Imaging prices at Swedish Hospital

Chicago, IL · every code in this section with a posted price and a Medicare benchmark.

434 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $9,181 $9,181 6.2×
Abdomen 1 View (74018) $460 $460 4.9×
Abdomen 2 views (74019) $566 $566 5.1×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,494 $1,494 3.5×
Angio internal mammary (75756) $3,755 $3,755 1.1×
Angio pulmonary bilat (75743) $5,182 $5,182 1.5×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $5,019 $5,019 1.5×
Angiography extremity bilateral rs&i (75716) $4,543 $4,543 1.3×
Angiography extremity unilateral rs&i (75710) $4,325 $4,325 1.3×
Angiography pulmonary unilateral slctv rs&i (75741) $5,182 $5,182 1.5×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $3,755 $3,755 1.1×
Ankle 2 views (73600) $352 $352 3.8×
Aortography thoracic serialography rs&i (75605) $5,818 $5,818 1.0×
Aortography thoracic w/o serialography rs&i (75600) $5,182 $5,182 1.5×
Artery X-Rays Abdomen (75726) $7,262 $7,262 1.2×
Artery X-Rays Adrenal Gland (75731) $5,019 $5,019 1.5×
Artery X-Rays Pelvis (75736) $6,073 $6,073 1.0×
Artery X-Rays Spine (75705) $7,231 $7,231 1.2×
Arthrogram ankle (73615) $1,188 $1,188 3.2×
Arthrogram hip (73525) $842 $842 2.3×
Arthrogram Wrist (73115) $1,498 $1,498 4.0×
Basic radiation dosimetry calculation (77300) $933 $933 6.5×
Bone age studies (77072) $231 $231 2.1×
Bone Imaging 3 Phase (78315) $4,834 $4,834 11.3×
Bone Imaging Limited Area (78300) $1,424 $1,424 3.3×
Bone Imaging Multiple Areas (78305) $1,728 $1,728 4.0×
Bone Imaging Whole Body (78306) $3,337 $3,337 7.8×
Bone marrow imaging limited area (78102) $1,374 $1,374 3.2×
Bone marrow imaging; whole body (78104) $1,397 $1,397 3.3×
Bone survey infant (77076) $519 $519 4.6×
Brachytx isodose complex (77318) $2,104 $2,104 5.2×
Brachytx isodose intermed (77317) $1,706 $1,706 4.3×
Brachytx Isodose Plan Simple (77316) $1,051 $1,051 2.6×
Brain Image W/Flow < 4 Views (78601) $1,805 $1,805 4.2×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,933 $1,933 3.3×
Brain Imaging Pet Metabolic Evaluation (78608) $5,404 $5,404 3.5×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $2,095 $2,095 3.6×
Cardiac MRI w/w/o contrast & further seq (75561) $4,436 $4,436 11.9×
Cardiac MRI w/w/o contrast w/stress (75563) $5,235 $5,235 6.2×
Cat Scan Follow-Up Study (76380) $583 $583 6.3×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,418 $1,418 2.4×
Cerebrospinal Fluid Scan (78630) $2,399 $2,399 4.1×
Chest 1 view (71045) $369 $369 4.0×
Chest 2 views (71046) $453 $453 4.9×
Chest 3 views (71047) $359 $359 3.8×
Chest 4 or more views (71048) $418 $418 3.7×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $893 $893 8.0×
Cisternography Positive Contrast Rs&I (70015) $1,069 $1,069 1.3×
Clavicle complete (73000) $436 $436 4.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $550 $550 4.9×
Continuing medical physics consltj pr wk (77336) $1,185 $1,185 8.2×
Contrast Exam Abdominl Aorta (75625) $4,830 $4,830 1.4×
Contrast X-Ray Bladder (74430) $918 $918 2.5×
Contrast X-Ray Of Elbow (73085) $1,451 $1,451 3.9×
Contrast X-Ray Of Knee Joint (73580) $1,188 $1,188 3.2×
Contrast Xray Throat/Cerv Esopha (74210) $1,076 $1,076 5.7×
Corpora cavernosography (74445) $1,030 $1,030 9.2×
CT abdomen and pelvis without and with contrast (74178) $6,865 $6,865 18.4×
CT abdomen and pelvis without contrast (74176) $3,726 $3,726 14.6×
CT abdomen w contrast (74160) $3,164 $3,164 16.8×
CT abdomen w wo contrast (74170) $3,725 $3,725 19.8×
CT abdomen w/o contrast (74150) $2,587 $2,587 23.1×
CT Angio Abdomen and Pelvis (74174) $3,521 $3,521 9.4×
CT Angio Chest (71275) $3,317 $3,317 17.6×
