Imaging prices at The University of Chicago Medical Center

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

450 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) $12,440 $12,440 8.4×
Abdomen 1 View (74018) $500 $500 5.4×
Abdomen 2 views (74019) $492 $492 4.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,552 $1,552 3.6×
Angio internal mammary (75756) $5,442 $5,442 1.6×
Angio pulmonary bilat (75743) $8,710 $8,710 2.6×
Angiography extremity bilateral rs&i (75716) $9,990 $9,990 3.0×
Angiography extremity unilateral rs&i (75710) $8,710 $8,710 2.6×
Angiography pulmonary unilateral slctv rs&i (75741) $8,710 $8,710 2.6×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $4,925 $4,925 1.5×
Ankle 2 views (73600) $361 $361 3.9×
Aortography thoracic serialography rs&i (75605) $8,710 $8,710 1.5×
Aortography thoracic w/o serialography rs&i (75600) $8,074 $8,074 2.4×
Artery X-Rays Abdomen (75726) $16,233 $16,233 2.7×
Artery X-Rays Adrenal Gland (75731) $8,710 $8,710 2.6×
Artery X-Rays Pelvis (75736) $8,965 $8,965 1.5×
Artery X-Rays Spine (75705) $16,233 $16,233 2.7×
Arthrogram ankle (73615) $1,158 $1,158 3.1×
Arthrogram hip (73525) $1,591 $1,591 4.3×
Arthrogram Wrist (73115) $1,351 $1,351 3.6×
Basic radiation dosimetry calculation (77300) $1,642 $1,642 11.4×
Bone age studies (77072) $352 $352 3.1×
Bone Imaging 3 Phase (78315) $5,571 $5,571 13.0×
Bone Imaging Limited Area (78300) $2,502 $2,502 5.8×
Bone Imaging Multiple Areas (78305) $2,486 $2,486 5.8×
Bone Imaging Whole Body (78306) $4,906 $4,906 11.5×
Bone marrow imaging limited area (78102) $1,622 $1,622 3.8×
Bone marrow imaging; whole body (78104) $2,327 $2,327 5.4×
Bone survey infant (77076) $192 $192 1.7×
Brachytx isodose complex (77318) $3,160 $3,160 7.9×
Brachytx isodose intermed (77317) $1,832 $1,832 4.6×
Brachytx Isodose Plan Simple (77316) $1,273 $1,273 3.2×
Brain Flow Imaging Only (78610) $2,567 $2,567 4.4×
Brain Image W/Flow < 4 Views (78601) $2,226 $2,226 5.2×
Brain Imaging Pet Metabolic Evaluation (78608) $8,932 $8,932 5.8×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $4,366 $4,366 7.5×
Cardiac MRI w/w/o contrast & further seq (75561) $4,648 $4,648 12.4×
Cardiac MRI w/w/o contrast w/stress (75563) $5,502 $5,502 6.5×
Cat Scan Follow-Up Study (76380) $2,682 $2,682 28.8×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $2,226 $2,226 3.8×
Cerebrospinal Fluid Scan (78630) $2,086 $2,086 3.6×
Chest 1 view (71045) $345 $345 3.7×
Chest 2 views (71046) $681 $681 7.3×
Chest 3 views (71047) $765 $765 8.2×
Chest 4 or more views (71048) $849 $849 7.6×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $240 $240 2.1×
Cisternography Positive Contrast Rs&I (70015) $1,976 $1,976 2.4×
Clavicle complete (73000) $466 $466 5.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,682 $2,682 23.9×
Continuing medical physics consltj pr wk (77336) $1,642 $1,642 11.4×
Contrast Exam Abdominl Aorta (75625) $10,011 $10,011 3.0×
Contrast X-Ray Bladder (74430)
range across 4 matching MRF lines		 $240–$1,649 $240–$1,649 varies
Contrast X-Ray Of Elbow (73085) $2,631 $2,631 7.0×
Contrast X-Ray Of Knee Joint (73580) $1,136 $1,136 3.0×
Contrast Xray Throat/Cerv Esopha (74210) $309 $309 1.6×
CT abdomen and pelvis without and with contrast (74178) $6,718 $6,718 18.0×
CT abdomen and pelvis without contrast (74176) $5,442 $5,442 21.3×
CT abdomen w contrast (74160) $2,854 $2,854 15.2×
CT abdomen w wo contrast (74170) $3,010 $3,010 16.0×
CT abdomen w/o contrast (74150) $1,968 $1,968 17.6×
CT Angio Abdomen and Pelvis (74174) $5,138 $5,138 13.7×
