Imaging prices at Saint Vincent Hospital
Worcester, MA · every code in this section with a posted price and a Medicare benchmark.
379 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) | $6,273.75 | $8,365 | 3.8× |
| Abdomen 1 View (74018) | $489 | $652 | 4.7× |
| Abdomen 2 views (74019) | $621.75 | $829 | 5.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,706 | $3,608 | 5.6× |
| Adrenal Cortex & Medulla Img (78075) | $4,864.50 | $6,486 | 3.1× |
| Angio internal mammary (75756) | $7,624.50 | $10,166 | 2.0× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$7,517.25–$9,063.75 | $10,023–$12,085 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $17,713.50 | $23,618 | 4.7× |
| Angiography extremity bilateral rs&i (75716) | $9,109.50 | $12,146 | 2.4× |
| Angiography extremity unilateral rs&i (75710) | $12,981.75 | $17,309 | 3.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$7,248.75–$13,314 | $9,665–$17,752 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$5,190–$7,720.50 | $6,920–$10,294 | varies |
| Ankle 2 views (73600) | $978 | $1,304 | 9.4× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$8,452.50–$12,647.25 | $11,270–$16,863 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $9,851.25 | $13,135 | 2.6× |
| Artery X-Rays Abdomen (75726) | $14,123.25 | $18,831 | 2.1× |
| Artery X-Rays Pelvis (75736) | $10,509.75 | $14,013 | 1.6× |
| Artery X-Rays Spine (75705) | $12,364.50 | $16,486 | 1.9× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$2,141.25–$3,107.25 | $2,855–$4,143 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,688.25–$2,736 | $2,251–$3,648 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,317.75–$3,107.25 | $1,757–$4,143 | varies |
| Basic radiation dosimetry calculation (77300) | $496.50 | $662 | 3.1× |
| Bone age studies (77072) | $471 | $628 | 3.8× |
| Bone Imaging 3 Phase (78315) | $3,644.25 | $4,859 | 7.6× |
| Bone Imaging Limited Area (78300) | $1,944 | $2,592 | 4.1× |
| Bone Imaging Multiple Areas (78305) | $3,163.50 | $4,218 | 6.6× |
| Bone Imaging Whole Body (78306) | $3,850.50 | $5,134 | 8.0× |
| Bone marrow imaging; whole body (78104) | $2,076.75 | $2,769 | 4.3× |
| Bone survey infant (77076) | $860.25 | $1,147 | 6.9× |
| Brachytx isodose complex (77318) | $3,167.25 | $4,223 | 7.1× |
| Brachytx isodose intermed (77317) | $4,323.75 | $5,765 | 9.6× |
| Brachytx Isodose Plan Simple (77316) | $1,554 | $2,072 | 3.5× |
| Brain Flow Imaging Only (78610) | $2,649.75 | $3,533 | 4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,280 | $3,040 | 3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,504.50 | $10,006 | 4.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $6,522 | $8,696 | 15.6× |
| Cat Scan Follow-Up Study (76380) | $3,026.25 | $4,035 | 29.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,161.50 | $2,882 | 3.3× |
| Cerebrospinal Fluid Scan (78630) | $2,814 | $3,752 | 4.3× |
| Chest 1 view (71045) | $444.75 | $593 | 4.3× |
| Chest 2 views (71046) | $450.75 | $601 | 4.3× |
| Chest 3 views (71047) | $334.50 | $446 | 3.2× |
| Chest 4 or more views (71048) | $607.50 | $810 | 4.8× |
| Clavicle complete (73000) | $1,039.50 | $1,386 | 10.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $300 | $400 | 2.4× |
| Continuing medical physics consltj pr wk (77336) | $951.75 | $1,269 | 5.9× |
| Contrast Exam Abdominl Aorta (75625) | $9,956.25 | $13,275 | 2.6× |
| Contrast X-Ray Bladder (74430) | $2,307.75 | $3,077 | 5.5× |
| Contrast X-Ray Of Elbow (73085) | $3,107.25 | $4,143 | 7.4× |
| Contrast X-Ray Of Knee Joint (73580) | $2,280.75 | $3,041 | 5.5× |
| CT abdomen and pelvis without and with contrast (74178) | $7,863 | $10,484 | 18.8× |
| CT abdomen and pelvis without contrast (74176) | $5,550 | $7,400 | 19.4× |
| CT abdomen w contrast (74160) | $3,078 | $4,104 | 14.6× |
| CT abdomen w wo contrast (74170) | $2,382 | $3,176 | 11.3× |
