Imaging prices at The Hospitals of Providence Memorial Campus
El Paso, TX · every code in this section with a posted price and a Medicare benchmark.
378 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) | $10,815.75 | $14,421 | 7.8× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$405–$956.25 | $540–$1,275 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$688.50–$1,182.75 | $918–$1,577 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$5,541.75–$6,414.75 | $7,389–$8,553 | varies |
| Angio internal mammary (75756) | $4,086 | $5,448 | 1.3× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$6,648–$6,812.25 | $8,864–$9,083 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,657.75 | $4,877 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$13,710–$14,890.50 | $18,280–$19,854 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$8,775.75–$9,354.75 | $11,701–$12,473 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,424.50 | $4,566 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $12,080.25 | $16,107 | 3.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$944.25–$1,014 | $1,259–$1,352 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$24,722.25–$25,254.75 | $32,963–$33,673 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $3,737.25 | $4,983 | 1.2× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$24,722.25–$25,254.75 | $32,963–$33,673 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$24,722.25–$25,254.75 | $32,963–$33,673 | varies |
| Artery X-Rays Spine (75705) | $24,188.25 | $32,251 | 4.3× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,454.25–$1,498.50 | $1,939–$1,998 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$2,686.50–$3,050.25 | $3,582–$4,067 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,278–$1,295.25 | $1,704–$1,727 | varies |
| Basic radiation dosimetry calculation (77300) | $521.25 | $695 | 3.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$890.25–$973.50 | $1,187–$1,298 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$2,435.25–$2,519.25 | $3,247–$3,359 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$2,754.75–$2,915.25 | $3,673–$3,887 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$3,825–$4,297.50 | $5,100–$5,730 | varies |
| Brachytx isodose complex (77318) | $1,386 | $1,848 | 3.7× |
| Brachytx isodose intermed (77317) | $1,027.50 | $1,370 | 2.7× |
| Brachytx Isodose Plan Simple (77316) | $793.50 | $1,058 | 2.1× |
| Brain Flow Imaging Only (78610) | $1,940.25 | $2,587 | 3.6× |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$3,672.75–$4,615.50 | $4,897–$6,154 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,364.75 | $11,153 | 5.8× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $9,366.75 | $12,489 | 17.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $5,091.75 | $6,789 | 14.5× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$405–$582 | $540–$776 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$1,420.50–$2,723.25 | $1,894–$3,631 | varies |
| Cerebrospinal Fluid Scan (78630) | $1,243.50 | $1,658 | 2.3× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$341.25–$1,253.25 | $455–$1,671 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$405–$1,133.25 | $540–$1,511 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$372.75–$852.75 | $497–$1,137 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$1,325.25–$1,393.50 | $1,767–$1,858 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$1,211.25–$1,272 | $1,615–$1,696 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$407.25–$436.50 | $543–$582 | varies |
| Continuing medical physics consltj pr wk (77336) | $1,062.75 | $1,417 | 7.9× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$2,833.50–$14,761.50 | $3,778–$19,682 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$1,915.50–$2,387.25 | $2,554–$3,183 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$3,309.75–$3,476.25 | $4,413–$4,635 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,590–$2,023.50 | $2,120–$2,698 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$6,421.50–$9,376.50 | $8,562–$12,502 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$9,423–$10,537.50 | $12,564–$14,050 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$4,421.25–$5,283.75 | $5,895–$7,045 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$4,752–$5,661 | $6,336–$7,548 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$2,987.25–$3,660 | $3,983–$4,880 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 7 matching MRF lines |
$7,021.50–$18,596.25 | $9,362–$24,795 | varies |
| CT Angio Chest (71275) range across 7 matching MRF lines |
$5,106–$6,825 | $6,808–$9,100 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$9,820.50–$12,015 | $13,094–$16,020 | varies |
| CT angio hrt w/3d image (75574) | $3,050.25 | $4,067 | 8.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 5 matching MRF lines |
$3,528–$4,331.25 | $4,704–$5,775 | varies |
| CT Angio Neck (70498) range across 6 matching MRF lines |
$6,070.50–$8,322 | $8,094–$11,096 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$7,962–$9,237 | $10,616–$12,316 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$4,824.75–$5,842.50 | $6,433–$7,790 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$7,475.25–$8,323.50 | $9,967–$11,098 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$5,988–$6,286.50 | $7,984–$8,382 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$3,771–$4,350 | $5,028–$5,800 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$4,198.50–$5,344.50 | $5,598–$7,126 | varies |
