Imaging prices at Tennova Jefferson Memorial Hospital
Jefferson City, TN · every code in this section with a posted price and a Medicare benchmark.
357 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) | $2,713.74 | $12,262.71 | 2.2× |
| Abdomen 1 View (74018) | $137.88 | $623.06 | 1.7× |
| Abdomen 2 views (74019) | $274.36 | $1,239.78 | 2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $921.76 | $4,165.19 | 2.5× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,173.81 | $5,304.16 | 1.0× |
| Angio internal mammary (75756) | $1,194.46 | $5,397.49 | 0.4× |
| Angio pulmonary bilat (75743) | $5,270.54 | $23,816.28 | 1.8× |
| Angiography extremity bilateral rs&i (75716) | $4,960.51 | $22,415.31 | 1.7× |
| Angiography extremity unilateral rs&i (75710) | $4,960.51 | $22,415.31 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,270.54 | $23,816.28 | 1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,618.12 | $7,311.89 | 0.6× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$137.16–$245.67 | $619.78–$1,110.13 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,558.63 | $16,080.59 | 0.7× |
| Artery X-Rays Abdomen (75726) | $8,820.85 | $39,859.26 | 1.7× |
| Artery X-Rays Pelvis (75736) | $3,558.63 | $16,080.59 | 0.7× |
| Artery X-Rays Spine (75705) | $7,351.58 | $33,219.97 | 1.5× |
| Arthrogram hip (73525) | $694.15 | $3,136.71 | 2.2× |
| Arthrogram Wrist (73115) | $694.15 | $3,136.71 | 2.2× |
| Basic radiation dosimetry calculation (77300) | $230.64 | $1,042.22 | 1.9× |
| Bone age studies (77072) | $144.86 | $654.58 | 1.5× |
| Bone Imaging 3 Phase (78315) | $866.25 | $3,914.36 | 2.4× |
| Bone Imaging Limited Area (78300) | $721.87 | $3,261.97 | 2.0× |
| Bone Imaging Whole Body (78306) | $830.15 | $3,751.23 | 2.3× |
| Bone marrow imaging limited area (78102) | $433.99 | $1,961.09 | 1.2× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$166.08–$175.64 | $750.48–$793.69 | varies |
| Brachytx isodose complex (77318) | $1,147.98 | $5,187.43 | 3.4× |
| Brachytx isodose intermed (77317) | $631.60 | $2,854.06 | 1.9× |
| Brachytx Isodose Plan Simple (77316) | $163.34 | $738.11 | 0.5× |
| Brain Image W/Flow < 4 Views (78601) | $406.16 | $1,835.33 | 1.1× |
| Brain imaging < 4 static views (78600) | $406.16 | $1,835.33 | 1.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $527.09 | $2,381.77 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,213.85 | $14,522.58 | 2.5× |
| Cardiac Shunt Detection (78428) | $829.80 | $3,749.64 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $788.18 | $3,561.59 | 10.0× |
| Cerebrospinal Fluid Scan (78630) | $1,465.77 | $6,623.43 | 3.0× |
| Chest 1 view (71045) | $113 | $510.61 | 1.4× |
| Chest 2 views (71046) | $169.51 | $765.99 | 2.1× |
| Chest 3 views (71047) | $173.36 | $783.36 | 2.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $109.11 | $493.05 | 1.2× |
| Cholecystography Oral Contrast (74290) | $335.07 | $1,514.12 | 2.1× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$175.70–$527.37 | $793.96–$2,383.05 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$146.92–$158.67 | $663.90–$717 | varies |
| Continuing medical physics consltj pr wk (77336) | $280.37 | $1,266.94 | 2.3× |
| Contrast Exam Abdominl Aorta (75625) | $3,776.31 | $17,064.22 | 1.3× |
| Contrast X-Ray Bladder (74430) | $495.96 | $2,241.12 | 1.6× |
| Contrast X-Ray Of Elbow (73085) | $489.99 | $2,214.15 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $489.99 | $2,214.15 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $2,573.46 | $11,628.83 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $2,313.14 | $10,452.52 | 10.7× |
| CT abdomen w contrast (74160) | $1,304.56 | $5,894.98 | 8.2× |
| CT abdomen w wo contrast (74170) | $1,445.42 | $6,531.51 | 9.1× |
| CT abdomen w/o contrast (74150) | $1,107.71 | $5,005.46 | 11.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,978.11 | $13,457.33 | 9.4× |
| CT Angio Chest (71275) | $1,164.27 | $5,261.05 | 7.3× |
| CT Angio Head (70496) | $1,369.57 | $6,188.76 | 8.6× |
| CT angio hrt w/3d image (75574) | $909.12 | $4,108.08 | 2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $652.57 | $2,948.80 | 4.1× |
| CT Angio Neck (70498) | $1,313.59 | $5,935.79 | 8.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$864.76–$1,142 | $3,907.62–$5,160.42 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $149.53 | $675.70 | 0.9× |
| CT cervical spine w/ contrast (72126) | $1,462.88 | $6,610.39 | 4.6× |