| CT abdomen w/o contrast (74150) | $2,061 | $2,748 | 16.4× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$886.50–$8,030.25 | $1,182–$10,707 | varies |
| CT Angio Chest (71275) | $4,120.50 | $5,494 | 19.6× |
| CT Angio Head (70496) | $3,825.75 | $5,101 | 18.2× |
| CT angio hrt w/3d image (75574) | $2,239.50 | $2,986 | 5.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,377.25–$3,706.50 | $4,503–$4,942 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$434.25–$4,980 | $579–$6,640 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$4,467.75–$4,578 | $5,957–$6,104 | varies |
| CT cervical spine w/ contrast (72126) | $3,582 | $4,776 | 8.6× |
| CT cervical spine w/o contrast (72125) | $3,248.25 | $4,331 | 25.9× |
| CT cervical spine w/wo cont (72127) | $7,481.25 | $9,975 | 35.6× |
| CT chest w contrast (71260) | $3,990 | $5,320 | 19.0× |
| CT chest w/wo contrast (71270) | $2,382 | $3,176 | 11.3× |
| CT head/brain with contrast (70460) | $1,434 | $1,912 | 6.8× |
| CT head/brain without and with contrast (70470) | $3,624.75 | $4,833 | 17.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,498.75 | $4,665 | 8.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $291.75 | $389 | 2.8× |
| CT hrt w/3d image congen (75573) | $2,441.25 | $3,255 | 5.8× |
| CT iac w contrast (70481) | $2,692.50 | $3,590 | 12.8× |
| CT l-spine w&w/o contrast (72133) | $6,093 | $8,124 | 29.0× |
| CT lower ext w/o (73700) | $3,609 | $4,812 | 28.8× |
| CT lower extremity w/contrast material (73701) | $3,203.25 | $4,271 | 15.2× |
| CT lumbar spine w contrast (72132) | $3,488.25 | $4,651 | 8.3× |
| CT lumbar spine w/o contrast (72131) | $4,456.50 | $5,942 | 35.6× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$434.25–$4,415.25 | $579–$5,887 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$256.50–$3,642.75 | $342–$4,857 | varies |
| CT neck tissue combo (70492) | $3,273 | $4,364 | 15.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $7,763.25 | $10,351 | 36.9× |
| CT orbits w/o contrast (70480) | $2,628.75 | $3,505 | 21.0× |
| CT pelvis w&w/o contrast (72194) | $2,598 | $3,464 | 12.4× |
| CT pelvis w/o contrast (72192) | $2,154.75 | $2,873 | 17.2× |
| CT scan of leg combo (73702) | $2,772.75 | $3,697 | 13.2× |
| CT scans face/jaw combo (70488) | $5,487.75 | $7,317 | 26.1× |
| CT soft tissue neck w contrast (70491) | $4,361.25 | $5,815 | 20.7× |
| CT soft tissue neck w/o contrast (70490) | $2,429.25 | $3,239 | 19.4× |
| CT thoracic spine w contrast (72129) | $3,975 | $5,300 | 18.9× |
| CT thoracic spine w/o contrast (72128) | $1,833 | $2,444 | 14.6× |
| CT thoracic spine w/wo cont (72130) | $4,458 | $5,944 | 21.2× |
| CT thorax w/o contrast (71250) | $3,367.50 | $4,490 | 26.9× |
| CT unlisted procedure (76497) | $2,562.75 | $3,417 | 24.6× |
| CT upper ext wo (73200) | $3,178.50 | $4,238 | 25.4× |
| CT upper extremity w/o & w/contrast material (73202) | $4,578 | $6,104 | 21.8× |
| CT upper extremity with contrast (73201) | $2,714.25 | $3,619 | 6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$434.25–$4,649.25 | $579–$6,199 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,330.25–$3,898.50 | $3,107–$5,198 | varies |
| CTA pelvis (72191) | $5,984.25 | $7,979 | 28.5× |
| Dilation ureters/urethra rs&i (74485) | $4,193.25 | $5,591 | 1.7× |
| Diskography lumbar (72295) | $10,802.25 | $14,403 | 4.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,086 | $1,448 | 8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,641.75 | $2,189 | 13.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $703.50 | $938 | 5.6× |
| Dxa Bone Density Axial (77080) | $1,692 | $2,256 | 13.5× |
| Dxa bone density study (77085) | $192 | $256 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,039.50 | $1,386 | 10.0× |
| Echo exam uterus (76831) | $2,016.75 | $2,689 | 7.1× |
