Imaging prices at UF Health Leesburg Hospital
Leesburg, FL · every code in this section with a posted price and a Medicare benchmark.
459 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $3,297.80 | $5,996 | 2.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Abdomen 2 views (74019) | $265.65 | $483 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,261.15 | $2,293 | 3.0× |
| Adrenal Cortex & Medulla Img (78075) | $3,239.50 | $5,890 | 2.4× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$6,817.25–$6,881.60 | $12,395–$12,512 | varies |
| Angio pulmonary bilat (75743) | $12,312.85 | $22,387 | 3.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,264.50 | $11,390 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $9,234.50 | $16,790 | 2.8× |
| Angiography extremity unilateral rs&i (75710) | $4,617.25 | $8,395 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,156.70 | $11,194 | 1.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,316.75 | $11,485 | 1.9× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$132.55–$244.75 | $241–$445 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,194.65 | $11,263 | 1.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,710.75 | $8,565 | 1.4× |
| Artery X-Rays Abdomen (75726) | $4,645.85 | $8,447 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $5,369.65 | $9,763 | 1.6× |
| Artery X-Rays Pelvis (75736) | $6,194.65 | $11,263 | 1.1× |
| Artery X-Rays Spine (75705) | $3,873.65 | $7,043 | 0.7× |
| Arthrogram ankle (73615) | $999.90 | $1,818 | 2.7× |
| Arthrogram hip (73525) | $993.85 | $1,807 | 2.7× |
| Arthrogram Wrist (73115) | $589.05 | $1,071 | 1.6× |
| Basic radiation dosimetry calculation (77300) | $354.75 | $645 | 2.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Bone Imaging 3 Phase (78315) | $1,530.65 | $2,783 | 3.7× |
| Bone Imaging Limited Area (78300) | $942.70 | $1,714 | 2.3× |
| Bone Imaging Multiple Areas (78305) | $849.20 | $1,544 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,414.05 | $2,571 | 3.4× |
| Bone marrow imaging; multiple areas (78103) | $849.20 | $1,544 | 2.0× |
| Bone marrow imaging; whole body (78104) | $942.70 | $1,714 | 2.3× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Brachytx isodose complex (77318) | $844.25 | $1,535 | 2.2× |
| Brachytx isodose intermed (77317) | $844.25 | $1,535 | 2.2× |
| Brachytx Isodose Plan Simple (77316) | $430.10 | $782 | 1.1× |
| Brain Flow Imaging Only (78610) | $1,104.95 | $2,009 | 1.9× |
| Brain Image W/Flow < 4 Views (78601) | $783.75 | $1,425 | 1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,357.40 | $2,468 | 2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,334 | $7,880 | 2.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $849.20 | $1,544 | 2.0× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,104.95 | $2,009 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,645.05 | $2,991 | 4.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,333 | $6,060 | 4.1× |
| Cardiac Shunt Detection (78428) | $942.70 | $1,714 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $182.05 | $331 | 2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,261.15 | $2,293 | 2.2× |
| Cerebrospinal Fluid Scan (78630) | $1,104.95 | $2,009 | 1.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$132.55–$198 | $241–$360 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$132.55–$242 | $241–$440 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $239.25 | $435 | 2.2× |
| Cholecystography Oral Contrast (74290) | $390.50 | $710 | 2.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,201.75 | $2,185 | 11.0× |
| Continuing medical physics consltj pr wk (77336) | $367.95 | $669 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) | $6,156.70 | $11,194 | 1.9× |
| Contrast X-Ray Bladder (74430) | $619.85 | $1,127 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $993.85 | $1,807 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $993.85 | $1,807 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,408 | $2,560 | 3.9× |
| CT abdomen and pelvis without contrast (74176) | $1,260.05 | $2,291 | 5.1× |
| CT abdomen w contrast (74160) | $1,201.75 | $2,185 | 6.6× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,201.75–$1,381.60 | $2,185–$2,512 | varies |
