Imaging prices at Texas Childrens Hospital
Houston, TX · every code in this section with a posted price and a Medicare benchmark.
418 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) | $4,901.72 | $7,316 | 3.5× |
| Abdomen 1 View (74018) | $323.61 | $483 | 3.7× |
| Abdomen 2 views (74019) | $348.40 | $520 | 3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,185.90 | $1,770 | 3.0× |
| Angio internal mammary (75756) | $1,176.52 | $1,756 | 0.4× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$2,046.18–$2,047.52 | $3,054–$3,056 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,003.97 | $2,991 | 0.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,215.02–$2,217.03 | $3,306–$3,309 | varies |
| Angiography extremity unilateral rs&i (75710) | $2,292.74 | $3,422 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$2,046.18–$2,047.52 | $3,054–$3,056 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,054.89 | $3,067 | 0.6× |
| Ankle 2 views (73600) | $367.83 | $549 | 4.2× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$2,267.28–$2,268.62 | $3,384–$3,386 | varies |
| Artery X-Rays Abdomen (75726) | $4,759.01 | $7,103 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $1,731.95 | $2,585 | 0.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,444.16 | $3,648 | 0.4× |
| Artery X-Rays Spine (75705) | $3,298.41 | $4,923 | 0.6× |
| Arthrogram ankle (73615) | $637.84 | $952 | 1.8× |
| Arthrogram hip (73525) | $832.81 | $1,243 | 2.4× |
| Arthrogram Wrist (73115) | $708.86 | $1,058 | 2.0× |
| Basic radiation dosimetry calculation (77300) | $625.11 | $933 | 4.6× |
| Bone age studies (77072) | $322.94 | $482 | 3.1× |
| Bone Imaging 3 Phase (78315) | $2,765.09 | $4,127 | 6.9× |
| Bone Imaging Limited Area (78300) | $1,067.31 | $1,593 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $968.15 | $1,445 | 2.4× |
| Bone Imaging Whole Body (78306) | $1,589.24 | $2,372 | 4.0× |
| Bone marrow imaging limited area (78102) | $615.06 | $918 | 1.5× |
| Bone marrow imaging; multiple areas (78103) | $812.71 | $1,213 | 2.0× |
| Bone marrow imaging; whole body (78104) | $1,002.99 | $1,497 | 2.5× |
| Bone survey infant (77076) | $507.86 | $758 | 4.8× |
| Brain Flow Imaging Only (78610) | $1,088.08 | $1,624 | 2.0× |
| Brain Image W/Flow < 4 Views (78601) | $836.83 | $1,249 | 2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,154.41 | $1,723 | 2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,276.51 | $12,353 | 5.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,690.05 | $4,015 | 7.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,697.06 | $5,518 | 4.7× |
| Cardiovasc nucl exam unlisted (78499) | $2,667.94 | $3,982 | 6.6× |
| Cat Scan Follow-Up Study (76380) | $746.38 | $1,114 | 8.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $696.13 | $1,039 | 1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $601.66 | $898 | 1.1× |
| Cerebrospinal Fluid Scan (78630) | $896.46 | $1,338 | 1.6× |
| Chest 1 view (71045) | $348.40 | $520 | 4.0× |
| Chest 2 views (71046) | $361.80 | $540 | 4.1× |
| Chest 3 views (71047) | $373.19 | $557 | 4.3× |
| Chest 4 or more views (71048) | $454.26 | $678 | 4.3× |
| Cholecystography Oral Contrast (74290) | $191.62 | $286 | 1.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $1,154.41 | $1,723 | 11.0× |
| Clavicle complete (73000) | $415.40 | $620 | 4.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $176.21 | $263 | 1.7× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$593.62–$594.96 | $886–$888 | varies |
| Contrast Exam Abdominl Aorta (75625) | $1,789.57 | $2,671 | 0.6× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$860.95–$862.29 | $1,285–$1,287 | varies |
| Contrast X-Ray Of Elbow (73085) | $613.72 | $916 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $716.23 | $1,069 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $5,073.91 | $7,573 | 14.5× |
| CT abdomen and pelvis without contrast (74176) | $3,980.47 | $5,941 | 16.6× |
| CT abdomen w contrast (74160) | $2,802.61 | $4,183 | 15.9× |
| CT abdomen w wo contrast (74170) | $3,404.27 | $5,081 | 19.3× |
| CT abdomen w/o contrast (74150) | $2,286.71 | $3,413 | 21.8× |
