Imaging prices at The Carle Foundation Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $10,143 $10,143 6.8×
Abdomen 1 View (74018) $609 $609 6.5×
Abdomen 2 views (74019) $840 $840 7.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,764 $1,764 4.1×
Angio internal mammary (75756)
range across 2 matching MRF lines		 $3,465–$5,523 $3,465–$5,523 varies
Angio pulmonary bilat (75743)
range across 2 matching MRF lines		 $6,090–$9,702 $6,090–$9,702 varies
Angiography Adrenal Bilateral Slctv Rs&I (75733) $4,326 $4,326 1.3×
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines		 $5,502–$8,799 $5,502–$8,799 varies
Angiography extremity unilateral rs&i (75710)
range across 3 matching MRF lines		 $3,875–$6,468 $3,875–$6,468 varies
Angiography pulmonary unilateral slctv rs&i (75741) $3,749 $3,749 1.1×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $6,889 $6,889 2.0×
Ankle 2 views (73600) $693 $693 7.4×
Aortography thoracic serialography rs&i (75605)
range across 2 matching MRF lines		 $8,589–$11,832 $8,589–$11,832 varies
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines		 $7,004–$11,204 $7,004–$11,204 varies
Artery X-Rays Adrenal Gland (75731) $4,704 $4,704 1.4×
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines		 $8,589–$11,832 $8,589–$11,832 varies
Artery X-Rays Spine (75705)
range across 2 matching MRF lines		 $7,004–$11,204 $7,004–$11,204 varies
Arthrogram ankle (73615) $1,166 $1,166 3.1×
Arthrogram hip (73525) $1,229 $1,229 3.3×
Arthrogram Wrist (73115) $2,426 $2,426 6.5×
Basic radiation dosimetry calculation (77300) $1,134 $1,134 7.9×
Bone age studies (77072) $956 $956 8.5×
Bone Imaging 3 Phase (78315) $2,993 $2,993 7.0×
Bone Imaging Limited Area (78300) $1,743 $1,743 4.1×
Bone Imaging Multiple Areas (78305) $2,321 $2,321 5.4×
Bone Imaging Whole Body (78306) $2,730 $2,730 6.4×
Bone marrow imaging limited area (78102) $1,176 $1,176 2.7×
Bone marrow imaging; whole body (78104) $1,628 $1,628 3.8×
Bone survey infant (77076) $840 $840 7.5×
Brachytx isodose complex (77318) $2,814 $2,814 7.0×
Brachytx isodose intermed (77317) $1,439 $1,439 3.6×
Brachytx Isodose Plan Simple (77316) $1,197 $1,197 3.0×
Brain Flow Imaging Only (78610) $1,680 $1,680 2.9×
Brain Image W/Flow < 4 Views (78601) $1,418 $1,418 3.3×
Brain Imaging Minimum 4 Static Views (78605) $1,491 $1,491 2.6×
Brain Imaging Pet Metabolic Evaluation (78608) $10,857 $10,857 7.1×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,596 $1,596 3.7×
Cardiac MRI w/w/o contrast & further seq (75561) $2,678 $2,678 7.2×
Cardiac MRI w/w/o contrast w/stress (75563) $2,720 $2,720 3.2×
Cat Scan Follow-Up Study (76380) $1,932 $1,932 20.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,176 $1,176 2.0×
Cerebrospinal Fluid Scan (78630) $2,583 $2,583 4.4×
Chest 1 view (71045)
range across 2 matching MRF lines		 $499–$609 $499–$609 varies
Chest 2 views (71046) $609 $609 6.5×
Chest 3 views (71047) $735 $735 7.9×
Chest 4 or more views (71048) $851 $851 7.6×
Cholecystography Oral Contrast (74290) $1,197 $1,197 6.4×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $935 $935 8.3×
Cisternography Positive Contrast Rs&I (70015) $5,586 $5,586 6.6×
Clavicle complete (73000) $693 $693 7.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $672 $672 6.0×
Continuing medical physics consltj pr wk (77336) $1,071 $1,071 7.4×
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines		 $6,017–$9,618 $6,017–$9,618 varies
Contrast X-Ray Bladder (74430)
range across 2 matching MRF lines		 $1,208–$1,911 $1,208–$1,911 varies
