Imaging prices at The Queen's Medical Center
Honolulu, HI · every code in this section with a posted price and a Medicare benchmark.
433 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) | $9,783.90 | $13,977 | 6.0× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$224–$448 | $320–$640 | varies |
| Abdomen 2 views (74019) | $286.30 | $409 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,468.60 | $2,098 | 3.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,191.40 | $1,702 | 0.8× |
| Angio internal mammary (75756) | $3,358.60 | $4,798 | 0.9× |
| Angio pulmonary bilat (75743) | $3,358.60 | $4,798 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,198.30 | $4,569 | 0.9× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,747.80–$7,495.60 | $5,354–$10,708 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$3,198.30–$6,396.60 | $4,569–$9,138 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,526.60 | $5,038 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,054.30 | $8,649 | 1.6× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$177.80–$355.60 | $254–$508 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,930.10 | $7,043 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,198.30 | $4,569 | 0.9× |
| Artery X-Rays Abdomen (75726) | $5,789 | $8,270 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $3,358.60 | $4,798 | 0.9× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$4,930.10–$14,790.30 | $7,043–$21,129 | varies |
| Artery X-Rays Spine (75705) range across 4 matching MRF lines |
$4,930.10–$98,602 | $7,043–$140,860 | varies |
| Arthrogram ankle (73615) | $634.90 | $907 | 1.5× |
| Arthrogram hip (73525) | $1,100.40 | $1,572 | 2.7× |
| Arthrogram Wrist (73115) | $736.40 | $1,052 | 1.8× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$753.20–$2,259.60 | $1,076–$3,228 | varies |
| Bone age studies (77072) | $219.10 | $313 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,134 | $1,620 | 2.4× |
| Bone Imaging Limited Area (78300) | $1,005.20 | $1,436 | 2.1× |
| Bone Imaging Multiple Areas (78305) | $987 | $1,410 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,080.10 | $1,543 | 2.3× |
| Bone marrow imaging limited area (78102) range across 3 matching MRF lines |
$1,019.90–$1,071 | $1,457–$1,530 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$330.40–$347.20 | $472–$496 | varies |
| Brachytx isodose complex (77318) | $2,300.20 | $3,286 | 5.2× |
| Brachytx isodose intermed (77317) | $2,196.60 | $3,138 | 5.0× |
| Brachytx Isodose Plan Simple (77316) | $1,500.80 | $2,144 | 3.4× |
| Brain Flow Imaging Only (78610) | $863.10 | $1,233 | 1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $812.70 | $1,161 | 1.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $674.10 | $963 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,062.50 | $4,375 | 1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,473.80 | $3,534 | 6.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,385.30 | $1,979 | 1.5× |
| Cardiac Shunt Detection (78428) | $578.90 | $827 | 1.2× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$324.80–$649.60 | $464–$928 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,697.50 | $2,425 | 2.6× |
| Cerebrospinal Fluid Scan (78630) | $2,313.50 | $3,305 | 3.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$217.70–$435.40 | $311–$622 | varies |
| Chest 2 views (71046) | $256.90 | $367 | 2.5× |
| Chest 3 views (71047) | $406.70 | $581 | 4.0× |
| Chest 4 or more views (71048) | $457.80 | $654 | 3.7× |
| Cholecystography Oral Contrast (74290) | $408.10 | $583 | 2.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$239.40–$478.80 | $342–$684 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $594.30 | $849 | 4.8× |
| Continuing medical physics consltj pr wk (77336) | $1,106 | $1,580 | 7.0× |
| Contrast Exam Abdominl Aorta (75625) | $3,561.60 | $5,088 | 1.0× |
| Contrast X-Ray Bladder (74430) | $625.80 | $894 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $667.10 | $953 | 1.6× |
| Contrast X-Ray Of Knee Joint (73580) | $499.80 | $714 | 1.2× |
| Corpora cavernosography (74445) | $1,860.60 | $2,658 | 15.1× |
| CT abdomen and pelvis without and with contrast (74178) | $3,430 | $4,900 | 8.3× |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$2,087.40–$2,359 | $2,982–$3,370 | varies |
| CT abdomen w contrast (74160) | $1,817.20 | $2,596 | 8.8× |
| CT abdomen w wo contrast (74170) | $1,830.50 | $2,615 | 8.8× |
