Imaging prices at Trinity Health Grand Rapids Hospital
Grand Rapids, MI · every code in this section with a posted price and a Medicare benchmark.
368 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) | $2,729.35 | $4,199 | 2.0× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$240.50–$18,776.56 | — | varies |
| Abdomen 2 views (74019) | $154.70 | $238 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $715 | $1,100 | 1.8× |
| Angio pulmonary bilat (75743) | $1,954.55 | $3,007 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $2,403.70 | $3,698 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $12,844.45 | — | 4.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,302.60 | $2,004 | 0.4× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$158.60–$494 | — | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,540.50 | $2,370 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,697.15 | $2,611 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $1,976 | $3,040 | 0.6× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,366.95 | $2,103 | 0.2× |
| Artery X-Rays Spine (75705) | $94,267.20 | — | 17.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$310.70–$466.05 | $478–$717 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$310.70–$466.05 | $478–$717 | varies |
| Basic radiation dosimetry calculation (77300) | $335.40 | $516 | 2.5× |
| Bone age studies (77072) | $165.10 | $254 | 1.6× |
| Bone Imaging 3 Phase (78315) | $872.95 | $1,343 | 2.2× |
| Bone Imaging Limited Area (78300) | $542.10 | $834 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $588.90 | $906 | 1.5× |
| Bone Imaging Whole Body (78306) | $833.95 | $1,283 | 2.1× |
| Bone survey infant (77076) | $169 | $260 | 1.6× |
| Brachytx isodose complex (77318) | $568.75 | $875 | 1.5× |
| Brachytx isodose intermed (77317) | $419.25 | $645 | 1.1× |
| Brachytx Isodose Plan Simple (77316) | $320.45 | $493 | 0.9× |
| Brain Flow Imaging Only (78610) | $552.50 | $850 | 1.0× |
| Brain Image W/Flow < 4 Views (78601) | $539.50 | $830 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $829.40 | $1,276 | 1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,430.70 | $5,278 | 2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $459.55 | $707 | 1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,587.95 | $2,443 | 4.6× |
| Cat Scan Follow-Up Study (76380) | $3,536.65 | — | 40.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $728 | $1,120 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $740.35 | $1,139 | 1.4× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$130.65–$14,578.13 | — | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$158.60–$241.80 | — | varies |
| Chest 3 views (71047) | $171.60 | $264 | 2.0× |
| Chest 4 or more views (71048) | $196.30 | $302 | 1.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$277.55–$392.60 | — | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $220.35 | $339 | 2.1× |
| Continuing medical physics consltj pr wk (77336) | $20,303.40 | — | 151.6× |
| Contrast Exam Abdominl Aorta (75625) | $2,023.45 | $3,113 | 0.6× |
| Contrast X-Ray Bladder (74430) | $284.70 | $438 | 0.8× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$310.70–$466.05 | $478–$717 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$310.70–$466.05 | $478–$717 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,291.25 | $3,525 | 6.6× |
| CT abdomen and pelvis without contrast (74176) | $1,713.40 | $2,636 | 7.2× |
| CT abdomen w contrast (74160) | $1,132.30 | $1,742 | 6.5× |
| CT abdomen w wo contrast (74170) | $1,312.35 | $2,019 | 7.5× |
| CT abdomen w/o contrast (74150) | $890.50 | $1,370 | 8.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,992.25 | $3,065 | 5.7× |
| CT Angio Chest (71275) | $1,346.15 | $2,071 | 7.7× |
| CT Angio Head (70496) | $2,612.67 | — | 14.9× |
| CT angio hrt w/3d image (75574) | $903.50 | $1,390 | 2.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$1,181.05–$1,771.25 | $1,817–$2,725 | varies |
| CT Angio Neck (70498) | $1,240.20 | $1,908 | 7.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,119.30 | $1,722 | 6.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $821.60 | $1,264 | 4.7× |
| CT cervical spine w/ contrast (72126) | $1,075.10 | $1,654 | 3.1× |
