Imaging prices at UF Health Jacksonville
Jacksonville, FL · every code in this section with a posted price and a Medicare benchmark.
438 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) | $4,821.90 | $8,767.09 | 3.3× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$413.49–$440.78 | $751.80–$801.41 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$554.58–$587.93 | $1,008.33–$1,068.96 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,440.27 | $2,618.67 | 3.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $2,012.06 | $3,658.29 | 1.5× |
| Adrenal Cortex & Medulla Img (78075) | $2,012.06 | $3,658.29 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $5,252.98 | $9,550.87 | 1.6× |
| Angiography extremity unilateral rs&i (75710) | $4,686.98 | $8,521.79 | 1.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$374.25–$395.48 | $680.46–$719.05 | varies |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$1,488.38–$1,555.09 | $2,706.15–$2,827.43 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,432.93–$1,499.63 | $2,605.32–$2,726.60 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,928.78–$2,013.67 | $3,506.87–$3,661.22 | varies |
| Basic radiation dosimetry calculation (77300) | $589.48 | $1,071.79 | 4.2× |
| Bone age studies (77072) | $274.16 | $498.48 | 2.5× |
| Bone Imaging 3 Phase (78315) | $1,121.39 | $2,038.89 | 2.7× |
| Bone Imaging Limited Area (78300) | $1,062.67 | $1,932.12 | 2.5× |
| Bone Imaging Multiple Areas (78305) | $1,140.14 | $2,072.98 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,196.42 | $2,175.30 | 2.9× |
| Bone marrow imaging limited area (78102) | $767.43 | $1,395.33 | 1.8× |
| Bone marrow imaging; multiple areas (78103) | $1,149.93 | $2,090.78 | 2.8× |
| Bone marrow imaging; whole body (78104) | $1,256.77 | $2,285.03 | 3.0× |
| Bone survey infant (77076) | $464.44 | $844.44 | 4.3× |
| Brachytx isodose complex (77318) | $1,392.97 | $2,532.67 | 3.6× |
| Brachytx isodose intermed (77317) | $1,080.40 | $1,964.36 | 2.8× |
| Brachytx Isodose Plan Simple (77316) | $724.65 | $1,317.54 | 1.9× |
| Brain Flow Imaging Only (78610) | $764.79 | $1,390.53 | 1.3× |
| Brain Image W/Flow < 4 Views (78601) | $617.38 | $1,122.50 | 1.5× |
| Brain imaging < 4 static views (78600) | $632.05 | $1,149.19 | 1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,207.83 | $2,196.05 | 2.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $764.79 | $1,390.53 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,401.14 | $13,456.62 | 5.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,133.49 | $3,879.07 | 5.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,877.27 | $5,231.40 | 7.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,877.27 | $5,231.40 | 3.5× |
| Cardiac Shunt Detection (78428) | $954.20 | $1,734.90 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $947.25 | $1,722.28 | 10.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $764.79 | $1,390.53 | 1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $764.79 | $1,390.53 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $829.42 | $1,508.03 | 1.5× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$322.14–$347.61 | $585.71–$632.02 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$459.16–$489.48 | $834.83–$889.96 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$487.70–$524.08 | $886.73–$952.88 | varies |
| Chest 4 or more views (71048) | $915.05 | $1,663.73 | 8.4× |
| Cholecystography Oral Contrast (74290) | $466.50 | $848.18 | 2.5× |
| Cisternography Positive Contrast Rs&I (70015) | $1,708.59 | $3,106.52 | 2.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$448.21–$478.52 | $814.92–$870.04 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $162.02 | $294.59 | 1.5× |
| Continuing medical physics consltj pr wk (77336) | $868.26 | $1,578.65 | 6.2× |
| Contrast X-Ray Bladder (74430) | $1,340.77 | $2,437.76 | 3.7× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$558.52–$789.52 | $1,015.49–$1,435.49 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,147.49–$1,217.22 | $2,086.34–$2,213.13 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $273.38 | $497.06 | 1.5× |
