Imaging prices at St. Michael Medical Center
Silverdale, WA · every code in this section with a posted price and a Medicare benchmark.
364 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $309.26 | $700.70 | 3.1× |
| Abdomen 2 views (74019) | $391.24 | $886.45 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,347.28 | $3,052.64 | 2.9× |
| Angio pulmonary bilat (75743) | $3,883.28 | $8,798.67 | 1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,900.05 | $8,836.67 | 1.1× |
| Angiography extremity bilateral rs&i (75716) | $3,891.22 | $8,816.65 | 1.1× |
| Aortography thoracic serialography rs&i (75605) | $3,412.78 | $7,732.62 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,971.64 | $8,998.87 | 1.1× |
| Artery X-Rays Abdomen (75726) | $5,125.09 | $11,612.34 | 0.8× |
| Artery X-Rays Spine (75705) | $4,281.76 | $9,701.54 | 0.7× |
| Basic radiation dosimetry calculation (77300) | $691.28 | $1,566.29 | 4.5× |
| Bone age studies (77072) | $298.13 | $675.48 | 2.5× |
| Bone Imaging 3 Phase (78315) | $2,198.90 | $4,982.22 | 4.8× |
| Bone Imaging Limited Area (78300) | $1,151.80 | $2,609.73 | 2.5× |
| Bone Imaging Multiple Areas (78305) | $1,199.39 | $2,717.55 | 2.6× |
| Bone Imaging Whole Body (78306) | $2,094.19 | $4,744.97 | 4.5× |
| Bone marrow imaging limited area (78102) | $700.87 | $1,588.01 | 1.5× |
| Bone marrow imaging; multiple areas (78103) | $749.93 | $1,699.17 | 1.6× |
| Bone marrow imaging; whole body (78104) | $848.05 | $1,921.49 | 1.8× |
| Bone survey infant (77076) | $354.57 | $803.36 | 2.9× |
| Brachytx isodose complex (77318) | $2,265.28 | $5,132.63 | 5.3× |
| Brain Flow Imaging Only (78610) | $903.03 | $2,046.07 | 1.4× |
| Brain Image W/Flow < 4 Views (78601) | $843.37 | $1,910.89 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,180.72 | $2,675.25 | 1.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $843.37 | $1,910.89 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,012.02 | $9,090.36 | 2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,811.04 | $4,103.42 | 3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,193.92 | $4,970.95 | 5.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,193.92 | $4,970.95 | 2.4× |
| Cardiac Shunt Detection (78428) | $1,175.48 | $2,663.37 | 2.6× |
| Cat Scan Follow-Up Study (76380) | $895.22 | $2,028.36 | 8.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,213.91 | $2,750.46 | 1.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $1,294.06 | $2,932.06 | 2.1× |
| Cerebrospinal Fluid Scan (78630) | $1,373.67 | $3,112.43 | 2.2× |
| Chest 1 view (71045) | $293.35 | $664.66 | 2.9× |
| Chest 2 views (71046) | $381.36 | $864.06 | 3.8× |
| Chest 3 views (71047) | $384.29 | $870.70 | 3.8× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$381.36–$384.29 | $864.06–$870.70 | varies |
| Cholecystography Oral Contrast (74290) | $297.52 | $674.10 | 1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $95.78 | $217 | 0.8× |
| Continuing medical physics consltj pr wk (77336) | $987.84 | $2,238.22 | 6.4× |
| Contrast Exam Abdominl Aorta (75625) | $3,982.44 | $9,023.34 | 1.1× |
| Contrast X-Ray Bladder (74430) | $647.61 | $1,467.34 | 1.6× |
| Contrast Xray Throat/Cerv Esopha (74210) | $745.43 | $1,688.97 | 3.7× |
| Corpora cavernosography (74445) | $482.05 | $1,092.21 | 4.0× |
| CT abdomen and pelvis without and with contrast (74178) | $5,978.98 | $13,547.07 | 14.9× |
| CT abdomen and pelvis without contrast (74176) | $4,530.95 | $10,266.14 | 16.5× |
| CT abdomen w contrast (74160) | $2,717.37 | $6,156.96 | 13.5× |
| CT abdomen w wo contrast (74170) | $2,921.17 | $6,618.73 | 14.5× |
| CT abdomen w/o contrast (74150) | $2,219.18 | $5,028.18 | 18.4× |