| CT abdomen w/o contrast (74150) | $1,499.40 | $2,142 | 12.1× |
| CT Angio Abdomen and Pelvis (74174) | $3,513.30 | $5,019 | 8.5× |
| CT Angio Chest (71275) | $1,749.30 | $2,499 | 8.4× |
| CT Angio Head (70496) range across 4 matching MRF lines |
$1,761.90–$3,523.80 | $2,517–$5,034 | varies |
| CT angio hrt w/3d image (75574) | $2,122.40 | $3,032 | 5.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,879.50–$3,759 | $2,685–$5,370 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,719.90–$1,943.20 | $2,457–$2,776 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$757.40–$1,712.20 | $1,082–$2,446 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $362.60 | $518 | 1.7× |
| CT cervical spine w/ contrast (72126) | $2,473.10 | $3,533 | 6.0× |
| CT cervical spine w/o contrast (72125) | $1,365 | $1,950 | 11.1× |
| CT cervical spine w/wo cont (72127) | $2,655.80 | $3,794 | 12.8× |
| CT chest w contrast (71260) | $1,493.10 | $2,133 | 7.2× |
| CT chest w/wo contrast (71270) | $1,878.80 | $2,684 | 9.1× |
| CT head/brain with contrast (70460) | $1,824.90 | $2,607 | 8.8× |
| CT head/brain without and with contrast (70470) | $1,876.70 | $2,681 | 9.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $970.90 | $1,387 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $92.40 | $132 | 0.9× |
| CT hrt w/3d image congen (75573) | $567.70 | $811 | 1.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,747.90–$1,792 | $2,497–$2,560 | varies |
| CT l-spine w&w/o contrast (72133) | $2,324.70 | $3,321 | 11.2× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,194.20–$7,165.20 | $1,706–$10,236 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,603.70–$3,207.40 | $2,291–$4,582 | varies |
| CT lumbar spine w contrast (72132) | $2,023 | $2,890 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,365 | $1,950 | 11.1× |
| CT maxillofacial w contrast (70487) | $1,694.70 | $2,421 | 8.2× |
| CT maxillofacial wo contrast (70486) | $1,194.20 | $1,706 | 9.7× |
| CT neck tissue combo (70492) | $2,114.70 | $3,021 | 10.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,033.50 | $2,905 | 9.8× |
| CT orbits w/o contrast (70480) | $1,430.80 | $2,044 | 11.6× |
| CT pelvis w&w/o contrast (72194) | $1,954.40 | $2,792 | 9.4× |
| CT pelvis w/o contrast (72192) | $1,282.40 | $1,832 | 10.4× |
| CT scan of leg combo (73702) | $1,984.50 | $2,835 | 9.6× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$2,456.30–$3,364.20 | $3,509–$4,806 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,299.20–$1,467.90 | $1,856–$2,097 | varies |
| CT soft tissue neck w/o contrast (70490) | $1,709.40 | $2,442 | 13.8× |
| CT thoracic spine w contrast (72129) | $1,733.20 | $2,476 | 8.4× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,159.20–$1,309.70 | $1,656–$1,871 | varies |
| CT thoracic spine w/wo cont (72130) | $1,851.50 | $2,645 | 8.9× |
| CT thorax w/o contrast (71250) | $1,383.20 | $1,976 | 11.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,281–$2,562 | $1,830–$3,660 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,823.50 | $2,605 | 8.8× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,539.30–$3,078.60 | $2,199–$4,398 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,879.50 | $2,685 | 9.1× |
| Cta Abdomen (74175) | $2,043.30 | $2,919 | 9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $721 | $1,030 | 1.7× |
| CTA pelvis (72191) | $2,240.70 | $3,201 | 10.8× |
| Dilation ureters/urethra rs&i (74485) | $2,811.20 | $4,016 | 1.1× |
| Discography Cerv/Thor Spine (72285) | $4,585 | $6,550 | 2.0× |
| Diskography lumbar (72295) | $3,767.40 | $5,382 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $328.30 | $469 | 2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$392.70–$412.30 | $561–$589 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $338.10 | $483 | 2.7× |
| Dxa Bone Density Axial (77080) | $290.50 | $415 | 2.4× |
| Dxa bone density study (77085) | $186.90 | $267 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $106.40 | $152 | 1.0× |
| Echo exam of fetal heart (76825) range across 3 matching MRF lines |
$1,407–$2,814 | $2,010–$4,020 | varies |
| Echo exam uterus (76831) | $831.60 | $1,188 | 3.0× |
| Echo Guide For Artery Repair (76936) | $535.50 | $765 | 2.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $805.70 | $1,151 | 2.9× |
| Echograp Trans R Pros Study (76873) | $1,219.40 | $1,742 | 9.9× |
| Esophageal Motility Study (78258) | $527.10 | $753 | 1.1× |
