Imaging prices at Thomas Memorial Hospital
South Charleston, WV · every code in this section with a posted price and a Medicare benchmark.
391 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 2 matching MRF lines |
$4,867.50–$5,233 | $9,735–$10,466 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$395.50–$425.50 | $791–$851 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$395.50–$425.50 | $791–$851 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,231.50 | $2,463 | 3.2× |
| Angio internal mammary (75756) | $5,783.50 | $11,567 | 1.9× |
| Angio pulmonary bilat (75743) | $5,149 | $10,298 | 1.7× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$5,379.50–$5,783 | $10,759–$11,566 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$5,703–$6,131 | $11,406–$12,262 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,146.50 | $10,293 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,870 | $5,740 | 0.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$182–$364 | $364–$728 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,039.50 | $10,079 | 0.9× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$9,315.50–$10,014.50 | $18,631–$20,029 | varies |
| Artery X-Rays Pelvis (75736) | $5,039.50 | $10,079 | 0.9× |
| Artery X-Rays Spine (75705) | $5,417 | $10,834 | 1.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,238–$2,476 | $2,476–$4,952 | varies |
| Arthrogram Wrist (73115) | $667.50 | $1,335 | 2.0× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$198–$552 | $396–$1,104 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$316–$340 | $632–$680 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,119–$1,231 | $2,238–$2,462 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,119–$1,231 | $2,238–$2,462 | varies |
| Bone Imaging Multiple Areas (78305) | $1,231.50 | $2,463 | 3.2× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,119–$1,231 | $2,238–$2,462 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$315–$339 | $630–$678 | varies |
| Brachytx isodose complex (77318) | $742 | $1,484 | 2.1× |
| Brachytx isodose intermed (77317) | $742 | $1,484 | 2.1× |
| Brachytx Isodose Plan Simple (77316) | $742 | $1,484 | 2.1× |
| Brain Flow Imaging Only (78610) | $2,027.50 | $4,055 | 3.9× |
| Brain imaging < 4 static views (78600) | $821 | $1,642 | 2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,732 | $7,464 | 7.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,517.50 | $11,035 | 4.0× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$192.50–$207 | $385–$414 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$377.50–$1,132.50 | $755–$2,265 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$377.50–$406 | $755–$812 | varies |
| Chest 3 views (71047) | $386.50 | $773 | 4.6× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$359.50–$386.50 | $719–$773 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$198.50–$397 | $397–$794 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $154 | $308 | 1.5× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$292.50–$314.50 | $585–$629 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,178.50–$5,567 | $10,357–$11,134 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$681.50–$733 | $1,363–$1,466 | varies |
| Contrast X-Ray Of Elbow (73085) | $1,331.50 | $2,663 | 4.0× |
| Contrast X-Ray Of Knee Joint (73580) | $921 | $1,842 | 2.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $259.50 | $519 | 1.5× |
| Corpora cavernosography (74445) | $155 | $310 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,544.50–$1,660.50 | $3,089–$3,321 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$2,370–$2,548 | $4,740–$5,096 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$372.50–$1,916.50 | $745–$3,833 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,210–$2,376 | $4,420–$4,752 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,783.50–$1,917.50 | $3,567–$3,835 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$913.50–$982.50 | $1,827–$1,965 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$1,889.50–$2,031.50 | $3,779–$4,063 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $582 | $1,164 | 1.7× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$99–$1,781.50 | $198–$3,563 | varies |
| CT hrt w/3d image congen (75573) | $1,400 | $2,800 | 4.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$862–$1,724 | $1,724–$3,448 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,782.50–$3,565 | $3,565–$7,130 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$913.50–$982.50 | $1,827–$1,965 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$862–$927 | $1,724–$1,854 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,373–$2,551 | $4,746–$5,102 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,782.50–$1,916.50 | $3,565–$3,833 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,210–$2,376 | $4,420–$4,752 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,937.50 | $9,875 | 2.5× |
| Discography Cerv/Thor Spine (72285) | $2,126 | $4,252 | 1.1× |
| Diskography lumbar (72295) | $2,126 | $4,252 | 1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $183.50 | $367 | 1.8× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$381–$410 | $762–$820 | varies |
| Dxa bone density study (77085) | $277 | $554 | 2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$131.50–$141.50 | $263–$283 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$768–$826 | $1,536–$1,652 | varies |
