Imaging prices at ThedaCare Medical Center - Wild Rose Inc
Wild Rose, WI · every code in this section with a posted price and a Medicare benchmark.
403 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) range across 3 matching MRF lines |
$1,130.64–$3,994.37 | $2,019–$7,132.80 | varies |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$132.33–$273.06 | $236.30–$487.60 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$163.74–$305.14 | $292.40–$544.90 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$694.01–$735.67 | $1,239.30–$1,313.70 | varies |
| Adrenal Cortex & Medulla Img (78075) range across 2 matching MRF lines |
$1,201.93–$1,562.51 | $2,146.30–$2,790.20 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$1,892.30–$2,460.08 | $3,379.10–$4,393 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$336.28–$2,993.93 | $600.50–$5,346.30 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$395.81–$3,850 | $706.80–$6,875 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$371.62–$3,080 | $663.60–$5,500 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$577.25–$2,395.12 | $1,030.80–$4,277 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 3 matching MRF lines |
$232.79–$3,728.70 | $415.70–$6,658.40 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$138.77–$152.66 | $247.80–$272.60 | varies |
| Aortography thoracic serialography rs&i (75605) range across 3 matching MRF lines |
$9,551.64–$10,506.83 | $410.40–$18,762.20 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$412.66–$3,095.68 | $736.90–$5,528 | varies |
| Artery X-Rays Adrenal Gland (75731) | $2,571.52 | $4,592 | 0.8× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$227.86–$3,095.68 | $406.90–$5,528 | varies |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$482.50–$3,221.12 | $861.60–$5,752 | varies |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$394.24–$575.23 | $704–$1,027.20 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$456.79–$891.13 | $815.70–$1,591.30 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$317.13–$481.99 | $566.30–$860.70 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$163.86–$479.25 | $292.60–$855.80 | varies |
| Bone age studies (77072) range across 4 matching MRF lines |
$114.69–$224.90 | $204.80–$401.60 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,161.33–$1,334.82 | $2,073.80–$2,383.60 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$694.01–$735.67 | $1,239.30–$1,313.70 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$1,124.20–$1,191.68 | $2,007.50–$2,128 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$995.96–$1,294.78 | $1,778.50–$2,312.10 | varies |
| Bone marrow imaging limited area (78102) range across 3 matching MRF lines |
$473.76–$675.08 | $846–$1,205.50 | varies |
| Bone survey infant (77076) range across 4 matching MRF lines |
$247.07–$327.38 | $441.20–$584.60 | varies |
| Brachytx isodose complex (77318) range across 3 matching MRF lines |
$763–$849.41 | $1,362.50–$1,516.80 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$482.33–$614.88 | $861.30–$1,098 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$369.43–$614.88 | $659.70–$1,098 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$722.74–$869.34 | $1,290.60–$1,552.40 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 9 matching MRF lines |
$3,414.54–$7,391.50 | $6,097.40–$13,199.10 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 3 matching MRF lines |
$269.19–$1,055.71 | $480.70–$1,885.20 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $332.53 | $593.80 | 0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 4 matching MRF lines |
$687.68–$1,242.53 | $1,228–$2,218.80 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 4 matching MRF lines |
$676.31–$2,017.96 | $1,207.70–$3,603.50 | varies |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$410.09–$580.72 | $732.30–$1,037 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$521.58–$678.05 | $931.40–$1,210.80 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$894.49–$948.14 | $1,597.30–$1,693.10 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$114.58–$213.47 | $204.60–$381.20 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$148.90–$235.20 | $265.90–$420 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$171.42–$218.46 | $306.10–$390.10 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$199.47–$219.41 | $356.20–$391.80 | varies |
| Cholecystography Oral Contrast (74290) | $318.02 | $567.90 | 1.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) range across 3 matching MRF lines |
$83.16–$256.20 | $148.50–$457.50 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$1,414.84–$1,556.35 | $2,526.50–$2,779.20 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$116.42–$142.58 | $207.90–$254.60 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$356.16–$438.98 | $636–$783.90 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$485.02–$494.93 | $866.10–$883.80 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$284.82–$2,450.56 | $508.60–$4,376 | varies |
| Contrast X-Ray Bladder (74430) range across 4 matching MRF lines |