| CT Angio Abdomen and Pelvis (74174) | $5,609.24 | $8,372 | 16.0× |
| CT Angio Chest (71275) | $2,594.91 | $3,873 | 14.7× |
| CT Angio Head (70496) | $2,840.80 | $4,240 | 16.1× |
| CT angio hrt w/3d image (75574) | $3,461.22 | $5,166 | 9.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,615.01 | $3,903 | 14.8× |
| CT Angio Neck (70498) | $2,556.72 | $3,816 | 14.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,726.90 | $4,070 | 15.5× |
| CT bone density (77078) | $582.23 | $869 | 6.7× |
| CT cervical spine w/ contrast (72126) | $2,885.02 | $4,306 | 8.2× |
| CT cervical spine w/o contrast (72125) | $2,730.25 | $4,075 | 26.0× |
| CT cervical spine w/wo cont (72127) | $2,876.98 | $4,294 | 16.3× |
| CT chest w contrast (71260) | $2,614.34 | $3,902 | 14.8× |
| CT chest w/wo contrast (71270) | $2,759.06 | $4,118 | 15.7× |
| CT head/brain with contrast (70460) | $2,373.14 | $3,542 | 13.5× |
| CT head/brain without and with contrast (70470) | $2,637.12 | $3,936 | 15.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,501.78 | $3,734 | 7.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $3,309.13 | $4,939 | 37.9× |
| CT hrt w/3d image congen (75573) | $2,197.60 | $3,280 | 6.3× |
| CT iac w contrast (70481) | $2,704.79 | $4,037 | 15.4× |
| CT l-spine w&w/o contrast (72133) | $2,876.98 | $4,294 | 16.3× |
| CT lower ext w/o (73700) | $2,149.36 | $3,208 | 20.5× |
| CT lower extremity w/contrast material (73701) | $1,910.84 | $2,852 | 10.8× |
| CT lumbar spine w contrast (72132) | $2,935.94 | $4,382 | 8.4× |
| CT lumbar spine w/o contrast (72131) | $2,694.74 | $4,022 | 25.7× |
| CT maxillofacial w contrast (70487) | $2,945.99 | $4,397 | 16.7× |
| CT maxillofacial wo contrast (70486) | $2,599.60 | $3,880 | 24.8× |
| CT neck tissue combo (70492) | $3,140.29 | $4,687 | 17.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,891.72 | $4,316 | 16.4× |
| CT orbits w/o contrast (70480) | $2,324.90 | $3,470 | 22.1× |
| CT pelvis w&w/o contrast (72194) | $2,852.86 | $4,258 | 16.2× |
| CT pelvis w/o contrast (72192) | $2,259.91 | $3,373 | 21.5× |
| CT scan of leg combo (73702) | $2,061.59 | $3,077 | 11.7× |
| CT scans face/jaw combo (70488) | $3,255.53 | $4,859 | 18.5× |
| CT soft tissue neck w contrast (70491) | $2,547.34 | $3,802 | 14.5× |
| CT soft tissue neck w/o contrast (70490) | $2,202.96 | $3,288 | 21.0× |
| CT thoracic spine w contrast (72129) | $2,838.12 | $4,236 | 16.1× |
| CT thoracic spine w/o contrast (72128) | $2,436.79 | $3,637 | 23.2× |
| CT thoracic spine w/wo cont (72130) | $2,955.37 | $4,411 | 16.8× |
| CT thorax w/o contrast (71250) | $2,168.12 | $3,236 | 20.6× |
| CT unlisted procedure (76497) | $2,577.49 | $3,847 | 29.5× |
| CT upper ext wo (73200) | $2,042.16 | $3,048 | 19.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,671.65 | $2,495 | 9.5× |
| CT upper extremity with contrast (73201) | $1,690.41 | $2,523 | 4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,510.49 | $3,747 | 14.2× |
| Cta Abdomen (74175) | $3,055.20 | $4,560 | 17.3× |
| CTA pelvis (72191) | $2,682.01 | $4,003 | 15.2× |
| Dilation ureters/urethra rs&i (74485) | $1,604.65 | $2,395 | 0.8× |
| Diskography lumbar (72295) | $1,680.36 | $2,508 | 0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$243.21–$244.55 | $363–$365 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$481.06–$482.40 | $718–$720 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$506.52–$507.86 | $756–$758 | varies |
| Dxa Bone Density Axial (77080) | $548.73 | $819 | 5.2× |
| Dxa bone density study (77085) | $230.48 | $344 | 2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $185.59 | $277 | 2.1× |
| Echo exam of fetal heart (76825) range across 4 matching MRF lines |
$2,024.07–$2,025.41 | $3,021–$3,023 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$369.84–$889.76 | $552–$1,328 | varies |
| Echo Guide For Artery Repair (76936) | $890.43 | $1,329 | 4.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 3 matching MRF lines |
$1,252.23–$1,253.57 | $1,869–$1,871 | varies |
| Esophageal Motility Study (78258) | $678.71 | $1,013 | 1.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$723.60–$833.48 | $1,080–$1,244 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 6 matching MRF lines |