Contrast X-Ray Of Elbow (73085) $1,554 $1,554 4.2×
Contrast X-Ray Of Knee Joint (73580) $1,922 $1,922 5.1×
CT abdomen and pelvis without and with contrast (74178) $8,285 $8,285 22.2×
CT abdomen and pelvis without contrast (74176) $6,195 $6,195 24.2×
CT abdomen w contrast (74160) $4,988 $4,988 26.5×
CT abdomen w wo contrast (74170) $5,492 $5,492 29.2×
CT abdomen w/o contrast (74150) $4,158 $4,158 37.1×
CT Angio Abdomen and Pelvis (74174) $5,208 $5,208 13.9×
CT Angio Chest (71275) $5,061 $5,061 26.9×
CT Angio Head (70496) $3,728 $3,728 19.8×
CT angio hrt w/3d image (75574) $1,869 $1,869 5.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,885 $3,885 20.7×
CT Angio Neck (70498) $4,988 $4,988 26.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $4,662 $4,662 24.8×
CT cervical spine w/ contrast (72126) $4,977 $4,977 13.3×
CT cervical spine w/o contrast (72125) $4,421 $4,421 39.5×
CT cervical spine w/wo cont (72127) $6,741 $6,741 35.9×
CT chest w contrast (71260) $4,977 $4,977 26.5×
CT chest w/wo contrast (71270) $5,618 $5,618 29.9×
CT colonography screening (74263) $1,764 $1,764 6.9×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,775 $1,775 9.4×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,365 $1,365 12.2×
CT head/brain with contrast (70460) $3,560 $3,560 18.9×
CT head/brain without and with contrast (70470) $4,095 $4,095 21.8×
CT heart contrast eval cardiac structure&morph (75572) $1,869 $1,869 5.0×
CT heart no contrast quant eval coronry calcium (75571) $651 $651 7.0×
CT hrt w/3d image congen (75573) $1,554 $1,554 4.2×
CT iac w contrast (70481) $3,518 $3,518 18.7×
CT l-spine w&w/o contrast (72133) $5,555 $5,555 29.6×
CT lower ext w/o (73700) $3,539 $3,539 31.6×
CT lower extremity w/contrast material (73701) $3,245 $3,245 17.3×
CT lumbar spine w contrast (72132) $5,198 $5,198 13.9×
CT lumbar spine w/o contrast (72131) $3,738 $3,738 33.4×
CT maxillofacial w contrast (70487) $4,347 $4,347 23.1×
CT maxillofacial wo contrast (70486) $3,581 $3,581 32.0×
CT neck tissue combo (70492) $4,421 $4,421 23.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $4,032 $4,032 21.5×
CT orbits w/o contrast (70480) $3,791 $3,791 33.8×
CT pelvis w&w/o contrast (72194) $4,589 $4,589 24.4×
CT pelvis w/o contrast (72192) $4,148 $4,148 37.0×
CT scan of leg combo (73702) $3,486 $3,486 18.5×
CT scans face/jaw combo (70488) $4,652 $4,652 24.7×
CT soft tissue neck w contrast (70491) $4,400 $4,400 23.4×
CT soft tissue neck w/o contrast (70490) $3,056 $3,056 27.3×
CT thoracic spine w contrast (72129) $4,032 $4,032 21.5×
CT thoracic spine w/o contrast (72128) $3,644 $3,644 32.5×
CT thoracic spine w/wo cont (72130) $4,347 $4,347 23.1×
CT thorax w/o contrast (71250) $3,906 $3,906 34.9×
CT unlisted procedure (76497) $3,497 $3,497 37.5×
CT upper ext wo (73200) $4,085 $4,085 36.5×
CT upper extremity w/o & w/contrast material (73202) $4,967 $4,967 26.4×
CT upper extremity with contrast (73201) $3,654 $3,654 9.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,788 $4,788 25.5×
Cta Abdomen (74175) $5,492 $5,492 29.2×
CTA pelvis (72191) $4,337 $4,337 23.1×
Dilation ureters/urethra rs&i (74485) $2,289 $2,289 1.0×
Diskography lumbar (72295)
range across 2 matching MRF lines		 $2,678–$4,284 $2,678–$4,284 varies
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $1,229 $1,229 11.0×
Doppler Echo Fetal Spectral Display Complete (76827) $1,397 $1,397 12.5×
Doppler Fetal Mid Cerebral Artery (76821) $1,229 $1,229 11.0×
Dxa Bone Density Axial (77080) $882 $882 7.9×
Dxa bone density study (77085) $1,208 $1,208 10.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $609 $609 6.5×