$115.70–$279.44 | $206.60–$499 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$269.08–$375.59 | $480.50–$670.70 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$344.40–$433.16 | $615–$773.50 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$1,255.41–$2,912 | $2,241.80–$5,200 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$513.41–$2,352 | $916.80–$4,200 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$852.26–$1,791.38 | $1,521.90–$3,198.90 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$853.89–$1,970.42 | $1,524.80–$3,518.60 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$410.09–$1,354.75 | $732.30–$2,419.20 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$1,404.26–$2,526.22 | $2,507.60–$4,511.10 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$851.20–$2,034.03 | $1,520–$3,632.20 | varies |
| CT Angio Head (70496) range across 5 matching MRF lines |
$851.20–$2,116.07 | $1,520–$3,778.70 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$1,043.39–$1,405.38 | $1,863.20–$2,509.60 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$891.35–$1,657.10 | $1,591.70–$2,959.10 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$851.20–$1,926.12 | $1,520–$3,439.50 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$851.20–$1,657.10 | $1,520–$2,959.10 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,120 | $2,000 | 6.6× |
| CT cervical spine w/ contrast (72126) range across 4 matching MRF lines |
$582.79–$1,826.33 | $1,040.70–$3,261.30 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$453.15–$1,660.40 | $809.20–$2,965 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$718.65–$1,511.72 | $1,283.30–$2,699.50 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$579.04–$1,783.94 | $1,034–$3,185.60 | varies |
| CT chest w/wo contrast (71270) range across 4 matching MRF lines |
$714.90–$1,973.50 | $1,276.60–$3,524.10 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$940.52–$1,125.82 | $1,679.50–$2,010.40 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$1,419.38–$1,447.77 | $2,534.60–$2,585.30 | varies |
| CT head/brain with contrast (70460) range across 4 matching MRF lines |
$479.14–$1,586.82 | $855.60–$2,833.60 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$576.02–$1,745.30 | $1,028.60–$3,116.60 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 3 matching MRF lines |
$731.25–$1,249.58 | $1,305.80–$2,231.40 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $28 | $50 | 0.3× |
| CT hrt w/3d image congen (75573) range across 3 matching MRF lines |
$916.27–$1,590.96 | $1,636.20–$2,841 | varies |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$717.42–$1,490.10 | $1,281.10–$2,660.90 | varies |
| CT l-spine w&w/o contrast (72133) range across 4 matching MRF lines |
$718.65–$1,871.24 | $1,283.30–$3,341.50 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$446.94–$1,521.35 | $798.10–$2,716.70 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$833.17–$1,673.50 | $1,487.80–$2,988.40 | varies |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$580.27–$1,702.23 | $1,036.20–$3,039.70 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$446.94–$1,547.56 | $798.10–$2,763.50 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$500.02–$1,544.42 | $892.90–$2,757.90 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$443.86–$1,404.03 | $792.60–$2,507.20 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$1,111.15–$1,552.77 | $1,984.20–$2,772.80 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$795.93–$1,639.23 | $1,421.30–$2,927.20 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$586.49–$1,354.75 | $1,047.30–$2,419.20 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$853.89–$1,899.30 | $1,524.80–$3,391.60 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$414.90–$1,644.22 | $740.90–$2,936.10 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$739.82–$1,998.53 | $1,321.10–$3,568.80 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$632.30–$1,699.10 | $1,129.10–$3,034.10 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$604.97–$1,411.59 | $1,080.30–$2,520.70 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$445.70–$1,276.80 | $795.90–$2,280 | varies |
| CT thoracic spine w contrast (72129) range across 4 matching MRF lines |
$584.02–$1,933.62 | $1,042.90–$3,452.90 | varies |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$450.69–$1,598.69 | $804.80–$2,854.80 | varies |
| CT thoracic spine w/wo cont (72130) range across 4 matching MRF lines |
$719.88–$1,757.73 | $1,285.50–$3,138.80 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$446.94–$1,531.94 | $798.10–$2,735.60 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$735.50–$2,307.87 | $1,313.40–$4,121.20 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$852.26–$2,849.28 | $1,521.90–$5,088 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$743.06–$2,564.24 | $1,326.90–$4,579 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$902.10–$2,206.85 | $1,610.90–$3,940.80 | varies |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$851.20–$1,796.42 | $1,520–$3,207.90 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,173.92 | $3,882 | 6.4× |
| CTA pelvis (72191) range across 3 matching MRF lines |
$851.20–$1,276.07 | $1,520–$2,278.70 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$3,681.61–$4,049.75 | $6,574.30–$7,231.70 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$3,573.08–$3,930.42 | $6,380.50–$7,018.60 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$3,018.29–$3,320.13 | $5,389.80–$5,928.80 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$302.51–$311.58 | $540.20–$556.40 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$302.51–$311.58 | $540.20–$556.40 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$215.10–$221.54 | $384.10–$395.60 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$182.62–$249.26 | $326.10–$445.10 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 3 matching MRF lines |