| CT Angio Abdomen and Pelvis (74174) | $5,897.76 | $13,363.05 | 14.7× |
| CT Angio Chest (71275) | $3,477.61 | $7,879.51 | 17.2× |
| CT Angio Head (70496) | $2,674.41 | $6,059.64 | 13.2× |
| CT angio hrt w/3d image (75574) | $1,456.74 | $3,300.66 | 3.6× |
| CT Angio Neck (70498) | $2,808.13 | $6,362.62 | 13.9× |
| CT cervical spine w/ contrast (72126) | $2,237.16 | $5,068.91 | 5.6× |
| CT cervical spine w/o contrast (72125) | $2,033.78 | $4,608.10 | 16.9× |
| CT cervical spine w/wo cont (72127) | $2,440.54 | $5,529.72 | 12.1× |
| CT chest w contrast (71260) | $2,698.93 | $6,115.19 | 13.4× |
| CT chest w/wo contrast (71270) | $2,914.85 | $6,604.41 | 14.4× |
| CT colonography screening (74263) | $1,426.88 | $3,233 | 5.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,169.53 | $2,649.90 | 5.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,063.21 | $2,409 | 8.8× |
| CT head/brain with contrast (70460) | $2,114.95 | $4,792.01 | 10.5× |
| CT head/brain without and with contrast (70470) | $2,368.74 | $5,367.05 | 11.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,456.74 | $3,300.66 | 3.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $114.93 | $260.40 | 1.1× |
| CT hrt w/3d image congen (75573) | $1,456.74 | $3,300.66 | 3.6× |
| CT iac w contrast (70481) | $2,084.83 | $4,723.77 | 10.3× |
| CT l-spine w&w/o contrast (72133) | $2,213.64 | $5,015.62 | 11.0× |
| CT lumbar spine w contrast (72132) | $2,029.17 | $4,597.65 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,844.70 | $4,179.68 | 15.3× |
| CT maxillofacial w contrast (70487) | $1,886.58 | $4,274.58 | 9.3× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$371.13–$1,855.65 | $840.90–$4,204.50 | varies |
| CT neck tissue combo (70492) | $2,538.36 | $5,751.36 | 12.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,116.66 | $4,795.89 | 10.5× |
| CT orbits w/o contrast (70480) | $1,909.77 | $4,327.12 | 15.9× |
| CT pelvis w&w/o contrast (72194) | $2,667.54 | $6,044.06 | 13.2× |
| CT pelvis w/o contrast (72192) | $2,000.66 | $4,533.05 | 16.6× |
| CT scans face/jaw combo (70488) | $2,118.54 | $4,800.14 | 10.5× |
| CT soft tissue neck w contrast (70491) | $2,086.32 | $4,727.15 | 10.3× |
| CT soft tissue neck w/o contrast (70490) | $1,860.30 | $4,215.04 | 15.5× |
| CT thoracic spine w contrast (72129) | $2,130.63 | $4,827.54 | 10.5× |
| CT thoracic spine w/o contrast (72128) | $1,936.94 | $4,388.67 | 16.1× |
| CT thoracic spine w/wo cont (72130) | $2,324.32 | $5,266.40 | 11.5× |
| CT thorax w/o contrast (71250) | $2,402.05 | $5,442.52 | 20.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,686.01 | $6,085.91 | 13.3× |
| Cta Abdomen (74175) | $2,830.93 | $6,414.26 | 14.0× |
| CTA pelvis (72191) | $2,541.53 | $5,758.56 | 12.6× |
| Dilation ureters/urethra rs&i (74485) | $1,590.11 | $3,602.83 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $3,080.86 | $6,980.56 | 1.4× |
| Diskography lumbar (72295) | $2,934.15 | $6,648.14 | 1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $378.03 | $856.53 | 3.1× |
| Dxa Bone Density Axial (77080) | $525.90 | $1,191.56 | 4.4× |
| Dxa bone density study (77085) | $845.82 | $1,916.43 | 7.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $226.15 | $512.39 | 2.3× |
| Echo exam of fetal heart (76825) | $825.64 | $1,870.72 | 1.3× |
| Echo exam uterus (76831) | $674.11 | $1,527.38 | 2.5× |
| Echo Guide For Artery Repair (76936) | $736.20 | $1,668.07 | 3.0× |
| Echograp Trans R Pros Study (76873) | $751.55 | $1,702.84 | 6.2× |
| Esophageal Motility Study (78258) | $689.77 | $1,562.87 | 1.5× |
| Esophagram (74220) | $815.34 | $1,847.38 | 4.0× |
| Fetal Biophys Profile W/Nst (76818) | $546.99 | $1,239.35 | 4.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $512.80 | $1,161.89 | 4.3× |
