Imaging prices at UAMS Medical Center
Little Rock, AR · every code in this section with a posted price and a Medicare benchmark.
447 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) | $2,451 | $4,085 | 1.9× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$118.80–$129.60 | $198–$216 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$103.20–$141.60 | $172–$236 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $624 | $1,040 | 1.7× |
| Adrenal Cortex & Medulla Img (78075) | $1,196.40 | $1,994 | 1.0× |
| Angio internal mammary (75756) | $2,622 | $4,370 | 0.9× |
| Angio pulmonary bilat (75743) | $2,857.80 | $4,763 | 1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,622 | $4,370 | 0.9× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$2,622–$2,857.80 | $4,370–$4,763 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$2,622–$2,857.80 | $4,370–$4,763 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,857.80 | $4,763 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,622 | $4,370 | 0.9× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$103.20–$206.40 | $172–$344 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,370.40 | $7,284 | 0.8× |
| Artery X-Rays Abdomen (75726) range across 4 matching MRF lines |
$4,370.40–$9,528 | $7,284–$15,880 | varies |
| Artery X-Rays Adrenal Gland (75731) | $2,622 | $4,370 | 0.9× |
| Artery X-Rays Pelvis (75736) range across 5 matching MRF lines |
$4,202.40–$8,740.80 | $7,004–$14,568 | varies |
| Artery X-Rays Spine (75705) | $4,758.60 | $7,931 | 0.9× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$574.20–$643.20 | $957–$1,072 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$354–$375 | $590–$625 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$207–$225.60 | $345–$376 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,075.80–$1,204.80 | $1,793–$2,008 | varies |
| Bone Imaging Limited Area (78300) | $345.60 | $576 | 0.9× |
| Bone Imaging Multiple Areas (78305) | $345.60 | $576 | 0.9× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$955.80–$1,041.60 | $1,593–$1,736 | varies |
| Bone marrow imaging limited area (78102) | $345.60 | $576 | 0.9× |
| Bone marrow imaging; multiple areas (78103) | $345.60 | $576 | 0.9× |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$383.40–$406.20 | $639–$677 | varies |
| Bone survey infant (77076) | $180 | $300 | 1.8× |
| Brachytx isodose complex (77318) | $310.20 | $517 | 0.9× |
| Brachytx isodose intermed (77317) | $310.20 | $517 | 0.9× |
| Brachytx Isodose Plan Simple (77316) | $310.20 | $517 | 0.9× |
| Brain Flow Imaging Only (78610) | $475.20 | $792 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $448.20 | $747 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$1,642.20–$1,789.80 | $2,737–$2,983 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$1,054.80–$1,149.60 | $1,758–$1,916 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,227 | $2,045 | 1.7× |
| Cardiac Shunt Detection (78428) | $345.60 | $576 | 0.9× |
| Cat Scan Follow-Up Study (76380) | $118.80 | $198 | 1.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $448.20 | $747 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $448.20 | $747 | 0.9× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$74.40–$162 | $124–$270 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$74.40–$83.40 | $124–$139 | varies |
| Chest 4 or more views (71048) | $109.20 | $182 | 1.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$115.80–$126 | $193–$210 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$94.20–$102.60 | $157–$171 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$277.20–$302.40 | $462–$504 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,622–$2,857.80 | $4,370–$4,763 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$354–$385.80 | $590–$643 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$354–$375 | $590–$625 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $354 | $590 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$1,298.40–$1,415.40 | $2,164–$2,359 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$761.40–$829.80 | $1,269–$1,383 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$947.40–$1,032.60 | $1,579–$1,721 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$994.80–$1,084.20 | $1,658–$1,807 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$428.40–$929.40 | $714–$1,549 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,242–$1,287.60 | $2,070–$2,146 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$676.80–$738 | $1,128–$1,230 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$1,137–$1,239.60 | $1,895–$2,066 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$634.80–$748.80 | $1,058–$1,248 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$135.90–$271.80 | $226.50–$453 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$1,139.40–$1,165.20 | $1,899–$1,942 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$774.60–$844.20 | $1,291–$1,407 | varies |
| CT bone density (77078) | $269.40 | $449 | 3.3× |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$609–$663.60 | $1,015–$1,106 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$579–$631.20 | $965–$1,052 | varies |
| CT cervical spine w/wo cont (72127) | $699 | $1,165 | 4.2× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$610.80–$666 | $1,018–$1,110 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$643.20–$700.80 | $1,072–$1,168 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $756.60 | $1,261 | 4.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $687 | $1,145 | 7.0× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$574.20–$625.80 | $957–$1,043 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$724.80–$839.94 | $1,208–$1,399.90 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $634.80 | $1,058 | 1.9× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$93.60–$102 | $156–$170 | varies |
