Imaging prices at UCF Lake Nona Hospital
Orlando, FL · every code in this section with a posted price and a Medicare benchmark.
266 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $17,680.29 | $17,680.29 | 12.2× |
| Abdomen 2 views (74019) | $4,415.30 | $4,415.30 | 40.4× |
| Acute gi blood loss imaging (78278) | $7,026.39 | $7,026.39 | 16.8× |
| Angiography extremity bilateral rs&i (75716) | $18,539.54 | $18,539.54 | 5.6× |
| Angiography extremity unilateral rs&i (75710) | $7,787.15 | $7,787.15 | 2.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $3,317.93 | $3,317.93 | 0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $5,539.62 | $5,539.62 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,261.07 | $5,261.07 | 1.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $5,261.07 | $5,261.07 | 0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) | $1,271.46 | $1,271.46 | 0.4× |
| Ankle 2 views (73600) | $2,186.87 | $2,186.87 | 24.1× |
| Aortogram thoracic (75605) | $14,634.17 | $14,634.17 | 2.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $23,951.12 | $23,951.12 | 7.3× |
| Aortography abdominal serialography rs&i (75625) | $15,633.82 | $15,633.82 | 4.7× |
| Arthrogram elbow (73085) | $1,607.09 | $1,607.09 | 4.4× |
| Arthrogram hip (73525) | $6,024.84 | $6,024.84 | 16.5× |
| Arthrogram knee (73580) | $6,246.12 | $6,246.12 | 17.1× |
| Arthrogram shoulder (73040) | $8,384.69 | $8,384.69 | 23.0× |
| Basic dosimetry (77300) | $2,436.45 | $2,436.45 | 17.4× |
| Bone &/Joint Imaging Limited Area (78300) | $1,573.52 | $1,573.52 | 3.8× |
| Bone &/joint imaging whole body (78306) | $14,393.38 | $14,393.38 | 34.5× |
| Bone Imaging 3 Phase (78315) | $9,324.20 | $9,324.20 | 22.3× |
| Bone survey complete (77075) | $6,371.91 | $6,371.91 | 58.4× |
| Brachytx isodose complex (77318) | $5,310.26 | $5,310.26 | 13.6× |
| Brachytx isodose intermed (77317) | $3,785.50 | $3,785.50 | 9.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) | $2,115.21 | $2,115.21 | 5.4× |
| Brain Imaging Vascular Flow Only (78610) | $8,601.03 | $8,601.03 | 15.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $10,632.90 | $10,632.90 | 25.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,785.65 | $1,785.65 | 4.9× |
| Cervical spine 2 or 3 views (72040) | $2,405.89 | $2,405.89 | 26.5× |
| Chest 1 view (71045) | $2,483.40 | $2,483.40 | 27.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $4,498.42 | $4,498.42 | 24.6× |
| Clavicle complete (73000) | $2,971.99 | $2,971.99 | 32.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $571.38 | $571.38 | 5.2× |
| Continuing medical physics consltj pr wk (77336) | $2,094.20 | $2,094.20 | 14.9× |
| CT abdomen and pelvis without and with contrast (74178) | $26,274.09 | $26,274.09 | 72.1× |
| CT abdomen and pelvis without contrast (74176) | $26,274.09 | $26,274.09 | 105.4× |
| CT abdomen w contrast (74160) | $22,141.42 | $22,141.42 | 120.9× |
| CT abdomen w wo contrast (74170) | $22,141.42 | $22,141.42 | 120.9× |
| CT abdomen w/o contrast (74150) | $22,141.42 | $22,141.42 | 202.8× |
| CT angio hrt w/3d image (75574) | $24,045.45 | $24,045.45 | 66.0× |
| CT angio lwr extr w/o&w/dye (73706) | $17,716.70 | $17,716.70 | 96.7× |
| CT angiography upper extremity lt (73206) | $17,716.70 | $17,716.70 | 96.7× |
| CT c-spine w/contrast (72126) | $22,141.42 | $22,141.42 | 60.8× |
