Imaging prices at Tufts Medical Center
Boston, MA · every code in this section with a posted price and a Medicare benchmark.
449 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) | $3,855.60 | $5,508 | 2.3× |
| Abdomen 1 View (74018) | $282.80 | $404 | 2.7× |
| Abdomen 2 views (74019) | $246.40 | $352 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,229.20 | $1,756 | 2.6× |
| Angio internal mammary (75756) | $6,632.50 | $9,475 | 1.8× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$7,317.10–$10,975.65 | $10,453–$15,679.50 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $8,608.60 | $12,298 | 2.3× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$7,317.10–$10,975.65 | $10,453–$15,679.50 | varies |
| Angiography extremity unilateral rs&i (75710) | $5,420.10 | $7,743 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,630 | $10,900 | 2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,109.70 | $5,871 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Aortography thoracic serialography rs&i (75605) | $10,398.50 | $14,855 | 1.6× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$4,319–$14,364 | $6,170–$20,520 | varies |
| Artery X-Rays Adrenal Gland (75731) | $8,199.10 | $11,713 | 2.2× |
| Artery X-Rays Pelvis (75736) | $4,319 | $6,170 | 0.6× |
| Artery X-Rays Spine (75705) | $16,100 | $23,000 | 2.4× |
| Arthrogram ankle (73615) | $1,323.70 | $1,891 | 3.2× |
| Arthrogram hip (73525) | $1,323.70 | $1,891 | 3.2× |
| Arthrogram Wrist (73115) | $1,248.10 | $1,783 | 3.0× |
| Basic radiation dosimetry calculation (77300) | $655.20 | $936 | 4.1× |
| Bone age studies (77072) | $293.30 | $419 | 2.3× |
| Bone Imaging 3 Phase (78315) | $1,463 | $2,090 | 3.1× |
| Bone Imaging Limited Area (78300) | $1,425.20 | $2,036 | 3.0× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$656.95–$1,313.90 | $938.50–$1,877 | varies |
| Bone marrow imaging; multiple areas (78103) | $798.70 | $1,141 | 1.7× |
| Bone marrow imaging; whole body (78104) | $1,229.20 | $1,756 | 2.6× |
| Bone survey infant (77076) | $478.80 | $684 | 3.8× |
| Brachytx isodose complex (77318) | $1,071.70 | $1,531 | 2.4× |
| Brachytx isodose intermed (77317) | $1,131.90 | $1,617 | 2.5× |
| Brachytx Isodose Plan Simple (77316) | $861 | $1,230 | 1.9× |
| Brain Image W/Flow < 4 Views (78601) | $1,381.80 | $1,974 | 2.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,174.20 | $3,106 | 3.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,585.40 | $5,122 | 2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,908.90 | $2,727 | 4.6× |
| Cat Scan Follow-Up Study (76380) | $294 | $420 | 2.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,696.80 | $2,424 | 2.6× |
| Cerebrospinal Fluid Scan (78630) | $1,696.80 | $2,424 | 2.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$141.40–$282.80 | $202–$404 | varies |
| Chest 2 views (71046) | $224 | $320 | 2.1× |
| Chest 3 views (71047) | $128.80 | $184 | 1.2× |
| Chest 4 or more views (71048) | $246.40 | $352 | 2.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $498.40 | $712 | 4.0× |
| Cisternography Positive Contrast Rs&I (70015) | $1,901.20 | $2,716 | 2.0× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $288.40 | $412 | 2.3× |
| Continuing medical physics consltj pr wk (77336) | $479.50 | $685 | 3.0× |
| Contrast Exam Abdominl Aorta (75625) | $7,317.10 | $10,453 | 1.9× |
| Contrast X-Ray Bladder (74430) | $985.60 | $1,408 | 2.4× |
| Contrast X-Ray Of Elbow (73085) | $1,557.50 | $2,225 | 3.7× |
| Contrast X-Ray Of Knee Joint (73580) | $1,323.70 | $1,891 | 3.2× |
| Contrast Xray Throat/Cerv Esopha (74210) | $429.10 | $613 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$755.30–$1,510.60 | $1,079–$2,158 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$468.30–$936.60 | $669–$1,338 | varies |
| CT abdomen w contrast (74160) | $1,025.50 | $1,465 | 4.9× |
| CT abdomen w wo contrast (74170) | $1,085.70 | $1,551 | 5.2× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$755.30–$1,510.60 | $1,079–$2,158 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$565.25–$1,130.50 | $807.50–$1,615 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$565.25–$1,130.50 | $807.50–$1,615 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$331.80–$663.60 | $474–$948 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$565.25–$1,695.75 | $807.50–$2,422.50 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$565.25–$1,130.50 | $807.50–$1,615 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$565.25–$1,130.50 | $807.50–$1,615 | varies |