| Echograp Trans R Pros Study (76873) | $1,263 | $1,684 | 10.1× |
| Esophagram (74220) | $1,588.50 | $2,118 | 7.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$1,556.25–$1,818.75 | $2,075–$2,425 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,529.25 | $2,039 | 12.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$416.25–$1,001.25 | $555–$1,335 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,460.50–$7,166.25 | $4,614–$9,555 | varies |
| Foot 2 views (73620) | $744 | $992 | 7.1× |
| Forearm 2 views (73090) | $1,036.50 | $1,382 | 9.9× |
| Gastric emptying imaging study (78264) | $1,419 | $1,892 | 3.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $4,359.75 | $5,813 | 9.1× |
| Gastroesophageal Reflux Exam (78262) | $1,725 | $2,300 | 3.6× |
| Gated Heart Planar Single (78472) | $4,261.50 | $5,682 | 8.9× |
| Gated Heart, Multiple (78473) | $3,829.50 | $5,106 | 8.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $5,784 | $7,712 | 8.9× |
| Hand 2 views (73120) | $887.25 | $1,183 | 7.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $7,166.25 | $9,555 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $13,273.50 | $17,698 | 3.5× |
| Hepatobil Syst Image W/Drug (78227) | $4,492.50 | $5,990 | 6.9× |
| Hepatobiliary System Imaging (78226) | $2,354.25 | $3,139 | 4.9× |
| Ht Musc Image Planar Mult (78454) | $5,746.50 | $7,662 | 3.7× |
| Ht Muscle Image Spect Sing (78451) | $4,653.75 | $6,205 | 3.0× |
| Hysterosalpingogram (74740) | $2,723.25 | $3,631 | 9.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $900.75 | $1,201 | 8.6× |
| Interstitial radiation source applic complex (77778) | $3,671.25 | $4,895 | 4.4× |
| K Flow/Funct Image Multiple (78709) | $1,578.75 | $2,105 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $3,820.50 | $5,094 | 5.9× |
| K Flow/Funct Image W/O Drug (78707) | $3,549.75 | $4,733 | 5.5× |
| Kidney Imaging Morphol (78700) | $1,623.75 | $2,165 | 3.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,862.25 | $2,483 | 3.9× |
| Knee 3 Views (73562) | $1,073.25 | $1,431 | 10.3× |
| Leveen/Shunt Patency Exam (78291) | $2,350.50 | $3,134 | 4.9× |
| Liver & Spleen Imaging Static Only (78215) | $2,703.75 | $3,605 | 5.6× |
| Liver imaging static only (78201) | $4,363.50 | $5,818 | 6.7× |
| Lung Perf&Ventilat Diferentl (78598) | $2,182.50 | $2,910 | 3.4× |
| Lung perfusion differential (78597) | $1,797 | $2,396 | 3.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,883 | $3,844 | 4.4× |
| Lung Ventilation Imaging (78579) | $1,604.25 | $2,139 | 3.3× |
| Lymph System Imaging (78195) | $4,437.75 | $5,917 | 6.8× |
| Magnetic Image Jaw Joint (70336) | $2,833.50 | $3,778 | 9.9× |
| Mammary ductogram or galactogram multiple (77054) | $1,516.50 | $2,022 | 5.3× |
| Mammary ductogram or galactogram single (77053) | $1,921.50 | $2,562 | 6.7× |
| Meckels Divert Exam (78290) | $1,723.50 | $2,298 | 3.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,390.50 | $1,854 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $360 | $480 | 3.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $99.75 | $133 | 2.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $375 | $500 | 3.3× |
| Mr safety implt pos&/immoblj (76019) | $243 | $324 | 3.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $987.75 | $1,317 | 3.5× |
| Mra Head W/O & W/Contrast Material (70546) | $5,155.50 | $6,874 | 12.3× |
| MRA head w/o contrast (70544) | $4,718.25 | $6,291 | 16.5× |
| MRA head with contrast (70545) | $2,427.75 | $3,237 | 5.8× |
| MRA neck w contrast (70548) | $2,427.75 | $3,237 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,155.50 | $6,874 | 12.3× |
| MRA neck w/o contrast (70547) | $4,184.25 | $5,579 | 14.6× |
| MRI abdomen w contrast (74182) | $6,868.50 | $9,158 | 16.4× |
| MRI abdomen w/o contrast (74181) | $8,108.25 | $10,811 | 28.4× |
