Imaging prices at St. Mary-Corwin Hospital
Pueblo, CO · every code in this section with a posted price and a Medicare benchmark.
395 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) | $4,477.29 | $11,193.21 | 3.1× |
| Abdomen 1 View (74018) | $329.92 | $824.79 | 3.6× |
| Abdomen 2 views (74019) | $476.11 | $1,190.26 | 4.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,569.56 | $3,923.88 | 3.7× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$2,843.96–$5,687.90 | $7,109.90–$14,219.74 | varies |
| Angio pulmonary bilat (75743) | $10,038.72 | $25,096.79 | 3.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,687.88 | $14,219.70 | 1.7× |
| Angiography extremity bilateral rs&i (75716) | $6,284.92 | $15,712.29 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $3,032.25 | $7,580.61 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,019.37 | $12,548.41 | 1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,594.16 | $3,985.40 | 0.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$278.34–$361.84 | $695.84–$904.60 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,015.61 | $7,539.02 | 0.5× |
| Artery X-Rays Abdomen (75726) | $3,201.12 | $8,002.79 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $2,843.96 | $7,109.90 | 0.9× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,702.88 | $6,757.20 | 0.5× |
| Artery X-Rays Spine (75705) | $4,602.14 | $11,505.33 | 0.8× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,020.29–$1,326.38 | $2,550.72–$3,315.95 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,147.70–$1,492 | $2,869.23–$3,729.99 | varies |
| Basic radiation dosimetry calculation (77300) | $460.01 | $1,150.01 | 3.2× |
| Bone age studies (77072) | $429.80 | $1,074.49 | 3.9× |
| Bone Imaging 3 Phase (78315) | $1,853.82 | $4,634.53 | 4.4× |
| Bone Imaging Limited Area (78300) | $1,451 | $3,627.49 | 3.4× |
| Bone Imaging Multiple Areas (78305) | $1,465.26 | $3,663.14 | 3.5× |
| Bone Imaging Whole Body (78306) | $2,123.70 | $5,309.24 | 5.0× |
| Bone survey infant (77076) | $390.17 | $975.42 | 3.5× |
| Brachytx isodose complex (77318) | $3,005.08 | $7,512.70 | 7.6× |
| Brachytx isodose intermed (77317) | $2,341.75 | $5,854.36 | 5.9× |
| Brachytx Isodose Plan Simple (77316) | $1,721.89 | $4,304.71 | 4.4× |
| Brain Image W/Flow < 4 Views (78601) | $703.12 | $1,757.79 | 1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $998.16 | $2,495.40 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,563.24 | $13,908.10 | 3.7× |
| Cat Scan Follow-Up Study (76380) | $693.16 | $1,732.89 | 7.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,367.10 | $3,417.73 | 2.4× |
| Cerebrospinal Fluid Scan (78630) | $1,732.42 | $4,331.04 | 3.0× |
| Chest 1 view (71045) | $362.28 | $905.70 | 3.9× |
| Chest 2 views (71046) | $423.17 | $1,057.91 | 4.6× |
| Chest 3 views (71047) | $494.21 | $1,235.51 | 5.4× |
| Chest 4 or more views (71048) | $501.94 | $1,254.83 | 4.6× |
| Cholecystography Oral Contrast (74290) | $490.75 | $1,226.86 | 2.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $389.49 | $973.72 | 3.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$338.78–$440.42 | $846.95–$1,101.03 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $398.18 | $995.45 | 3.6× |
| Continuing medical physics consltj pr wk (77336) | $618.41 | $1,546.01 | 4.4× |
| Contrast Exam Abdominl Aorta (75625) | $3,241.44 | $8,103.60 | 1.0× |
| Contrast X-Ray Bladder (74430) | $963.85 | $2,409.61 | 2.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$590.14–$767.18 | $1,475.35–$1,917.94 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$521.20–$677.57 | $1,303–$1,693.92 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,476.01 | $11,190.01 | 12.2× |
| CT abdomen and pelvis without contrast (74176) | $3,340.54 | $8,351.35 | 13.3× |
| CT abdomen w contrast (74160) | $2,118.40 | $5,295.99 | 11.4× |
| CT abdomen w wo contrast (74170) | $2,506.57 | $6,266.42 | 13.5× |
| CT abdomen w/o contrast (74150) | $1,859.74 | $4,649.33 | 16.9× |
| CT Angio Abdomen and Pelvis (74174) | $5,084.68 | $12,711.69 | 13.8× |
| CT Angio Chest (71275) | $2,711.46 | $6,778.65 | 14.7× |
| CT Angio Head (70496) | $2,521.29 | $6,303.21 | 13.6× |
