Imaging prices at UConn John Dempsey Hospital
Farmington, CT · every code in this section with a posted price and a Medicare benchmark.
365 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) | $5,524.80 | $9,208 | 3.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$174–$263.40 | $290–$439 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$174–$568.20 | $290–$947 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $780.60 | $1,301 | 1.6× |
| Adrenal Cortex & Medulla Img (78075) | $2,154 | $3,590 | 1.4× |
| Angio pulmonary bilat (75743) | $6,464.40 | $10,774 | 1.7× |
| Angiography extremity bilateral rs&i (75716) | $6,028.80 | $10,048 | 1.6× |
| Angiography extremity unilateral rs&i (75710) | $4,542.60 | $7,571 | 1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,028.80 | $10,048 | 1.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$139.20–$253.80 | $232–$423 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,028.80 | $10,048 | 0.9× |
| Artery X-Rays Abdomen (75726) | $9,205.80 | $15,343 | 1.4× |
| Artery X-Rays Pelvis (75736) | $6,943.80 | $11,573 | 1.0× |
| Artery X-Rays Spine (75705) | $9,679.80 | $16,133 | 1.5× |
| Arthrogram hip (73525) | $900.60 | $1,501 | 2.2× |
| Basic radiation dosimetry calculation (77300) | $315 | $525 | 2.0× |
| Bone age studies (77072) range across 2 matching MRF lines |
$154.80–$173.40 | $258–$289 | varies |
| Bone Imaging 3 Phase (78315) | $1,021.20 | $1,702 | 2.1× |
| Bone Imaging Limited Area (78300) | $1,308.60 | $2,181 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,461 | $2,435 | 3.0× |
| Bone marrow imaging limited area (78102) | $666 | $1,110 | 1.4× |
| Bone marrow imaging; multiple areas (78103) | $742.20 | $1,237 | 1.5× |
| Bone marrow imaging; whole body (78104) | $822 | $1,370 | 1.7× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$222.60–$223.20 | $371–$372 | varies |
| Brachytx isodose complex (77318) | $1,363.20 | $2,272 | 3.0× |
| Brachytx isodose intermed (77317) | $981 | $1,635 | 2.2× |
| Brachytx Isodose Plan Simple (77316) | $527.40 | $879 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,693.20 | $7,822 | 2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,833 | $3,055 | 4.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,683.20 | $4,472 | 2.9× |
| Cat Scan Follow-Up Study (76380) | $558 | $930 | 5.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $898.80 | $1,498 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $1,033.20 | $1,722 | 1.6× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$139.20–$263.40 | $232–$439 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$174–$346.80 | $290–$578 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$135–$366 | $225–$610 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$126.60–$433.80 | $211–$723 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$174–$295.80 | $290–$493 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $523.80 | $873 | 4.2× |
| Continuing medical physics consltj pr wk (77336) | $696.60 | $1,161 | 4.3× |
| Contrast Exam Abdominl Aorta (75625) | $4,542.60 | $7,571 | 1.2× |
| Contrast X-Ray Bladder (74430) | $591 | $985 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,525.40–$2,526.60 | $4,209–$4,211 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,791.60 | $2,986 | 6.3× |
| CT abdomen w contrast (74160) | $1,727.40 | $2,879 | 8.2× |
| CT abdomen w wo contrast (74170) | $2,022.60 | $3,371 | 9.6× |
| CT abdomen w/o contrast (74150) | $1,432.20 | $2,387 | 11.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,677.20 | $4,462 | 6.4× |
| CT Angio Chest (71275) | $1,689 | $2,815 | 8.0× |
| CT Angio Head (70496) | $1,377.60 | $2,296 | 6.6× |
| CT angio hrt w/3d image (75574) | $1,171.80 | $1,953 | 2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,878 | $3,130 | 8.9× |
| CT Angio Neck (70498) | $1,377.60 | $2,296 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,900.80 | $3,168 | 9.0× |
| CT bone density (77078) | $147.60 | $246 | 1.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,168.80 | $1,948 | 5.6× |
| CT cervical spine w/ contrast (72126) | $1,518.60 | $2,531 | 3.6× |
| CT cervical spine w/o contrast (72125) | $1,338.60 | $2,231 | 10.7× |
| CT cervical spine w/wo cont (72127) | $1,663.20 | $2,772 | 7.9× |