| Fluoroscopy up to 1 hr (76000) | $588.05 | $1,332.38 | 2.1× |
| Follow-Up Angiography (75898) | $3,257.10 | $7,379.87 | 0.9× |
| Gastric emptying imaging study (78264) | $1,548.41 | $3,508.36 | 3.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,007.92 | $4,549.51 | 4.4× |
| Gastroesophageal Reflux Exam (78262) | $1,182.95 | $2,680.31 | 2.6× |
| Gated Heart Planar Single (78472) | $1,630.70 | $3,694.80 | 3.5× |
| Gated Heart, Multiple (78473) | $2,024.78 | $4,587.71 | 4.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,403.12 | $5,444.94 | 3.8× |
| Heart first pass single,planar (78481) | $1,225.38 | $2,776.43 | 2.0× |
| Heart Image (Pet) Multiple (78492) | $4,544.59 | $10,297.06 | 2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,267.62 | $7,403.71 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,111.79 | $4,784.86 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,794.42 | $4,065.77 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,704.70 | $3,862.48 | 3.7× |
| Ht Musc Image Planar Mult (78454) | $1,855.23 | $4,203.55 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $3,026.28 | $6,856.88 | 2.0× |
| Hysterosalpingogram (74740) | $575.72 | $1,304.45 | 2.1× |
| Image fusion (77399) | $907.31 | $2,055.75 | 5.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $451.90 | $1,023.90 | 4.5× |
| Infant hip ultrasound, limited static exam (76886) | $402.95 | $912.98 | 4.0× |
| Interstitial radiation source applic complex (77778) | $3,405.19 | $7,715.41 | 4.2× |
| Joint Survey Single View (77077) | $242.49 | $549.42 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $1,557.41 | $3,528.74 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $1,483.25 | $3,360.71 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,458.53 | $3,304.70 | 2.3× |
| Kidney Imaging Morphol (78700) | $1,013.55 | $2,296.48 | 2.2× |
| Leveen/Shunt Patency Exam (78291) | $828.16 | $1,876.42 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,088.86 | $2,467.11 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,170.77 | $2,652.70 | 2.5× |
| Liver imaging static only (78201) | $1,129.68 | $2,559.61 | 1.8× |
| Liver imaging w/vascular flow (78202) | $1,089.58 | $2,468.75 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,757.32 | $3,981.69 | 2.8× |
| Lung perfusion differential (78597) | $1,167.25 | $2,644.72 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,722.83 | $3,903.56 | 2.8× |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$740.82–$871.80 | $1,678.53–$1,975.30 | varies |
| Lymph System Imaging (78195) | $1,732.78 | $3,926.10 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,124.55 | $2,547.98 | 0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,755.78 | $6,244 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $1,931.30 | $4,375.90 | 7.0× |
| Mammary ductogram or galactogram multiple (77054) | $701.81 | $1,590.13 | 2.6× |
| Mammary ductogram or galactogram single (77053) | $653.16 | $1,479.92 | 2.4× |
| Meckels Divert Exam (78290) | $916.98 | $2,077.66 | 2.0× |
| Mlc imrt design & construction per imrt plan (77338) | $3,058.77 | $6,930.50 | 7.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $27.03 | $61.23 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $101.29 | $229.48 | 0.9× |
| Mr safety implt pos&/immoblj (76019) | $65.55 | $148.50 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $266.71 | $604.30 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,248.34 | $7,360.03 | 8.1× |
| MRA head w/o contrast (70544) | $2,209.75 | $5,006.82 | 8.0× |
| MRA head with contrast (70545) | $2,408.63 | $5,457.43 | 6.0× |
| MRA neck w contrast (70548) | $2,340.76 | $5,303.64 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,715.49 | $8,418.49 | 9.2× |