| CT bone density (77078) | $286.30 | $409 | 2.7× |
| CT cervical spine w/ contrast (72126) | $1,355.90 | $1,937 | 3.2× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT cervical spine w/wo cont (72127) | $1,085.70 | $1,551 | 5.2× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$512.75–$1,025.50 | $732.50–$1,465 | varies |
| CT chest w/wo contrast (71270) | $1,085.70 | $1,551 | 5.2× |
| CT head/brain with contrast (70460) | $1,025.50 | $1,465 | 4.9× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$542.85–$1,085.70 | $775.50–$1,551 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $756 | $1,080 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $261.80 | $374 | 2.5× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$512.75–$1,025.50 | $732.50–$1,465 | varies |
| CT iac w contrast (70481) | $1,025.50 | $1,465 | 4.9× |
| CT l-spine w&w/o contrast (72133) | $1,085.70 | $1,551 | 5.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$490–$735 | $700–$1,050 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,025.50–$1,538.25 | $1,465–$2,197.50 | varies |
| CT lumbar spine w contrast (72132) | $1,640.80 | $2,344 | 3.9× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT maxillofacial w contrast (70487) | $1,025.50 | $1,465 | 4.9× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$542.85–$1,085.70 | $775.50–$1,551 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,085.70 | $1,551 | 5.2× |
| CT orbits w/o contrast (70480) | $490 | $700 | 3.9× |
| CT pelvis w&w/o contrast (72194) | $922.60 | $1,318 | 4.4× |
| CT pelvis w/o contrast (72192) | $490 | $700 | 3.9× |
| CT scan of leg combo (73702) | $1,085.70 | $1,551 | 5.2× |
| CT scans face/jaw combo (70488) | $926.80 | $1,324 | 4.4× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$512.75–$1,025.50 | $732.50–$1,465 | varies |
| CT soft tissue neck w/o contrast (70490) | $490 | $700 | 3.9× |
| CT thoracic spine w contrast (72129) | $1,204.70 | $1,721 | 5.7× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT thoracic spine w/wo cont (72130) | $1,085.70 | $1,551 | 5.2× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$245–$490 | $350–$700 | varies |
| CT upper ext wo (73200) | $490 | $700 | 3.9× |
| CT upper extremity w/o & w/contrast material (73202) | $1,085.70 | $1,551 | 5.2× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,355.90–$2,033.85 | $1,937–$2,905.50 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$512.75–$1,025.50 | $732.50–$1,465 | varies |
| Cta Abdomen (74175) | $1,130.50 | $1,615 | 5.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,261 | $3,230 | 5.4× |
| CTA pelvis (72191) | $1,130.50 | $1,615 | 5.4× |
| Dilation ureters/urethra rs&i (74485) | $5,781.30 | $8,259 | 2.3× |
| Discography Cerv/Thor Spine (72285) | $8,786.40 | $12,552 | 3.8× |
| Diskography lumbar (72295) | $8,786.40 | $12,552 | 3.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $395.50 | $565 | 3.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$705.60–$1,058.40 | $1,008–$1,512 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $361.90 | $517 | 2.9× |
| Dxa Bone Density Axial (77080) | $361.90 | $517 | 2.9× |
| Dxa bone density study (77085) | $415.80 | $594 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $235.90 | $337 | 2.3× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$1,339.10–$2,008.65 | $1,913–$2,869.50 | varies |
| Echo exam uterus (76831) | $579.60 | $828 | 2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $896.70 | $1,281 | 3.1× |
| Echograp Trans R Pros Study (76873) | $484.40 | $692 | 3.9× |
| Esophageal Motility Study (78258) | $1,229.20 | $1,756 | 2.6× |
| Esophagram (74220) | $679.70 | $971 | 3.2× |
| Fetal Biophys Profile W/Nst (76818) | $521.50 | $745 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $423.50 | $605 | 3.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,049.30 | $1,499 | 3.7× |
| Fluoroscopy up to 1 hr (76000) | $466.90 | $667 | 1.6× |
| Follow-Up Angiography (75898) | $2,755.20 | $3,936 | 0.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Gastric emptying imaging study (78264) | $1,313.90 | $1,877 | 2.7× |
| Gastroesophageal Reflux Exam (78262) | $1,229.20 | $1,756 | 2.6× |