CT Angio Chest (71275) $3,284 $3,284 17.5×
CT Angio Head (70496) $2,822 $2,822 15.0×
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines		 $1,016–$1,717 $1,016–$1,717 varies
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,430 $2,430 12.9×
CT Angio Neck (70498) $2,627 $2,627 14.0×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,313 $3,313 17.6×
CT cervical spine w/ contrast (72126) $2,683 $2,683 7.2×
CT cervical spine w/o contrast (72125) $2,632 $2,632 23.5×
CT cervical spine w/wo cont (72127) $2,806 $2,806 14.9×
CT chest w contrast (71260) $2,846 $2,846 15.1×
CT chest w/wo contrast (71270) $3,264 $3,264 17.4×
CT colonography screening (74263) $1,646 $1,646 6.4×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,254 $1,254 6.7×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,136 $1,136 10.1×
CT head/brain with contrast (70460) $2,712 $2,712 14.4×
CT head/brain without and with contrast (70470) $3,021 $3,021 16.1×
CT heart contrast eval cardiac structure&morph (75572) $1,478 $1,478 4.0×
CT heart no contrast quant eval coronry calcium (75571) $50 $50 0.5×
CT hrt w/3d image congen (75573) $896 $896 2.4×
CT iac w contrast (70481) $3,014 $3,014 16.0×
CT l-spine w&w/o contrast (72133) $2,958 $2,958 15.7×
CT lower ext w/o (73700) $2,822 $2,822 25.2×
CT lower extremity w/contrast material (73701) $3,580 $3,580 19.0×
CT lumbar spine w contrast (72132) $2,710 $2,710 7.2×
CT lumbar spine w/o contrast (72131) $2,344 $2,344 20.9×
CT maxillofacial w contrast (70487) $2,740 $2,740 14.6×
CT maxillofacial wo contrast (70486) $2,728 $2,728 24.4×
CT neck tissue combo (70492) $2,753 $2,753 14.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,158 $3,158 16.8×
CT orbits w/o contrast (70480) $2,546 $2,546 22.7×
CT pelvis w&w/o contrast (72194) $2,921 $2,921 15.5×
CT pelvis w/o contrast (72192) $1,973 $1,973 17.6×
CT scan of leg combo (73702) $4,717 $4,717 25.1×
CT scans face/jaw combo (70488) $2,924 $2,924 15.6×
CT soft tissue neck w contrast (70491) $2,523 $2,523 13.4×
CT soft tissue neck w/o contrast (70490) $2,378 $2,378 21.2×
CT thoracic spine w contrast (72129) $2,670 $2,670 14.2×
CT thoracic spine w/o contrast (72128) $2,135 $2,135 19.1×
CT thoracic spine w/wo cont (72130) $3,208 $3,208 17.1×
CT thorax w/o contrast (71250) $2,682 $2,682 23.9×
CT unlisted procedure (76497) $541 $541 5.8×
CT upper ext wo (73200) $3,057 $3,057 27.3×
CT upper extremity w/o & w/contrast material (73202) $3,598 $3,598 19.1×
CT upper extremity with contrast (73201) $3,425 $3,425 9.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,390 $1,390 7.4×
Cta Abdomen (74175) $3,190 $3,190 17.0×
CTA pelvis (72191) $2,713 $2,713 14.4×
Dilation ureters/urethra rs&i (74485) $3,879 $3,879 1.7×
Discography Cerv/Thor Spine (72285) $4,239 $4,239 2.0×
Diskography lumbar (72295) $7,089 $7,089 3.4×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828)
range across 3 matching MRF lines		 $145–$1,230 $145–$1,230 varies
Doppler Echo Fetal Spectral Display Complete (76827)
range across 4 matching MRF lines		 $266–$1,706 $266–$1,706 varies
Doppler Fetal Mid Cerebral Artery (76821)
range across 4 matching MRF lines		 $412–$3,351 $412–$3,351 varies
Dxa Bone Density Axial (77080)
range across 4 matching MRF lines		 $136–$1,110 $136–$1,110 varies
Dxa bone density study (77085)
range across 3 matching MRF lines		 $395–$858 $395–$858 varies
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 3 matching MRF lines		 $134–$281 $134–$281 varies
Echo exam of fetal heart (76825)
range across 3 matching MRF lines		 $678–$2,659 $678–$2,659 varies
