Imaging prices at Trinity Regional Medical Center
Fort Dodge, IA · every code in this section with a posted price and a Medicare benchmark.
335 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) | $7,365.56 | $9,206.95 | 5.5× |
| Abdomen 1 View (74018) | $200.42 | $250.52 | 2.4× |
| Abdomen 2 views (74019) | $257.80 | $322.25 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,330.12 | $1,662.64 | 3.5× |
| Adrenal Cortex & Medulla Img (78075) | $1,551.08 | $1,938.85 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $2,959.34 | $3,699.17 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,959.34 | $3,699.17 | 1.0× |
| Ankle 2 views (73600) | $149.20 | $186.49 | 1.8× |
| Aortography thoracic serialography rs&i (75605) | $2,795.98 | $3,494.97 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,795.98 | $3,494.97 | 0.9× |
| Artery X-Rays Abdomen (75726) | $3,084.75 | $3,855.93 | 0.6× |
| Artery X-Rays Pelvis (75736) | $3,343.29 | $4,179.11 | 0.6× |
| Arthrogram ankle (73615) | $461.88 | $577.34 | 1.4× |
| Arthrogram hip (73525) | $644.48 | $805.59 | 1.9× |
| Arthrogram Wrist (73115) | $312.04 | $390.05 | 0.9× |
| Basic radiation dosimetry calculation (77300) | $528.76 | $660.95 | 4.1× |
| Bone age studies (77072) | $128.78 | $160.97 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,147.57 | $1,434.46 | 3.0× |
| Bone Imaging Limited Area (78300) | $1,147.57 | $1,434.46 | 3.0× |
| Bone Imaging Multiple Areas (78305) | $1,147.57 | $1,434.46 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,147.57 | $1,434.46 | 3.0× |
| Bone marrow imaging limited area (78102) | $451.68 | $564.59 | 1.2× |
| Bone survey infant (77076) | $472.36 | $590.44 | 4.7× |
| Brain Image W/Flow < 4 Views (78601) | $2,131.44 | $2,664.29 | 5.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,116.53 | $5,145.66 | 3.0× |
| Cat Scan Follow-Up Study (76380) | $487.85 | $609.81 | 5.8× |
| Chest 1 view (71045) | $154.16 | $192.69 | 1.8× |
| Chest 2 views (71046) | $284.84 | $356.04 | 3.4× |
| Chest 3 views (71047) | $284.84 | $356.04 | 3.4× |
| Chest 4 or more views (71048) | $300.50 | $375.62 | 3.0× |
| Clavicle complete (73000) | $234.44 | $293.05 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $158.18 | $197.72 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $318.95 | $398.68 | 2.5× |
| Contrast Exam Abdominl Aorta (75625) | $3,520.18 | $4,400.22 | 1.2× |
| Contrast X-Ray Bladder (74430) | $274.69 | $343.36 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $418.88 | $523.60 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $644.48 | $805.59 | 1.9× |
| CT abdomen and pelvis without and with contrast (74178) | $4,310.47 | $5,388.08 | 12.9× |
| CT abdomen and pelvis without contrast (74176) | $3,573.57 | $4,466.96 | 15.6× |
| CT abdomen w contrast (74160) | $2,362.80 | $2,953.50 | 14.0× |
| CT abdomen w wo contrast (74170) | $2,412.37 | $3,015.46 | 14.3× |
| CT abdomen w/o contrast (74150) | $1,711.20 | $2,139 | 17.0× |
| CT Angio Abdomen and Pelvis (74174) | $4,953.68 | $6,192.09 | 14.8× |
| CT Angio Chest (71275) | $2,914.68 | $3,643.34 | 17.3× |
| CT Angio Head (70496) | $2,882.41 | $3,603.01 | 17.1× |
| CT angio hrt w/3d image (75574) | $2,357.12 | $2,946.39 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,474.96 | $3,093.69 | 14.7× |
| CT Angio Neck (70498) | $2,891.67 | $3,614.58 | 17.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,474.96 | $3,093.69 | 14.7× |
| CT bone density (77078) | $271.88 | $339.85 | 3.2× |
| CT cervical spine w/ contrast (72126) | $2,714.27 | $3,392.83 | 8.1× |
| CT cervical spine w/o contrast (72125) | $2,396.27 | $2,995.33 | 23.8× |
| CT cervical spine w/wo cont (72127) | $2,920.60 | $3,650.75 | 17.3× |
| CT chest w contrast (71260) | $2,217.88 | $2,772.34 | 13.2× |
| CT chest w/wo contrast (71270) | $2,332.60 | $2,915.74 | 13.8× |
| CT head/brain with contrast (70460) | $2,542.60 | $3,178.24 | 15.1× |