| Gated Heart Planar Single (78472) | $1,483.30 | $2,119 | 3.1× |
| Gated Heart, Multiple (78473) | $1,773.80 | $2,534 | 3.7× |
| GI Endoscopic US S&I (76975) | $710.50 | $1,015 | 2.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$345.10–$517.65 | $493–$739.50 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,520 | $3,600 | 3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,258.90 | $3,227 | 2.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,142 | $3,060 | 2.6× |
| Heart Image (Pet) Multiple (78492) | $6,580 | $9,400 | 3.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$3,658.55–$7,317.10 | $5,226.50–$10,453 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $8,608.60 | $12,298 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,465.10 | $2,093 | 2.3× |
| Hepatobiliary System Imaging (78226) | $1,313.90 | $1,877 | 2.7× |
| Ht Musc Image Planar Mult (78454) | $4,467.40 | $6,382 | 2.9× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$1,898.75–$3,797.50 | $2,712.50–$5,425 | varies |
| Hyperthermia external generated superficial (77600) | $1,074.50 | $1,535 | 2.3× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $2,412.90 | $3,447 | 3.6× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $2,412.90 | $3,447 | 3.6× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $2,412.90 | $3,447 | 3.6× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $3,153.50 | $4,505 | 3.8× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$354.55–$709.10 | $506.50–$1,013 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$286.30–$429.45 | $409–$613.50 | varies |
| Infant hip ultrasound, limited static exam (76886) | $315 | $450 | 3.0× |
| Infusion Ivp (74410) | $819.70 | $1,171 | 3.9× |
| Interstitial radiation source applic complex (77778) | $2,773.40 | $3,962 | 3.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,153.50 | $4,505 | 3.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,399.60 | $3,428 | 3.6× |
| Intracavitary radiation source applic simple (77761) | $2,412.90 | $3,447 | 3.6× |
| Joint Survey Single View (77077) | $331.10 | $473 | 2.6× |
| K Flow/Funct Image Multiple (78709) | $1,913.10 | $2,733 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,397.90 | $1,997 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,347.50 | $1,925 | 2.1× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,114.40 | $1,592 | 2.3× |
| Kidney Imaging Morphol (78700) | $1,327.20 | $1,896 | 2.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,229.20 | $1,756 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,229.20 | $1,756 | 2.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,676.50 | $2,395 | 3.5× |
| Liver imaging static only (78201) | $2,118.90 | $3,027 | 3.3× |
| Liver imaging w/vascular flow (78202) | $3,189.20 | $4,556 | 4.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,464.40 | $2,092 | 2.3× |
| Lung perfusion differential (78597) | $1,348.20 | $1,926 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,554.70 | $2,221 | 2.4× |
| Lung Ventilation Imaging (78579) | $1,229.20 | $1,756 | 2.6× |
| Lymph System Imaging (78195) | $1,465.10 | $2,093 | 2.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $2,428.30 | $3,469 | 1.3× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,254.40 | $1,792 | 1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,782.80 | $5,404 | 1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,428.30 | $3,469 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $1,141.70 | $1,631 | 4.0× |
| Magnetic Resonance Elastography (76391) | $217.70 | $311 | 0.8× |
| Mammary ductogram or galactogram single (77053) | $860.30 | $1,229 | 3.0× |
| Meckels Divert Exam (78290) | $1,229.20 | $1,756 | 2.6× |
| Medical physics dose eval radiation expos w/rprt (76145) | $1,684.90 | $2,407 | 3.8× |
| Mlc imrt design & construction per imrt plan (77338) | $1,211.70 | $1,731 | 2.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,908.90 | $2,727 | 4.6× |
| MRA head w/o contrast (70544) | $1,141.70 | $1,631 | 4.0× |
| MRA head with contrast (70545) | $1,651.30 | $2,359 | 3.9× |
| MRA neck w contrast (70548) | $1,651.30 | $2,359 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,908.90 | $2,727 | 4.6× |
| MRA neck w/o contrast (70547) | $1,141.70 | $1,631 | 4.0× |
| MRI abdomen w contrast (74182) | $1,461.60 | $2,088 | 3.5× |
