Imaging prices at Stamford Hospital
Stamford, CT · every code in this section with a posted price and a Medicare benchmark.
426 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) range across 2 matching MRF lines |
$119–$19,770.79 | $119–$19,770.79 | varies |
| Abdomen 1 View (74018) range across 9 matching MRF lines |
$11–$954 | $11–$954 | varies |
| Abdomen 2 views (74019) range across 6 matching MRF lines |
$6–$2,135.93 | $6–$2,135.93 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,670.14 | $4,670.14 | 9.7× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$5,220.06–$17,511.57 | $5,220.06–$17,511.57 | varies |
| Angio pulmonary bilat (75743) | $19,935.87 | $19,935.87 | 5.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $19,935.87 | $19,935.87 | 5.3× |
| Angiography extremity bilateral rs&i (75716) | $19,935.87 | $19,935.87 | 5.3× |
| Angiography extremity unilateral rs&i (75710) | $19,935.87 | $19,935.87 | 5.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $19,935.87 | $19,935.87 | 5.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $13,758.53 | $13,758.53 | 3.6× |
| Ankle 2 views (73600) range across 10 matching MRF lines |
$7–$934.42 | $7–$934.42 | varies |
| Aortography thoracic serialography rs&i (75605) | $19,935.87 | $19,935.87 | 3.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $19,935.87 | $19,935.87 | 5.3× |
| Artery X-Rays Abdomen (75726) | $19,935.87 | $19,935.87 | 3.0× |
| Artery X-Rays Adrenal Gland (75731) | $19,935.87 | $19,935.87 | 5.3× |
| Artery X-Rays Pelvis (75736) | $19,935.87 | $19,935.87 | 3.0× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$17,129.52–$19,935.87 | $17,129.52–$19,935.87 | varies |
| Arthrogram ankle (73615) | $5,522.04 | $5,522.04 | 13.2× |
| Arthrogram hip (73525) | $5,522.04 | $5,522.04 | 13.2× |
| Arthrogram Wrist (73115) | $5,259.08 | $5,259.08 | 12.6× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$803–$2,194.76 | $803–$2,194.76 | varies |
| Bone age studies (77072) range across 5 matching MRF lines |
$10–$934.42 | $10–$934.42 | varies |
| Bone Imaging 3 Phase (78315) | $4,670.93 | $4,670.93 | 9.7× |
| Bone Imaging Limited Area (78300) | $5,149.71 | $5,149.71 | 10.7× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$79–$5,149.71 | $79–$5,149.71 | varies |
| Bone marrow imaging limited area (78102) | $5,379.06 | $5,379.06 | 11.2× |
| Bone marrow imaging; multiple areas (78103) | $5,379.06 | $5,379.06 | 11.2× |
| Bone survey infant (77076) | $1,565.79 | $1,565.79 | 12.5× |
| Brachytx isodose complex (77318) | $6,058.11 | $6,058.11 | 13.5× |
| Brachytx isodose intermed (77317) | $6,058.11 | $6,058.11 | 13.5× |
| Brachytx Isodose Plan Simple (77316) | $1,430.96 | $1,430.96 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $10,923.41 | $10,923.41 | 16.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $19,582.30 | $19,582.30 | 11.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$147–$11,305.60 | $147–$11,305.60 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $11,305.60 | $11,305.60 | 12.0× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$5–$2,318.70 | $5–$2,318.70 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,179.03 | $2,179.03 | 3.3× |
| Cerebrospinal Fluid Scan (78630) | $12,043.09 | $12,043.09 | 18.5× |
| Chest 1 view (71045) range across 10 matching MRF lines |
$6–$9,241 | $6–$9,241 | varies |
| Chest 2 views (71046) range across 10 matching MRF lines |
$20–$3,992 | $20–$3,992 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$31–$934.42 | $31–$934.42 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Cholecystography Oral Contrast (74290) | $1,821.63 | $1,821.63 | 8.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $538.58 | $538.58 | 4.3× |
| Cisternography Positive Contrast Rs&I (70015) | $10,137.38 | $10,137.38 | 10.8× |
| Clavicle complete (73000) range across 12 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 4 matching MRF lines |
$121–$4,119.15 | $121–$4,119.15 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$984–$2,194.76 | $984–$2,194.76 | varies |
| Contrast Exam Abdominl Aorta (75625) | $19,935.87 | $19,935.87 | 5.3× |
| Contrast X-Ray Bladder (74430) | $3,571.87 | $3,571.87 | 8.5× |
| Contrast X-Ray Of Elbow (73085) | $5,522.04 | $5,522.04 | 13.2× |
| Contrast X-Ray Of Knee Joint (73580) | $5,522.04 | $5,522.04 | 13.2× |
