Imaging prices at Terre Haute Regional Hospital
Terre Haute, IN · 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) range across 2 matching MRF lines |
$6,438.60–$6,690 | $10,731–$11,150 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$254.40–$264.60 | $424–$441 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$369–$383.40 | $615–$639 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,224–$1,272 | $2,040–$2,120 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$3,411.60–$3,544.80 | $5,686–$5,908 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$3,702.60–$3,847.20 | $6,171–$6,412 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$7,972.20–$8,283 | $13,287–$13,805 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,236–$4,401 | $7,060–$7,335 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,425.40–$3,559.20 | $5,709–$5,932 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$3,645.60–$3,787.80 | $6,076–$6,313 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$2,114.40–$2,196.60 | $3,524–$3,661 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$246.60–$435.60 | $411–$726 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$3,412.20–$3,545.40 | $5,687–$5,909 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$5,676.60–$5,898 | $9,461–$9,830 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$3,425.40–$3,559.20 | $5,709–$5,932 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$4,488.60–$4,663.80 | $7,481–$7,773 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$4,247.40–$4,413 | $7,079–$7,355 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$790.20–$820.80 | $1,317–$1,368 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$949.20–$986.40 | $1,582–$1,644 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$769.80–$799.80 | $1,283–$1,333 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$678.60–$705 | $1,131–$1,175 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$294.60–$306 | $491–$510 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,728.60–$1,795.80 | $2,881–$2,993 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$932.40–$969 | $1,554–$1,615 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,870.80–$1,944 | $3,118–$3,240 | varies |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$862.80–$896.40 | $1,438–$1,494 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$305.40–$317.40 | $509–$529 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$1,024.20–$1,064.40 | $1,707–$1,774 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$1,024.20–$1,064.40 | $1,707–$1,774 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$558.60–$580.20 | $931–$967 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$2,101.20–$2,183.40 | $3,502–$3,639 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$495–$514.20 | $825–$857 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$234–$243 | $390–$405 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$284.40–$295.20 | $474–$492 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$308.40–$544.80 | $514–$908 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$355.80–$369.60 | $593–$616 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$272.40–$481.20 | $454–$802 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$161.40–$167.40 | $269–$279 | varies |
| Continuing medical physics consltj pr wk (77336) | $822.60 | $1,371 | 5.8× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,439.80–$3,574.20 | $5,733–$5,957 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$745.20–$774 | $1,242–$1,290 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$745.20–$774 | $1,242–$1,290 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$918.60–$954.60 | $1,531–$1,591 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$950.40–$987.60 | $1,584–$1,646 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$876–$910.20 | $1,460–$1,517 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$811.20–$873.60 | $1,352–$1,456 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$950.40–$987.60 | $1,584–$1,646 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$873–$1,541.40 | $1,455–$2,569 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$907.20–$1,541.40 | $1,512–$2,569 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $29.40 | $49 | 0.3× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$789–$1,407 | $1,315–$2,345 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$824.40–$1,437.60 | $1,374–$2,396 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$840.60–$1,528.20 | $1,401–$2,547 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$824.40–$856.80 | $1,374–$1,428 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$789–$819.60 | $1,315–$1,366 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$789–$1,407 | $1,315–$2,345 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$873.60–$1,528.20 | $1,456–$2,547 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$824.40–$1,437.60 | $1,374–$2,396 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$2,016.60–$2,095.20 | $3,361–$3,492 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$2,016.60–$2,095.20 | $3,361–$3,492 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$233.40–$242.40 | $389–$404 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$431.40–$448.20 | $719–$747 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$268.80–$279 | $448–$465 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$450.60–$468 | $751–$780 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$178.20–$185.40 | $297–$309 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$827.40–$859.80 | $1,379–$1,433 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$468.60–$486.60 | $781–$811 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$549.60–$571.20 | $916–$952 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$670.20–$696.60 | $1,117–$1,161 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$603–$626.40 | $1,005–$1,044 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$481.20–$499.80 | $802–$833 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$642.60–$667.80 | $1,071–$1,113 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$594.60–$618 | $991–$1,030 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$474–$492.60 | $790–$821 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$1,989–$2,066.40 | $3,315–$3,444 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$251.40–$443.40 | $419–$739 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$297.60–$526.20 | $496–$877 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,653.60–$1,717.80 | $2,756–$2,863 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,338.60–$1,390.80 | $2,231–$2,318 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$323.40–$550.80 | $539–$918 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$4,983.60–$5,178 | $8,306–$8,630 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$5,020.80–$5,216.40 | $8,368–$8,694 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$3,148.80–$3,271.80 | $5,248–$5,453 | varies |