| Esophagram (74220) | $490 | $700 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $907.20 | $1,296 | 7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $376.60 | $538 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $336.70 | $481 | 1.2× |
| Follow-Up Angiography (75898) | $2,758 | $3,940 | 0.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$196–$392 | $280–$560 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$213.50–$427 | $305–$610 | varies |
| Gastric emptying imaging study (78264) | $1,340.50 | $1,915 | 2.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,568.70 | $2,241 | 3.3× |
| Gastric Mucosa Imaging (78261) | $455 | $650 | 1.0× |
| Gastroesophageal Reflux Exam (78262) | $587.30 | $839 | 1.2× |
| Gated Heart Planar Single (78472) | $704.20 | $1,006 | 1.5× |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$1,056.30–$1,108.80 | $1,509–$1,584 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,830.50 | $2,615 | 2.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$241.50–$483 | $345–$690 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,986.40 | $8,552 | 7.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$5,163.20–$5,421.50 | $7,376–$7,745 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,246.90 | $6,067 | 5.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,951.80 | $7,074 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,358.60 | $4,798 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,117.20 | $1,596 | 1.7× |
| Hepatobiliary System Imaging (78226) | $798 | $1,140 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,667.40 | $2,382 | 1.1× |
| Hysterosalpingogram (74740) | $1,152.90 | $1,647 | 4.1× |
| Image fusion (77399) | $556.50 | $795 | 3.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $186.20 | $266 | 1.8× |
| Infant hip ultrasound, limited static exam (76886) | $364 | $520 | 3.5× |
| Infusion Ivp (74410) | $869.40 | $1,242 | 4.2× |
| Interstitial radiation source applic complex (77778) | $5,290.60 | $7,558 | 6.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,220.70 | $4,601 | 3.9× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,142.70 | $3,061 | 3.3× |
| Intracavitary radiation source applic simple (77761) | $1,431.50 | $2,045 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $1,605.80 | $2,294 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $1,604.40 | $2,292 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,383.90 | $1,977 | 2.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $980 | $1,400 | 2.1× |
| Kidney Imaging Morphol (78700) | $575.40 | $822 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $651.70 | $931 | 1.4× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$248.50–$561.40 | $355–$802 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $643.30 | $919 | 1.4× |
| Leveen/Shunt Patency Exam (78291) | $797.30 | $1,139 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $613.20 | $876 | 1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $775.60 | $1,108 | 1.6× |
| Liver imaging static only (78201) | $806.40 | $1,152 | 1.3× |
| Liver imaging w/vascular flow (78202) | $1,072.40 | $1,532 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,814.40 | $2,592 | 2.8× |
| Lung perfusion differential (78597) | $704.20 | $1,006 | 1.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,196.30 | $1,709 | 1.9× |
| Lung Ventilation Imaging (78579) | $1,094.80 | $1,564 | 2.3× |
| Lymph System Imaging (78195) | $1,171.10 | $1,673 | 1.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,358.60 | $4,798 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,042.20 | $4,346 | 0.8× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,634.80–$2,766.40 | $3,764–$3,952 | varies |
| Mammary ductogram or galactogram multiple (77054) | $711.90 | $1,017 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $627.90 | $897 | 2.2× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$2,192.40–$2,302.30 | $3,132–$3,289 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $2,092.30 | $2,989 | 4.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,797.90 | $3,997 | 6.8× |
| MRA head w/o contrast (70544) | $2,394.70 | $3,421 | 8.5× |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$3,116.40–$3,272.50 | $4,452–$4,675 | varies |
| MRA neck w contrast (70548) | $2,593.50 | $3,705 | 6.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,077.90 | $4,397 | 7.5× |
| MRA neck w/o contrast (70547) | $2,364.60 | $3,378 | 8.4× |