Echo exam uterus (76831)
range across 4 matching MRF lines		 $991–$2,759 $991–$2,759 varies
Echo Guide For Artery Repair (76936) $2,721 $2,721 11.8×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,496 $1,496 5.9×
Echograp Trans R Pros Study (76873) $2,331 $2,331 20.8×
Esophagram (74220) $1,170 $1,170 6.2×
Fetal Biophys Profile W/Nst (76818)
range across 4 matching MRF lines		 $1,358–$2,738 $1,358–$2,738 varies
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 4 matching MRF lines		 $626–$1,876 $626–$1,876 varies
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $788 $788 3.1×
Fluoroscopy up to 1 hr (76000)
range across 4 matching MRF lines		 $140–$1,905 $140–$1,905 varies
Follow-Up Angiography (75898) $3,542 $3,542 1.0×
Foot 2 views (73620) $447 $447 4.8×
Forearm 2 views (73090) $490 $490 5.3×
Gastric emptying imaging study (78264) $3,817 $3,817 8.9×
Gastroesophageal Reflux Exam (78262) $1,553 $1,553 3.6×
Gated Heart Planar Single (78472) $1,918 $1,918 4.5×
Hand 2 views (73120) $385 $385 3.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $12,963 $12,963 17.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $12,556 $12,556 16.8×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $10,767 $10,767 14.4×
Heart first pass single,planar (78481) $2,264 $2,264 3.9×
Heart Image (Pet) Multiple (78492) $5,148 $5,148 3.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $8,710 $8,710 2.6×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $8,710 $8,710 2.6×
Hepatobil Syst Image W/Drug (78227) $5,324 $5,324 9.1×
Hepatobiliary System Imaging (78226) $3,888 $3,888 9.1×
Ht Musc Image Planar Mult (78454) $6,297 $6,297 4.5×
Ht Muscle Image Spect Sing (78451) $5,968 $5,968 4.3×
Hysterosalpingogram (74740) $2,216 $2,216 8.7×
Image fusion (77399) $675 $675 4.7×
Infant hip ultrasound with hip movement (dynamic) (76885) $487 $487 5.2×
Infant hip ultrasound, limited static exam (76886) $329 $329 3.5×
Interstitial radiation source applic complex (77778) $10,142 $10,142 13.6×
Intracavitary Radiation Source Applic Complex (77763) $9,719 $9,719 13.0×
Intracavitary Radiation Source Applic Intermed (77762) $6,848 $6,848 11.6×
Intracavitary radiation source applic simple (77761) $5,169 $5,169 8.7×
Joint Survey Single View (77077) $345 $345 3.1×
K Flow/Funct Image W/Drug (78708) $3,859 $3,859 6.6×
K Flow/Funct Image W/O Drug (78707) $3,472 $3,472 6.0×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $974 $974 2.3×
Kidney Imaging Morphol (78700) $1,022 $1,022 2.4×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $2,045 $2,045 4.8×
Knee 3 Views (73562) $550 $550 5.9×
Leveen/Shunt Patency Exam (78291) $1,633 $1,633 3.8×
Liver & Spleen Imaging Static Only (78215) $1,551 $1,551 3.6×
Liver & Spleen Imaging W/Vascular Flow (78216) $837 $837 2.0×
Liver imaging w/vascular flow (78202) $1,526 $1,526 2.6×
Lung Perf&Ventilat Diferentl (78598) $1,994 $1,994 3.4×
Lung perfusion differential (78597) $933 $933 2.2×
Lung Ventilat&Perfus Imaging (78582) $1,990 $1,990 3.4×
Lung Ventilation Imaging (78579) $752 $752 1.8×
Lymph System Imaging (78195) $3,966 $3,966 6.8×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $4,272 $4,272 2.5×
Lymphangiography extremity only unilateral rs&i (75801) $4,272 $4,272 6.4×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $3,177 $3,177 0.9×
Lymphangiography, pelvic/abdominal, unilateral (75805) $3,224 $3,224 1.0×
Magnetic Image Jaw Joint (70336) $6,083 $6,083 23.8×
Magnetic Resonance Elastography (76391) $5,060 $5,060 19.8×