| Corpora cavernosography (74445) | $1,211.91 | $2,203.48 | 11.1× |
| CT abdomen and pelvis without and with contrast (74178) | $5,640.21 | $10,254.93 | 15.5× |
| CT abdomen and pelvis without contrast (74176) | $3,776.52 | $6,866.40 | 15.2× |
| CT abdomen w contrast (74160) | $2,894.25 | $5,262.27 | 15.8× |
| CT abdomen w wo contrast (74170) | $3,220.83 | $5,856.06 | 17.6× |
| CT abdomen w/o contrast (74150) | $2,700.97 | $4,910.85 | 24.7× |
| CT Angio Abdomen and Pelvis (74174) | $4,947.89 | $8,996.17 | 13.6× |
| CT Angio Chest (71275) | $2,350.19 | $4,273.07 | 12.8× |
| CT Angio Head (70496) | $3,275.26 | $5,955.02 | 17.9× |
| CT angio hrt w/3d image (75574) | $2,925.08 | $5,318.32 | 8.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,565.17 | $4,663.95 | 14.0× |
| CT Angio Neck (70498) | $3,275.26 | $5,955.02 | 17.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,389.96 | $6,163.56 | 18.5× |
| CT bone density (77078) | $204.71 | $372.20 | 2.3× |
| CT cervical spine w/ contrast (72126) | $2,672.65 | $4,859.36 | 7.3× |
| CT cervical spine w/o contrast (72125) | $2,210.27 | $4,018.67 | 20.2× |
| CT cervical spine w/wo cont (72127) | $3,237.50 | $5,886.36 | 17.7× |
| CT chest w contrast (71260) | $1,648.74 | $2,997.71 | 9.0× |
| CT chest w/wo contrast (71270) | $1,694.57 | $3,081.03 | 9.3× |
| CT head/brain with contrast (70460) | $2,571.44 | $4,675.34 | 14.0× |
| CT head/brain without and with contrast (70470) | $2,927.02 | $5,321.85 | 16.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,925.08 | $5,318.32 | 8.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $492.38 | $895.23 | 5.4× |
| CT hrt w/3d image congen (75573) | $2,925.08 | $5,318.32 | 8.0× |
| CT iac w contrast (70481) | $2,500.48 | $4,546.33 | 13.7× |
| CT l-spine w&w/o contrast (72133) | $3,301.64 | $6,002.99 | 18.0× |
| CT lower ext w/o (73700) | $1,775.37 | $3,227.95 | 16.3× |
| CT lower extremity w/contrast material (73701) | $1,903.68 | $3,461.23 | 10.4× |
| CT lumbar spine w contrast (72132) | $2,708.46 | $4,924.48 | 7.4× |
| CT lumbar spine w/o contrast (72131) | $2,240.25 | $4,073.19 | 20.5× |
| CT maxillofacial w contrast (70487) | $2,104.13 | $3,825.69 | 11.5× |
| CT maxillofacial wo contrast (70486) | $1,826.84 | $3,321.53 | 16.7× |
| CT neck tissue combo (70492) | $1,761.60 | $3,202.90 | 9.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,971.07 | $5,401.94 | 16.2× |
| CT orbits w/o contrast (70480) | $2,323.51 | $4,224.56 | 21.3× |
| CT pelvis w&w/o contrast (72194) | $2,808.44 | $5,106.26 | 15.3× |
| CT pelvis w/o contrast (72192) | $2,517.68 | $4,577.60 | 23.1× |
| CT scan of leg combo (73702) | $2,026.14 | $3,683.89 | 11.1× |
| CT scans face/jaw combo (70488) | $2,865.86 | $5,210.65 | 15.6× |
| CT soft tissue neck w contrast (70491) | $1,414.99 | $2,572.70 | 7.7× |
| CT soft tissue neck w/o contrast (70490) | $1,209.47 | $2,199.03 | 11.1× |
| CT thoracic spine w contrast (72129) | $3,240 | $5,890.90 | 17.7× |
| CT thoracic spine w/o contrast (72128) | $2,441.04 | $4,438.25 | 22.4× |
| CT thoracic spine w/wo cont (72130) | $3,596.57 | $6,539.22 | 19.6× |
| CT thorax w/o contrast (71250) | $1,539.60 | $2,799.27 | 14.1× |
| CT unlisted procedure (76497) | $2,178.61 | $3,961.10 | 24.0× |
| CT upper ext wo (73200) | $1,951.16 | $3,547.56 | 17.9× |
| CT upper extremity w/o & w/contrast material (73202) | $2,563.51 | $4,660.93 | 14.0× |
| CT upper extremity with contrast (73201) | $2,246.09 | $4,083.80 | 6.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $7,075.67 | $12,864.86 | 38.6× |
| Cta Abdomen (74175) | $2,775.95 | $5,047.18 | 15.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $392.15 | $713 | 1.1× |
| CTA pelvis (72191) | $2,890.09 | $5,254.70 | 15.8× |
| Diskography lumbar (72295) | $2,106.17 | $3,829.40 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $372.87 | $677.95 | 3.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $952.24 | $1,731.35 | 8.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $418.38 | $760.69 | 3.8× |
| Dxa Bone Density Axial (77080) | $903.63 | $1,642.96 | 8.3× |