| MRI abdomen w contrast (74182) | $2,496.90 | $3,567 | 6.1× |
| MRI abdomen w/o contrast (74181) | $2,333.80 | $3,334 | 8.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,962.40 | $4,232 | 3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,606.10–$5,212.20 | $3,723–$7,446 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,976.40 | $4,252 | 3.2× |
| MRI bone marrow blood supply (77084) | $2,794.40 | $3,992 | 9.9× |
| MRI brain functional w/o physician admnistration (70554) | $1,652.70 | $2,361 | 5.9× |
| MRI brain functional w/physician admnistration (70555) | $1,127 | $1,610 | 4.0× |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$2,362.50–$2,480.80 | $3,375–$3,544 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,072 | $2,960 | 7.4× |
| MRI cardiac w/o cont stress (75559) | $1,279.60 | $1,828 | 2.0× |
| MRI cardiac w/o contrast (75557) | $2,142 | $3,060 | 7.6× |
| MRI cervical spine w/o cont (72141) | $1,456.70 | $2,081 | 5.2× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,966.60–$3,115 | $4,238–$4,450 | varies |
| MRI chest wo w contrast (71552) | $2,676.10 | $3,823 | 6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $737.80 | $1,054 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,433.90 | $3,477 | 5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,958.90–$5,917.80 | $4,227–$8,454 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $2,553.60 | $3,648 | 6.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,599.80 | $3,714 | 9.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,507.40 | $3,582 | 6.1× |
| MRI pelvis w/o & w contrast (72197) | $2,720.90 | $3,887 | 6.6× |
| MRI pelvis w/o contrast (72195) | $2,310 | $3,300 | 8.2× |
| MRI spectroscopy (76390) | $2,629.90 | $3,757 | 25.6× |
| MRI thoracic spine w/o contrast (72146) | $2,010.40 | $2,872 | 7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,422–$4,844 | $3,460–$6,920 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,467.50 | $3,525 | 6.0× |
| MRI, abdomen, combo (74183) | $2,671.90 | $3,817 | 6.5× |
| MRI, dorsal spine combo (72157) | $2,462.60 | $3,518 | 6.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,285.50–$4,571 | $3,265–$6,530 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,682.40–$5,364.80 | $3,832–$7,664 | varies |
| MRI, lumbar spine combo (72158) | $2,461.20 | $3,516 | 6.0× |
| Myelogram cervical (72240) | $1,209.60 | $1,728 | 1.3× |
| Myelogram Lumbar (72265) | $816.20 | $1,166 | 0.9× |
| Myelography thoracic (72255) | $1,209.60 | $1,728 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,209.60 | $1,728 | 1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,835 | $4,050 | 1.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,226.40 | $1,752 | 0.8× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,334.50–$2,638.30 | $3,335–$3,769 | varies |
| Neck soft tissue (70360) | $287.70 | $411 | 2.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,057.70 | $1,511 | 2.3× |
| Nm csf leak detection (78650) | $1,191.40 | $1,702 | 0.8× |
| Nm myocard infarct spect (78469) | $1,072.40 | $1,532 | 1.7× |
| Nm red cell survival study (78130) | $608.30 | $869 | 1.3× |
| Nm whole blood volume (78122) | $1,276.80 | $1,824 | 2.0× |
| Nonvascular Shunt X-Ray (75809) | $218.40 | $312 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,908.30 | $9,869 | 4.2× |
| Nuclear Rx Intra-Arterial (79445) | $849.80 | $1,214 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $587.30 | $839 | 2.1× |
| Ob us nuchal meas 1 gest (76813) | $369.60 | $528 | 3.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $374.50 | $535 | 3.0× |
| Optic foramina (70190) | $221.20 | $316 | 2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $779.80 | $1,114 | 1.2× |
| Parathyroid Planar Imaging (78070) | $690.90 | $987 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $779.80 | $1,114 | 1.7× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$192.50–$385 | $275–$550 | varies |
| Peritoneogram Rs&I (74190) | $1,225.70 | $1,751 | 1.9× |
| Pet Image Skull-Thigh (78812) | $2,889.60 | $4,128 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $3,398.50 | $4,855 | 2.0× |
| PET image w/CT, full body (78816) | $4,940.60 | $7,058 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,532.20–$3,708.60 | $5,046–$5,298 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,546.60 | $3,638 | 1.7× |