| CT hrt w/3d image congen (75573) range across 3 matching MRF lines |
$634.80–$691.80 | $1,058–$1,153 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$769.20–$838.20 | $1,282–$1,397 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$981–$1,066.20 | $1,635–$1,777 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$69–$222.60 | $115–$371 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$228.60–$587.40 | $381–$979 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$931.80–$1,015.80 | $1,553–$1,693 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$885.60–$965.40 | $1,476–$1,609 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$697.80–$760.80 | $1,163–$1,268 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$603–$657 | $1,005–$1,095 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$851.40–$1,026.54 | $1,419–$1,710.90 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$848.40–$924.60 | $1,414–$1,541 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$732.60–$798.60 | $1,221–$1,331 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$749.40–$839.40 | $1,249–$1,399 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$535.20–$583.20 | $892–$972 | varies |
| CT scan of leg combo (73702) | $275.40 | $459 | 1.7× |
| CT scans face/jaw combo (70488) | $807.60 | $1,346 | 4.9× |
| CT soft tissue neck w contrast (70491) | $832.20 | $1,387 | 5.0× |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$178.80–$732.60 | $298–$1,221 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$687–$748.80 | $1,145–$1,248 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$652.80–$711.60 | $1,088–$1,186 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$766.20–$1,116.48 | $1,277–$1,860.80 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$580.20–$632.40 | $967–$1,054 | varies |
| CT unlisted procedure (76497) | $74.40 | $124 | 0.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$752.40–$842.40 | $1,254–$1,404 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $885.60 | $1,476 | 5.4× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$771.60–$864 | $1,286–$1,440 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$901.80–$982.80 | $1,503–$1,638 | varies |
| Cta Abdomen (74175) | $1,096.80 | $1,828 | 6.7× |
| CTA pelvis (72191) range across 3 matching MRF lines |
$867.60–$953.38 | $1,446–$1,588.96 | varies |
| Discography Cerv/Thor Spine (72285) | $1,607.40 | $2,679 | 0.9× |
| Diskography lumbar (72295) | $1,607.40 | $2,679 | 0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $174.60 | $291 | 1.8× |
| Dxa Bone Density Axial (77080) range across 6 matching MRF lines |
$193.80–$264 | $323–$440 | varies |
| Dxa bone density study (77085) range across 4 matching MRF lines |
$253.80–$264 | $423–$440 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 5 matching MRF lines |
$88.80–$104.40 | $148–$174 | varies |
| Echo exam of fetal heart (76825) | $456.60 | $761 | 0.9× |
| Echo exam uterus (76831) | $252 | $420 | 1.1× |
| Echo Guide For Artery Repair (76936) | $242.40 | $404 | 1.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $211.80 | $353 | 0.9× |
| Esophagram (74220) range across 2 matching MRF lines |
$185.40–$202.20 | $309–$337 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$296.40–$322.80 | $494–$538 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $157.80 | $263 | 1.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $211.80 | $353 | 0.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$250.80–$273.60 | $418–$456 | varies |
| Follow-Up Angiography (75898) | $2,538.60 | $4,231 | 0.9× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$42.90–$85.80 | $71.50–$143 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$37.20–$81 | $62–$135 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$610.80–$666 | $1,018–$1,110 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $345.60 | $576 | 0.9× |
| Gastric Mucosa Imaging (78261) | $351.60 | $586 | 0.9× |
| Gastroesophageal Reflux Exam (78262) | $351.60 | $586 | 0.9× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$507.60–$565 | $846–$941.67 | varies |
| Gated Heart, Multiple (78473) | $345.60 | $576 | 0.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $448.20 | $747 | 0.9× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$51.60–$112.20 | $86–$187 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $649.20 | $1,082 | 1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $649.20 | $1,082 | 1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $649.20 | $1,082 | 1.0× |
| Heart first pass single,planar (78481) | $448.20 | $747 | 0.9× |
| Heart Image (Pet) Multiple (78492) | $1,356 | $2,260 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$2,622–$2,936.40 | $4,370–$4,894 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$2,622–$2,936.40 | $4,370–$4,894 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$559.09–$574.20 | $931.81–$957 | varies |
| Hepatobiliary System Imaging (78226) | $476.40 | $794 | 1.3× |
| Ht Musc Image Planar Mult (78454) | $1,196.40 | $1,994 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $2,130 | $3,550 | 1.8× |