Mammary ductogram or galactogram multiple (77054) $913 $913 3.6×
Mammary ductogram or galactogram single (77053) $1,040 $1,040 4.1×
Meckels Divert Exam (78290) $2,722 $2,722 6.4×
Mlc imrt design & construction per imrt plan (77338) $12,047 $12,047 30.0×
Mr safety determination physician/other qhp (76016) $187 $187 2.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $53 $53 1.7×
Mr safety implt electronics prepj supvj phys/qhp (76018) $195 $195 1.9×
Mr safety implt pos&/immoblj (76019) $127 $127 2.0×
Mr safety med physics xm customization plng&mntr (76017) $513 $513 2.0×
Mra Head W/O & W/Contrast Material (70546) $4,224 $4,224 11.3×
MRA head w/o contrast (70544) $3,650 $3,650 14.3×
MRA head with contrast (70545) $4,014 $4,014 10.7×
MRA neck w contrast (70548) $3,853 $3,853 10.3×
Mra Neck W/O &W/Contrast Material (70549) $4,371 $4,371 11.7×
MRA neck w/o contrast (70547) $3,640 $3,640 14.2×
MRI abdomen w contrast (74182) $5,947 $5,947 15.9×
MRI abdomen w/o contrast (74181)
range across 2 matching MRF lines		 $598–$5,060 $598–$5,060 varies
MRI any jt lower extrem w/contrast material (73722) $5,735 $5,735 6.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $7,177 $7,177 19.2×
MRI any jt upper extremity w/contrast matrl (73222) $6,062 $6,062 7.2×
MRI bone marrow blood supply (77084) $358 $358 1.4×
MRI brain functional w/o physician admnistration (70554) $1,710 $1,710 6.7×
MRI brain functional w/physician admnistration (70555) $2,768 $2,768 10.8×
MRI Breast W/O Contrast Bilateral (77047) $2,833 $2,833 11.1×
MRI Breast Without Contrast Material Unilateral (77046) $1,970 $1,970 7.7×
MRI cardiac w/o cont stress (75559) $5,185 $5,185 8.9×
MRI cardiac w/o contrast (75557) $3,662 $3,662 14.3×
MRI cervical spine w contrast (72142) $5,708 $5,708 15.3×
MRI cervical spine w/o cont (72141) $4,708 $4,708 18.4×
MRI chest w/o contrast (71550) $6,411 $6,411 25.1×
MRI chest with contrast (71551) $6,780 $6,780 8.1×
MRI chest wo w contrast (71552) $7,323 $7,323 19.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $5,679 $5,679 15.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $6,529 $6,529 17.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,045 $5,045 19.7×
MRI lumbar spine w contrast (72149) $6,656 $6,656 17.8×
Mri Neck Spine W/O & W/Dye (72156) $7,141 $7,141 19.1×
MRI orbit face &/neck w/o contrast (70540) $3,681 $3,681 14.4×
MRI orbit face neck w contrast (70542) $3,998 $3,998 10.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543)
range across 3 matching MRF lines		 $2,437–$5,678 $2,437–$5,678 varies
MRI pelvis w contrast (72196)
range across 2 matching MRF lines		 $2,187–$5,168 $2,187–$5,168 varies
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines		 $2,807–$7,689 $2,807–$7,689 varies
MRI pelvis w/o contrast (72195) $4,662 $4,662 18.2×
MRI spectroscopy (76390) $4,235 $4,235 45.4×
MRI thoracic spine w/o contrast (72146) $6,213 $6,213 24.3×
MRI upper extremity oth than jt w/contr matrl (73219) $4,119 $4,119 11.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,675 $3,675 14.4×
Mri Uppr Extremity W/O&W/Dye (73220) $7,980 $7,980 21.3×
MRI, abdomen, combo (74183) $7,364 $7,364 19.7×
MRI, dorsal spine combo (72157) $9,338 $9,338 25.0×
MRI, dorsal spine contrast (72147) $8,914 $8,914 23.8×
MRI, joint upper extrem (73221) $5,241 $5,241 20.5×
MRI, joint upper extrem combo (73223) $7,416 $7,416 19.8×
MRI, lumbar spine combo (72158) $9,654 $9,654 25.8×
Myelogram cervical (72240) $2,477 $2,477 2.9×
Myelogram Lumbar (72265) $4,019 $4,019 4.8×
Myelography thoracic (72255) $2,416 $2,416 2.9×
