Imaging prices at St. Mary's Medical Center
West Palm Beach, FL · every code in this section with a posted price and a Medicare benchmark.
335 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) | $8,356.50 | $11,142 | 5.8× |
| Abdomen 1 View (74018) | $620.25 | $827 | 6.8× |
| Abdomen 2 views (74019) | $987.75 | $1,317 | 9.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,215 | $1,620 | 2.9× |
| Angio pulmonary bilat (75743) | $8,556 | $11,408 | 2.6× |
| Angiography extremity bilateral rs&i (75716) | $5,913 | $7,884 | 1.8× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$6,228–$8,471.25 | $8,304–$11,295 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,214.50 | $8,286 | 1.9× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$636.75–$930 | $849–$1,240 | varies |
| Aortography thoracic serialography rs&i (75605) | $8,060.25 | $10,747 | 1.4× |
| Artery X-Rays Abdomen (75726) | $9,548.25 | $12,731 | 1.6× |
| Artery X-Rays Pelvis (75736) | $8,678.25 | $11,571 | 1.5× |
| Artery X-Rays Spine (75705) | $10,537.50 | $14,050 | 1.8× |
| Arthrogram ankle (73615) | $1,232.25 | $1,643 | 3.4× |
| Arthrogram hip (73525) | $1,911 | $2,548 | 5.2× |
| Basic radiation dosimetry calculation (77300) | $1,803.75 | $2,405 | 12.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$545.25–$582.75 | $727–$777 | varies |
| Bone Imaging 3 Phase (78315) | $3,270.75 | $4,361 | 7.8× |
| Bone Imaging Limited Area (78300) | $2,919.75 | $3,893 | 7.0× |
| Bone Imaging Whole Body (78306) | $2,472.75 | $3,297 | 5.9× |
| Bone marrow imaging; multiple areas (78103) | $3,667.50 | $4,890 | 8.8× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$2,807.25–$2,829 | $3,743–$3,772 | varies |
| Brachytx isodose complex (77318) | $3,960.75 | $5,281 | 10.1× |
| Brachytx isodose intermed (77317) | $2,671.50 | $3,562 | 6.8× |
| Brachytx Isodose Plan Simple (77316) | $2,286 | $3,048 | 5.8× |
| Brain Flow Imaging Only (78610) | $1,244.25 | $1,659 | 2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $7,773 | $10,364 | 21.3× |
| Cat Scan Follow-Up Study (76380) | $873.75 | $1,165 | 9.6× |
| Cerebrospinal Fluid Scan (78630) | $1,356 | $1,808 | 2.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$321–$505.50 | $428–$674 | varies |
| Chest 2 views (71046) | $576 | $768 | 6.3× |
| Chest 3 views (71047) | $736.50 | $982 | 8.1× |
| Chest 4 or more views (71048) | $759 | $1,012 | 7.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$687–$903 | $916–$1,204 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,427.25 | $1,903 | 10.2× |
| Contrast Exam Abdominl Aorta (75625) | $5,468.25 | $7,291 | 1.7× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$681–$1,001.25 | $908–$1,335 | varies |
| Contrast X-Ray Of Elbow (73085) | $1,818 | $2,424 | 5.0× |
| Contrast X-Ray Of Knee Joint (73580) | $3,159.75 | $4,213 | 8.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$11,062.50–$11,166 | $14,750–$14,888 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$8,914.50–$11,841 | $11,886–$15,788 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$5,040.75–$5,444.25 | $6,721–$7,259 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$5,921.25–$7,457.25 | $7,895–$9,943 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$5,164.50–$5,361.75 | $6,886–$7,149 | varies |
| CT Angio Abdomen and Pelvis (74174) | $7,929 | $10,572 | 21.8× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$9,398.25–$12,171.75 | $12,531–$16,229 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$5,204.25–$9,412.50 | $6,939–$12,550 | varies |
| CT angio hrt w/3d image (75574) | $2,195.25 | $2,927 | 6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$5,259.75–$8,325.75 | $7,013–$11,101 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,723.50–$6,055.50 | $6,298–$8,074 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$5,702.25–$10,830.75 | $7,603–$14,441 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$5,335.50–$7,867.50 | $7,114–$10,490 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$5,511–$6,894 | $7,348–$9,192 | varies |
| CT cervical spine w/wo cont (72127) | $8,181 | $10,908 | 44.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$5,918.25–$9,050.25 | $7,891–$12,067 | varies |