| MRI any jt lower extrem w/contrast material (73722) | $7,279.50 | $9,706 | 7.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $8,351.25 | $11,135 | 20.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,804.75 | $9,073 | 7.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $10,817.25 | $14,423 | 37.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $11,128.50 | $14,838 | 38.9× |
| MRI cervical spine w contrast (72142) | $6,405 | $8,540 | 15.3× |
| MRI cervical spine w/o cont (72141) | $5,655.75 | $7,541 | 19.8× |
| MRI chest w/o contrast (71550) | $4,108.50 | $5,478 | 14.4× |
| MRI chest with contrast (71551) | $6,756.75 | $9,009 | 7.2× |
| MRI chest wo w contrast (71552) | $3,770.25 | $5,027 | 9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $10,835.25 | $14,447 | 25.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $10,093.50 | $13,458 | 24.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,931.50 | $9,242 | 24.2× |
| MRI lumbar spine w contrast (72149) | $5,532 | $7,376 | 13.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $6,786 | $9,048 | 16.2× |
| MRI orbit face &/neck w/o contrast (70540) | $3,357.75 | $4,477 | 11.7× |
| MRI orbit face neck w contrast (70542) | $5,742.75 | $7,657 | 13.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,824.25 | $9,099 | 16.3× |
| MRI pelvis w contrast (72196) | $8,226.75 | $10,969 | 19.7× |
| MRI pelvis w/o & w contrast (72197) | $8,067 | $10,756 | 19.3× |
| MRI pelvis w/o contrast (72195) | $6,234.75 | $8,313 | 21.8× |
| MRI thoracic spine w/o contrast (72146) | $5,800.50 | $7,734 | 20.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $9,723 | $12,964 | 23.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,897.50 | $6,530 | 17.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,721.50 | $8,962 | 16.1× |
| MRI, abdomen, combo (74183) | $11,900.25 | $15,867 | 28.5× |
| MRI, dorsal spine combo (72157) | $7,523.25 | $10,031 | 18.0× |
| MRI, dorsal spine contrast (72147) | $8,958 | $11,944 | 21.4× |
| MRI, joint upper extrem (73221) | $12,876.75 | $17,169 | 45.0× |
| MRI, joint upper extrem combo (73223) | $5,671.50 | $7,562 | 13.6× |
| MRI, lumbar spine combo (72158) | $15,123.75 | $20,165 | 36.2× |
| Myelogram cervical (72240) | $1,899.75 | $2,533 | 2.0× |
| Myelogram Lumbar (72265) | $1,859.25 | $2,479 | 2.0× |
| Myelography thoracic (72255) | $2,589.75 | $3,453 | 2.8× |
| Myelograpy 2/more regions rs&i (72270) | $5,813.25 | $7,751 | 6.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $4,672.50 | $6,230 | 9.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,488 | $5,984 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $8,033.25 | $10,711 | 5.2× |
| Neck soft tissue (70360) | $811.50 | $1,082 | 7.8× |
| Nm csf leak detection (78650) | $2,109.75 | $2,813 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $1,514.25 | $2,019 | 12.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,205.25 | $5,607 | 2.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,830.75 | $2,441 | 6.5× |
| Nuclear Rx Oral Admin (79005) | $1,650.75 | $2,201 | 5.9× |
| Ob us nuchal meas 1 gest (76813) | $1,597.50 | $2,130 | 12.8× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $924.75 | $1,233 | 8.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $1,089 | $1,452 | 8.7× |
| Parathyroid Planar Imaging (78070) | $2,027.25 | $2,703 | 4.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $4,692 | $6,256 | 9.8× |
| Pelvis 1 or 2 views (72170) | $837.75 | $1,117 | 6.7× |
| Pet Image W/Ct Lmtd (78814) | $8,349.75 | $11,133 | 4.9× |
| PET image w/CT, full body (78816) | $8,995.50 | $11,994 | 5.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,530.50 | $11,374 | 5.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,166.25 | $9,555 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,521 | $2,028 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,137 | $1,516 | 9.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,080.75–$1,947 | $1,441–$2,596 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $1,307.25 | $1,743 | 12.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $672 | $896 | 6.4× |