| CT head/brain without and with contrast (70470) | $2,542.60 | $3,178.24 | 15.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $79.20 | $99 | 0.9× |
| CT iac w contrast (70481) | $1,969.78 | $2,462.22 | 11.7× |
| CT l-spine w&w/o contrast (72133) | $2,920.60 | $3,650.75 | 17.3× |
| CT lower ext w/o (73700) | $1,172.31 | $1,465.38 | 11.7× |
| CT lower extremity w/contrast material (73701) | $1,805.01 | $2,256.26 | 10.7× |
| CT lumbar spine w contrast (72132) | $2,714.26 | $3,392.82 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $2,398.52 | $2,998.14 | 23.9× |
| CT maxillofacial w contrast (70487) | $2,023.45 | $2,529.31 | 12.0× |
| CT maxillofacial wo contrast (70486) | $1,608.28 | $2,010.34 | 16.0× |
| CT neck tissue combo (70492) | $2,262.30 | $2,827.87 | 13.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,084.52 | $2,605.65 | 12.4× |
| CT orbits w/o contrast (70480) | $1,524.04 | $1,905.04 | 15.2× |
| CT pelvis w&w/o contrast (72194) | $2,386.61 | $2,983.26 | 14.2× |
| CT pelvis w/o contrast (72192) | $1,699.94 | $2,124.92 | 16.9× |
| CT scan of leg combo (73702) | $2,191.90 | $2,739.87 | 13.0× |
| CT scans face/jaw combo (70488) | $2,138.20 | $2,672.75 | 12.7× |
| CT soft tissue neck w contrast (70491) | $2,147.51 | $2,684.38 | 12.7× |
| CT soft tissue neck w/o contrast (70490) | $1,524.04 | $1,905.04 | 15.2× |
| CT thoracic spine w contrast (72129) | $2,714.26 | $3,392.82 | 16.1× |
| CT thoracic spine w/o contrast (72128) | $2,396.27 | $2,995.33 | 23.8× |
| CT thoracic spine w/wo cont (72130) | $2,920.60 | $3,650.75 | 17.3× |
| CT thorax w/o contrast (71250) | $1,524.04 | $1,905.04 | 15.2× |
| CT upper ext wo (73200) | $1,172.31 | $1,465.38 | 11.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,919.76 | $2,399.70 | 11.4× |
| CT upper extremity with contrast (73201) | $1,805.01 | $2,256.26 | 5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,201.36 | $6,501.69 | 30.8× |
| Cta Abdomen (74175) | $3,007.43 | $3,759.28 | 17.8× |
| CTA pelvis (72191) | $2,981.67 | $3,727.08 | 17.7× |
| Discography Cerv/Thor Spine (72285) | $1,425.36 | $1,781.69 | 0.8× |
| Dxa Bone Density Axial (77080) | $325.52 | $406.90 | 3.2× |
| Echo exam uterus (76831) | $482.84 | $603.55 | 2.1× |
| Echo Guide For Artery Repair (76936) | $726.69 | $908.36 | 3.5× |
| Esophagram (74220) | $323.99 | $404.98 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $736.32 | $920.40 | 7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $736.32 | $920.40 | 7.3× |
| Fluoroscopy up to 1 hr (76000) | $649.87 | $812.33 | 2.8× |
| Follow-Up Angiography (75898) | $332.37 | $415.46 | 0.1× |
| Foot 2 views (73620) | $142.08 | $177.60 | 1.7× |
| Forearm 2 views (73090) | $214.27 | $267.83 | 2.6× |
| Gastric emptying imaging study (78264) | $1,295.84 | $1,619.79 | 3.4× |
| Gastroesophageal Reflux Exam (78262) | $741.70 | $927.12 | 1.9× |
| Gated Heart Planar Single (78472) | $1,301.28 | $1,626.60 | 3.4× |
| Hand 2 views (73120) | $164.11 | $205.13 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,347.74 | $1,684.67 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,028.41 | $1,285.51 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $2,119.67 | $2,649.58 | 1.7× |
| Hysterosalpingogram (74740) | $914.08 | $1,142.60 | 4.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $384.62 | $480.77 | 4.6× |
| Infant hip ultrasound, limited static exam (76886) | $384.62 | $480.77 | 4.6× |
| Joint Survey Single View (77077) | $349.38 | $436.72 | 3.5× |
| K Flow/Funct Image Multiple (78709) | $1,566.63 | $1,958.28 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $1,566.63 | $1,958.28 | 3.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,566.63 | $1,958.28 | 3.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $741.70 | $927.12 | 1.9× |
| Knee 3 Views (73562) | $229.67 | $287.08 | 2.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,048.74 | $1,310.92 | 2.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,197.98 | $1,497.47 | 3.1× |