| CT cervical spine w/o contrast (72125) | $1,262.03 | $5,702.81 | 13.3× |
| CT cervical spine w/wo cont (72127) | $1,243.73 | $5,620.13 | 7.8× |
| CT chest w contrast (71260) | $1,284.90 | $5,806.13 | 8.1× |
| CT chest w/wo contrast (71270) | $1,151.63 | $5,203.93 | 7.2× |
| CT head/brain with contrast (70460) | $962.55 | $4,349.52 | 6.0× |
| CT head/brain without and with contrast (70470) | $1,133.43 | $5,121.70 | 7.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $499.09 | $2,255.28 | 1.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $48.17 | $217.66 | 0.6× |
| CT hrt w/3d image congen (75573) | $416.94 | $1,884.07 | 1.3× |
| CT iac w contrast (70481) | $1,136.05 | $5,133.54 | 7.1× |
| CT l-spine w&w/o contrast (72133) | $1,325.60 | $5,990.06 | 8.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$876.82–$1,846.27 | $3,962.15–$8,342.83 | varies |
| CT lower extremity w/contrast material (73701) | $885.52 | $4,001.44 | 5.6× |
| CT lumbar spine w contrast (72132) | $1,326.26 | $5,993.04 | 4.2× |
| CT lumbar spine w/o contrast (72131) | $1,092.73 | $4,937.79 | 11.5× |
| CT maxillofacial w contrast (70487) | $950.49 | $4,295.04 | 6.0× |
| CT maxillofacial wo contrast (70486) | $902.96 | $4,080.26 | 9.5× |
| CT neck tissue combo (70492) | $1,401.92 | $6,334.93 | 8.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,130.17 | $5,106.96 | 7.1× |
| CT orbits w/o contrast (70480) | $920.38 | $4,158.97 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $1,140.55 | $5,153.85 | 7.2× |
| CT pelvis w/o contrast (72192) | $962.55 | $4,349.52 | 10.1× |
| CT scan of leg combo (73702) | $962.55 | $4,349.52 | 6.0× |
| CT scans face/jaw combo (70488) | $1,454.36 | $6,571.88 | 9.1× |
| CT soft tissue neck w contrast (70491) | $953.01 | $4,306.42 | 6.0× |
| CT soft tissue neck w/o contrast (70490) | $928.48 | $4,195.57 | 9.8× |
| CT thoracic spine w contrast (72129) | $1,217.15 | $5,500.02 | 7.6× |
| CT thoracic spine w/o contrast (72128) | $968.47 | $4,376.29 | 10.2× |
| CT thoracic spine w/wo cont (72130) | $1,239.97 | $5,603.13 | 7.8× |
| CT thorax w/o contrast (71250) | $999.95 | $4,518.51 | 10.5× |
| CT upper ext wo (73200) | $809.10 | $3,656.11 | 8.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,152.52 | $5,207.95 | 7.2× |
| CT upper extremity with contrast (73201) | $982.30 | $4,438.79 | 3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,468.51 | $6,635.82 | 9.2× |
| Cta Abdomen (74175) | $1,334.50 | $6,030.28 | 8.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,683.16 | $12,124.55 | 8.5× |
| CTA pelvis (72191) | $1,670.02 | $7,546.42 | 10.5× |
| Dilation ureters/urethra rs&i (74485) | $2,357.47 | $10,652.82 | 1.2× |
| Diskography lumbar (72295) | $4,810.62 | $21,738.01 | 2.7× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$250.91–$284.40 | $1,133.80–$1,285.14 | varies |
| Dxa bone density study (77085) range across 3 matching MRF lines |
$241.46–$273.70 | $1,091.12–$1,236.76 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$133.39–$218 | $602.74–$985.11 | varies |
| Echo Guide For Artery Repair (76936) | $476.01 | $2,150.95 | 2.4× |
| Echograp Trans R Pros Study (76873) | $363.41 | $1,642.14 | 3.8× |
| Esophagram (74220) | $183.83 | $830.66 | 1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $250.06 | $1,129.95 | 2.6× |
| Fluoroscopy up to 1 hr (76000) | $303.44 | $1,371.19 | 1.4× |
| Follow-Up Angiography (75898) | $1,691.67 | $7,644.24 | 0.6× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$154.04–$314.21 | $696.09–$1,419.83 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$168.38–$341.70 | $760.88–$1,544.06 | varies |
| Gastric emptying imaging study (78264) | $1,044.22 | $4,718.57 | 2.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $439.84 | $1,987.53 | 1.2× |
| Gastroesophageal Reflux Exam (78262) | $623.39 | $2,816.93 | 1.7× |
| Gated Heart Planar Single (78472) | $981.76 | $4,436.31 | 2.7× |
| Gated Heart, Multiple (78473) | $886.95 | $4,007.89 | 2.4× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$137.16–$284.23 | $619.78–$1,284.36 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,165.78 | $5,267.85 | 1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,173.92 | $5,304.64 | 1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,553.16 | $7,018.36 | 2.5× |