| CT abdomen w/o contrast (74150) | $1,085.15 | $1,973 | 9.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,408 | $2,560 | 3.9× |
| CT Angio Chest (71275) | $1,201.75 | $2,185 | 6.6× |
| CT Angio Head (70496) | $1,699.50 | $3,090 | 9.3× |
| CT angio hrt w/3d image (75574) | $1,201.75 | $2,185 | 3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,201.75 | $2,185 | 6.6× |
| CT Angio Neck (70498) | $1,201.75 | $2,185 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $952.05 | $1,731 | 5.2× |
| CT cervical spine w/ contrast (72126) | $1,198.45 | $2,179 | 3.3× |
| CT cervical spine w/o contrast (72125) | $1,141.25 | $2,075 | 10.5× |
| CT cervical spine w/wo cont (72127) | $1,258.95 | $2,289 | 6.9× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,201.75–$1,321.65 | $2,185–$2,403 | varies |
| CT chest w/wo contrast (71270) | $1,381.60 | $2,512 | 7.5× |
| CT colonography screening (74263) | $1,849.10 | $3,362 | 7.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $952.05 | $1,731 | 5.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $952.05 | $1,731 | 8.7× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$1,201.75–$1,609.85 | $2,185–$2,927 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,201.75–$1,699.50 | $2,185–$3,090 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,201.75 | $2,185 | 3.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $952.05 | $1,731 | 10.5× |
| CT hrt w/3d image congen (75573) | $952.05 | $1,731 | 2.6× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$1,201.75–$1,261.70 | $2,185–$2,294 | varies |
| CT l-spine w&w/o contrast (72133) | $1,444.30 | $2,626 | 7.9× |
| CT lower ext w/o (73700) | $1,201.75 | $2,185 | 11.0× |
| CT lower extremity w/contrast material (73701) range across 7 matching MRF lines |
$1,201.75–$1,261.70 | $2,185–$2,294 | varies |
| CT lumbar spine w contrast (72132) | $1,375.55 | $2,501 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $1,285.35 | $2,337 | 11.8× |
| CT maxillofacial w contrast (70487) | $1,261.70 | $2,294 | 6.9× |
| CT maxillofacial wo contrast (70486) | $1,201.75 | $2,185 | 11.0× |
| CT neck tissue combo (70492) | $1,324.40 | $2,408 | 7.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$952.05–$1,324.40 | $1,731–$2,408 | varies |
| CT orbits w/o contrast (70480) | $1,201.75 | $2,185 | 11.0× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$952.05–$1,324.40 | $1,731–$2,408 | varies |
| CT pelvis w/o contrast (72192) | $1,201.75 | $2,185 | 11.0× |
| CT scan of leg combo (73702) | $952.05 | $1,731 | 5.2× |
| CT scans face/jaw combo (70488) | $1,324.40 | $2,408 | 7.2× |
| CT soft tissue neck w contrast (70491) | $1,261.70 | $2,294 | 6.9× |
| CT soft tissue neck w/o contrast (70490) | $1,201.75 | $2,185 | 11.0× |
| CT thoracic spine w contrast (72129) | $1,285.35 | $2,337 | 7.0× |
| CT thoracic spine w/o contrast (72128) | $1,201.75 | $2,185 | 11.0× |
| CT thoracic spine w/wo cont (72130) | $1,349.70 | $2,454 | 7.4× |
| CT thorax w/o contrast (71250) | $1,201.75 | $2,185 | 11.0× |
| CT upper ext wo (73200) range across 8 matching MRF lines |
$1,085.15–$1,201.75 | $1,973–$2,185 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 7 matching MRF lines |
$952.05–$1,218.80 | $1,731–$2,216 | varies |
| CT upper extremity with contrast (73201) range across 7 matching MRF lines |
$1,160.50–$1,201.75 | $2,110–$2,185 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,201.75 | $2,185 | 6.6× |
| Cta Abdomen (74175) | $1,201.75 | $2,185 | 6.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $686.40 | $1,248 | 1.9× |
| CTA pelvis (72191) | $952.05 | $1,731 | 5.2× |
| Dilation ureters/urethra rs&i (74485) | $3,917.65 | $7,123 | 1.8× |
| Discography Cerv/Thor Spine (72285) | $3,841.75 | $6,985 | 1.9× |
| Diskography lumbar (72295) | $7,943.65 | $14,443 | 3.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $376.20 | $684 | 3.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $376.20 | $684 | 3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $245.30 | $446 | 2.2× |
| Dxa Bone Density Axial (77080) | $353.10 | $642 | 3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $163.35 | $297 | 1.8× |