| Radex elbow complete minimum 3 views (73080) | $1,125.75 | $1,501 | 10.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $890.25 | $1,187 | 7.1× |
| Radex fingr minimum 2 views (73140) | $783.75 | $1,045 | 7.5× |
| Radex foot complete minimum 3 views (73630) | $1,180.50 | $1,574 | 11.3× |
| Radex Hand Minimum 3 Views (73130) | $1,255.50 | $1,674 | 12.0× |
| Radex lower extremity infant minimum 2 views (73592) | $474.75 | $633 | 4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $695.25 | $927 | 6.7× |
| Radex Ribs Unilateral 2 Views (71100) | $784.50 | $1,046 | 7.5× |
| Radex shoulder complete minimum 2 views (73030) | $1,231.50 | $1,642 | 11.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $605.25 | $807 | 5.8× |
| Radex Spine 1 View Specify Level (72020) | $643.50 | $858 | 6.2× |
| Radex Sternum Minimum 2 Views (71120) | $794.25 | $1,059 | 7.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $362.25 | $483 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $350.25 | $467 | 3.4× |
| Radex upper extremity infant minimum 2 views (73092) | $941.25 | $1,255 | 7.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $1,086 | $1,448 | 10.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,036.50 | $1,382 | 8.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $51,601.50 | $68,802 | 5.8× |
| Radiation treatment delivery level 1 (77402) | $1,005.75 | $1,341 | 8.2× |
| Radiation treatment delivery level 2 (77407) | $1,617.75 | $2,157 | 3.5× |
| Radiation treatment delivery level 3 (77412) | $3,381 | $4,508 | 5.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $911.25 | $1,215 | 7.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $569.25 | $759 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $1,155.75 | $1,541 | 5.5× |
| Radiologic exam colon single contrast study (74270) | $1,080.75 | $1,441 | 5.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $154.50 | $206 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) | $1,062 | $1,416 | 8.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $809.25 | $1,079 | 6.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $812.25 | $1,083 | 3.9× |
| Radiologic exam swallow function contrast study (74230) | $830.25 | $1,107 | 3.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,944 | $2,592 | 9.2× |
| Radiologic examination femur 1 view (73551) | $337.50 | $450 | 3.2× |
| Radiologic examination femur minimum 2 views (73552) | $492.75 | $657 | 4.7× |
| Radiologic examination knee 1/2 views (73560) | $1,071.75 | $1,429 | 10.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $1,233 | $1,644 | 9.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,096.50 | $1,462 | 10.5× |
| Ribs bilateral 3 views (71110) | $855.75 | $1,141 | 6.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,674 | $2,232 | 3.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,913.75 | $3,885 | 6.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $7,109.25 | $9,479 | 10.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $9,162.75 | $12,217 | 14.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,549.25 | $3,399 | 3.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,936 | $5,248 | 2.5× |
| Rp Therapy Intravenous Administration (79101) | $1,743 | $2,324 | 6.2× |
| Scapula (73010) | $1,365 | $1,820 | 10.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$151.50–$717.75 | $202–$957 | varies |
| Shoulder 1 view (73020) | $470.25 | $627 | 4.5× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,659.75–$2,009.25 | $2,213–$2,679 | varies |
| Sialogram (70390) | $1,136.25 | $1,515 | 4.0× |