| CT c-spine w/o contrast (72125) | $22,141.42 | $22,141.42 | 202.8× |
| CT cervical spine w&w/o contrast (72127) | $22,141.42 | $22,141.42 | 120.9× |
| CT chest w contrast (71260) | $22,141.42 | $22,141.42 | 120.9× |
| CT chest w/wo contrast (71270) | $20,558.15 | $20,558.15 | 112.2× |
| CT head/brain with contrast (70460) | $22,141.42 | $22,141.42 | 120.9× |
| CT head/brain without and with contrast (70470) | $22,141.42 | $22,141.42 | 120.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $22,141.42 | $22,141.42 | 243.6× |
| CT iac w contrast (70481) | $22,141.42 | $22,141.42 | 120.9× |
| CT lower ext w/o (73700) | $22,141.42 | $22,141.42 | 202.8× |
| CT lower extremity w wo contrast (73702) | $22,141.42 | $22,141.42 | 120.9× |
| CT lower extremity w/contrast material (73701) | $22,141.42 | $22,141.42 | 120.9× |
| CT lumbar spine w & w/o contrast (72133) | $22,277.42 | $22,277.42 | 121.6× |
| CT lumbar spine w/contrast (72132) | $22,141.42 | $22,141.42 | 60.8× |
| CT lumbar spine w/o contrast (72131) | $22,141.42 | $22,141.42 | 202.8× |
| CT maxillofacial w contrast (70487) | $22,141.42 | $22,141.42 | 120.9× |
| CT maxillofacial w/wo contrast (70488) | $22,141.42 | $22,141.42 | 120.9× |
| CT maxillofacial wo contrast (70486) | $22,141.42 | $22,141.42 | 202.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $22,141.42 | $22,141.42 | 120.9× |
| CT orbits w/o contrast (70480) | $22,141.42 | $22,141.42 | 202.8× |
| CT pelvis w/o contrast (72192) | $22,141.42 | $22,141.42 | 202.8× |
| CT pelvis w/wo contrast (72194) | $22,141.42 | $22,141.42 | 120.9× |
| CT scan of arm combo (73202) | $22,141.42 | $22,141.42 | 120.9× |
| CT soft tissue neck w contrast (70491) | $22,141.42 | $22,141.42 | 120.9× |
| CT soft tissue neck w/o & w/contrast material (70492) | $22,141.42 | $22,141.42 | 120.9× |
| CT soft tissue neck w/o contrast (70490) | $22,141.42 | $22,141.42 | 202.8× |
| CT thoracic spine w/contrast (72129) | $22,141.42 | $22,141.42 | 120.9× |
| CT thoracic spine w/o contrast (72128) | $22,141.42 | $22,141.42 | 202.8× |
| CT thoracic spine w/wo contrast (72130) | $22,141.42 | $22,141.42 | 120.9× |
| CT thorax w/o contrast (71250) | $22,141.42 | $22,141.42 | 202.8× |
| CT upper ext wo (73200) | $23,093.44 | $23,093.44 | 211.5× |
| CT upper extremity with contrast (73201) | $22,141.42 | $22,141.42 | 60.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $22,141.42 | $22,141.42 | 120.9× |
| Cta Abdomen (74175) | $22,141.42 | $22,141.42 | 120.9× |
| CTA abdomen pelvis (74174) | $26,274.09 | $26,274.09 | 72.1× |
| CTA chest (71275) | $22,141.42 | $22,141.42 | 120.9× |
| Cta Head (70496) | $22,141.42 | $22,141.42 | 120.9× |
| Cta Neck (70498) | $22,141.42 | $22,141.42 | 120.9× |
| Cta Pelvis (72191) | $22,141.42 | $22,141.42 | 120.9× |
| Cystography minimum 3 views rs&i (74430) | $4,498.42 | $4,498.42 | 12.3× |
| Dxa bone density study 1/> sites axial skel (77080) | $5,088.10 | $5,088.10 | 46.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $2,973.11 | $2,973.11 | 32.7× |
| Esophagus (74220) | $4,782.59 | $4,782.59 | 26.1× |
| Facial bones min 3 views (70150) | $4,388.34 | $4,388.34 | 40.2× |
| Fetal biophysical profile non-stress testing (76818) | $4,243.36 | $4,243.36 | 38.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $4,435.19 | $4,435.19 | 40.6× |