| CT chest w/wo contrast (71270) | $8,773.50 | $11,698 | 47.9× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$5,405.25–$5,837.25 | $7,207–$7,783 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$5,372.25–$6,184.50 | $7,163–$8,246 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,897.50 | $2,530 | 5.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $634.50 | $846 | 7.0× |
| CT hrt w/3d image congen (75573) | $2,389.50 | $3,186 | 6.6× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$6,547.50–$7,983 | $8,730–$10,644 | varies |
| CT l-spine w&w/o contrast (72133) | $6,522.75 | $8,697 | 35.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$3,459.75–$5,702.25 | $4,613–$7,603 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$4,820.25–$5,929.50 | $6,427–$7,906 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$4,998.75–$6,801 | $6,665–$9,068 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$4,371.75–$6,339 | $5,829–$8,452 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$4,544.25–$5,702.25 | $6,059–$7,603 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$3,681–$5,764.50 | $4,908–$7,686 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$4,969.50–$6,760.50 | $6,626–$9,014 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$8,748.75–$9,696 | $11,665–$12,928 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$6,324.75–$8,340 | $8,433–$11,120 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$5,205–$6,496.50 | $6,940–$8,662 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$3,672.75–$5,752.50 | $4,897–$7,670 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$5,288.25–$6,225.75 | $7,051–$8,301 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$5,518.50–$5,769.75 | $7,358–$7,693 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$5,063.25–$5,273.25 | $6,751–$7,031 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$4,795.50–$6,005.25 | $6,394–$8,007 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$5,957.25–$8,784.75 | $7,943–$11,713 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$6,607.50–$7,165.50 | $8,810–$9,554 | varies |
| CT thoracic spine w/wo cont (72130) | $7,902 | $10,536 | 43.1× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$6,042.75–$6,135 | $8,057–$8,180 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$5,171.25–$5,219.25 | $6,895–$6,959 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $7,944 | $10,592 | 43.4× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$5,604.75–$7,584 | $7,473–$10,112 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$4,635–$6,834 | $6,180–$9,112 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$5,253.75–$10,053 | $7,005–$13,404 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$4,642.50–$8,711.25 | $6,190–$11,615 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,188 | $5,584 | 1.9× |
| Diskography lumbar (72295) | $3,191.25 | $4,255 | 1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $1,069.50 | $1,426 | 9.8× |
| Dxa Bone Density Axial (77080) | $1,026 | $1,368 | 9.4× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$2,834.25–$3,857.25 | $3,779–$5,143 | varies |
| Echo exam uterus (76831) | $1,722 | $2,296 | 6.9× |
| Echo Guide For Artery Repair (76936) | $1,872 | $2,496 | 8.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,468.50 | $1,958 | 5.9× |
| Echograp Trans R Pros Study (76873) | $1,658.25 | $2,211 | 15.2× |
| Esophagram (74220) | $1,183.50 | $1,578 | 6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,716 | $2,288 | 15.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $7,098 | $9,464 | 28.5× |
| Fluoroscopy up to 1 hr (76000) | $1,759.50 | $2,346 | 7.1× |
| Follow-Up Angiography (75898) | $3,425.25 | $4,567 | 1.0× |
| Foot 2 views (73620) | $829.50 | $1,106 | 9.1× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$725.25–$1,218 | $967–$1,624 | varies |
| Gastric emptying imaging study (78264) | $3,171 | $4,228 | 7.6× |
| Gastroesophageal Reflux Exam (78262) | $2,007 | $2,676 | 4.8× |