| Dxa bone density study (77085) | $162.02 | $294.59 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $873.87 | $1,588.86 | 9.6× |
| Echo exam of fetal heart (76825) | $952.24 | $1,731.35 | 1.7× |
| Echo exam uterus (76831) | $403.21 | $733.11 | 1.6× |
| Echo Guide For Artery Repair (76936) | $1,018.62 | $1,852.04 | 4.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $952.24 | $1,731.35 | 3.8× |
| Esophageal Motility Study (78258) | $915.87 | $1,665.22 | 2.2× |
| Esophagram (74220) | $305.02 | $554.58 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,276.18 | $2,320.32 | 11.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,202.78 | $2,186.87 | 11.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $504.99 | $918.16 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $848.18 | $1,542.14 | 3.4× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$438.29–$462.54 | $796.89–$840.99 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$536.59–$600.12 | $975.62–$1,091.12 | varies |
| Gastric emptying imaging study (78264) | $1,010.47 | $1,837.22 | 2.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $589.22 | $1,071.30 | 1.4× |
| Gastric Mucosa Imaging (78261) | $1,083.05 | $1,969.19 | 2.6× |
| Gastroesophageal Reflux Exam (78262) | $947.67 | $1,723.04 | 2.3× |
| Gastrointestinal Protein Loss (78282) | $613.29 | $1,115.08 | 1.5× |
| Gated Heart Planar Single (78472) | $1,891.27 | $3,438.67 | 4.5× |
| Gated Heart, Multiple (78473) | $3,256.50 | $5,920.91 | 7.8× |
| GI Endoscopic US S&I (76975) | $651.79 | $1,185.08 | 2.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $764.79 | $1,390.53 | 1.3× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$406.72–$427.94 | $739.49–$778.08 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,231.53 | $2,239.14 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,231.53 | $2,239.14 | 1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,231.53 | $2,239.14 | 1.7× |
| Heart Image (Pet) Multiple (78492) | $7,593.62 | $13,806.58 | 5.1× |
| Hepatobil Syst Image W/Drug (78227) | $764.79 | $1,390.53 | 1.3× |
| Hepatobiliary System Imaging (78226) | $589.22 | $1,071.30 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $5,164.09 | $9,389.25 | 3.8× |
| Hysterosalpingogram (74740) | $1,264.92 | $2,299.86 | 5.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $611.67 | $1,112.12 | 6.7× |
| Infusion Ivp (74410) | $349.05 | $634.64 | 1.9× |
| Interstitial radiation source applic complex (77778) | $18,710.32 | $34,018.76 | 25.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $18,710.32 | $34,018.76 | 25.7× |
| Intracavitary Radiation Source Applic Intermed (77762) | $18,710.32 | $34,018.76 | 32.4× |
| Intracavitary radiation source applic simple (77761) | $18,710.32 | $34,018.76 | 32.4× |
| Joint Survey Single View (77077) | $295.80 | $537.81 | 2.7× |
| K Flow/Funct Image Multiple (78709) | $1,337.51 | $2,431.83 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $1,589.52 | $2,890.03 | 2.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,630.29 | $2,964.16 | 2.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $949.31 | $1,726.01 | 2.3× |
| Kidney Imaging Morphol (78700) | $826.97 | $1,503.58 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,124.65 | $2,044.82 | 2.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$473.46–$500.74 | $860.83–$910.44 | varies |
| Leveen/Shunt Patency Exam (78291) | $910.16 | $1,654.83 | 2.2× |
| Liver & Spleen Imaging Static Only (78215) | $866.12 | $1,574.76 | 2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $994.98 | $1,809.05 | 2.4× |
| Liver imaging static only (78201) | $823.71 | $1,497.65 | 1.5× |
| Liver imaging w/vascular flow (78202) | $1,017.81 | $1,850.57 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $764.79 | $1,390.53 | 1.3× |
| Lung perfusion differential (78597) | $589.22 | $1,071.30 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $764.79 | $1,390.53 | 1.3× |
| Lung Ventilation Imaging (78579) | $589.22 | $1,071.30 | 1.4× |
| Lymph System Imaging (78195) | $1,212.73 | $2,204.96 | 2.1× |
| Magnetic Image Jaw Joint (70336) | $2,411.43 | $4,384.41 | 9.7× |