$103.32–$160.66 | $184.50–$286.90 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$628.43–$816.98 | $1,122.20–$1,458.90 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$461.50–$564.98 | $824.10–$1,008.90 | varies |
| Echo Guide For Artery Repair (76936) range across 3 matching MRF lines |
$417.42–$502.94 | $745.40–$898.10 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$443.41–$456.74 | $791.80–$815.60 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$313.60–$439.77 | $560–$785.30 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$518.84–$723.07 | $926.50–$1,291.20 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 7 matching MRF lines |
$251.16–$408.02 | $448.50–$728.60 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$132.83–$406.11 | $237.20–$725.20 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$372.57–$2,477.16 | $665.30–$4,423.50 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$124.77–$264.26 | $222.80–$471.90 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$129.25–$254.41 | $230.80–$454.30 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$996.74–$1,056.55 | $1,779.90–$1,886.70 | varies |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$612.25–$648.98 | $1,093.30–$1,158.90 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$220.81–$961.13 | $394.30–$1,716.30 | varies |
| Gated Heart, Multiple (78473) | $331.02 | $591.10 | 0.9× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$138.10–$194.43 | $246.60–$347.20 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 3 matching MRF lines |
$1,413.38–$2,113.38 | $2,523.90–$3,773.90 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 3 matching MRF lines |
$1,002.90–$2,066.34 | $1,790.90–$3,689.90 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 3 matching MRF lines |
$513.30–$1,977.02 | $916.60–$3,530.40 | varies |
| Heart first pass single,planar (78481) | $222.38 | $397.10 | 0.4× |
| Heart Image (Pet) Multiple (78492) | $407.01 | $726.80 | 0.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$1,437.30–$1,868.72 | $2,566.60–$3,337 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$5,471.20–$5,759.15 | $9,770–$10,284.20 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,548.90–$1,641.86 | $2,765.90–$2,931.90 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$763.50–$992.43 | $1,363.40–$1,772.20 | varies |
| Ht Musc Image Planar Mult (78454) | $2,558.81 | $4,569.30 | 2.0× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$310.91–$2,509.98 | $555.20–$4,482.10 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$344.62–$476.28 | $615.40–$850.50 | varies |
| Image fusion (77399) range across 2 matching MRF lines |
$654.75–$668.14 | $1,169.20–$1,193.10 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 4 matching MRF lines |
$410.59–$478.91 | $733.20–$855.20 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 3 matching MRF lines |
$344.23–$421.01 | $614.70–$751.80 | varies |
| Interstitial radiation source applic complex (77778) range across 3 matching MRF lines |
$2,016.95–$2,309.66 | $3,601.70–$4,124.40 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $2,284.74 | $4,079.90 | 3.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,518.50 | $2,711.60 | 2.8× |
| Intracavitary radiation source applic simple (77761) | $1,016.57 | $1,815.30 | 1.9× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$171.70–$207.82 | $306.60–$371.10 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$940.80–$997.25 | $1,680–$1,780.80 | varies |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$845.32–$915.04 | $1,509.50–$1,634 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$626.47–$814.41 | $1,118.70–$1,454.30 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$389.26–$506.02 | $695.10–$903.60 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$170.07–$308.39 | $303.70–$550.70 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$694.01–$735.67 | $1,239.30–$1,313.70 | varies |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$1,028.72–$1,090.43 | $1,837–$1,947.20 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,095.58–$1,161.33 | $1,956.40–$2,073.80 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 3 matching MRF lines |
$1,182.83–$1,420.89 | $2,112.20–$2,537.30 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$694.01–$735.67 | $1,239.30–$1,313.70 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$951.72–$1,008.84 | $1,699.50–$1,801.50 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$998.42–$1,717.30 | $1,782.90–$3,066.60 | varies |
| Magnetic Resonance Elastography (76391) range across 2 matching MRF lines |
$408.02–$469.22 | $728.60–$837.90 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$173.99–$244.44 | $310.70–$436.50 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$694.01–$735.67 | $1,239.30–$1,313.70 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 3 matching MRF lines |
$1,130.64–$1,892.52 | $2,019–$3,379.50 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$1,775.03–$2,780.79 | $3,169.70–$4,965.70 | varies |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$1,156.85–$2,297.79 | $2,065.80–$4,103.20 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$1,136.18–$2,642.08 | $2,028.90–$4,718 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$1,447.49–$2,520 | $2,584.80–$4,500 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 4 matching MRF lines |