| CT head/brain with contrast (70460) range across 4 matching MRF lines |
$5,704.50–$6,476.25 | $7,606–$8,635 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$4,877.25–$5,783.25 | $6,503–$7,711 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,769 | $3,692 | 7.9× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$135–$280.50 | $180–$374 | varies |
| CT hrt w/3d image congen (75573) | $2,769 | $3,692 | 7.9× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$4,271.25–$4,914 | $5,695–$6,552 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$3,262.50–$3,457.50 | $4,350–$4,610 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$686.25–$3,178.50 | $915–$4,238 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,196–$2,592.75 | $2,928–$3,457 | varies |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$2,842.50–$3,612.75 | $3,790–$4,817 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$3,649.50–$4,683 | $4,866–$6,244 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$6,336.75–$7,405.50 | $8,449–$9,874 | varies |
| CT maxillofacial wo contrast (70486) range across 6 matching MRF lines |
$595.50–$3,789.75 | $794–$5,053 | varies |
| CT neck tissue combo (70492) range across 5 matching MRF lines |
$3,037.50–$3,470.25 | $4,050–$4,627 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$2,484.75–$2,740.50 | $3,313–$3,654 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$3,741.75–$4,261.50 | $4,989–$5,682 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$3,133.50–$3,984.75 | $4,178–$5,313 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$3,637.50–$4,406.25 | $4,850–$5,875 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,678.25–$2,813.25 | $3,571–$3,751 | varies |
| CT scans face/jaw combo (70488) range across 6 matching MRF lines |
$1,518.75–$4,722.75 | $2,025–$6,297 | varies |
| CT soft tissue neck w contrast (70491) range across 4 matching MRF lines |
$2,821.50–$4,701 | $3,762–$6,268 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$2,719.50–$3,416.25 | $3,626–$4,555 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$3,769.50–$4,566.75 | $5,026–$6,089 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$3,904.50–$4,478.25 | $5,206–$5,971 | varies |
| CT thoracic spine w/wo cont (72130) | $4,953.75 | $6,605 | 28.1× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$3,276–$3,678 | $4,368–$4,904 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,525–$4,268.25 | $4,700–$5,691 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$4,652.25–$4,886.25 | $6,203–$6,515 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$3,933–$4,687.50 | $5,244–$6,250 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$4,921.50–$5,959.50 | $6,562–$7,946 | varies |
| Cta Abdomen (74175) range across 7 matching MRF lines |
$2,619.75–$3,553.50 | $3,493–$4,738 | varies |
| CTA pelvis (72191) range across 5 matching MRF lines |
$5,072.25–$9,479.25 | $6,763–$12,639 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 2 matching MRF lines |
$1,146–$1,169.25 | $1,528–$1,559 | varies |
| Dilation ureters/urethra rs&i (74485) | $8,838.75 | $11,785 | 4.2× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$6,457.50–$9,135 | $8,610–$12,180 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$4,314–$9,135 | $5,752–$12,180 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $918 | $1,224 | 8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$729–$918 | $972–$1,224 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$786.75–$1,439.25 | $1,049–$1,919 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$672.75–$1,213.50 | $897–$1,618 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$672.75–$1,073.25 | $897–$1,431 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 3 matching MRF lines |
$357–$712.50 | $476–$950 | varies |
| Echo exam of fetal heart (76825) range across 3 matching MRF lines |
$729–$2,948.25 | $972–$3,931 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$1,488.75–$1,641 | $1,985–$2,188 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$726.75–$2,774.25 | $969–$3,699 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$2,400.75–$2,447.25 | $3,201–$3,263 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$1,515.75–$1,687.50 | $2,021–$2,250 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$1,299–$1,473.75 | $1,732–$1,965 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$765–$1,176.75 | $1,020–$1,569 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $5,069.25 | $6,759 | 21.1× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,778.25–$1,933.50 | $2,371–$2,578 | varies |
| Follow-Up Angiography (75898) | $7,000.50 | $9,334 | 2.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$1,014–$1,092 | $1,352–$1,456 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$1,117.50–$1,224.75 | $1,490–$1,633 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,482.50–$3,433.50 | $3,310–$4,578 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $4,012.50 | $5,350 | 10.0× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$5,057.25–$5,280 | $6,743–$7,040 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$4,224.75–$5,186.25 | $5,633–$6,915 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $4,012.50 | $5,350 | 7.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$927.75–$1,059.75 | $1,237–$1,413 | varies |