| Gated Heart Planar Single (78472) | $2,745 | $3,660 | 6.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$497.25–$582.75 | $663–$777 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $10,827 | $14,436 | 14.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $10,827 | $14,436 | 14.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $10,827 | $14,436 | 14.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,654.50 | $6,206 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $3,273.75 | $4,365 | 5.8× |
| Hepatobiliary System Imaging (78226) | $3,649.50 | $4,866 | 8.7× |
| Hysterosalpingogram (74740) | $2,330.25 | $3,107 | 9.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,092 | $1,456 | 12.0× |
| Infusion Ivp (74410) | $2,208 | $2,944 | 12.1× |
| Interstitial radiation source applic complex (77778) | $6,954 | $9,272 | 9.6× |
| K Flow/Funct Image Multiple (78709) | $5,136 | $6,848 | 9.1× |
| K Flow/Funct Image W/Drug (78708) | $4,147.50 | $5,530 | 7.3× |
| K Flow/Funct Image W/O Drug (78707) | $3,832.50 | $5,110 | 6.8× |
| Kidney Imaging Morphol (78700) | $2,464.50 | $3,286 | 5.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$768.75–$919.50 | $1,025–$1,226 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,623 | $2,164 | 3.9× |
| Liver & Spleen Imaging Static Only (78215) | $3,321 | $4,428 | 8.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,800 | $2,400 | 4.3× |
| Liver imaging static only (78201) | $3,785.25 | $5,047 | 6.7× |
| Liver imaging w/vascular flow (78202) | $4,419.75 | $5,893 | 7.8× |
| Lung perfusion differential (78597) | $2,127 | $2,836 | 5.1× |
| Lung Ventilat&Perfus Imaging (78582) | $4,388.25 | $5,851 | 7.7× |
| Lymph System Imaging (78195) | $2,957.25 | $3,943 | 5.2× |
| Magnetic Image Jaw Joint (70336) | $6,505.50 | $8,674 | 26.1× |
| Mammary ductogram or galactogram multiple (77054) | $1,453.50 | $1,938 | 5.8× |
| Mammary ductogram or galactogram single (77053) | $1,398 | $1,864 | 5.6× |
| Meckels Divert Exam (78290) | $1,072.50 | $1,430 | 2.6× |
| Mlc imrt design & construction per imrt plan (77338) | $2,577 | $3,436 | 6.6× |
| Mr safety determination physician/other qhp (76016) | $360 | $480 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $99.75 | $133 | 3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $375 | $500 | 3.8× |
| Mr safety implt pos&/immoblj (76019) | $243 | $324 | 3.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $987.75 | $1,317 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) | $8,385 | $11,180 | 23.0× |
| MRA head w/o contrast (70544) | $7,563.75 | $10,085 | 30.4× |
| MRA head with contrast (70545) | $7,752 | $10,336 | 21.3× |
| MRA neck w contrast (70548) | $7,245.75 | $9,661 | 19.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,467.50 | $11,290 | 23.2× |
| MRA neck w/o contrast (70547) | $5,848.50 | $7,798 | 23.5× |
| MRI abdomen w contrast (74182) | $5,499 | $7,332 | 15.1× |
| MRI abdomen w/o contrast (74181) | $3,339 | $4,452 | 13.4× |
| MRI any jt lower extrem w/contrast material (73722) | $7,071 | $9,428 | 8.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,518.75 | $10,025 | 20.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $7,581 | $10,108 | 9.3× |
| MRI brain functional w/o physician admnistration (70554) | $2,761.50 | $3,682 | 11.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $6,403.50 | $8,538 | 25.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $5,544 | $7,392 | 22.2× |
| MRI cardiac w/o contrast (75557) | $4,821 | $6,428 | 19.3× |
| MRI cervical spine w contrast (72142) | $8,984.25 | $11,979 | 24.7× |
| MRI cervical spine w/o cont (72141) | $10,710 | $14,280 | 43.0× |
| MRI chest w/o contrast (71550) | $6,273 | $8,364 | 25.2× |
| MRI chest with contrast (71551) | $8,181 | $10,908 | 10.0× |
| MRI chest wo w contrast (71552) | $7,263 | $9,684 | 19.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,867 | $5,156 | 10.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $8,952.75 | $11,937 | 24.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,035.50 | $6,714 | 20.2× |
| MRI lumbar spine w contrast (72149) | $7,713 | $10,284 | 21.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $9,567.75 | $12,757 | 26.3× |