CT Angio Head (70496) $2,619 $2,619 13.9×
CT angio hrt w/3d image (75574) $2,441 $2,441 6.5×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,235 $3,235 17.2×
CT Angio Neck (70498) $3,056 $3,056 16.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,662 $1,662 8.8×
CT cervical spine w/ contrast (72126) $2,703 $2,703 7.2×
CT cervical spine w/o contrast (72125) $2,579 $2,579 23.0×
CT cervical spine w/wo cont (72127) $2,828 $2,828 15.0×
CT chest w contrast (71260) $3,156 $3,156 16.8×
CT chest w/wo contrast (71270) $3,848 $3,848 20.5×
CT head/brain with contrast (70460) $2,453 $2,453 13.1×
CT head/brain without and with contrast (70470) $3,403 $3,403 18.1×
CT heart contrast eval cardiac structure&morph (75572) $1,661 $1,661 4.4×
CT heart no contrast quant eval coronry calcium (75571) $25 $25 0.3×
CT hrt w/3d image congen (75573) $1,609 $1,609 4.3×
CT iac w contrast (70481) $2,539 $2,539 13.5×
CT l-spine w&w/o contrast (72133) $3,289 $3,289 17.5×
CT lower ext w/o (73700) $2,567 $2,567 22.9×
CT lower extremity w/contrast material (73701) $2,885 $2,885 15.3×
CT lumbar spine w contrast (72132) $3,037 $3,037 8.1×
CT lumbar spine w/o contrast (72131) $2,841 $2,841 25.4×
CT maxillofacial w contrast (70487) $2,071 $2,071 11.0×
CT maxillofacial wo contrast (70486) $1,893 $1,893 16.9×
CT neck tissue combo (70492) $3,446 $3,446 18.3×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,769 $2,769 14.7×
CT orbits w/o contrast (70480) $2,134 $2,134 19.0×
CT pelvis w&w/o contrast (72194) $3,432 $3,432 18.3×
CT pelvis w/o contrast (72192) $2,114 $2,114 18.9×
CT scan of leg combo (73702) $3,174 $3,174 16.9×
CT scans face/jaw combo (70488) $2,210 $2,210 11.8×
CT soft tissue neck w contrast (70491) $2,999 $2,999 16.0×
CT soft tissue neck w/o contrast (70490) $2,786 $2,786 24.9×
CT thoracic spine w contrast (72129) $2,461 $2,461 13.1×
CT thoracic spine w/o contrast (72128) $2,401 $2,401 21.4×
CT thoracic spine w/wo cont (72130) $2,769 $2,769 14.7×
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $835–$2,851 $835–$2,851 varies
CT upper ext wo (73200) $2,293 $2,293 20.5×
CT upper extremity w/o & w/contrast material (73202) $2,710 $2,710 14.4×
CT upper extremity with contrast (73201) $2,422 $2,422 6.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,835 $2,835 15.1×
Cta Abdomen (74175) $2,560 $2,560 13.6×
CTA pelvis (72191) $1,787 $1,787 9.5×
Dilation ureters/urethra rs&i (74485) $2,238 $2,238 1.0×
Discography Cerv/Thor Spine (72285) $4,476 $4,476 2.1×
Diskography lumbar (72295) $4,476 $4,476 2.1×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $437 $437 3.9×
Doppler Echo Fetal Spectral Display Complete (76827) $514 $514 4.6×
Doppler Fetal Mid Cerebral Artery (76821) $521 $521 4.7×
Dxa Bone Density Axial (77080) $596 $596 5.3×
Dxa bone density study (77085) $476 $476 4.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $235 $235 2.5×
Echo exam of fetal heart (76825) $1,770 $1,770 3.0×
Echo exam uterus (76831)
range across 2 matching MRF lines		 $286–$810 $286–$810 varies
Echo Guide For Artery Repair (76936) $1,093 $1,093 4.7×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,229 $1,229 4.8×
Echograp Trans R Pros Study (76873)
range across 2 matching MRF lines		 $307–$1,149 $307–$1,149 varies
Esophagram (74220) $988 $988 5.3×
Fetal Biophys Profile W/Nst (76818) $1,235 $1,235 11.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $736 $736 6.6×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $1,459 $1,459 5.7×
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines		 $245–$834 $245–$834 varies
Follow-Up Angiography (75898) $3,513 $3,513 1.0×
Foot 2 views (73620) $318 $318 3.4×
Forearm 2 views (73090) $420 $420 4.5×
