Imaging prices at St. Mary Medical Center
Long Beach, CA · every code in this section with a posted price and a Medicare benchmark.
325 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) | $2,885.30 | $6,710 | 1.6× |
| Abdomen 1 View (74018) | $122.12 | $284 | 1.1× |
| Abdomen 2 views (74019) | $193.93 | $451 | 1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,055.22 | $2,454 | 2.1× |
| Angio internal mammary (75756) | $4,080.70 | $9,490 | 1.0× |
| Angio pulmonary bilat (75743) | $3,682.95 | $8,565 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,032.04 | $14,028 | 1.5× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,765.69–$4,849.97 | $11,083–$11,279 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,682.95 | $8,565 | 0.9× |
| Aortography thoracic serialography rs&i (75605) | $6,446.13 | $14,991 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,962.02 | $9,214 | 1.0× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$6,145.99–$6,402.27 | $14,293–$14,889 | varies |
| Artery X-Rays Pelvis (75736) | $6,446.13 | $14,991 | 0.9× |
| Artery X-Rays Spine (75705) | $5,921.96 | $13,772 | 0.8× |
| Basic radiation dosimetry calculation (77300) | $604.58 | $1,406 | 3.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$123.41–$125.56 | $287–$292 | varies |
| Bone Imaging 3 Phase (78315) | $353.46 | $822 | 0.7× |
| Bone Imaging Limited Area (78300) | $706.49 | $1,643 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $902.57 | $2,099 | 1.8× |
| Bone Imaging Whole Body (78306) | $353.46 | $822 | 0.7× |
| Bone marrow imaging limited area (78102) | $839.79 | $1,953 | 1.6× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$721.54–$735.30 | $1,678–$1,710 | varies |
| Brachytx isodose complex (77318) | $500.09 | $1,163 | 1.0× |
| Brachytx isodose intermed (77317) | $500.09 | $1,163 | 1.0× |
| Brachytx Isodose Plan Simple (77316) | $500.09 | $1,163 | 1.0× |
| Brain Flow Imaging Only (78610) | $795.07 | $1,849 | 1.1× |
| Brain Image W/Flow < 4 Views (78601) | $1,286.13 | $2,991 | 2.5× |
| Brain imaging < 4 static views (78600) | $913.32 | $2,124 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,286.13 | $2,991 | 1.8× |
| Brain Imaging Minimum 4 Static Views (78605) | $913.32 | $2,124 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,234.96 | $2,872 | 2.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,763.43 | $4,101 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $600.71 | $1,397 | 5.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,547.14 | $3,598 | 2.2× |
| Cerebrospinal Fluid Scan (78630) | $1,002.76 | $2,332 | 1.4× |
| Chest 1 view (71045) | $258 | $600 | 2.3× |
| Chest 2 views (71046) | $335.40 | $780 | 3.0× |
| Chest 3 views (71047) | $412.80 | $960 | 3.7× |
| Chest 4 or more views (71048) | $516 | $1,200 | 3.8× |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$208.55–$212.85 | $485–$495 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $172.86 | $402 | 1.3× |
| Continuing medical physics consltj pr wk (77336) | $448.49 | $1,043 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$4,026.09–$4,106.50 | $9,363–$9,550 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$247.68–$252.84 | $576–$588 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $545.67 | $1,269 | 1.2× |
| CT abdomen and pelvis without contrast (74176) | $289.82 | $674 | 0.9× |
| CT abdomen w contrast (74160) | $277.78 | $646 | 1.2× |
| CT abdomen w wo contrast (74170) | $277.78 | $646 | 1.2× |
| CT abdomen w/o contrast (74150) | $122.12 | $284 | 0.9× |
| CT Angio Abdomen and Pelvis (74174) | $285.09 | $663 | 0.6× |
| CT Angio Chest (71275) | $283.80 | $660 | 1.3× |
| CT Angio Head (70496) | $377.11 | $877 | 1.7× |
| CT angio hrt w/3d image (75574) | $1,501.56 | $3,492 | 3.3× |
| CT Angio Neck (70498) | $369.37 | $859 | 1.6× |
| CT cervical spine w/ contrast (72126) | $607.16 | $1,412 | 1.4× |
| CT cervical spine w/o contrast (72125) | $151.79 | $353 | 1.1× |
| CT cervical spine w/wo cont (72127) | $3,743.58 | $8,706 | 16.6× |
| CT chest w contrast (71260) | $374.53 | $871 | 1.7× |
| CT chest w/wo contrast (71270) | $374.53 | $871 | 1.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $308.31 | $717 | 1.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $187.91 | $437 | 1.4× |
| CT head/brain with contrast (70460) | $380.12 | $884 | 1.7× |
| CT head/brain without and with contrast (70470) | $380.12 | $884 | 1.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,501.56 | $3,492 | 3.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $246.82 | $574 | 2.2× |
| CT hrt w/3d image congen (75573) | $1,501.56 | $3,492 | 3.3× |
| CT iac w contrast (70481) | $1,793.53 | $4,171 | 8.0× |