| Hyperthermia external generated superficial (77600) | $221.40 | $369 | 0.6× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $496.80 | $828 | 1.0× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $496.80 | $828 | 1.0× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $496.80 | $828 | 1.0× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $649.20 | $1,082 | 1.0× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$231.60–$245.40 | $386–$409 | varies |
| Image fusion (77399) | $207 | $345 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $74.40 | $124 | 0.9× |
| Infant hip ultrasound, limited static exam (76886) | $74.40 | $124 | 0.9× |
| Interstitial radiation source applic complex (77778) | $649.20 | $1,082 | 1.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $649.20 | $1,082 | 1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $496.80 | $828 | 1.0× |
| Intracavitary radiation source applic simple (77761) | $496.80 | $828 | 1.0× |
| K Flow/Funct Image Multiple (78709) | $867 | $1,445 | 1.7× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$474.60–$517.20 | $791–$862 | varies |
| Kidney Imaging Morphol (78700) | $345 | $575 | 0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $345 | $575 | 0.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$44.10–$96 | $73.50–$160 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $345.60 | $576 | 0.9× |
| Leveen/Shunt Patency Exam (78291) | $345.60 | $576 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $345.60 | $576 | 0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $345.60 | $576 | 0.9× |
| Liver imaging static only (78201) | $1,128 | $1,880 | 2.2× |
| Liver imaging w/vascular flow (78202) | $1,128 | $1,880 | 2.2× |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$527.40–$574.80 | $879–$958 | varies |
| Lung perfusion differential (78597) | $345.60 | $576 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$448.20–$488.40 | $747–$814 | varies |
| Lung Ventilation Imaging (78579) | $345.60 | $576 | 0.9× |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$778.80–$872.40 | $1,298–$1,454 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,288.20 | $2,147 | 0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) | $568.80 | $948 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,622 | $4,370 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,622 | $4,370 | 0.9× |
| Magnetic Image Jaw Joint (70336) | $211.80 | $353 | 0.9× |
| Magnetic Resonance Elastography (76391) range across 3 matching MRF lines |
$211.80–$237 | $353–$395 | varies |
| Mammary ductogram or galactogram multiple (77054) | $211.80 | $353 | 0.9× |
| Mammary ductogram or galactogram single (77053) | $211.80 | $353 | 0.9× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$345.60–$366.60 | $576–$611 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $530.40 | $884 | 1.5× |
| Mr safety determination physician/other qhp (76016) | $55.80 | $93 | 0.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $15.60 | $26 | 0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $58.20 | $97 | 0.7× |
| Mr safety implt pos&/immoblj (76019) | $37.20 | $62 | 0.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $152.40 | $254 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,253.40–$1,566.60 | $2,089–$2,611 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,082.40–$2,475.83 | $1,804–$4,126.38 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$1,105.20–$1,464.60 | $1,842–$2,441 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$904.20–$958.20 | $1,507–$1,597 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,153.80–$1,257.60 | $1,923–$2,096 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$889.80–$969.60 | $1,483–$1,616 | varies |
| MRI abdomen w contrast (74182) | $1,260 | $2,100 | 3.8× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,044.60–$1,138.80 | $1,741–$1,898 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$735.60–$1,236 | $1,226–$2,060 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$769.20–$1,292.40 | $1,282–$2,154 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$962.70–$1,925.40 | $1,604.50–$3,209 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$886.80–$940.20 | $1,478–$1,567 | varies |
| MRI brain functional w/physician admnistration (70555) | $1,590 | $2,650 | 7.1× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$211.80–$237 | $353–$395 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $237 | $395 | 1.1× |
| MRI cardiac w/o cont stress (75559) | $1,071.60 | $1,786 | 2.1× |
| MRI cardiac w/o contrast (75557) | $994.20 | $1,657 | 4.4× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,018.80–$1,080 | $1,698–$1,800 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$958.20–$1,044.60 | $1,597–$1,741 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$750–$817.80 | $1,250–$1,363 | varies |
| MRI chest with contrast (71551) | $850.80 | $1,418 | 1.2× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$789.60–$884.40 | $1,316–$1,474 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,144.20–$1,716.60 | $1,907–$2,861 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$1,382.40–$2,322 | $2,304–$3,870 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 7 matching MRF lines |
$495.90–$2,887.80 | $826.50–$4,813 | varies |
