Syst Image W/Drug (78227) | $851.70 | $1,419.50 | 1.6× |
| Hepatobiliary System Imaging (78226) | $851.70 | $1,419.50 | 2.1× |
| Ht Musc Image Planar Mult (78454) | $844.08 | $1,406.80 | 0.7× |
| Ht Muscle Image Spect Sing (78451) range across 7 matching MRF lines |
$1,178.04–$1,178.34 | $1,963.40–$1,963.90 | varies |
| Hysterosalpingogram (74740) | $379.80 | $633 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$71.40–$225.78 | $119–$376.30 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 3 matching MRF lines |
$60–$200.28 | $100–$333.80 | varies |
| Interstitial radiation source applic complex (77778) | $3,473.40 | $5,789 | 5.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $606.48 | $1,010.80 | 0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) | $583.02 | $971.70 | 1.1× |
| Intracavitary radiation source applic simple (77761) | $590.58 | $984.30 | 1.1× |
| Joint Survey Single View (77077) | $322.32 | $537.20 | 3.1× |
| K Flow/Funct Image W/Drug (78708) | $957.60 | $1,596 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $864.24 | $1,440.40 | 1.6× |
| Kidney Imaging Morphol (78700) | $315 | $525 | 0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $339 | $565 | 0.8× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$17.40–$303.96 | $29–$506.60 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $565.68 | $942.80 | 1.4× |
| Leveen/Shunt Patency Exam (78291) | $695.82 | $1,159.70 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $830.82 | $1,384.70 | 2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $498.54 | $830.90 | 1.2× |
| Liver imaging static only (78201) | $734.10 | $1,223.50 | 1.3× |
| Liver imaging w/vascular flow (78202) | $486.78 | $811.30 | 0.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,052.04 | $1,753.40 | 1.9× |
| Lung perfusion differential (78597) | $1,052.04 | $1,753.40 | 2.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,156.14 | $1,926.90 | 2.1× |
| Lung Ventilation Imaging (78579) | $297.84 | $496.40 | 0.7× |
| Lymph System Imaging (78195) | $771 | $1,285 | 1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,640.40 | $2,734 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$129–$1,497.18 | $215–$2,495.30 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 6 matching MRF lines |
$41.40–$248.70 | $69–$414.50 | varies |
| Mammary ductogram or galactogram single (77053) range across 8 matching MRF lines |
$33–$281.46 | $55–$469.10 | varies |
| Meckels Divert Exam (78290) | $405.84 | $676.40 | 1.0× |
| Medical physics dose eval radiation expos w/rprt (76145) | $180.62 | $301.03 | 0.5× |
| Mlc imrt design & construction per imrt plan (77338) | $6,642.12 | $11,070.20 | 17.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $36.75 | $61.25 | 1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $154.21 | $257.01 | 1.6× |
| Mr safety implt pos&/immoblj (76019) | $89.10 | $148.50 | 1.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $362.58 | $604.30 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$169.80–$1,552.92 | $283–$2,588.20 | varies |
| MRA head w/o contrast (70544) range across 6 matching MRF lines |
$115.20–$1,243.44 | $192–$2,072.40 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$115.20–$1,441.02 | $192–$2,401.70 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$115.20–$1,545 | $192–$2,575 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$169.80–$1,617.36 | $283–$2,695.60 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$115.20–$1,521.90 | $192–$2,536.50 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$122.40–$2,163 | $204–$3,605 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$147.60–$1,535.28 | $246–$2,558.80 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 16 matching MRF lines |
$109.80–$3,032.88 | $183–$5,054.80 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$148.80–$3,619.92 | $248–$6,033.20 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 14 matching MRF lines |
$109.80–$3,090 | $183–$5,150 | varies |
| MRI bone marrow blood supply (77084) range across 3 matching MRF lines |
$87.11–$795.66 | $145.18–$1,326.10 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 6 matching MRF lines |
$171–$1,088.82 | $285–$1,814.70 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $674.10 | $1,123.50 | 2.8× |
| MRI cardiac w/o cont stress (75559) range across 2 matching MRF lines |
$160.26–$1,057.98 | $267.10–$1,763.30 | varies |
| MRI cardiac w/o contrast (75557) range across 4 matching MRF lines |
$201.60–$1,110.84 | $336–$1,851.40 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$178.20–$2,200.26 | $297–$3,667.10 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$147.60–$1,752.48 | $246–$2,920.80 | varies |
| MRI chest w/o contrast (71550) range across 4 matching MRF lines |
$147.60–$1,514.52 | $246–$2,524.20 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$122.40–$1,734.78 | $204–$2,891.30 | varies |