| Fluoroscopy up to 1 hr (76000) | $4,537.73 | $4,537.73 | 18.2× |
| Foot 2 views (73620) | $2,666.48 | $2,666.48 | 29.3× |
| Forearm 2 views (73090) | $2,752.96 | $2,752.96 | 30.3× |
| Hand 2 views (73120) | $1,510.70 | $1,510.70 | 13.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) | $6,194.75 | $6,194.75 | 8.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) | $9,574.98 | $9,574.98 | 13.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) | $10,804.06 | $10,804.06 | 14.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $15,056.50 | $15,056.50 | 4.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) | $15,056.50 | $15,056.50 | 4.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $13,145.33 | $13,145.33 | 23.2× |
| Hepatobiliary syst imaging including gallbladder (78226) | $12,066.41 | $12,066.41 | 28.9× |
| Image fusion (77399) | $1,147.80 | $1,147.80 | 8.2× |
| Interstitial radiation source applic complex (77778) | $33,384.70 | $33,384.70 | 45.9× |
| Kidney imaging morphology (78700) | $7,670.25 | $7,670.25 | 18.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $11,361.90 | $11,361.90 | 20.0× |
| Knee 3 views (73562) | $2,603.58 | $2,603.58 | 28.6× |
| Lung perf&ventilat diferentl (78598) | $22,995.58 | $22,995.58 | 40.6× |
| Lung perfusion differential (78597) | $22,212.92 | $22,212.92 | 53.2× |
| Lung ventilation imaging (78579) | $9,903.90 | $9,903.90 | 23.7× |
| Lymphoscintigraphy (78195) | $8,307.10 | $8,307.10 | 14.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) | $12,632.11 | $12,632.11 | 15.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $12,632.11 | $12,632.11 | 34.7× |
| Mlc imrt design & construction per imrt plan (77338) | $1,691.43 | $1,691.43 | 4.3× |
| MRA head w & w/o contrast (70546) | $19,058.98 | $19,058.98 | 52.3× |
| MRA head w/o contrast (70544) | $15,272.84 | $15,272.84 | 61.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $19,058.98 | $19,058.98 | 52.3× |
| MRA neck w/o contrast (70547) | $8,424.91 | $8,424.91 | 33.8× |
| MRI abdomen w contrast (74182) | $21,628.56 | $21,628.56 | 59.4× |
| MRI abdomen w/o & w/contrast material (74183) | $25,772.77 | $25,772.77 | 70.7× |
| MRI abdomen w/o contrast (74181) | $16,735.51 | $16,735.51 | 67.2× |
| MRI any jt lower extrem w/contrast material (73722) | $12,632.11 | $12,632.11 | 15.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $12,632.11 | $12,632.11 | 34.7× |
| MRI breast w/o contrast bilateral (77047) | $934.84 | $934.84 | 3.8× |
| MRI breast wo contrast unilateral (77046) | $934.84 | $934.84 | 3.8× |
| MRI cardiac w/o contrast (75557) | $1,208.60 | $1,208.60 | 4.9× |
| MRI cervical spine w/o contrast (72141) | $14,632.49 | $14,632.49 | 58.7× |
| MRI chest w/o & w/contrast material (71552) | $10,721.55 | $10,721.55 | 29.4× |
| MRI chest w/o contrast (71550) | $6,892.26 | $6,892.26 | 27.7× |
| MRI chest with contrast (71551) | $9,191.23 | $9,191.23 | 11.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $12,632.11 | $12,632.11 | 34.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $12,632.11 | $12,632.11 | 50.7× |
| MRI orbit face &/neck w/o contrast (70540) | $11,485.54 | $11,485.54 | 46.1× |
| MRI orbit/face/neck w&w/o cont (70543) | $14,386.38 | $14,386.38 | 39.5× |
| MRI pelvis w/o & w/contrast material (72197) | $14,386.38 | $14,386.38 | 39.5× |