| Echo exam of fetal heart (76825) | $1,054.35 | $1,917 | 1.8× |
| Echo exam uterus (76831) | $457.60 | $832 | 1.8× |
| Echo Guide For Artery Repair (76936) | $606.10 | $1,102 | 2.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,006.50 | $1,830 | 4.0× |
| Esophageal Motility Study (78258) | $1,261.15 | $2,293 | 3.0× |
| Esophagram (74220) | $367.95 | $669 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $363.55 | $661 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $376.20 | $684 | 3.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,323.85 | $2,407 | 5.3× |
| Fluoroscopy up to 1 hr (76000) | $671.55 | $1,221 | 2.7× |
| Follow-Up Angiography (75898) | $1,571.35 | $2,857 | 0.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$132.55–$218.90 | $241–$398 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$132.55–$188.65 | $241–$343 | varies |
| Gastric emptying imaging study (78264) | $1,497.65 | $2,723 | 3.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $849.20 | $1,544 | 2.0× |
| Gastroesophageal Reflux Exam (78262) | $1,261.15 | $2,293 | 3.0× |
| Gated Heart Planar Single (78472) | $1,261.15 | $2,293 | 3.0× |
| Gated Heart, Multiple (78473) | $942.70 | $1,714 | 2.3× |
| GI Endoscopic US S&I (76975) | $524.15 | $953 | 2.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$163.35–$329.45 | $297–$599 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,925 | $3,500 | 2.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,406.25 | $4,375 | 3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,492.70 | $2,714 | 2.1× |
| Heart first pass single,planar (78481) | $1,104.95 | $2,009 | 1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,617.25 | $8,395 | 1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,156.70 | $11,194 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,530.65 | $2,783 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,493.25 | $2,715 | 3.6× |
| Ht Musc Image Planar Mult (78454) | $3,239.50 | $5,890 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $3,239.50 | $5,890 | 2.4× |
| Hysterosalpingogram (74740) | $405.35 | $737 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $278.85 | $507 | 3.1× |
| Interstitial radiation source applic complex (77778) | $1,925 | $3,500 | 2.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,259.50 | $2,290 | 2.2× |
| Intracavitary radiation source applic simple (77761) | $1,259.50 | $2,290 | 2.2× |
| Intraop radiaj tx deliver xray single tx session (77424) | $19,817.60 | $36,032 | 2.6× |
| Joint Survey Single View (77077) | $242 | $440 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $1,261.15 | $2,293 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,415.70 | $2,574 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,240.80 | $2,256 | 2.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,261.15 | $2,293 | 3.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $849.20 | $1,544 | 2.0× |
| Knee 3 Views (73562) | $262.35 | $477 | 2.9× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,261.15 | $2,293 | 3.0× |
| Leveen/Shunt Patency Exam (78291) | $1,261.15 | $2,293 | 3.0× |
| Liver & Spleen Imaging Static Only (78215) | $741.40 | $1,348 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $741.40 | $1,348 | 1.8× |
| Liver imaging static only (78201) | $1,104.95 | $2,009 | 1.9× |
| Liver imaging w/vascular flow (78202) | $2,578.95 | $4,689 | 4.5× |
| Lung Perf&Ventilat Diferentl (78598) | $1,647.25 | $2,995 | 2.9× |
| Lung perfusion differential (78597) | $1,338.15 | $2,433 | 3.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,530.65 | $2,783 | 2.7× |
| Lung Ventilation Imaging (78579) | $849.20 | $1,544 | 2.0× |
| Lymph System Imaging (78195) | $1,530.65 | $2,783 | 2.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,571.35 | $2,857 | 1.0× |
| Lymphangiography extremity only unilateral rs&i (75801) | $533.50 | $970 | 0.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $6,130.30 | $11,146 | 1.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $6,264.50 | $11,390 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $1,323.85 | $2,407 | 5.3× |