| MRI lumbar spine w contrast (72149) | $763.80 | $1,273 | 2.3× |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$1,099.80–$1,198.80 | $1,833–$1,998 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$890.40–$970.80 | $1,484–$1,618 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$935.40–$993 | $1,559–$1,655 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,193.40–$1,300.80 | $1,989–$2,168 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$911.40–$990.60 | $1,519–$1,651 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$956.40–$1,042.20 | $1,594–$1,737 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$862.20–$939.60 | $1,437–$1,566 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$665.40–$745.20 | $1,109–$1,242 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$958.20–$1,044.60 | $1,597–$1,741 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$993.60–$1,490.40 | $1,656–$2,484 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$816.60–$1,460.40 | $1,361–$2,434 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$965.40–$1,621.80 | $1,609–$2,703 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$1,267.20–$1,381.20 | $2,112–$2,302 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$1,635–$1,693.20 | $2,725–$2,822 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,018.80–$1,080 | $1,698–$1,800 | varies |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$859.50–$2,578.80 | $1,432.50–$4,298 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$1,357.20–$2,280 | $2,262–$3,800 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$859.20–$936.60 | $1,432–$1,561 | varies |
| Myelogram cervical (72240) | $714 | $1,190 | 1.0× |
| Myelogram Lumbar (72265) | $714 | $1,190 | 1.0× |
| Myelography thoracic (72255) | $714 | $1,190 | 1.0× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$655.20–$714 | $1,092–$1,190 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $345.60 | $576 | 0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,196.40 | $1,994 | 1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,196.40 | $1,994 | 1.0× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,969.20–$2,062.20 | $3,282–$3,437 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,356 | $2,260 | 1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) range across 2 matching MRF lines |
$1,356–$1,437.60 | $2,260–$2,396 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) range across 2 matching MRF lines |
$2,065.20–$2,251.20 | $3,442–$3,752 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$85.20–$93 | $142–$155 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $221.40 | $369 | 0.6× |
| Nm csf leak detection (78650) | $1,196.40 | $1,994 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $286.80 | $478 | 2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,073.80 | $5,123 | 2.4× |
| Nuclear Rx Intra-Arterial (79445) | $1,264.80 | $2,108 | 5.8× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$272.40–$297 | $454–$495 | varies |
| Ob us nuchal meas 1 gest (76813) | $103.20 | $172 | 1.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 3 matching MRF lines |
$181.80–$363.60 | $303–$606 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $232.80 | $388 | 2.4× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 2 matching MRF lines |
$102.60–$153.60 | $171–$256 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $189.60 | $316 | 1.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$132–$363.60 | $220–$606 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 6 matching MRF lines |
$132.30–$475.20 | $220.50–$792 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$22.80–$24 | $38–$40 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) range across 4 matching MRF lines |
$158.40–$316.80 | $264–$528 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$448.20–$488.40 | $747–$814 | varies |
| Parathyroid Planar Imaging (78070) | $564 | $940 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $345.60 | $576 | 0.9× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$103.20–$224.40 | $172–$374 | varies |
| Peritoneogram Rs&I (74190) | $538.20 | $897 | 1.0× |
| Pet Image Skull-Thigh (78812) | $1,356 | $2,260 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $1,356 | $2,260 | 1.0× |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$1,642.20–$1,789.80 | $2,737–$2,983 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$1,642.20–$1,789.80 | $2,737–$2,983 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,196.40 | $1,994 | 1.0× |
| PET whole body (78813) range across 3 matching MRF lines |
$1,356–$1,437.60 | $2,260–$2,396 | varies |
| Proton tx delivery intermediate (77523) | $1,257 | $2,095 | 1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,779.20 | $4,632 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $345.60 | $576 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$112.80–$123 | $188–$205 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$456.60–$497.40 | $761–$829 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$66–$264 | $110–$440 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$100.20–$112.20 | $167–$187 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$125.40–$136.80 | $209–$228 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$74.40–$162 | $124–$270 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$65.10–$142.20 | $108.50–$237 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$37.20–$81 | $62–$135 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $78.60 | $131 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $103.20 | $172 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $81 | $135 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$40.20–$87.60 | $67–$146 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $74.40 | $124 | 0.9× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$118.80–$129.60 | $198–$216 | varies |