| Magnetic Resonance Elastography (76391) | $283.20 | $514.91 | 1.1× |
| Mammary ductogram or galactogram multiple (77054) | $882.43 | $1,604.41 | 3.5× |
| Mammary ductogram or galactogram single (77053) | $778.85 | $1,416.09 | 3.1× |
| Meckels Divert Exam (78290) | $1,161.35 | $2,111.54 | 2.8× |
| Mlc imrt design & construction per imrt plan (77338) | $930.21 | $1,691.29 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,029.78 | $5,508.69 | 8.3× |
| MRA head w/o contrast (70544) | $2,249.29 | $4,089.62 | 9.0× |
| MRA head with contrast (70545) | $2,506.20 | $4,556.72 | 6.9× |
| MRA neck w contrast (70548) | $2,506.20 | $4,556.72 | 6.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,170.05 | $5,763.73 | 8.7× |
| MRA neck w/o contrast (70547) | $2,131.86 | $3,876.11 | 8.6× |
| MRI abdomen w contrast (74182) | $2,694.26 | $4,898.66 | 7.4× |
| MRI abdomen w/o contrast (74181) | $2,497.55 | $4,541 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) | $4,104.52 | $7,462.76 | 5.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,924.63 | $8,953.88 | 13.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,466.82 | $9,939.67 | 6.7× |
| MRI bone marrow blood supply (77084) | $4,038.94 | $7,343.53 | 16.2× |
| MRI brain functional w/o physician admnistration (70554) | $805.77 | $1,465.03 | 3.2× |
| MRI brain functional w/physician admnistration (70555) | $805.77 | $1,465.03 | 3.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,422 | $2,585.45 | 5.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,422 | $2,585.45 | 5.7× |
| MRI cardiac w/o cont stress (75559) | $2,877.27 | $5,231.40 | 5.0× |
| MRI cardiac w/o contrast (75557) | $2,826.38 | $5,138.88 | 11.3× |
| MRI cervical spine w contrast (72142) | $2,986.88 | $5,430.69 | 8.2× |
| MRI cervical spine w/o cont (72141) | $2,596.40 | $4,720.72 | 10.4× |
| MRI chest w/o contrast (71550) | $4,915.83 | $8,937.87 | 19.7× |
| MRI chest with contrast (71551) | $5,359.16 | $9,743.93 | 6.5× |
| MRI chest wo w contrast (71552) | $6,788.01 | $12,341.84 | 18.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $4,205.32 | $7,646.04 | 11.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,045.99 | $9,174.53 | 13.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,659.23 | $6,653.14 | 14.7× |
| MRI lumbar spine w contrast (72149) | $3,090.62 | $5,619.31 | 8.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,012.52 | $7,295.49 | 11.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,631.79 | $4,785.07 | 10.6× |
| MRI orbit face neck w contrast (70542) | $3,195.34 | $5,809.70 | 8.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,483.23 | $6,333.14 | 9.6× |
| MRI pelvis w contrast (72196) | $4,492.06 | $8,167.39 | 12.3× |
| MRI pelvis w/o & w contrast (72197) | $5,685.05 | $10,336.46 | 15.6× |
| MRI pelvis w/o contrast (72195) | $4,116.27 | $7,484.12 | 16.5× |
| MRI spectroscopy (76390) | $4,202.38 | $7,640.69 | 46.2× |
| MRI thoracic spine w/o contrast (72146) | $2,831.27 | $5,147.77 | 11.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,871.78 | $8,857.79 | 13.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,141.70 | $7,530.37 | 16.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,851.43 | $10,638.96 | 16.1× |
| MRI, abdomen, combo (74183) | $3,232.53 | $5,877.32 | 8.9× |
| MRI, dorsal spine combo (72157) | $4,009.58 | $7,290.15 | 11.0× |
| MRI, dorsal spine contrast (72147) | $3,256.99 | $5,921.80 | 8.9× |
| MRI, joint upper extrem (73221) | $4,752.39 | $8,640.71 | 19.1× |
| MRI, joint upper extrem combo (73223) | $6,559 | $11,925.46 | 18.0× |
| MRI, lumbar spine combo (72158) | $3,910.74 | $7,110.43 | 10.7× |
| Myelogram cervical (72240) | $1,680.04 | $3,054.62 | 2.1× |
| Myelogram Lumbar (72265) | $1,680.04 | $3,054.62 | 2.1× |
| Myelography thoracic (72255) | $1,562.60 | $2,841.09 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $2,381.80 | $4,330.54 | 2.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,382.37 | $2,513.40 | 3.3× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,267.37 | $2,304.31 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $6,739.73 | $12,254.06 | 5.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,257.77 | $4,105.03 | 1.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,610.40 | $2,928 | 1.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,484.90 | $4,518 | 1.1× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$203.89–$231.18 | $370.70–$420.32 | varies |