| CT angio hrt w/3d image (75574) | $2,295.30 | $5,738.23 | 6.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,703.42–$2,214.43 | $4,258.54–$5,536.07 | varies |
| CT Angio Neck (70498) | $2,601.84 | $6,504.60 | 14.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,598.90–$2,078.56 | $3,997.23–$5,196.40 | varies |
| CT cervical spine w/ contrast (72126) | $2,295.16 | $5,737.88 | 6.2× |
| CT cervical spine w/o contrast (72125) | $1,966.46 | $4,916.15 | 17.8× |
| CT cervical spine w/wo cont (72127) | $2,678.78 | $6,696.93 | 14.5× |
| CT chest w contrast (71260) | $1,679.50 | $4,198.74 | 9.1× |
| CT chest w/wo contrast (71270) | $3,140.61 | $7,851.51 | 17.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $613.46 | $1,533.65 | 3.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $521.45 | $1,303.61 | 4.7× |
| CT head/brain with contrast (70460) | $1,634.66 | $4,086.63 | 8.8× |
| CT head/brain without and with contrast (70470) | $2,125.37 | $5,313.41 | 11.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,950.99 | $4,877.47 | 5.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $973.84 | $2,434.59 | 10.6× |
| CT hrt w/3d image congen (75573) | $1,090.71 | $2,726.77 | 3.0× |
| CT iac w contrast (70481) | $1,728.56 | $4,321.38 | 9.3× |
| CT l-spine w&w/o contrast (72133) | $2,465.08 | $6,162.68 | 13.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,403.04–$1,823.95 | $3,507.60–$4,559.87 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,711.68–$2,225.16 | $4,279.18–$5,562.90 | varies |
| CT lumbar spine w contrast (72132) | $2,416.36 | $6,040.89 | 6.6× |
| CT lumbar spine w/o contrast (72131) | $1,937.81 | $4,844.52 | 17.6× |
| CT maxillofacial w contrast (70487) | $1,157.81 | $2,894.51 | 6.3× |
| CT maxillofacial wo contrast (70486) | $851.04 | $2,127.60 | 7.7× |
| CT neck tissue combo (70492) | $2,013.36 | $5,033.39 | 10.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,366.63–$2,490.22 | $5,916.57–$6,225.55 | varies |
| CT orbits w/o contrast (70480) | $1,634.02 | $4,085.03 | 14.8× |
| CT pelvis w&w/o contrast (72194) | $2,506.57 | $6,266.42 | 13.5× |
| CT pelvis w/o contrast (72192) | $1,881.69 | $4,704.21 | 17.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,016.29–$2,621.18 | $5,040.72–$6,552.94 | varies |
| CT scans face/jaw combo (70488) | $1,591.54 | $3,978.84 | 8.6× |
| CT soft tissue neck w contrast (70491) | $1,629.76 | $4,074.39 | 8.8× |
| CT soft tissue neck w/o contrast (70490) | $1,583.78 | $3,959.45 | 14.4× |
| CT thoracic spine w contrast (72129) | $2,367.03 | $5,917.56 | 12.8× |
| CT thoracic spine w/o contrast (72128) | $1,995.64 | $4,989.10 | 18.1× |
| CT thoracic spine w/wo cont (72130) | $1,841.63 | $4,604.07 | 10.0× |
| CT thorax w/o contrast (71250) | $1,458.10 | $3,645.25 | 13.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,337.20–$1,738.34 | $3,342.98–$4,345.85 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,016.29–$2,621.18 | $5,040.72–$6,552.94 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,594.75–$2,073.17 | $3,986.87–$5,182.92 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,711.46 | $6,778.65 | 14.7× |
| Cta Abdomen (74175) | $2,832.82 | $7,082.05 | 15.3× |
| CTA pelvis (72191) | $2,862 | $7,155 | 15.5× |
| Dilation ureters/urethra rs&i (74485) | $3,599.19 | $8,997.96 | 1.6× |
| Discography Cerv/Thor Spine (72285) | $2,062.19 | $5,155.47 | 1.0× |
| Diskography lumbar (72295) | $2,062.19 | $5,155.47 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $326.48 | $816.18 | 3.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $491.76 | $1,229.40 | 4.5× |
| Dxa Bone Density Axial (77080) | $175.72 | $439.28 | 1.6× |
| Dxa bone density study (77085) | $567.31 | $1,418.27 | 5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $175.72 | $439.28 | 1.9× |
| Echo Guide For Artery Repair (76936) | $1,097.88 | $2,744.70 | 4.8× |
| Echograp Trans R Pros Study (76873) | $1,314 | $3,285 | 11.9× |
| Esophagram (74220) | $769.81 | $1,924.51 | 4.2× |
| Fetal Biophys Profile W/Nst (76818) | $1,049.41 | $2,623.51 | 9.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $661.58 | $1,653.94 | 6.0× |
| Fluoroscopy up to 1 hr (76000) | $591.92 | $1,479.80 | 2.4× |