| CT cervical spine w/o contrast (72125) | $960.05 | $1,477 | 9.2× |
| CT cervical spine w/wo cont (72127) | $1,222.65 | $1,881 | 7.0× |
| CT chest w contrast (71260) | $1,105.65 | $1,701 | 6.3× |
| CT chest w/wo contrast (71270) | $1,224.60 | $1,884 | 7.0× |
| CT head/brain with contrast (70460) | $988.65 | $1,521 | 5.7× |
| CT head/brain without and with contrast (70470) | $1,150.50 | $1,770 | 6.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $838.50 | $1,290 | 2.4× |
| CT iac w contrast (70481) | $986.05 | $1,517 | 5.6× |
| CT l-spine w&w/o contrast (72133) | $1,222.65 | $1,881 | 7.0× |
| CT lower ext w/o (73700) range across 9 matching MRF lines |
$918.45–$1,377.35 | $1,413–$2,119 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,050.40–$1,575.60 | $1,616–$2,424 | varies |
| CT lumbar spine w contrast (72132) | $1,075.10 | $1,654 | 3.1× |
| CT lumbar spine w/o contrast (72131) | $960.05 | $1,477 | 9.2× |
| CT maxillofacial w contrast (70487) | $965.90 | $1,486 | 5.5× |
| CT maxillofacial wo contrast (70486) | $841.10 | $1,294 | 8.1× |
| CT neck tissue combo (70492) | $1,116.05 | $1,717 | 6.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,160.90 | $1,786 | 6.6× |
| CT orbits w/o contrast (70480) | $712.40 | $1,096 | 6.8× |
| CT pelvis w&w/o contrast (72194) | $1,216.80 | $1,872 | 7.0× |
| CT pelvis w/o contrast (72192) | $891.80 | $1,372 | 8.6× |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$1,152.45–$1,728.35 | $1,773–$2,659 | varies |
| CT scans face/jaw combo (70488) | $1,095.25 | $1,685 | 6.3× |
| CT soft tissue neck w contrast (70491) | $985.40 | $1,516 | 5.6× |
| CT soft tissue neck w/o contrast (70490) | $726.70 | $1,118 | 7.0× |
| CT thoracic spine w contrast (72129) | $1,075.10 | $1,654 | 6.2× |
| CT thoracic spine w/o contrast (72128) | $960.05 | $1,477 | 9.2× |
| CT thoracic spine w/wo cont (72130) | $1,222.65 | $1,881 | 7.0× |
| CT thorax w/o contrast (71250) | $913.25 | $1,405 | 8.8× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$823.55–$1,235.65 | — | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,019.20–$1,528.80 | $1,568–$2,352 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$924.30–$1,386.45 | $1,422–$2,133 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,413.10 | $2,174 | 8.1× |
| Cta Abdomen (74175) | $1,389.05 | $2,137 | 7.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,464.80 | $3,792 | 7.1× |
| CTA pelvis (72191) | $1,111.50 | $1,710 | 6.4× |
| Dilation ureters/urethra rs&i (74485) | $530.40 | $816 | 0.3× |
| Diskography lumbar (72295) | $1,210.30 | $1,862 | 0.6× |
| Dxa Bone Density Axial (77080) | $304.20 | $468 | 2.9× |
| Dxa bone density study (77085) | $243.10 | $374 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $81.90 | $126 | 0.9× |
| Echo exam uterus (76831) | $253.50 | $390 | 1.1× |
| Echo Guide For Artery Repair (76936) | $470.60 | $724 | 2.2× |
| Echograp Trans R Pros Study (76873) | $338 | $520 | 3.2× |
| Esophagram (74220) | $230.10 | $354 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) | $263.25 | $405 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $252.20 | $388 | 2.4× |
| Fluoroscopy up to 1 hr (76000) | $321.10 | $494 | 1.4× |
| Follow-Up Angiography (75898) | $2,179.45 | $3,353 | 0.7× |
| Foot 2 views (73620) range across 12 matching MRF lines |
$136.50–$204.75 | $210–$315 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$147.55–$289.90 | — | varies |
| Gastric emptying imaging study (78264) | $699.40 | $1,076 | 1.8× |
| Gated Heart Planar Single (78472) | $455 | $700 | 1.1× |
| Gated Heart, Multiple (78473) | $726.70 | $1,118 | 1.8× |
| Hand 2 views (73120) range across 12 matching MRF lines |
$140.40–$211.25 | $216–$325 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,146.30 | $3,302 | 3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,118.35 | $3,259 | 3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,941.55 | $2,987 | 2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,302.60 | $2,004 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $959.40 | $1,476 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,138.15 | $1,751 | 2.1× |
| Hepatobiliary System Imaging (78226) | $793 | $1,220 | 2.0× |
| Ht Musc Image Planar Mult (78454) | $1,899.95 | $2,923 | 1.5× |