| Nm csf leak detection (78650) | $2,012.06 | $3,658.29 | 1.5× |
| Nm myocard infarct spect (78469) | $1,768.11 | $3,214.75 | 3.1× |
| Nonvascular Shunt X-Ray (75809) | $336.82 | $612.40 | 3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,069.10 | $7,398.36 | 2.8× |
| Nuclear Rx Intra-Arterial (79445) | $2,286.16 | $4,156.65 | 9.4× |
| Nuclear Rx Oral Admin (79005) | $992.37 | $1,804.30 | 4.1× |
| Ob us nuchal meas 1 gest (76813) | $310.23 | $564.06 | 2.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $139.66 | $253.93 | 1.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $258.36 | $469.75 | 2.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $258.36 | $469.75 | 2.4× |
| Optic foramina (70190) | $277.76 | $505.02 | 3.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $624.05 | $1,134.63 | 1.1× |
| Parathyroid Planar Imaging (78070) | $689.96 | $1,254.47 | 1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,182.56 | $2,150.10 | 2.8× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$483.37–$510.66 | $878.86–$928.47 | varies |
| Perineogram (74775) | $380.87 | $692.49 | 1.5× |
| Pet Image Skull-Thigh (78812) | $8,457.61 | $15,377.47 | 5.7× |
| Pet Image W/Ct Lmtd (78814) | $10,358.18 | $18,833.05 | 6.9× |
| PET image w/CT, full body (78816) | $10,358.18 | $18,833.05 | 6.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $10,358.18 | $18,833.05 | 6.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $9,726.94 | $17,685.34 | 7.2× |
| Pet Myocardial Sngl Study (78491) | $3,949.72 | $7,181.31 | 2.6× |
| PET whole body (78813) | $8,457.61 | $15,377.47 | 5.7× |
| Platelet survival study Non-Facility (78191) | $1,075.72 | $1,955.85 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $589.22 | $1,071.30 | 1.4× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,045.55 | $1,901 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$819.63–$868.14 | $1,490.23–$1,578.43 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $678.54 | $1,233.71 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$428.37–$455.65 | $778.85–$828.46 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$449.10–$469.69 | $816.55–$853.99 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$519.45–$563.34 | $944.45–$1,024.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$614.14–$653.56 | $1,116.62–$1,188.29 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$339.09–$357.27 | $616.52–$649.59 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$537.49–$564.78 | $977.26–$1,026.87 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$467.15–$494.44 | $849.37–$898.98 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$248–$272.25 | $450.90–$495 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $620.46 | $1,128.10 | 5.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$387.78–$415.07 | $705.06–$754.68 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $371.08 | $674.69 | 4.1× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$443.70–$480.08 | $806.73–$872.88 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$490.59–$519.70 | $891.98–$944.90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$217.34–$244.63 | $395.17–$444.78 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $561.10 | $1,020.18 | 3.1× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$608.72–$632.98 | $1,106.77–$1,150.87 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$499.61–$529.93 | $908.39–$963.51 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $349.91 | $636.20 | 3.9× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$312.03–$333.25 | $567.33–$605.91 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$162.02–$185.06 | $294.59–$336.48 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$483.37–$510.66 | $878.86–$928.47 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,442.93 | $2,623.50 | 13.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $21,487.83 | $39,068.78 | 2.8× |
