Imaging prices at Tennova LaFollette Medical Center
LaFollette, 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) | $3,310.93 | $12,262.71 | 2.6× |
| Abdomen 1 View (74018) | $168.23 | $623.06 | 2.1× |
| Abdomen 2 views (74019) | $334.74 | $1,239.78 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,124.60 | $4,165.19 | 3.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,432.12 | $5,304.16 | 1.2× |
| Angio internal mammary (75756) | $1,457.32 | $5,397.49 | 0.5× |
| Angio pulmonary bilat (75743) | $6,430.40 | $23,816.28 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $6,052.13 | $22,415.31 | 2.1× |
| Angiography extremity unilateral rs&i (75710) | $6,052.13 | $22,415.31 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,430.40 | $23,816.28 | 2.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,974.21 | $7,311.89 | 0.7× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$167.34–$299.74 | $619.78–$1,110.13 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,341.76 | $16,080.59 | 0.9× |
| Artery X-Rays Abdomen (75726) | $10,762 | $39,859.26 | 2.1× |
| Artery X-Rays Pelvis (75736) | $4,341.76 | $16,080.59 | 0.9× |
| Artery X-Rays Spine (75705) | $8,969.39 | $33,219.97 | 1.8× |
| Arthrogram hip (73525) | $846.91 | $3,136.71 | 2.7× |
| Arthrogram Wrist (73115) | $846.91 | $3,136.71 | 2.7× |
| Basic radiation dosimetry calculation (77300) | $281.40 | $1,042.22 | 2.3× |
| Bone age studies (77072) | $176.74 | $654.58 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,056.88 | $3,914.36 | 2.9× |
| Bone Imaging Limited Area (78300) | $880.73 | $3,261.97 | 2.4× |
| Bone Imaging Whole Body (78306) | $1,012.83 | $3,751.23 | 2.8× |
| Bone marrow imaging limited area (78102) | $529.49 | $1,961.09 | 1.5× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$202.63–$214.30 | $750.48–$793.69 | varies |
| Brachytx isodose complex (77318) | $1,400.61 | $5,187.43 | 4.1× |
| Brachytx isodose intermed (77317) | $770.60 | $2,854.06 | 2.3× |
| Brachytx Isodose Plan Simple (77316) | $199.29 | $738.11 | 0.6× |
| Brain Image W/Flow < 4 Views (78601) | $495.54 | $1,835.33 | 1.4× |
| Brain imaging < 4 static views (78600) | $495.54 | $1,835.33 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $643.08 | $2,381.77 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,921.10 | $14,522.58 | 3.0× |
| Cardiac Shunt Detection (78428) | $1,012.40 | $3,749.64 | 2.8× |
| Cat Scan Follow-Up Study (76380) | $961.63 | $3,561.59 | 12.2× |
| Cerebrospinal Fluid Scan (78630) | $1,788.33 | $6,623.43 | 3.6× |
| Chest 1 view (71045) | $137.86 | $510.61 | 1.7× |
| Chest 2 views (71046) | $206.82 | $765.99 | 2.6× |
| Chest 3 views (71047) | $211.51 | $783.36 | 2.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $133.12 | $493.05 | 1.4× |
| Cholecystography Oral Contrast (74290) | $408.81 | $1,514.12 | 2.6× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$214.37–$643.42 | $793.96–$2,383.05 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$179.25–$193.59 | $663.90–$717 | varies |
| Continuing medical physics consltj pr wk (77336) | $342.07 | $1,266.94 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) | $4,607.34 | $17,064.22 | 1.6× |
| Contrast X-Ray Bladder (74430) | $605.10 | $2,241.12 | 1.9× |
| Contrast X-Ray Of Elbow (73085) | $597.82 | $2,214.15 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $597.82 | $2,214.15 | 1.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,139.78 | $11,628.83 | 9.9× |
| CT abdomen and pelvis without contrast (74176) | $2,822.18 | $10,452.52 | 13.0× |
| CT abdomen w contrast (74160) | $1,591.64 | $5,894.98 | 10.0× |
| CT abdomen w wo contrast (74170) | $1,763.51 | $6,531.51 | 11.1× |
| CT abdomen w/o contrast (74150) | $1,351.47 | $5,005.46 | 14.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,633.48 | $13,457.33 | 11.5× |
| CT Angio Chest (71275) | $1,420.48 | $5,261.05 | 8.9× |
| CT Angio Head (70496) | $1,670.97 | $6,188.76 | 10.5× |
| CT angio hrt w/3d image (75574) | $1,109.18 | $4,108.08 | 3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $796.18 | $2,948.80 | 5.0× |
| CT Angio Neck (70498) | $1,602.66 | $5,935.79 | 10.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,055.06–$1,393.31 | $3,907.62–$5,160.42 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $182.44 | $675.70 | 1.1× |
| CT cervical spine w/ contrast (72126) | $1,784.81 | $6,610.39 | 5.6× |