| MRI abdomen w/o contrast (74181) | $1,141.70 | $1,631 | 4.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$859.60–$1,719.20 | $1,228–$2,456 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,719.20–$2,578.80 | $2,456–$3,684 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,719.20 | $2,456 | 1.8× |
| MRI brain functional w/o physician admnistration (70554) | $1,141.70 | $1,631 | 4.0× |
| MRI brain functional w/physician admnistration (70555) | $1,141.70 | $1,631 | 4.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,151.50 | $1,645 | 4.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,151.50 | $1,645 | 4.0× |
| MRI cardiac w/o contrast (75557) | $1,141.70 | $1,631 | 4.0× |
| MRI cervical spine w contrast (72142) | $1,719.20 | $2,456 | 4.1× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$570.85–$1,141.70 | $815.50–$1,631 | varies |
| MRI chest w/o contrast (71550) | $1,141.70 | $1,631 | 4.0× |
| MRI chest with contrast (71551) | $1,461.60 | $2,088 | 1.6× |
| MRI chest wo w contrast (71552) | $1,908.90 | $2,727 | 4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,651.30 | $2,359 | 3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$954.45–$2,863.35 | $1,363.50–$4,090.50 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,141.70 | $1,631 | 4.0× |
| MRI lumbar spine w contrast (72149) | $1,719.20 | $2,456 | 4.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,908.90 | $2,727 | 4.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,141.70 | $1,631 | 4.0× |
| MRI orbit face neck w contrast (70542) | $1,719.20 | $2,456 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,908.90 | $2,727 | 4.6× |
| MRI pelvis w contrast (72196) | $1,403.50 | $2,005 | 3.4× |
| MRI pelvis w/o & w contrast (72197) | $1,759.80 | $2,514 | 4.2× |
| MRI pelvis w/o contrast (72195) | $1,026.20 | $1,466 | 3.6× |
| MRI spectroscopy (76390) | $1,628.20 | $2,326 | 15.6× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$570.85–$1,141.70 | $815.50–$1,631 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,719.20 | $2,456 | 4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$570.85–$1,712.55 | $815.50–$2,446.50 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,908.90 | $2,727 | 4.6× |
| MRI, abdomen, combo (74183) | $1,908.90 | $2,727 | 4.6× |
| MRI, dorsal spine combo (72157) | $1,908.90 | $2,727 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,719.20 | $2,456 | 4.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,141.70–$1,712.55 | $1,631–$2,446.50 | varies |
| MRI, joint upper extrem combo (73223) | $1,908.90 | $2,727 | 4.6× |
| MRI, lumbar spine combo (72158) | $1,908.90 | $2,727 | 4.6× |
| Myelogram cervical (72240) | $1,969.10 | $2,813 | 2.1× |
| Myelogram Lumbar (72265) | $1,969.10 | $2,813 | 2.1× |
| Myelography thoracic (72255) | $1,969.10 | $2,813 | 2.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,969.10 | $2,813 | 2.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,624.30 | $3,749 | 5.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,467.40 | $6,382 | 2.9× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$1,898.75–$3,797.50 | $2,712.50–$5,425 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,295.20 | $6,136 | 2.5× |
| N-invas est c ffr sw aly CTA (75580) | $2,396.10 | $3,423 | 2.3× |
| Neck soft tissue (70360) | $233.10 | $333 | 2.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,074.50 | $1,535 | 2.3× |
| Nm csf leak detection (78650) | $2,577.40 | $3,682 | 1.7× |
| Nonvascular Shunt X-Ray (75809) | $484.40 | $692 | 3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,194.70 | $7,421 | 3.1× |
| Nuclear Rx Intra-Arterial (79445) | $661.50 | $945 | 2.4× |
| Nuclear Rx Oral Admin (79005) | $836.50 | $1,195 | 3.0× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$242.55–$485.10 | $346.50–$693 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $227.50 | $325 | 1.8× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$406.70–$610.05 | $581–$871.50 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 4 matching MRF lines |
$138.60–$415.80 | $198–$594 | varies |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $387.10 | $553 | 3.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$470.40–$705.60 | $672–$1,008 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $112 | $160 | 3.2× |
| Ophthalmic us dx quantitative a-scan only (76511) | $420 | $600 | 3.4× |