| Heart first pass single,planar (78481) range across 2 matching MRF lines |
$6,233.25–$7,137.75 | $8,311–$9,517 | varies |
| Heart Image (Pet) Multiple (78492) | $8,364.75 | $11,153 | 5.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $9,009 | $12,012 | 2.8× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$4,452–$5,343 | $5,936–$7,124 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$3,526.50–$4,674.75 | $4,702–$6,233 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$4,448.25–$5,150.25 | $5,931–$6,867 | varies |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $3,762 | $5,016 | 6.8× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$2,307.75–$2,471.25 | $3,077–$3,295 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$643.50–$741.75 | $858–$989 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$651–$657.75 | $868–$877 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,260.75 | $1,681 | 2.3× |
| Intracavitary radiation source applic simple (77761) | $1,324.50 | $1,766 | 2.4× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$1,083.75–$1,106.25 | $1,445–$1,475 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$4,961.25–$5,418.75 | $6,615–$7,225 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$3,597–$3,759 | $4,796–$5,012 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$3,520.50–$3,959.25 | $4,694–$5,279 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 2 matching MRF lines |
$2,793.75–$3,117 | $3,725–$4,156 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$2,800.50–$3,024.75 | $3,734–$4,033 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$1,089–$1,117.50 | $1,452–$1,490 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$1,928.25–$2,733.75 | $2,571–$3,645 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$3,711–$4,335.75 | $4,948–$5,781 | varies |
| Liver imaging static only (78201) | $3,670.50 | $4,894 | 6.7× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$2,019–$2,106 | $2,692–$2,808 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$1,408.50–$1,706.25 | $1,878–$2,275 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$3,420.75–$4,068 | $4,561–$5,424 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$3,765.75–$3,953.25 | $5,021–$5,271 | varies |
| Mammary ductogram or galactogram multiple (77054) | $3,403.50 | $4,538 | 14.2× |
| Mammary ductogram or galactogram single (77053) | $2,625.75 | $3,501 | 11.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$3,759–$5,585.25 | $5,012–$7,447 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $1,942.50 | $2,590 | 5.2× |
| Mr safety determination physician/other qhp (76016) | $338.25 | $451 | 3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $93.75 | $125 | 3.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $352.50 | $470 | 3.7× |
| Mr safety implt pos&/immoblj (76019) | $228 | $304 | 3.8× |
| Mr safety med physics xm customization plng&mntr (76017) | $927.75 | $1,237 | 3.9× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$3,190.50–$4,057.50 | $4,254–$5,410 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$2,792.25–$3,199.50 | $3,723–$4,266 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$3,452.25–$3,805.50 | $4,603–$5,074 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$3,624.75–$4,167.75 | $4,833–$5,557 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$3,661.50–$4,657.50 | $4,882–$6,210 | varies |
| MRA neck w/o contrast (70547) range across 4 matching MRF lines |
$2,950.50–$3,530.25 | $3,934–$4,707 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$5,801.25–$6,396 | $7,735–$8,528 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$4,533.75–$5,764.50 | $6,045–$7,686 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$4,151.25–$4,713 | $5,535–$6,284 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$8,695.50–$10,464 | $11,594–$13,952 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$5,285.25–$5,928 | $7,047–$7,904 | varies |
| MRI cervical spine w contrast (72142) range across 4 matching MRF lines |
$4,599.75–$5,304 | $6,133–$7,072 | varies |
| MRI cervical spine w/o cont (72141) range across 5 matching MRF lines |
$4,670.25–$5,738.25 | $6,227–$7,651 | varies |
| MRI chest w/o contrast (71550) range across 4 matching MRF lines |
$3,780.75–$4,318.50 | $5,041–$5,758 | varies |
| MRI chest with contrast (71551) | $5,094.75 | $6,793 | 6.5× |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$5,314.50–$6,295.50 | $7,086–$8,394 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$5,113.50–$12,785.25 | $6,818–$17,047 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$9,799.50–$11,453.25 | $13,066–$15,271 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 5 matching MRF lines |
$5,351.25–$6,804.75 | $7,135–$9,073 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$4,914.75–$5,616 | $6,553–$7,488 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$9,069–$10,736.25 | $12,092–$14,315 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$3,122.25–$3,779.25 | $4,163–$5,039 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$3,690.75–$4,069.50 | $4,921–$5,426 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$5,597.25–$5,614.50 | $7,463–$7,486 | varies |
| MRI pelvis w contrast (72196) range across 4 matching MRF lines |