| PET whole body (78813) | $3,322.90 | $4,747 | 2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$4,951.80–$5,199.60 | $7,074–$7,428 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,048.60 | $1,498 | 2.2× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,923.60 | $2,748 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $627.90 | $897 | 5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $970.90 | $1,387 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$241.50–$483 | $345–$690 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$168.70–$337.40 | $241–$482 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$232.40–$464.80 | $332–$664 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $328.30 | $469 | 2.7× |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$157.50–$355.60 | $225–$508 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$231–$462 | $330–$660 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$231–$462 | $330–$660 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $144.20 | $206 | 1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $285.60 | $408 | 2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$252.70–$285.60 | $361–$408 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$238.70–$477.40 | $341–$682 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$219.80–$439.60 | $314–$628 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$168.70–$177.10 | $241–$253 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,144.50 | $1,635 | 5.5× |
| Radex Spine 1 View Specify Level (72020) | $291.90 | $417 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $277.90 | $397 | 2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $311.50 | $445 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$156.10–$312.20 | $223–$446 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $233.80 | $334 | 1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$262.50–$787.50 | $375–$1,125 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $641.90 | $917 | 5.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $35,484.40 | $50,692 | 4.1× |
| Radiation treatment delivery level 1 (77402) | $855.40 | $1,222 | 7.1× |
| Radiation treatment delivery level 2 (77407) | $1,017.80 | $1,454 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $1,287.30 | $1,839 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$417.90–$472.50 | $597–$675 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $335.30 | $479 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $1,124.90 | $1,607 | 5.4× |
| Radiologic exam colon single contrast study (74270) | $997.50 | $1,425 | 4.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $585.90 | $837 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$298.20–$673.40 | $426–$962 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$319.90–$361.20 | $457–$516 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$688.10–$705.60 | $983–$1,008 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$432.60–$488.60 | $618–$698 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $1,068.20 | $1,526 | 5.2× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$231–$462 | $330–$660 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$281.40–$562.80 | $402–$804 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$186.90–$373.80 | $267–$534 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $569.10 | $813 | 4.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$197.40–$446.60 | $282–$638 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $455 | $650 | 0.7× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $404.60 | $578 | 1.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,400.70 | $2,001 | 5.1× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $608.30 | $869 | 0.9× |
| Ribs bilateral 3 views (71110) | $343 | $490 | 2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $585.20 | $836 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $773.50 | $1,105 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,611.40 | $2,302 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,572.20 | $2,246 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,258.90 | $3,227 | 3.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,096.10 | $4,423 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,096.10 | $4,423 | 1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,535.40 | $3,622 | 1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,168.60 | $3,098 | 7.9× |
| Rp Therapy Intravenous Administration (79101) | $821.10 | $1,173 | 3.0× |