| Radiation treatment delivery level 1 (77402) | $191.48 | $348.15 | 1.8× |
| Radiation treatment delivery level 2 (77407) | $911.43 | $1,657.15 | 2.3× |
| Radiation treatment delivery level 3 (77412) | $1,159.25 | $2,107.72 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$535.68–$570.85 | $973.97–$1,037.91 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $723.39 | $1,315.26 | 6.6× |
| Radiologic exam colon double contrast study (74280) | $693.22 | $1,260.40 | 3.8× |
| Radiologic exam colon single contrast study (74270) | $533.37 | $969.77 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$582.58–$612.89 | $1,059.23–$1,114.35 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$582.58–$616.53 | $1,059.23–$1,120.97 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $273.38 | $497.06 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $421.65 | $766.63 | 2.3× |
| Radiologic exam teeth complete full mouth (70320) range across 3 matching MRF lines |
$354–$390.38 | $643.64–$709.79 | varies |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $354 | $643.64 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $486.88 | $885.24 | 2.7× |
| Radiologic examination femur 1 view (73551) | $450.91 | $819.84 | 5.0× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$541.10–$567.17 | $983.81–$1,031.22 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$433.79–$458.04 | $788.70–$832.80 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $524.86 | $954.29 | 4.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $203.89 | $370.70 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$547.40–$571.66 | $995.28–$1,039.38 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $762.72 | $1,386.76 | 1.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 3 matching MRF lines |
$131.70–$145.05 | $239.46–$263.72 | varies |
| Radiopharm Dacryocystography (78660) | $677.73 | $1,232.23 | 1.6× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $891.73 | $1,621.32 | 3.7× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $931.15 | $1,693 | 3.8× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $3,209.28 | $5,835.05 | 13.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $398.59 | $724.71 | 1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $398.59 | $724.71 | 1.0× |
| Ribs bilateral 3 views (71110) | $459.94 | $836.25 | 4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $883.25 | $1,605.90 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,291.02 | $2,347.31 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,310.46 | $4,200.83 | 4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,012.06 | $3,658.29 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,577.96 | $4,687.20 | 4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,012.06 | $3,658.29 | 1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,257.77 | $4,105.03 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,012.06 | $3,658.29 | 1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,565.86 | $2,847.02 | 6.4× |
| Rp Therapy Intravenous Administration (79101) | $2,460.74 | $4,474.08 | 10.1× |
| Salivary Gland Function Study (78232) | $657.33 | $1,195.15 | 1.6× |
| Salivary Gland Imaging (78230) | $617.38 | $1,122.50 | 1.5× |
| Salivary Gland Imaging Serial Images (78231) | $672.01 | $1,221.84 | 1.6× |
| Scapula (73010) range across 3 matching MRF lines |
$516.74–$547.06 | $939.53–$994.65 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $260.98 | $474.51 | 11.2× |
| Sella turcica (70240) | $414.84 | $754.26 | 4.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$240.80–$263.84 | $437.81–$479.70 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,497.36–$1,576.19 | $2,722.47–$2,865.80 | varies |
| Sialogram (70390) range across 3 matching MRF lines |
$464.05–$536.81 | $843.72–$976.02 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$483.37–$519.15 | $878.86–$943.91 | varies |
| Special dosimetry (77331) | $321.02 | $583.68 | 2.3× |