$1,783.77–$2,800 | $3,185.30–$5,000 | varies |
| MRA neck w/o contrast (70547) range across 4 matching MRF lines |
$1,163.06–$2,296 | $2,076.90–$4,100 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$1,280.22–$2,501.13 | $2,286.10–$4,466.30 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$903.11–$2,411.30 | $1,612.70–$4,305.90 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,208.82–$2,824.47 | $2,158.60–$5,043.70 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,455.61–$3,530.13 | $2,599.30–$6,303.80 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$1,207.19–$2,619.79 | $2,155.70–$4,678.20 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$498.29–$690.65 | $889.80–$1,233.30 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$1,146.82–$1,318.86 | $2,047.90–$2,355.10 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$893.31–$1,106.17 | $1,595.20–$1,975.30 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$735.06–$1,919.90 | $1,312.60–$3,428.40 | varies |
| MRI cardiac w/o cont stress (75559) range across 3 matching MRF lines |
$867.38–$1,427.44 | $1,548.90–$2,549 | varies |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$677.88–$866.77 | $1,210.50–$1,547.80 | varies |
| MRI cervical spine w contrast (72142) range across 4 matching MRF lines |
$972.72–$2,578.02 | $1,737–$4,603.60 | varies |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$614.60–$2,343.60 | $1,097.50–$4,185 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,187.98–$1,807.62 | $2,121.40–$3,227.90 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$1,489.32–$1,821.23 | $2,659.50–$3,252.20 | varies |
| MRI chest wo w contrast (71552) range across 4 matching MRF lines |
$1,719.26–$2,513.39 | $3,070.10–$4,488.20 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,124.42–$2,506.56 | $2,007.90–$4,476 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,372.45–$2,741.54 | $2,450.80–$4,895.60 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$1,034.71–$1,973.78 | $1,847.70–$3,524.60 | varies |
| MRI lumbar spine w contrast (72149) range across 4 matching MRF lines |
$950.26–$2,716.17 | $1,696.90–$4,850.30 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$1,082.98–$2,735.71 | $1,933.90–$4,885.20 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$1,012.26–$2,297.79 | $1,807.60–$4,103.20 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$1,118.21–$1,821.23 | $1,996.80–$3,252.20 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$1,337.56–$2,780.79 | $2,388.50–$4,965.70 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$1,126.94–$1,792 | $2,012.40–$3,200 | varies |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$1,363.71–$2,811.20 | $2,435.20–$5,020 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$1,052.13–$2,297.79 | $1,878.80–$4,103.20 | varies |
| MRI spectroscopy (76390) range across 3 matching MRF lines |
$1,536.98–$2,051.67 | $2,744.60–$3,663.70 | varies |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$614.60–$2,774.07 | $1,097.50–$4,953.70 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$1,303.06–$1,807.62 | $2,326.90–$3,227.90 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$1,103.87–$2,297.79 | $1,971.20–$4,103.20 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$1,577.69–$2,297.79 | $2,817.30–$4,103.20 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$1,367.46–$3,090.19 | $2,441.90–$5,518.20 | varies |
| MRI, dorsal spine combo (72157) range across 4 matching MRF lines |
$1,086.29–$3,390.46 | $1,939.80–$6,054.40 | varies |
| MRI, dorsal spine contrast (72147) range across 4 matching MRF lines |
$963.09–$3,082.63 | $1,719.80–$5,504.70 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,016.79–$2,289.73 | $1,815.70–$4,088.80 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,460.42–$3,054.97 | $2,607.90–$5,455.30 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$1,079.79–$2,993.37 | $1,928.20–$5,345.30 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$608.33–$669.14 | $1,086.30–$1,194.90 | varies |
| Myelogram Lumbar (72265) | $675.02 | $1,205.40 | 0.9× |
| Myelography thoracic (72255) | $574.45 | $1,025.80 | 0.8× |
| Myelograpy 2/more regions rs&i (72270) | $1,052.46 | $1,879.40 | 1.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $158.98 | $283.90 | 0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,558.81 | $4,569.30 | 2.0× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$1,714.61–$2,706.48 | $3,061.80–$4,833 | varies |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$100.91–$181.16 | $180.20–$323.50 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,319.08 | $2,355.50 | 3.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$210.62–$223.27 | $376.10–$398.70 | varies |
| Nm myocard infarct spect (78469) | $207.42 | $370.40 | 0.4× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$278.10–$305.93 | $496.60–$546.30 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 3 matching MRF lines |
$2,107.22–$4,820.82 | $3,762.90–$8,608.60 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 3 matching MRF lines |
$453.38–$525.56 | $809.60–$938.50 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$243.54–$361.98 | $434.90–$646.40 | varies |
| Ob us nuchal meas 1 gest (76813) range across 3 matching MRF lines |