| Salivary Gland Function Study (78232) | $576.80 | $824 | 1.2× |
| Salivary Gland Imaging (78230) | $455 | $650 | 1.0× |
| Salivary Gland Imaging Serial Images (78231) | $658 | $940 | 1.4× |
| Scapula (73010) range across 3 matching MRF lines |
$208.60–$417.20 | $298–$596 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $81.90 | $117 | 3.5× |
| Sella turcica (70240) | $174.30 | $249 | 1.7× |
| Shoulder 1 view (73020) range across 5 matching MRF lines |
$199.50–$450.80 | $285–$644 | varies |
| Shoulder Arthrography (73040) | $973 | $1,390 | 2.4× |
| Sialogram (70390) | $592.20 | $846 | 2.1× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$287.70–$324.80 | $411–$464 | varies |
| Special dosimetry (77331) | $716.80 | $1,024 | 4.5× |
| Special Physics Consult (77370) range across 3 matching MRF lines |
$1,159.20–$1,217.30 | $1,656–$1,739 | varies |
| Special teletherapy port plan (77321) | $2,092.30 | $2,989 | 4.7× |
| Special treatment procedure (77470) | $3,376.80 | $4,824 | 5.2× |
| Speech evaluation, complex (70371) | $510.30 | $729 | 1.8× |
| Stereotactic Body Radiation Delivery (77373) range across 3 matching MRF lines |
$3,642.80–$14,800.80 | $5,204–$21,144 | varies |
| Sternoclavicular joints (71130) | $272.30 | $389 | 2.6× |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$2,758–$5,516 | $3,940–$7,880 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $905.10 | $1,293 | 2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $691.60 | $988 | 1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) | $579.60 | $828 | 2.1× |
| Testicular Imaging W/Flow (78761) | $693 | $990 | 1.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,092.30 | $2,989 | 4.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,092.30 | $2,989 | 4.7× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$967.40–$1,177.40 | $1,382–$1,682 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$242.90–$274.40 | $347–$392 | varies |
| Thoracic spine 3 views (72072) | $324.80 | $464 | 2.6× |
| Thoracolumbar 2 views (72080) | $277.90 | $397 | 2.7× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$375.90–$394.80 | $537–$564 | varies |
| Thyroid Met Imaging Body (78018) | $1,470 | $2,100 | 2.3× |
| Thyroid Uptake Measurement (78012) | $1,250.90 | $1,787 | 2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,313.90 | $1,877 | 2.8× |
| Tx Devices Design & Construction Complex (77334) | $2,361.80 | $3,374 | 5.3× |
| Tx devices design & construction intermediate (77333) | $1,073.10 | $1,533 | 6.8× |
| Tx devices design & construction simple (77332) | $757.40 | $1,082 | 4.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$480.20–$961.80 | $686–$1,374 | varies |
| Ultrasound Exam Aaa Screen (76706) | $506.10 | $723 | 4.1× |
| Ultrasound, abdomen limited (76705) | $557.90 | $797 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$338.10–$354.90 | $483–$507 | varies |
| Unlisted fluoroscopic procedure (76496) | $329.70 | $471 | 3.2× |
| Unlisted magnetic resonance procedure (76498) | $128.10 | $183 | 1.2× |
| Unlisted us procedure (76999) | $214.90 | $307 | 2.1× |
| Upper gi w/o kub (74240) | $471.10 | $673 | 2.3× |
| Ureteral Reflux Study (78740) | $567 | $810 | 1.2× |
| Urethrocystogram voiding (74455) | $864.50 | $1,235 | 3.1× |
| Urethrocystography retrograde (74450) | $1,102.50 | $1,575 | 3.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$454.30–$910 | $649–$1,300 | varies |
| Us chest (76604) | $574.70 | $821 | 4.7× |
| Us complete joint (76881) | $551.60 | $788 | 4.5× |
| Us exam, pelvic, limited (76857) | $519.40 | $742 | 4.2× |
| Us head (76506) | $504 | $720 | 4.1× |
| Us kidney transplant (76776) | $369.60 | $528 | 3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$350–$700 | $500–$1,000 | varies |
| Us ob detailed single fetus (76811) | $632.80 | $904 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $448 | $640 | 3.6× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$369.60–$417.90 | $528–$597 | varies |
| Us pelvic non ob complete (76856) | $557.90 | $797 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $369.60 | $528 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $688.80 | $984 | 5.6× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$687.40–$1,374.80 | $982–$1,964 | varies |
| Us retroperitoneal limited (76775) | $519.40 | $742 | 4.2× |
| Us scrotum and contents (76870) | $453.60 | $648 | 3.7× |
| Us spinal canal and contents (76800) | $406 | $580 | 3.3× |