Echo exam of fetal heart (76825) $2,247 $2,247 3.8×
Echo exam uterus (76831) $1,575 $1,575 6.2×
Echo Guide For Artery Repair (76936) $2,069 $2,069 8.9×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,376 $1,376 5.4×
Echograp Trans R Pros Study (76873) $1,271 $1,271 11.3×
Esophagram (74220) $1,344 $1,344 7.2×
Fetal Biophys Profile W/Nst (76818) $1,397 $1,397 12.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,397 $1,397 12.5×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $5,891 $5,891 23.0×
Fluoroscopy up to 1 hr (76000)
range across 6 matching MRF lines		 $1,302–$1,701 $1,302–$1,701 varies
Follow-Up Angiography (75898)
range across 2 matching MRF lines		 $5,167–$6,889 $5,167–$6,889 varies
Foot 2 views (73620) $693 $693 7.4×
Forearm 2 views (73090) $609 $609 6.5×
Gastric emptying imaging study (78264) $2,993 $2,993 7.0×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $3,854 $3,854 9.0×
Gastroesophageal Reflux Exam (78262) $2,153 $2,153 5.0×
Gastrointestinal Protein Loss (78282) $2,027 $2,027 4.7×
Gated Heart Planar Single (78472) $2,583 $2,583 6.0×
Gated Heart, Multiple (78473) $3,056 $3,056 7.1×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $5,418 $5,418 9.3×
Hand 2 views (73120) $924 $924 8.2×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $9,902 $9,902 13.3×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $5,334 $5,334 7.1×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $3,276 $3,276 4.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $4,085 $4,085 1.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,465 $3,465 1.0×
Hepatobil Syst Image W/Drug (78227) $3,854 $3,854 6.6×
Hepatobiliary System Imaging (78226) $2,195 $2,195 5.1×
Ht Musc Image Planar Mult (78454) $5,607 $5,607 4.0×
Ht Muscle Image Spect Sing (78451) $5,607 $5,607 4.0×
Hysterosalpingogram (74740) $1,334 $1,334 5.2×
Image fusion (77399) $1,180 $1,180 8.2×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,019 $1,019 10.9×
Infant hip ultrasound, limited static exam (76886)
range across 2 matching MRF lines		 $509–$830 $509–$830 varies
Interstitial radiation source applic complex (77778) $5,744 $5,744 7.7×
Intracavitary Radiation Source Applic Complex (77763) $3,549 $3,549 4.8×
Intracavitary Radiation Source Applic Intermed (77762) $3,045 $3,045 5.1×
Intracavitary radiation source applic simple (77761) $2,394 $2,394 4.0×
Joint Survey Single View (77077) $840 $840 7.5×
K Flow/Funct Image Multiple (78709) $2,100 $2,100 3.6×
K Flow/Funct Image W/Drug (78708) $2,426 $2,426 4.2×
K Flow/Funct Image W/O Drug (78707) $2,100 $2,100 3.6×
Kidney Imaging Morphol (78700) $1,743 $1,743 4.1×
Knee 3 Views (73562) $693 $693 7.4×
Leveen/Shunt Patency Exam (78291) $1,418 $1,418 3.3×
Liver & Spleen Imaging Static Only (78215) $2,132 $2,132 5.0×
Liver imaging static only (78201) $2,741 $2,741 4.7×
Liver imaging w/vascular flow (78202) $4,704 $4,704 8.1×
Lung Perf&Ventilat Diferentl (78598) $2,268 $2,268 3.9×
Lung perfusion differential (78597) $1,418 $1,418 3.3×
Lung Ventilat&Perfus Imaging (78582) $3,371 $3,371 5.8×
Lymph System Imaging (78195) $2,604 $2,604 4.5×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $1,922 $1,922 1.1×
Lymphangiography extremity only unilateral rs&i (75801) $1,229 $1,229 1.8×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $6,889 $6,889 2.0×
Lymphangiography, pelvic/abdominal, unilateral (75805) $6,889 $6,889 2.0×
Magnetic Image Jaw Joint (70336) $5,576 $5,576 21.8×
Magnetic Resonance Elastography (76391) $7,098 $7,098 27.8×