| CT cervical spine w/o contrast (72125) | $1,539.76 | $5,702.81 | 16.2× |
| CT cervical spine w/wo cont (72127) | $1,517.44 | $5,620.13 | 9.5× |
| CT chest w contrast (71260) | $1,567.66 | $5,806.13 | 9.9× |
| CT chest w/wo contrast (71270) | $1,405.06 | $5,203.93 | 8.8× |
| CT head/brain with contrast (70460) | $1,174.37 | $4,349.52 | 7.4× |
| CT head/brain without and with contrast (70470) | $1,382.86 | $5,121.70 | 8.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $608.93 | $2,255.28 | 1.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $58.77 | $217.66 | 0.7× |
| CT hrt w/3d image congen (75573) | $508.70 | $1,884.07 | 1.6× |
| CT iac w contrast (70481) | $1,386.06 | $5,133.54 | 8.7× |
| CT l-spine w&w/o contrast (72133) | $1,617.32 | $5,990.06 | 10.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,069.78–$2,252.56 | $3,962.15–$8,342.83 | varies |
| CT lower extremity w/contrast material (73701) | $1,080.39 | $4,001.44 | 6.8× |
| CT lumbar spine w contrast (72132) | $1,618.12 | $5,993.04 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,333.20 | $4,937.79 | 14.1× |
| CT maxillofacial w contrast (70487) | $1,159.66 | $4,295.04 | 7.3× |
| CT maxillofacial wo contrast (70486) | $1,101.67 | $4,080.26 | 11.6× |
| CT neck tissue combo (70492) | $1,710.43 | $6,334.93 | 10.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,378.88 | $5,106.96 | 8.7× |
| CT orbits w/o contrast (70480) | $1,122.92 | $4,158.97 | 11.8× |
| CT pelvis w&w/o contrast (72194) | $1,391.54 | $5,153.85 | 8.7× |
| CT pelvis w/o contrast (72192) | $1,174.37 | $4,349.52 | 12.4× |
| CT scan of leg combo (73702) | $1,174.37 | $4,349.52 | 7.4× |
| CT scans face/jaw combo (70488) | $1,774.41 | $6,571.88 | 11.1× |
| CT soft tissue neck w contrast (70491) | $1,162.73 | $4,306.42 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $1,132.80 | $4,195.57 | 11.9× |
| CT thoracic spine w contrast (72129) | $1,485.01 | $5,500.02 | 9.3× |
| CT thoracic spine w/o contrast (72128) | $1,181.60 | $4,376.29 | 12.5× |
| CT thoracic spine w/wo cont (72130) | $1,512.85 | $5,603.13 | 9.5× |
| CT thorax w/o contrast (71250) | $1,220 | $4,518.51 | 12.9× |
| CT upper ext wo (73200) | $987.15 | $3,656.11 | 10.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,406.15 | $5,207.95 | 8.8× |
| CT upper extremity with contrast (73201) | $1,198.47 | $4,438.79 | 3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,791.67 | $6,635.82 | 11.3× |
| Cta Abdomen (74175) | $1,628.18 | $6,030.28 | 10.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,273.63 | $12,124.55 | 10.3× |
| CTA pelvis (72191) | $2,037.53 | $7,546.42 | 12.8× |
| Dilation ureters/urethra rs&i (74485) | $2,876.26 | $10,652.82 | 1.5× |
| Diskography lumbar (72295) | $5,869.26 | $21,738.01 | 3.3× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$306.13–$346.99 | $1,133.80–$1,285.14 | varies |
| Dxa bone density study (77085) range across 3 matching MRF lines |
$294.60–$333.93 | $1,091.12–$1,236.76 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$162.74–$265.98 | $602.74–$985.11 | varies |
| Echo Guide For Artery Repair (76936) | $580.76 | $2,150.95 | 3.0× |
| Echograp Trans R Pros Study (76873) | $443.38 | $1,642.14 | 4.7× |
| Esophagram (74220) | $224.28 | $830.66 | 1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $305.09 | $1,129.95 | 3.2× |
| Fluoroscopy up to 1 hr (76000) | $370.22 | $1,371.19 | 1.7× |
| Follow-Up Angiography (75898) | $2,063.94 | $7,644.24 | 0.7× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$187.94–$383.35 | $696.09–$1,419.83 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$205.44–$416.90 | $760.88–$1,544.06 | varies |
| Gastric emptying imaging study (78264) | $1,274.01 | $4,718.57 | 3.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $536.63 | $1,987.53 | 1.5× |
| Gastroesophageal Reflux Exam (78262) | $760.57 | $2,816.93 | 2.1× |
| Gated Heart Planar Single (78472) | $1,197.80 | $4,436.31 | 3.3× |
| Gated Heart, Multiple (78473) | $1,082.13 | $4,007.89 | 3.0× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$167.34–$346.78 | $619.78–$1,284.36 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,422.32 | $5,267.85 | 2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,432.25 | $5,304.64 | 2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,894.96 | $7,018.36 | 3.0× |