| Skull less than 4 views (70250) | $745.50 | $994 | 6.0× |
| Special dosimetry (77331) | $396 | $528 | 2.5× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$616.50–$1,715.25 | $822–$2,287 | varies |
| Special teletherapy port plan (77321) | $2,908.50 | $3,878 | 6.5× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,922–$4,130.25 | $3,896–$5,507 | varies |
| Spleen Imaging (78185) | $1,869.75 | $2,493 | 3.9× |
| Stereotactic Body Radiation Delivery (77373) | $20,670.75 | $27,561 | 9.6× |
| Sternoclavicular joints (71130) | $366 | $488 | 3.5× |
| Superior sagittal sinus venogram (75870) | $3,115.50 | $4,154 | 0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,185 | $5,580 | 9.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,097.75 | $2,797 | 4.7× |
| Testicular Imaging W/Flow (78761) | $2,049.75 | $2,733 | 4.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,593.50 | $7,458 | 12.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,260.50 | $3,014 | 5.0× |
| Ther rad simulaj-aided field setting simple (77280) | $1,388.25 | $1,851 | 8.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $3,711 | $4,948 | 17.7× |
| Thoracic spine 2 views (72070) | $1,388.25 | $1,851 | 11.1× |
| Thoracic spine 3 views (72072) | $1,071.75 | $1,429 | 8.6× |
| Thoracolumbar 2 views (72080) | $843 | $1,124 | 8.1× |
| Thyroid Imaging With Vascular Flow (78013) | $660.75 | $881 | 1.4× |
| Thyroid Met Imaging Body (78018) | $1,681.50 | $2,242 | 2.6× |
| Thyroid Uptake Measurement (78012) | $975.75 | $1,301 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,445 | $3,260 | 5.1× |
| Tx Devices Design & Construction Complex (77334) | $2,592 | $3,456 | 5.8× |
| Tx devices design & construction intermediate (77333) | $1,707 | $2,276 | 10.6× |
| Tx devices design & construction simple (77332) | $1,045.50 | $1,394 | 6.5× |
| Ultrasound Breast Limited (76642) | $1,446.75 | $1,929 | 13.9× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$1,323–$2,672.25 | $1,764–$3,563 | varies |
| Ultrasound, abdomen limited (76705) | $2,709.75 | $3,613 | 21.6× |
| Umbilical-artery Doppler (OB) (76820) | $996.75 | $1,329 | 8.0× |
| Unlisted magnetic resonance procedure (76498) | $4,152 | $5,536 | 39.8× |
| Upper gi w/o kub (74240) | $2,151 | $2,868 | 10.2× |
| Ureteral Reflux Study (78740) | $1,311.75 | $1,749 | 2.7× |
| Urethrocystogram voiding (74455) | $2,061 | $2,748 | 7.2× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,215–$2,270.25 | $1,620–$3,027 | varies |
| Us breast unilateral complete (76641) | $981 | $1,308 | 7.8× |
| Us chest (76604) range across 2 matching MRF lines |
$618–$681 | $824–$908 | varies |
| Us complete joint (76881) | $701.25 | $935 | 5.6× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$637.50–$752.25 | $850–$1,003 | varies |
| Us head (76506) range across 2 matching MRF lines |
$618.75–$1,226.25 | $825–$1,635 | varies |
| Us kidney transplant (76776) | $1,116.75 | $1,489 | 8.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$701.25–$1,479.75 | $935–$1,973 | varies |
| Us ob detailed single fetus (76811) | $3,604.50 | $4,806 | 12.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$1,161.75–$1,698.75 | $1,549–$2,265 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$562.50–$948 | $750–$1,264 | varies |
| Us pelvic non ob complete (76856) | $3,071.25 | $4,095 | 24.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $458.25 | $611 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$548.25–$846.75 | $731–$1,129 | varies |
| Us retroperitoneal complete (76770) | $2,543.25 | $3,391 | 20.3× |
| Us retroperitoneal limited (76775) | $735 | $980 | 5.9× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,290.75–$1,326.75 | $1,721–$1,769 | varies |
| Us spinal canal and contents (76800) | $603 | $804 | 4.8× |
| Us thyroid (76536) | $1,461 | $1,948 | 11.7× |
| Us transrectal (76872) | $1,229.25 | $1,639 | 9.8× |