| Heart Image (Pet) Multiple (78492) range across 2 matching MRF lines |
$4,137.60–$4,299 | $6,896–$7,165 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$2,640–$2,743.20 | $4,400–$4,572 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$3,309.60–$3,438.60 | $5,516–$5,731 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,762.20–$1,831.20 | $2,937–$3,052 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,338.80–$2,430 | $3,898–$4,050 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$725.40–$753.60 | $1,209–$1,256 | varies |
| Image fusion (77399) range across 2 matching MRF lines |
$543–$564 | $905–$940 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$152.40–$158.40 | $254–$264 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$481.80–$500.40 | $803–$834 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$4,767.60–$4,953.60 | $7,946–$8,256 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$2,243.40–$2,331 | $3,739–$3,885 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$2,954.40–$3,069.60 | $4,924–$5,116 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,423.20–$1,479 | $2,372–$2,465 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,406.40–$1,461 | $2,344–$2,435 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$358.80–$610.20 | $598–$1,017 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$1,222.20–$1,269.60 | $2,037–$2,116 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,396.20–$1,450.80 | $2,327–$2,418 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,536–$1,596 | $2,560–$2,660 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$967.20–$1,005 | $1,612–$1,675 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,626.60–$1,690.20 | $2,711–$2,817 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 2 matching MRF lines |
$1,238.40–$1,286.40 | $2,064–$2,144 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 2 matching MRF lines |
$1,927.20–$2,002.20 | $3,212–$3,337 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Mammary ductogram or galactogram single (77053) | $420.60 | $701 | 1.7× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$890.40–$925.20 | $1,484–$1,542 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$2,289–$2,378.40 | $3,815–$3,964 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$904.80–$1,598.40 | $1,508–$2,664 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$937.20–$1,655.40 | $1,562–$2,759 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$940.20–$1,656 | $1,567–$2,760 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$937.20–$1,655.40 | $1,562–$2,759 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$873–$1,541.40 | $1,455–$2,569 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$323.40–$336 | $539–$560 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$940.20–$1,598.40 | $1,567–$2,664 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$873–$1,541.40 | $1,455–$2,569 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$937.20–$1,655.40 | $1,562–$2,759 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$904.80–$940.20 | $1,508–$1,567 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$937.20–$973.80 | $1,562–$1,623 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$870.60–$904.80 | $1,451–$1,508 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,077.60–$1,119.60 | $1,796–$1,866 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$1,077.60–$1,119.60 | $1,796–$1,866 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$1,077.60–$1,119.60 | $1,796–$1,866 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$503.40–$523.20 | $839–$872 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,232.20–$3,358.20 | $5,387–$5,597 | varies |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) range across 2 matching MRF lines |
$3,426–$3,559.80 | $5,710–$5,933 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,680 | $7,800 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$929.40–$965.40 | $1,549–$1,609 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$254.40–$264.60 | $424–$441 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $287.40 | $479 | 0.7× |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$1,294.80–$1,345.20 | $2,158–$2,242 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$366.60–$381 | $611–$635 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$7,796.40–$8,100.60 | $12,994–$13,501 | varies |
| Nuclear medicine study of endocrine organs (78099) range across 2 matching MRF lines |
$583.80–$606.60 | $973–$1,011 | varies |
| Nuclear Rx Intra-Arterial (79445) | $1,392.60 | $2,321 | 5.6× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$999–$1,038 | $1,665–$1,730 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$387.60–$402.60 | $646–$671 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$1,762.20–$1,831.20 | $2,937–$3,052 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,061.40–$1,102.80 | $1,769–$1,838 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$288.60–$300 | $481–$500 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$4,008–$4,164.60 | $6,680–$6,941 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,783.80–$4,970.40 | $7,973–$8,284 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$4,525.20–$4,701.60 | $7,542–$7,836 | varies |
| Pet Myocardial Sngl Study (78491) range across 2 matching MRF lines |