| Heart Image (Pet) Multiple (78492) | $2,431.63 | $9,006.04 | 1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,393.20 | $5,160 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $469.58 | $1,739.19 | 0.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,422.17 | $5,267.31 | 2.9× |
| Hepatobiliary System Imaging (78226) | $984.58 | $3,646.59 | 2.7× |
| Ht Musc Image Planar Mult (78454) | $1,788.92 | $6,625.62 | 1.5× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,822.83–$3,822.85 | $14,158.62–$14,158.70 | varies |
| Hysterosalpingogram (74740) | $840.13 | $3,111.59 | 3.9× |
| Interstitial radiation source applic complex (77778) | $4,562.99 | $16,899.96 | 7.2× |
| K Flow/Funct Image Multiple (78709) | $1,665.25 | $6,167.61 | 3.4× |
| K Flow/Funct Image W/Drug (78708) | $1,507.84 | $5,584.59 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,367.17 | $5,063.59 | 2.8× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$235.06–$405.66 | $870.59–$1,502.43 | varies |
| Leveen/Shunt Patency Exam (78291) | $641.46 | $2,375.79 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $810.35 | $3,001.30 | 2.2× |
| Liver imaging static only (78201) | $2,184.54 | $8,090.88 | 4.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,391.68 | $5,154.36 | 2.8× |
| Lung Ventilation Imaging (78579) | $721.51 | $2,672.27 | 2.0× |
| Lymph System Imaging (78195) | $1,016.95 | $3,766.49 | 2.1× |
| Magnetic Image Jaw Joint (70336) | $1,727.91 | $6,399.67 | 8.0× |
| Mammary ductogram or galactogram multiple (77054) | $450.82 | $1,669.71 | 2.1× |
| Mammary ductogram or galactogram single (77053) | $533.34 | $1,975.33 | 2.5× |
| Meckels Divert Exam (78290) | $760.57 | $2,816.93 | 2.1× |
| Mlc imrt design & construction per imrt plan (77338) | $777.14 | $2,878.28 | 2.3× |
| Mr safety determination physician/other qhp (76016) | $107.35 | $397.60 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $29.86 | $110.59 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $111.91 | $414.48 | 1.3× |
| Mr safety implt pos&/immoblj (76019) | $72.42 | $268.23 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $294.71 | $1,091.52 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,178.55 | $8,068.70 | 6.9× |
| MRA head w/o contrast (70544) | $1,833.56 | $6,790.96 | 8.5× |
| MRA head with contrast (70545) | $2,052.98 | $7,603.64 | 6.5× |
| MRA neck w contrast (70548) | $1,491.39 | $5,523.66 | 4.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,718.53 | $6,364.91 | 5.4× |
| MRA neck w/o contrast (70547) | $1,398.97 | $5,181.36 | 6.5× |
| MRI abdomen w contrast (74182) | $1,986.93 | $7,359 | 6.3× |
| MRI abdomen w/o contrast (74181) | $1,489.92 | $5,518.23 | 6.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,008.10–$3,619.14 | $7,437.40–$13,404.23 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,126.13–$4,437.07 | $7,874.54–$16,433.61 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,997.36 | $7,397.63 | 2.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,322.38 | $4,897.71 | 6.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $686.96 | $2,544.29 | 3.2× |
| MRI cervical spine w contrast (72142) | $2,275.18 | $8,426.59 | 7.2× |
| MRI cervical spine w/o cont (72141) | $1,971.40 | $7,301.49 | 9.1× |
| MRI chest w/o contrast (71550) | $1,593.75 | $5,902.79 | 7.4× |
| MRI chest with contrast (71551) | $1,601.22 | $5,930.45 | 2.3× |
| MRI chest wo w contrast (71552) | $2,207.90 | $8,177.42 | 7.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,170.12–$3,759.13 | $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 |
$2,218.54–$4,437.07 | $8,216.80–$16,433.61 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,768.47–$2,980.10 | $6,549.88–$11,037.42 | varies |
| MRI lumbar spine w contrast (72149) | $1,904.22 | $7,052.66 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,779.35 | $10,293.88 | 8.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,593 | $5,899.99 | 7.4× |
| MRI orbit face neck w contrast (70542) | $1,814.75 | $6,721.30 | 5.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,364.22 | $8,756.37 | 7.5× |
| MRI pelvis w contrast (72196) | $1,997.89 | $7,399.59 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $2,236.08 | $8,281.78 | 7.1× |
| MRI pelvis w/o contrast (72195) | $1,661.69 | $6,154.41 | 7.7× |
| MRI thoracic spine w/o contrast (72146) | $1,625.06 | $6,018.75 | 7.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,204.58 | $8,165.11 | 7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,688.90 | $6,255.19 | 7.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,650.30 | $9,815.92 | 8.4× |