Gastric emptying imaging study (78264) $2,585 $2,585 6.0×
Gastroesophageal Reflux Exam (78262) $1,863 $1,863 4.3×
Gated Heart Planar Single (78472) $2,911 $2,911 6.8×
Hand 2 views (73120) $300 $300 2.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $5,948 $5,948 8.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $7,329 $7,329 9.8×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $9,436 $9,436 12.6×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $4,929 $4,929 1.5×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $5,182 $5,182 1.5×
Hepatobil Syst Image W/Drug (78227) $2,816 $2,816 4.8×
Hepatobiliary System Imaging (78226) $1,643 $1,643 3.8×
Ht Musc Image Planar Mult (78454) $5,175 $5,175 3.7×
Ht Muscle Image Spect Sing (78451) $4,629 $4,629 3.3×
Hysterosalpingogram (74740) $1,195 $1,195 4.7×
Infant hip ultrasound with hip movement (dynamic) (76885) $978 $978 10.5×
Infant hip ultrasound, limited static exam (76886) $493 $493 5.3×
Infusion Ivp (74410) $949 $949 5.0×
Interstitial radiation source applic complex (77778) $8,638 $8,638 11.6×
Intracavitary Radiation Source Applic Intermed (77762) $7,418 $7,418 12.5×
Intracavitary radiation source applic simple (77761) $6,421 $6,421 10.8×
Joint Survey Single View (77077) $390 $390 3.5×
K Flow/Funct Image W/Drug (78708) $2,628 $2,628 4.5×
K Flow/Funct Image W/O Drug (78707) $3,277 $3,277 5.6×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $1,018 $1,018 2.4×
Kidney Imaging Morphol (78700) $2,269 $2,269 5.3×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,931 $1,931 4.5×
Knee 3 Views (73562) $426 $426 4.6×
Leveen/Shunt Patency Exam (78291) $1,337 $1,337 3.1×
Liver & Spleen Imaging Static Only (78215) $1,704 $1,704 4.0×
Liver imaging static only (78201) $2,415 $2,415 4.2×
Liver imaging w/vascular flow (78202) $1,521 $1,521 2.6×
Lung Perf&Ventilat Diferentl (78598) $2,431 $2,431 4.2×
Lung Ventilat&Perfus Imaging (78582) $2,608 $2,608 4.5×
Lung Ventilation Imaging (78579) $1,868 $1,868 4.4×
Lymph System Imaging (78195) $3,239 $3,239 5.6×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $3,513 $3,513 1.0×
Lymphangiography, pelvic/abdominal, unilateral (75805) $3,402 $3,402 1.0×
Magnetic Image Jaw Joint (70336) $2,138 $2,138 8.4×
Magnetic Resonance Elastography (76391) $1,230 $1,230 4.8×
Mammary ductogram or galactogram multiple (77054) $1,157 $1,157 4.5×
Mammary ductogram or galactogram single (77053) $882 $882 3.4×
Meckels Divert Exam (78290) $2,666 $2,666 6.2×
Mlc imrt design & construction per imrt plan (77338) $3,306 $3,306 8.2×
Mra Head W/O & W/Contrast Material (70546) $4,277 $4,277 11.4×
MRA head w/o contrast (70544) $3,382 $3,382 13.2×
MRA head with contrast (70545) $3,709 $3,709 9.9×
MRA neck w contrast (70548) $3,961 $3,961 10.6×
Mra Neck W/O &W/Contrast Material (70549) $4,401 $4,401 11.8×
MRA neck w/o contrast (70547) $3,394 $3,394 13.3×
MRI abdomen w contrast (74182) $3,462 $3,462 9.3×
MRI abdomen w/o contrast (74181) $3,301 $3,301 12.9×
MRI any jt lower extrem w/contrast material (73722) $4,401 $4,401 5.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,743 $4,743 12.7×
MRI any jt upper extremity w/contrast matrl (73222) $3,695 $3,695 4.4×
MRI bone marrow blood supply (77084) $1,805 $1,805 7.1×
MRI brain functional w/o physician admnistration (70554) $3,654 $3,654 14.3×
MRI brain functional w/physician admnistration (70555) $3,654 $3,654 14.3×
MRI Breast W/O Contrast Bilateral (77047) $2,144 $2,144 8.4×
MRI Breast Without Contrast Material Unilateral (77046) $1,944 $1,944 7.6×
MRI cardiac w/o cont stress (75559) $2,663 $2,663 4.5×
MRI cardiac w/o contrast (75557) $2,805 $2,805 11.0×
MRI cervical spine w contrast (72142) $4,023 $4,023 10.8×
