Imaging prices at Trinity Health Ann Arbor
Ypsilanti, MI · every code in this section with a posted price and a Medicare benchmark.
369 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) | $2,932.80 | $4,512 | 2.1× |
| Abdomen 1 View (74018) | $203.45 | — | 2.3× |
| Abdomen 2 views (74019) | $208.65 | $321 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,109.55 | $1,707 | 2.8× |
| Angio internal mammary (75756) | $2,060.50 | $3,170 | 0.7× |
| Angio pulmonary bilat (75743) | $3,025.10 | $4,654 | 1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,033.85 | $3,129 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $3,293.55 | $5,067 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,195.70 | $3,378 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,016.95 | $3,103 | 0.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$399.75–$466.05 | — | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,713.75 | $4,175 | 0.5× |
| Artery X-Rays Abdomen (75726) | $36,067.33 | — | 6.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,332.20 | $3,588 | 0.4× |
| Artery X-Rays Spine (75705) | $32,544.58 | — | 5.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$345.15–$518.05 | $531–$797 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$312.65–$468.65 | $481–$721 | varies |
| Basic radiation dosimetry calculation (77300) | $30,424.55 | — | 226.3× |
| Bone age studies (77072) | $112.45 | $173 | 1.1× |
| Bone Imaging 3 Phase (78315) | $1,462.50 | $2,250 | 3.7× |
| Bone Imaging Limited Area (78300) | $678.60 | $1,044 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $822.25 | $1,265 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,446.25 | $2,225 | 3.6× |
| Bone marrow imaging limited area (78102) | $444.60 | $684 | 1.1× |
| Bone survey infant (77076) | $169 | $260 | 1.6× |
| Brachytx isodose complex (77318) | $1,698.45 | $2,613 | 4.5× |
| Brachytx isodose intermed (77317) | $1,663.35 | $2,559 | 4.4× |
| Brachytx Isodose Plan Simple (77316) | $1,353.95 | $2,083 | 3.6× |
| Brain Flow Imaging Only (78610) | $531.70 | $818 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $975 | $1,500 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,230.50 | $4,970 | 2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,554.15 | $2,391 | 4.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,592.50 | $2,450 | 2.0× |
| Cat Scan Follow-Up Study (76380) | $536.90 | $826 | 6.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $971.10 | $1,494 | 1.8× |
| Cerebrospinal Fluid Scan (78630) | $968.50 | $1,490 | 1.8× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$162.50–$17,413.66 | — | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$237.90–$343.20 | — | varies |
| Chest 3 views (71047) | $244.40 | $376 | 2.8× |
| Chest 4 or more views (71048) | $248.95 | $383 | 2.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $208 | $320 | 2.0× |
| Clavicle complete (73000) range across 18 matching MRF lines |
$215.80–$323.70 | $332–$498 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $488.80 | $752 | 4.7× |
| Continuing medical physics consltj pr wk (77336) | $30,424.55 | — | 226.3× |
| Contrast Exam Abdominl Aorta (75625) | $1,781 | $2,740 | 0.6× |
| Contrast X-Ray Bladder (74430) | $345.15 | $531 | 1.0× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$318.50–$477.75 | $490–$735 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,025.45 | $6,193 | 11.5× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$3,398.85–$3,539.22 | — | varies |
| CT abdomen w contrast (74160) | $2,048.80 | $3,152 | 11.7× |
| CT abdomen w wo contrast (74170) | $2,169.05 | $3,337 | 12.4× |
| CT abdomen w/o contrast (74150) | $1,688.70 | $2,598 | 16.1× |
| CT Angio Abdomen and Pelvis (74174) | $5,551.97 | — | 15.9× |
| CT Angio Chest (71275) | $3,210.67 | — | 18.3× |
| CT Angio Head (70496) | $5,555.87 | — | 31.7× |
| CT angio hrt w/3d image (75574) | $3,462 | $3,462 | 9.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$1,510.60–$2,265.90 | $2,324–$3,486 | varies |
| CT Angio Neck (70498) | $5,555.87 | — | 31.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,160.25 | $1,785 | 6.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $995.15 | $1,531 | 5.7× |
| CT cervical spine w/ contrast (72126) | $1,805.05 | $2,777 | 5.2× |