| MRI, abdomen, combo (74183) | $2,320.47 | $8,594.33 | 7.3× |
| MRI, dorsal spine combo (72157) | $2,666.38 | $9,875.47 | 8.4× |
| MRI, dorsal spine contrast (72147) | $1,814.96 | $6,722.09 | 5.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,801.13–$3,080.07 | $6,670.86–$11,407.68 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,162.21–$2,788.50 | $4,304.49–$10,327.76 | varies |
| MRI, lumbar spine combo (72158) | $2,722.33 | $10,082.70 | 8.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,564.63 | $13,202.32 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $3,873.69 | $14,346.99 | 3.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,285.12 | $8,463.42 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,519.83 | $5,629 | 2.0× |
| Neck soft tissue (70360) | $183.41 | $679.30 | 2.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $493.58 | $1,828.06 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $167.34 | $619.78 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,708.95 | $17,440.56 | 3.7× |
| Nuclear Rx Intra-Arterial (79445) | $319.31 | $1,182.62 | 1.5× |
| Nuclear Rx Oral Admin (79005) | $896.68 | $3,321.05 | 4.2× |
| Panoramic X-ray of jaws (70355) | $217.79 | $806.64 | 2.8× |
| Parathyroid Planar Imaging (78070) | $1,299.71 | $4,813.75 | 3.6× |
| Pelvis 1 or 2 views (72170) | $225.19 | $834.04 | 2.4× |
| Pet Image Skull-Thigh (78812) | $2,339.66 | $8,665.42 | 1.8× |
| Pet Image W/Ct Lmtd (78814) | $3,104.10 | $11,496.65 | 2.4× |
| PET image w/CT, full body (78816) | $2,981.37 | $11,042.12 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,022.13 | $11,193.07 | 2.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,043.15 | $7,567.22 | 1.7× |
| Pet Myocardial Sngl Study (78491) | $2,802.65 | $10,380.17 | 2.2× |
| PET whole body (78813) | $2,981.37 | $11,042.12 | 2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,892.63 | $10,713.45 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $665.58 | $2,465.10 | 1.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $967.67 | $3,583.97 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $368.32 | $1,364.15 | 3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $746.78 | $2,765.86 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$206.82–$384.10 | $765.99–$1,422.59 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$176.53–$360.30 | $653.82–$1,334.46 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$218.25–$447.39 | $808.35–$1,657.01 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $270.84 | $1,003.10 | 2.9× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$190.50–$364.70 | $705.57–$1,350.75 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$225.19–$384.18 | $834.04–$1,422.90 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$207.33–$420.68 | $767.89–$1,558.07 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$170.11–$357.03 | $630.04–$1,322.34 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$342.20–$356.73 | $1,267.40–$1,321.21 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $231.17 | $856.18 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $222.72 | $824.88 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$210.47–$421.56 | $779.52–$1,561.33 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $121.40 | $449.62 | 1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $266.43 | $986.78 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $184.94 | $684.96 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) | $325.94 | $1,207.19 | 4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $235.34 | $871.64 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$175.29–$306.29 | $649.22–$1,134.41 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$212.55–$370.13 | $787.23–$1,370.84 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,256.14 | $4,652.36 | 13.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,204.42 | $63,720.08 | 2.6× |
| Radiation treatment delivery level 1 (77402) | $1,512.59 | $5,602.19 | 16.3× |
| Radiation treatment delivery level 2 (77407) | $1,635.50 | $6,057.42 | 4.7× |
| Radiation treatment delivery level 3 (77412) | $1,699.81 | $6,295.60 | 3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $199.81 | $740.05 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $334.74 | $1,239.78 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $538.54 | $1,994.59 | 3.4× |