| MRA neck w/o contrast (70547) | $2,154.99 | $4,882.73 | 7.8× |
| MRI abdomen w contrast (74182) | $2,781.61 | $6,302.52 | 6.9× |
| MRI abdomen w/o contrast (74181) | $1,972.42 | $4,469.06 | 7.2× |
| MRI bone marrow blood supply (77084) | $1,921.44 | $4,353.55 | 7.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,167.89 | $4,911.97 | 7.9× |
| MRI cardiac w/o cont stress (75559) | $1,773.43 | $4,018.19 | 2.8× |
| MRI cardiac w/o contrast (75557) | $1,554.03 | $3,521.09 | 5.7× |
| MRI cervical spine w contrast (72142) | $2,935.68 | $6,651.60 | 7.3× |
| MRI cervical spine w/o cont (72141) | $2,887.55 | $6,542.56 | 10.5× |
| MRI chest w/o contrast (71550) | $2,311.17 | $5,236.60 | 8.4× |
| MRI chest with contrast (71551) | $2,786.07 | $6,312.62 | 3.1× |
| MRI chest wo w contrast (71552) | $3,799.18 | $8,608.12 | 9.5× |
| MRI lumbar spine w contrast (72149) | $3,068.87 | $6,953.40 | 7.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,644.14 | $10,522.61 | 11.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,957.73 | $4,435.79 | 7.1× |
| MRI orbit face neck w contrast (70542) | $2,651.09 | $6,006.80 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,078.61 | $9,241.24 | 10.2× |
| MRI pelvis w contrast (72196) | $2,462.51 | $5,579.52 | 6.1× |
| MRI pelvis w/o & w contrast (72197) | $4,104.19 | $9,299.20 | 10.2× |
| MRI pelvis w/o contrast (72195) | $2,257.31 | $5,114.56 | 8.2× |
| MRI spectroscopy (76390) | $1,101.34 | $2,495.39 | 11.0× |
| MRI thoracic spine w/o contrast (72146) | $3,021.84 | $6,846.83 | 11.0× |
| MRI, abdomen, combo (74183) | $3,793.10 | $8,594.35 | 9.4× |
| MRI, dorsal spine combo (72157) | $4,648.98 | $10,533.58 | 11.6× |
| MRI, dorsal spine contrast (72147) | $3,068.33 | $6,952.16 | 7.6× |
| MRI, lumbar spine combo (72158) | $4,653.62 | $10,544.09 | 11.6× |
| Myelogram cervical (72240) | $1,538.90 | $3,486.81 | 1.7× |
| Myelogram Lumbar (72265) | $1,538.90 | $3,486.81 | 1.7× |
| Myelography thoracic (72255) | $1,538.90 | $3,486.81 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,757.37 | $3,981.82 | 1.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,175.48 | $2,663.37 | 2.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,036.55 | $9,145.94 | 2.7× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,243.85 | $2,818.29 | 2.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,414.46 | $3,204.85 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $3,947.32 | $8,943.76 | 2.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,617.88 | $10,463.11 | 2.8× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $7,157.71 | $16,217.83 | 2.8× |
| N-invas est c ffr sw aly CTA (75580) | $2,194.83 | $4,973 | 2.2× |
| Neck soft tissue (70360) | $255.89 | $579.77 | 2.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $441.54 | $1,000.43 | 1.0× |
| Nm csf leak detection (78650) | $1,301.48 | $2,948.86 | 0.9× |
| Nm myocard infarct spect (78469) | $1,428.82 | $3,237.39 | 2.3× |
| Nonvascular Shunt X-Ray (75809) | $406.31 | $920.59 | 3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,581.22 | $12,645.84 | 3.5× |
| Nuclear Rx Intra-Arterial (79445) | $758.28 | $1,718.10 | 2.8× |
| Nuclear Rx Oral Admin (79005) | $1,031.41 | $2,336.94 | 3.8× |
| Ob us nuchal meas 1 gest (76813) | $497.14 | $1,126.41 | 4.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $561.56 | $1,272.37 | 4.7× |
| Optic foramina (70190) | $169.25 | $383.47 | 1.7× |
| Parathyroid Planar Imaging (78070) | $1,274.70 | $2,888.18 | 2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,111.31 | $7,049.54 | 6.8× |
| Pelvis 1 or 2 views (72170) | $366.16 | $829.63 | 3.0× |