| Corpora cavernosography (74445) | $1,743.47 | $1,743.47 | 13.9× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$123–$13,273.42 | $123–$13,273.42 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$151–$8,886.48 | $151–$8,886.48 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$14–$6,271.94 | $14–$6,271.94 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$22–$7,042.44 | $22–$7,042.44 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$11–$4,119.15 | $11–$4,119.15 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$19–$11,719.92 | $19–$11,719.92 | varies |
| CT Angio Chest (71275) range across 8 matching MRF lines |
$18–$7,189.25 | $18–$7,189.25 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$30–$7,189.25 | $30–$7,189.25 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$209–$5,683.22 | $209–$5,683.22 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$31–$7,189.25 | $31–$7,189.25 | varies |
| CT Angio Neck (70498) range across 6 matching MRF lines |
$22–$7,189.25 | $22–$7,189.25 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$12–$7,189.25 | $12–$7,189.25 | varies |
| CT bone density (77078) | $1,530.83 | $1,530.83 | 14.7× |
| CT cervical spine w/ contrast (72126) | $6,271.94 | $6,271.94 | 15.0× |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$28–$5,026.92 | $28–$5,026.92 | varies |
| CT cervical spine w/wo cont (72127) | $7,042.44 | $7,042.44 | 33.5× |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$263–$6,271.94 | $263–$6,271.94 | varies |
| CT chest w/wo contrast (71270) | $7,042.44 | $7,042.44 | 33.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$9–$667.56 | $9–$667.56 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$9–$6,271.94 | $9–$6,271.94 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$12–$7,042.44 | $12–$7,042.44 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 4 matching MRF lines |
$156–$5,683.22 | $156–$5,683.22 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 4 matching MRF lines |
$149–$1,195 | $149–$1,195 | varies |
| CT hrt w/3d image congen (75573) | $5,683.22 | $5,683.22 | 13.6× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$40–$6,271.94 | $40–$6,271.94 | varies |
| CT l-spine w&w/o contrast (72133) | $7,042.44 | $7,042.44 | 33.5× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$48–$5,026.92 | $48–$5,026.92 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$56–$6,271.94 | $56–$6,271.94 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$19–$6,271.94 | $19–$6,271.94 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$36–$5,026.92 | $36–$5,026.92 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$70–$6,271.94 | $70–$6,271.94 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$194–$5,026.92 | $194–$5,026.92 | varies |
| CT neck tissue combo (70492) range across 4 matching MRF lines |
$14–$7,042.44 | $14–$7,042.44 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $7,042.44 | $7,042.44 | 33.5× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$18–$5,026.92 | $18–$5,026.92 | varies |
| CT pelvis w&w/o contrast (72194) | $7,042.44 | $7,042.44 | 33.5× |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$10–$4,119.15 | $10–$4,119.15 | varies |
| CT scan of leg combo (73702) | $7,042.44 | $7,042.44 | 33.5× |
| CT scans face/jaw combo (70488) | $7,042.44 | $7,042.44 | 33.5× |
| CT soft tissue neck w contrast (70491) range across 4 matching MRF lines |
$40–$6,271.94 | $40–$6,271.94 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$10–$5,026.92 | $10–$5,026.92 | varies |
| CT thoracic spine w contrast (72129) | $6,271.94 | $6,271.94 | 29.8× |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$8–$5,026.92 | $8–$5,026.92 | varies |
| CT thoracic spine w/wo cont (72130) | $7,042.44 | $7,042.44 | 33.5× |
| CT thorax w/o contrast (71250) range across 8 matching MRF lines |
$6–$4,119.15 | $6–$4,119.15 | varies |
| CT unlisted procedure (76497) | $318.89 | $318.89 | 3.1× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$58–$5,026.92 | $58–$5,026.92 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $7,042.44 | $7,042.44 | 33.5× |
| CT upper extremity with contrast (73201) range across 5 matching MRF lines |
$18–$6,271.94 | $18–$6,271.94 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$29–$7,189.25 | $29–$7,189.25 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$14–$7,189.25 | $14–$7,189.25 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$11–$7,189.25 | $11–$7,189.25 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $4,375.81 | $4,375.81 | 15.3× |