| CT cervical spine w/o contrast (72125) | $1,677 | $2,580 | 16.0× |
| CT cervical spine w/wo cont (72127) | $1,840.80 | $2,832 | 10.5× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$4,170.72–$6,148.67 | — | varies |
| CT chest w/wo contrast (71270) | $2,029.30 | $3,122 | 11.6× |
| CT colonography screening (74263) | $1,087 | $1,087 | 4.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,420.90 | $2,186 | 8.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,262.95 | $1,943 | 12.1× |
| CT head/brain with contrast (70460) | $1,775.15 | $2,731 | 10.1× |
| CT head/brain without and with contrast (70470) | $1,942.85 | $2,989 | 11.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,622.40 | $2,496 | 4.6× |
| CT iac w contrast (70481) | $1,520.02 | — | 8.7× |
| CT l-spine w&w/o contrast (72133) | $1,963.65 | $3,021 | 11.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,368.25–$2,397.85 | — | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,378–$2,067.65 | $2,120–$3,181 | varies |
| CT lumbar spine w contrast (72132) | $1,922.70 | $2,958 | 5.5× |
| CT lumbar spine w/o contrast (72131) | $1,687.40 | $2,596 | 16.1× |
| CT maxillofacial w contrast (70487) | $1,909.70 | $2,938 | 10.9× |
| CT maxillofacial wo contrast (70486) | $1,801.15 | $2,771 | 17.2× |
| CT neck tissue combo (70492) | $2,137.85 | $3,289 | 12.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,368.90 | $2,106 | 7.8× |
| CT orbits w/o contrast (70480) | $1,260.35 | — | 12.1× |
| CT pelvis w&w/o contrast (72194) | $1,794.65 | $2,761 | 10.2× |
| CT pelvis w/o contrast (72192) | $1,313.65 | $2,021 | 12.6× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,428.05–$2,143.05 | $2,197–$3,297 | varies |
| CT scans face/jaw combo (70488) | $1,938.95 | $2,983 | 11.1× |
| CT soft tissue neck w contrast (70491) | $2,156.37 | — | 12.3× |
| CT soft tissue neck w/o contrast (70490) | $1,501.50 | $2,310 | 14.4× |
| CT thoracic spine w contrast (72129) | $1,812.85 | $2,789 | 10.3× |
| CT thoracic spine w/o contrast (72128) | $1,703 | $2,620 | 16.3× |
| CT thoracic spine w/wo cont (72130) | $1,881.75 | $2,895 | 10.7× |
| CT thorax w/o contrast (71250) | $1,580.80 | $2,432 | 15.1× |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$1,309.10–$1,963.65 | $2,014–$3,021 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,411.15–$2,117.05 | $2,171–$3,257 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$1,385.80–$2,078.05 | $2,132–$3,197 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,169.05 | $3,337 | 12.4× |
| Cta Abdomen (74175) | $1,915.55 | $2,947 | 10.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $5,395 | $8,300 | 15.5× |
| CTA pelvis (72191) | $1,763.45 | $2,713 | 10.1× |
| Dilation ureters/urethra rs&i (74485) | $1,849.25 | $2,845 | 0.9× |
| Diskography lumbar (72295) | $1,759.55 | $2,707 | 0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $202.15 | $311 | 1.9× |
| Dxa Bone Density Axial (77080) | $466.70 | $718 | 4.5× |
| Dxa bone density study (77085) | $474.50 | $730 | 4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $106.60 | $164 | 1.2× |
| Echo exam uterus (76831) | $255.45 | $393 | 1.1× |
| Echograp Trans R Pros Study (76873) | $295.75 | $455 | 2.8× |
| Esophagram (74220) | $289.25 | $445 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $362.70 | $558 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $180.05 | $277 | 1.7× |
| Fluoroscopy up to 1 hr (76000) | $248.30 | $382 | 1.0× |
| Follow-Up Angiography (75898) | $3,152.50 | $4,850 | 1.0× |
| Foot 2 views (73620) range across 12 matching MRF lines |
$158.60–$237.90 | $244–$366 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$178.75–$378.95 | — | varies |
| Gastric emptying imaging study (78264) | $971.10 | $1,494 | 2.4× |
| Gated Heart Planar Single (78472) | $861.90 | $1,326 | 2.2× |
| Hand 2 views (73120) range across 12 matching MRF lines |
$156.65–$234 | $241–$360 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,682.60 | $7,204 | 6.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,319.55 | $5,107 | 4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,892.50 | $4,450 | 4.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,154.40 | $1,776 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,120.60 | $1,724 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,240.85 | $1,909 | 2.3× |