$294.45–$314.72 | $525.80–$562 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$188.61–$331.07 | $336.80–$591.20 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$32.82–$33.82 | $58.60–$60.40 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$263.76–$290.14 | $471–$518.10 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 3 matching MRF lines |
$890.23–$1,178.91 | $1,589.70–$2,105.20 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$602.67–$648.98 | $1,076.20–$1,158.90 | varies |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$123.42–$255.08 | $220.40–$455.50 | varies |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$1,000.83–$1,100.90 | $1,787.20–$1,965.90 | varies |
| Pet Image W/Ct Lmtd (78814) range across 7 matching MRF lines |
$3,612.28–$7,057.62 | $6,450.50–$12,602.90 | varies |
| PET image w/CT, full body (78816) range across 9 matching MRF lines |
$4,260.14–$7,610.85 | $7,607.40–$13,590.80 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 12 matching MRF lines |
$3,672.70–$7,606.03 | $6,558.40–$13,582.20 | varies |
| Pet Myocardial Sngl Study (78491) | $342.94 | $612.40 | 0.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$1,437.30–$1,868.72 | $2,566.60–$3,337 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $675.08 | $1,205.50 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$152.66–$389.03 | $272.60–$694.70 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$155.57–$351.68 | $277.80–$628 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$154.95–$218.46 | $276.70–$390.10 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$126.28–$221.14 | $225.50–$394.90 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$144.09–$237.78 | $257.30–$424.60 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$152.66–$233.24 | $272.60–$416.50 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$167.38–$231.95 | $298.90–$414.20 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$151.48–$289.74 | $270.50–$517.40 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$163.24–$303.58 | $291.50–$542.10 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$95.26–$139.55 | $170.10–$249.20 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$131.94–$198.46 | $235.60–$354.40 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$163.63–$224.45 | $292.20–$400.80 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$152.99–$289.13 | $273.20–$516.30 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$105.34–$116.37 | $188.10–$207.80 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 3 matching MRF lines |
$1,338.06–$1,631 | $2,389.40–$2,912.50 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$108.53–$247.41 | $193.80–$441.80 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$148.74–$256.31 | $265.60–$457.70 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$263.76–$318.64 | $471–$569 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$129.02–$199.53 | $230.40–$356.30 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$99.96–$139.55 | $178.50–$249.20 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$180.99–$309.06 | $323.20–$551.90 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $439.38 | $784.60 | 4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 4 matching MRF lines |
$23,251.14–$23,725.63 | $41,519.90–$42,367.20 | varies |
| Radiation treatment delivery level 1 (77402) range across 5 matching MRF lines |
$420–$709.02 | $750–$1,266.10 | varies |
| Radiation treatment delivery level 2 (77407) range across 5 matching MRF lines |
$709.02–$1,607.20 | $1,266.10–$2,870 | varies |
| Radiation treatment delivery level 3 (77412) range across 5 matching MRF lines |
$836.47–$2,304.96 | $1,493.70–$4,116 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 4 matching MRF lines |
$139.33–$305.14 | $248.80–$544.90 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$190.68–$334.10 | $340.50–$596.60 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$625.74–$729.06 | $1,117.40–$1,301.90 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$389.20–$538.38 | $695–$961.40 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $348.99 | $623.20 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$188.78–$327.60 | $337.10–$585 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$187.49–$280.73 | $334.80–$501.30 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$315.90–$381.64 | $564.10–$681.50 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$349.16–$453.94 | $623.50–$810.60 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$396.76–$508.82 | $708.50–$908.60 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$129.25–$256.09 | $230.80–$457.30 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$157.47–$281.79 | $281.20–$503.20 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$151.37–$271.15 | $270.30–$484.20 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$170.07–$195.44 | $303.70–$349 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$139.55–$255.08 | $249.20–$455.50 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $441.84 | $789 | 1.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $441.84 | $789 | 1.2× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$386.18–$424.82 | $689.60–$758.60 | varies |
| Ribs bilateral 3 views (71110) range across 4 matching MRF lines |