| Radiologic exam colon single contrast study (74270) | $447.36 | $1,656.88 | 2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $387.41 | $1,434.86 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$232.77–$530.46 | $862.10–$1,964.67 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $291.59 | $1,079.96 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $349.03 | $1,292.69 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $227.08 | $841.05 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $565.59 | $2,094.79 | 3.6× |
| Radiologic examination femur 1 view (73551) | $350.20 | $1,297.05 | 4.4× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$283.59–$700.40 | $1,050.32–$2,594.07 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$187.53–$380.66 | $694.57–$1,409.87 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $421.90 | $1,562.59 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$213.52–$364.77 | $790.81–$1,350.99 | varies |
| Ribs bilateral 3 views (71110) | $328.03 | $1,214.93 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,517.41 | $9,323.75 | 5.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,365.18 | $8,759.91 | 4.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,604.54 | $5,942.73 | 3.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,670.07 | $6,185.43 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $487.70 | $1,806.28 | 2.3× |
| Scapula (73010) range across 4 matching MRF lines |
$180.45–$360.02 | $668.34–$1,333.40 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$48.34–$65.92 | $179.04–$244.13 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$179.26–$325.21 | $663.92–$1,204.49 | varies |
| Shoulder Arthrography (73040) | $896.74 | $3,321.25 | 2.8× |
| Skull less than 4 views (70250) | $224.22 | $830.43 | 2.4× |
| Special dosimetry (77331) | $521.09 | $1,929.97 | 4.3× |
| Special Physics Consult (77370) | $1,178.05 | $4,363.14 | 9.7× |
| Special teletherapy port plan (77321) | $670.88 | $2,484.73 | 2.0× |
| Special treatment procedure (77470) | $899.73 | $3,332.32 | 1.8× |
| Stereotactic Body Radiation Delivery (77373) | $3,429.92 | $12,703.40 | 2.1× |
| Sternoclavicular joints (71130) | $250.67 | $928.39 | 3.2× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $38.85 | $143.89 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $991.29 | $3,671.44 | 2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $646.57 | $2,394.71 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $821.42 | $3,042.31 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $679.24 | $2,515.70 | 2.0× |
| Ther rad simulaj-aided field setting simple (77280) | $401.55 | $1,487.24 | 3.3× |
| Thoracic spine 2 views (72070) | $250.89 | $929.21 | 2.6× |
| Thoracic spine 3 views (72072) | $310.29 | $1,149.21 | 3.3× |
| Thoracolumbar 2 views (72080) | $265.41 | $982.99 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $334.47 | $1,238.79 | 0.9× |
| Thyroid Met Imaging Body (78018) | $1,118 | $4,140.74 | 2.3× |
| Thyroid Uptake Measurement (78012) | $380.24 | $1,408.31 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $674.04 | $2,496.43 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $587.06 | $2,174.31 | 1.7× |
| Tx devices design & construction intermediate (77333) | $455.57 | $1,687.29 | 3.7× |
| Tx devices design & construction simple (77332) | $532.84 | $1,973.48 | 4.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$259.62–$590.39 | $961.55–$2,186.62 | varies |
| Ultrasound elastography first target lesion (76982) | $338.84 | $1,254.98 | 3.6× |
| Ultrasound Elastography Parenchyma (76981) | $338.84 | $1,254.98 | 3.6× |
| Ultrasound Exam Aaa Screen (76706) | $202.94 | $751.63 | 2.1× |
| Ultrasound, abdomen limited (76705) | $383.43 | $1,420.12 | 4.0× |
| Unlisted Dx Radiographic Procedure (76499) | $100.51 | $372.27 | 1.3× |
| Upper gi w/o kub (74240) | $390.06 | $1,444.67 | 2.5× |
| Urethrocystogram voiding (74455) | $605.10 | $2,241.12 | 2.8× |
| Urethrocystography retrograde (74450) | $605.10 | $2,241.12 | 2.8× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$242.81–$476.85 | $899.31–$1,766.11 | varies |
| Us chest (76604) | $292.69 | $1,084.03 | 3.1× |
| Us complete joint (76881) range across 2 matching MRF lines |
$303.32–$499.70 | $1,123.41–$1,850.74 | varies |
| Us exam, pelvic, limited (76857) | $229.65 | $850.55 | 2.4× |