| CT l-spine w&w/o contrast (72133) | $340.13 | $791 | 1.5× |
| CT lumbar spine w contrast (72132) | $547.82 | $1,274 | 1.2× |
| CT lumbar spine w/o contrast (72131) | $141.90 | $330 | 1.1× |
| CT maxillofacial w contrast (70487) | $1,839.97 | $4,279 | 8.2× |
| CT maxillofacial wo contrast (70486) | $152.22 | $354 | 1.1× |
| CT neck tissue combo (70492) | $2,839.72 | $6,604 | 12.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,977.57 | $4,599 | 8.8× |
| CT orbits w/o contrast (70480) | $138.03 | $321 | 1.0× |
| CT pelvis w&w/o contrast (72194) | $316.91 | $737 | 1.4× |
| CT pelvis w/o contrast (72192) | $135.88 | $316 | 1.0× |
| CT scans face/jaw combo (70488) | $2,205.04 | $5,128 | 9.8× |
| CT soft tissue neck w contrast (70491) | $310.03 | $721 | 1.4× |
| CT soft tissue neck w/o contrast (70490) | $143.19 | $333 | 1.1× |
| CT thoracic spine w contrast (72129) | $337.12 | $784 | 1.5× |
| CT thoracic spine w/o contrast (72128) | $138.03 | $321 | 1.0× |
| CT thoracic spine w/wo cont (72130) | $337.12 | $784 | 1.5× |
| CT thorax w/o contrast (71250) | $172.86 | $402 | 1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $279.07 | $649 | 1.2× |
| Cta Abdomen (74175) | $285.09 | $663 | 1.3× |
| CTA pelvis (72191) | $1,726.45 | $4,015 | 7.7× |
| Dilation ureters/urethra rs&i (74485) | $2,422.62 | $5,634 | 0.9× |
| Diskography lumbar (72295) | $4,112.52 | $9,564 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $219.73 | $511 | 1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $139.32 | $324 | 1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $131.58 | $306 | 1.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$347.44–$354.32 | $808–$824 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$198.23–$202.10 | $461–$470 | varies |
| Echo exam of fetal heart (76825) | $619.20 | $1,440 | 0.9× |
| Echo exam uterus (76831) | $375.39 | $873 | 1.2× |
| Echo Guide For Artery Repair (76936) | $418.39 | $973 | 1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $361.20 | $840 | 1.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$129.43–$132.01 | $301–$307 | varies |
| Fetal Biophys Profile W/Nst (76818) | $267.46 | $622 | 2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $219.30 | $510 | 1.6× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$260.58–$325.94 | $606–$758 | varies |
| Follow-Up Angiography (75898) | $4,263.45 | $9,915 | 1.0× |
| Gastric emptying imaging study (78264) | $354.75 | $825 | 0.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $489.34 | $1,138 | 1.0× |
| Gastric Mucosa Imaging (78261) | $407.21 | $947 | 0.8× |
| Gated Heart Planar Single (78472) | $570.61 | $1,327 | 1.1× |
| Gated Heart, Multiple (78473) | $372.38 | $866 | 0.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $649.73 | $1,511 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,759.13 | $4,091 | 2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,612.50 | $3,750 | 1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,409.11 | $3,277 | 1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,866.99 | $8,993 | 1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,866.99 | $8,993 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) | $457.52 | $1,064 | 0.7× |
| Hepatobiliary System Imaging (78226) | $356.04 | $828 | 0.7× |
| Ht Musc Image Planar Mult (78454) | $1,985.31 | $4,617 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $1,210.88 | $2,816 | 0.7× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$527.18–$537.93 | $1,226–$1,251 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $122.55 | $285 | 1.1× |
| Infant hip ultrasound, limited static exam (76886) | $83.42 | $194 | 0.7× |
| Interstitial radiation source applic complex (77778) | $947.72 | $2,204 | 1.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $892.25 | $2,075 | 1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $790.34 | $1,838 | 1.1× |
| Intracavitary radiation source applic simple (77761) | $790.34 | $1,838 | 1.1× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$236.07–$240.80 | $549–$560 | varies |
| K Flow/Funct Image Multiple (78709) | $1,219.91 | $2,837 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $505.68 | $1,176 | 0.7× |
| K Flow/Funct Image W/O Drug (78707) | $774.86 | $1,802 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $741.75 | $1,725 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $1,395.35 | $3,245 | 2.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $554.70 | $1,290 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $641.99 | $1,493 | 0.9× |
| Lung perfusion differential (78597) | $521.59 | $1,213 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $458.81 | $1,067 | 0.7× |