| MRI chest wo w contrast (71552) range across 4 matching MRF lines |
$160.20–$2,092.26 | $267–$3,487.10 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 12 matching MRF lines |
$109.80–$2,565.72 | $183–$4,276.20 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 12 matching MRF lines |
$150.60–$3,212.76 | $251–$5,354.60 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$92.40–$2,350.56 | $154–$3,917.60 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$165–$2,348.40 | $275–$3,914 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$237–$2,423.28 | $395–$4,038.80 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$138.60–$1,703.04 | $231–$2,838.40 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$109.80–$2,082.66 | $183–$3,471.10 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$148.80–$2,273.82 | $248–$3,789.70 | varies |
| MRI pelvis w contrast (72196) range across 4 matching MRF lines |
$147.60–$1,737.78 | $246–$2,896.30 | varies |
| MRI pelvis w/o & w contrast (72197) range across 7 matching MRF lines |
$161.40–$2,374.20 | $269–$3,957 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$103.20–$1,655.58 | $172–$2,759.30 | varies |
| MRI spectroscopy (76390) range across 3 matching MRF lines |
$136.20–$920.22 | $227–$1,533.70 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$147.60–$1,721.88 | $246–$2,869.80 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 12 matching MRF lines |
$109.80–$2,719.20 | $183–$4,532 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 12 matching MRF lines |
$92.40–$2,356.32 | $154–$3,927.20 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 12 matching MRF lines |
$151.20–$3,241.68 | $252–$5,402.80 | varies |
| MRI, abdomen, combo (74183) range across 9 matching MRF lines |
$161.40–$2,420.40 | $269–$4,034 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$237–$2,451.54 | $395–$4,085.90 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$178.20–$2,378.82 | $297–$3,964.70 | varies |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$129–$3,021.72 | $215–$5,036.20 | varies |
| MRI, joint upper extrem combo (73223) range across 12 matching MRF lines |
$148.80–$3,600.48 | $248–$6,000.80 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$218.40–$2,529 | $364–$4,215 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $501.60 | $836 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $664.14 | $1,106.90 | 0.5× |
| Myocardial Spect Multiple Studies (78452) range across 7 matching MRF lines |
$2,043–$2,043.24 | $3,405–$3,405.40 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,068.80 | $3,448 | 1.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,068.80 | $3,448 | 1.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,225.60 | $5,376 | 1.5× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) range across 4 matching MRF lines |
$2,068.80–$4,125.60 | $3,448–$6,876 | varies |
| N-invas est c ffr sw aly CTA (75580) | $1,495.83 | $2,493.05 | 1.7× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$16.20–$119.46 | $27–$199.10 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $530.40 | $884 | 1.3× |
| Nm csf leak detection (78650) | $532.92 | $888.20 | 0.4× |
| Nm red cell survival study (78130) | $730.20 | $1,217 | 1.8× |
| Nonvascular Shunt X-Ray (75809) | $346.98 | $578.30 | 3.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,099.60 | $10,166 | 4.4× |
| Nuclear Rx Intra-Arterial (79445) | $356.10 | $593.50 | 1.5× |
| Nuclear Rx Oral Admin (79005) | $552 | $920 | 2.4× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$63.60–$167.82 | $106–$279.70 | varies |
| Panoramic X-ray of jaws (70355) | $172.20 | $287 | 2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,152 | $1,920 | 2.1× |
| Parathyroid Planar Imaging (78070) | $508.68 | $847.80 | 1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,152 | $1,920 | 2.9× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$16.20–$204 | $27–$340 | varies |
| Perineogram (74775) | $256.98 | $428.30 | 1.1× |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$702.60–$740.22 | $1,171–$1,233.70 | varies |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$162–$1,717.74 | $270–$2,862.90 | varies |
| Pet Image W/Ct Lmtd (78814) range across 8 matching MRF lines |
$183.60–$3,480 | $306–$5,800 | varies |
| PET image w/CT, full body (78816) range across 6 matching MRF lines |
$207–$3,511.44 | $345–$5,852.40 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 15 matching MRF lines |