| Heart Image (Pet) Multiple (78492) | $1,993.04 | $9,006.04 | 1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,141.91 | $5,160 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $384.88 | $1,739.19 | 0.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,165.66 | $5,267.31 | 2.4× |
| Hepatobiliary System Imaging (78226) | $806.99 | $3,646.59 | 2.2× |
| Ht Musc Image Planar Mult (78454) | $1,466.25 | $6,625.62 | 1.2× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,133.30–$3,133.32 | $14,158.62–$14,158.70 | varies |
| Hysterosalpingogram (74740) | $688.59 | $3,111.59 | 3.2× |
| Interstitial radiation source applic complex (77778) | $3,739.96 | $16,899.96 | 5.9× |
| K Flow/Funct Image Multiple (78709) | $1,364.89 | $6,167.61 | 2.8× |
| K Flow/Funct Image W/Drug (78708) | $1,235.87 | $5,584.59 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,120.57 | $5,063.59 | 2.3× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$192.66–$332.49 | $870.59–$1,502.43 | varies |
| Leveen/Shunt Patency Exam (78291) | $525.76 | $2,375.79 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $664.19 | $3,001.30 | 1.8× |
| Liver imaging static only (78201) | $1,790.51 | $8,090.88 | 3.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,140.66 | $5,154.36 | 2.3× |
| Lung Ventilation Imaging (78579) | $591.37 | $2,672.27 | 1.6× |
| Lymph System Imaging (78195) | $833.52 | $3,766.49 | 1.7× |
| Magnetic Image Jaw Joint (70336) | $1,416.25 | $6,399.67 | 6.5× |
| Mammary ductogram or galactogram multiple (77054) | $369.51 | $1,669.71 | 1.7× |
| Mammary ductogram or galactogram single (77053) | $437.14 | $1,975.33 | 2.0× |
| Meckels Divert Exam (78290) | $623.39 | $2,816.93 | 1.7× |
| Mlc imrt design & construction per imrt plan (77338) | $636.96 | $2,878.28 | 1.9× |
| Mr safety determination physician/other qhp (76016) | $87.99 | $397.60 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $24.47 | $110.59 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $91.72 | $414.48 | 1.1× |
| Mr safety implt pos&/immoblj (76019) | $59.36 | $268.23 | 1.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $241.55 | $1,091.52 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,785.60 | $8,068.70 | 5.6× |
| MRA head w/o contrast (70544) | $1,502.84 | $6,790.96 | 6.9× |
| MRA head with contrast (70545) | $1,682.69 | $7,603.64 | 5.3× |
| MRA neck w contrast (70548) | $1,222.39 | $5,523.66 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,408.55 | $6,364.91 | 4.5× |
| MRA neck w/o contrast (70547) | $1,146.64 | $5,181.36 | 5.3× |
| MRI abdomen w contrast (74182) | $1,628.55 | $7,359 | 5.1× |
| MRI abdomen w/o contrast (74181) | $1,221.18 | $5,518.23 | 5.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,645.90–$2,966.36 | $7,437.40–$13,404.23 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,742.64–$3,636.76 | $7,874.54–$16,433.61 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,637.10 | $7,397.63 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,083.86 | $4,897.71 | 5.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $563.05 | $2,544.29 | 2.6× |
| MRI cervical spine w contrast (72142) | $1,864.80 | $8,426.59 | 5.9× |
| MRI cervical spine w/o cont (72141) | $1,615.82 | $7,301.49 | 7.5× |
| MRI chest w/o contrast (71550) | $1,306.29 | $5,902.79 | 6.0× |
| MRI chest with contrast (71551) | $1,312.41 | $5,930.45 | 1.8× |
| MRI chest wo w contrast (71552) | $1,809.66 | $8,177.42 | 5.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,778.69–$3,081.10 | $8,037.48–$13,922.71 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,818.38–$3,636.76 | $8,216.80–$16,433.61 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,449.49–$2,442.58 | $6,549.88–$11,037.42 | varies |
| MRI lumbar spine w contrast (72149) | $1,560.75 | $7,052.66 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,278.04 | $10,293.88 | 7.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,305.67 | $5,899.99 | 6.0× |
| MRI orbit face neck w contrast (70542) | $1,487.42 | $6,721.30 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,937.78 | $8,756.37 | 6.1× |
| MRI pelvis w contrast (72196) | $1,637.53 | $7,399.59 | 5.2× |
| MRI pelvis w/o & w contrast (72197) | $1,832.76 | $8,281.78 | 5.8× |
| MRI pelvis w/o contrast (72195) | $1,361.97 | $6,154.41 | 6.3× |
| MRI thoracic spine w/o contrast (72146) | $1,331.95 | $6,018.75 | 6.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,806.94 | $8,165.11 | 5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,384.27 | $6,255.19 | 6.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,172.26 | $9,815.92 | 6.9× |