MRI cervical spine w/o cont (72141) $3,974 $3,974 15.5×
MRI chest w/o contrast (71550) $2,724 $2,724 10.7×
MRI chest with contrast (71551) $3,420 $3,420 4.1×
MRI chest wo w contrast (71552) $3,999 $3,999 10.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $4,401 $4,401 11.8×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,715 $4,715 12.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,129 $4,129 16.1×
MRI lumbar spine w contrast (72149) $4,652 $4,652 12.4×
Mri Neck Spine W/O & W/Dye (72156) $5,532 $5,532 14.8×
MRI orbit face &/neck w/o contrast (70540) $3,675 $3,675 14.4×
MRI orbit face neck w contrast (70542) $4,401 $4,401 11.8×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $5,222 $5,222 14.0×
MRI pelvis w contrast (72196) $3,460 $3,460 9.3×
MRI pelvis w/o & w contrast (72197) $4,014 $4,014 10.7×
MRI pelvis w/o contrast (72195) $3,414 $3,414 13.4×
MRI spectroscopy (76390) $1,002 $1,002 10.7×
MRI thoracic spine w/o contrast (72146) $4,397 $4,397 17.2×
MRI upper extremity oth than jt w/contr matrl (73219) $4,336 $4,336 11.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $4,009 $4,009 15.7×
Mri Uppr Extremity W/O&W/Dye (73220) $4,968 $4,968 13.3×
MRI, abdomen, combo (74183) $4,175 $4,175 11.2×
MRI, dorsal spine combo (72157) $5,193 $5,193 13.9×
MRI, dorsal spine contrast (72147) $4,652 $4,652 12.4×
MRI, joint upper extrem (73221) $3,680 $3,680 14.4×
MRI, joint upper extrem combo (73223) $4,057 $4,057 10.9×
MRI, lumbar spine combo (72158) $5,628 $5,628 15.1×
Myelogram cervical (72240) $1,826 $1,826 2.2×
Myelogram Lumbar (72265) $1,826 $1,826 2.2×
Myelography thoracic (72255) $2,554 $2,554 3.0×
Myelograpy 2/more regions rs&i (72270) $1,548 $1,548 1.8×
Myocardial Imaging Pet Metabolic Evaluation (78459) $4,793 $4,793 3.5×
Myocardial Spect Multiple Studies (78452) $7,131 $7,131 5.1×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $3,411 $3,411 2.2×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $5,178 $5,178 2.2×
N-invas est c ffr sw aly CTA (75580) $4,365 $4,365 4.7×
Neck soft tissue (70360) $462 $462 5.0×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $1,338 $1,338 3.2×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,079 $1,079 2.5×
Nonvascular Shunt X-Ray (75809) $1,242 $1,242 11.1×
Ntsty modul radthx pln dose-vol histos (77301) $12,631 $12,631 8.5×
Nuclear Rx Intra-Arterial (79445) $1,566 $1,566 6.3×
Nuclear Rx Oral Admin (79005) $3,068 $3,068 12.3×
Ob us nuchal meas 1 gest (76813) $860 $860 7.7×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $115 $115 1.0×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $115 $115 1.0×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $30 $30 1.0×
Optic foramina (70190) $239 $239 2.6×
Panoramic X-ray of jaws (70355) $439 $439 4.7×
Parathyroid imaging w/tomographic spect & CT (78072) $2,339 $2,339 4.0×
Parathyroid Planar Imaging (78070) $2,227 $2,227 5.2×
Parathyroid planar imaging w/wo subtraction (78071) $2,950 $2,950 6.9×
Pelvis 1 or 2 views (72170) $435 $435 3.9×
Perineogram (74775) $980 $980 3.8×
Peritoneogram Rs&I (74190) $1,214 $1,214 2.1×
Pet Image W/Ct Lmtd (78814) $3,589 $3,589 2.3×
PET image w/CT, full body (78816) $11,557 $11,557 7.5×
PET imaging CT attenuation skull base mid-thigh (78815) $10,422 $10,422 6.8×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $5,019 $5,019 1.5×
Pulmonary Perfusion Imaging Particulate (78580) $2,254 $2,254 5.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $751 $751 6.7×
Radex abscess/fistula/sinus tract rs&i (76080) $1,102 $1,102 1.9×
Radex Ankle Complete Minimum 3 Views (73610) $453 $453 4.9×
Radex Calcaneus Minimum 2 Views (73650) $417 $417 4.5×