Myelograpy 2/more regions rs&i (72270) $5,091 $5,091 6.1×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,308 $1,308 3.1×
Myocardial Imaging Pet Metabolic Evaluation (78459) $9,617 $9,617 6.9×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $4,366 $4,366 3.1×
Myocardial Spect Multiple Studies (78452) $9,684 $9,684 7.0×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $4,139 $4,139 2.7×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $4,139 $4,139 2.7×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $6,456 $6,456 2.7×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $7,890 $7,890 3.3×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $7,890 $7,890 4.9×
N-invas est c ffr sw aly CTA (75580) $4,201 $4,201 4.6×
Neck soft tissue (70360) $573 $573 6.1×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $706 $706 1.6×
Nm csf leak detection (78650) $2,226 $2,226 1.6×
Nm myocard infarct spect (78469) $1,436 $1,436 2.5×
Ntsty modul radthx pln dose-vol histos (77301) $18,924 $18,924 12.8×
Nuclear Rx Intra-Arterial (79445) $1,410 $1,410 5.6×
Nuclear Rx Oral Admin (79005) $1,950 $1,950 7.8×
Ob us nuchal meas 1 gest (76813)
range across 3 matching MRF lines		 $708–$1,885 $708–$1,885 varies
Oph bmtry us echograpy a-scan io lens pwr cal (76519)
range across 4 matching MRF lines		 $435–$1,092 $435–$1,092 varies
Oph us dx ant sgm us immersion b-scan/hr biom (76513)
range across 3 matching MRF lines		 $323–$954 $323–$954 varies
Ophthalmic Biometry US Echograpy a-Scan (76516)
range across 4 matching MRF lines		 $410–$854 $410–$854 varies
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 4 matching MRF lines		 $670–$1,458 $670–$1,458 varies
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514)
range across 4 matching MRF lines		 $172–$567 $172–$567 varies
Panoramic X-ray of jaws (70355) $596 $596 6.4×
Parathyroid imaging w/tomographic spect & CT (78072) $6,362 $6,362 10.9×
Parathyroid Planar Imaging (78070) $2,183 $2,183 5.1×
Parathyroid planar imaging w/wo subtraction (78071) $5,786 $5,786 13.5×
Pelvis 1 or 2 views (72170) $536 $536 4.8×
Perineogram (74775) $860 $860 3.4×
Pet Image W/Ct Lmtd (78814) $4,100 $4,100 2.7×
PET image w/CT, full body (78816) $17,687 $17,687 11.5×
PET imaging CT attenuation skull base mid-thigh (78815) $15,173 $15,173 9.9×
Pet Myocardial Sngl Study (78491) $3,990 $3,990 2.6×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $4,204 $4,204 3.0×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $1,559 $1,559 1.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $8,710 $8,710 2.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,952 $1,952 4.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $895 $895 8.0×
Radex abscess/fistula/sinus tract rs&i (76080) $2,033 $2,033 3.5×
Radex Ankle Complete Minimum 3 Views (73610) $562 $562 6.0×
Radex Calcaneus Minimum 2 Views (73650) $475 $475 5.1×
Radex elbow complete minimum 3 views (73080) $492 $492 5.3×
Radex Facial Bones Complete Minimum 3 Views (70150) $813 $813 7.3×
Radex fingr minimum 2 views (73140) $386 $386 4.1×
Radex foot complete minimum 3 views (73630) $570 $570 6.1×
Radex Hand Minimum 3 Views (73130) $552 $552 5.9×
Radex lower extremity infant minimum 2 views (73592) $597 $597 6.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $704 $704 7.5×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $681 $681 7.3×
Radex Ribs Unilateral 2 Views (71100) $393 $393 4.2×
Radex shoulder complete minimum 2 views (73030) $521 $521 5.6×