| Hepatobiliary System Imaging (78226) | $988 | $1,520 | 2.5× |
| Ht Musc Image Planar Mult (78454) | $1,343.55 | $2,067 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $1,125.80 | $1,732 | 0.9× |
| Hysterosalpingogram (74740) | $475.15 | $731 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $300.95 | $463 | 3.5× |
| Infant hip ultrasound, limited static exam (76886) | $287.95 | $443 | 3.3× |
| Interstitial radiation source applic complex (77778) | $1,919.45 | $2,953 | 2.8× |
| K Flow/Funct Image Multiple (78709) | $941.20 | $1,448 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $626.60 | $964 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $825.50 | $1,270 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $734.50 | $1,130 | 1.8× |
| Knee 3 Views (73562) range across 18 matching MRF lines |
$178.75–$268.45 | $275–$413 | varies |
| Liver & Spleen Imaging Static Only (78215) | $546 | $840 | 1.4× |
| Lung Perf&Ventilat Diferentl (78598) | $873.60 | $1,344 | 1.6× |
| Lung perfusion differential (78597) | $680.55 | $1,047 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $919.75 | $1,415 | 1.7× |
| Lung Ventilation Imaging (78579) | $567.45 | $873 | 1.4× |
| Lymph System Imaging (78195) | $955.50 | $1,470 | 1.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $989.95 | $1,523 | 0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) | $659.75 | $1,015 | 1.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,848.35 | $7,459 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,231.80 | $4,972 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $1,521 | $2,340 | 6.4× |
| Magnetic Resonance Elastography (76391) | $399.75 | $615 | 1.7× |
| Meckels Divert Exam (78290) | $936 | $1,440 | 2.3× |
| Mlc imrt design & construction per imrt plan (77338) | $35,308.65 | — | 94.3× |
| Mra Head W/O & W/Contrast Material (70546) | $2,471.30 | $3,802 | 7.1× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,732.90–$5,208.45 | — | varies |
| MRA head with contrast (70545) | $1,779.70 | $2,738 | 5.1× |
| MRA neck w contrast (70548) | $1,501.50 | $2,310 | 4.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,867.45 | $2,873 | 5.4× |
| MRA neck w/o contrast (70547) | $889.85 | $1,369 | 3.7× |
| MRI abdomen w contrast (74182) | $2,340 | $3,600 | 6.7× |
| MRI abdomen w/o contrast (74181) | $2,047.50 | $3,150 | 8.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,656.55–$3,985.15 | $4,087–$6,131 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$2,704.65–$4,057.30 | $4,161–$6,242 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,805.78–$3,806.14 | — | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,087.80 | $3,212 | 8.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,391.65 | $2,141 | 5.8× |
| MRI cardiac w/o contrast (75557) | $734.50 | $1,130 | 3.1× |
| MRI cervical spine w contrast (72142) | $3,022.50 | $4,650 | 8.7× |
| MRI cervical spine w/o cont (72141) | $2,969.85 | $4,569 | 12.4× |
| MRI chest w/o contrast (71550) | $1,749.15 | $2,691 | 7.3× |
| MRI chest wo w contrast (71552) | $2,983.50 | $4,590 | 8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,765.75–$4,148.95 | $4,255–$6,383 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,050.75–$3,075.80 | $3,155–$4,732 | varies |
| MRI lumbar spine w contrast (72149) | $3,022.50 | $4,650 | 8.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,932.85 | $7,589 | 14.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,696.50 | $2,610 | 7.1× |
| MRI orbit face neck w contrast (70542) | $2,052.70 | $3,158 | 5.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,998.45 | $4,613 | 8.6× |
| MRI pelvis w contrast (72196) | $2,025.40 | $3,116 | 5.8× |
| MRI pelvis w/o & w contrast (72197) | $3,175.25 | $4,885 | 9.1× |
| MRI pelvis w/o contrast (72195) | $1,929.85 | $2,969 | 8.1× |
| MRI thoracic spine w/o contrast (72146) | $2,969.85 | $4,569 | 12.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,748.50–$2,622.75 | $2,690–$4,035 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,085.20–$3,127.80 | $3,208–$4,812 | varies |
| MRI, abdomen, combo (74183) | $3,871.40 | $5,956 | 11.1× |
| MRI, dorsal spine combo (72157) | $4,932.85 | $7,589 | 14.1× |