| MRI pelvis w/o contrast (72195) | $8,513.55 | $8,513.55 | 34.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $18,529.43 | $18,529.43 | 50.9× |
| MRI spinal canal lumbar w/contrast material (72149) | $17,845.92 | $17,845.92 | 49.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $18,905.01 | $18,905.01 | 51.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $21,747.53 | $21,747.53 | 59.7× |
| MRI thoracic spine w/o contrast (72146) | $13,049.68 | $13,049.68 | 52.4× |
| MRI up ext w/o contrast (73218) | $12,632.11 | $12,632.11 | 50.7× |
| MRI upper ext joint w/o contrast (73221) | $12,632.11 | $12,632.11 | 50.7× |
| MRI, joint upper extrem combo (73223) | $18,943.50 | $18,943.50 | 52.0× |
| Myelogram Cervical (72240) | $3,555.27 | $3,555.27 | 4.3× |
| Myelogram Lumbar (72265) | $3,555.27 | $3,555.27 | 4.3× |
| Myelogram thoracic (72255) | $3,555.27 | $3,555.27 | 4.3× |
| Myelography 2 or more regions (72270) | $3,555.27 | $3,555.27 | 4.3× |
| Myocardial Spect Multiple Studies (78452) | $26,275.49 | $26,275.49 | 19.4× |
| Myocardial spect single study at rest or stress (78451) | $24,915.47 | $24,915.47 | 18.4× |
| Neck soft tissue (70360) | $2,929.31 | $2,929.31 | 32.2× |
| Nm gastric emptying study (78264) | $4,455.65 | $4,455.65 | 10.7× |
| Nonvascular shunt X-ray (75809) | $697.51 | $697.51 | 6.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,536.37 | $5,536.37 | 3.8× |
| Parathyroid Planar Imaging (78070) | $3,493.37 | $3,493.37 | 8.4× |
| Pelvis 1 or 2 views (72170) | $3,082.06 | $3,082.06 | 28.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $15,056.50 | $15,056.50 | 4.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) | $9,140.60 | $9,140.60 | 2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $16,217.63 | $16,217.63 | 38.8× |
| Radex Ankle Compl Minimum 3 Views (73610) | $2,749.59 | $2,749.59 | 30.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $2,655.24 | $2,655.24 | 29.2× |
| Radex Elbw Compl Minimum 3 Views (73080) | $3,212.35 | $3,212.35 | 35.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $4,718.56 | $4,718.56 | 43.2× |
| Radex fingr minimum 2 views (73140) | $2,666.48 | $2,666.48 | 29.3× |
| Radex Foot Compl Minimum 3 Views (73630) | $2,841.70 | $2,841.70 | 31.3× |
| Radex Hand Minimum 3 Views (73130) | $2,841.70 | $2,841.70 | 31.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $375.15 | $375.15 | 4.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) | $621.13 | $621.13 | 5.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $3,326.92 | $3,326.92 | 30.5× |
| Radex Humerus Minimum 2 Views (73060) | $3,360.62 | $3,360.62 | 37.0× |
| Radex Kne 1/2 Views (73560) | $2,777.67 | $2,777.67 | 30.6× |
| Radex Kne Compl 4/More Views (73564) | $3,134.85 | $3,134.85 | 28.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $4,687.11 | $4,687.11 | 42.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $3,439.24 | $3,439.24 | 37.8× |
| Radex Sho Compl Minimum 2 Views (73030) | $3,288.73 | $3,288.73 | 36.2× |
| Radex Toe Minimum 2 Views (73660) | $2,603.58 | $2,603.58 | 28.6× |
| Radex upper extremity infant minimum 2 views (73092) | $4,121.02 | $4,121.02 | 37.7× |
| Radex Wrst Compl Minimum 3 Views (73110) | $3,539.20 | $3,539.20 | 38.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $29,374.49 | $29,374.49 | 3.8× |