| Follow-Up Angiography (75898) | $1,353.02 | $3,382.53 | 0.4× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$249.29–$324.05 | $623.22–$810.11 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$398.83–$518.48 | $997.07–$1,296.19 | varies |
| Gastric emptying imaging study (78264) | $1,575.69 | $3,939.21 | 3.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,809.71 | $4,524.26 | 4.3× |
| Gated Heart Planar Single (78472) | $2,196.76 | $5,491.89 | 5.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,262.15 | $5,655.36 | 3.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$330.06–$429.08 | $825.13–$1,072.70 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,595.23 | $13,988.06 | 7.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,429.65 | $13,574.11 | 7.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,265.58 | $13,163.93 | 7.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,884.69 | $4,711.71 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,696.21 | $4,240.52 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $1,890.45 | $4,726.11 | 3.3× |
| Hepatobiliary System Imaging (78226) | $1,718.58 | $4,296.43 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $4,042.80 | $10,106.99 | 3.0× |
| Hysterosalpingogram (74740) | $1,059.32 | $2,648.30 | 4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $563.79 | $1,409.46 | 6.1× |
| Interstitial radiation source applic complex (77778) | $7,515.34 | $18,788.34 | 10.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,160.04 | $7,900.09 | 4.3× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $4,965.92 | $12,414.78 | 0.6× |
| Intraop radiaj tx deliver xray single tx session (77424) | $4,965.92 | $12,414.78 | 0.6× |
| K Flow/Funct Image Multiple (78709) | $2,826.60 | $7,066.49 | 4.9× |
| K Flow/Funct Image W/Drug (78708) | $1,824.36 | $4,560.89 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,920.53 | $4,801.32 | 3.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$464.62–$603.98 | $1,161.54–$1,509.95 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,043.23 | $2,608.07 | 2.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,204.12 | $3,010.30 | 2.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,883.36 | $4,708.38 | 3.3× |
| Lung perfusion differential (78597) | $1,308.98 | $3,272.45 | 3.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,207.74 | $5,519.34 | 3.9× |
| Lung Ventilation Imaging (78579) | $1,308.98 | $3,272.45 | 3.1× |
| Lymph System Imaging (78195) | $1,969.10 | $4,922.73 | 3.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,355.08–$4,710.15 | $5,887.69–$11,775.36 | varies |
| Mammary ductogram or galactogram multiple (77054) | $1,049.28 | $2,623.20 | 4.2× |
| Mammary ductogram or galactogram single (77053) | $823.13 | $2,057.81 | 3.3× |
| Meckels Divert Exam (78290) | $1,101.48 | $2,753.70 | 2.6× |
| Medical physics dose eval radiation expos w/rprt (76145) | $588.68 | $1,471.70 | 1.5× |
| Mlc imrt design & construction per imrt plan (77338) | $8,392.75 | $20,981.86 | 21.2× |
| Mr safety determination physician/other qhp (76016) | $551.20 | $1,378 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $551.20 | $1,378 | 18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $551.20 | $1,378 | 5.5× |
| Mr safety implt pos&/immoblj (76019) | $551.20 | $1,378 | 8.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $551.20 | $1,378 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,228 | $8,069.99 | 8.8× |
| MRA head w/o contrast (70544) | $1,337.88 | $3,344.69 | 5.3× |
| MRA head with contrast (70545) | $1,972.70 | $4,931.75 | 5.4× |
| MRA neck w contrast (70548) | $2,078.56 | $5,196.38 | 5.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,618.49 | $6,546.22 | 7.1× |
| MRA neck w/o contrast (70547) | $1,832.03 | $4,580.07 | 7.3× |
| MRI abdomen w contrast (74182) | $2,380.05 | $5,950.11 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,656.37 | $4,140.92 | 6.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,074.54–$4,149.07 | $5,186.33–$10,372.67 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,681.28–$5,362.60 | $6,703.19–$13,406.48 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,096.39–$4,192.76 | $5,240.97–$10,481.88 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $3,255.95 | $8,139.86 | 12.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,627.98 | $4,069.94 | 6.5× |