$3,490.80–$3,627 | $5,818–$6,045 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$2,469–$2,565 | $4,115–$4,275 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$949.20–$986.40 | $1,582–$1,644 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$474–$492.60 | $790–$821 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$613.80–$637.80 | $1,023–$1,063 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$305.40–$538.80 | $509–$898 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$257.40–$454.20 | $429–$757 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$305.40–$538.80 | $509–$898 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$373.20–$387.60 | $622–$646 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$232.20–$422.40 | $387–$704 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$315.60–$506.40 | $526–$844 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$320.40–$544.80 | $534–$908 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$283.20–$480.60 | $472–$801 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$281.40–$292.20 | $469–$487 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$305.40–$317.40 | $509–$529 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$308.40–$320.40 | $514–$534 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$322.20–$569.40 | $537–$949 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$196.80–$204.60 | $328–$341 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$264–$274.20 | $440–$457 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$305.40–$317.40 | $509–$529 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$303.60–$315.60 | $506–$526 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$226.80–$400.80 | $378–$668 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$278.40–$473.40 | $464–$789 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$301.80–$533.40 | $503–$889 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,455.60 | $27,426 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $838.20 | $1,397 | 7.8× |
| Radiation treatment delivery level 2 (77407) | $1,548 | $2,580 | 3.8× |
| Radiation treatment delivery level 3 (77412) | $2,257.20 | $3,762 | 3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$387.60–$402.60 | $646–$671 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$328.80–$341.40 | $548–$569 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$982.80–$1,021.20 | $1,638–$1,702 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$736.20–$765 | $1,227–$1,275 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$525.60–$546 | $876–$910 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$430.80–$760.20 | $718–$1,267 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$288.60–$300 | $481–$500 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$546–$567 | $910–$945 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$490.80–$510 | $818–$850 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$799.20–$830.40 | $1,332–$1,384 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$254.40–$264.60 | $424–$441 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$301.80–$532.80 | $503–$888 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$308.40–$544.80 | $514–$908 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$283.20–$500.40 | $472–$834 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) range across 2 matching MRF lines |
$1,839.60–$1,911.60 | $3,066–$3,186 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) range across 2 matching MRF lines |
$1,647.60–$1,711.80 | $2,746–$2,853 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$406.80–$422.40 | $678–$704 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,694.40–$1,760.40 | $2,824–$2,934 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$2,518.20–$2,616.60 | $4,197–$4,361 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,694.40–$1,760.40 | $2,824–$2,934 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,948.80–$2,025 | $3,248–$3,375 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 2 matching MRF lines |
$1,067.40–$1,108.80 | $1,779–$1,848 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$840.60–$873.60 | $1,401–$1,456 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$297.60–$526.20 | $496–$877 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$68.40–$70.80 | $114–$118 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$196.20–$347.40 | $327–$579 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$816.60–$848.40 | $1,361–$1,414 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$436.80–$453.60 | $728–$756 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$290.40–$301.80 | $484–$503 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$365.40–$379.80 | $609–$633 | varies |
| Special Physics Consult (77370) | $1,007.40 | $1,679 | 7.1× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,072.80–$1,114.80 | $1,788–$1,858 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,566.80–$2,667 | $4,278–$4,445 | varies |
| Stereotactic Body Radiation Delivery (77373) | $9,507.60 | $15,846 | 5.0× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$254.40–$264.60 | $424–$441 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$1,995.60–$2,073.60 | $3,326–$3,456 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$2,104.20–$2,186.40 | $3,507–$3,644 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$730.20–$758.40 | $1,217–$1,264 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,236.80–$2,323.80 | $3,728–$3,873 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,829.40–$1,900.80 | $3,049–$3,168 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$1,118.40–$1,162.20 | $1,864–$1,937 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$328.80–$341.40 | $548–$569 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$359.40–$373.20 | $599–$622 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$308.40–$320.40 | $514–$534 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$642.60–$667.80 | $1,071–$1,113 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,169–$2,253.60 | $3,615–$3,756 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,224–$1,272 | $2,040–$2,120 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,228.20–$1,276.20 | $2,047–$2,127 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$873–$907.20 | $1,455–$1,512 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$607.80–$631.80 | $1,013–$1,053 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$352.20–$366 | $587–$610 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$420–$436.20 | $700–$727 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$397.80–$413.40 | $663–$689 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$333–$346.20 | $555–$577 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$721.20–$749.40 | $1,202–$1,249 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$436.20–$453 | $727–$755 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$514.20–$534 | $857–$890 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$796.20–$827.40 | $1,327–$1,379 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $243 | $405 | 22.