| MRI, dorsal spine contrast (72147) | $3,022.50 | $4,650 | 8.7× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$2,581.80–$3,871.40 | $3,972–$5,956 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,629.25–$3,944.20 | $4,045–$6,068 | varies |
| MRI, lumbar spine combo (72158) | $4,932.85 | $7,589 | 14.1× |
| Myelogram cervical (72240) | $875.55 | $1,347 | 1.1× |
| Myelogram Lumbar (72265) | $849.55 | $1,307 | 1.1× |
| Myelography thoracic (72255) | $849.55 | $1,307 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,051.05 | $1,617 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,088.75 | $1,675 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $3,361.15 | $5,171 | 2.6× |
| N-invas est c ffr sw aly CTA (75580) | $3,403.40 | $5,236 | 4.0× |
| Neck soft tissue (70360) | $211.90 | $326 | 2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $308.10 | $474 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $297.70 | $458 | 2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,797.35 | $8,919 | 4.2× |
| Nuclear Rx Oral Admin (79005) | $819 | $1,260 | 3.5× |
| Ob us nuchal meas 1 gest (76813) | $275.60 | $424 | 2.6× |
| Panoramic X-ray of jaws (70355) | $133.25 | $205 | 1.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,260.35 | $1,939 | 2.3× |
| Parathyroid Planar Imaging (78070) | $822.25 | $1,265 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $991.90 | $1,526 | 2.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$164.45–$555.10 | — | varies |
| Peritoneogram Rs&I (74190) | $576.55 | $887 | 1.1× |
| Pet Image W/Ct Lmtd (78814) | $2,984.15 | $4,591 | 2.1× |
| PET image w/CT, full body (78816) | $3,705 | $5,700 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,662.10 | $5,634 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $832 | $1,280 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $352.95 | $543 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $439.40 | $676 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$213.20–$616.20 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$120.90–$181.35 | $186–$279 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$213.85–$672.10 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $259.35 | $399 | 2.5× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$89.05–$133.25 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$193.05–$566.80 | — | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$216.45–$755.95 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$81.25–$121.55 | $125–$187 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$124.80–$187.20 | $192–$288 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $162.50 | $250 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $198.25 | $305 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$234–$579.80 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $84.50 | $130 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $206.05 | $317 | 2.4× |
| Radex Sternum Minimum 2 Views (71120) | $190.45 | $293 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $109.20 | $168 | 1.3× |
| Radex Toe Minimum 2 Views (73660) range across 15 matching MRF lines |
$67.60–$101.40 | $104–$156 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$106.60–$160.55 | $164–$247 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$200.20–$624.65 | — | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $345.15 | $531 | 3.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $19,262.10 | $29,634 | 2.6× |
| Radiation treatment delivery level 1 (77402) | $1,088.75 | $1,675 | 10.7× |
| Radiation treatment delivery level 2 (77407) | $3,332.55 | $5,127 | 8.6× |
| Radiation treatment delivery level 3 (77412) | $19,758.70 | — | 35.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $185.90 | $286 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $217.75 | $335 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $640.25 | $985 | 3.6× |
| Radiologic exam colon single contrast study (74270) | $370.50 | $570 | 2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $325.65 | $501 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 12 matching MRF lines |
$197.60–$297.05 | $304–$457 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $183.95 | $283 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $279.50 | $430 | 1.6× |