| Radiation treatment delivery level 2 (77407) | $3,764.63 | $3,764.63 | 9.3× |
| Radiation treatment delivery level 3 (77412) | $3,764.63 | $3,764.63 | 6.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $4,063.74 | $4,063.74 | 44.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $4,761.24 | $4,761.24 | 43.6× |
| Radiologic exam chest 2 views (71046) | $3,003.44 | $3,003.44 | 33.0× |
| Radiologic exam colon single contrast study (74270) | $6,748.19 | $6,748.19 | 36.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $6,820.07 | $6,820.07 | 37.2× |
| Radiologic exam upr gi trc single contrast study (74240) | $12,621.40 | $12,621.40 | 68.9× |
| Radiologic examination femur 1 view (73551) | $375.15 | $375.15 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $3,288.73 | $3,288.73 | 36.2× |
| Radiological examination surgical specimen (76098) | $1,318.64 | $1,318.64 | 2.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,058.05 | $1,058.05 | 2.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,058.05 | $1,058.05 | 2.6× |
| Ribs bilateral 3 views (71110) | $3,761.60 | $3,761.60 | 34.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) | $4,803.24 | $4,803.24 | 11.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $6,966.58 | $6,966.58 | 12.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $9,282.21 | $9,282.21 | 16.4× |
| Rp therapy intra-arterial particulate admn (79445) | $1,542.45 | $1,542.45 | 6.3× |
| Sacroiliac Joints < 3 Views (72200) | $421.20 | $421.20 | 3.9× |
| Scapula (73010) | $2,895.61 | $2,895.61 | 26.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $296.99 | $296.99 | 12.7× |
| Shoulder 1 view (73020) | $1,925.16 | $1,925.16 | 21.2× |
| Small bowel series (74250) | $6,943.62 | $6,943.62 | 37.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) | $3,886.95 | $3,886.95 | 9.9× |
| Special dosimetry (77331) | $4,483.70 | $4,483.70 | 31.9× |
| Special Physics Consult (77370) | $3,952.43 | $3,952.43 | 28.2× |
| Special treatment procedure (77470) | $5,427.64 | $5,427.64 | 9.4× |
| Spine thoracic 3 views (72072) | $3,265.14 | $3,265.14 | 29.9× |
| Splenoportograpy rs&i (75810) | $5,261.07 | $5,261.07 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $19,202.45 | $19,202.45 | 10.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $5,310.26 | $5,310.26 | 13.6× |
| Ther rad simulaj-aided field setting complex (77290) | $5,593.20 | $5,593.20 | 14.3× |
| Ther rad simulaj-aided field setting simple (77280) | $2,567.41 | $2,567.41 | 18.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $10,398.46 | $10,398.46 | 24.9× |
| Treatment device complex (77334) | $5,260.85 | $5,260.85 | 13.5× |
| Treatment device intermediate (77333) | $2,641.54 | $2,641.54 | 18.8× |
| Treatment devices simple (77332) | $1,978.06 | $1,978.06 | 14.1× |
| Ultrasound breast complete (76641) | $3,428.67 | $3,428.67 | 31.4× |
| Ultrasound, abdomen limited (76705) | $4,499.91 | $4,499.91 | 41.2× |
| Umbilical-artery Doppler (OB) (76820) | $1,838.56 | $1,838.56 | 16.8× |
| Urethrocystogram voiding (74455) | $4,915.12 | $4,915.12 | 19.7× |
| Urethrocystography retrograde rs&i (74450) | $3,398.80 | $3,398.80 | 13.6× |
| Us breast unilateral limited (76642) | $2,816.20 | $2,816.20 | 31.0× |
| Us chest (76604) | $1,322.01 | $1,322.01 | 12.1× |