Meckels Divert Exam (78290) $1,890 $1,890 4.4×
Medical physics dose eval radiation expos w/rprt (76145) $1,040 $1,040 2.6×
Mlc imrt design & construction per imrt plan (77338) $2,121 $2,121 5.3×
Mr safety determination physician/other qhp (76016) $389 $389 4.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $110 $110 3.5×
Mr safety implt electronics prepj supvj phys/qhp (76018) $404 $404 4.0×
Mr safety implt pos&/immoblj (76019) $263 $263 4.2×
Mr safety med physics xm customization plng&mntr (76017) $1,061 $1,061 4.1×
Mra Head W/O & W/Contrast Material (70546) $7,928 $7,928 21.2×
MRA head w/o contrast (70544) $4,841 $4,841 18.9×
MRA head with contrast (70545) $9,093 $9,093 24.3×
MRA neck w contrast (70548) $8,337 $8,337 22.3×
Mra Neck W/O &W/Contrast Material (70549) $7,928 $7,928 21.2×
MRA neck w/o contrast (70547) $4,841 $4,841 18.9×
MRI abdomen w contrast (74182) $7,928 $7,928 21.2×
MRI abdomen w/o contrast (74181) $5,145 $5,145 20.1×
MRI any jt lower extrem w/contrast material (73722) $9,828 $9,828 11.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $7,928 $7,928 21.2×
MRI any jt upper extremity w/contrast matrl (73222) $8,558 $8,558 10.2×
MRI brain functional w/o physician admnistration (70554) $5,219 $5,219 20.4×
MRI Breast W/O Contrast Bilateral (77047) $3,497 $3,497 13.7×
MRI Breast Without Contrast Material Unilateral (77046) $1,785 $1,785 7.0×
MRI cardiac w/o cont stress (75559) $2,237 $2,237 3.8×
MRI cardiac w/o contrast (75557) $1,932 $1,932 7.6×
MRI cervical spine w contrast (72142) $9,093 $9,093 24.3×
MRI cervical spine w/o cont (72141) $5,397 $5,397 21.1×
MRI chest w/o contrast (71550) $5,576 $5,576 21.8×
MRI chest with contrast (71551) $6,416 $6,416 7.6×
MRI chest wo w contrast (71552) $9,093 $9,093 24.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $9,093 $9,093 24.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $7,928 $7,928 21.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,576 $5,576 21.8×
MRI lumbar spine w contrast (72149) $9,093 $9,093 24.3×
Mri Neck Spine W/O & W/Dye (72156) $7,928 $7,928 21.2×
MRI orbit face &/neck w/o contrast (70540) $4,841 $4,841 18.9×
MRI orbit face neck w contrast (70542) $5,565 $5,565 14.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $9,093 $9,093 24.3×
MRI pelvis w contrast (72196) $9,093 $9,093 24.3×
MRI pelvis w/o & w contrast (72197) $9,093 $9,093 24.3×
MRI pelvis w/o contrast (72195) $5,576 $5,576 21.8×
MRI spectroscopy (76390) $5,082 $5,082 54.5×
MRI thoracic spine w/o contrast (72146) $5,072 $5,072 19.8×
MRI upper extremity oth than jt w/contr matrl (73219) $6,447 $6,447 17.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $5,576 $5,576 21.8×
Mri Uppr Extremity W/O&W/Dye (73220) $9,093 $9,093 24.3×
MRI, abdomen, combo (74183) $7,928 $7,928 21.2×
MRI, dorsal spine combo (72157) $7,928 $7,928 21.2×
MRI, dorsal spine contrast (72147) $6,657 $6,657 17.8×
MRI, joint upper extrem (73221) $5,576 $5,576 21.8×
MRI, joint upper extrem combo (73223) $7,928 $7,928 21.2×
MRI, lumbar spine combo (72158) $7,928 $7,928 21.2×
Myelogram cervical (72240) $4,484 $4,484 5.3×
Myelogram Lumbar (72265)
range across 2 matching MRF lines		 $2,594–$4,127 $2,594–$4,127 varies
Myelography thoracic (72255) $2,153 $2,153 2.6×
Myelograpy 2/more regions rs&i (72270) $3,224 $3,224 3.8×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $2,058 $2,058 4.8×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $4,116 $4,116 3.0×