| Ht Muscle Image Spect Sing (78451) | $1,433.90 | $2,206 | 1.1× |
| Hysterosalpingogram (74740) | $356.69 | — | 1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $328.25 | $505 | 3.8× |
| Infant hip ultrasound, limited static exam (76886) | $208 | $320 | 2.4× |
| Infusion Ivp (74410) | $388.05 | $597 | 2.2× |
| Interstitial radiation source applic complex (77778) | $1,253.20 | $1,928 | 1.8× |
| Joint Survey Single View (77077) | $125.45 | $193 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $860.60 | $1,324 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $623.35 | $959 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $576.55 | $887 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $542.10 | $834 | 1.4× |
| Knee 3 Views (73562) range across 15 matching MRF lines |
$176.15–$264.55 | $271–$407 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $391.95 | $603 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $752.05 | $1,157 | 1.4× |
| Lung perfusion differential (78597) | $489.45 | $753 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $893.10 | $1,374 | 1.7× |
| Lung Ventilation Imaging (78579) | $439.40 | $676 | 1.1× |
| Lymph System Imaging (78195) | $907.40 | $1,396 | 1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,720.30 | $7,262 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,350.75 | $5,155 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $848.25 | $1,305 | 3.6× |
| Mammary ductogram or galactogram single (77053) | $209.95 | $323 | 0.9× |
| Meckels Divert Exam (78290) | $691.60 | $1,064 | 1.7× |
| Mlc imrt design & construction per imrt plan (77338) | $901.55 | $1,387 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,811.55 | $2,787 | 5.2× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,370.20–$2,161.90 | — | varies |
| MRA head with contrast (70545) | $1,591.20 | $2,448 | 4.6× |
| MRA neck w contrast (70548) | $1,523.60 | $2,344 | 4.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,767.35 | $2,719 | 5.1× |
| MRA neck w/o contrast (70547) | $1,235.65 | $1,901 | 5.2× |
| MRI abdomen w contrast (74182) | $1,549.60 | $2,384 | 4.5× |
| MRI abdomen w/o contrast (74181) | $1,352 | $2,080 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,664–$2,496 | $2,560–$3,840 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,998.10–$2,996.50 | $3,074–$4,610 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,747.20–$2,621.45 | $2,688–$4,033 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,184.95 | $1,823 | 5.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $789.75 | $1,215 | 3.3× |
| MRI cardiac w/o contrast (75557) | $564.20 | $868 | 2.4× |
| MRI cervical spine w contrast (72142) | $1,636.70 | $2,518 | 4.7× |
| MRI cervical spine w/o cont (72141) | $1,546.35 | $2,379 | 6.5× |
| MRI chest w/o contrast (71550) | $1,116.70 | $1,718 | 4.7× |
| MRI chest wo w contrast (71552) | $1,516.45 | $2,333 | 4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$1,892.15–$2,837.90 | $2,911–$4,366 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$1,366.95–$2,050.10 | $2,103–$3,154 | varies |
| MRI lumbar spine w contrast (72149) | $1,636.70 | $2,518 | 4.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,983.15 | $3,051 | 5.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,020.50 | $1,570 | 4.3× |
| MRI orbit face neck w contrast (70542) | $1,381.90 | $2,126 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,907.10 | $2,934 | 5.5× |
| MRI pelvis w contrast (72196) | $1,595.10 | $2,454 | 4.6× |
| MRI pelvis w/o & w contrast (72197) | $1,938.95 | $2,983 | 5.6× |
| MRI pelvis w/o contrast (72195) | $1,341.60 | $2,064 | 5.6× |
| MRI spectroscopy (76390) | $993.85 | $1,529 | 11.5× |
| MRI thoracic spine w/o contrast (72146) | $1,546.35 | $2,379 | 6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,345.50–$2,018.90 | $2,070–$3,106 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,774.50–$2,662.40 | $2,730–$4,096 | varies |
| MRI, abdomen, combo (74183) | $1,975.35 | $3,039 | 5.7× |
| MRI, dorsal spine combo (72157) | $1,983.15 | $3,051 | 5.7× |
| MRI, dorsal spine contrast (72147) | $1,636.70 | $2,518 | 4.7× |
| MRI, joint upper extrem (73221) | $1,509.30 | — | 6.3× |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,925.30–$2,887.95 | $2,962–$4,443 | varies |