| Dilation ureters/urethra rs&i (74485) | $11,664.99 | $11,664.99 | 4.7× |
| Discography Cerv/Thor Spine (72285) | $36,279.08 | $36,279.08 | 15.5× |
| Diskography lumbar (72295) | $36,279.08 | $36,279.08 | 15.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $823.81 | $823.81 | 6.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$213–$1,369.64 | $213–$1,369.64 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$29–$694.69 | $29–$694.69 | varies |
| Dxa Bone Density Axial (77080) range across 6 matching MRF lines |
$105–$1,687 | $105–$1,687 | varies |
| Dxa bone density study (77085) range across 5 matching MRF lines |
$60–$1,508.98 | $60–$1,508.98 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$209–$4,799.28 | $209–$4,799.28 | varies |
| Echo exam uterus (76831) | $3,203.79 | $3,203.79 | 11.2× |
| Echo Guide For Artery Repair (76936) | $2,255.15 | $2,255.15 | 8.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,172.15 | $2,172.15 | 7.6× |
| Echograp Trans R Pros Study (76873) | $2,074.31 | $2,074.31 | 16.6× |
| Esophagram (74220) range across 3 matching MRF lines |
$183–$1,821.63 | $183–$1,821.63 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$325–$2,231.85 | $325–$2,231.85 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$25–$2,114.65 | $25–$2,114.65 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,670.09 | $4,670.09 | 16.3× |
| Fluoroscopy up to 1 hr (76000) | $1,780.70 | $1,780.70 | 6.2× |
| Follow-Up Angiography (75898) | $6,883.25 | $6,883.25 | 1.8× |
| Foot 2 views (73620) range across 9 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Forearm 2 views (73090) range across 10 matching MRF lines |
$40–$934.42 | $40–$934.42 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$42–$4,670.14 | $42–$4,670.14 | varies |
| Gastroesophageal Reflux Exam (78262) | $5,148.87 | $5,148.87 | 10.7× |
| Gated Heart Planar Single (78472) | $6,364.34 | $6,364.34 | 13.3× |
| Hand 2 views (73120) range across 10 matching MRF lines |
$19–$934.42 | $19–$934.42 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,973.61 | $7,973.61 | 9.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $7,246.21 | $7,246.21 | 8.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,170.35 | $6,170.35 | 7.4× |
| Heart first pass single,planar (78481) | $6,364.34 | $6,364.34 | 9.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $19,935.87 | $19,935.87 | 5.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $19,935.87 | $19,935.87 | 5.3× |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$31–$5,368.39 | $31–$5,368.39 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$29–$5,368.39 | $29–$5,368.39 | varies |
| Ht Musc Image Planar Mult (78454) | $9,343.59 | $9,343.59 | 6.0× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$13,738.70–$14,988.58 | $13,738.70–$14,988.58 | varies |
| Hysterosalpingogram (74740) | $3,894.81 | $3,894.81 | 13.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$33–$1,300.21 | $33–$1,300.21 | varies |
| Infusion Ivp (74410) | $3,571.87 | $3,571.87 | 17.0× |
| Interstitial radiation source applic complex (77778) | $11,620.49 | $11,620.49 | 13.9× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,191.54 | $4,191.54 | 5.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $4,625.90 | $4,625.90 | 7.0× |
| Intracavitary radiation source applic simple (77761) | $2,806.89 | $2,806.89 | 4.2× |
| Joint Survey Single View (77077) | $934.42 | $934.42 | 7.5× |
| K Flow/Funct Image Multiple (78709) | $6,135.90 | $6,135.90 | 9.4× |
| K Flow/Funct Image W/Drug (78708) | $6,135.90 | $6,135.90 | 9.4× |
| K Flow/Funct Image W/O Drug (78707) | $6,764.82 | $6,764.82 | 10.4× |
| Kidney Imaging Morphol (78700) | $6,135.90 | $6,135.90 | 12.8× |
| Knee 3 Views (73562) range across 20 matching MRF lines |
$8–$934.42 | $8–$934.42 | varies |
| Liver & Spleen Imaging Static Only (78215) | $5,489.27 | $5,489.27 | 11.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $5,489.27 | $5,489.27 | 11.5× |
| Liver imaging static only (78201) | $7,644.93 | $7,644.93 | 11.7× |
| Lung Perf&Ventilat Diferentl (78598) | $6,111.69 | $6,111.69 | 9.4× |
| Lung perfusion differential (78597) | $2,302.28 | $2,302.28 | 4.8× |