$195.22–$434.34 | $348.60–$775.60 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$595.90–$648.98 | $1,064.10–$1,158.90 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$1,113.39–$1,180.20 | $1,988.20–$2,107.50 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$1,240.79–$1,613.02 | $2,215.70–$2,880.40 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$3,872.12–$4,104.46 | $6,914.50–$7,329.40 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$1,707.89–$2,193.18 | $3,049.80–$3,916.40 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 4 matching MRF lines |
$2,428.16–$2,573.87 | $4,336–$4,596.20 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$2,288.55–$2,336.26 | $4,086.70–$4,171.90 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $516.38 | $922.10 | 2.3× |
| Rp Therapy Intravenous Administration (79101) range across 3 matching MRF lines |
$254.86–$435.79 | $455.10–$778.20 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$104.16–$148.18 | $186–$264.60 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$64.62–$115.64 | $115.40–$206.50 | varies |
| Sella turcica (70240) range across 3 matching MRF lines |
$105.34–$168.56 | $188.10–$301 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$83.50–$237.78 | $149.10–$424.60 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$288.29–$465.70 | $514.80–$831.60 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$388.42–$427.28 | $693.60–$763 | varies |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$110.38–$133 | $197.10–$237.50 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$229.10–$294.56 | $409.10–$526 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$399.56–$407.74 | $713.50–$728.10 | varies |
| Special teletherapy port plan (77321) range across 3 matching MRF lines |
$251.38–$1,128.23 | $448.90–$2,014.70 | varies |
| Special treatment procedure (77470) range across 3 matching MRF lines |
$534.97–$2,321.98 | $955.30–$4,146.40 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 4 matching MRF lines |
$5,165.78–$5,271.22 | $9,224.60–$9,412.90 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$182.90–$251.89 | $326.60–$449.80 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$1,995.11–$2,194.64 | $3,562.70–$3,919 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 3 matching MRF lines |
$764.62–$1,516.93 | $1,365.40–$2,708.80 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 3 matching MRF lines |
$369.43–$1,365.50 | $659.70–$2,438.40 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$412.94–$1,360.74 | $737.40–$2,429.90 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 3 matching MRF lines |
$285.49–$693.28 | $509.80–$1,238 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 3 matching MRF lines |
$189.39–$852.21 | $338.20–$1,521.80 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 3 matching MRF lines |
$378.67–$515.09 | $676.20–$919.80 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$145.77–$240.02 | $260.30–$428.60 | varies |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$174.10–$237.78 | $310.90–$424.60 | varies |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$151.14–$216.50 | $269.90–$386.60 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$319.03–$414.74 | $569.70–$740.60 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$894.49–$948.14 | $1,597.30–$1,693.10 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$674.24–$729.18 | $1,204–$1,302.10 | varies |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$303.02–$1,073.13 | $541.10–$1,916.30 | varies |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$198.18–$481.26 | $353.90–$859.40 | varies |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$119.67–$439.04 | $213.70–$784 | varies |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$200.37–$420.50 | $357.80–$750.90 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 3 matching MRF lines |
$188.61–$365.12 | $336.80–$652 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$243.04–$389.20 | $434–$695 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$425.21–$516.82 | $759.30–$922.90 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$217.28–$260.85 | $388–$465.80 | varies |
| Unlisted magnetic resonance procedure (76498) range across 5 matching MRF lines |
$151.42–$1,778.06 | $270.40–$3,175.10 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$304.53–$313.66 | $543.80–$560.10 | varies |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$382.98–$479.92 | $683.90–$857 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$439.04–$570.75 | $784–$1,019.20 | varies |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$396.26–$492.91 | $707.60–$880.20 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$408.86–$543.09 | $730.10–$969.80 | varies |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$250.43–$462.34 | $447.20–$825.60 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$216.38–$311.53 | $386.40–$556.30 | varies |
| Us complete joint (76881) range across 10 matching MRF lines |
$293.16–$411.71 | $523.50–$735.20 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$215.71–$249.54 | $385.20–$445.60 | varies |
| Us head (76506) range across 3 matching MRF lines |
$300.50–$402.02 | $536.60–$717.90 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$186.37–$226.91 | $332.80–$405.20 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 10 matching MRF lines |