Myocardial Spect Multiple Studies (78452) $5,607 $5,607 4.0×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $5,586 $5,586 3.6×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $5,586 $5,586 3.6×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $8,663 $8,663 3.7×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $10,595 $10,595 4.5×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $10,595 $10,595 6.5×
N-invas est c ffr sw aly CTA (75580) $5,460 $5,460 5.9×
Neck soft tissue (70360) $693 $693 7.4×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $1,533 $1,533 3.7×
Nm myocard infarct spect (78469) $3,098 $3,098 5.3×
Nonvascular Shunt X-Ray (75809)
range across 2 matching MRF lines		 $840–$977 $840–$977 varies
Ntsty modul radthx pln dose-vol histos (77301) $10,143 $10,143 6.8×
Nuclear Rx Intra-Arterial (79445) $2,499 $2,499 10.0×
Nuclear Rx Oral Admin (79005) $2,342 $2,342 9.4×
Ob us nuchal meas 1 gest (76813) $1,292 $1,292 11.5×
Oph bmtry us echograpy a-scan io lens pwr cal (76519)
range across 2 matching MRF lines		 $725–$1,166 $725–$1,166 varies
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $777 $777 6.9×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 3 matching MRF lines		 $546–$882 $546–$882 varies
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $163 $163 5.3×
Optic foramina (70190) $452 $452 4.8×
Panoramic X-ray of jaws (70355) $609 $609 6.5×
Parathyroid imaging w/tomographic spect & CT (78072) $2,867 $2,867 4.9×
Parathyroid Planar Imaging (78070) $2,121 $2,121 5.0×
Parathyroid planar imaging w/wo subtraction (78071) $3,014 $3,014 7.0×
Pelvis 1 or 2 views (72170) $840 $840 7.5×
Perineogram (74775) $746 $746 2.9×
Peritoneogram Rs&I (74190)
range across 2 matching MRF lines		 $1,187–$1,880 $1,187–$1,880 varies
Pet Image W/Ct Lmtd (78814) $10,857 $10,857 7.1×
PET image w/CT, full body (78816) $10,857 $10,857 7.1×
PET imaging CT attenuation skull base mid-thigh (78815) $10,857 $10,857 7.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $3,749 $3,749 1.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,691 $1,691 3.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $882 $882 7.9×
Radex abscess/fistula/sinus tract rs&i (76080) $1,911 $1,911 3.3×
Radex Ankle Complete Minimum 3 Views (73610) $693 $693 7.4×
Radex Calcaneus Minimum 2 Views (73650) $693 $693 7.4×
Radex elbow complete minimum 3 views (73080) $693 $693 7.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $893 $893 8.0×
Radex fingr minimum 2 views (73140) $693 $693 7.4×
Radex foot complete minimum 3 views (73630) $693 $693 7.4×
Radex Hand Minimum 3 Views (73130) $693 $693 7.4×
Radex lower extremity infant minimum 2 views (73592) $609 $609 6.5×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $903 $903 8.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $693 $693 7.4×
Radex Ribs Unilateral 2 Views (71100) $693 $693 7.4×
Radex shoulder complete minimum 2 views (73030) $683 $683 7.3×
Radex Sinuses Paransl < 3 Views (70210) $620 $620 6.6×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $1,197 $1,197 6.4×
Radex Spine 1 View Specify Level (72020) $609 $609 6.5×
Radex Sternum Minimum 2 Views (71120) $693 $693 7.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $641 $641 6.9×
Radex Toe Minimum 2 Views (73660) $693 $693 7.4×
Radex upper extremity infant minimum 2 views (73092) $446 $446 4.0×
Radex Wrist Complete Minimum 3 Views (73110) $693 $693 7.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,974 $1,974 17.6×
Radiation Delivery Stereotactic Cranial Linear (77372) $25,484 $25,484 3.2×
Radiation treatment delivery level 1 (77402) $1,029 $1,029 9.4×