| MRI, abdomen, combo (74183) | $1,901.93 | $8,594.33 | 6.0× |
| MRI, dorsal spine combo (72157) | $2,185.44 | $9,875.47 | 6.9× |
| MRI, dorsal spine contrast (72147) | $1,487.60 | $6,722.09 | 4.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,476.26–$2,524.52 | $6,670.86–$11,407.68 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$952.58–$2,285.53 | $4,304.49–$10,327.76 | varies |
| MRI, lumbar spine combo (72158) | $2,231.30 | $10,082.70 | 7.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,921.67 | $13,202.32 | 2.5× |
| Myocardial Spect Multiple Studies (78452) | $3,174.99 | $14,346.99 | 2.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,872.95 | $8,463.42 | 0.9× |
| N-invas est c ffr sw aly CTA (75580) | $1,245.70 | $5,629 | 1.6× |
| Neck soft tissue (70360) | $150.33 | $679.30 | 1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $404.55 | $1,828.06 | 1.1× |
| Nonvascular Shunt X-Ray (75809) | $137.16 | $619.78 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,859.60 | $17,440.56 | 3.1× |
| Nuclear Rx Intra-Arterial (79445) | $261.71 | $1,182.62 | 1.2× |
| Nuclear Rx Oral Admin (79005) | $734.95 | $3,321.05 | 3.5× |
| Panoramic X-ray of jaws (70355) | $178.51 | $806.64 | 2.3× |
| Parathyroid Planar Imaging (78070) | $1,065.28 | $4,813.75 | 2.9× |
| Pelvis 1 or 2 views (72170) | $184.57 | $834.04 | 1.9× |
| Pet Image Skull-Thigh (78812) | $1,917.66 | $8,665.42 | 1.5× |
| Pet Image W/Ct Lmtd (78814) | $2,544.21 | $11,496.65 | 2.0× |
| PET image w/CT, full body (78816) | $2,443.62 | $11,042.12 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,477.03 | $11,193.07 | 1.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,674.63 | $7,567.22 | 1.4× |
| Pet Myocardial Sngl Study (78491) | $2,297.13 | $10,380.17 | 1.8× |
| PET whole body (78813) | $2,443.62 | $11,042.12 | 1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,370.89 | $10,713.45 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $545.53 | $2,465.10 | 1.5× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $793.13 | $3,583.97 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $301.89 | $1,364.15 | 3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $612.08 | $2,765.86 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$169.51–$314.82 | $765.99–$1,422.59 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$144.69–$295.32 | $653.82–$1,334.46 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$178.89–$366.70 | $808.35–$1,657.01 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $221.99 | $1,003.10 | 2.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$156.14–$298.92 | $705.57–$1,350.75 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$184.57–$314.89 | $834.04–$1,422.90 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$169.93–$344.80 | $767.89–$1,558.07 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$139.43–$292.63 | $630.04–$1,322.34 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$280.48–$292.38 | $1,267.40–$1,321.21 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $189.47 | $856.18 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $182.55 | $824.88 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$172.51–$345.52 | $779.52–$1,561.33 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $99.50 | $449.62 | 1.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $218.37 | $986.78 | 1.4× |
| Radex Spine 1 View Specify Level (72020) | $151.58 | $684.96 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $267.15 | $1,207.19 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $192.89 | $871.64 | 2.4× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$143.67–$251.04 | $649.22–$1,134.41 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$174.21–$303.37 | $787.23–$1,370.84 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,029.57 | $4,652.36 | 10.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,101.25 | $63,720.08 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $1,239.76 | $5,602.19 | 13.4× |
| Radiation treatment delivery level 2 (77407) | $1,340.51 | $6,057.42 | 3.8× |
| Radiation treatment delivery level 3 (77412) | $1,393.22 | $6,295.60 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $163.77 | $740.05 | 1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $274.36 | $1,239.78 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $441.40 | $1,994.59 | 2.8× |