| Radiologic exam swallow function contrast study (74230) | $382.20 | $588 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $253.50 | $390 | 1.4× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$81.90–$123.50 | $126–$190 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 15 matching MRF lines |
$214.50–$321.10 | $330–$494 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$232.05–$38,303.82 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $163.80 | $252 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$312–$655.85 | — | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $540.80 | $832 | 1.4× |
| Ribs bilateral 3 views (71110) | $339.30 | $522 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $768.95 | $1,183 | 1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $792.35 | $1,219 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,886.30 | $2,902 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,314.30 | $2,022 | 2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,132.95 | $1,743 | 2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,566.50 | $2,410 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,661.40 | $2,556 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $801.45 | $1,233 | 3.4× |
| Scapula (73010) range across 9 matching MRF lines |
$159.90–$239.85 | $246–$369 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$317.20–$462.15 | — | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$36,620.84–$37,562.82 | — | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$356.85–$535.60 | $549–$824 | varies |
| Skull less than 4 views (70250) | $105.30 | $162 | 1.0× |
| Special dosimetry (77331) | $206.70 | $318 | 1.5× |
| Special Physics Consult (77370) | $778.05 | $1,197 | 5.8× |
| Special teletherapy port plan (77321) | $1,304.55 | $2,007 | 3.5× |
| Special treatment procedure (77470) | $3,261.70 | $5,018 | 5.9× |
| Stereotactic Body Radiation Delivery (77373) | $11,771.50 | $18,110 | 6.6× |
| Sternoclavicular joints (71130) | $206.05 | $317 | 2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,412.80 | $3,712 | 6.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $315.25 | $485 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,725.10 | $2,654 | 4.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,179.75 | $1,815 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $762.45 | $1,173 | 5.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $387.40 | $596 | 2.2× |
| Thoracic spine 2 views (72070) | $179.40 | $276 | 1.7× |
| Thoracic spine 3 views (72072) | $274.95 | $423 | 2.6× |
| Thoracolumbar 2 views (72080) | $98.15 | $151 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $606.45 | $933 | 1.5× |
| Thyroid Met Imaging Body (78018) | $928.85 | $1,429 | 1.7× |
| Thyroid Uptake Measurement (78012) | $345.15 | $531 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $755.95 | $1,163 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $1,134.90 | $1,746 | 3.0× |
| Tx devices design & construction intermediate (77333) | $553.15 | $851 | 4.1× |
| Tx devices design & construction simple (77332) | $16,996.85 | — | 126.4× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$380.90–$572 | $586–$880 | varies |
| Ultrasound Exam Aaa Screen (76706) | $209.95 | $323 | 2.0× |
| Ultrasound, abdomen limited (76705) | $622.70 | — | 6.0× |
| Umbilical-artery Doppler (OB) (76820) | $275.60 | $424 | 2.6× |
| Unlisted fluoroscopic procedure (76496) | $895.70 | $1,378 | 10.3× |
| Upper gi w/o kub (74240) | $245.70 | $378 | 1.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $243.75 | $375 | 22.0× |
| Urea breath test c-14 isotopic analysis (78268) | $261.95 | $403 | 2.8× |
| Urethrocystogram voiding (74455) | $306.80 | $472 | 1.3× |
| Urethrocystography retrograde (74450) | $374.40 | $576 | 1.6× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$387.40–$581.10 | $596–$894 | varies |
| Us chest (76604) | $324.35 | $499 | 3.1× |
| Us complete joint (76881) | $548.60 | $844 | 5.2× |
| Us exam, pelvic, limited (76857) | $166.40 | $256 | 1.6× |
| Us head (76506) | $436.80 | $672 | 4.2× |
| Us kidney transplant (76776) | $432.25 | $665 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $371.15 | $571 | 3.5× |
| Us ob detailed single fetus (76811) | $792.35 | $1,219 | 3.3× |
| Us ob limited 1 or more fetuses (76815) | $383.50 | $590 | 3.7× |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$434.85–$1,023.10 | — | varies |