| Special Physics Consult (77370) | $1,666.12 | $3,029.30 | 11.9× |
| Special teletherapy port plan (77321) | $1,423.96 | $2,589.01 | 3.6× |
| Special treatment procedure (77470) | $1,683.95 | $3,061.73 | 2.9× |
| Speech evaluation, complex (70371) | $643.47 | $1,169.95 | 2.6× |
| Spleen Imaging (78185) | $1,172.77 | $2,132.30 | 2.8× |
| Stereotactic Body Radiation Delivery (77373) | $4,504.63 | $8,190.24 | 2.4× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$452.72–$486.07 | $823.13–$883.76 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,021.27 | $1,856.85 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $982.78 | $1,786.88 | 2.5× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$1,038.91–$1,135.93 | $1,888.93–$2,065.33 | varies |
| Testicular Imaging W/Flow (78761) | $886.51 | $1,611.83 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,831.61 | $6,966.57 | 9.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,994.33 | $5,444.23 | 7.7× |
| Ther rad simulaj-aided field setting simple (77280) | $2,040.65 | $3,710.27 | 14.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $862.04 | $1,567.35 | 4.7× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$600.62–$632.15 | $1,092.03–$1,149.36 | varies |
| Thoracic spine 3 views (72072) | $315.65 | $573.90 | 2.9× |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$490.59–$523.94 | $891.98–$952.61 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $747.86 | $1,359.75 | 1.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $704.64 | $1,281.16 | 1.7× |
| Thyroid Imaging With Vascular Flow (78013) | $603.50 | $1,097.28 | 1.4× |
| Thyroid Met Imaging Body (78018) | $957.46 | $1,740.84 | 1.7× |
| Thyroid Uptake Measurement (78012) | $1,052.88 | $1,914.33 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,311.41 | $2,384.38 | 3.1× |
| Tx Devices Design & Construction Complex (77334) | $1,681.14 | $3,056.62 | 4.3× |
| Tx devices design & construction intermediate (77333) | $796.92 | $1,448.95 | 5.7× |
| Tx devices design & construction simple (77332) | $653.30 | $1,187.82 | 4.7× |
| Ultrasound Breast Limited (76642) | $177.14 | $322.08 | 1.9× |
| Ultrasound elastography first target lesion (76982) | $249.56 | $453.75 | 2.3× |
| Ultrasound Elastography Parenchyma (76981) | $249.56 | $453.75 | 2.3× |
| Ultrasound Exam Aaa Screen (76706) | $310.23 | $564.06 | 2.8× |
| Ultrasound, abdomen limited (76705) | $901.35 | $1,638.81 | 8.3× |
| Umbilical-artery Doppler (OB) (76820) | $376.78 | $685.06 | 3.5× |
| Unlisted Dx Radiographic Procedure (76499) | $1,019.44 | $1,853.53 | 11.2× |
| Unlisted fluoroscopic procedure (76496) | $366.99 | $667.26 | 4.0× |
| Unlisted magnetic resonance procedure (76498) | $647.87 | $1,177.95 | 7.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,220.26 | $2,218.66 | 11.5× |
| Unlisted us procedure (76999) | $585.24 | $1,064.08 | 6.4× |
| Upper gi w/o kub (74240) | $453.45 | $824.45 | 2.5× |
| Ureteral Reflux Study (78740) | $589.22 | $1,071.30 | 1.4× |
| Urethrocystogram voiding (74455) | $781.30 | $1,420.55 | 3.1× |
| Urethrocystography retrograde (74450) | $515.43 | $937.15 | 2.1× |
| Us breast unilateral complete (76641) | $355.26 | $645.92 | 3.3× |
| Us chest (76604) | $474.66 | $863.01 | 4.3× |
| Us complete joint (76881) | $224.96 | $409.02 | 2.1× |
| Us exam, pelvic, limited (76857) | $462.91 | $841.65 | 4.2× |
| Us head (76506) | $613.62 | $1,115.68 | 5.6× |
| Us kidney transplant (76776) | $489.34 | $889.70 | 4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $335.68 | $610.33 | 3.1× |
| Us ob detailed single fetus (76811) | $420.83 | $765.14 | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $416.92 | $758.03 | 3.8× |
| Us ob transvaginal (76817) | $224.96 | $409.02 | 2.1× |
| Us pelvic non ob complete (76856) | $592.09 | $1,076.52 | 5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $224.96 | $409.02 | 2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $351.34 | $638.80 | 3.2× |
| Us retroperitoneal complete (76770) | $706.60 | $1,284.72 | 6.5× |
| Us retroperitoneal limited (76775) | $489.34 | $889.70 | 4.5× |
| Us scrotum and contents (76870) | $564.69 | $1,026.70 | 5.2× |