| Perineogram (74775) | $478.69 | $1,084.60 | 1.7× |
| Peritoneogram Rs&I (74190) | $432.24 | $979.36 | 0.7× |
| Pet Image Skull-Thigh (78812) | $4,460.97 | $10,107.60 | 2.7× |
| Pet Image W/Ct Lmtd (78814) | $4,349.76 | $9,855.62 | 2.6× |
| PET image w/CT, full body (78816) | $4,803.65 | $10,884.03 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,538.88 | $10,284.12 | 2.8× |
| Pet Myocardial Sngl Study (78491) | $4,425.36 | $10,026.90 | 2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,471.45 | $7,865.55 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,016.47 | $2,303.10 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $485.53 | $1,100.10 | 4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $501.03 | $1,135.21 | 0.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $360.84 | $817.57 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $376.40 | $852.84 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $340.07 | $770.52 | 3.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $184.53 | $418.09 | 1.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $287.38 | $651.13 | 2.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,046.24 | $2,370.55 | 5.2× |
| Radex Spine 1 View Specify Level (72020) | $270.58 | $613.06 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $288.11 | $652.79 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $376.82 | $853.78 | 3.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,658.74 | $3,758.33 | 13.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $9,078.67 | $20,570.30 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $581.87 | $1,318.38 | 5.0× |
| Radiation treatment delivery level 2 (77407) | $689.23 | $1,561.63 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $924.15 | $2,093.92 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $411.96 | $933.40 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $442.24 | $1,002 | 3.7× |
| Radiologic exam colon double contrast study (74280) | $822.61 | $1,863.85 | 4.1× |
| Radiologic exam colon single contrast study (74270) | $676.12 | $1,531.93 | 3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $809.28 | $1,833.65 | 4.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $413.76 | $937.48 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $925.88 | $2,097.83 | 4.6× |
| Radiologic exam swallow function contrast study (74230) | $853 | $1,932.70 | 4.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $802.59 | $1,818.49 | 4.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $444.53 | $1,007.19 | 3.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $200.21 | $453.63 | 2.0× |
| Radiopharm Dacryocystography (78660) | $936.65 | $2,122.23 | 2.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,093.27 | $2,477.11 | 4.1× |
| Renal Cyst Study (74470) | $742.07 | $1,681.37 | 1.2× |
| Ribs bilateral 3 views (71110) | $352.43 | $798.51 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,012.17 | $2,293.34 | 2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,299.20 | $2,943.69 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,356.68 | $5,339.71 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,722.18 | $3,902.09 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,812.83 | $4,107.47 | 2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,356.68 | $5,339.71 | 1.6× |
| Rp Therapy Intravenous Administration (79101) | $1,082.98 | $2,453.78 | 4.0× |
| Salivary Gland Imaging Serial Images (78231) | $858.12 | $1,944.30 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $125.97 | $285.40 | 5.4× |
| Sella turcica (70240) | $130.59 | $295.88 | 1.3× |
| Sialogram (70390) | $516.43 | $1,170.11 | 1.9× |
| Skull less than 4 views (70250) | $362.82 | $822.07 | 3.0× |