| Us encephalogram (76506) | $982.26 | $982.26 | 9.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $3,097.01 | $3,097.01 | 28.4× |
| Us ob detailed single fetus (76811) | $6,100.41 | $6,100.41 | 24.5× |
| Us ob limited (76815) | $4,858.14 | $4,858.14 | 44.5× |
| Us ob transvaginal (76817) | $6,507.18 | $6,507.18 | 59.6× |
| Us pelvic non ob complete (76856) | $5,107.75 | $5,107.75 | 46.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $4,635.11 | $4,635.11 | 42.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $6,507.18 | $6,507.18 | 59.6× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $3,853.93 | $3,853.93 | 35.3× |
| Us retroperitoneal complete (76770) | $5,955.96 | $5,955.96 | 54.6× |
| Us retroperitoneal limited (76775) | $5,574.61 | $5,574.61 | 51.1× |
| Us scrotum and contents (76870) | $4,691.74 | $4,691.74 | 43.0× |
| Us soft tissue head/neck (76536) | $4,720.63 | $4,720.63 | 43.2× |
| Us spinal canal and contents (76800) | $671.40 | $671.40 | 6.2× |
| Venogram adrenal unilat (75840) | $7,682.69 | $7,682.69 | 2.3× |
| Venogram extremity bilateral (75822) | $1,106.35 | $1,106.35 | 0.7× |
| Venogram Extremity Unilateral (75820) | $2,454.76 | $2,454.76 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $4,249.07 | $4,249.07 | 1.3× |
| Venography caval superior serialography rs&i (75827) | $5,261.07 | $5,261.07 | 3.2× |
| Venography Renal Bilateral (75833) | $13,425.61 | $13,425.61 | 4.1× |
| Venography renal unilateral selective rs&i (75831) | $5,261.07 | $5,261.07 | 1.6× |
| Venography venous sinus/jugular cath rs&i (75860) | $5,261.07 | $5,261.07 | 1.6× |
| Venous sampling by catheter (75893) | $4,953.31 | $4,953.31 | 0.9× |
| Wrist 2 views (73100) | $2,186.87 | $2,186.87 | 24.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $3,987.36 | $3,987.36 | 36.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $3,288.73 | $3,288.73 | 36.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $2,742.85 | $2,742.85 | 30.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $2,492.38 | $2,492.38 | 22.8× |
| X-ray exam of femur 2/> (73552) | $3,452.72 | $3,452.72 | 38.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $2,229.55 | $2,229.55 | 24.5× |
| X-ray leg, infant (73592) | $4,762.37 | $4,762.37 | 52.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $4,259.17 | $4,259.17 | 39.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $4,669.14 | $4,669.14 | 42.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $3,003.44 | $3,003.44 | 33.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $3,761.60 | $3,761.60 | 34.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $4,949.94 | $4,949.94 | 45.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $2,026.25 | $2,026.25 | 18.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $4,085.08 | $4,085.08 | 45.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $4,098.56 | $4,098.56 | 45.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $3,681.85 | $3,681.85 | 33.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $2,905.72 | $2,905.72 | 26.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $3,506.63 | $3,506.63 | 38.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $3,351.63 | $3,351.63 | 30.7× |
| Xr c-spine 4 or 5 views (72050) | $3,823.37 | $3,823.37 | 35.0× |
| Xr c-spine 6 or more views (72052) | $4,848.85 | $4,848.85 | 44.4× |