| MRI cervical spine w contrast (72142) | $2,272.59 | $5,681.47 | 6.2× |
| MRI cervical spine w/o cont (72141) | $2,249.40 | $5,623.50 | 8.9× |
| MRI chest w/o contrast (71550) | $2,325.32 | $5,813.28 | 9.2× |
| MRI chest with contrast (71551) | $2,636.29 | $6,590.72 | 3.2× |
| MRI chest wo w contrast (71552) | $3,270.03 | $8,175.07 | 8.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,206.61–$4,413.20 | $5,516.52–$11,033 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,744.84–$5,489.68 | $6,862.08–$13,724.20 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,954.93–$3,909.86 | $4,887.32–$9,774.65 | varies |
| MRI lumbar spine w contrast (72149) | $2,662.38 | $6,655.95 | 7.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,647.96 | $9,119.89 | 9.9× |
| MRI orbit face &/neck w/o contrast (70540) | $2,857.44 | $7,143.60 | 11.4× |
| MRI orbit face neck w contrast (70542) | $2,916.76 | $7,291.88 | 7.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,985.77 | $7,464.41 | 8.1× |
| MRI pelvis w contrast (72196) | $2,313.46 | $5,783.64 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $3,137.32 | $7,843.28 | 8.5× |
| MRI pelvis w/o contrast (72195) | $1,805.93 | $4,514.81 | 7.2× |
| MRI spectroscopy (76390) | $1,422.64 | $3,556.59 | 15.5× |
| MRI thoracic spine w/o contrast (72146) | $2,035.58 | $5,088.95 | 8.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,206.61–$4,413.20 | $5,516.52–$11,033 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,766.67–$3,533.35 | $4,416.66–$8,833.36 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,744.84–$5,489.68 | $6,862.08–$13,724.20 | varies |
| MRI, abdomen, combo (74183) | $2,748.26 | $6,870.63 | 7.5× |
| MRI, dorsal spine combo (72157) | $3,355.70 | $8,389.23 | 9.1× |
| MRI, dorsal spine contrast (72147) | $2,413.76 | $6,034.39 | 6.6× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,839.39–$3,678.77 | $4,598.46–$9,196.91 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,761.73–$5,523.48 | $6,904.32–$13,808.68 | varies |
| MRI, lumbar spine combo (72158) | $3,647.96 | $9,119.89 | 9.9× |
| Myelogram cervical (72240) | $930.97 | $2,327.41 | 1.1× |
| Myelogram Lumbar (72265) | $930.97 | $2,327.41 | 1.1× |
| Myelography thoracic (72255) | $869.45 | $2,173.62 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,458.09 | $3,645.21 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $998.16 | $2,495.40 | 2.4× |
| Myocardial Spect Multiple Studies (78452) | $4,461.76 | $11,154.39 | 3.3× |
| N-invas est c ffr sw aly CTA (75580) | $6,749.58 | $16,873.94 | 7.5× |
| Neck soft tissue (70360) | $382.44 | $956.08 | 4.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $609.41 | $1,523.51 | 1.4× |
| Nm csf leak detection (78650) | $2,134.62 | $5,336.54 | 1.6× |
| Nm myocard infarct spect (78469) | $998.16 | $2,495.40 | 1.7× |
| Nonvascular Shunt X-Ray (75809) | $632.26 | $1,580.64 | 5.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,601.96 | $14,004.90 | 3.8× |
| Nuclear Rx Oral Admin (79005) | $1,221.72 | $3,054.29 | 5.0× |
| Panoramic X-ray of jaws (70355) | $371.32 | $928.30 | 4.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,340.88 | $8,352.18 | 5.8× |
| Parathyroid Planar Imaging (78070) | $2,020.76 | $5,051.88 | 4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,938.03 | $7,345.07 | 7.0× |
| Pelvis 1 or 2 views (72170) | $353.46 | $883.63 | 3.2× |
| Peritoneogram Rs&I (74190) | $932.02 | $2,330.04 | 1.6× |
| Pet Image W/Ct Lmtd (78814) | $3,223.42 | $8,058.55 | 2.1× |
| PET image w/CT, full body (78816) | $4,504.06 | $11,260.15 | 3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,087.41 | $10,218.52 | 2.7× |