Radiation treatment delivery level 2 (77407) $1,134 $1,134 2.7×
Radiation treatment delivery level 3 (77412) $1,890 $1,890 3.2×
Radiolog exam mandible compl minimum 4 views (70110) $956 $956 8.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $882 $882 7.9×
Radiologic exam colon double contrast study (74280) $1,544 $1,544 8.2×
Radiologic exam colon single contrast study (74270) $1,449 $1,449 7.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,271 $1,271 6.8×
Radiologic exam knee complete 4/more views (73564) $1,029 $1,029 9.2×
Radiologic exam pelvis compl minimum 3 views (72190) $956 $956 8.5×
Radiologic Exam Small Int Single Contrast Study (74250) $1,344 $1,344 7.2×
Radiologic exam swallow function contrast study (74230) $1,344 $1,344 7.2×
Radiologic exam teeth complete full mouth (70320) $341 $341 1.3×
Radiologic exam upr gi trc double contrast study (74246) $1,544 $1,544 8.2×
Radiologic examination femur 1 view (73551) $746 $746 8.0×
Radiologic examination femur minimum 2 views (73552) $882 $882 9.5×
Radiologic examination knee 1/2 views (73560) $609 $609 6.5×
Radiologic Examination Osseous Survey Limited (77074) $1,386 $1,386 12.4×
Radiologic examination tibia & fibula 2 views (73590) $693 $693 7.4×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $840 $840 1.4×
Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) $2,247 $2,247 9.0×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $1,880 $1,880 7.5×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $4,421 $4,421 10.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $2,688 $2,688 6.5×
Renal Cyst Study (74470) $1,229 $1,229 2.1×
Ribs bilateral 3 views (71110) $840 $840 7.5×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,680 $1,680 3.9×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,709 $2,709 6.3×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $5,607 $5,607 9.6×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $5,607 $5,607 9.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $5,156 $5,156 8.9×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,909 $2,909 2.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,087 $3,087 2.0×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $2,415 $2,415 1.7×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $2,289 $2,289 9.2×
Rp Therapy Intravenous Administration (79101) $1,596 $1,596 6.4×
Scapula (73010) $840 $840 7.5×
Screening Digital Breast Tomosynthesis Bi (77063) $735 $735 31.4×
Sella turcica (70240) $336 $336 3.6×
Shoulder 1 view (73020) $609 $609 6.5×
Shoulder Arthrography (73040) $2,709 $2,709 7.2×
Skull less than 4 views (70250) $840 $840 7.5×
Special dosimetry (77331) $1,134 $1,134 7.9×
Special Physics Consult (77370) $1,554 $1,554 10.8×
Special teletherapy port plan (77321) $3,150 $3,150 7.9×
Special treatment procedure (77470) $4,421 $4,421 7.5×
Speech evaluation, complex (70371) $1,691 $1,691 6.6×
Spleen Imaging (78185) $1,218 $1,218 2.8×
Stereotactic Body Radiation Delivery (77373) $14,742 $14,742 7.7×
Sternoclavicular joints (71130) $714 $714 7.7×
Superior sagittal sinus venogram (75870) $6,889 $6,889 2.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $672 $672 6.1×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $609 $609 6.5×
Tbs technical calculation only (77091) $368 $368 3.9×
Telethx isodose pln cplx w/basic dosimetry (77307) $2,741 $2,741 6.8×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,901 $1,901 4.7×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $3,581 $3,581 8.9×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,741 $2,741 6.8×