| Echo Guide For Artery Repair (76936) | $526.50 | $1,053 | 2.5× |
| Echograp Trans R Pros Study (76873) | $350.50 | $701 | 3.5× |
| Esophagram (74220) range across 2 matching MRF lines |
$521–$560.50 | $1,042–$1,121 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$449.50–$575.50 | $899–$1,151 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$158.50–$442.50 | $317–$885 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$558.50–$600.50 | $1,117–$1,201 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$182–$392 | $364–$784 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$198.50–$213.50 | $397–$427 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,119.50–$1,231.50 | $2,239–$2,463 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,231.50 | $2,463 | 3.2× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,324–$1,456.50 | $2,648–$2,913 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$198.50–$427 | $397–$854 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,047 | $2,094 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,047 | $2,094 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,047 | $2,094 | 1.6× |
| Heart Image (Pet) Multiple (78492) | $3,980.50 | $7,961 | 2.9× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,287.50–$1,416.50 | $2,575–$2,833 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$1,287.50–$1,416.50 | $2,575–$2,833 | varies |
| Ht Musc Image Planar Mult (78454) | $4,385.50 | $8,771 | 3.5× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,567.50–$2,824.50 | $5,135–$5,649 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$682–$733.50 | $1,364–$1,467 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$353.50–$380.50 | $707–$761 | varies |
| Infant hip ultrasound, limited static exam (76886) | $303.50 | $607 | 3.6× |
| Infusion Ivp (74410) | $599 | $1,198 | 3.6× |
| Interstitial radiation source applic complex (77778) | $1,047.50 | $2,095 | 1.6× |
| Intraop radiaj tx deliver xray single tx session (77424) | $11,366 | $22,732 | 1.6× |
| Joint Survey Single View (77077) | $159 | $318 | 1.6× |
| K Flow/Funct Image Multiple (78709) | $1,586 | $3,172 | 3.0× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,442–$1,586.50 | $2,884–$3,173 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$1,441.50–$1,586 | $2,883–$3,172 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,586.50 | $3,173 | 4.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$292–$584 | $584–$1,168 | varies |
| Leveen/Shunt Patency Exam (78291) | $944 | $1,888 | 2.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,416.50 | $2,833 | 3.7× |
| Liver imaging static only (78201) | $2,825 | $5,650 | 5.4× |
| Lung Perf&Ventilat Diferentl (78598) | $1,639 | $3,278 | 3.1× |
| Lung perfusion differential (78597) | $1,164 | $2,328 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,490–$1,639 | $2,980–$3,278 | varies |
| Lung Ventilation Imaging (78579) | $1,164 | $2,328 | 3.0× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$297–$1,103 | $594–$2,206 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,748–$1,879.50 | $3,496–$3,759 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $247.50 | $495 | 1.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $742.50 | $1,485 | 1.4× |
| Mammary ductogram or galactogram multiple (77054) | $468 | $936 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $468 | $936 | 2.0× |
| Meckels Divert Exam (78290) | $1,231.50 | $2,463 | 3.2× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$2,881–$3,097.50 | $5,762–$6,195 | varies |
| Mr safety determination physician/other qhp (76016) | $292.50 | $585 | 3.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $30 | $60 | 1.1× |
| Mr safety implt pos&/immoblj (76019) | $72.50 | $145 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $111.50 | $223 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$2,849.50–$3,063.50 | $5,699–$6,127 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,730–$1,860 | $3,460–$3,720 | varies |
| MRA head with contrast (70545) | $3,062 | $6,124 | 9.1× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$2,849–$3,063 | $5,698–$6,126 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,848.50–$3,062.50 | $5,697–$6,125 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$1,730–$1,860 | $3,460–$3,720 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,876.50–$3,092.50 | $5,753–$6,185 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,747–$1,878.50 | $3,494–$3,757 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,166–$3,403.50 | $6,332–$6,807 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,438–$2,175 | $2,876–$4,350 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,172.50–$3,503 | $4,345–$7,006 | varies |
| MRI bone marrow blood supply (77084) | $1,672.50 | $3,345 | 7.3× |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$1,688.50–$2,583.50 | $3,377–$5,167 | varies |
| MRI cervical spine w contrast (72142) | $3,063 | $6,126 | 9.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,730.50–$1,860.50 | $3,461–$3,721 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,746.50–$1,877.50 | $3,493–$3,755 | varies |
| MRI chest with contrast (71551) | $3,092.50 | $6,185 | 4.1× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,873–$3,088.50 | $5,746–$6,177 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,672.50 | $3,345 | 5.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,875–$3,091.50 | $5,750–$6,183 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,746.50–$1,877.50 | $3,493–$3,755 | varies |