| Special dosimetry (77331) | $398.17 | $902.15 | 2.6× |
| Special teletherapy port plan (77321) | $1,288.11 | $2,918.58 | 3.0× |
| Special treatment procedure (77470) | $3,374.98 | $7,646.96 | 5.3× |
| Speech evaluation, complex (70371) | $653.79 | $1,481.33 | 2.4× |
| Srs Multisource (77371) | $50,594.45 | $114,636.17 | 6.0× |
| Stereotactic Body Radiation Delivery (77373) | $5,861.12 | $13,280.03 | 2.8× |
| Sternoclavicular joints (71130) | $273.71 | $620.15 | 2.7× |
| Superior sagittal sinus venogram (75870) | $1,694.88 | $3,840.23 | 0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,709.27 | $3,872.82 | 4.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,267.71 | $2,872.34 | 2.9× |
| Testicular Imaging W/Flow (78761) | $918.89 | $2,081.99 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,437.24 | $5,522.26 | 5.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,706.07 | $3,865.58 | 4.0× |
| Ther rad simulaj-aided field setting simple (77280) | $1,198.31 | $2,715.11 | 7.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $351.46 | $796.33 | 1.7× |
| Thoracic spine 2 views (72070) | $360.44 | $816.67 | 3.0× |
| Thoracic spine 3 views (72072) | $411.50 | $932.37 | 3.4× |
| Thoracolumbar 2 views (72080) | $308.11 | $698.11 | 3.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $959.16 | $2,173.24 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $857.64 | $1,943.22 | 1.9× |
| Thyroid Met Imaging Body (78018) | $1,621.11 | $3,673.08 | 2.6× |
| Thyroid Uptake Measurement (78012) | $460.03 | $1,042.31 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,008.99 | $2,286.14 | 2.2× |
| Tx Devices Design & Construction Complex (77334) | $1,281.95 | $2,904.61 | 3.0× |
| Tx devices design & construction intermediate (77333) | $792.22 | $1,794.99 | 5.1× |
| Tx devices design & construction simple (77332) | $559.70 | $1,268.15 | 3.6× |
| Ultrasound elastography first target lesion (76982) | $237.41 | $537.91 | 2.0× |
| Ultrasound Elastography Parenchyma (76981) | $237.41 | $537.91 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $482.12 | $1,092.36 | 4.0× |
| Ultrasound, abdomen limited (76705) | $580.52 | $1,315.32 | 4.8× |
| Umbilical-artery Doppler (OB) (76820) | $341.52 | $773.80 | 2.8× |
| Unlisted fluoroscopic procedure (76496) | $688.15 | $1,559.18 | 6.9× |
| Unlisted magnetic resonance procedure (76498) | $2,162.11 | $4,898.87 | 21.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$1,224.37–$3,187.95 | $2,774.14–$7,223.20 | varies |
| Upper gi w/o kub (74240) | $924.98 | $2,095.80 | 4.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $181.18 | $410.50 | 16.4× |
| Urea breath test c-14 isotopic analysis (78268) | $335.26 | $759.62 | 3.6× |
| Ureteral Reflux Study (78740) | $925.39 | $2,096.72 | 2.0× |
| Urethrocystogram voiding (74455) | $834.62 | $1,891.05 | 3.0× |
| Urethrocystography retrograde (74450) | $642.01 | $1,454.65 | 2.3× |
| Us chest (76604) | $541.60 | $1,227.14 | 4.5× |
| Us exam, pelvic, limited (76857) | $506.49 | $1,147.59 | 4.2× |
| Us head (76506) | $462.02 | $1,046.83 | 3.8× |
| Us ob detailed single fetus (76811) | $950.92 | $2,154.58 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $428.11 | $969.99 | 3.6× |
| Us ob transvaginal (76817) | $564.53 | $1,279.10 | 4.7× |
| Us pelvic non ob complete (76856) | $706.73 | $1,601.29 | 5.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $666.79 | $1,510.79 | 5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $413.99 | $938.01 | 3.4× |
| Us retroperitoneal complete (76770) | $773.11 | $1,751.68 | 6.4× |
| Us retroperitoneal limited (76775) | $530.93 | $1,202.97 | 4.4× |
| Us scrotum and contents (76870) | $629.58 | $1,426.49 | 5.2× |