| MRI, lumbar spine combo (72158) | $1,983.15 | $3,051 | 5.7× |
| Myelogram cervical (72240) | $653.90 | $1,006 | 0.8× |
| Myelogram Lumbar (72265) | $768.95 | $1,183 | 1.0× |
| Myelography thoracic (72255) | $653.90 | $1,006 | 0.8× |
| Myelograpy 2/more regions rs&i (72270) | $845.65 | $1,301 | 1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,645.80 | $2,532 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $882.05 | $1,357 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $2,250.30 | $3,462 | 1.7× |
| N-invas est c ffr sw aly CTA (75580) | $2,746.25 | $4,225 | 3.2× |
| Neck soft tissue (70360) | $145.60 | $224 | 1.7× |
| Nonvascular Shunt X-Ray (75809) | $226.20 | $348 | 2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,232.15 | $6,511 | 3.1× |
| Nuclear Rx Intra-Arterial (79445) | $396.50 | $610 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $377 | $580 | 1.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $982.80 | $1,512 | 1.8× |
| Parathyroid Planar Imaging (78070) | $572.65 | $881 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $818.35 | $1,259 | 2.1× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$179.40–$477.75 | — | varies |
| Peritoneogram Rs&I (74190) | $585 | $900 | 1.1× |
| Pet Image W/Ct Lmtd (78814) | $3,442.40 | $5,296 | 2.4× |
| PET image w/CT, full body (78816) | $3,780.40 | $5,816 | 2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,692 | $5,680 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $544.05 | $837 | 1.4× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $926.90 | $1,426 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $216.45 | — | 2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $960.63 | — | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$271.05–$538.20 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$129.35–$195 | — | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$148.20–$419.25 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $208.65 | $321 | 2.0× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$119.60–$250.90 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 15 matching MRF lines |
$170.30–$256.10 | $262–$394 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$159.25–$635.70 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$116.35–$174.20 | $179–$268 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$118.30–$176.80 | $182–$272 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $156 | $240 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $174.20 | $268 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$275.60–$484.25 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $101.40 | $156 | 1.2× |
| Radex Spine 1 View Specify Level (72020) | $135.20 | $208 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) | $178.75 | $275 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $113.75 | $175 | 1.3× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$117.65–$219.05 | — | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$111.15–$167.05 | $171–$257 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$165.75–$715.65 | — | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $267.80 | $412 | 2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,421.50 | $19,110 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $820.30 | $1,262 | 8.1× |
| Radiation treatment delivery level 2 (77407) | $1,313.65 | $2,021 | 3.4× |
| Radiation treatment delivery level 3 (77412) | $2,095.60 | $3,224 | 3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $227.50 | $350 | 2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $162.50 | $250 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $464.75 | $715 | 2.7× |
| Radiologic exam colon single contrast study (74270) | $349.70 | $538 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$204.75–$307.45 | — | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $204.10 | $314 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $268.45 | $413 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $261.95 | $403 | 1.5× |
| Radiologic exam teeth complete full mouth (70320) | $23,090.26 | — | 97.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $158.60 | $244 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $330.85 | $509 | 1.9× |