Radex elbow complete minimum 3 views (73080) $472 $472 5.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $711 $711 6.3×
Radex fingr minimum 2 views (73140) $341 $341 3.7×
Radex foot complete minimum 3 views (73630) $453 $453 4.9×
Radex Hand Minimum 3 Views (73130) $453 $453 4.9×
Radex lower extremity infant minimum 2 views (73592) $231 $231 2.5×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $319 $319 2.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $503 $503 5.4×
Radex Ribs Unilateral 2 Views (71100) $539 $539 5.8×
Radex shoulder complete minimum 2 views (73030) $491 $491 5.3×
Radex Sinuses Paransl < 3 Views (70210) $298 $298 3.2×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $760 $760 4.0×
Radex Spine 1 View Specify Level (72020) $458 $458 4.9×
Radex Sternum Minimum 2 Views (71120) $376 $376 4.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $425 $425 4.6×
Radex Toe Minimum 2 Views (73660) $344 $344 3.7×
Radex upper extremity infant minimum 2 views (73092) $231 $231 2.1×
Radex Wrist Complete Minimum 3 Views (73110) $407 $407 4.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,076 $1,076 9.6×
Radiation treatment delivery level 1 (77402) $705 $705 6.4×
Radiation treatment delivery level 2 (77407) $1,060 $1,060 2.6×
Radiation treatment delivery level 3 (77412) $1,256 $1,256 2.1×
Radiolog exam mandible compl minimum 4 views (70110) $445 $445 4.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $582 $582 5.2×
Radiologic exam colon double contrast study (74280) $1,449 $1,449 7.7×
Radiologic exam colon single contrast study (74270) $1,170 $1,170 6.2×
Radiologic Exam Esophagus Double Contrast Study (74221) $988 $988 5.3×
Radiologic exam knee complete 4/more views (73564) $503 $503 4.5×
Radiologic exam pelvis compl minimum 3 views (72190) $756 $756 6.7×
Radiologic Exam Small Int Single Contrast Study (74250) $1,031 $1,031 5.5×
Radiologic exam swallow function contrast study (74230) $932 $932 5.0×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $95 $95 0.4×
Radiologic exam upr gi trc double contrast study (74246) $928 $928 4.9×
Radiologic examination femur 1 view (73551) $313 $313 3.4×
Radiologic examination femur minimum 2 views (73552) $446 $446 4.8×
Radiologic examination knee 1/2 views (73560) $396 $396 4.2×
Radiologic Examination Osseous Survey Limited (77074) $857 $857 7.6×
Radiologic examination tibia & fibula 2 views (73590) $425 $425 4.6×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $634 $634 1.1×
Radiologic examination, teeth; single view Non-Facility (70300) $43 $43 0.5×
Renal Cyst Study (74470) $1,451 $1,451 2.5×
Ribs bilateral 3 views (71110) $552 $552 4.9×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,527 $1,527 3.6×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $5,713 $5,713 9.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,772 $2,772 4.8×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,007 $3,007 5.2×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,007 $3,007 2.2×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,411 $3,411 2.2×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,007 $3,007 2.2×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $2,102 $2,102 8.4×
Rp Therapy Intravenous Administration (79101) $1,410 $1,410 5.6×
Salivary Gland Imaging Serial Images (78231) $1,368 $1,368 3.2×
Scapula (73010) $474 $474 4.2×
Screening Digital Breast Tomosynthesis Bi (77063) $112 $112 4.8×
Sella turcica (70240) $231 $231 2.5×
Shoulder 1 view (73020) $351 $351 3.8×
Shoulder Arthrography (73040) $926 $926 2.5×
Sialogram (70390) $1,157 $1,157 4.5×
Skull less than 4 views (70250) $542 $542 4.8×
Special dosimetry (77331) $1,529 $1,529 10.6×