$202.20–$3,480 | $337–$5,800 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$130.80–$1,990.74 | $218–$3,317.90 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$167.40–$1,717.74 | $279–$2,862.90 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,817.40 | $3,029 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $596.16 | $993.60 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$30–$273.72 | $50–$456.20 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $330 | $550 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$17.40–$289.80 | $29–$483 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$15.60–$130.98 | $26–$218.30 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$16.20–$279.84 | $27–$466.40 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$24–$195 | $40–$325 | varies |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$13.20–$238.56 | $22–$397.60 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$17.40–$257.04 | $29–$428.40 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$16.20–$326.76 | $27–$544.60 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $137.88 | $229.80 | 1.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$31.20–$81.18 | $52–$135.30 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$16.20–$219.60 | $27–$366 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $124.14 | $206.90 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$21–$210 | $35–$350 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$17.40–$284.40 | $29–$474 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$16.20–$143.34 | $27–$238.90 | varies |
| Radex Spine 1 View Specify Level (72020) range across 5 matching MRF lines |
$14.40–$199.20 | $24–$332 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$18.60–$197.40 | $31–$329 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$22.80–$301.44 | $38–$502.40 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$13.20–$185.76 | $22–$309.60 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$15–$275.76 | $25–$459.60 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$16.20–$282.96 | $27–$471.60 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $270.60 | $451 | 2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,280 | $23,800 | 1.9× |
| Radiation treatment delivery level 1 (77402) | $346.80 | $578 | 3.4× |
| Radiation treatment delivery level 2 (77407) | $579.48 | $965.80 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $845.28 | $1,408.80 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$23.40–$170.34 | $39–$283.90 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$28.80–$186.60 | $48–$311 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$91.80–$566.76 | $153–$944.60 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$64.20–$424.20 | $107–$707 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $261 | $435 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$21–$340.68 | $35–$567.80 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$20.40–$232.80 | $34–$388 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$44.35–$285.60 | $73.92–$476 | varies |
| Radiologic exam swallow function contrast study (74230) | $309.66 | $516.10 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$410.10–$410.16 | $683.50–$683.60 | varies |
| Radiologic examination femur 1 view (73551) range across 5 matching MRF lines |
$15.60–$238.92 | $26–$398.20 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$17.40–$294 | $29–$490 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$16.20–$223.32 | $27–$372.20 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$41.40–$280.32 | $69–$467.20 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $90.60 | $151 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$16.20–$289.44 | $27–$482.40 | varies |
| Renal Cyst Study (74470) | $298.68 | $497.80 | 0.5× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$25.20–$303.78 | $42–$506.30 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $432.48 | $720.80 | 1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 4 matching MRF lines |
$367.98–$527.40 | $613.30–$879 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,114.20 | $1,857 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 4 matching MRF lines |
$942.72–$1,033.32 | $1,571.20–$1,722.20 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 10 matching MRF lines |
$1,027.92–$1,823.40 | $1,713.20–$3,039 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 5 matching MRF lines |
$485.16–$2,001.93 | $808.60–$3,336.55 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $810 | $1,350 | 3.5× |
| Rp Therapy Intravenous Administration (79101) | $720 | $1,200 | 3.1× |
| Salivary Gland Function Study (78232) | $524.16 | $873.60 | 1.3× |
| Scapula (73010) range across 6 matching MRF lines |
$16.20–$244.08 | $27–$406.80 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
$32.87–$42 | $54.78–$70 | varies |
| Sella turcica (70240) range across 3 matching MRF lines |
$18–$122.04 | $30–$203.40 | varies |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$14.40–$166.92 | $24–$278.20 | varies |
| Shoulder Arthrography (73040) range across 6 matching MRF lines |
$57–$536.28 | $95–$893.80 | varies |