| Radiologic examination femur 1 view (73551) range across 12 matching MRF lines |
$98.15–$148.20 | $151–$228 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 12 matching MRF lines |
$170.30–$256.10 | $262–$394 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$143–$31,531.10 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $139.10 | $214 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$231.40–$302.25 | — | varies |
| Ribs bilateral 3 views (71110) | $241.80 | $372 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $471.90 | $726 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $594.75 | $915 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,592.50 | $2,450 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,560 | $2,400 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,289.60 | $1,984 | 2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,554.80 | $2,392 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,680.90 | $2,586 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,413.75 | $2,175 | 1.1× |
| Rp Therapy Intravenous Administration (79101) | $294.45 | $453 | 1.3× |
| Scapula (73010) range across 9 matching MRF lines |
$143.65–$215.80 | $221–$332 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$53.30–$80.60 | $82–$124 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$124.15–$186.55 | — | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$310.70–$466.05 | $478–$717 | varies |
| Skull less than 4 views (70250) | $174.85 | $269 | 1.7× |
| Special dosimetry (77331) | $232.70 | $358 | 1.7× |
| Special Physics Consult (77370) | $352.95 | $543 | 2.6× |
| Special teletherapy port plan (77321) | $356.85 | $549 | 1.0× |
| Special treatment procedure (77470) | $1,459.25 | $2,245 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $7,266.35 | $11,179 | 4.1× |
| Sternoclavicular joints (71130) | $102.70 | $158 | 1.2× |
| Superior sagittal sinus venogram (75870) | $1,151.15 | $1,771 | 0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $537.55 | $827 | 1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $241.15 | $371 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,045.20 | $1,608 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $844.35 | $1,299 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $456.95 | $703 | 3.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $296.40 | $456 | 1.7× |
| Thoracic spine 2 views (72070) | $165.10 | $254 | 1.6× |
| Thoracic spine 3 views (72072) | $199.55 | $307 | 1.9× |
| Thoracolumbar 2 views (72080) | $148.20 | $228 | 1.7× |
| Thyroid Imaging With Vascular Flow (78013) | $467.35 | $719 | 1.2× |
| Thyroid Met Imaging Body (78018) | $833.30 | $1,282 | 1.5× |
| Thyroid Uptake Measurement (78012) | $266.50 | $410 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $573.30 | $882 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $800.15 | $1,231 | 2.1× |
| Tx devices design & construction intermediate (77333) | $5,354.05 | — | 40.0× |
| Tx devices design & construction simple (77332) | $12,810.85 | — | 95.7× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$217.10–$325.65 | $334–$501 | varies |
| Ultrasound Elastography Parenchyma (76981) | $299.65 | $461 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $241.15 | $371 | 2.3× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$358.15–$716.30 | — | varies |
| Umbilical-artery Doppler (OB) (76820) | $246.35 | $379 | 2.4× |
| Unlisted fluoroscopic procedure (76496) | $804.05 | $1,237 | 9.3× |
| Unlisted us procedure (76999) | $319.15 | $491 | 3.7× |
| Upper gi w/o kub (74240) | $320.45 | $493 | 1.8× |
| Urethrocystogram voiding (74455) | $276.25 | $425 | 1.2× |
| Urethrocystography retrograde (74450) | $262.60 | $404 | 1.1× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$295.75–$443.95 | $455–$683 | varies |
| Us chest (76604) | $258.05 | $397 | 2.5× |
| Us complete joint (76881) | $271.70 | $418 | 2.6× |
| Us exam, pelvic, limited (76857) | $217.75 | $335 | 2.1× |
| Us head (76506) | $248.30 | $382 | 2.4× |
| Us kidney transplant (76776) | $353.60 | $544 | 3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $261.95 | — | 2.5× |
| Us ob detailed single fetus (76811) | $471.25 | $725 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $283.40 | $436 | 2.7× |