$667.32–$668.66 | $996–$998 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 6 matching MRF lines |
$749.06–$750.40 | $1,118–$1,120 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,375.82 | $3,546 | 9.9× |
| Fluoroscopy up to 1 hr (76000) | $522.60 | $780 | 2.2× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$1,360.10–$1,361.44 | $2,030–$2,032 | varies |
| Foot 2 views (73620) | $361.13 | $539 | 4.1× |
| Forearm 2 views (73090) | $447.56 | $668 | 5.1× |
| Gastric emptying imaging study (78264) | $2,293.41 | $3,423 | 5.7× |
| Gastric Mucosa Imaging (78261) | $1,365.46 | $2,038 | 3.4× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$540.69–$542.03 | $807–$809 | varies |
| Gastrointestinal Protein Loss (78282) | $646.55 | $965 | 1.6× |
| Gated Heart Planar Single (78472) | $1,069.32 | $1,596 | 2.7× |
| Hand 2 views (73120) | $339.69 | $507 | 3.2× |
| Heart Image (Pet) Multiple (78492) | $3,599.91 | $5,373 | 2.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,912.49 | $4,347 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$1,882.70–$1,884.04 | $2,810–$2,812 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,643.15 | $3,945 | 4.8× |
| Hepatobiliary System Imaging (78226) | $2,150.70 | $3,210 | 5.4× |
| Ht Musc Image Planar Mult (78454) | $676.03 | $1,009 | 0.5× |
| Ht Muscle Image Spect Sing (78451) | $1,504.82 | $2,246 | 1.2× |
| Hysterosalpingogram (74740) | $1,143.02 | $1,706 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $462.97 | $691 | 5.3× |
| Infant hip ultrasound, limited static exam (76886) | $418.08 | $624 | 4.8× |
| Joint Survey Single View (77077) | $273.36 | $408 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $1,951.04 | $2,912 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,225.43 | $1,829 | 2.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,019.07 | $1,521 | 2.5× |
| Kidney Imaging Morphol (78700) | $1,737.98 | $2,594 | 4.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $981.55 | $1,465 | 2.4× |
| Knee 3 Views (73562) | $447.56 | $668 | 5.1× |
| Leveen/Shunt Patency Exam (78291) | $604.34 | $902 | 1.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,408.34 | $2,102 | 3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $858.94 | $1,282 | 2.1× |
| Liver imaging w/vascular flow (78202) | $925.27 | $1,381 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,453.23 | $2,169 | 2.7× |
| Lung perfusion differential (78597) | $1,366.80 | $2,040 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,992.58 | $2,974 | 3.7× |
| Lung Ventilation Imaging (78579) | $680.72 | $1,016 | 1.7× |
| Lymph System Imaging (78195) | $1,663.61 | $2,483 | 3.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $565.48 | $844 | 0.4× |
| Lymphangiography extremity only unilateral rs&i (75801) | $432.15 | $645 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $637.84 | $952 | 0.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $276.71 | $413 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $2,824.05 | $4,215 | 11.8× |
| Magnetic Resonance Elastography (76391) | $2,273.31 | $3,393 | 9.5× |
| Meckels Divert Exam (78290) | $410.04 | $612 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,187.91 | $1,773 | 3.2× |
| Mra Head W/O & W/Contrast Material (70546) | $4,879.61 | $7,283 | 13.9× |
| MRA head w/o contrast (70544) | $2,776.48 | $4,144 | 11.6× |
| MRA head with contrast (70545) | $2,848.84 | $4,252 | 8.1× |
| MRA neck w contrast (70548) | $2,897.08 | $4,324 | 8.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,512.14 | $5,242 | 10.0× |
| MRA neck w/o contrast (70547) | $2,448.18 | $3,654 | 10.2× |
| MRI abdomen w contrast (74182) | $3,888.01 | $5,803 | 11.1× |
| MRI abdomen w/o contrast (74181) | $3,227.39 | $4,817 | 13.5× |
| MRI any jt lower extrem w/contrast material (73722) | $4,045.46 | $6,038 | 5.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,881.98 | $5,794 | 11.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,356.70 | $5,010 | 4.3× |
| MRI brain functional w/o physician admnistration (70554) | $3,234.76 | $4,828 | 13.5× |