| Sialogram (70390) | $367.98 | $613.30 | 1.5× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$22.80–$199.86 | $38–$333.10 | varies |
| Special dosimetry (77331) | $336 | $560 | 2.5× |
| Special Physics Consult (77370) | $918 | $1,530 | 6.8× |
| Special teletherapy port plan (77321) | $748.20 | $1,247 | 2.0× |
| Special treatment procedure (77470) | $2,044.08 | $3,406.80 | 3.7× |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$77.40–$215.52 | $129–$359.20 | varies |
| Spleen Imaging (78185) | $565.68 | $942.80 | 1.4× |
| Stereotactic Body Radiation Delivery (77373) | $8,161.80 | $13,603 | 4.6× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$21–$187.14 | $35–$311.90 | varies |
| Superior sagittal sinus venogram (75870) | $854.34 | $1,423.90 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,243.60 | $5,406 | 8.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,567.68 | $2,612.80 | 4.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $649.14 | $1,081.90 | 2.7× |
| Testicular Imaging W/Flow (78761) | $451.68 | $752.80 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,375.80–$1,985.40 | $2,293–$3,309 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,119.72 | $1,866.20 | 3.0× |
| Ther rad simulaj-aided field setting simple (77280) | $769.20 | $1,282 | 5.7× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$21–$193.38 | $35–$322.30 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$24–$236.28 | $40–$393.80 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$21–$193.80 | $35–$323 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $449.94 | $749.90 | 1.1× |
| Thyroid Met Imaging Body (78018) | $799.26 | $1,332.10 | 1.5× |
| Thyroid Uptake Measurement (78012) | $258 | $430 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $679.86 | $1,133.10 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $1,283.76 | $2,139.60 | 3.4× |
| Tx devices design & construction intermediate (77333) | $480.60 | $801 | 3.6× |
| Tx devices design & construction simple (77332) | $511.92 | $853.20 | 3.8× |
| Ultrasound Breast Limited (76642) range across 8 matching MRF lines |
$72.60–$489 | $121–$815 | varies |
| Ultrasound Elastography Parenchyma (76981) | $192 | $320 | 1.8× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$51–$230.94 | $85–$384.90 | varies |
| Ultrasound, abdomen limited (76705) range across 14 matching MRF lines |
$54.60–$439.14 | $91–$731.90 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$27–$183.24 | $45–$305.40 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 4 matching MRF lines |
$60–$337.04 | $100–$561.73 | varies |
| Unlisted magnetic resonance procedure (76498) range across 5 matching MRF lines |
$171–$3,597.10 | $285–$5,995.16 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $707.70 | $1,179.50 | 6.9× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$42–$261.36 | $70–$435.60 | varies |
| Upper gi w/o kub (74240) | $385.80 | $643 | 2.2× |
| Ureteral Reflux Study (78740) | $339 | $565 | 0.8× |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$31.80–$420.42 | $53–$700.70 | varies |
| Urethrocystography retrograde (74450) | $348.60 | $581 | 1.5× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$78–$747.60 | $130–$1,246 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$51–$415.74 | $85–$692.90 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$61.20–$370.32 | $102–$617.20 | varies |
| Us exam, pelvic, limited (76857) range across 8 matching MRF lines |
$36–$429 | $60–$715 | varies |
| Us head (76506) range across 3 matching MRF lines |
$60–$319.74 | $100–$532.90 | varies |
| Us kidney transplant (76776) | $272.22 | $453.70 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$42–$272.82 | $70–$454.70 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$102–$350.57 | $170–$584.28 | varies |
| Us ob limited 1 or more fetuses (76815) range across 7 matching MRF lines |
$34.80–$272.82 | $58–$454.70 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$40.80–$165.66 | $68–$276.10 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$64.20–$588.96 | $107–$981.60 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 5 matching MRF lines |
$53.40–$466.92 | $89–$778.20 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 7 matching MRF lines |
$51.60–$387 | $86–$645 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$69–$563.10 | $115–$938.50 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$54–$563.04 | $90–$938.40 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$60–$549.72 | $100–$916.20 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$109.80–$195.90 | $183–$326.50 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$52.20–$403.74 | $87–$672.90 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$64.80–$375.60 | $108–$626 | varies |
| Vasogram (74440) | $256.98 | $428.30 | 1.1× |