| Radiologic exam colon single contrast study (74270) | $366.67 | $1,656.88 | 2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $317.53 | $1,434.86 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$190.78–$434.78 | $862.10–$1,964.67 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $239 | $1,079.96 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $286.07 | $1,292.69 | 1.8× |
| Radiologic exam swallow function contrast study (74230) | $186.12 | $841.05 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $463.58 | $2,094.79 | 2.9× |
| Radiologic examination femur 1 view (73551) | $287.04 | $1,297.05 | 3.6× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$232.44–$574.07 | $1,050.32–$2,594.07 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$153.71–$312 | $694.57–$1,409.87 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $345.80 | $1,562.59 | 3.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$175.01–$298.97 | $790.81–$1,350.99 | varies |
| Ribs bilateral 3 views (71110) | $268.86 | $1,214.93 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,063.35 | $9,323.75 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,938.57 | $8,759.91 | 3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,315.13 | $5,942.73 | 2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,368.84 | $6,185.43 | 1.2× |
| Rp Therapy Intravenous Administration (79101) | $399.73 | $1,806.28 | 1.9× |
| Scapula (73010) range across 4 matching MRF lines |
$147.90–$295.08 | $668.34–$1,333.40 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$39.62–$54.03 | $179.04–$244.13 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$146.93–$266.55 | $663.92–$1,204.49 | varies |
| Shoulder Arthrography (73040) | $734.99 | $3,321.25 | 2.3× |
| Skull less than 4 views (70250) | $183.77 | $830.43 | 1.9× |
| Special dosimetry (77331) | $427.10 | $1,929.97 | 3.5× |
| Special Physics Consult (77370) | $965.56 | $4,363.14 | 7.9× |
| Special teletherapy port plan (77321) | $549.87 | $2,484.73 | 1.6× |
| Special treatment procedure (77470) | $737.44 | $3,332.32 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $2,811.26 | $12,703.40 | 1.7× |
| Sternoclavicular joints (71130) | $205.45 | $928.39 | 2.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $31.84 | $143.89 | 0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $812.49 | $3,671.44 | 2.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $529.95 | $2,394.71 | 1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $673.26 | $3,042.31 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $556.72 | $2,515.70 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $329.13 | $1,487.24 | 2.7× |
| Thoracic spine 2 views (72070) | $205.63 | $929.21 | 2.2× |
| Thoracic spine 3 views (72072) | $254.32 | $1,149.21 | 2.7× |
| Thoracolumbar 2 views (72080) | $217.54 | $982.99 | 2.8× |
| Thyroid Imaging With Vascular Flow (78013) | $274.14 | $1,238.79 | 0.8× |
| Thyroid Met Imaging Body (78018) | $916.35 | $4,140.74 | 1.9× |
| Thyroid Uptake Measurement (78012) | $311.66 | $1,408.31 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $552.46 | $2,496.43 | 1.5× |
| Tx Devices Design & Construction Complex (77334) | $481.17 | $2,174.31 | 1.4× |
| Tx devices design & construction intermediate (77333) | $373.40 | $1,687.29 | 3.1× |
| Tx devices design & construction simple (77332) | $436.73 | $1,973.48 | 3.6× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$212.79–$483.90 | $961.55–$2,186.62 | varies |
| Ultrasound elastography first target lesion (76982) | $277.73 | $1,254.98 | 2.9× |
| Ultrasound Elastography Parenchyma (76981) | $277.73 | $1,254.98 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $166.34 | $751.63 | 1.8× |
| Ultrasound, abdomen limited (76705) | $314.27 | $1,420.12 | 3.3× |
| Unlisted Dx Radiographic Procedure (76499) | $82.38 | $372.27 | 1.0× |
| Upper gi w/o kub (74240) | $319.71 | $1,444.67 | 2.0× |
| Urethrocystogram voiding (74455) | $495.96 | $2,241.12 | 2.3× |
| Urethrocystography retrograde (74450) | $495.96 | $2,241.12 | 2.3× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$199.02–$390.84 | $899.31–$1,766.11 | varies |
| Us chest (76604) | $239.90 | $1,084.03 | 2.5× |
| Us complete joint (76881) range across 2 matching MRF lines |
$248.61–$409.57 | $1,123.41–$1,850.74 | varies |
| Us exam, pelvic, limited (76857) | $188.23 | $850.55 | 2.0× |