| Magnetic Resonance Elastography (76391) | $1,323.85 | $2,407 | 5.3× |
| Mammary ductogram or galactogram multiple (77054) | $437.25 | $795 | 1.8× |
| Mammary ductogram or galactogram single (77053) | $437.25 | $795 | 1.8× |
| Meckels Divert Exam (78290) | $1,261.15 | $2,293 | 3.0× |
| Mlc imrt design & construction per imrt plan (77338) | $986.70 | $1,794 | 2.5× |
| Mr safety determination physician/other qhp (76016) | $179.67 | $326.67 | 2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.97 | $90.86 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $187.30 | $340.55 | 1.9× |
| Mr safety implt pos&/immoblj (76019) | $121.20 | $220.37 | 2.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $554.44 | $1,008.08 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,590.60 | $2,892 | 4.4× |
| MRA head w/o contrast (70544) | $1,368.95 | $2,489 | 5.5× |
| MRA head with contrast (70545) | $1,485.55 | $2,701 | 4.1× |
| MRA neck w contrast (70548) | $1,368.95 | $2,489 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,658.25 | $3,015 | 4.6× |
| MRA neck w/o contrast (70547) | $1,323.85 | $2,407 | 5.3× |
| MRI abdomen w contrast (74182) | $1,366.20 | $2,484 | 3.8× |
| MRI abdomen w/o contrast (74181) | $1,584 | $2,880 | 6.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$1,584–$1,659.90 | $2,880–$3,018 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$1,658.25–$1,742.40 | $3,015–$3,168 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,610.95 | $2,929 | 2.0× |
| MRI bone marrow blood supply (77084) | $519.20 | $944 | 2.1× |
| MRI brain functional w/o physician admnistration (70554) | $1,323.85 | $2,407 | 5.3× |
| MRI brain functional w/physician admnistration (70555) | $1,323.85 | $2,407 | 5.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,323.85 | $2,407 | 5.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $519.20 | $944 | 2.1× |
| MRI cardiac w/o contrast (75557) | $1,323.85 | $2,407 | 5.3× |
| MRI cervical spine w contrast (72142) | $1,366.20 | $2,484 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,606.55 | $2,921 | 6.4× |
| MRI chest w/o contrast (71550) | $1,323.85 | $2,407 | 5.3× |
| MRI chest with contrast (71551) | $1,327.15 | $2,413 | 1.6× |
| MRI chest wo w contrast (71552) | $1,366.20 | $2,484 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,323.85 | $2,407 | 3.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,658.25 | $3,015 | 4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,513.05 | $2,751 | 6.1× |
| MRI lumbar spine w contrast (72149) | $1,366.20 | $2,484 | 3.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,658.25 | $3,015 | 4.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,323.85 | $2,407 | 5.3× |
| MRI orbit face neck w contrast (70542) | $1,366.20 | $2,484 | 3.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,658.25 | $3,015 | 4.6× |
| MRI pelvis w contrast (72196) | $1,366.20 | $2,484 | 3.8× |
| MRI pelvis w/o & w contrast (72197) | $1,658.25 | $3,015 | 4.6× |
| MRI pelvis w/o contrast (72195) | $1,330.45 | $2,419 | 5.3× |
| MRI spectroscopy (76390) | $1,323.85 | $2,407 | 14.6× |
| MRI thoracic spine w/o contrast (72146) | $1,606.55 | $2,921 | 6.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,323.85 | $2,407 | 3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,451.45 | $2,639 | 5.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,658.25 | $3,015 | 4.6× |
| MRI, abdomen, combo (74183) | $1,658.25 | $3,015 | 4.6× |
| MRI, dorsal spine combo (72157) | $1,658.25 | $3,015 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,366.20 | $2,484 | 3.8× |
| MRI, joint upper extrem (73221) | $1,507 | $2,740 | 6.0× |
| MRI, joint upper extrem combo (73223) | $1,658.25 | $3,015 | 4.6× |
| MRI, lumbar spine combo (72158) | $1,658.25 | $3,015 | 4.6× |
| Myelogram Lumbar (72265) | $1,892 | $3,440 | 2.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,892 | $3,440 | 2.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,135 | $5,700 | 2.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,239.50 | $5,890 | 2.4× |