| CT chest w contrast (71260) | $1,412.40 | $2,354 | 6.7× |
| CT chest w/wo contrast (71270) | $1,551 | $2,585 | 7.4× |
| CT head/brain with contrast (70460) | $1,168.80 | $1,948 | 5.6× |
| CT head/brain without and with contrast (70470) | $1,374 | $2,290 | 6.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $819 | $1,365 | 2.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $78 | $130 | 0.7× |
| CT hrt w/3d image congen (75573) | $819 | $1,365 | 2.0× |
| CT iac w contrast (70481) | $1,402.80 | $2,338 | 6.7× |
| CT l-spine w&w/o contrast (72133) | $1,663.20 | $2,772 | 7.9× |
| CT lower ext w/o (73700) | $1,271.40 | $2,119 | 10.1× |
| CT lower extremity w/contrast material (73701) | $1,441.80 | $2,403 | 6.9× |
| CT lumbar spine w contrast (72132) | $1,518.60 | $2,531 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $1,338.60 | $2,231 | 10.7× |
| CT maxillofacial w contrast (70487) | $1,361.40 | $2,269 | 6.5× |
| CT maxillofacial wo contrast (70486) | $940.80 | $1,568 | 7.5× |
| CT neck tissue combo (70492) | $1,618.20 | $2,697 | 7.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,624.80 | $2,708 | 7.7× |
| CT orbits w/o contrast (70480) | $1,271.40 | $2,119 | 10.1× |
| CT pelvis w&w/o contrast (72194) | $1,410 | $2,350 | 6.7× |
| CT pelvis w/o contrast (72192) | $1,062.60 | $1,771 | 8.5× |
| CT scan of leg combo (73702) | $1,608.60 | $2,681 | 7.7× |
| CT scans face/jaw combo (70488) | $1,695 | $2,825 | 8.1× |
| CT soft tissue neck w contrast (70491) | $1,537.80 | $2,563 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $1,271.40 | $2,119 | 10.1× |
| CT thoracic spine w contrast (72129) | $1,518.60 | $2,531 | 7.2× |
| CT thoracic spine w/o contrast (72128) | $1,338.60 | $2,231 | 10.7× |
| CT thoracic spine w/wo cont (72130) | $1,663.20 | $2,772 | 7.9× |
| CT thorax w/o contrast (71250) | $523.80 | $873 | 4.2× |
| CT unlisted procedure (76497) | $368.40 | $614 | 3.5× |
| CT upper ext wo (73200) | $1,271.40 | $2,119 | 10.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,608 | $2,680 | 7.6× |
| CT upper extremity with contrast (73201) | $1,441.80 | $2,403 | 3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,371 | $2,285 | 6.5× |
| Cta Abdomen (74175) | $2,051.40 | $3,419 | 9.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,067.60 | $3,446 | 4.9× |
| CTA pelvis (72191) | $1,618.20 | $2,697 | 7.7× |
| Dilation ureters/urethra rs&i (74485) | $1,845 | $3,075 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $5,184 | $8,640 | 2.2× |
| Diskography lumbar (72295) | $5,184 | $8,640 | 2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $243.60 | $406 | 1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $244.20 | $407 | 1.9× |
| Dxa Bone Density Axial (77080) | $574.80 | $958 | 4.6× |
| Dxa bone density study (77085) | $574.80 | $958 | 4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $270 | $450 | 2.6× |
| Echo exam of fetal heart (76825) | $1,066.80 | $1,778 | 1.6× |
| Esophageal Motility Study (78258) | $575.40 | $959 | 1.2× |
| Esophagram (74220) | $577.80 | $963 | 2.7× |
| Fetal Biophys Profile W/Nst (76818) | $315 | $525 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$285–$286.20 | $475–$477 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $2,065.20 | $3,442 | 7.2× |
| Fluoroscopy up to 1 hr (76000) | $394.80 | $658 | 1.4× |
| Follow-Up Angiography (75898) | $1,287 | $2,145 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$253.80–$282 | $423–$470 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$174–$356.40 | $290–$594 | varies |
| Gastric emptying imaging study (78264) | $696.60 | $1,161 | 1.5× |
| Gated Heart Planar Single (78472) | $772.80 | $1,288 | 1.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$139.20–$308.40 | $232–$514 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,223.20 | $5,372 | 3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,223.20 | $5,372 | 3.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,030.80 | $1,718 | 1.6× |
| Hepatobiliary System Imaging (78226) | $802.80 | $1,338 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $2,793 | $4,655 | 1.8× |
| Hysterosalpingogram (74740) | $658.20 | $1,097 | 2.3× |
| Infant hip ultrasound, limited static exam (76886) | $388.80 | $648 | 3.7× |