| Us head (76506) range across 2 matching MRF lines |
$157.95–$238.26 | $585–$882.44 | varies |
| Us kidney transplant (76776) | $445.71 | $1,650.76 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$312.57–$499.70 | $1,157.66–$1,850.74 | varies |
| Us ob limited 1 or more fetuses (76815) | $237.49 | $879.60 | 2.5× |
| Us ob transvaginal (76817) | $404.18 | $1,496.96 | 4.3× |
| Us pelvic non ob complete (76856) | $325.17 | $1,204.32 | 3.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $405.76 | $1,502.80 | 4.3× |
| Us retroperitoneal complete (76770) | $265.43 | $983.09 | 2.8× |
| Us retroperitoneal limited (76775) | $267.93 | $992.34 | 2.8× |
| Us scrotum and contents (76870) | $265.68 | $984.01 | 2.8× |
| Us spinal canal and contents (76800) | $199.94 | $740.51 | 2.1× |
| Us thyroid (76536) | $318 | $1,177.77 | 3.4× |
| Us transrectal (76872) | $426.50 | $1,579.62 | 4.5× |
| Vein X-Ray Chest (75827) | $1,457.32 | $5,397.49 | 1.0× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,393.97–$1,457.32 | $5,162.85–$5,397.49 | varies |
| Venography caval inferior serialography rs&i (75825) | $6,052.13 | $22,415.31 | 2.1× |
| Venography extremity bilateral rs&i (75822) | $1,843.66 | $6,828.36 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,942.53 | $7,194.56 | 1.4× |
| Venography Renal Bilateral (75833) | $4,539.10 | $16,811.47 | 1.6× |
| Venography Renal Unilateral (75831) | $4,539.10 | $16,811.47 | 1.6× |
| Venous sampling by catheter (75893) | $4,341.76 | $16,080.59 | 0.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$182.64–$325.08 | $676.44–$1,204.01 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $287.37 | $1,064.34 | 3.6× |
| X-ray antegrade pyelogram tube (74425) | $605.10 | $2,241.12 | 1.9× |
| X-Ray Aorta Leg Arteries (75630) | $6,052.13 | $22,415.31 | 2.1× |
| X-Ray Bend Only L-S Spine (72120) | $143.19 | $530.33 | 1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$180.29–$318.96 | $667.75–$1,181.33 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$698.45–$746.78 | $2,586.85–$2,765.86 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,022.89 | $3,788.47 | 13.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $628.06 | $2,326.15 | 6.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,256.14 | $4,652.36 | 13.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $270.14 | $1,000.52 | 3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $571.07 | $2,115.08 | 7.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $571.07 | $2,115.08 | 6.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,315.11 | $4,870.79 | 13.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,315.11 | $4,870.79 | 13.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,466.20 | $5,430.37 | 15.5× |
| X-Ray Exam L-S Spine Bending (72114) | $376 | $1,392.61 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $215.63 | $798.64 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $452.81 | $1,677.07 | 4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $235.97 | $873.95 | 2.5× |
| X-ray eye for foreign body (70030) | $119.57 | $442.84 | 1.5× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$188.51–$376.09 | $698.19–$1,392.92 | varies |
| X-ray IV pyelogram (ivp) (74400) | $642.93 | $2,381.24 | 4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $159.98 | $592.51 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $168.39 | $623.68 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $267.58 | $991.03 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $159.48 | $590.65 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $266.42 | $986.75 | 2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $195.78 | $725.11 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $210.88 | $781.02 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $333.17 | $1,233.98 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $399.81 | $1,480.78 | 4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $642.93 | $2,381.24 | 2.0× |
| X-Rays Bone Length Studies (77073) | $243.38 | $901.39 | 2.6× |
| X-Rays Bone Survey Complete (77075) | $504.62 | $1,868.96 | 5.3× |
| Xr c-spine 4 or 5 views (72050) | $307.05 | $1,137.22 | 3.2× |
| Xr facial bones less than 3 views (70140) | $157.15 | $582.03 | 2.0× |
| Xr orbits complete 4 views (70200) | $247.14 | $915.34 | 2.6× |
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.