| MRI brain functional w/physician admnistration (70555) | $2,952.69 | $4,407 | 12.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,247.85 | $3,355 | 9.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,062.93 | $3,079 | 8.6× |
| MRI cardiac w/o cont stress (75559) | $3,520.85 | $5,255 | 6.4× |
| MRI cardiac w/o contrast (75557) | $2,490.39 | $3,717 | 10.4× |
| MRI cervical spine w contrast (72142) | $3,646.81 | $5,443 | 10.4× |
| MRI cervical spine w/o cont (72141) | $3,706.44 | $5,532 | 15.5× |
| MRI chest w/o contrast (71550) | $2,878.32 | $4,296 | 12.0× |
| MRI chest with contrast (71551) | $2,499.77 | $3,731 | 3.2× |
| MRI chest wo w contrast (71552) | $4,044.12 | $6,036 | 11.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,749.01 | $4,103 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,164.05 | $6,215 | 11.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,859.56 | $4,268 | 11.9× |
| MRI lumbar spine w contrast (72149) | $3,831.06 | $5,718 | 10.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,007.58 | $7,474 | 14.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,768.44 | $4,132 | 11.6× |
| MRI orbit face neck w contrast (70542) | $2,680.67 | $4,001 | 7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,295.37 | $6,411 | 12.3× |
| MRI pelvis w contrast (72196) | $3,168.43 | $4,729 | 9.0× |
| MRI pelvis w/o & w contrast (72197) | $4,285.99 | $6,397 | 12.2× |
| MRI pelvis w/o contrast (72195) | $3,169.10 | $4,730 | 13.2× |
| MRI spectroscopy (76390) | $2,182.19 | $3,257 | 25.0× |
| MRI thoracic spine w/o contrast (72146) | $2,678.66 | $3,998 | 11.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,138.28 | $4,684 | 9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,035.77 | $4,531 | 12.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,062.21 | $6,063 | 11.6× |
| MRI, abdomen, combo (74183) | $4,600.22 | $6,866 | 13.1× |
| MRI, dorsal spine combo (72157) | $4,684.64 | $6,992 | 13.4× |
| MRI, dorsal spine contrast (72147) | $3,137.61 | $4,683 | 9.0× |
| MRI, joint upper extrem (73221) | $3,312.48 | $4,944 | 13.8× |
| MRI, joint upper extrem combo (73223) | $4,177.45 | $6,235 | 11.9× |
| MRI, lumbar spine combo (72158) | $4,990.16 | $7,448 | 14.2× |
| Musculoskeletal Nuclear Exam (78399) | $520.59 | $777 | 1.3× |
| Myelogram cervical (72240) | $1,281.71 | $1,913 | 1.6× |
| Myelogram Lumbar (72265) | $2,001.96 | $2,988 | 2.5× |
| Myelography thoracic (72255) | $1,581.87 | $2,361 | 2.0× |
| Myelograpy 2/more regions rs&i (72270) | $1,445.19 | $2,157 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $367.16 | $548 | 0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,735.92 | $5,576 | 2.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $459.62 | $686 | 0.4× |
| Myocardial Spect Multiple Studies (78452) | $3,092.72 | $4,616 | 2.4× |
| Neck soft tissue (70360) | $440.86 | $658 | 5.0× |
| Nervous system nuclear exam (78699) | $1,502.81 | $2,243 | 3.7× |
| Nm csf leak detection (78650) | $661.29 | $987 | 0.5× |
| Nm myocard infarct spect (78469) | $531.98 | $794 | 1.0× |
| Nm unlisted gi procedure (78299) | $729.63 | $1,089 | 1.8× |
| Nonvascular Shunt X-Ray (75809) | $486.42 | $726 | 4.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,756.95 | $10,085 | 4.9× |
| Nuclear medicine study of endocrine organs (78099) | $864.97 | $1,291 | 2.2× |
| Nuclear Rx Intra-Arterial (79445) | $1,270.32 | $1,896 | 5.4× |
| Nuclear Rx Oral Admin (79005) | $1,746.02 | $2,606 | 7.4× |
| Ob us nuchal meas 1 gest (76813) | $529.97 | $791 | 5.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $176.21 | $263 | 2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $176.21 | $263 | 1.7× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $158.12 | $236 | 5.4× |
| Optic foramina (70190) | $186.26 | $278 | 2.1× |
| Panoramic X-ray of jaws (70355) | $201 | $300 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,900.12 | $2,836 | 3.5× |
| Parathyroid Planar Imaging (78070) | $1,763.44 | $2,632 | 4.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,395.61 | $2,083 | 3.5× |
| Pelvis 1 or 2 views (72170) | $481.73 | $719 | 4.6× |
| Perineogram (74775) range across 2 matching MRF lines |
$702.83–$704.17 | $1,049–$1,051 | varies |
| Peritoneogram Rs&I (74190) | $324.95 | $485 | 0.6× |