| Lung Perf&Ventilat Diferentl (78598) | $2,131.44 | $2,664.29 | 4.1× |
| Lung perfusion differential (78597) | $1,626.43 | $2,033.03 | 4.2× |
| Lung Ventilat&Perfus Imaging (78582) | $2,131.44 | $2,664.29 | 4.1× |
| Lung Ventilation Imaging (78579) | $2,131.44 | $2,664.29 | 5.5× |
| Lymph System Imaging (78195) | $1,266.18 | $1,582.72 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $2,921.27 | $3,651.58 | 12.7× |
| Mammary ductogram or galactogram multiple (77054) | $1,170.24 | $1,462.80 | 5.1× |
| Meckels Divert Exam (78290) | $741.70 | $927.12 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $9,021.08 | $11,276.34 | 25.1× |
| Mr safety determination physician/other qhp (76016) | $178.60 | $223.25 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.68 | $62.09 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $186.19 | $232.73 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $120.49 | $150.61 | 2.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $490.31 | $612.88 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $4,138.39 | $5,172.98 | 12.3× |
| MRA head w/o contrast (70544) | $2,655.80 | $3,319.74 | 11.6× |
| MRA head with contrast (70545) | $3,535.24 | $4,419.05 | 10.5× |
| MRA neck w contrast (70548) | $3,535.24 | $4,419.05 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,612.45 | $4,515.56 | 10.8× |
| MRA neck w/o contrast (70547) | $2,989.84 | $3,737.30 | 13.0× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,406.30–$3,521.31 | $1,757.87–$4,401.63 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,280.80–$2,921.37 | $1,600.99–$3,651.71 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,521.31 | $4,401.63 | 4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,184.76 | $5,230.94 | 12.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,521.31 | $4,401.63 | 4.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,917.33 | $2,396.66 | 8.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,684.53 | $2,105.66 | 7.3× |
| MRI cervical spine w contrast (72142) | $3,124.82 | $3,906.02 | 9.3× |
| MRI cervical spine w/o cont (72141) | $1,991.06 | $2,488.82 | 8.7× |
| MRI chest w/o contrast (71550) | $2,782.26 | $3,477.82 | 12.1× |
| MRI chest with contrast (71551) | $3,521.31 | $4,401.63 | 4.7× |
| MRI chest wo w contrast (71552) | $4,184.76 | $5,230.94 | 12.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,521.31 | $4,401.63 | 10.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,477.34 | $5,596.67 | 13.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,921.37 | $3,651.71 | 12.7× |
| MRI lumbar spine w contrast (72149) | $3,888.77 | $4,860.96 | 11.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,124.82 | $3,906.02 | 9.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,655.80 | $3,319.74 | 11.6× |
| MRI orbit face neck w contrast (70542) | $3,201.19 | $4,001.48 | 9.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,876.48 | $4,845.60 | 11.6× |
| MRI pelvis w contrast (72196) | $3,521.31 | $4,401.63 | 10.5× |
| MRI pelvis w/o & w contrast (72197) | $4,477.34 | $5,596.67 | 13.3× |
| MRI pelvis w/o contrast (72195) | $2,921.37 | $3,651.71 | 12.7× |
| MRI thoracic spine w/o contrast (72146) | $2,921.37 | $3,651.71 | 12.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,921.37 | $3,651.71 | 12.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,477.34 | $5,596.67 | 13.3× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,987.10–$4,264.15 | $2,483.87–$5,330.18 | varies |
| MRI, dorsal spine combo (72157) | $4,477.34 | $5,596.67 | 13.3× |
| MRI, dorsal spine contrast (72147) | $3,888.77 | $4,860.96 | 11.6× |
| MRI, joint upper extrem (73221) | $2,921.37 | $3,651.71 | 12.7× |
| MRI, joint upper extrem combo (73223) | $4,476.44 | $5,595.54 | 13.3× |
| MRI, lumbar spine combo (72158) | $4,477.34 | $5,596.67 | 13.3× |