| Panoramic X-ray of jaws (70355) | $197.40 | $282 | 1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,068.50 | $2,955 | 3.2× |
| Parathyroid Planar Imaging (78070) | $945 | $1,350 | 2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,997.80 | $2,854 | 4.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$146.65–$293.30 | $209.50–$419 | varies |
| Perineogram (74775) | $819.70 | $1,171 | 2.9× |
| Peritoneogram Rs&I (74190) | $1,997.80 | $2,854 | 3.1× |
| PET image w/CT, full body (78816) | $5,280.80 | $7,544 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,280.80 | $7,544 | 3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,317.10 | $10,453 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,045.10 | $1,493 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $429.10 | $613 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $929.60 | $1,328 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $395.50 | $565 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $233.80 | $334 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $230.30 | $329 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) | $311.50 | $445 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $233.10 | $333 | 2.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $527.10 | $753 | 2.5× |
| Radex Spine 1 View Specify Level (72020) | $219.10 | $313 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $233.10 | $333 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$113.05–$226.10 | $161.50–$323 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $345.80 | $494 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $532 | $760 | 4.2× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$336–$1,109.50 | $480–$1,585 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$542.50–$1,936.20 | $775–$2,766 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$870.80–$2,013.20 | $1,244–$2,876 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $296.10 | $423 | 2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$180.95–$361.90 | $258.50–$517 | varies |
| Radiologic exam colon double contrast study (74280) | $772.80 | $1,104 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $609.70 | $871 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $507.50 | $725 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$233.80–$350.70 | $334–$501 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $233.80 | $334 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $453.60 | $648 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $582.40 | $832 | 2.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $482.30 | $689 | 2.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$264.60–$396.90 | $378–$567 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$75.60–$113.40 | $108–$162 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $429.10 | $613 | 3.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $303.10 | $433 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $438.20 | $626 | 0.7× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $224 | $320 | 2.1× |
| Radiopharm Dacryocystography (78660) | $945 | $1,350 | 2.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,124.90 | $1,607 | 4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $2,142 | $3,060 | 4.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $2,142 | $3,060 | 4.6× |
| Renal Cyst Study (74470) | $2,350.60 | $3,358 | 3.6× |
| Ribs bilateral 3 views (71110) | $415.10 | $593 | 3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,342.60 | $1,918 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,040 | $7,200 | 7.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,991.10 | $4,273 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$1,660.05–$3,320.10 | $2,371.50–$4,743 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,199.80 | $1,714 | 0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,514.80 | $2,164 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,320.10 | $4,743 | 2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,135.40 | $1,622 | 4.1× |
| Rp Therapy Intravenous Administration (79101) | $814.10 | $1,163 | 2.9× |
| Scapula (73010) | $233.10 | $333 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$49.70–$99.40 | $71–$142 | varies |
| Sella turcica (70240) | $233.10 | $333 | 2.2× |
| Shoulder 1 view (73020) | $264.60 | $378 | 2.5× |
| Shoulder Arthrography (73040) | $1,023.40 | $1,462 | 2.4× |