| Lung Ventilation Imaging (78579) | $434.30 | $1,010 | 0.8× |
| Lymph System Imaging (78195) | $1,037.16 | $2,412 | 1.5× |
| Magnetic Image Jaw Joint (70336) | $1,741.07 | $4,049 | 5.7× |
| Meckels Divert Exam (78290) | $744.33 | $1,731 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $481.60 | $1,120 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $39.99 | $93 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,408.68 | $3,276 | 3.1× |
| MRA head w/o contrast (70544) | $1,381.16 | $3,212 | 4.5× |
| MRA head with contrast (70545) | $1,381.16 | $3,212 | 3.1× |
| MRA neck w contrast (70548) | $1,689.90 | $3,930 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,074.32 | $4,824 | 4.6× |
| MRA neck w/o contrast (70547) | $1,165.30 | $2,710 | 3.8× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,011.54–$2,051.53 | $4,678–$4,771 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,332.14–$1,385.46 | $3,098–$3,222 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $596.84 | $1,388 | 1.9× |
| MRI cardiac w/o cont stress (75559) | $568.46 | $1,322 | 0.8× |
| MRI cardiac w/o contrast (75557) | $1,234.96 | $2,872 | 4.0× |
| MRI cervical spine w contrast (72142) | $3,644.68 | $8,476 | 8.1× |
| MRI cervical spine w/o cont (72141) | $2,513.35 | $5,845 | 8.2× |
| MRI chest w/o contrast (71550) | $1,479.20 | $3,440 | 4.8× |
| MRI chest with contrast (71551) | $2,144.84 | $4,988 | 2.1× |
| MRI chest wo w contrast (71552) | $2,469.06 | $5,742 | 5.5× |
| MRI lumbar spine w contrast (72149) | $2,397.68 | $5,576 | 5.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,189.06 | $9,742 | 9.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,578.10 | $3,670 | 5.1× |
| MRI orbit face neck w contrast (70542) | $2,340.49 | $5,443 | 5.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,629.88 | $6,116 | 5.9× |
| MRI pelvis w contrast (72196) | $3,336.80 | $7,760 | 7.4× |
| MRI pelvis w/o & w contrast (72197) | $3,749.17 | $8,719 | 8.4× |
| MRI pelvis w/o contrast (72195) | $2,249.33 | $5,231 | 7.3× |
| MRI thoracic spine w/o contrast (72146) | $1,533.81 | $3,567 | 5.0× |
| MRI, abdomen, combo (74183) | $2,304.80 | $5,360 | 5.1× |
| MRI, dorsal spine combo (72157) | $2,555.92 | $5,944 | 5.7× |
| MRI, dorsal spine contrast (72147) | $2,223.96 | $5,172 | 5.0× |
| MRI, lumbar spine combo (72158) | $2,755.87 | $6,409 | 6.1× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$492.78–$502.67 | $1,146–$1,169 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$492.78–$502.67 | $1,146–$1,169 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$492.78–$502.67 | $1,146–$1,169 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$462.25–$471.28 | $1,075–$1,096 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $570.61 | $1,327 | 1.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,647.76 | $3,832 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $1,210.88 | $2,816 | 0.7× |
| N-invas est c ffr sw aly CTA (75580) | $988.14 | $2,298 | 0.9× |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$75.25–$197.80 | $175–$460 | varies |
| Nm csf leak detection (78650) | $694.45 | $1,615 | 0.4× |
| Nm myocard infarct spect (78469) | $465.69 | $1,083 | 0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,747.70 | $6,390 | 1.5× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$305.73–$504.39 | $711–$1,173 | varies |
| Nuclear Rx Oral Admin (79005) | $246.82 | $574 | 0.8× |
| Ob us nuchal meas 1 gest (76813) | $214.14 | $498 | 1.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $146.63 | $341 | 1.1× |
| Optic foramina (70190) range across 2 matching MRF lines |
$141.47–$144.05 | $329–$335 | varies |
| Parathyroid Planar Imaging (78070) | $351.74 | $818 | 0.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$156.09–$159.10 | $363–$370 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,866.99 | $8,993 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $434.30 | $1,010 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$129.43–$132.01 | $301–$307 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$472.57–$652.31 | $1,099–$1,517 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$123.41–$125.56 | $287–$292 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$191.35–$195.22 | $445–$454 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$237.36–$242.52 | $552–$564 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$238.65–$243.81 | $555–$567 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$1,286.99–$1,314.08 | $2,993–$3,056 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$75.25–$221.88 | $175–$516 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$65.79–$67.08 | $153–$156 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$65.79–$67.08 | $153–$156 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$1,016.95–$1,037.16 | $2,365–$2,412 | varies |