$202.83–$313.04 | $362.20–$559 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$411.66–$843.92 | $735.10–$1,507 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$319.14–$413.22 | $569.90–$737.90 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$371.28–$449.06 | $663–$801.90 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$429.41–$567.84 | $766.80–$1,014 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$389.98–$571.54 | $696.40–$1,020.60 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$329.22–$532.39 | $587.90–$950.70 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$387.35–$526.06 | $691.70–$939.40 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$151.48–$506.30 | $270.50–$904.10 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$341.04–$474.15 | $609–$846.70 | varies |
| Us spinal canal and contents (76800) range across 4 matching MRF lines |
$439.43–$464.63 | $784.70–$829.70 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$397.99–$537.43 | $710.70–$959.70 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$346.53–$661.08 | $618.80–$1,180.50 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$229.82–$1,808.80 | $410.40–$3,230 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$5,380.48–$5,663.84 | $9,608–$10,114 | varies |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$233.80–$2,081.52 | $417.50–$3,717 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$226.91–$2,127.16 | $405.20–$3,798.50 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$297.98–$1,532.72 | $532.10–$2,737 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$279.89–$790.16 | $499.80–$1,411 | varies |
| Venography Renal Bilateral (75833) | $5,380.48 | $9,608 | 1.8× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,013.14–$2,214.46 | $3,594.90–$3,954.40 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$2,428.78–$3,157.28 | $4,337.10–$5,638 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$134.46–$147.90 | $240.10–$264.10 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$115.86–$237.78 | $206.90–$424.60 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$124.26–$210.06 | $221.90–$375.10 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$924.28–$1,126.38 | $1,650.50–$2,011.40 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$403.37–$6,335.06 | $720.30–$11,312.60 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$131.94–$235.70 | $235.60–$420.90 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$129.25–$180.38 | $230.80–$322.10 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$118.66–$772.58 | $211.90–$1,379.60 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$133.39–$280.17 | $238.20–$500.30 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$280.34–$311.08 | $500.60–$555.50 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$237.50–$336 | $424.10–$600 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$145.60–$240.24 | $260–$429 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$207.93–$332.86 | $371.30–$594.40 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$262.98–$391.89 | $469.60–$699.80 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$182.90–$364 | $326.60–$650 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$238.06–$457.86 | $425.10–$817.60 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$274.18–$560 | $489.60–$1,000 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$208.71–$463.23 | $372.70–$827.20 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$175.45–$270.20 | $313.30–$482.50 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$211.68–$397.32 | $378–$709.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$130.48–$318.19 | $233–$568.20 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$144.14–$234.81 | $257.40–$419.30 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$142.58–$242.26 | $254.60–$432.60 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$500.14–$552.72 | $893.10–$987 | varies |
| X-ray IV pyelogram+tomography (74415) range across 3 matching MRF lines |
$585.82–$1,619.35 | $1,046.10–$2,891.70 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$176.51–$338.58 | $315.20–$604.60 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$176.96–$236.82 | $316–$422.90 | varies |
| X-ray nose-rectum child f.b. (76010) range across 4 matching MRF lines |
$93.52–$268.58 | $167–$479.60 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 4 matching MRF lines |
$164.42–$478.02 | $293.60–$853.60 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$174.10–$255.19 | $310.90–$455.70 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$144.09–$254.35 | $257.30–$454.20 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 4 matching MRF lines |
$120.06–$254.41 | $214.40–$454.30 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$137.87–$246.74 | $246.20–$440.60 | varies |
| X-Ray Stress View (77071) range across 3 matching MRF lines |
$116.37–$238.45 | $207.80–$425.80 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$143.70–$216.16 | $256.60–$386 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$924.28–$1,190.34 | $1,650.50–$2,125.60 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$86.91–$198.41 | $155.20–$354.30 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$324.46–$408.24 | $579.40–$729 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$236.38–$374.92 | $422.10–$669.50 | varies |
| Xr facial bones less than 3 views (70140) | $99.46 | $177.60 | 1.2× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$152.66–$201.21 | $272.60–$359.30 | 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.