| Vein X-Ray Chest (75827) | $1,519.44 | $2,532.40 | 1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,932.36 | $3,220.60 | 0.6× |
| Vein X-Ray Skull Epidural (75872) | $854.34 | $1,423.90 | 1.4× |
| Vein X-Ray Spleen/Liver (75810) | $854.34 | $1,423.90 | 0.3× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$557.70–$1,301.10 | $929.50–$2,168.50 | varies |
| Venography Adrenal Unilateral (75840) range across 3 matching MRF lines |
$948.54–$1,027.62 | $1,580.90–$1,712.70 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$1,447.08–$1,447.20 | $2,411.80–$2,412 | varies |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$1,239–$1,239.18 | $2,065–$2,065.30 | varies |
| Venography extremity unilateral rs&i (75820) range across 8 matching MRF lines |
$929.04–$1,301.40 | $1,548.40–$2,169 | varies |
| Venography Orbital Rs&I (75880) range across 2 matching MRF lines |
$791.34–$791.40 | $1,318.90–$1,319 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$1,162.02–$1,162.20 | $1,936.70–$1,937 | varies |
| Venography Renal Unilateral (75831) range across 5 matching MRF lines |
$948.54–$1,440 | $1,580.90–$2,400 | varies |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$993.12 | $1,655.20 | 0.2× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$13.20–$249.36 | $22–$415.60 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$22.80–$117.60 | $38–$196 | varies |
| X-ray antegrade pyelogram tube (74425) | $238.50 | $397.50 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $2,802 | $4,670 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$21–$200.04 | $35–$333.40 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$14.40–$193.80 | $24–$323 | varies |
| X-Ray Exam Breast Specimen (76098) range across 6 matching MRF lines |
$53.40–$659.52 | $89–$1,099.20 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $85.80 | $143 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $142.20 | $237 | 1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $270.60 | $451 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$17.40–$280.20 | $29–$467 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$20.40–$308.04 | $34–$513.40 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$26.40–$324 | $44–$540 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$21–$215.22 | $35–$358.70 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$27.60–$308.04 | $46–$513.40 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$29.40–$252 | $49–$420 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$33.60–$432.72 | $56–$721.20 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$21–$290.16 | $35–$483.60 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$33–$446.40 | $55–$744 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$25.80–$242.46 | $43–$404.10 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$16.80–$41.94 | $28–$69.90 | varies |
| X-ray head for orthodontia (70350) range across 2 matching MRF lines |
$10.27–$37.86 | $17.12–$63.10 | varies |
| X-ray humerus (73060) range across 8 matching MRF lines |
$16.20–$261.96 | $27–$436.60 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$45.60–$374.22 | $76–$623.70 | varies |
| X-ray IV pyelogram+tomography (74415) range across 3 matching MRF lines |
$48.60–$554.28 | $81–$923.80 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$15.60–$195.84 | $26–$326.40 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$16.20–$209.46 | $27–$349.10 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$21.60–$251.28 | $36–$418.80 | varies |
| X-ray nose-rectum child f.b. (76010) | $111.66 | $186.10 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$31.20–$309.24 | $52–$515.40 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$18–$169.56 | $30–$282.60 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$19.20–$84.36 | $32–$140.60 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$16.20–$230.40 | $27–$384 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$23.40–$224.04 | $39–$373.40 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$31.20–$245.10 | $52–$408.50 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$19.80–$236.64 | $33–$394.40 | varies |
| X-Ray Tmj Unilat (70328) | $157.80 | $263 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $594 | $990 | 1.7× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$25.20–$102.78 | $42–$171.30 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$79.20–$322.32 | $132–$537.20 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$28.80–$403.92 | $48–$673.20 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$18–$124.20 | $30–$207 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$18.60–$64.02 | $31–$106.70 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$25.80–$228.60 | $43–$381 | varies |
| Xr Tomogram Single Plane (76100) range across 3 matching MRF lines |
$54–$219.66 | $90–$366.10 | varies |
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.