| MRI orbit face &/neck w/o contrast (70540) | $6,613.50 | $8,818 | 26.5× |
| MRI orbit face neck w contrast (70542) | $8,262 | $11,016 | 22.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $8,082.75 | $10,777 | 22.2× |
| MRI pelvis w contrast (72196) | $9,250.50 | $12,334 | 25.4× |
| MRI pelvis w/o & w contrast (72197) | $6,973.50 | $9,298 | 19.1× |
| MRI pelvis w/o contrast (72195) | $8,892 | $11,856 | 35.7× |
| MRI spectroscopy (76390) | $393.75 | $525 | 4.3× |
| MRI thoracic spine w/o contrast (72146) | $7,810.50 | $10,414 | 31.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $7,179 | $9,572 | 19.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,586.50 | $8,782 | 26.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $7,548.75 | $10,065 | 20.7× |
| MRI, abdomen, combo (74183) | $3,576.75 | $4,769 | 9.8× |
| MRI, dorsal spine combo (72157) | $7,260 | $9,680 | 19.9× |
| MRI, dorsal spine contrast (72147) | $8,993.25 | $11,991 | 24.7× |
| MRI, joint upper extrem (73221) | $7,678.50 | $10,238 | 30.8× |
| MRI, joint upper extrem combo (73223) | $8,542.50 | $11,390 | 23.4× |
| MRI, lumbar spine combo (72158) | $7,260 | $9,680 | 19.9× |
| Myelogram cervical (72240) | $3,258 | $4,344 | 4.0× |
| Myelogram Lumbar (72265) | $3,358.50 | $4,478 | 4.1× |
| Myelography thoracic (72255) | $1,758.75 | $2,345 | 2.1× |
| Myelograpy 2/more regions rs&i (72270) | $5,206.50 | $6,942 | 6.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,175.25 | $1,567 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $4,728.75 | $6,305 | 3.5× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$729–$970.50 | $972–$1,294 | varies |
| Nonvascular Shunt X-Ray (75809) | $1,345.50 | $1,794 | 12.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,891.75 | $5,189 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $2,468.25 | $3,291 | 10.1× |
| Panoramic X-ray of jaws (70355) | $755.25 | $1,007 | 8.3× |
| Parathyroid Planar Imaging (78070) | $3,535.50 | $4,714 | 8.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$793.50–$1,205.25 | $1,058–$1,607 | varies |
| Perineogram (74775) | $2,211 | $2,948 | 8.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,904.25 | $6,539 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,423.25 | $3,231 | 5.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,266–$1,546.50 | $1,688–$2,062 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$772.50–$1,183.50 | $1,030–$1,578 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$780–$1,140.75 | $1,040–$1,521 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$621.75–$714.75 | $829–$953 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$1,027.50–$1,050 | $1,370–$1,400 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$765.75–$1,128 | $1,021–$1,504 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$548.25–$951.75 | $731–$1,269 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$414.75–$774 | $553–$1,032 | varies |
| Radex Hand Minimum 3 Views (73130) | $961.50 | $1,282 | 10.6× |
| Radex lower extremity infant minimum 2 views (73592) | $448.50 | $598 | 4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$623.25–$792 | $831–$1,056 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $1,576.50 | $2,102 | 17.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$602.25–$841.50 | $803–$1,122 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$627.75–$661.50 | $837–$882 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$759–$971.25 | $1,012–$1,295 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$613.50–$834.75 | $818–$1,113 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $963.75 | $1,285 | 10.6× |
| Radex Toe Minimum 2 Views (73660) | $761.25 | $1,015 | 8.4× |
| Radex upper extremity infant minimum 2 views (73092) | $448.50 | $598 | 4.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$660.75–$1,119 | $881–$1,492 | varies |
| Radiation treatment delivery level 1 (77402) | $659.25 | $879 | 6.2× |
| Radiation treatment delivery level 2 (77407) | $659.25 | $879 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $1,588.50 | $2,118 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$853.50–$1,006.50 | $1,138–$1,342 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $834 | $1,112 | 7.6× |