| Us ob transvaginal (76817) | $310.05 | $477 | 3.0× |
| Us pelvic non ob complete (76856) | $402.35 | $619 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $399.10 | $614 | 3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $278.85 | $429 | 2.7× |
| Us retroperitoneal complete (76770) | $376.35 | $579 | 3.6× |
| Us retroperitoneal limited (76775) | $341.90 | — | 3.3× |
| Us scrotum and contents (76870) | $367.90 | $566 | 3.5× |
| Us spinal canal and contents (76800) | $263.90 | $406 | 2.5× |
| Us thyroid (76536) | $346.45 | $533 | 3.3× |
| Us transrectal (76872) | $321.10 | $494 | 3.1× |
| Vein X-Ray Chest (75827) | $822.25 | $1,265 | 0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,066 | $1,640 | 0.3× |
| Venogram Sinus/Jugular (75860) | $949 | $1,460 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,274.65 | $1,961 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $1,106.95 | $1,703 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $737.75 | $1,135 | 0.5× |
| Venography Renal Unilateral (75831) | $1,347.45 | $2,073 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,302.60 | $2,004 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $74.75 | $115 | 0.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$270.40–$293.15 | — | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $167.05 | $257 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $384.80 | $592 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,787.85 | $4,289 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $204.10 | $314 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$240.50–$1,119.31 | — | varies |
| X-Ray Exam Breast Specimen (76098) | $15,495.46 | — | 28.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $171.60 | $264 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $245.05 | $377 | 2.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $255.45 | $393 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $138.45 | $213 | 1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$334.75–$350.35 | — | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $189.80 | $292 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $237.25 | $365 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $247 | $380 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $284.70 | $438 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $326.95 | $503 | 3.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $187.20 | $288 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $278.20 | $428 | 2.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $210.60 | $324 | 2.0× |
| X-ray eye for foreign body (70030) range across 9 matching MRF lines |
$117.65–$176.15 | $181–$271 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$334.75–$501.15 | — | varies |
| X-ray IV pyelogram (ivp) (74400) | $339.95 | $523 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $87.75 | $135 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $94.90 | $146 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $200.20 | $308 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $228.80 | $352 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $271.70 | $418 | 2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $178.10 | $274 | 1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $101.40 | $156 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $169 | $260 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $226.85 | $349 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $198.25 | $305 | 1.9× |
| X-Ray Stress View (77071) | $144.30 | $222 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $209.30 | $322 | 2.0× |
| X-Ray Tmj Unilat (70328) | $74.10 | $114 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $461.50 | $710 | 1.3× |
| X-Rays Bone Length Studies (77073) | $169.65 | $261 | 1.6× |
| X-Rays Bone Survey Complete (77075) | $226.20 | $348 | 2.2× |
| Xr c-spine 4 or 5 views (72050) | $228.80 | $352 | 2.2× |
| Xr facial bones less than 3 views (70140) | $104.65 | $161 | 1.2× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$78–$117.65 | $120–$181 | varies |
| Xr orbits complete 4 views (70200) | $187.85 | $289 | 1.8× |
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.