| Us spinal canal and contents (76800) | $493.25 | $896.81 | 4.5× |
| Us thyroid (76536) | $562.73 | $1,023.15 | 5.2× |
| Us transrectal (76872) | $1,076.53 | $1,957.33 | 9.9× |
| Vascular Flow Imaging (78445) | $936.25 | $1,702.28 | 2.2× |
| Venous thrombosis imaging (78457) | $915.87 | $1,665.22 | 1.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,429.66 | $2,599.39 | 3.4× |
| Vertebral fracture assessment via dxa (77086) | $155.77 | $283.22 | 1.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$433.79–$455 | $788.70–$827.28 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$316.55–$346.86 | $575.54–$630.66 | varies |
| X-ray antegrade pyelogram tube (74425) | $558.52 | $1,015.49 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$395–$436.23 | $718.18–$793.15 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$452.72–$491.41 | $823.13–$893.48 | varies |
| X-Ray Exam Breast Specimen (76098) | $762.72 | $1,386.76 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $360.73 | $655.88 | 4.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$721.46–$768.76 | $1,311.74–$1,397.74 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,082.19 | $1,967.62 | 9.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$270.55–$294.80 | $491.90–$536 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$450.91–$476.38 | $819.84–$866.15 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $721.46 | $1,311.74 | 6.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $631.28 | $1,147.78 | 5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$721.46–$765.12 | $1,311.74–$1,391.12 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $811.64 | $1,475.71 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$467.15–$523.55 | $849.37–$951.90 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$714.24–$745.77 | $1,298.62–$1,355.95 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$676.36–$728.51 | $1,229.75–$1,324.56 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$358.03–$395.62 | $650.96–$719.31 | varies |
| X-ray eye for foreign body (70030) | $209.60 | $381.09 | 2.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$487.89–$515.17 | $887.07–$936.68 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,219.25 | $2,216.82 | 6.7× |
| X-ray IV pyelogram+tomography (74415) | $572.52 | $1,040.95 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$426.56–$452.03 | $775.57–$821.88 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$243.50–$267.75 | $442.72–$486.82 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$502.32–$532.64 | $913.31–$968.44 | varies |
| X-ray nose-rectum child f.b. (76010) | $281.13 | $511.14 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$444.60–$493.11 | $808.36–$896.56 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$621.36–$652.89 | $1,129.75–$1,187.08 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$257.92–$285.82 | $468.95–$519.67 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$525.77–$553.66 | $955.94–$1,006.66 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$388.69–$428.10 | $706.70–$778.37 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$512.24–$557.72 | $931.34–$1,014.03 | varies |
| X-Ray Stress View (77071) | $233.57 | $424.68 | 2.6× |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$363.43–$472.58 | $660.79–$859.24 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$365.24–$395.56 | $664.07–$719.20 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $625.53 | $1,137.33 | 1.7× |
| X-Rays Bone Length Studies (77073) | $970.35 | $1,764.28 | 8.9× |
| X-Rays Bone Survey Complete (77075) | $701.62 | $1,275.67 | 6.4× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$642.10–$687.58 | $1,167.45–$1,250.14 | varies |
| Xr facial bones less than 3 views (70140) | $281.36 | $511.57 | 3.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $195.70 | $355.81 | 1.8× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$477.06–$519.51 | $867.39–$944.57 | varies |
| Xr Tomogram Single Plane (76100) | $371.08 | $674.69 | 3.4× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.