Radex Sinuses Paransl < 3 Views (70210) $262 $262 2.8×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $578 $578 3.1×
Radex Spine 1 View Specify Level (72020) $368 $368 3.9×
Radex Sternum Minimum 2 Views (71120) $484 $484 5.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $438 $438 4.7×
Radex Toe Minimum 2 Views (73660) $557 $557 6.0×
Radex upper extremity infant minimum 2 views (73092) $650 $650 5.8×
Radex Wrist Complete Minimum 3 Views (73110) $555 $555 6.0×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $715 $715 6.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $35,522 $35,522 4.5×
Radiation treatment delivery level 1 (77402) $1,115 $1,115 10.2×
Radiation treatment delivery level 2 (77407) $1,515 $1,515 3.7×
Radiation treatment delivery level 3 (77412) $2,778 $2,778 4.7×
Radiolog exam mandible compl minimum 4 views (70110) $682 $682 6.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $549 $549 4.9×
Radiologic exam colon double contrast study (74280) $2,394 $2,394 12.7×
Radiologic exam colon single contrast study (74270) $1,697 $1,697 9.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $457 $457 2.4×
Radiologic exam knee complete 4/more views (73564) $858 $858 7.7×
Radiologic exam pelvis compl minimum 3 views (72190) $753 $753 6.7×
Radiologic Exam Small Int Single Contrast Study (74250) $1,470 $1,470 7.8×
Radiologic exam swallow function contrast study (74230) $1,293 $1,293 6.9×
Radiologic exam upr gi trc double contrast study (74246) $1,144 $1,144 6.1×
Radiologic examination femur 1 view (73551) $413 $413 4.4×
Radiologic examination femur minimum 2 views (73552) $465 $465 5.0×
Radiologic examination knee 1/2 views (73560) $439 $439 4.7×
Radiologic Examination Osseous Survey Limited (77074) $564 $564 5.0×
Radiologic examination tibia & fibula 2 views (73590) $589 $589 6.3×
Red Cell Volume Determination Spx 1 Sampling (78120) $2,142 $2,142 5.0×
Red Cell Volume Determination Spx Mult Samplings (78121) $1,575 $1,575 2.7×
Renal Cyst Study (74470) $2,332 $2,332 4.0×
Ribs bilateral 3 views (71110) $827 $827 7.4×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,983 $1,983 4.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,902 $2,902 6.8×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,384 $4,384 7.5×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $5,456 $5,456 9.4×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 4 matching MRF lines		 $2,156–$3,648 $2,156–$3,648 varies
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,648 $3,648 2.6×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,139 $4,139 2.7×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,648 $3,648 2.6×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $2,966 $2,966 11.9×
Rp Therapy Intravenous Administration (79101) $2,070 $2,070 8.3×
Salivary Gland Function Study (78232) $1,085 $1,085 2.5×
Salivary Gland Imaging (78230) $1,099 $1,099 2.6×
Salivary Gland Imaging Serial Images (78231) $776 $776 1.8×
Scapula (73010) $488 $488 4.4×
Screening Digital Breast Tomosynthesis Bi (77063) $90 $90 3.8×
Shoulder 1 view (73020) $361 $361 3.9×
Shoulder Arthrography (73040) $2,458 $2,458 6.6×
Sialogram (70390) $1,027 $1,027 4.0×
Skull less than 4 views (70250) $690 $690 6.2×
Special dosimetry (77331) $2,026 $2,026 14.1×
Special Physics Consult (77370) $2,337 $2,337 16.2×
Special teletherapy port plan (77321) $3,227 $3,227 8.0×
Special treatment procedure (77470) $5,573 $5,573 9.4×
Speech evaluation, complex (70371) $1,195 $1,195 4.7×
Spleen Imaging (78185) $1,309 $1,309 3.1×
Stereotactic Body Radiation Delivery (77373) $13,642 $13,642 7.1×