Ther rad simulaj-aided field setting simple (77280) $1,691 $1,691 11.7×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $1,544 $1,544 8.2×
Thoracic spine 2 views (72070) $840 $840 7.5×
Thoracic spine 3 views (72072) $840 $840 7.5×
Thoracolumbar 2 views (72080) $693 $693 7.4×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $1,785 $1,785 4.2×
Thyroid Imaging With Vascular Flow (78013) $2,247 $2,247 5.2×
Thyroid Met Imaging Body (78018) $2,688 $2,688 4.6×
Thyroid Uptake Measurement (78012) $735 $735 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,174 $2,174 5.1×
Tx Devices Design & Construction Complex (77334) $2,741 $2,741 6.8×
Tx devices design & construction intermediate (77333) $1,386 $1,386 9.6×
Tx devices design & construction simple (77332) $1,218 $1,218 8.5×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $977–$1,040 $977–$1,040 varies
Ultrasound elastography first target lesion (76982) $525 $525 4.7×
Ultrasound Elastography Parenchyma (76981) $525 $525 4.7×
Ultrasound Exam Aaa Screen (76706)
range across 2 matching MRF lines		 $1,197–$1,229 $1,197–$1,229 varies
Ultrasound trgt dynamic microbubble 1st lesion (76978) $1,575 $1,575 4.2×
Ultrasound, abdomen limited (76705)
range across 5 matching MRF lines		 $1,386–$1,523 $1,386–$1,523 varies
Umbilical-artery Doppler (OB) (76820) $1,050 $1,050 9.4×
Unlisted Dx Radiographic Procedure (76499) $1,134 $1,134 12.2×
Unlisted fluoroscopic procedure (76496)
range across 22 matching MRF lines		 $347–$6,269 $347–$6,269 varies
Unlisted magnetic resonance procedure (76498) $1,313 $1,313 14.1×
Upper gi w/o kub (74240) $1,344 $1,344 7.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $62 $62 5.6×
Urea breath test c-14 isotopic analysis (78268) $441 $441 4.7×
Ureteral Reflux Study (78740) $1,722 $1,722 4.0×
Urethrocystogram voiding (74455) $1,953 $1,953 7.6×
Urethrocystography retrograde (74450)
range across 2 matching MRF lines		 $1,082–$1,722 $1,082–$1,722 varies
Us bone density measurement (76977) $499 $499 4.5×
Us breast unilateral complete (76641) $1,397 $1,397 12.5×
Us chest (76604)
range across 5 matching MRF lines		 $1,050–$1,229 $1,050–$1,229 varies
Us complete joint (76881)
range across 2 matching MRF lines		 $1,071–$1,397 $1,071–$1,397 varies
Us exam, pelvic, limited (76857)
range across 4 matching MRF lines		 $1,302–$1,397 $1,302–$1,397 varies
Us head (76506) $1,229 $1,229 11.0×
Us kidney transplant (76776) $1,617 $1,617 14.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,397 $1,397 12.5×
Us ob detailed single fetus (76811) $2,531 $2,531 9.9×
Us ob limited 1 or more fetuses (76815) $1,397 $1,397 12.5×
Us ob transvaginal (76817) $1,397 $1,397 12.5×
Us pelvic non ob complete (76856) $1,397 $1,397 12.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,397 $1,397 12.5×
Us preg uterus real time f/u trnsabdl per fetus (76816) $1,397 $1,397 12.5×
Us retroperitoneal complete (76770) $1,659 $1,659 14.8×
Us retroperitoneal limited (76775)
range across 4 matching MRF lines		 $1,397–$1,512 $1,397–$1,512 varies
Us scrotum and contents (76870) $1,397 $1,397 12.5×
Us spinal canal and contents (76800) $1,229 $1,229 11.0×
Us thyroid (76536) $1,397 $1,397 12.5×
Us transrectal (76872) $1,344 $1,344 12.0×
Vascular Flow Imaging (78445) $2,027 $2,027 4.7×
Vein X-Ray Chest (75827)
range across 2 matching MRF lines		 $3,014–$4,788 $3,014–$4,788 varies
Vein X-Ray Liver W/O Hemodyn (75887) $5,167 $5,167 1.5×
Vein X-Ray Skull Epidural (75872)
range across 2 matching MRF lines		 $2,289–$2,426 $2,289–$2,426 varies