| MRI lumbar spine w contrast (72149) | $3,091.50 | $6,183 | 9.2× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,848–$3,062 | $5,696–$6,124 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$1,730.50–$1,860.50 | $3,461–$3,721 | varies |
| MRI orbit face neck w contrast (70542) | $3,063 | $6,126 | 9.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,848–$3,062 | $5,696–$6,124 | varies |
| MRI pelvis w contrast (72196) | $3,092.50 | $6,185 | 9.2× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,875–$3,091 | $5,750–$6,182 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,746.50–$1,877.50 | $3,493–$3,755 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,746.50–$1,877.50 | $3,493–$3,755 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$2,876–$3,092 | $5,752–$6,184 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,746.50–$1,877.50 | $3,493–$3,755 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,875–$3,091 | $5,750–$6,182 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,874.50–$3,090.50 | $5,749–$6,181 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,875.50–$3,091.50 | $5,751–$6,183 | varies |
| MRI, dorsal spine contrast (72147) | $3,091.50 | $6,183 | 9.2× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,746.50–$3,755 | $3,493–$7,510 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,876–$3,092 | $5,752–$6,184 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,875.50–$3,091.50 | $5,751–$6,183 | varies |
| Myelogram cervical (72240) | $1,609 | $3,218 | 2.1× |
| Myelogram Lumbar (72265) | $1,609 | $3,218 | 2.1× |
| Myelography thoracic (72255) | $761.50 | $1,523 | 1.0× |
| Myelograpy 2/more regions rs&i (72270) | $1,609 | $3,218 | 2.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,986.50–$4,385.50 | $7,973–$8,771 | varies |
| N-invas est c ffr sw aly CTA (75580) | $3,236 | $6,472 | 3.9× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$210.50–$226.50 | $421–$453 | varies |
| Nm csf leak detection (78650) | $2,824.50 | $5,649 | 2.3× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$201–$216.50 | $402–$433 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,532.50–$2,722.50 | $5,065–$5,445 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$926.50–$1,019.50 | $1,853–$2,039 | varies |
| Ob us nuchal meas 1 gest (76813) | $304 | $608 | 3.0× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $453.50 | $907 | 4.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $314.50 | $629 | 3.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $338.50 | $677 | 3.4× |
| Optic foramina (70190) | $234.50 | $469 | 2.8× |
| Panoramic X-ray of jaws (70355) | $143.50 | $287 | 1.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$733.50–$807 | $1,467–$1,614 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$778.50–$864.50 | $1,557–$1,729 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$250–$269 | $500–$538 | varies |
| Perineogram (74775) | $545.50 | $1,091 | 2.4× |
| Pet Image Skull-Thigh (78812) | $3,980.50 | $7,961 | 2.9× |
| Pet Image W/Ct Lmtd (78814) | $3,647.50 | $7,295 | 2.7× |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$3,393–$3,960.50 | $6,786–$7,921 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,393–$4,083 | $6,786–$8,166 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,199.50 | $2,399 | 1.0× |
| Pet Myocardial Sngl Study (78491) | $2,284 | $4,568 | 1.7× |
| PET whole body (78813) | $1,490.50 | $2,981 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,164 | $2,328 | 3.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,069.50 | $2,139 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$262–$282 | $524–$564 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,332 | $2,664 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$202.50–$405 | $405–$810 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$198.50–$213.50 | $397–$427 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$210.50–$421 | $421–$842 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$198.50–$397 | $397–$794 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$202.50–$405 | $405–$810 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$202.50–$405 | $405–$810 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$212–$424 | $424–$848 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $339.50 | $679 | 3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$210–$226 | $420–$452 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $557 | $1,114 | 6.7× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$229.50–$247 | $459–$494 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$269–$538 | $538–$1,076 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$207.50–$223.50 | $415–$447 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,014.50 | $2,029 | 6.0× |
| Radex Spine 1 View Specify Level (72020) | $160.50 | $321 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$212–$228 | $424–$456 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $275 | $550 | 3.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$193.50–$208.50 | $387–$417 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $678 | $1,356 | 6.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$198.50–$427 | $397–$854 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$214–$230.50 | $428–$461 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,365.50 | $22,731 | 1.6× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$936.50–$1,198.50 | $1,873–$2,397 | varies |