| Interstitial radiation source applic complex (77778) | $1,841.40 | $3,069 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $855.60 | $1,426 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $898.80 | $1,498 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $898.80 | $1,498 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$149.40–$398.40 | $249–$664 | varies |
| Liver & Spleen Imaging Static Only (78215) | $850.80 | $1,418 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $937.80 | $1,563 | 2.0× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$885.60–$2,078.40 | $1,476–$3,464 | varies |
| Liver imaging w/vascular flow (78202) | $885.60 | $1,476 | 1.4× |
| Lung Perf&Ventilat Diferentl (78598) | $817.20 | $1,362 | 1.3× |
| Lung perfusion differential (78597) | $661.80 | $1,103 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $898.80 | $1,498 | 1.4× |
| Lung Ventilation Imaging (78579) | $522 | $870 | 1.1× |
| Lymph System Imaging (78195) | $931.20 | $1,552 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $1,775.40 | $2,959 | 6.2× |
| Magnetic Resonance Elastography (76391) | $517.20 | $862 | 1.8× |
| Mammary ductogram or galactogram multiple (77054) | $524.40 | $874 | 1.8× |
| Mammary ductogram or galactogram single (77053) | $524.40 | $874 | 1.8× |
| Meckels Divert Exam (78290) | $780.60 | $1,301 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $960 | $1,600 | 2.1× |
| Mr safety determination physician/other qhp (76016) | $217.20 | $362 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $61.80 | $103 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $227.40 | $379 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $148.80 | $248 | 2.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $598.20 | $997 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $3,085.20 | $5,142 | 7.4× |
| MRA head w/o contrast (70544) | $2,122.20 | $3,537 | 7.4× |
| MRA head with contrast (70545) | $2,317.80 | $3,863 | 5.5× |
| MRA neck w contrast (70548) | $2,436.60 | $4,061 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,085.20 | $5,142 | 7.4× |
| MRA neck w/o contrast (70547) | $1,801.20 | $3,002 | 6.3× |
| MRI abdomen w contrast (74182) | $1,773 | $2,955 | 4.2× |
| MRI abdomen w/o contrast (74181) | $1,698.60 | $2,831 | 5.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,317.80 | $3,863 | 2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,963.40 | $4,939 | 7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,317.80 | $3,863 | 2.5× |
| MRI brain functional w/o physician admnistration (70554) | $1,505.40 | $2,509 | 5.3× |
| MRI brain functional w/physician admnistration (70555) | $2,125.20 | $3,542 | 7.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $517.20 | $862 | 1.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $394.80 | $658 | 1.4× |
| MRI cardiac w/o cont stress (75559) | $1,745.40 | $2,909 | 2.7× |
| MRI cardiac w/o contrast (75557) | $1,236 | $2,060 | 4.3× |
| MRI cervical spine w contrast (72142) | $2,317.80 | $3,863 | 5.5× |
| MRI cervical spine w/o cont (72141) | $2,122.20 | $3,537 | 7.4× |
| MRI chest w/o contrast (71550) | $1,698.60 | $2,831 | 5.9× |
| MRI chest with contrast (71551) | $2,082.60 | $3,471 | 2.2× |
| MRI chest wo w contrast (71552) | $2,472 | $4,120 | 5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,212.80 | $3,688 | 5.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,085.20 | $5,142 | 7.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,122.20 | $3,537 | 7.4× |
| MRI lumbar spine w contrast (72149) | $2,317.80 | $3,863 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,472 | $4,120 | 5.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,698.60 | $2,831 | 5.9× |
| MRI orbit face neck w contrast (70542) | $1,855.80 | $3,093 | 4.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,085.20 | $5,142 | 7.4× |
| MRI pelvis w contrast (72196) | $2,065.20 | $3,442 | 4.9× |
| MRI pelvis w/o & w contrast (72197) | $2,472 | $4,120 | 5.9× |
| MRI pelvis w/o contrast (72195) | $1,698.60 | $2,831 | 5.9× |
| MRI spectroscopy (76390) | $562.20 | $937 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $2,122.20 | $3,537 | 7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,801.20 | $3,002 | 6.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,472 | $4,120 | 5.9× |