| Myelogram cervical (72240) | $750.40 | $937.99 | 1.0× |
| Myelogram Lumbar (72265) | $750.40 | $937.99 | 1.0× |
| Myelography thoracic (72255) | $750.40 | $937.99 | 1.0× |
| Myelograpy 2/more regions rs&i (72270) | $750.40 | $937.99 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $2,354.12 | $2,942.65 | 1.9× |
| Neck soft tissue (70360) | $147.16 | $183.95 | 1.8× |
| Nm myocard infarct spect (78469) | $2,354.12 | $2,942.65 | 4.5× |
| Nonvascular Shunt X-Ray (75809) | $203.99 | $254.98 | 2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,842.97 | $11,053.71 | 6.6× |
| Nuclear medicine study of endocrine organs (78099) | $478.37 | $597.96 | 1.2× |
| Nuclear Rx Oral Admin (79005) | $428.44 | $535.54 | 1.9× |
| Optic foramina (70190) | $159.69 | $199.61 | 1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $500.55 | $625.68 | 1.0× |
| Parathyroid Planar Imaging (78070) | $381.96 | $477.44 | 1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $381.96 | $477.44 | 1.0× |
| Pelvis 1 or 2 views (72170) | $196.47 | $245.58 | 2.0× |
| Peritoneogram Rs&I (74190) | $699.45 | $874.31 | 1.3× |
| Pet Image W/Ct Lmtd (78814) | $3,052.69 | $3,815.86 | 2.2× |
| PET image w/CT, full body (78816) | $4,528.18 | $5,660.22 | 3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,528.18 | $5,660.22 | 3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $916.51 | $1,145.63 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $428.31 | $535.38 | 4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $315.75 | $394.68 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $224.98 | $281.22 | 2.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $224.98 | $281.22 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $224.98 | $281.22 | 2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $349.38 | $436.72 | 3.5× |
| Radex fingr minimum 2 views (73140) | $133.60 | $167 | 1.6× |
| Radex foot complete minimum 3 views (73630) | $224.98 | $281.22 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $224.98 | $281.22 | 2.7× |
| Radex lower extremity infant minimum 2 views (73592) | $264.89 | $331.11 | 3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $421.94 | $527.42 | 4.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $253.09 | $316.36 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $271.88 | $339.85 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) | $234.44 | $293.05 | 2.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $161.88 | $202.34 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $161.88 | $202.34 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $275.35 | $344.18 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $552.96 | $691.20 | 6.6× |
| Radex Toe Minimum 2 Views (73660) | $157.15 | $196.43 | 1.9× |
| Radex upper extremity infant minimum 2 views (73092) | $182.76 | $228.45 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $224.98 | $281.22 | 2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $574.96 | $718.69 | 5.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,651.49 | $19,564.36 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $370.24 | $462.79 | 3.8× |
| Radiation treatment delivery level 2 (77407) | $510.99 | $638.73 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $561.48 | $701.85 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $349.38 | $436.72 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $315.19 | $393.98 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $530.77 | $663.46 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $500.25 | $625.31 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $365.43 | $456.78 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) | $277.84 | $347.30 | 2.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $295.28 | $369.10 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $387.90 | $484.87 | 2.3× |