| Vascular Flow Imaging (78445) | $2,518.50 | $3,358 | 5.3× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,967–$5,856.75 | $3,956–$7,809 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,900.75 | $9,201 | 1.8× |
| Vein X-Ray Skull Epidural (75872) | $2,783.25 | $3,711 | 3.7× |
| Venogram Sinus/Jugular (75860) | $3,606.75 | $4,809 | 1.0× |
| Venography Adrenal Unilateral (75840) | $17,044.50 | $22,726 | 4.5× |
| Venography caval inferior serialography rs&i (75825) | $7,578.75 | $10,105 | 2.0× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$3,368.25–$4,788.75 | $4,491–$6,385 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$3,173.25–$4,051.50 | $4,231–$5,402 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$8,428.50–$14,142 | $11,238–$18,856 | varies |
| Venography Renal Unilateral (75831) | $10,264.50 | $13,686 | 2.7× |
| Venous sampling by catheter (75893) | $10,369.50 | $13,826 | 1.6× |
| Venous thrombosis imaging (78457) | $2,004 | $2,672 | 3.1× |
| Wrist 2 views (73100) | $900.75 | $1,201 | 8.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $561 | $748 | 5.4× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,782.75–$2,310 | $2,377–$3,080 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$12,190.50–$13,632.75 | $16,254–$18,177 | varies |
| X-Ray Bend Only L-S Spine (72120) | $350.25 | $467 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,158.75 | $1,545 | 11.1× |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$1,600.50–$3,326.25 | $2,134–$4,435 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $337.50 | $450 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $500.25 | $667 | 4.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,419 | $1,892 | 11.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$460.50–$525 | $614–$700 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$492.75–$963 | $657–$1,284 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $733.50 | $978 | 5.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $735 | $980 | 5.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $687.75 | $917 | 5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,185.75 | $1,581 | 9.5× |
| X-Ray Exam L-S Spine Bending (72114) | $1,481.25 | $1,975 | 11.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,597.50 | $2,130 | 15.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $799.50 | $1,066 | 6.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,558.50 | $2,078 | 12.4× |
| X-ray eye for foreign body (70030) | $594 | $792 | 5.7× |
| X-ray humerus (73060) | $1,226.25 | $1,635 | 11.8× |
| X-ray IV pyelogram (ivp) (74400) | $2,599.50 | $3,466 | 12.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $863.25 | $1,151 | 8.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $879 | $1,172 | 8.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,807.50 | $2,410 | 14.4× |
| X-ray nose-rectum child f.b. (76010) | $789.75 | $1,053 | 7.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,086.75 | $1,449 | 8.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $789.75 | $1,053 | 6.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $416.25 | $555 | 3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $990 | $1,320 | 9.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $742.50 | $990 | 7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,024.50 | $1,366 | 8.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,260.75 | $1,681 | 3.0× |
| X-Rays Bone Length Studies (77073) | $520.50 | $694 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $1,204.50 | $1,606 | 9.6× |
| Xr c-spine 4 or 5 views (72050) | $1,515 | $2,020 | 12.1× |
| Xr facial bones less than 3 views (70140) | $687.75 | $917 | 6.6× |
| Xr orbits complete 4 views (70200) | $1,162.50 | $1,550 | 9.3× |
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.