| Radiation treatment delivery level 1 (77402) | $415.81 | $967 | 3.2× |
| Radiation treatment delivery level 2 (77407) | $453.22 | $1,054 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $620.92 | $1,444 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$129–$130.72 | $300–$304 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $201.24 | $468 | 1.5× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$135.02–$140.61 | $314–$327 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$135.02–$140.61 | $314–$327 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $198.66 | $462 | 0.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$156.09–$159.10 | $363–$370 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$116.53–$119.97 | $271–$279 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$129–$132.01 | $300–$307 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $116.96 | $272 | 0.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $117.82 | $274 | 0.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 2 matching MRF lines |
$522.45–$652.31 | $1,215–$1,517 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,612.50 | $3,750 | 3.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,465.87 | $3,409 | 3.0× |
| Renal Cyst Study (74470) | $2,176.66 | $5,062 | 3.1× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$129.43–$132.01 | $301–$307 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $655.75 | $1,525 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,470.17 | $3,419 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,132.19 | $2,633 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $556.42 | $1,294 | 0.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,728.17 | $4,019 | 1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,947.04 | $4,528 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,728.17 | $4,019 | 1.0× |
| Rp Therapy Intravenous Administration (79101) | $504.39 | $1,173 | 1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $58.05 | $135 | 2.5× |
| Sella turcica (70240) range across 2 matching MRF lines |
$92.45–$94.17 | $215–$219 | varies |
| Skull less than 4 views (70250) | $130.29 | $303 | 1.0× |
| Special dosimetry (77331) | $144.05 | $335 | 0.8× |
| Special Physics Consult (77370) | $591.68 | $1,376 | 3.4× |
| Special teletherapy port plan (77321) | $484.61 | $1,127 | 1.0× |
| Special treatment procedure (77470) | $1,061.67 | $2,469 | 1.5× |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$344.43–$351.31 | $801–$817 | varies |
| Stereotactic Body Radiation Delivery (77373) | $3,397 | $7,900 | 1.5× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$258.86–$263.59 | $602–$613 | varies |
| Superior sagittal sinus venogram (75870) | $3,766.80 | $8,760 | 0.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $334.54 | $778 | 2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,087.47 | $2,529 | 2.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $577.06 | $1,342 | 1.2× |
| Testicular Imaging W/Flow (78761) | $1,084.03 | $2,521 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,062.96 | $2,472 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $711.22 | $1,654 | 1.5× |
| Ther rad simulaj-aided field setting simple (77280) | $764.97 | $1,779 | 4.4× |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$117.82–$245.53 | $274–$571 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$117.82–$120.40 | $274–$280 | varies |
| Thoracolumbar 2 views (72080) | $69.23 | $161 | 0.6× |
| Thyroid Imaging With Vascular Flow (78013) | $390.44 | $908 | 0.8× |
| Thyroid Met Imaging Body (78018) | $479.45 | $1,115 | 0.7× |
| Thyroid Uptake Measurement (78012) | $288.10 | $670 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $372.38 | $866 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $1,208.30 | $2,810 | 2.5× |
| Tx devices design & construction intermediate (77333) | $422.69 | $983 | 2.4× |
| Tx devices design & construction simple (77332) | $628.23 | $1,461 | 3.6× |
| Ultrasound elastography first target lesion (76982) | $193.07 | $449 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $183.18 | $426 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $239.94 | $558 | 1.8× |
| Ultrasound, abdomen limited (76705) | $519.01 | $1,207 | 3.9× |
| Umbilical-artery Doppler (OB) (76820) | $127.71 | $297 | 0.9× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$232.63–$236.93 | $541–$551 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $149.64 | $348 | 1.1× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$429.57–$438.17 | $999–$1,019 | varies |