| Radiologic exam swallow function contrast study (74230) | $377.24 | $471.55 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $530.77 | $663.46 | 3.1× |
| Radiologic examination femur 1 view (73551) | $232.36 | $290.44 | 2.8× |
| Radiologic examination femur minimum 2 views (73552) | $282.27 | $352.83 | 3.4× |
| Radiologic examination knee 1/2 views (73560) | $229.67 | $287.08 | 2.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $790.45 | $988.06 | 7.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $241.04 | $301.30 | 2.9× |
| Ribs bilateral 3 views (71110) | $358.65 | $448.31 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $770.94 | $963.67 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $770.94 | $963.67 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,654.17 | $3,317.71 | 5.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,654.17 | $3,317.71 | 5.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,654.17 | $3,317.71 | 5.1× |
| Rp Therapy Intravenous Administration (79101) | $504.82 | $631.02 | 2.3× |
| Scapula (73010) | $234.44 | $293.05 | 2.3× |
| Shoulder 1 view (73020) | $157.15 | $196.43 | 1.9× |
| Shoulder Arthrography (73040) | $312.04 | $390.05 | 0.9× |
| Sialogram (70390) | $292.13 | $365.16 | 1.3× |
| Skull less than 4 views (70250) | $161.88 | $202.34 | 1.6× |
| Special dosimetry (77331) | $528.76 | $660.95 | 4.1× |
| Special Physics Consult (77370) | $528.14 | $660.17 | 4.1× |
| Special teletherapy port plan (77321) | $952.97 | $1,191.21 | 2.6× |
| Special treatment procedure (77470) | $1,633.84 | $2,042.30 | 3.1× |
| Stereotactic Body Radiation Delivery (77373) | $9,826.76 | $12,283.44 | 5.7× |
| Sternoclavicular joints (71130) | $270.08 | $337.60 | 3.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,125.55 | $5,156.93 | 11.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,903.18 | $3,628.97 | 8.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,704.03 | $2,130.03 | 4.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,137.92 | $1,422.40 | 3.2× |
| Ther rad simulaj-aided field setting simple (77280) | $921.01 | $1,151.26 | 7.1× |
| Thoracic spine 2 views (72070) | $262.65 | $328.31 | 2.6× |
| Thoracic spine 3 views (72072) | $345.39 | $431.73 | 3.4× |
| Thoracolumbar 2 views (72080) | $161.88 | $202.34 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $695.60 | $869.50 | 1.8× |
| Thyroid Met Imaging Body (78018) | $998.39 | $1,247.98 | 1.9× |
| Thyroid Uptake Measurement (78012) | $343.33 | $429.16 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $901.92 | $1,127.39 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $1,002.34 | $1,252.92 | 2.8× |
| Tx devices design & construction intermediate (77333) | $644.36 | $805.45 | 5.0× |
| Tx devices design & construction simple (77332) | $525.04 | $656.30 | 4.1× |
| Ultrasound Breast Limited (76642) | $238.47 | $298.08 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $154.92 | $193.64 | 1.5× |
| Ultrasound, abdomen limited (76705) | $515.83 | $644.78 | 5.1× |
| Umbilical-artery Doppler (OB) (76820) | $198.83 | $248.53 | 2.0× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,034.93 | $1,293.66 | 2.7× |
| Unlisted us procedure (76999) | $384.62 | $480.77 | 4.6× |
| Upper gi w/o kub (74240) | $425.53 | $531.91 | 2.5× |
| Urethrocystogram voiding (74455) | $260.24 | $325.29 | 1.1× |
| Urethrocystography retrograde (74450) | $274.69 | $343.36 | 1.2× |
| Us breast unilateral complete (76641) | $349.67 | $437.08 | 3.5× |
| Us chest (76604) | $415.62 | $519.52 | 4.1× |
| Us complete joint (76881) | $376.77 | $470.96 | 3.7× |
| Us exam, pelvic, limited (76857) | $366.08 | $457.60 | 3.6× |
| Us head (76506) | $384.62 | $480.77 | 3.8× |
| Us kidney transplant (76776) | $257.30 | $321.62 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $376.77 | $470.96 | 3.7× |
| Us ob detailed single fetus (76811) | $497.12 | $621.39 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $164.99 | $206.23 | 1.6× |