| Us thyroid (76536) | $574.70 | $821 | 4.7× |
| Us transrectal (76872) | $1,047.20 | $1,496 | 8.5× |
| Vascular Flow Imaging (78445) | $702.80 | $1,004 | 1.5× |
| Vasogram (74440) | $534.10 | $763 | 1.9× |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,428–$1,499.40 | $2,040–$2,142 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,758 | $3,940 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$3,198.30–$3,357.90 | $4,569–$4,797 | varies |
| Venogram Sinus/Jugular (75860) range across 6 matching MRF lines |
$3,198.30–$12,793.20 | $4,569–$18,276 | varies |
| Venography Adrenal Unilateral (75840) | $3,198.30 | $4,569 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $3,804.50 | $5,435 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $3,276 | $4,680 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $1,355.90 | $1,937 | 0.7× |
| Venography Orbital Rs&I (75880) | $3,358.60 | $4,798 | 4.5× |
| Venography Renal Bilateral (75833) | $3,357.90 | $4,797 | 0.9× |
| Venography Renal Unilateral (75831) | $3,358.60 | $4,798 | 0.9× |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$4,930.10–$5,176.50 | $7,043–$7,395 | varies |
| Venous thrombosis imaging (78457) | $1,072.40 | $1,532 | 1.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,253.70 | $1,791 | 2.7× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$182.70–$413 | $261–$590 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $290.50 | $415 | 2.8× |
| X-ray antegrade pyelogram tube (74425) | $1,085.70 | $1,551 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$3,198.30–$6,529.60 | $4,569–$9,328 | varies |
| X-Ray Bend Only L-S Spine (72120) | $245.70 | $351 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$200.20–$452.20 | $286–$646 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$703.50–$1,407 | $1,005–$2,010 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $186.20 | $266 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $406 | $580 | 3.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $515.90 | $737 | 4.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $210 | $300 | 2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$314.30–$628.60 | $449–$898 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $332.50 | $475 | 2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $333.90 | $477 | 2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$546.70–$1,093.40 | $781–$1,562 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $800.80 | $1,144 | 6.5× |
| X-Ray Exam L-S Spine Bending (72114) | $311.50 | $445 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $277.20 | $396 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $374.50 | $535 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$265.30–$299.60 | $379–$428 | varies |
| X-ray eye for foreign body (70030) | $273.70 | $391 | 2.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$177.80–$355.60 | $254–$508 | varies |
| X-ray IV pyelogram (ivp) (74400) | $858.90 | $1,227 | 4.1× |
| X-ray IV pyelogram+tomography (74415) | $933.10 | $1,333 | 4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $238 | $340 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $253.40 | $362 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $281.40 | $402 | 2.3× |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$338.10–$354.90 | $483–$507 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $506.80 | $724 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$224–$253.40 | $320–$362 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $218.40 | $312 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$227.50–$256.90 | $325–$367 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $360.50 | $515 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $455 | $650 | 3.7× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$140–$147 | $200–$210 | varies |
| X-ray thoracic spine 4 vw (72074) | $209.30 | $299 | 1.7× |
| X-Ray Tmj Unilat (70328) | $117.60 | $168 | 1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $769.30 | $1,099 | 1.9× |
| X-Rays Bone Length Studies (77073) | $1,197.70 | $1,711 | 9.7× |
| X-Rays Bone Survey Complete (77075) | $729.40 | $1,042 | 5.9× |
| Xr c-spine 4 or 5 views (72050) | $319.90 | $457 | 2.6× |
| Xr facial bones less than 3 views (70140) | $184.80 | $264 | 1.8× |
| Xr orbits complete 4 views (70200) | $312.90 | $447 | 2.5× |
| Xr Tomogram Single Plane (76100) | $396.20 | $566 | 3.2× |
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.