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$671.40–$697.80 | $1,119–$1,163 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$813–$844.80 | $1,355–$1,408 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$442.80–$460.20 | $738–$767 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$442.80–$460.20 | $738–$767 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$490.80–$510 | $818–$850 | varies |
| Us head (76506) range across 2 matching MRF lines |
$403.80–$419.40 | $673–$699 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$426.60–$443.40 | $711–$739 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$743.40–$772.20 | $1,239–$1,287 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$439.20–$456.60 | $732–$761 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$614.40–$638.40 | $1,024–$1,064 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$792–$822.60 | $1,320–$1,371 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$617.40–$641.40 | $1,029–$1,069 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$607.80–$631.80 | $1,013–$1,053 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$759.60–$789 | $1,266–$1,315 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$501–$520.80 | $835–$868 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$588–$610.80 | $980–$1,018 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$579–$601.80 | $965–$1,003 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$452.40–$469.80 | $754–$783 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$628.20–$652.80 | $1,047–$1,088 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,694.40–$1,760.40 | $2,824–$2,934 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$2,083.20–$2,164.20 | $3,472–$3,607 | varies |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$2,453.40–$2,548.80 | $4,089–$4,248 | varies |
| Venography Adrenal Unilateral (75840) range across 2 matching MRF lines |
$4,270.20–$4,437 | $7,117–$7,395 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$5,520–$5,735.40 | $9,200–$9,559 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,743–$1,810.80 | $2,905–$3,018 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,328.40–$1,380 | $2,214–$2,300 | varies |
| Venography Orbital Rs&I (75880) range across 2 matching MRF lines |
$1,238.40–$1,286.40 | $2,064–$2,144 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$4,530–$4,706.40 | $7,550–$7,844 | varies |
| Venography Renal Unilateral (75831) | $2,032.20 | $3,387 | 0.6× |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$4,405.20–$4,576.80 | $7,342–$7,628 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$280.80–$497.40 | $468–$829 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$283.20–$294 | $472–$490 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$627–$651.60 | $1,045–$1,086 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$3,439.80–$3,574.20 | $5,733–$5,957 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$332.40–$345.60 | $554–$576 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$251.40–$443.40 | $419–$739 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$728.40–$756.60 | $1,214–$1,261 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$268.80–$279 | $448–$465 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$359.40–$373.20 | $599–$622 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$234–$243 | $390–$405 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$291.60–$303 | $486–$505 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$474–$492.60 | $790–$821 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$603–$626.40 | $1,005–$1,044 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$328.80–$341.40 | $548–$569 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$529.20–$549.60 | $882–$916 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$374.40–$388.80 | $624–$648 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$193.80–$201.60 | $323–$336 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$291.60–$514.80 | $486–$858 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$246–$255.60 | $410–$426 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$261–$271.20 | $435–$452 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$382.80–$397.80 | $638–$663 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$186–$193.20 | $310–$322 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$406.80–$422.40 | $678–$704 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$335.40–$348.60 | $559–$581 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$294.60–$306 | $491–$510 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$297.60–$309 | $496–$515 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$395.40–$411 | $659–$685 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$406.80–$422.40 | $678–$704 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$369.60–$384 | $616–$640 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$932.40–$969 | $1,554–$1,615 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$322.20–$334.80 | $537–$558 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$305.40–$317.40 | $509–$529 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$474–$492.60 | $790–$821 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$315.60–$328.20 | $526–$547 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$373.20–$387.60 | $622–$646 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$395.40–$411 | $659–$685 | varies |
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.