| Ureteral Reflux Study (78740) | $958.47 | $2,229 | 1.9× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$236.50–$240.37 | $550–$559 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$236.50–$240.37 | $550–$559 | varies |
| Us chest (76604) | $214.57 | $499 | 1.6× |
| Us exam, pelvic, limited (76857) | $334.54 | $778 | 2.5× |
| Us head (76506) | $195.22 | $454 | 1.5× |
| Us kidney transplant (76776) | $205.11 | $477 | 1.5× |
| Us ob detailed single fetus (76811) | $382.70 | $890 | 1.2× |
| Us ob limited 1 or more fetuses (76815) | $219.73 | $511 | 1.6× |
| Us ob transvaginal (76817) | $191.35 | $445 | 1.4× |
| Us pelvic non ob complete (76856) | $499.66 | $1,162 | 3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $227.47 | $529 | 1.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $219.73 | $511 | 1.6× |
| Us retroperitoneal complete (76770) | $280.79 | $653 | 2.1× |
| Us retroperitoneal limited (76775) | $218.87 | $509 | 1.6× |
| Us scrotum and contents (76870) | $460.10 | $1,070 | 3.4× |
| Us spinal canal and contents (76800) | $178.45 | $415 | 1.3× |
| Us thyroid (76536) | $348.73 | $811 | 2.6× |
| Us transrectal (76872) range across 2 matching MRF lines |
$145.34–$368.94 | $338–$858 | varies |
| Vein X-Ray Chest (75827) | $1,892.43 | $4,401 | 0.9× |
| Vein X-Ray Skull Epidural (75872) | $848.82 | $1,974 | 1.1× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,659.37–$3,766.80 | $3,859–$8,760 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$2,657.40–$4,026.09 | $6,180–$9,363 | varies |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$776.58–$1,990.90 | $1,806–$4,630 | varies |
| Venography Orbital Rs&I (75880) | $848.82 | $1,974 | 1.1× |
| Venography Renal Bilateral (75833) | $3,866.99 | $8,993 | 1.0× |
| Venous sampling by catheter (75893) | $3,837.32 | $8,924 | 0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $825.17 | $1,919 | 1.6× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$355.61–$362.92 | $827–$844 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$127.71–$130.29 | $297–$303 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$4,831.48–$5,032.72 | $11,236–$11,704 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 4 matching MRF lines |
$448.92–$478.16 | $1,044–$1,112 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$472.14–$621.35 | $1,098–$1,445 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$65.79–$67.08 | $153–$156 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$123.41–$125.56 | $287–$292 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$813.56–$829.90 | $1,892–$1,930 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$142.33–$145.77 | $331–$339 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$142.33–$145.77 | $331–$339 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$795.07–$812.27 | $1,849–$1,889 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$156.52–$160.82 | $364–$374 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$74.82–$79.12 | $174–$184 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$140.61–$145.34 | $327–$338 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$774.86–$790.34 | $1,802–$1,838 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$152.65–$172.43 | $355–$401 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$313.47–$319.92 | $729–$744 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$156.52–$160.82 | $364–$374 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$123.84–$125.99 | $288–$293 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$497.08–$507.40 | $1,156–$1,180 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$129–$131.15 | $300–$305 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$231.34–$235.64 | $538–$548 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$68.80–$70.52 | $160–$164 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$65.79–$67.08 | $153–$156 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$361.63–$367.65 | $841–$855 | varies |
| X-ray thoracic spine 4 vw (72074) range across 4 matching MRF lines |
$117.82–$326.37 | $274–$759 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$487.19–$497.51 | $1,133–$1,157 | varies |
| X-Rays Bone Length Studies (77073) | $227.90 | $530 | 1.7× |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$693.59–$714.23 | $1,613–$1,661 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$140.61–$145.34 | $327–$338 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$65.79–$67.08 | $153–$156 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$168.56–$171.57 | $392–$399 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$123.41–$125.56 | $287–$292 | 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.