| MRI, abdomen, combo (74183) | $2,472 | $4,120 | 5.9× |
| MRI, dorsal spine combo (72157) | $3,085.20 | $5,142 | 7.4× |
| MRI, dorsal spine contrast (72147) | $2,317.80 | $3,863 | 5.5× |
| MRI, joint upper extrem (73221) | $2,122.20 | $3,537 | 7.4× |
| MRI, joint upper extrem combo (73223) | $2,619.60 | $4,366 | 6.3× |
| MRI, lumbar spine combo (72158) | $3,085.20 | $5,142 | 7.4× |
| Myelogram cervical (72240) | $1,419.60 | $2,366 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,879.20 | $3,132 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $2,953.20 | $4,922 | 1.9× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$174–$321 | $290–$535 | varies |
| Nm csf leak detection (78650) | $1,863 | $3,105 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $742.80 | $1,238 | 5.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,220 | $8,700 | 3.1× |
| Nuclear Rx Intra-Arterial (79445) | $456 | $760 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $940.80 | $1,568 | 3.4× |
| Ob us nuchal meas 1 gest (76813) | $364.80 | $608 | 2.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $220.20 | $367 | 1.4× |
| Parathyroid Planar Imaging (78070) | $886.20 | $1,477 | 1.8× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$174–$250.80 | $290–$418 | varies |
| Peritoneogram Rs&I (74190) | $1,382.40 | $2,304 | 2.1× |
| Pet Image W/Ct Lmtd (78814) | $3,618 | $6,030 | 2.1× |
| PET image w/CT, full body (78816) | $5,727 | $9,545 | 3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,727 | $9,545 | 3.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,028.80 | $10,048 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $575.40 | $959 | 1.2× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $2,151 | $3,585 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$223.20–$597.60 | $372–$996 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $786.60 | $1,311 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$174–$337.20 | $290–$562 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$174–$308.40 | $290–$514 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$174–$398.40 | $290–$664 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$226.80–$420.60 | $378–$701 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$174–$324.60 | $290–$541 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$174–$289.20 | $290–$482 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$174–$398.40 | $290–$664 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $188.40 | $314 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$174–$282.60 | $290–$471 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $411 | $685 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$174–$286.20 | $290–$477 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $274.80 | $458 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $311.40 | $519 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$174–$436.80 | $290–$728 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$171.60–$481.80 | $286–$803 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$174–$282.60 | $290–$471 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $192.60 | $321 | 1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$174–$398.40 | $290–$664 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,185.40 | $20,309 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $498 | $830 | 4.1× |
| Radiation treatment delivery level 2 (77407) | $1,608.60 | $2,681 | 3.5× |
| Radiation treatment delivery level 3 (77412) | $2,145 | $3,575 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$226.80–$520.20 | $378–$867 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $231.60 | $386 | 1.8× |
| Radiologic exam colon double contrast study (74280) | $1,005 | $1,675 | 4.8× |
| Radiologic exam colon single contrast study (74270) | $1,005 | $1,675 | 4.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $577.80 | $963 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$174–$449.40 | $290–$749 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$506.40–$507.60 | $844–$846 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $661.80 | $1,103 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $558.60 | $931 | 2.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $741.60 | $1,236 | 3.5× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$436.80–$487.20 | $728–$812 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$139.20–$337.20 | $232–$562 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$162.60–$274.80 | $271–$458 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$174–$273 | $290–$455 | varies |