Special Physics Consult (77370) $1,464 $1,464 10.2×
Special teletherapy port plan (77321) $2,028 $2,028 5.1×
Special treatment procedure (77470) $4,615 $4,615 7.8×
Stereotactic Body Radiation Delivery (77373)
range across 2 matching MRF lines		 $14,544–$25,417 $14,544–$25,417 varies
Sternoclavicular joints (71130) $319 $319 3.4×
Superior sagittal sinus venogram (75870) $3,579 $3,579 1.1×
Tbs technical calculation only (77091) $417 $417 4.5×
Telethx isodose pln cplx w/basic dosimetry (77307) $2,635 $2,635 6.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $864 $864 2.2×
Temporomandble Jt Arthrography Rs&I (70332) $1,498 $1,498 5.9×
Testicular Imaging W/Flow (78761) $1,738 $1,738 4.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $3,050 $3,050 7.6×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,549 $2,549 6.4×
Ther rad simulaj-aided field setting simple (77280) $1,698 $1,698 11.8×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $915 $915 4.9×
Thoracic spine 2 views (72070) $465 $465 4.2×
Thoracic spine 3 views (72072) $634 $634 5.7×
Thoracolumbar 2 views (72080) $540 $540 5.8×
Thyroid Imaging With Vascular Flow (78013) $1,093 $1,093 2.6×
Thyroid Met Imaging Body (78018) $3,126 $3,126 5.4×
Thyroid Uptake Measurement (78012) $829 $829 1.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,492 $3,492 8.2×
Tx Devices Design & Construction Complex (77334) $2,533 $2,533 6.3×
Tx devices design & construction intermediate (77333) $1,351 $1,351 9.4×
Tx devices design & construction simple (77332) $1,159 $1,159 8.0×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $163–$422 $163–$422 varies
Ultrasound elastography first target lesion (76982) $580 $580 5.2×
Ultrasound Elastography Parenchyma (76981) $599 $599 5.3×
Ultrasound Exam Aaa Screen (76706) $602 $602 5.4×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $1,076 $1,076 2.9×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $253–$861 $253–$861 varies
Umbilical-artery Doppler (OB) (76820) $339 $339 3.0×
Unlisted Dx Radiographic Procedure (76499)
range across 3 matching MRF lines		 $70–$5,696 $70–$5,696 varies
Unlisted fluoroscopic procedure (76496) $1,125 $1,125 12.1×
Unlisted magnetic resonance procedure (76498) $2,950 $2,950 31.6×
Unlisted us procedure (76999)
range across 2 matching MRF lines		 $176–$755 $176–$755 varies
Upper gi w/o kub (74240) $935 $935 5.0×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $423 $423 38.2×
Urea breath test c-14 isotopic analysis (78268) $542 $542 5.7×
Ureteral Reflux Study (78740) $2,198 $2,198 5.1×
Urethrocystogram voiding (74455) $808 $808 3.2×
Urethrocystography retrograde (74450) $772 $772 3.0×
Us bone density measurement (76977) $243 $243 2.2×
Us breast unilateral complete (76641) $291 $291 2.6×
Us chest (76604) $678 $678 6.1×
Us complete joint (76881)
range across 2 matching MRF lines		 $275–$1,549 $275–$1,549 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $118–$829 $118–$829 varies
Us head (76506) $378 $378 3.4×
Us kidney transplant (76776) $1,298 $1,298 11.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $118–$529 $118–$529 varies
Us ob detailed single fetus (76811) $1,289 $1,289 5.0×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $179–$756 $179–$756 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines		 $139–$596 $139–$596 varies
Us pelvic non ob complete (76856)
range across 2 matching MRF lines		 $291–$1,024 $291–$1,024 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $745 $745 6.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $744 $744 6.6×
Us retroperitoneal complete (76770) $1,115 $1,115 10.0×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $269–$902 $269–$902 varies