| Lung Ventilat&Perfus Imaging (78582) | $6,111.69 | $6,111.69 | 9.4× |
| Lung Ventilation Imaging (78579) | $4,296.37 | $4,296.37 | 9.0× |
| Lymph System Imaging (78195) | $5,379.06 | $5,379.06 | 8.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $3,835.53 | $3,835.53 | 2.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $3,835.53 | $3,835.53 | 5.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,835.53 | $3,835.53 | 1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,835.53 | $3,835.53 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $7,380.47 | $7,380.47 | 25.8× |
| Magnetic Resonance Elastography (76391) range across 2 matching MRF lines |
$35–$1,097.95 | $35–$1,097.95 | varies |
| Meckels Divert Exam (78290) | $5,148.87 | $5,148.87 | 10.7× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$172–$4,064.03 | $172–$4,064.03 | varies |
| Mr safety determination physician/other qhp (76016) | $421 | $421 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $117 | $117 | 3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $439 | $439 | 3.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,155.88 | $1,155.88 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$28–$11,305.60 | $28–$11,305.60 | varies |
| MRA head w/o contrast (70544) range across 7 matching MRF lines |
$18–$7,380.47 | $18–$7,380.47 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$8,650.06–$8,952.80 | $8,650.06–$8,952.80 | varies |
| MRA neck w contrast (70548) | $8,952.80 | $8,952.80 | 21.4× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$52–$11,305.60 | $52–$11,305.60 | varies |
| MRA neck w/o contrast (70547) range across 6 matching MRF lines |
$18–$7,380.47 | $18–$7,380.47 | varies |
| MRI abdomen w contrast (74182) | $8,952.80 | $8,952.80 | 21.4× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$56–$7,380.47 | $56–$7,380.47 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $8,952.80 | $8,952.80 | 9.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$26–$11,305.60 | $26–$11,305.60 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,952.80 | $8,952.80 | 9.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $10,650.11 | $10,650.11 | 37.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $10,159.16 | $10,159.16 | 35.5× |
| MRI cardiac w/o cont stress (75559) | $7,380.47 | $7,380.47 | 11.3× |
| MRI cardiac w/o contrast (75557) | $7,380.47 | $7,380.47 | 25.8× |
| MRI cervical spine w contrast (72142) | $8,952.80 | $8,952.80 | 21.4× |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$111–$7,380.47 | $111–$7,380.47 | varies |
| MRI chest w/o contrast (71550) | $7,380.47 | $7,380.47 | 25.8× |
| MRI chest with contrast (71551) | $8,952.80 | $8,952.80 | 9.5× |
| MRI chest wo w contrast (71552) | $11,305.60 | $11,305.60 | 27.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $8,952.80 | $8,952.80 | 21.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$72–$11,305.60 | $72–$11,305.60 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$15–$7,380.47 | $15–$7,380.47 | varies |
| MRI lumbar spine w contrast (72149) | $8,952.80 | $8,952.80 | 21.4× |
| Mri Neck Spine W/O & W/Dye (72156) range across 6 matching MRF lines |
$23–$11,305.60 | $23–$11,305.60 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $7,380.47 | $7,380.47 | 25.8× |
| MRI orbit face neck w contrast (70542) | $8,952.80 | $8,952.80 | 21.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$24–$11,305.60 | $24–$11,305.60 | varies |
| MRI pelvis w contrast (72196) | $8,952.80 | $8,952.80 | 21.4× |
| MRI pelvis w/o & w contrast (72197) range across 9 matching MRF lines |
$39–$11,305.60 | $39–$11,305.60 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$26–$7,380.47 | $26–$7,380.47 | varies |
| MRI spectroscopy (76390) | $2,179.31 | $2,179.31 | 20.9× |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$41–$7,380.47 | $41–$7,380.47 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $8,952.80 | $8,952.80 | 21.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$13–$7,380.47 | $13–$7,380.47 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $11,305.60 | $11,305.60 | 27.0× |
| MRI, abdomen, combo (74183) range across 5 matching MRF lines |
$282–$11,305.60 | $282–$11,305.60 | varies |
| MRI, dorsal spine combo (72157) range across 6 matching MRF lines |
$20–$11,305.60 | $20–$11,305.60 | varies |