| Pet Image Skull-Thigh (78812) | $4,947.95 | $7,385 | 3.4× |
| Pet Image W/Ct Lmtd (78814) | $4,860.18 | $7,254 | 3.4× |
| PET image w/CT, full body (78816) | $6,514.41 | $9,723 | 4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,850.75 | $10,225 | 4.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,660.21 | $5,463 | 2.8× |
| Pet Myocardial Sngl Study (78491) | $3,221.36 | $4,808 | 2.2× |
| PET whole body (78813) | $4,334.90 | $6,470 | 3.0× |
| Proton trmt simple w/comp (77522) | $3,153.69 | $4,707 | 2.5× |
| Proton tx delivery complex (77525) | $3,689.02 | $5,506 | 2.9× |
| Proton tx delivery intermediate (77523) | $3,884.66 | $5,798 | 3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$2,777.15–$2,778.49 | $4,145–$4,147 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,367.47 | $2,041 | 3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $420.09 | $627 | 4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $836.83 | $1,249 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $452.92 | $676 | 5.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $353.09 | $527 | 4.0× |
| Radex elbow complete minimum 3 views (73080) | $452.92 | $676 | 5.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $256.61 | $383 | 2.4× |
| Radex fingr minimum 2 views (73140) | $385.92 | $576 | 4.4× |
| Radex foot complete minimum 3 views (73630) | $452.92 | $676 | 5.2× |
| Radex Hand Minimum 3 Views (73130) | $416.74 | $622 | 4.8× |
| Radex lower extremity infant minimum 2 views (73592) | $178.22 | $266 | 2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $186.26 | $278 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $239.19 | $357 | 2.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $413.39 | $617 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $276.71 | $413 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) | $496.47 | $741 | 5.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $225.12 | $336 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $428.13 | $639 | 4.9× |
| Radex Sternum Minimum 2 Views (71120) | $196.98 | $294 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $252.59 | $377 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $367.83 | $549 | 4.2× |
| Radex upper extremity infant minimum 2 views (73092) | $178.22 | $266 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $509.87 | $761 | 5.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $568.83 | $849 | 5.4× |
| Radiation treatment delivery level 3 (77412) | $1,057.93 | $1,579 | 1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $324.28 | $484 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $495.80 | $740 | 4.7× |
| Radiologic exam colon double contrast study (74280) | $648.56 | $968 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $1,052.57 | $1,571 | 6.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $548.73 | $819 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) | $487.09 | $727 | 4.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $494.46 | $738 | 4.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $449.57 | $671 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $620.42 | $926 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $344.38 | $514 | 2.0× |
| Radiologic examination femur 1 view (73551) | $278.05 | $415 | 3.2× |
| Radiologic examination femur minimum 2 views (73552) | $453.59 | $677 | 5.2× |
| Radiologic examination knee 1/2 views (73560) | $422.77 | $631 | 4.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $756.43 | $1,129 | 7.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $469.67 | $701 | 5.4× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $138.02 | $206 | 0.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $276.04 | $412 | 1.2× |
| Renal Cyst Study (74470) | $909.19 | $1,357 | 1.7× |
| Ribs bilateral 3 views (71110) | $404.68 | $604 | 3.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $940.68 | $1,404 | 2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,650.21 | $2,463 | 4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,840.44 | $5,732 | 7.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,178.48 | $4,744 | 5.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,985.88 | $2,964 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $1,285.73 | $1,919 | 5.5× |