| Radiation treatment delivery level 2 (77407) | $1,198.50 | $2,397 | 3.2× |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$469–$1,534 | $938–$3,068 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$315.50–$339.50 | $631–$679 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $425.50 | $851 | 4.2× |
| Radiologic exam colon double contrast study (74280) | $733 | $1,466 | 4.4× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$521–$560.50 | $1,042–$1,121 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$1,496.50–$1,609 | $2,993–$3,218 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$526–$1,052 | $1,052–$2,104 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$315.50–$339.50 | $631–$679 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$373.50–$402 | $747–$804 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$346–$372 | $692–$744 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$439–$472 | $878–$944 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$383.50–$412.50 | $767–$825 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$193.50–$417 | $387–$834 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$185.50–$399 | $371–$798 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $254.50 | $509 | 2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $128 | $256 | 1.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$198.50–$397 | $397–$794 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $117 | $234 | 1.4× |
| Renal Cyst Study (74470) | $1,087 | $2,174 | 2.1× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,455.50 | $2,911 | 3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,277 | $2,554 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,399.50 | $8,799 | 8.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,824 | $5,648 | 5.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,270.50–$2,498 | $4,541–$4,996 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,967 | $5,934 | 2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,363.50 | $6,727 | 2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,184 | $2,368 | 1.0× |
| Rp Therapy Intravenous Administration (79101) | $1,939.50 | $3,879 | 8.7× |
| Scapula (73010) range across 3 matching MRF lines |
$205–$410 | $410–$820 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$697.50–$750 | $1,395–$1,500 | varies |
| Sella turcica (70240) | $191 | $382 | 2.3× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$182–$196 | $364–$392 | varies |
| Shoulder Arthrography (73040) | $1,331 | $2,662 | 4.0× |
| Sialogram (70390) | $704.50 | $1,409 | 3.1× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$598–$643 | $1,196–$1,286 | varies |
| Special dosimetry (77331) | $368 | $736 | 2.9× |
| Special Physics Consult (77370) range across 3 matching MRF lines |
$389.50–$419 | $779–$838 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$690–$742 | $1,380–$1,484 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,115–$1,199 | $2,230–$2,398 | varies |
| Srs Multisource (77371) | $11,366 | $22,732 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$3,759.50–$4,041.50 | $7,519–$8,083 | varies |
| Sternoclavicular joints (71130) | $269 | $538 | 3.2× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $117.50 | $235 | 1.2× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $117.50 | $235 | 1.2× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $43 | $86 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$690–$742 | $1,380–$1,484 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $741.50 | $1,483 | 2.1× |
| Testicular Imaging W/Flow (78761) | $1,586 | $3,172 | 4.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$973.50–$1,047 | $1,947–$2,094 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $742 | $1,484 | 2.1× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$583.50–$627.50 | $1,167–$1,255 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $433.50 | $867 | 2.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$193.50–$208.50 | $387–$417 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $821 | $1,642 | 2.1× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,322.50–$1,455 | $2,645–$2,910 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$992–$1,091.50 | $1,984–$2,183 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$731–$2,193 | $1,462–$4,386 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$487.50–$524.50 | $975–$1,049 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$310–$333.50 | $620–$667 | varies |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$173.50–$1,129 | $347–$2,258 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$62–$134.50 | $124–$269 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$271.50–$380 | $543–$760 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$661.50–$712 | $1,323–$1,424 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$217.50–$268 | $435–$536 | varies |
| Unlisted fluoroscopic procedure (76496) | $649.50 | $1,299 | 7.8× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$210.50–$425 | $421–$850 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$682–$733.50 | $1,364–$1,467 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$527.50–$596 | $1,055–$1,192 | varies |