| Skull less than 4 views (70250) | $361.90 | $517 | 2.9× |
| Special dosimetry (77331) | $427 | $610 | 2.7× |
| Special Physics Consult (77370) | $2,679.60 | $3,828 | 16.6× |
| Special teletherapy port plan (77321) | $961.80 | $1,374 | 2.1× |
| Special treatment procedure (77470) | $1,536.50 | $2,195 | 2.3× |
| Speech evaluation, complex (70371) | $570.50 | $815 | 2.0× |
| Spleen Imaging (78185) | $1,229.20 | $1,756 | 2.6× |
| Srs Multisource (77371) | $52,813.60 | $75,448 | 6.0× |
| Stereotactic Body Radiation Delivery (77373) | $6,119.40 | $8,742 | 2.9× |
| Sternoclavicular joints (71130) | $233.10 | $333 | 2.2× |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$2,261–$3,391.50 | $3,230–$4,845 | varies |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $263.20 | $376 | 2.2× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $1,180.20 | $1,686 | 26.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,637.30 | $2,339 | 13.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $824.60 | $1,178 | 1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $537.60 | $768 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $900.20 | $1,286 | 3.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,526 | $2,180 | 3.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,131.90 | $1,617 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $525 | $750 | 3.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $530.60 | $758 | 2.5× |
| Thoracic spine 2 views (72070) | $336 | $480 | 2.7× |
| Thoracic spine 3 views (72072) | $385.70 | $551 | 3.1× |
| Thoracolumbar 2 views (72080) | $233.10 | $333 | 2.2× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $1,229.20 | $1,756 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $1,087.80 | $1,554 | 2.3× |
| Thyroid Met Imaging Body (78018) | $1,348.20 | $1,926 | 2.1× |
| Thyroid Uptake Measurement (78012) | $899.50 | $1,285 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,185.10 | $1,693 | 2.5× |
| Tx Devices Design & Construction Complex (77334) | $1,487.50 | $2,125 | 3.3× |
| Tx devices design & construction intermediate (77333) | $529.90 | $757 | 3.3× |
| Tx devices design & construction simple (77332) | $529.90 | $757 | 3.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$140.70–$422.10 | $201–$603 | varies |
| Ultrasound Elastography Parenchyma (76981) | $361.90 | $517 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $298.20 | $426 | 2.4× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$365.40–$408.80 | $522–$584 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$180.95–$361.90 | $258.50–$517 | varies |
| Unlis px ther radiol clinical tx planning (77299) | $1,120 | $1,600 | 7.0× |
| Unlisted Dx Radiographic Procedure (76499) | $233.10 | $333 | 2.2× |
| Unlisted fluoroscopic procedure (76496) | $308 | $440 | 3.0× |
| Unlisted magnetic resonance procedure (76498) | $683.90 | $977 | 6.6× |
| Unlisted us procedure (76999) | $352.80 | $504 | 3.4× |
| Upper gi w/o kub (74240) | $609.70 | $871 | 2.9× |
| Ureteral Reflux Study (78740) | $1,327.20 | $1,896 | 2.8× |
| Urethrocystogram voiding (74455) | $636.30 | $909 | 2.2× |
| Urethrocystography retrograde (74450) | $543.20 | $776 | 1.9× |
| Us breast unilateral complete (76641) | $283.50 | $405 | 2.3× |
| Us chest (76604) | $398.30 | $569 | 3.2× |
| Us complete joint (76881) range across 4 matching MRF lines |
$425.60–$638.40 | $608–$912 | varies |
| Us exam, pelvic, limited (76857) | $361.90 | $517 | 2.9× |
| Us head (76506) | $428.40 | $612 | 3.4× |
| Us kidney transplant (76776) | $452.20 | $646 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $234.50 | $335 | 1.9× |
| Us ob detailed single fetus (76811) | $870.10 | $1,243 | 3.0× |
| Us ob limited 1 or more fetuses (76815) | $408.80 | $584 | 3.3× |
| Us ob transvaginal (76817) | $428.40 | $612 | 3.4× |
| Us pelvic non ob complete (76856) | $452.90 | $647 | 3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $466.90 | $667 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $507.50 | $725 | 4.1× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$356.30–$452.20 | $509–$646 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$350.70–$431.90 | $501–$617 | varies |
| Us scrotum and contents (76870) | $433.30 | $619 | 3.5× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$262.50–$302.40 | $375–$432 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$373.80–$448 | $534–$640 | varies |