| MRI, dorsal spine contrast (72147) | $8,952.80 | $8,952.80 | 21.4× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$106–$7,380.47 | $106–$7,380.47 | varies |
| MRI, joint upper extrem combo (73223) | $11,305.60 | $11,305.60 | 27.0× |
| MRI, lumbar spine combo (72158) range across 6 matching MRF lines |
$35–$11,305.60 | $35–$11,305.60 | varies |
| Myelogram cervical (72240) | $10,137.38 | $10,137.38 | 10.8× |
| Myelogram Lumbar (72265) | $10,137.38 | $10,137.38 | 10.8× |
| Myelography thoracic (72255) | $10,137.38 | $10,137.38 | 10.8× |
| Myelograpy 2/more regions rs&i (72270) | $10,137.38 | $10,137.38 | 10.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $6,364.34 | $6,364.34 | 13.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $9,343.59 | $9,343.59 | 6.0× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$487–$15,119.98 | $487–$15,119.98 | varies |
| N-invas est c ffr sw aly CTA (75580) | $5,540.53 | $5,540.53 | 5.4× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$14–$934.42 | $14–$934.42 | varies |
| Nm csf leak detection (78650) | $10,923.41 | $10,923.41 | 7.0× |
| Nonvascular Shunt X-Ray (75809) | $764.34 | $764.34 | 6.1× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$128–$19,770.79 | $128–$19,770.79 | varies |
| Nuclear Rx Intra-Arterial (79445) | $4,539.08 | $4,539.08 | 16.2× |
| Nuclear Rx Oral Admin (79005) | $4,117.10 | $4,117.10 | 14.7× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$1,024–$2,278.52 | $1,024–$2,278.52 | varies |
| Optic foramina (70190) | $934.42 | $934.42 | 9.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $5,506.36 | $5,506.36 | 8.5× |
| Parathyroid Planar Imaging (78070) | $4,614.71 | $4,614.71 | 9.6× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$22–$5,506.36 | $22–$5,506.36 | varies |
| Pelvis 1 or 2 views (72170) range across 6 matching MRF lines |
$8–$934.42 | $8–$934.42 | varies |
| Peritoneogram Rs&I (74190) | $2,135.93 | $2,135.93 | 3.3× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$89–$21,589.50 | $89–$21,589.50 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 5 matching MRF lines |
$83–$21,062.93 | $83–$21,062.93 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $19,935.87 | $19,935.87 | 5.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,896.94 | $3,896.94 | 8.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$6–$1,565.79 | $6–$1,565.79 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$103–$2,135.93 | $103–$2,135.93 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 16 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$10–$934.42 | $10–$934.42 | varies |
| Radex elbow complete minimum 3 views (73080) range across 19 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$10–$934.42 | $10–$934.42 | varies |
| Radex foot complete minimum 3 views (73630) range across 20 matching MRF lines |
$8–$934.42 | $8–$934.42 | varies |
| Radex Hand Minimum 3 Views (73130) range across 16 matching MRF lines |
$8–$934.42 | $8–$934.42 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$8–$934.42 | $8–$934.42 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $934.42 | $934.42 | 7.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$21–$934.42 | $21–$934.42 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 6 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 21 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $934.42 | $934.42 | 9.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,438.07 | $1,438.07 | 6.8× |
| Radex Spine 1 View Specify Level (72020) | $477.51 | $477.51 | 4.6× |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$15–$934.42 | $15–$934.42 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $934.42 | $934.42 | 9.0× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$15–$934.42 | $15–$934.42 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 12 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,505.57 | $1,505.57 | 12.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $64,551.80 | $64,551.80 | 7.3× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$14–$1,928.43 | $14–$1,928.43 | varies |
| Radiation treatment delivery level 2 (77407) | $1,928.43 | $1,928.43 | 4.2× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,047–$3,721.79 | $2,047–$3,721.79 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$10–$934.42 | $10–$934.42 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 7 matching MRF lines |