| Radiopharm Dacryocystography (78660) | $497.40 | $829 | 1.0× |
| Ribs bilateral 3 views (71110) | $552.60 | $921 | 4.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $815.40 | $1,359 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,442.60 | $4,071 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,308.60 | $2,181 | 2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,340.60 | $3,901 | 3.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,497.80 | $4,163 | 1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,655.60 | $4,426 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,343 | $3,905 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $558.60 | $931 | 2.0× |
| Salivary Gland Imaging Serial Images (78231) | $508.80 | $848 | 1.1× |
| Scapula (73010) range across 2 matching MRF lines |
$134.40–$446.40 | $224–$744 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42 | $70 | 1.8× |
| Shoulder 1 view (73020) | $276.60 | $461 | 2.7× |
| Sialogram (70390) | $524.40 | $874 | 1.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$134.40–$298.80 | $224–$498 | varies |
| Special dosimetry (77331) | $193.80 | $323 | 1.2× |
| Special Physics Consult (77370) | $757.80 | $1,263 | 4.7× |
| Special teletherapy port plan (77321) | $661.80 | $1,103 | 1.5× |
| Special treatment procedure (77470) | $2,244 | $3,740 | 3.4× |
| Stereotactic Body Radiation Delivery (77373) | $9,752.40 | $16,254 | 4.5× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$151.20–$300 | $252–$500 | varies |
| Tbs technical calculation only (77091) | $215.40 | $359 | 2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,194.60 | $1,991 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $527.40 | $879 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,540.80 | $2,568 | 3.4× |
| Ther rad simulaj-aided field setting simple (77280) | $671.40 | $1,119 | 4.2× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$174–$327.60 | $290–$546 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$226.80–$424.20 | $378–$707 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$150.60–$324.60 | $251–$541 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $728.40 | $1,214 | 1.5× |
| Thyroid Met Imaging Body (78018) | $898.80 | $1,498 | 1.4× |
| Thyroid Uptake Measurement (78012) | $367.80 | $613 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $661.80 | $1,103 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $2,276.40 | $3,794 | 5.1× |
| Tx devices design & construction intermediate (77333) | $244.20 | $407 | 1.5× |
| Tx devices design & construction simple (77332) | $681 | $1,135 | 4.2× |
| Ultrasound Breast Limited (76642) | $250.80 | $418 | 2.4× |
| Ultrasound elastography first target lesion (76982) | $208.80 | $348 | 1.7× |
| Ultrasound Elastography Parenchyma (76981) | $208.80 | $348 | 1.7× |
| Ultrasound Exam Aaa Screen (76706) | $192.60 | $321 | 1.5× |
| Ultrasound, abdomen limited (76705) | $456 | $760 | 3.6× |
| Umbilical-artery Doppler (OB) (76820) | $279.60 | $466 | 2.2× |
| Unlisted fluoroscopic procedure (76496) | $186 | $310 | 1.8× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$513.60–$7,720.20 | $856–$12,867 | varies |
| Upper gi w/o kub (74240) | $828.60 | $1,381 | 3.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $59.40 | $99 | 5.4× |
| Urea breath test c-14 isotopic analysis (78268) | $303.60 | $506 | 3.2× |
| Urethrocystogram voiding (74455) | $414.60 | $691 | 1.4× |
| Urethrocystography retrograde (74450) | $546 | $910 | 1.9× |
| Us breast unilateral complete (76641) | $250.80 | $418 | 2.0× |
| Us chest (76604) | $388.80 | $648 | 3.1× |
| Us complete joint (76881) | $270 | $450 | 2.2× |
| Us exam, pelvic, limited (76857) | $270 | $450 | 2.2× |
| Us head (76506) | $321 | $535 | 2.6× |
| Us kidney transplant (76776) | $249 | $415 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $173.40 | $289 | 1.4× |
| Us ob detailed single fetus (76811) | $513.60 | $856 | 1.8× |