| Rp Therapy Unlisted Procedure (79999) | $485.08 | $724 | 2.1× |
| Salivary Gland Function Study (78232) | $435.50 | $650 | 1.1× |
| Salivary Gland Imaging (78230) | $688.76 | $1,028 | 1.7× |
| Salivary Gland Imaging Serial Images (78231) | $715.56 | $1,068 | 1.8× |
| Scapula (73010) | $232.49 | $347 | 2.2× |
| Shoulder 1 view (73020) | $395.97 | $591 | 4.5× |
| Shoulder Arthrography (73040) | $818.07 | $1,221 | 2.3× |
| Sialogram (70390) | $368.50 | $550 | 1.5× |
| Skull less than 4 views (70250) | $319.59 | $477 | 3.0× |
| Special teletherapy port plan (77321) | $1,083.39 | $1,617 | 2.9× |
| Special treatment procedure (77470) | $2,596.25 | $3,875 | 4.7× |
| Speech evaluation, complex (70371) | $322.27 | $481 | 1.3× |
| Spleen Imaging (78185) | $687.42 | $1,026 | 1.7× |
| Sternoclavicular joints (71130) | $174.20 | $260 | 2.0× |
| Superior sagittal sinus venogram (75870) | $1,016.39 | $1,517 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,154.05 | $3,215 | 5.7× |
| Temporomandble Jt Arthrography Rs&I (70332) | $453.59 | $677 | 1.9× |
| Testicular Imaging W/Flow (78761) | $663.97 | $991 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,946.35 | $2,905 | 5.2× |
| Ther rad simulaj-aided field setting simple (77280) | $856.93 | $1,279 | 6.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $644.54 | $962 | 3.7× |
| Thoracic spine 2 views (72070) | $471.68 | $704 | 4.5× |
| Thoracolumbar 2 views (72080) | $471.68 | $704 | 5.4× |
| Thyroid Imaging With Vascular Flow (78013) | $785.91 | $1,173 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,727.26 | $2,578 | 3.2× |
| Thyroid Uptake Measurement (78012) | $1,191.93 | $1,779 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,109.16 | $3,148 | 5.3× |
| Tx Devices Design & Construction Complex (77334) | $1,283.72 | $1,916 | 3.4× |
| Tx devices design & construction intermediate (77333) | $880.38 | $1,314 | 6.5× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$477.71–$479.05 | $713–$715 | varies |
| Ultrasound Elastography Parenchyma (76981) | $956.76 | $1,428 | 9.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,507.50 | $2,250 | 4.3× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$749.06–$750.40 | $1,118–$1,120 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$499.15–$500.49 | $745–$747 | varies |
| Unlisted fluoroscopic procedure (76496) | $439.52 | $656 | 5.0× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $672.01 | $1,003 | 1.7× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $811.37 | $1,211 | 2.0× |
| Unlisted magnetic resonance procedure (76498) | $3,174.46 | $4,738 | 36.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $842.86 | $1,258 | 2.1× |
| Unlisted respiratory px dx nuclear medicine (78599) | $1,189.25 | $1,775 | 3.0× |
| Unlisted us procedure (76999) | $372.52 | $556 | 4.3× |
| Upper gi w/o kub (74240) | $911.20 | $1,360 | 5.2× |
| Ureteral Reflux Study (78740) | $1,086.74 | $1,622 | 2.7× |
| Urethrocystogram voiding (74455) | $942.69 | $1,407 | 3.9× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$811.37–$812.71 | $1,211–$1,213 | varies |
| Us breast unilateral complete (76641) | $570.84 | $852 | 5.4× |
| Us chest (76604) range across 2 matching MRF lines |
$442.20–$444.21 | $660–$663 | varies |
| Us complete joint (76881) | $610.37 | $911 | 5.8× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$443.54–$444.88 | $662–$664 | varies |
| Us head (76506) | $461.63 | $689 | 4.4× |
| Us kidney transplant (76776) | $905.17 | $1,351 | 8.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$491.78–$493.12 | $734–$736 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$684.74–$686.08 | $1,022–$1,024 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$745.71–$747.05 | $1,113–$1,115 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$799.31–$800.65 | $1,193–$1,195 | varies |