$6–$2,135.93 | $6–$2,135.93 | varies |
| Radiologic exam colon double contrast study (74280) | $2,946.24 | $2,946.24 | 14.0× |
| Radiologic exam colon single contrast study (74270) | $1,821.63 | $1,821.63 | 8.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 3 matching MRF lines |
$15–$1,821.63 | $15–$1,821.63 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 11 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$16–$934.42 | $16–$934.42 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$54–$1,821.63 | $54–$1,821.63 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$190–$1,821.63 | $190–$1,821.63 | varies |
| Radiologic exam teeth complete full mouth (70320) | $626.92 | $626.92 | 2.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $626.92 | $626.92 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$12–$1,821.63 | $12–$1,821.63 | varies |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$170–$934.42 | $170–$934.42 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 7 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| Radiologic examination knee 1/2 views (73560) range across 15 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$7–$1,565.79 | $7–$1,565.79 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $934.42 | $934.42 | 9.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 12 matching MRF lines |
$7–$934.42 | $7–$934.42 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $626.92 | $626.92 | 6.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,160.53 | $1,160.53 | 2.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,160.53 | $1,160.53 | 2.5× |
| Renal Cyst Study (74470) | $4,375.81 | $4,375.81 | 6.7× |
| Ribs bilateral 3 views (71110) | $934.42 | $934.42 | 7.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $6,037.11 | $6,037.11 | 12.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $10,622.78 | $10,622.78 | 22.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $20,043.43 | $20,043.43 | 30.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $10,622.78 | $10,622.78 | 16.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$68–$10,622.78 | $68–$10,622.78 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $7,846.97 | $7,846.97 | 4.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $6,917.35 | $6,917.35 | 4.5× |
| Rp Therapy Intravenous Administration (79101) | $4,117.10 | $4,117.10 | 14.7× |
| Scapula (73010) range across 4 matching MRF lines |
$12–$934.42 | $12–$934.42 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
$123.69–$8,632 | $123.69–$8,632 | varies |
| Sella turcica (70240) | $934.42 | $934.42 | 9.0× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$17–$934.42 | $17–$934.42 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$77–$5,522.04 | $77–$5,522.04 | varies |
| Sialogram (70390) | $4,375.81 | $4,375.81 | 15.3× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| Special dosimetry (77331) | $2,194.76 | $2,194.76 | 13.6× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$23–$2,194.76 | $23–$2,194.76 | varies |
| Special teletherapy port plan (77321) | $3,133.67 | $3,133.67 | 7.0× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$77–$6,878.15 | $77–$6,878.15 | varies |
| Speech evaluation, complex (70371) | $1,780.70 | $1,780.70 | 6.2× |
| Stereotactic Body Radiation Delivery (77373) | $44,966.48 | $44,966.48 | 21.0× |
| Sternoclavicular joints (71130) | $934.42 | $934.42 | 9.0× |
| Superior sagittal sinus venogram (75870) | $7,051.78 | $7,051.78 | 1.9× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) range across 6 matching MRF lines |
$98–$837 | $98–$837 | varies |
| Tbs technical calculation only (77091) range across 6 matching MRF lines |
$98–$837 | $98–$837 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$94–$2,194.70 | $94–$2,194.70 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,194.70 | $2,194.70 | 4.9× |
| Temporomandble Jt Arthrography Rs&I (70332) | $5,522.04 | $5,522.04 | 19.3× |
| Testicular Imaging W/Flow (78761) | $6,135.90 | $6,135.90 | 12.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$164–$5,678.01 | $164–$5,678.01 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $5,678.01 | $5,678.01 | 12.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$229–$2,194.76 | $229–$2,194.76 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $855.11 | $855.11 | 4.1× |