| Radex Sternum Minimum 2 Views (71120) | $74.40 | $124 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $85.20 | $142 | 1.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$120.60–$131.40 | $201–$219 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $103.20 | $172 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$66–$264 | $110–$440 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $174.60 | $291 | 1.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $24,799.80 | $41,333 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $207 | $345 | 2.2× |
| Radiation treatment delivery level 2 (77407) | $221.40 | $369 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $41.40 | $69 | 0.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$103.20–$153.60 | $172–$256 | varies |
| Radiologic exam colon double contrast study (74280) | $226.80 | $378 | 1.4× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$185.40–$202.20 | $309–$337 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $167.40 | $279 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$64.80–$145.20 | $108–$242 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$131.40–$143.40 | $219–$239 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$163.80–$178.80 | $273–$298 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$163.80–$178.80 | $273–$298 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$185.40–$202.20 | $309–$337 | varies |
| Radiologic examination femur 1 view (73551) | $74.40 | $124 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$37.20–$89.40 | $62–$149 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$37.20–$81 | $62–$135 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $161.40 | $269 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$37.20–$354.60 | $62–$591 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $221.40 | $369 | 0.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $221.40 | $369 | 0.6× |
| Renal Cyst Study (74470) | $456.60 | $761 | 0.9× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $345.60 | $576 | 0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $366.60 | $611 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,196.40 | $1,994 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,196.40 | $1,994 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,196.40–$1,303.80 | $1,994–$2,173 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,196.40 | $1,994 | 1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,356 | $2,260 | 1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 3 matching MRF lines |
$1,196.40–$1,339.80 | $1,994–$2,233 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $228.60 | $381 | 1.0× |
| Rp Therapy Intravenous Administration (79101) | $297 | $495 | 1.4× |
| Salivary Gland Imaging (78230) | $351.60 | $586 | 0.9× |
| Scapula (73010) range across 3 matching MRF lines |
$129–$144.60 | $215–$241 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$99–$108 | $165–$180 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| Shoulder Arthrography (73040) | $530.40 | $884 | 1.6× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Special dosimetry (77331) | $207 | $345 | 1.6× |
| Special Physics Consult (77370) | $255.60 | $426 | 2.0× |
| Special teletherapy port plan (77321) | $310.20 | $517 | 0.9× |
| Special treatment procedure (77470) | $1,007.40 | $1,679 | 1.9× |
| Speech evaluation, complex (70371) | $211.80 | $353 | 0.9× |
| Stereotactic Body Radiation Delivery (77373) | $5,505.60 | $9,176 | 3.3× |
| Sternoclavicular joints (71130) | $74.40 | $124 | 0.9× |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$2,622–$2,779.20 | $4,370–$4,632 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $110.40 | $184 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $310.20 | $517 | 0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $310.20 | $517 | 0.9× |
| Testicular Imaging W/Flow (78761) | $345.60 | $576 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $646.20 | $1,077 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $431.40 | $719 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $394.20 | $657 | 3.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Thoracic spine 3 views (72072) | $112.20 | $187 | 1.1× |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$109.80–$119.40 | $183–$199 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $345.60 | $576 | 0.9× |
| Thyroid Imaging With Vascular Flow (78013) | $345.60 | $576 | 0.9× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$824.40–$1,091.29 | $1,374–$1,818.81 | varies |
| Thyroid Uptake Measurement (78012) | $345.60 | $576 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$411–$460.20 | $685–$767 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$338.40–$340.20 | $564–$567 | varies |
| Tx devices design & construction intermediate (77333) | $207 | $345 | 1.6× |
| Tx devices design & construction simple (77332) | $207 | $345 | 1.6× |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$72.60–$162.60 | $121–$271 | varies |
| Ultrasound elastography first target lesion (76982) | $103.20 | $172 | 1.1× |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Ultrasound Exam Aaa Screen (76706) | $103.20 | $172 | 1.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $185.40 | $309 | 0.6× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$132.60–$144.60 | $221–$241 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$135.60–$147.60 | $226–$246 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $74.40 | $124 | 0.9× |
| Unlisted fluoroscopic procedure (76496) | $74.40 | $124 | 0.9× |