| Us ob transvaginal (76817) | $497.12 | $621.40 | 4.9× |
| Us pelvic non ob complete (76856) | $447.73 | $559.66 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $447.73 | $559.66 | 4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $372.81 | $466.01 | 3.7× |
| Us retroperitoneal complete (76770) | $515.83 | $644.78 | 5.1× |
| Us retroperitoneal limited (76775) | $515.83 | $644.78 | 5.1× |
| Us scrotum and contents (76870) | $384.62 | $480.77 | 3.8× |
| Us spinal canal and contents (76800) | $384.62 | $480.77 | 3.8× |
| Us thyroid (76536) | $366.32 | $457.89 | 3.6× |
| Vein X-Ray Chest (75827) | $1,364.55 | $1,705.68 | 0.9× |
| Venogram Sinus/Jugular (75860) | $1,138.51 | $1,423.13 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $2,266.70 | $2,833.37 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,077.72 | $1,347.14 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,077.72 | $1,347.14 | 0.7× |
| Wrist 2 views (73100) | $149.20 | $186.49 | 1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $283.58 | $354.47 | 3.4× |
| X-ray antegrade pyelogram tube (74425) | $281.45 | $351.81 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $4,118.10 | $5,147.62 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $261.31 | $326.63 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $164.11 | $205.13 | 2.0× |
| X-Ray Exam Breast Specimen (76098) | $187.55 | $234.43 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $155.04 | $193.80 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $310.08 | $387.60 | 3.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $419.92 | $524.89 | 4.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $240.82 | $301.02 | 2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $290.72 | $363.40 | 3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $323.47 | $404.33 | 3.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $349.66 | $437.07 | 3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $432.30 | $540.37 | 4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $559.44 | $699.29 | 5.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $261.31 | $326.63 | 3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $359.47 | $449.33 | 3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $271.88 | $339.85 | 2.7× |
| X-ray eye for foreign body (70030) | $147.16 | $183.95 | 1.8× |
| X-ray humerus (73060) | $234.44 | $293.05 | 2.8× |
| X-ray IV pyelogram (ivp) (74400) | $916.64 | $1,145.80 | 5.4× |
| X-ray IV pyelogram+tomography (74415) | $1,151.08 | $1,438.84 | 6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $79.37 | $99.21 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $229.67 | $287.08 | 2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $328.23 | $410.28 | 3.3× |
| X-ray nose-rectum child f.b. (76010) | $200.42 | $250.52 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $358.65 | $448.31 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $283.58 | $354.47 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $225.08 | $281.35 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $283.58 | $354.47 | 3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $349.38 | $436.72 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $379.90 | $474.87 | 3.8× |
| X-Ray Stress View (77071) | $450 | $562.49 | 5.4× |
| X-ray thoracic spine 4 vw (72074) | $361.41 | $451.76 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $625.87 | $782.33 | 1.9× |
| X-Rays Bone Length Studies (77073) | $461.91 | $577.38 | 4.6× |
| X-Rays Bone Survey Complete (77075) | $1,031.68 | $1,289.60 | 10.3× |
| Xr c-spine 4 or 5 views (72050) | $363.36 | $454.19 | 3.6× |
| Xr facial bones less than 3 views (70140) | $264.89 | $331.11 | 3.2× |
| Xr orbits complete 4 views (70200) | $349.38 | $436.72 | 3.5× |
| Xr Tomogram Single Plane (76100) | $694.76 | $868.44 | 6.9× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.