| Radiologic exam colon double contrast study (74280) | $1,554.75 | $2,073 | 8.5× |
| Radiologic exam colon single contrast study (74270) | $1,336.50 | $1,782 | 7.3× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$732–$988.50 | $976–$1,318 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,477.50 | $1,970 | 13.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,045.50 | $1,394 | 5.7× |
| Radiologic exam swallow function contrast study (74230) | $1,344.75 | $1,793 | 7.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$544.50–$721.50 | $726–$962 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$705.75–$1,194 | $941–$1,592 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$497.25–$900 | $663–$1,200 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $401.25 | $535 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$810–$1,155.75 | $1,080–$1,541 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,355.50 | $8,474 | 11.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,592.75 | $3,457 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $6,373.50 | $8,498 | 11.2× |
| Rp Therapy Intravenous Administration (79101) | $3,157.50 | $4,210 | 13.0× |
| Salivary Gland Function Study (78232) | $2,613.75 | $3,485 | 6.3× |
| Salivary Gland Imaging Serial Images (78231) | $2,201.25 | $2,935 | 5.3× |
| Scapula (73010) range across 2 matching MRF lines |
$570–$773.25 | $760–$1,031 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $154.50 | $206 | 6.6× |
| Sella turcica (70240) | $585 | $780 | 6.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$612–$909.75 | $816–$1,213 | varies |
| Shoulder Arthrography (73040) | $1,686 | $2,248 | 4.6× |
| Skull less than 4 views (70250) | $960 | $1,280 | 8.8× |
| Special dosimetry (77331) | $1,770 | $2,360 | 12.6× |
| Special Physics Consult (77370) | $3,403.50 | $4,538 | 24.2× |
| Special teletherapy port plan (77321) | $2,367.75 | $3,157 | 6.1× |
| Special treatment procedure (77470) | $3,602.25 | $4,803 | 6.2× |
| Sternoclavicular joints (71130) | $799.50 | $1,066 | 8.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $789 | $1,052 | 7.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,016.50 | $4,022 | 7.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,243.50 | $1,658 | 3.2× |
| Testicular Imaging W/Flow (78761) | $2,377.50 | $3,170 | 5.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,664.75 | $3,553 | 6.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,915.25 | $3,887 | 7.5× |
| Ther rad simulaj-aided field setting simple (77280) | $1,299.75 | $1,733 | 9.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,845 | $2,460 | 10.1× |
| Thoracic spine 2 views (72070) | $660 | $880 | 6.0× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$1,098.75–$1,170 | $1,465–$1,560 | varies |
| Thoracolumbar 2 views (72080) | $525.75 | $701 | 5.8× |
| Thyroid Imaging With Vascular Flow (78013) | $1,919.25 | $2,559 | 4.6× |
| Thyroid Met Imaging Body (78018) | $4,224.75 | $5,633 | 7.5× |
| Thyroid Uptake Measurement (78012) | $1,652.25 | $2,203 | 4.0× |
| Tx Devices Design & Construction Complex (77334) | $2,414.25 | $3,219 | 6.2× |
| Tx devices design & construction intermediate (77333) | $2,398.50 | $3,198 | 17.1× |
| Tx devices design & construction simple (77332) | $1,366.50 | $1,822 | 9.7× |
| Ultrasound, abdomen limited (76705) | $1,558.50 | $2,078 | 14.3× |
| Umbilical-artery Doppler (OB) (76820) | $1,102.50 | $1,470 | 10.1× |
| Upper gi w/o kub (74240) | $1,934.25 | $2,579 | 10.6× |
| Ureteral Reflux Study (78740) | $4,763.25 | $6,351 | 11.4× |
| Urethrocystogram voiding (74455) | $2,097 | $2,796 | 8.4× |
| Urethrocystography retrograde (74450) | $969.75 | $1,293 | 3.9× |
| Us breast unilateral complete (76641) | $736.50 | $982 | 6.7× |
| Us chest (76604) | $771 | $1,028 | 7.1× |
| Us exam, pelvic, limited (76857) | $454.50 | $606 | 4.2× |
| Us head (76506) | $1,199.25 | $1,599 | 11.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,155.75 | $1,541 | 10.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$1,313.25–$1,506 | $1,751–$2,008 | varies |