| Us head (76506) range across 2 matching MRF lines |
$129.46–$195.28 | $585–$882.44 | varies |
| Us kidney transplant (76776) | $365.31 | $1,650.76 | 3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$256.19–$409.57 | $1,157.66–$1,850.74 | varies |
| Us ob limited 1 or more fetuses (76815) | $194.66 | $879.60 | 2.1× |
| Us ob transvaginal (76817) | $331.28 | $1,496.96 | 3.5× |
| Us pelvic non ob complete (76856) | $266.52 | $1,204.32 | 2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $332.57 | $1,502.80 | 3.5× |
| Us retroperitoneal complete (76770) | $217.56 | $983.09 | 2.3× |
| Us retroperitoneal limited (76775) | $219.60 | $992.34 | 2.3× |
| Us scrotum and contents (76870) | $217.76 | $984.01 | 2.3× |
| Us spinal canal and contents (76800) | $163.87 | $740.51 | 1.7× |
| Us thyroid (76536) | $260.64 | $1,177.77 | 2.7× |
| Us transrectal (76872) | $349.57 | $1,579.62 | 3.7× |
| Vein X-Ray Chest (75827) | $1,194.46 | $5,397.49 | 0.8× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,142.54–$1,194.46 | $5,162.85–$5,397.49 | varies |
| Venography caval inferior serialography rs&i (75825) | $4,960.51 | $22,415.31 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $1,511.12 | $6,828.36 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,592.16 | $7,194.56 | 1.1× |
| Venography Renal Bilateral (75833) | $3,720.38 | $16,811.47 | 1.3× |
| Venography Renal Unilateral (75831) | $3,720.38 | $16,811.47 | 1.3× |
| Venous sampling by catheter (75893) | $3,558.63 | $16,080.59 | 0.7× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$149.70–$266.45 | $676.44–$1,204.01 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $235.54 | $1,064.34 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $495.96 | $2,241.12 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $4,960.51 | $22,415.31 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $117.36 | $530.33 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$147.77–$261.43 | $667.75–$1,181.33 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$572.47–$612.08 | $2,586.85–$2,765.86 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $838.39 | $3,788.47 | 10.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $514.78 | $2,326.15 | 5.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,029.57 | $4,652.36 | 10.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $221.42 | $1,000.52 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $468.07 | $2,115.08 | 5.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $468.07 | $2,115.08 | 4.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,077.91 | $4,870.79 | 11.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,077.91 | $4,870.79 | 11.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,201.74 | $5,430.37 | 12.7× |
| X-Ray Exam L-S Spine Bending (72114) | $308.18 | $1,392.61 | 3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $176.74 | $798.64 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $371.14 | $1,677.07 | 3.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $193.41 | $873.95 | 2.0× |
| X-ray eye for foreign body (70030) | $98 | $442.84 | 1.2× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$154.51–$308.25 | $698.19–$1,392.92 | varies |
| X-ray IV pyelogram (ivp) (74400) | $526.97 | $2,381.24 | 3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $131.12 | $592.51 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $138.02 | $623.68 | 1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $219.31 | $991.03 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $130.71 | $590.65 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $218.37 | $986.75 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $160.47 | $725.11 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $172.84 | $781.02 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $273.08 | $1,233.98 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $327.70 | $1,480.78 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $526.97 | $2,381.24 | 1.7× |
| X-Rays Bone Length Studies (77073) | $199.48 | $901.39 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $413.60 | $1,868.96 | 4.4× |
| Xr c-spine 4 or 5 views (72050) | $251.67 | $1,137.22 | 2.7× |
| Xr facial bones less than 3 views (70140) | $128.80 | $582.03 | 1.6× |
| Xr orbits complete 4 views (70200) | $202.56 | $915.34 | 2.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.