| PET whole body (78813) | $4,396.40 | $10,990.99 | 2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,019.37 | $12,548.41 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,466.06 | $3,665.15 | 3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $668.90 | $1,672.25 | 6.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $798.02 | $1,995.04 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$432.53–$562.28 | $1,081.32–$1,405.69 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$344.91–$448.40 | $862.27–$1,121 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$418.09–$543.52 | $1,045.21–$1,358.78 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $592.58 | $1,481.43 | 5.4× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$311.04–$622.10 | $777.60–$1,555.23 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$430.95–$560.22 | $1,077.36–$1,400.55 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$416.34–$541.23 | $1,040.83–$1,353.07 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$430.84–$560.09 | $1,077.10–$1,400.22 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$298.33–$387.82 | $745.81–$969.55 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $510.17 | $1,275.41 | 5.6× |
| Radex Ribs Unilateral 2 Views (71100) | $463.47 | $1,158.67 | 5.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$444.22–$577.46 | $1,110.54–$1,443.65 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $346.57 | $866.42 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $368.23 | $920.57 | 4.0× |
| Radex Sternum Minimum 2 Views (71120) | $416.39 | $1,040.97 | 4.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $731.65 | $1,829.12 | 8.0× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$324.57–$421.94 | $811.42–$1,054.84 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$226.92–$295 | $567.29–$737.49 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$415.37–$539.98 | $1,038.42–$1,349.94 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $721.61 | $1,804.02 | 6.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,749.56 | $19,373.90 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $545.89 | $1,364.71 | 5.1× |
| Radiation treatment delivery level 2 (77407) | $664.07 | $1,660.16 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $853.98 | $2,134.93 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $624.87 | $1,562.16 | 5.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $501.60 | $1,253.98 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $1,296.90 | $3,242.24 | 7.0× |
| Radiologic exam colon single contrast study (74270) | $1,187.19 | $2,967.96 | 6.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $741.85 | $1,854.62 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$483.98–$629.16 | $1,209.94–$1,572.88 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $397.12 | $992.78 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $886.24 | $2,215.58 | 4.8× |
| Radiologic exam swallow function contrast study (74230) | $188.34 | $470.83 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,132.79 | $2,831.96 | 6.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$260.84–$339.08 | $652.08–$847.70 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$409.37–$532.17 | $1,023.42–$1,330.41 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$400.22–$520.27 | $1,000.53–$1,300.66 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $576.50 | $1,441.24 | 5.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$456.28–$593.17 | $1,140.70–$1,482.91 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $5,429.65 | $13,574.11 | 13.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $5,265.58 | $13,163.93 | 12.9× |
| Renal Cyst Study (74470) | $976.67 | $2,441.66 | 1.7× |
| Ribs bilateral 3 views (71110) | $721.67 | $1,804.16 | 6.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,282.62 | $3,206.55 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,690.79 | $4,226.97 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,476.64 | $8,691.60 | 6.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,078.79 | $7,696.96 | 5.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,731.54 | $4,328.85 | 3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,315.22 | $5,788.03 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,546.73 | $6,366.82 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,904.70 | $4,761.75 | 1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,710.04 | $4,275.08 | 6.9× |
| Rp Therapy Intravenous Administration (79101) | $2,970.31 | $7,425.77 | 12.1× |
| Scapula (73010) range across 2 matching MRF lines |