$4,947.75–$5,505 | $6,597–$7,340 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$6,252.75–$7,758 | $8,337–$10,344 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$3,986.25–$5,069.25 | $5,315–$6,759 | varies |
| MRI spectroscopy (76390) | $2,051.25 | $2,735 | 23.5× |
| MRI thoracic spine w/o contrast (72146) range across 6 matching MRF lines |
$4,562.25–$5,331.75 | $6,083–$7,109 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$5,285.25–$5,550 | $7,047–$7,400 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$4,029.75–$5,124 | $5,373–$6,832 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$6,492.75–$7,119.75 | $8,657–$9,493 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$6,282.75–$7,845.75 | $8,377–$10,461 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$6,678.75–$7,905 | $8,905–$10,540 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$5,841–$7,071 | $7,788–$9,428 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$4,050–$5,150.25 | $5,400–$6,867 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$6,222–$7,463.25 | $8,296–$9,951 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$6,468–$7,617 | $8,624–$10,156 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$2,722.50–$2,940 | $3,630–$3,920 | varies |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$2,847–$3,621 | $3,796–$4,828 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$4,014–$4,086.75 | $5,352–$5,449 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$3,155.25–$3,243.75 | $4,207–$4,325 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $7,208.25 | $9,611 | 5.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,445.25–$9,318 | $5,927–$12,424 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$1,169.25–$1,280.25 | $1,559–$1,707 | varies |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$645–$732 | $860–$976 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,240 | $8,320 | 4.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,540.50 | $2,054 | 6.6× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$2,250–$2,625 | $3,000–$3,500 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$803.25–$973.50 | $1,071–$1,298 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$1,392.75–$1,515 | $1,857–$2,020 | varies |
| Panoramic X-ray of jaws (70355) | $856.50 | $1,142 | 9.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,358.75 | $3,145 | 4.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$3,609.75–$5,188.50 | $4,813–$6,918 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$2,358.75–$2,397 | $3,145–$3,196 | varies |
| Pelvis 1 or 2 views (72170) range across 6 matching MRF lines |
$324–$1,096.50 | $432–$1,462 | varies |
| Pet Image Skull-Thigh (78812) | $8,364.75 | $11,153 | 5.8× |
| PET image w/CT, full body (78816) | $8,364.75 | $11,153 | 5.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,364.75 | $11,153 | 5.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $7,208.25 | $9,611 | 5.5× |
| PET whole body (78813) | $8,364.75 | $11,153 | 5.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,227.75 | $5,637 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,605–$1,710.75 | $2,140–$2,281 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$1,869–$2,190 | $2,492–$2,920 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,168.50–$1,333.50 | $1,558–$1,778 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,224–$1,288.50 | $1,632–$1,718 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$990–$1,260 | $1,320–$1,680 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$1,245–$1,354.50 | $1,660–$1,806 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$1,923.75–$2,274.75 | $2,565–$3,033 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$1,059–$1,095.75 | $1,412–$1,461 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,206.75–$1,329 | $1,609–$1,772 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$1,181.25–$1,242.75 | $1,575–$1,657 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$399.75–$444.75 | $533–$593 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $675 | $900 | 6.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$1,224–$1,351.50 | $1,632–$1,802 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $790.50 | $1,054 | 9.0× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$1,518.75–$1,932 | $2,025–$2,576 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$1,189.50–$1,266 | $1,586–$1,688 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$770.25–$891.75 | $1,027–$1,189 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $3,127.50 | $4,170 | 17.7× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$939–$1,062.75 | $1,252–$1,417 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$747.75–$854.25 | $997–$1,139 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$932.25–$1,188 | $1,243–$1,584 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$1,051.50–$1,159.50 | $1,402–$1,546 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$515.25–$653.25 | $687–$871 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$1,181.25–$1,242.75 | $1,575–$1,657 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$2,884.50–$3,027 | $3,846–$4,036 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$1,663.50–$1,947 | $2,218–$2,596 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 4 matching MRF lines |