Vein X-Ray Spleen/Liver (75810) $6,889 $6,889 2.0×
Venogram Sinus/Jugular (75860)
range across 2 matching MRF lines		 $5,187–$6,889 $5,187–$6,889 varies
Venography Adrenal Unilateral (75840) $6,889 $6,889 2.0×
Venography caval inferior serialography rs&i (75825)
range across 2 matching MRF lines		 $4,347–$6,951 $4,347–$6,951 varies
Venography extremity bilateral rs&i (75822)
range across 3 matching MRF lines		 $2,804–$4,977 $2,804–$4,977 varies
Venography extremity unilateral rs&i (75820) $4,095 $4,095 2.4×
Venography Orbital Rs&I (75880)
range across 2 matching MRF lines		 $2,058–$2,195 $2,058–$2,195 varies
Venography Renal Bilateral (75833) $6,185 $6,185 1.8×
Venography Renal Unilateral (75831)
range across 2 matching MRF lines		 $3,696–$5,891 $3,696–$5,891 varies
Venous sampling by catheter (75893) $11,832 $11,832 2.0×
Vertebral fracture assessment via dxa (77086) $809 $809 8.7×
Wrist 2 views (73100) $693 $693 7.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $693 $693 7.4×
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines		 $1,491–$2,384 $1,491–$2,384 varies
X-Ray Aorta Leg Arteries (75630)
range across 2 matching MRF lines		 $5,859–$9,387 $5,859–$9,387 varies
X-Ray Bend Only L-S Spine (72120) $840 $840 7.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $693 $693 7.4×
X-Ray Exam Breast Specimen (76098) $1,029 $1,029 1.8×
X-Ray Exam Entire Spi 1 Vw (72081) $861 $861 9.2×
X-Ray Exam Entire Spi 2/3 Vw (72082) $1,523 $1,523 13.6×
X-Ray Exam Entire Spi 4/5 Vw (72083) $1,659 $1,659 14.8×
X-Ray Exam Hip Uni 1 View (73501) $704 $704 7.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $914 $914 9.8×
X-Ray Exam Hip Uni 4/> Views (73503) $1,113 $1,113 9.9×
X-Ray Exam Hips Bi 2 Views (73521) $861 $861 7.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $1,029 $1,029 9.2×
X-Ray Exam Hips Bi 5/> Views (73523) $1,218 $1,218 10.9×
X-Ray Exam L-S Spine Bending (72114) $924 $924 8.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $830 $830 8.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,092 $1,092 9.7×
X-Ray Exam Unilat Ribs/Chest (71101) $840 $840 7.5×
X-ray eye for foreign body (70030) $693 $693 7.4×
X-ray head for orthodontia (70350) $578 $578 6.2×
X-ray humerus (73060) $609 $609 6.5×
X-ray IV pyelogram (ivp) (74400) $1,407 $1,407 7.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $651 $651 7.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $746 $746 8.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $840 $840 7.5×
X-ray nose-rectum child f.b. (76010) $693 $693 7.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $924 $924 8.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $1,302 $1,302 11.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $851 $851 7.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $609 $609 6.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $861 $861 9.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $840 $840 7.5×
X-Ray Stress View (77071) $478 $478 5.1×
X-ray thoracic spine 4 vw (72074) $956 $956 8.5×
X-Ray Tmj Unilat (70328) $599 $599 6.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $2,688 $2,688 7.2×
X-Rays Bone Length Studies (77073) $956 $956 8.5×
X-Rays Bone Survey Complete (77075) $2,027 $2,027 18.1×
Xr c-spine 4 or 5 views (72050) $956 $956 8.5×
Xr facial bones less than 3 views (70140) $704 $704 7.5×
XR Mastoids < 3 Views Bilateral (70120) $840 $840 7.5×
Xr orbits complete 4 views (70200) $956 $956 8.5×
Xr Tomogram Single Plane (76100) $956 $956 8.5×

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.