$361.69–$470.21 | $904.21–$1,175.52 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Sella turcica (70240) | $226.92 | $567.29 | 2.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$272.52–$354.28 | $681.28–$885.69 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$760.44–$988.57 | $1,901.10–$2,471.41 | varies |
| Sialogram (70390) | $826.98 | $2,067.44 | 3.3× |
| Skull less than 4 views (70250) | $471.28 | $1,178.20 | 4.3× |
| Special dosimetry (77331) | $1,006.06 | $2,515.13 | 7.1× |
| Special Physics Consult (77370) | $1,297.59 | $3,243.97 | 9.2× |
| Special teletherapy port plan (77321) | $1,198.71 | $2,996.77 | 3.0× |
| Special treatment procedure (77470) | $1,895.79 | $4,739.46 | 3.3× |
| Speech evaluation, complex (70371) | $413.48 | $1,033.69 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $4,148.66 | $10,371.65 | 2.2× |
| Sternoclavicular joints (71130) | $469.66 | $1,174.15 | 5.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $424.66 | $1,061.65 | 3.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,461.99 | $6,154.97 | 6.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,454.72 | $3,636.78 | 3.7× |
| Testicular Imaging W/Flow (78761) | $775.46 | $1,938.65 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,642.84 | $4,107.08 | 4.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,239.82 | $3,099.54 | 3.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,006.06 | $2,515.13 | 7.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $316.30 | $790.74 | 1.7× |
| Thoracic spine 2 views (72070) | $503.36 | $1,258.38 | 4.6× |
| Thoracic spine 3 views (72072) | $617.50 | $1,543.74 | 5.6× |
| Thoracolumbar 2 views (72080) | $301.43 | $753.57 | 3.3× |
| Thyroid Imaging With Vascular Flow (78013) | $852.56 | $2,131.38 | 2.0× |
| Thyroid Met Imaging Body (78018) | $2,921.25 | $7,303.11 | 5.1× |
| Thyroid Uptake Measurement (78012) | $497.06 | $1,242.64 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,141.68 | $2,854.20 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $1,044.43 | $2,611.06 | 2.6× |
| Tx devices design & construction intermediate (77333) | $887.88 | $2,219.68 | 6.3× |
| Tx devices design & construction simple (77332) | $879.28 | $2,198.20 | 6.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$305.96–$611.91 | $764.88–$1,529.77 | varies |
| Ultrasound Exam Aaa Screen (76706) | $350.60 | $876.48 | 3.2× |
| Ultrasound, abdomen limited (76705) | $779.46 | $1,948.65 | 7.1× |
| Umbilical-artery Doppler (OB) (76820) | $183.44 | $458.59 | 1.7× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$369.99–$4,383.62 | $924.97–$10,959.03 | varies |
| Unlisted fluoroscopic procedure (76496) | $700.02 | $1,750.03 | 7.6× |
| Unlisted magnetic resonance procedure (76498) | $512.82 | $1,282.05 | 5.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $2,636.18 | $6,590.45 | 24.5× |
| Upper gi w/o kub (74240) | $983.61 | $2,459.01 | 5.3× |
| Ureteral Reflux Study (78740) | $768 | $1,919.98 | 1.8× |
| Urethrocystogram voiding (74455) | $1,055.59 | $2,638.97 | 4.2× |
| Urethrocystography retrograde (74450) | $1,344.02 | $3,360.05 | 5.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$305.96–$611.91 | $764.88–$1,529.77 | varies |
| Us chest (76604) | $674.92 | $1,687.30 | 6.1× |
| Us complete joint (76881) range across 2 matching MRF lines |
$695.95–$1,391.86 | $1,739.86–$3,479.65 | varies |
| Us exam, pelvic, limited (76857) | $604.30 | $1,510.73 | 5.5× |
| Us head (76506) | $523.37 | $1,308.42 | 4.7× |
| Us kidney transplant (76776) | $601.73 | $1,504.31 | 5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$695.95–$1,391.86 | $1,739.86–$3,479.65 | varies |
| Us ob detailed single fetus (76811) | $1,225.74 | $3,064.33 | 4.9× |
| Us ob limited 1 or more fetuses (76815) | $477.36 | $1,193.38 | 4.3× |
| Us ob transvaginal (76817) | $583.68 | $1,459.19 | 5.3× |
| Us pelvic non ob complete (76856) | $983.38 | $2,458.45 | 8.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $648.43 | $1,621.07 | 5.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $610.66 | $1,526.65 | 5.5× |
| Us retroperitoneal complete (76770) | $1,097.12 | $2,742.79 | 9.9× |
| Us retroperitoneal limited (76775) | $947 | $2,367.48 | 8.6× |
| Us scrotum and contents (76870) | $907.64 | $2,269.08 | 8.2× |