$688.50–$1,181.25 | $918–$1,575 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$2,478.75–$3,150 | $3,305–$4,200 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,958.25–$2,409.75 | $2,611–$3,213 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,719.75–$1,994.25 | $2,293–$2,659 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$2,086.50–$2,370 | $2,782–$3,160 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$1,509.75–$1,713 | $2,013–$2,284 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$1,624.50–$1,950 | $2,166–$2,600 | varies |
| Radiologic examination femur 1 view (73551) | $406.50 | $542 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $827.25 | $1,103 | 9.5× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$918–$1,081.50 | $1,224–$1,442 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$485.25–$571.50 | $647–$762 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $1,182.75 | $1,577 | 13.5× |
| Renal Cyst Study (74470) | $3,636.75 | $4,849 | 6.6× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$1,159.50–$1,377.75 | $1,546–$1,837 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,053.25 | $4,071 | 7.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,955.25 | $2,607 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$3,366–$9,173.25 | $4,488–$12,231 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$3,765.75–$5,217.75 | $5,021–$6,957 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$5,717.25–$8,126.25 | $7,623–$10,835 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $6,201 | $8,268 | 4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $7,227.75 | $9,637 | 5.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $6,377.25 | $8,503 | 4.9× |
| Rp Therapy Intravenous Administration (79101) | $2,190 | $2,920 | 9.3× |
| Scapula (73010) range across 4 matching MRF lines |
$984.75–$1,156.50 | $1,313–$1,542 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $175.50 | $234 | 7.5× |
| Sella turcica (70240) | $495.75 | $661 | 5.7× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$932.25–$1,215.75 | $1,243–$1,621 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,716.75–$1,834.50 | $2,289–$2,446 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$1,205.25–$1,239 | $1,607–$1,652 | varies |
| Special dosimetry (77331) | $905.25 | $1,207 | 6.7× |
| Special Physics Consult (77370) | $1,267.50 | $1,690 | 9.4× |
| Special teletherapy port plan (77321) | $1,327.50 | $1,770 | 3.5× |
| Special treatment procedure (77470) | $3,845.25 | $5,127 | 6.9× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$760.50–$828.75 | $1,014–$1,105 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $918.75 | $1,225 | 2.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $627 | $836 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,517.75 | $3,357 | 6.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,199.75 | $2,933 | 5.8× |
| Ther rad simulaj-aided field setting simple (77280) | $1,346.25 | $1,795 | 10.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$2,579.25–$2,946.75 | $3,439–$3,929 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$1,497–$1,574.25 | $1,996–$2,099 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$2,203.50–$2,297.25 | $2,938–$3,063 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$1,134–$1,441.50 | $1,512–$1,922 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$3,672.75–$3,856.50 | $4,897–$5,142 | varies |
| Thyroid Met Imaging Body (78018) | $2,813.25 | $3,751 | 5.2× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$1,465.50–$1,679.25 | $1,954–$2,239 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$3,127.50–$3,177.75 | $4,170–$4,237 | varies |
| Tx Devices Design & Construction Complex (77334) | $1,064.25 | $1,419 | 2.8× |
| Tx devices design & construction intermediate (77333) | $636 | $848 | 4.7× |
| Tx devices design & construction simple (77332) | $450.75 | $601 | 3.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$559.50–$607.50 | $746–$810 | varies |
| Ultrasound elastography first target lesion (76982) | $408 | $544 | 3.9× |
| Ultrasound Elastography Parenchyma (76981) | $408 | $544 | 3.9× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$633–$886.50 | $844–$1,182 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$1,998.75–$2,334.75 | $2,665–$3,113 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$751.50–$1,266 | $1,002–$1,688 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$2,352–$2,749.50 | $3,136–$3,666 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$2,154–$3,394.50 | $2,872–$4,526 | varies |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$2,388–$2,640.75 | $3,184–$3,521 | varies |
| Urethrocystography retrograde (74450) | $1,008.75 | $1,345 | 4.2× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$681–$885 | $908–$1,180 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$1,170–$1,324.50 | $1,560–$1,766 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$1,247.25–$1,373.25 | $1,663–$1,831 | varies |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$1,202.25–$1,912.50 | $1,603–$2,550 | varies |
| Us head (76506) range across 2 matching MRF lines |