| Thoracic spine 2 views (72070) range across 9 matching MRF lines |
$14–$934.42 | $14–$934.42 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$7–$934.42 | $7–$934.42 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $2,565.43 | $2,565.43 | 5.4× |
| Thyroid Met Imaging Body (78018) | $5,475.82 | $5,475.82 | 8.4× |
| Thyroid Uptake Measurement (78012) | $1,949.71 | $1,949.71 | 4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$21–$3,982.93 | $21–$3,982.93 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$709–$4,064.03 | $709–$4,064.03 | varies |
| Tx devices design & construction intermediate (77333) | $2,365.61 | $2,365.61 | 14.7× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$138–$4,064.03 | $138–$4,064.03 | varies |
| Ultrasound Breast Limited (76642) range across 10 matching MRF lines |
$18–$1,120 | $18–$1,120 | varies |
| Ultrasound elastography first target lesion (76982) | $756.66 | $756.66 | 6.0× |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$162–$756.66 | $162–$756.66 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 5 matching MRF lines |
$18–$591.86 | $18–$591.86 | varies |
| Ultrasound, abdomen limited (76705) range across 13 matching MRF lines |
$6–$2,267 | $6–$2,267 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$421–$870.67 | $421–$870.67 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$17–$4,375.27 | $17–$4,375.27 | varies |
| Unlisted fluoroscopic procedure (76496) | $1,656.59 | $1,656.59 | 15.9× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$54–$2,884.08 | $54–$2,884.08 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $6,444.92 | $6,444.92 | 52.7× |
| Unlisted us procedure (76999) | $634.76 | $634.76 | 6.1× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$57–$1,821.63 | $57–$1,821.63 | varies |
| Ureteral Reflux Study (78740) | $6,135.90 | $6,135.90 | 12.8× |
| Urethrocystogram voiding (74455) | $3,571.87 | $3,571.87 | 12.5× |
| Urethrocystography retrograde (74450) | $3,571.87 | $3,571.87 | 12.5× |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$8–$469.82 | $8–$469.82 | varies |
| Us chest (76604) range across 6 matching MRF lines |
$7–$1,300.21 | $7–$1,300.21 | varies |
| Us complete joint (76881) range across 7 matching MRF lines |
$9–$1,926.98 | $9–$1,926.98 | varies |
| Us exam, pelvic, limited (76857) range across 8 matching MRF lines |
$7–$1,292.65 | $7–$1,292.65 | varies |
| Us head (76506) range across 3 matching MRF lines |
$73–$1,300.21 | $73–$1,300.21 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$17–$2,024.93 | $17–$2,024.93 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 13 matching MRF lines |
$20–$1,245.90 | $20–$1,245.90 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,145–$2,999.29 | $1,145–$2,999.29 | varies |
| Us ob limited 1 or more fetuses (76815) range across 6 matching MRF lines |
$257–$2,545 | $257–$2,545 | varies |
| Us ob transvaginal (76817) range across 6 matching MRF lines |
$12–$1,317.80 | $12–$1,317.80 | varies |
| Us pelvic non ob complete (76856) range across 7 matching MRF lines |
$33–$2,024.93 | $33–$2,024.93 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$1,134–$2,332.78 | $1,134–$2,332.78 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 5 matching MRF lines |
$6–$1,748 | $6–$1,748 | varies |
| Us retroperitoneal complete (76770) range across 7 matching MRF lines |
$60–$2,024.93 | $60–$2,024.93 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$11–$2,024.93 | $11–$2,024.93 | varies |
| Us scrotum and contents (76870) range across 6 matching MRF lines |
$19–$2,024.93 | $19–$2,024.93 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$31–$2,024.93 | $31–$2,024.93 | varies |
| Us thyroid (76536) range across 22 matching MRF lines |
$8–$2,024.93 | $8–$2,024.93 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$61–$2,024.93 | $61–$2,024.93 | varies |
| Vascular Flow Imaging (78445) | $4,163.59 | $4,163.59 | 8.7× |
| Vasogram (74440) | $3,571.87 | $3,571.87 | 12.5× |
| Vein X-Ray Chest (75827) | $7,051.78 | $7,051.78 | 3.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $14,446.46 | $14,446.46 | 3.8× |
| Vein X-Ray Skull Epidural (75872) | $7,051.78 | $7,051.78 | 9.4× |
| Vein X-Ray Spleen/Liver (75810) | $19,935.87 | $19,935.87 | 5.3× |
| Venogram Sinus/Jugular (75860) | $7,051.78 | $7,051.78 | 1.9× |