| Us spinal canal and contents (76800) | $572.19 | $1,430.47 | 5.2× |
| Us thyroid (76536) | $821.42 | $2,053.55 | 7.4× |
| Us transrectal (76872) | $274.13 | $685.31 | 2.5× |
| Vein X-Ray Chest (75827) | $2,323.72 | $5,809.29 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,604.75 | $6,511.87 | 0.8× |
| Venogram Sinus/Jugular (75860) | $1,647.18 | $4,117.94 | 0.5× |
| Venography Adrenal Unilateral (75840) | $5,019.37 | $12,548.41 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $1,618.77 | $4,046.91 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $2,044.39 | $5,110.96 | 1.2× |
| Venography extremity unilateral rs&i (75820) | $1,022.20 | $2,555.49 | 0.6× |
| Venography Renal Bilateral (75833) | $10,038.72 | $25,096.79 | 3.0× |
| Venography Renal Unilateral (75831) | $5,019.37 | $12,548.41 | 1.5× |
| Venous sampling by catheter (75893) | $5,019.37 | $12,548.41 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $398.89 | $997.21 | 4.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$313.35–$407.38 | $783.37–$1,018.43 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $502.33 | $1,255.81 | 5.5× |
| X-ray antegrade pyelogram tube (74425) | $777.43 | $1,943.56 | 2.1× |
| X-Ray Aorta Leg Arteries (75630) | $5,698.40 | $14,245.98 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $108.10 | $270.23 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$342.98–$445.89 | $857.44–$1,114.72 | varies |
| X-Ray Exam Breast Specimen (76098) | $469.61 | $1,174.02 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $352.44 | $881.09 | 3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $591.01 | $1,477.52 | 5.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $642.34 | $1,605.85 | 5.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $296.16 | $740.40 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$426.22–$639.33 | $1,065.54–$1,598.31 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $487.22 | $1,218.04 | 4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $533.58 | $1,333.94 | 4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $505.04 | $1,262.58 | 4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $688.41 | $1,721.01 | 6.2× |
| X-Ray Exam L-S Spine Bending (72114) | $753.95 | $1,884.86 | 6.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $545.36 | $1,363.38 | 5.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $878.80 | $2,196.99 | 8.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $555.15 | $1,387.86 | 5.0× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$323.17–$420.13 | $807.92–$1,050.32 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$394.23–$512.50 | $985.57–$1,281.25 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,585.49 | $3,963.71 | 8.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $531.98 | $1,329.95 | 5.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $380.46 | $951.14 | 4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $639.04 | $1,597.60 | 5.8× |
| X-ray nose-rectum child f.b. (76010) | $195.31 | $488.26 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $898.94 | $2,247.35 | 8.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $502.67 | $1,256.66 | 4.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $203.57 | $508.92 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $464.99 | $1,162.46 | 5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $664.26 | $1,660.65 | 7.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $766.02 | $1,915.05 | 6.9× |
| X-Ray Stress View (77071) | $327.68 | $819.19 | 3.6× |
| X-ray thoracic spine 4 vw (72074) | $205.49 | $513.72 | 1.9× |
| X-Ray Tmj Unilat (70328) | $108.10 | $270.23 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,173.18 | $2,932.95 | 3.2× |
| X-Rays Bone Length Studies (77073) | $257.58 | $643.94 | 2.3× |
| X-Rays Bone Survey Complete (77075) | $693.57 | $1,733.92 | 6.3× |
| Xr c-spine 4 or 5 views (72050) | $671.13 | $1,677.81 | 6.1× |
| Xr facial bones less than 3 views (70140) | $330.06 | $825.13 | 3.6× |
| Xr orbits complete 4 views (70200) | $686.20 | $1,715.50 | 6.2× |
| Xr Tomogram Single Plane (76100) | $860.90 | $2,152.25 | 7.8× |
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.