| Unlisted magnetic resonance procedure (76498) | $74.40 | $124 | 0.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $207 | $345 | 2.2× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$109.80–$119.40 | $183–$199 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$185.40–$202.20 | $309–$337 | varies |
| Ureteral Reflux Study (78740) | $345.60 | $576 | 0.9× |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$211.80–$231 | $353–$385 | varies |
| Urethrocystography retrograde (74450) | $247.80 | $413 | 1.1× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$65.10–$218.40 | $108.50–$364 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$93–$101.40 | $155–$169 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$103.20–$115.80 | $172–$193 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Us head (76506) range across 2 matching MRF lines |
$234.60–$248.40 | $391–$414 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$326.40–$355.80 | $544–$593 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$154.80–$168.60 | $258–$281 | varies |
| Us ob detailed single fetus (76811) | $231 | $385 | 1.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$184.80–$201.60 | $308–$336 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$140.40–$153 | $234–$255 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$139.80–$152.40 | $233–$254 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$190.80–$208.20 | $318–$347 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$172.20–$187.80 | $287–$313 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$142.20–$154.80 | $237–$258 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$249.60–$271.80 | $416–$453 | varies |
| Us spinal canal and contents (76800) | $157.20 | $262 | 1.6× |
| Us thyroid (76536) range across 3 matching MRF lines |
$365.40–$398.40 | $609–$664 | varies |
| Us transrectal (76872) | $273 | $455 | 2.8× |
| Vascular Flow Imaging (78445) | $345.60 | $576 | 0.9× |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,288.20–$1,404 | $2,147–$2,340 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$2,622–$2,779.20 | $4,370–$4,632 | varies |
| Vein X-Ray Spleen/Liver (75810) | $2,622 | $4,370 | 0.9× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$2,622–$2,779.20 | $4,370–$4,632 | varies |
| Venography Adrenal Unilateral (75840) | $2,622 | $4,370 | 0.9× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$2,622–$2,857.80 | $4,370–$4,763 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$1,288.20–$1,404 | $2,147–$2,340 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$1,288.20–$1,404 | $2,147–$2,340 | varies |
| Venography Renal Bilateral (75833) | $2,691 | $4,485 | 0.9× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,622–$2,691 | $4,370–$4,485 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$4,370.40–$8,740.80 | $7,284–$14,568 | varies |
| Venous thrombosis imaging (78457) | $1,128 | $1,880 | 2.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $345.60 | $576 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $74.40 | $124 | 0.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$68.10–$136.20 | $113.50–$227 | varies |
| X-ray antegrade pyelogram tube (74425) | $354 | $590 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,622 | $4,370 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $172.80 | $288 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$40.50–$81 | $67.50–$135 | varies |
| X-Ray Exam Breast Specimen (76098) | $456.60 | $761 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$103.20–$143.40 | $172–$239 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$74.40–$98.40 | $124–$164 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$103.20–$115.80 | $172–$193 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $128.40 | $214 | 1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$103.20–$145.80 | $172–$243 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $220.20 | $367 | 2.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$74.40–$148.80 | $124–$248 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$149.40–$162.60 | $249–$271 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$37.20–$81 | $62–$135 | varies |
| X-ray IV pyelogram (ivp) (74400) | $273 | $455 | 1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $74.40 | $124 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $86.40 | $144 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$103.20–$112.20 | $172–$187 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $103.20 | $172 | 1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$122.40–$133.20 | $204–$222 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $112.20 | $187 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$74.40–$81 | $124–$135 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $115.80 | $193 | 1.2× |
| X-Ray Stress View (77071) range across 3 matching MRF lines |
$129–$136.80 | $215–$228 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$129.60–$141 | $216–$235 | varies |
| X-Ray Tmj Unilat (70328) | $85.20 | $142 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $174 | $290 | 0.5× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$124.80–$136.20 | $208–$227 | varies |
| X-Rays Bone Survey Complete (77075) | $240.60 | $401 | 2.4× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$118.80–$129.60 | $198–$216 | varies |
| Xr facial bones less than 3 views (70140) | $74.40 | $124 | 0.9× |
| Xr orbits complete 4 views (70200) | $103.20 | $172 | 1.1× |
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.