Sternoclavicular joints (71130) $597 $597 6.4×
Superior sagittal sinus venogram (75870) $4,187 $4,187 1.2×
Surface Applic Low Dose Rate Radionuclide Source (77789) $1,073 $1,073 9.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $3,993 $3,993 10.0×
Telethx isodose pln smpl w/dosimetry calculation (77306) $727 $727 1.8×
Testicular Imaging W/Flow (78761) $1,515 $1,515 3.5×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $5,558 $5,558 13.9×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $3,325 $3,325 8.3×
Ther rad simulaj-aided field setting simple (77280) $2,886 $2,886 20.0×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $1,077 $1,077 5.7×
Thoracic spine 2 views (72070) $352 $352 3.1×
Thoracic spine 3 views (72072) $587 $587 5.2×
Thoracolumbar 2 views (72080) $603 $603 6.5×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $2,091 $2,091 4.9×
Thyroid Imaging With Vascular Flow (78013) $1,605 $1,605 3.7×
Thyroid Met Imaging Body (78018) $4,495 $4,495 7.7×
Thyroid Uptake Measurement (78012) $1,415 $1,415 3.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,466 $3,466 8.1×
Tx Devices Design & Construction Complex (77334) $3,030 $3,030 7.6×
Tx devices design & construction intermediate (77333) $2,444 $2,444 17.0×
Tx devices design & construction simple (77332) $1,543 $1,543 10.7×
Ultrasound Breast Limited (76642)
range across 4 matching MRF lines		 $220–$1,149 $220–$1,149 varies
Ultrasound Elastography Parenchyma (76981)
range across 4 matching MRF lines		 $264–$945 $264–$945 varies
Ultrasound Exam Aaa Screen (76706) $323 $323 2.9×
Ultrasound, abdomen limited (76705)
range across 11 matching MRF lines		 $283–$2,358 $283–$2,358 varies
Umbilical-artery Doppler (OB) (76820)
range across 4 matching MRF lines		 $1,144–$2,336 $1,144–$2,336 varies
Unlisted Dx Radiographic Procedure (76499)
range across 9 matching MRF lines		 $125–$1,844 $125–$1,844 varies
Unlisted fluoroscopic procedure (76496) $796 $796 8.5×
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines		 $541–$9,326 $541–$9,326 varies
Unlisted us procedure (76999) $926 $926 9.9×
Upper gi w/o kub (74240) $1,624 $1,624 8.6×
Ureteral Reflux Study (78740) $1,579 $1,579 3.7×
Urethrocystogram voiding (74455)
range across 4 matching MRF lines		 $198–$2,228 $198–$2,228 varies
Urethrocystography retrograde (74450) $1,126 $1,126 4.4×
Us breast unilateral complete (76641)
range across 4 matching MRF lines		 $237–$1,230 $237–$1,230 varies
Us chest (76604)
range across 11 matching MRF lines		 $198–$1,480 $198–$1,480 varies
Us complete joint (76881)
range across 3 matching MRF lines		 $204–$1,403 $204–$1,403 varies
Us exam, pelvic, limited (76857)
range across 4 matching MRF lines		 $211–$807 $211–$807 varies
Us head (76506) $1,186 $1,186 10.6×
Us kidney transplant (76776) $1,175 $1,175 10.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 3 matching MRF lines		 $153–$501 $153–$501 varies
Us ob detailed single fetus (76811)
range across 4 matching MRF lines		 $797–$2,476 $797–$2,476 varies
Us ob limited 1 or more fetuses (76815)
range across 4 matching MRF lines		 $707–$1,668 $707–$1,668 varies
Us ob transvaginal (76817)
range across 4 matching MRF lines		 $670–$1,381 $670–$1,381 varies
Us pelvic non ob complete (76856)
range across 4 matching MRF lines		 $458–$2,345 $458–$2,345 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 4 matching MRF lines		 $673–$1,375 $673–$1,375 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 4 matching MRF lines		 $557–$1,381 $557–$1,381 varies