| Us ob transvaginal (76817) | $1,179.75 | $1,573 | 10.8× |
| Us pelvic non ob complete (76856) | $1,989 | $2,652 | 18.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,176.75 | $1,569 | 10.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $489 | $652 | 4.5× |
| Us retroperitoneal complete (76770) | $1,554.75 | $2,073 | 14.2× |
| Us retroperitoneal limited (76775) | $1,534.50 | $2,046 | 14.1× |
| Us scrotum and contents (76870) | $1,288.50 | $1,718 | 11.8× |
| Us spinal canal and contents (76800) | $1,660.50 | $2,214 | 15.2× |
| Us thyroid (76536) | $1,432.50 | $1,910 | 13.1× |
| Us transrectal (76872) | $1,759.50 | $2,346 | 16.1× |
| Vein X-Ray Chest (75827) | $3,650.25 | $4,867 | 2.2× |
| Venogram Sinus/Jugular (75860) | $6,986.25 | $9,315 | 2.1× |
| Venography caval inferior serialography rs&i (75825) | $4,447.50 | $5,930 | 1.3× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$4,677–$6,384.75 | $6,236–$8,513 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$4,581.75–$5,770.50 | $6,109–$7,694 | varies |
| Venous sampling by catheter (75893) | $9,069 | $12,092 | 1.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$859.50–$942.75 | $1,146–$1,257 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $924.75 | $1,233 | 10.2× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$938.25–$1,170 | $1,251–$1,560 | varies |
| X-Ray Bend Only L-S Spine (72120) | $750 | $1,000 | 6.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$696.75–$959.25 | $929–$1,279 | varies |
| X-Ray Exam Breast Specimen (76098) | $834.75 | $1,113 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$369.75–$544.50 | $493–$726 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$962.25–$1,311 | $1,283–$1,748 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$1,166.25–$1,718.25 | $1,555–$2,291 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$790.50–$1,122.75 | $1,054–$1,497 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$769.50–$1,746.75 | $1,026–$2,329 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$733.50–$753.75 | $978–$1,005 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $2,577 | $3,436 | 23.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,378.50 | $1,838 | 12.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$1,119–$1,397.25 | $1,492–$1,863 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$852–$1,266 | $1,136–$1,688 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$1,512.75–$1,782.75 | $2,017–$2,377 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,117.50 | $1,490 | 10.2× |
| X-ray eye for foreign body (70030) | $725.25 | $967 | 8.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$656.25–$931.50 | $875–$1,242 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,842.75 | $2,457 | 10.1× |
| X-ray IV pyelogram+tomography (74415) | $2,803.50 | $3,738 | 15.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $702.75 | $937 | 7.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$689.25–$741 | $919–$988 | varies |
| X-ray nose-rectum child f.b. (76010) | $423 | $564 | 4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$916.50–$1,164.75 | $1,222–$1,553 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $341.25 | $455 | 3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $502.50 | $670 | 4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$671.25–$796.50 | $895–$1,062 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$854.25–$1,119 | $1,139–$1,492 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,313.25 | $1,751 | 12.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,104.75 | $1,473 | 3.0× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$859.50–$863.25 | $1,146–$1,151 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$2,313–$2,723.25 | $3,084–$3,631 | varies |
| Xr c-spine 4 or 5 views (72050) | $1,540.50 | $2,054 | 14.1× |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$653.25–$859.50 | $871–$1,146 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$781.50–$1,062 | $1,042–$1,416 | varies |
| Xr Tomogram Single Plane (76100) | $1,751.25 | $2,335 | 16.0× |
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.