| Us pelvic non ob complete (76856) | $1,015.05 | $1,515 | 9.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$987.58–$988.92 | $1,474–$1,476 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$657.27–$658.61 | $981–$983 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$885.74–$887.08 | $1,322–$1,324 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$571.51–$572.85 | $853–$855 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$641.19–$739.01 | $957–$1,103 | varies |
| Us spinal canal and contents (76800) | $450.24 | $672 | 4.3× |
| Us thyroid (76536) range across 3 matching MRF lines |
$493.79–$722.93 | $737–$1,079 | varies |
| Us transrectal (76872) | $1,467.97 | $2,191 | 14.0× |
| Vascular Flow Imaging (78445) | $447.56 | $668 | 1.1× |
| Vein X-Ray Chest (75827) | $2,357.06 | $3,518 | 1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$2,389.89–$2,391.23 | $3,567–$3,569 | varies |
| Vein X-Ray Spleen/Liver (75810) | $1,829.77 | $2,731 | 0.6× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,023.76–$1,025.10 | $1,528–$1,530 | varies |
| Venography Adrenal Unilateral (75840) | $1,488.74 | $2,222 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $2,959.39 | $4,417 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,457.92 | $2,176 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,453.90 | $2,170 | 0.9× |
| Venography Renal Bilateral (75833) | $2,046.18 | $3,054 | 0.6× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,046.18–$2,047.52 | $3,054–$3,056 | varies |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,186.57 | $1,771 | 0.2× |
| Venous thrombosis imaging (78457) | $714.22 | $1,066 | 1.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $941.35 | $1,405 | 2.3× |
| Vertebral fracture assessment via dxa (77086) | $210.38 | $314 | 2.4× |
| Wrist 2 views (73100) | $373.86 | $558 | 4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $176.88 | $264 | 2.0× |
| X-ray antegrade pyelogram tube (74425) | $905.17 | $1,351 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $1,945.01 | $2,903 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $432.82 | $646 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $424.11 | $633 | 4.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $392.62 | $586 | 4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $668.66 | $998 | 6.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $698.81 | $1,043 | 6.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $292.12 | $436 | 3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $397.98 | $594 | 4.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $486.42 | $726 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $352.42 | $526 | 3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $446.89 | $667 | 4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $515.23 | $769 | 4.9× |
| X-Ray Exam L-S Spine Bending (72114) | $530.64 | $792 | 5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $553.42 | $826 | 6.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $604.34 | $902 | 5.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $312.22 | $466 | 3.0× |
| X-ray humerus (73060) | $393.29 | $587 | 4.5× |
| X-ray IV pyelogram (ivp) (74400) | $397.31 | $593 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $150.75 | $225 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $216.41 | $323 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$449.57–$518.58 | $671–$774 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $468.33 | $699 | 4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $254.60 | $380 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $150.75 | $225 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $317.58 | $474 | 3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $481.73 | $719 | 5.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $616.40 | $920 | 5.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $889.09 | $1,327 | 2.5× |
| X-Rays Bone Length Studies (77073) | $519.25 | $775 | 4.9× |
| X-Rays Bone Survey Complete (77075) | $843.53 | $1,259 | 8.0× |
| Xr c-spine 4 or 5 views (72050) | $572.85 | $855 | 5.5× |
| Xr facial bones less than 3 views (70140) | $132.66 | $198 | 1.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $138.02 | $206 | 1.3× |
| Xr orbits complete 4 views (70200) | $229.14 | $342 | 2.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.