| Us bone density measurement (76977) | $161 | $322 | 1.6× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$294.34–$883 | $588.67–$1,766 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$442–$475.50 | $884–$951 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$282.50–$662 | $565–$1,324 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$442–$475.50 | $884–$951 | varies |
| Us head (76506) range across 2 matching MRF lines |
$673.50–$724.50 | $1,347–$1,449 | varies |
| Us kidney transplant (76776) | $470.50 | $941 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$358.41–$818 | $716.81–$1,636 | varies |
| Us ob detailed single fetus (76811) | $749 | $1,498 | 3.3× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$282.50–$475 | $565–$950 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$442–$475.50 | $884–$951 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$661.50–$711.50 | $1,323–$1,423 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$530–$570 | $1,060–$1,140 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$336.50–$565 | $673–$1,130 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$530–$570 | $1,060–$1,140 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$353–$430.50 | $706–$861 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$441.50–$475 | $883–$950 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$487.50–$524.50 | $975–$1,049 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$495–$532.50 | $990–$1,065 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$244.50–$263 | $489–$526 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,642–$2,840.50 | $5,284–$5,681 | varies |
| Vein X-Ray Spleen/Liver (75810) | $2,870 | $5,740 | 0.9× |
| Venogram Sinus/Jugular (75860) | $2,870 | $5,740 | 0.9× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$2,669.50–$2,870 | $5,339–$5,740 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,642–$2,840.50 | $5,284–$5,681 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,297–$2,469.50 | $4,594–$4,939 | varies |
| Venography Renal Unilateral (75831) | $3,157 | $6,314 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $352.50 | $705 | 4.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$182–$196 | $364–$392 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$197–$212 | $394–$424 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,332 | $2,664 | 4.0× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$5,132.50–$5,517.50 | $10,265–$11,035 | varies |
| X-Ray Bend Only L-S Spine (72120) | $637.50 | $1,275 | 6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$193.50–$208.50 | $387–$417 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,126–$1,210.50 | $2,252–$2,421 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$263.50–$283.50 | $527–$567 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$529–$569 | $1,058–$1,138 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$197–$231.50 | $394–$463 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$197–$212 | $394–$424 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$324–$348.50 | $648–$697 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$215–$262 | $430–$524 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$216.50–$240 | $433–$480 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$216.50–$233 | $433–$466 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$96–$288 | $192–$576 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$594–$639 | $1,188–$1,278 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$598–$643 | $1,196–$1,286 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$357.50–$384.50 | $715–$769 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$395.50–$425.50 | $791–$851 | varies |
| X-ray head for orthodontia (70350) | $117 | $234 | 1.4× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$182–$364 | $364–$728 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$241–$550.50 | $482–$1,101 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $339.50 | $679 | 4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$193.50–$208.50 | $387–$417 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$598–$643 | $1,196–$1,286 | varies |
| X-ray nose-rectum child f.b. (76010) | $359 | $718 | 4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$323–$347.50 | $646–$695 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$407.50–$438.50 | $815–$877 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $265 | $530 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$197–$212 | $394–$424 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$324.50–$349 | $649–$698 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$333–$358 | $666–$716 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$317.50–$341.50 | $635–$683 | varies |
| X-Ray Tmj Unilat (70328) | $117 | $234 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$1,238.50–$1,331.50 | $2,477–$2,663 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$236.50–$254.50 | $473–$509 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$549.50–$591 | $1,099–$1,182 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$333–$358 | $666–$716 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$258.50–$278 | $517–$556 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $234.50 | $469 | 2.3× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$315.50–$339.50 | $631–$679 | 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.