| Us spinal canal and contents (76800) | $531.52 | $1,204.31 | 4.4× |
| Us thyroid (76536) | $539.77 | $1,222.99 | 4.5× |
| Us transrectal (76872) | $570.96 | $1,293.66 | 4.7× |
| Vascular Flow Imaging (78445) | $465.56 | $1,054.85 | 1.0× |
| Vein X-Ray Chest (75827) | $3,573.96 | $8,097.82 | 2.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,118.50 | $4,800.06 | 0.6× |
| Vein X-Ray Spleen/Liver (75810) | $1,998.55 | $4,528.28 | 0.5× |
| Venogram Sinus/Jugular (75860) | $2,087.93 | $4,730.78 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $3,762.06 | $8,524.02 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,443.69 | $3,271.07 | 0.8× |
| Venography Renal Bilateral (75833) | $2,402.25 | $5,442.97 | 0.7× |
| Venous sampling by catheter (75893) | $3,412.78 | $7,732.62 | 0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $874.62 | $1,981.68 | 1.9× |
| Vertebral fracture assessment via dxa (77086) | $247.68 | $561.18 | 2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $349.71 | $792.35 | 3.5× |
| X-ray antegrade pyelogram tube (74425) | $614.72 | $1,392.82 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $4,115.19 | $9,324.12 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $436.23 | $988.39 | 3.6× |
| X-Ray Exam Breast Specimen (76098) | $439.74 | $996.35 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $979.66 | $2,219.69 | 9.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,335.89 | $3,026.84 | 11.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,547.41 | $3,506.09 | 12.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $305.62 | $692.45 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $340.09 | $770.55 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $374.55 | $848.64 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $593.66 | $1,345.10 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $393.59 | $891.78 | 3.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $616.62 | $1,397.12 | 5.1× |
| X-ray eye for foreign body (70030) | $253.79 | $575.03 | 2.5× |
| X-ray IV pyelogram (ivp) (74400) | $892.61 | $2,022.45 | 4.4× |
| X-ray IV pyelogram+tomography (74415) | $968.40 | $2,194.17 | 4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $255.41 | $578.70 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $280.90 | $636.45 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $393.59 | $891.78 | 3.3× |
| X-ray nose-rectum child f.b. (76010) | $238.66 | $540.74 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $444 | $1,006 | 3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $359.24 | $813.95 | 3.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $239.49 | $542.63 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $320.32 | $725.77 | 3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $344.86 | $781.36 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $510.98 | $1,157.75 | 4.2× |
| X-Ray Stress View (77071) | $344.42 | $780.36 | 3.4× |
| X-ray thoracic spine 4 vw (72074) | $453.56 | $1,027.65 | 3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,010.50 | $2,289.56 | 2.5× |
| X-Rays Bone Length Studies (77073) | $366.47 | $830.33 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $635.04 | $1,438.85 | 5.3× |
| Xr c-spine 4 or 5 views (72050) | $554.30 | $1,255.92 | 4.6× |
| Xr facial bones less than 3 views (70140) | $288.67 | $654.06 | 2.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $271.08 | $614.20 | 2.3× |
| Xr myelogram posterior fossa (70010) | $1,307.41 | $2,962.29 | 3.3× |
| Xr orbits complete 4 views (70200) | $383.20 | $868.24 | 3.2× |
| Xr Tomogram Single Plane (76100) | $493.79 | $1,118.82 | 4.1× |
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.