| Us pelvic non ob complete (76856) | $1,508.65 | — | 14.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$680.55–$1,005.55 | — | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $218.40 | $336 | 2.1× |
| Us retroperitoneal complete (76770) | $755.95 | — | 7.2× |
| Us retroperitoneal limited (76775) | $351 | — | 3.4× |
| Us scrotum and contents (76870) | $537.55 | — | 5.1× |
| Us spinal canal and contents (76800) | $295.75 | $455 | 2.8× |
| Us thyroid (76536) | $546 | — | 5.2× |
| Us transrectal (76872) | $403 | $620 | 3.9× |
| Vein X-Ray Chest (75827) | $1,918.15 | $2,951 | 1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,077.05 | $1,657 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,154.40 | $1,776 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,234.70 | $3,438 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $967.20 | $1,488 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $644.80 | $992 | 0.4× |
| Venography Renal Unilateral (75831) | $1,154.40 | $1,776 | 0.4× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$1,864.20 | $2,868 | 0.3× |
| Vertebral fracture assessment via dxa (77086) | $119.60 | $184 | 1.4× |
| Wrist 2 views (73100) range across 15 matching MRF lines |
$153.40–$230.75 | $236–$355 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $217.10 | $334 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $683.80 | $1,052 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) | $1,764.10 | $2,714 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $141.05 | $217 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$312.65–$763.10 | — | varies |
| X-Ray Exam Breast Specimen (76098) | $16,323.74 | — | 29.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $111.15 | $171 | 1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $165.10 | $254 | 1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $291.20 | $448 | 2.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $32,962.38 | — | 378.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$144.95–$559.65 | — | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $188.50 | $290 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $217.10 | $334 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $284.05 | $437 | 2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $353.60 | $544 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $181.35 | $279 | 1.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $233.35 | $359 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $328.25 | $505 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $226.20 | $348 | 2.2× |
| X-ray eye for foreign body (70030) range across 9 matching MRF lines |
$124.80–$187.20 | $192–$288 | varies |
| X-ray humerus (73060) | $419.90 | — | 4.8× |
| X-ray IV pyelogram (ivp) (74400) | $379.60 | $584 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $85.15 | $131 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $159.25 | $245 | 1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $274.30 | $422 | 2.6× |
| X-ray nose-rectum child f.b. (76010) | $81.90 | $126 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $347.75 | $535 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $146.90 | $226 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $112.45 | $173 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $157.95 | $243 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $271.05 | $417 | 3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $289.25 | $445 | 2.8× |
| X-Ray Stress View (77071) | $134.55 | $207 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $333.45 | $513 | 3.2× |
| X-Ray Tmj Unilat (70328) | $72.80 | $112 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $739.05 | $1,137 | 2.1× |
| X-Rays Bone Length Studies (77073) | $141.05 | $217 | 1.3× |
| X-Rays Bone Survey Complete (77075) | $243.75 | $375 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $317.20 | $488 | 3.0× |
| Xr facial bones less than 3 views (70140) | $146.90 | $226 | 1.7× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$101.40–$152.10 | $156–$234 | varies |
| Xr orbits complete 4 views (70200) | $114.40 | $176 | 1.1× |
| Xr Tomogram Single Plane (76100) | $219.05 | $337 | 2.1× |
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.