| Us ob limited 1 or more fetuses (76815) | $260.40 | $434 | 2.1× |
| Us ob transvaginal (76817) | $405 | $675 | 3.2× |
| Us pelvic non ob complete (76856) | $436.80 | $728 | 3.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $366 | $610 | 2.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $343.80 | $573 | 2.7× |
| Us retroperitoneal complete (76770) | $420.60 | $701 | 3.4× |
| Us retroperitoneal limited (76775) | $459.60 | $766 | 3.7× |
| Us scrotum and contents (76870) | $745.20 | $1,242 | 5.9× |
| Us spinal canal and contents (76800) | $308.40 | $514 | 2.5× |
| Us thyroid (76536) | $543 | $905 | 4.3× |
| Us transrectal (76872) | $260.40 | $434 | 2.1× |
| Vascular Flow Imaging (78445) | $524.40 | $874 | 1.1× |
| Vein X-Ray Chest (75827) | $2,092.80 | $3,488 | 1.1× |
| Venogram Sinus/Jugular (75860) | $3,002.40 | $5,004 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $6,028.80 | $10,048 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $1,499.40 | $2,499 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $2,265 | $3,775 | 1.2× |
| Venography Renal Unilateral (75831) | $4,542.60 | $7,571 | 1.2× |
| Venous sampling by catheter (75893) | $6,943.80 | $11,573 | 1.0× |
| Vertebral fracture assessment via dxa (77086) | $270 | $450 | 2.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$174–$343.80 | $290–$573 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$174–$366 | $290–$610 | varies |
| X-ray antegrade pyelogram tube (74425) | $684 | $1,140 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $4,542.60 | $7,571 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$182.40–$546 | $304–$910 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$337.20–$375.60 | $562–$626 | varies |
| X-Ray Exam Breast Specimen (76098) | $786.60 | $1,311 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$433.80–$434.40 | $723–$724 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$478.20–$478.80 | $797–$798 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$540–$540.60 | $900–$901 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$436.80–$487.20 | $728–$812 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$436.80–$487.20 | $728–$812 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$477.60–$478.80 | $796–$798 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$543–$606.60 | $905–$1,011 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$543–$606.60 | $905–$1,011 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$708–$709.80 | $1,180–$1,183 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$223.20–$712.80 | $372–$1,188 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$174–$385.20 | $290–$642 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$250.20–$639 | $417–$1,065 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$226.80–$501 | $378–$835 | varies |
| X-ray eye for foreign body (70030) | $199.20 | $332 | 1.9× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$174–$356.40 | $290–$594 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$226.80–$424.80 | $378–$708 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$154.80–$291 | $258–$485 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$174–$382.20 | $290–$637 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$250.20–$636 | $417–$1,060 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$154.80–$369.60 | $258–$616 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $330 | $550 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$174–$398.40 | $290–$664 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$154.80–$507.60 | $258–$846 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$249.60–$546 | $416–$910 | varies |
| X-ray thoracic spine 4 vw (72074) | $456 | $760 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $815.40 | $1,359 | 1.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$173.40–$184.80 | $289–$308 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$222.60–$343.80 | $371–$573 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$183–$581.40 | $305–$969 | varies |
| Xr facial bones less than 3 views (70140) | $325.80 | $543 | 3.1× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$169.20–$318 | $282–$530 | varies |
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.