| Us transrectal (76872) | $452.20 | $646 | 3.6× |
| Vascular Flow Imaging (78445) | $1,155.70 | $1,651 | 2.4× |
| Vasogram (74440) | $819.70 | $1,171 | 2.9× |
| Vein X-Ray Chest (75827) | $4,109.70 | $5,871 | 2.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$1,746.50–$3,493 | $2,495–$4,990 | varies |
| Vein X-Ray Skull Epidural (75872) | $4,109.70 | $5,871 | 5.5× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$6,632.50–$9,948.75 | $9,475–$14,212.50 | varies |
| Venography Adrenal Unilateral (75840) | $8,608.60 | $12,298 | 2.3× |
| Venography caval inferior serialography rs&i (75825) | $7,317.10 | $10,453 | 1.9× |
| Venography extremity bilateral rs&i (75822) | $2,410.10 | $3,443 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $2,577.40 | $3,682 | 1.4× |
| Venography Orbital Rs&I (75880) | $4,109.70 | $5,871 | 5.5× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$8,608.60–$12,912.90 | $12,298–$18,447 | varies |
| Venography Renal Unilateral (75831) | $7,317.10 | $10,453 | 1.9× |
| Venous sampling by catheter (75893) | $10,398.50 | $14,855 | 1.6× |
| Venous thrombosis imaging (78457) | $2,202.90 | $3,147 | 3.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,229.20 | $1,756 | 2.6× |
| Vertebral fracture assessment via dxa (77086) | $233.10 | $333 | 2.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$116.55–$349.65 | $166.50–$499.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| X-ray antegrade pyelogram tube (74425) | $872.90 | $1,247 | 2.1× |
| X-Ray Aorta Leg Arteries (75630) | $7,317.10 | $10,453 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $695.80 | $994 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $75.60 | $108 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $459.20 | $656 | 3.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $180.60 | $258 | 1.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $264.60 | $378 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$75.60–$113.40 | $108–$162 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$390.60–$411.60 | $558–$588 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$361.90–$542.85 | $517–$775.50 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$126–$189 | $180–$270 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$462.70–$694.05 | $661–$991.50 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $429.10 | $613 | 3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $282.80 | $404 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $429.10 | $613 | 3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $296.10 | $423 | 2.4× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$233.10–$349.65 | $333–$499.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $819.70 | $1,171 | 3.9× |
| X-ray IV pyelogram+tomography (74415) | $819.70 | $1,171 | 3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $233.10 | $333 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$282.80–$424.20 | $404–$606 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $361.90 | $517 | 2.9× |
| X-ray nose-rectum child f.b. (76010) | $233.80 | $334 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$429.10–$643.65 | $613–$919.50 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $361.90 | $517 | 2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $268.10 | $383 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $233.10 | $333 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $233.10 | $333 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $429.10 | $613 | 3.4× |
| X-Ray Stress View (77071) | $270.20 | $386 | 2.6× |
| X-ray thoracic spine 4 vw (72074) | $390.60 | $558 | 3.1× |
| X-Ray Tmj Unilat (70328) | $311.50 | $445 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,199.10 | $1,713 | 2.9× |
| X-Rays Bone Length Studies (77073) | $286.30 | $409 | 2.3× |
| X-Rays Bone Survey Complete (77075) | $429.10 | $613 | 3.4× |
| Xr c-spine 4 or 5 views (72050) | $429.10 | $613 | 3.4× |
| Xr facial bones less than 3 views (70140) | $233.10 | $333 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $233.10 | $333 | 1.9× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$143.15–$286.30 | $204.50–$409 | varies |
| Xr Tomogram Single Plane (76100) | $429.10 | $613 | 3.4× |
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.