| Venography Adrenal Unilateral (75840) | $19,935.87 | $19,935.87 | 5.3× |
| Venography caval inferior serialography rs&i (75825) | $19,935.87 | $19,935.87 | 5.3× |
| Venography extremity bilateral rs&i (75822) | $13,758.53 | $13,758.53 | 7.3× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$7,428–$13,930.06 | $7,428–$13,930.06 | varies |
| Venography Orbital Rs&I (75880) | $7,051.78 | $7,051.78 | 9.4× |
| Venography Renal Bilateral (75833) | $19,935.87 | $19,935.87 | 5.3× |
| Venography Renal Unilateral (75831) | $19,935.87 | $19,935.87 | 5.3× |
| Venous sampling by catheter (75893) | $19,935.87 | $19,935.87 | 3.0× |
| Vertebral fracture assessment via dxa (77086) | $304.12 | $304.12 | 2.9× |
| Wrist 2 views (73100) range across 8 matching MRF lines |
$29–$934.42 | $29–$934.42 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,743.47 | $1,743.47 | 4.2× |
| X-Ray Aorta Leg Arteries (75630) | $19,935.87 | $19,935.87 | 5.3× |
| X-Ray Bend Only L-S Spine (72120) | $1,565.79 | $1,565.79 | 12.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 8 matching MRF lines |
$6–$889.91 | $6–$889.91 | varies |
| X-Ray Exam Breast Specimen (76098) range across 5 matching MRF lines |
$91–$1,689.91 | $91–$1,689.91 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$12–$1,565.79 | $12–$1,565.79 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 5 matching MRF lines |
$8–$1,565.79 | $8–$1,565.79 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,565.79 | $1,565.79 | 12.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $902.06 | $902.06 | 8.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 18 matching MRF lines |
$7–$902.06 | $7–$902.06 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $902.06 | $902.06 | 7.2× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 7 matching MRF lines |
$9–$1,565.79 | $9–$1,565.79 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$14–$1,565.79 | $14–$1,565.79 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 7 matching MRF lines |
$7–$1,565.79 | $7–$1,565.79 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 7 matching MRF lines |
$6–$1,565.79 | $6–$1,565.79 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 11 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 7 matching MRF lines |
$6–$1,565.79 | $6–$1,565.79 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 6 matching MRF lines |
$9–$934.42 | $9–$934.42 | varies |
| X-ray eye for foreign body (70030) | $934.42 | $934.42 | 9.0× |
| X-ray head for orthodontia (70350) | $934.42 | $934.42 | 9.0× |
| X-ray humerus (73060) range across 11 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| X-ray IV pyelogram (ivp) (74400) | $3,571.87 | $3,571.87 | 17.0× |
| X-ray IV pyelogram+tomography (74415) | $3,571.87 | $3,571.87 | 17.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $934.42 | $934.42 | 9.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 5 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 11 matching MRF lines |
$19–$934.42 | $19–$934.42 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 6 matching MRF lines |
$6–$1,565.79 | $6–$1,565.79 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 6 matching MRF lines |
$7–$934.42 | $7–$934.42 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $633.06 | $633.06 | 5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 6 matching MRF lines |
$5–$934.42 | $5–$934.42 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$11–$934.42 | $11–$934.42 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$8–$1,565.79 | $8–$1,565.79 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$6–$934.42 | $6–$934.42 | varies |
| X-Ray Tmj Unilat (70328) | $934.42 | $934.42 | 9.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,239.79 | $3,239.79 | 7.7× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$20–$934.42 | $20–$934.42 | varies |
| X-Rays Bone Survey Complete (77075) | $1,565.79 | $1,565.79 | 12.5× |
| Xr c-spine 4 or 5 views (72050) range across 13 matching MRF lines |
$8–$1,565.79 | $8–$1,565.79 | varies |
| Xr facial bones less than 3 views (70140) | $934.42 | $934.42 | 9.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $934.42 | $934.42 | 7.5× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$7–$934.42 | $7–$934.42 | varies |
| Xr Tomogram Single Plane (76100) | $1,565.79 | $1,565.79 | 12.5× |
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.