Us scrotum and contents (76870)
range across 2 matching MRF lines		 $242–$1,169 $242–$1,169 varies
Us spinal canal and contents (76800) $782 $782 7.0×
Us thyroid (76536)
range across 2 matching MRF lines		 $281–$987 $281–$987 varies
Us transrectal (76872)
range across 2 matching MRF lines		 $313–$797 $313–$797 varies
Vascular Flow Imaging (78445) $1,072 $1,072 2.5×
Vein X-Ray Chest (75827) $3,816 $3,816 2.3×
Vein X-Ray Liver W/O Hemodyn (75887) $3,755 $3,755 1.1×
Vein X-Ray Skull Epidural (75872) $3,755 $3,755 5.6×
Venogram Sinus/Jugular (75860) $3,491 $3,491 1.0×
Venography Adrenal Unilateral (75840) $5,019 $5,019 1.5×
Venography caval inferior serialography rs&i (75825) $4,342 $4,342 1.3×
Venography extremity bilateral rs&i (75822) $2,681 $2,681 1.6×
Venography extremity unilateral rs&i (75820) $2,037 $2,037 1.2×
Venography Orbital Rs&I (75880) $3,579 $3,579 5.3×
Venography Renal Bilateral (75833) $5,182 $5,182 1.5×
Venography Renal Unilateral (75831) $5,182 $5,182 1.5×
Venous sampling by catheter (75893) $5,882 $5,882 1.0×
Venous Thrombosis Imaging Venogram Bilateral (78458) $1,107 $1,107 2.6×
Vertebral fracture assessment via dxa (77086) $297 $297 3.2×
Wrist 2 views (73100) $331 $331 3.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $231 $231 2.5×
X-ray antegrade pyelogram tube (74425) $1,122 $1,122 3.0×
X-Ray Aorta Leg Arteries (75630) $5,248 $5,248 1.6×
X-Ray Bend Only L-S Spine (72120) $551 $551 4.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $385 $385 4.1×
X-Ray Exam Breast Specimen (76098) $651 $651 1.1×
X-Ray Exam Entire Spi 1 Vw (72081) $286 $286 3.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $544 $544 4.9×
X-Ray Exam Entire Spi 4/5 Vw (72083) $1,076 $1,076 9.6×
X-Ray Exam Hip Uni 1 View (73501) $360 $360 3.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $453 $453 4.9×
X-Ray Exam Hip Uni 4/> Views (73503) $564 $564 5.0×
X-Ray Exam Hips Bi 2 Views (73521) $609 $609 5.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $690 $690 6.2×
X-Ray Exam Hips Bi 5/> Views (73523) $1,076 $1,076 9.6×
X-Ray Exam L-S Spine Bending (72114) $678 $678 6.1×
X-Ray Exam Neck Spine 2-3 Vw (72040) $514 $514 5.5×
X-Ray Exam Neck Spine 6/>Vws (72052) $728 $728 6.5×
X-Ray Exam Unilat Ribs/Chest (71101) $632 $632 5.6×
X-ray eye for foreign body (70030) $549 $549 5.9×
X-ray humerus (73060) $453 $453 4.9×
X-ray IV pyelogram (ivp) (74400) $1,125 $1,125 6.0×
X-ray IV pyelogram+tomography (74415) $1,635 $1,635 8.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $231 $231 2.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $418 $418 4.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $506 $506 4.5×
X-ray nose-rectum child f.b. (76010) $245 $245 2.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,042 $1,042 9.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $516 $516 4.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $394 $394 3.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $491 $491 5.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $738 $738 7.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $623 $623 5.6×
X-Ray Stress View (77071) $438 $438 4.7×
X-ray thoracic spine 4 vw (72074) $755 $755 6.7×
X-Ray Tmj Unilat (70328) $239 $239 2.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $941 $941 2.5×
X-Rays Bone Length Studies (77073) $518 $518 4.6×
X-Rays Bone Survey Complete (77075) $1,009 $1,009 9.0×
Xr c-spine 4 or 5 views (72050) $731 $731 6.5×
Xr facial bones less than 3 views (70140) $306 $306 3.3×
Xr orbits complete 4 views (70200) $562 $562 5.0×
Xr Tomogram Single Plane (76100) $583 $583 5.2×

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.