$2,823–$3,153.75 | $3,764–$4,205 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$1,127.25–$1,260.75 | $1,503–$1,681 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$595.50–$682.50 | $794–$910 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$1,062.75–$1,565.25 | $1,417–$2,087 | varies |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$974.25–$1,520.25 | $1,299–$2,027 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$1,062–$2,295.75 | $1,416–$3,061 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$1,905.75–$2,122.50 | $2,541–$2,830 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$2,491.50–$2,858.25 | $3,322–$3,811 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$438–$959.25 | $584–$1,279 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$1,882.50–$2,199.75 | $2,510–$2,933 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$1,934.25–$2,397.75 | $2,579–$3,197 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$982.50–$1,313.25 | $1,310–$1,751 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$1,146.75–$1,332 | $1,529–$1,776 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$1,520.25–$1,699.50 | $2,027–$2,266 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$1,299–$1,899.75 | $1,732–$2,533 | varies |
| Vascular Flow Imaging (78445) | $1,236 | $1,648 | 3.1× |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$3,695.25–$4,110.75 | $4,927–$5,481 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $12,078.75 | $16,105 | 3.8× |
| Vein X-Ray Spleen/Liver (75810) | $2,722.50 | $3,630 | 0.9× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$4,296–$4,511.25 | $5,728–$6,015 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$4,587–$5,306.25 | $6,116–$7,075 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$2,808–$3,370.50 | $3,744–$4,494 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$1,756.50–$1,994.25 | $2,342–$2,659 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$3,080.25–$8,407.50 | $4,107–$11,210 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,988–$8,407.50 | $3,984–$11,210 | varies |
| Venous sampling by catheter (75893) | $24,722.25 | $32,963 | 4.4× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$708–$747.75 | $944–$997 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$1,045.50–$1,134.75 | $1,394–$1,513 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$1,260–$1,281.75 | $1,680–$1,709 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,431 | $1,908 | 4.1× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$3,717–$4,159.50 | $4,956–$5,546 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$3,131.25–$3,287.25 | $4,175–$4,383 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$1,038–$1,064.25 | $1,384–$1,419 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$816–$871.50 | $1,088–$1,162 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 5 matching MRF lines |
$1,004.25–$1,278 | $1,339–$1,704 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 5 matching MRF lines |
$1,824.75–$2,319.75 | $2,433–$3,093 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $3,027 | $4,036 | 28.8× |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$447.75–$959.25 | $597–$1,279 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$344.25–$896.25 | $459–$1,195 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$544.50–$671.25 | $726–$895 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$841.50–$986.25 | $1,122–$1,315 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$841.50–$1,188.75 | $1,122–$1,585 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$1,054.50–$1,278 | $1,406–$1,704 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$1,227–$1,515 | $1,636–$2,020 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$1,014–$1,182.75 | $1,352–$1,577 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$1,095.75–$1,241.25 | $1,461–$1,655 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$1,769.25–$2,144.25 | $2,359–$2,859 | varies |
| X-ray head for orthodontia (70350) | $846.75 | $1,129 | 9.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$1,172.25–$1,215.75 | $1,563–$1,621 | varies |
| X-ray IV pyelogram (ivp) (74400) | $3,017.25 | $4,023 | 17.1× |
| X-ray IV pyelogram+tomography (74415) | $3,176.25 | $4,235 | 18.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$895.50–$972 | $1,194–$1,296 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 6 matching MRF lines |
$686.25–$1,068 | $915–$1,424 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$960.75–$1,064.25 | $1,281–$1,419 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$1,726.50–$2,035.50 | $2,302–$2,714 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$795.75–$929.25 | $1,061–$1,239 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$996.75–$1,181.25 | $1,329–$1,575 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$1,983–$2,009.25 | $2,644–$2,679 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$1,761.75–$1,872 | $2,349–$2,496 | varies |
| X-ray thoracic spine 4 vw (72074) | $688.50 | $918 | 6.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,154.75 | $2,873 | 6.1× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$595.50–$2,445.75 | $794–$3,261 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$1,802.25–$2,006.25 | $2,403–$2,675 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$2,143.50–$2,181 | $2,858–$2,908 | varies |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$1,299.75–$1,557 | $1,733–$2,076 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$1,544.25–$1,814.25 | $2,059–$2,419 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$2,382.75–$2,457.75 | $3,177–$3,277 | 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.