Us retroperitoneal complete (76770) $2,138 $2,138 19.1×
Us retroperitoneal limited (76775) $1,912 $1,912 17.1×
Us scrotum and contents (76870) $1,688 $1,688 15.1×
Us spinal canal and contents (76800) $824 $824 7.4×
Us thyroid (76536)
range across 4 matching MRF lines		 $408–$2,116 $408–$2,116 varies
Us transrectal (76872)
range across 4 matching MRF lines		 $304–$1,338 $304–$1,338 varies
Vascular Flow Imaging (78445) $1,624 $1,624 3.8×
Vein X-Ray Chest (75827) $6,183 $6,183 3.7×
Vein X-Ray Liver W/O Hemodyn (75887) $7,084 $7,084 2.1×
Vein X-Ray Skull Epidural (75872) $4,925 $4,925 7.3×
Vein X-Ray Spleen/Liver (75810) $8,074 $8,074 2.4×
Venogram Sinus/Jugular (75860) $3,864 $3,864 1.1×
Venography caval inferior serialography rs&i (75825) $8,710 $8,710 2.6×
Venography extremity bilateral rs&i (75822) $5,295 $5,295 3.1×
Venography extremity unilateral rs&i (75820) $3,909 $3,909 2.3×
Venography Renal Bilateral (75833) $8,710 $8,710 2.6×
Venography Renal Unilateral (75831) $8,710 $8,710 2.6×
Venous sampling by catheter (75893) $8,710 $8,710 1.5×
Vertebral fracture assessment via dxa (77086)
range across 3 matching MRF lines		 $211–$502 $211–$502 varies
Wrist 2 views (73100) $439 $439 4.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $626 $626 6.7×
X-ray antegrade pyelogram tube (74425) $2,217 $2,217 5.9×
X-Ray Aorta Leg Arteries (75630) $10,131 $10,131 3.0×
X-Ray Bend Only L-S Spine (72120) $547 $547 4.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $398 $398 4.3×
X-Ray Exam Breast Specimen (76098) $913 $913 1.6×
X-Ray Exam Entire Spi 1 Vw (72081) $454 $454 4.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $542 $542 4.8×
X-Ray Exam Entire Spi 4/5 Vw (72083) $611 $611 5.5×
X-Ray Exam Hip Uni 1 View (73501) $465 $465 5.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $568 $568 6.1×
X-Ray Exam Hip Uni 4/> Views (73503) $697 $697 6.2×
X-Ray Exam Hips Bi 2 Views (73521) $568 $568 5.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $748 $748 6.7×
X-Ray Exam Hips Bi 5/> Views (73523) $802 $802 7.2×
X-Ray Exam L-S Spine Bending (72114) $1,026 $1,026 9.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $718 $718 7.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $970 $970 8.7×
X-Ray Exam Unilat Ribs/Chest (71101) $483 $483 4.3×
X-ray humerus (73060) $526 $526 5.6×
X-ray IV pyelogram (ivp) (74400) $842 $842 4.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $462 $462 5.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $354 $354 3.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $524 $524 4.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $987 $987 8.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $587 $587 5.2×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $329 $329 2.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $673 $673 7.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $741 $741 7.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $844 $844 7.5×
X-Ray Stress View (77071) $352 $352 3.8×
X-ray thoracic spine 4 vw (72074) $681 $681 6.1×
X-Ray Tmj Unilat (70328) $173 $173 1.9×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,708 $1,708 4.6×
X-Rays Bone Length Studies (77073) $416 $416 3.7×
X-Rays Bone Survey Complete (77075) $948 $948 8.5×
Xr c-spine 4 or 5 views (72050) $844 $844 7.5×
Xr facial bones less than 3 views (70140) $250 $250 2.7×
XR Mastoids < 3 Views Bilateral (70120) $261 $261 2.3×
Xr orbits complete 4 views (70200) $745 $745 6.7×
Xr Tomogram Single Plane (76100) $323 $323 2.9×

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.