| Myocardial Spect Multiple Studies (78452) | $3,239.50 | $5,890 | 2.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,135 | $5,700 | 2.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,135 | $5,700 | 2.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,802.70 | $6,914 | 1.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,295.60 | $5,992 | 1.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,135 | $5,700 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) | $2,201.10 | $4,002 | 2.5× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $623.15 | $1,133 | 1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $849.20 | $1,544 | 2.0× |
| Nm csf leak detection (78650) | $2,339.15 | $4,253 | 1.7× |
| Nm unlisted gi procedure (78299) | $849.20 | $1,544 | 2.0× |
| Nonvascular Shunt X-Ray (75809) | $248.05 | $451 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,379.20 | $6,144 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $506.55 | $921 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $1,261.15 | $2,293 | 5.2× |
| Ob us nuchal meas 1 gest (76813) | $245.30 | $446 | 2.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $257.95 | $469 | 1.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $239.25 | $435 | 2.2× |
| Optic foramina (70190) | $163.35 | $297 | 1.8× |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,261.15 | $2,293 | 2.2× |
| Parathyroid Planar Imaging (78070) | $1,261.15 | $2,293 | 3.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $942.70 | $1,714 | 2.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Peritoneogram Rs&I (74190) | $991.10 | $1,802 | 1.7× |
| Pet Image Skull-Thigh (78812) | $3,915.45 | $7,119 | 2.6× |
| Pet Image W/Ct Lmtd (78814) | $3,407.80 | $6,196 | 2.3× |
| PET image w/CT, full body (78816) | $4,334 | $7,880 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,117.30 | $7,486 | 2.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,135 | $5,700 | 2.3× |
| PET whole body (78813) | $3,915.45 | $7,119 | 2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,156.70 | $11,194 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,297.45 | $2,359 | 3.1× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,829.85 | $3,327 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$163.35–$557.15 | $297–$1,013 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $658.35 | $1,197 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$132.55–$303.05 | $241–$551 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$132.55–$189.75 | $241–$345 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$132.55–$171.05 | $241–$311 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$132.55–$229.90 | $241–$418 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$132.55–$345.95 | $241–$629 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $168.30 | $306 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $163.35 | $297 | 1.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $488.40 | $888 | 2.7× |
| Radex Spine 1 View Specify Level (72020) | $204.05 | $371 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$132.55–$189.75 | $241–$345 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$163.35–$282.70 | $297–$514 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$163.35–$513.15 | $297–$933 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $18,521.25 | $33,675 | 2.4× |
| Radiation treatment delivery level 1 (77402) | $375.65 | $683 | 3.5× |
| Radiation treatment delivery level 2 (77407) | $367.95 | $669 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $646.25 | $1,175 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$36.85–$282.70 | $67–$514 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$163.35–$440.55 | $297–$801 | varies |
| Radiologic exam colon double contrast study (74280) | $513.15 | $933 | 2.8× |
| Radiologic exam colon single contrast study (74270) | $367.95 | $669 | 2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $294.25 | $535 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$163.35–$315.15 | $297–$573 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $282.70 | $514 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $353.10 | $642 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $367.95 | $669 | 2.0× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$132.55–$134.75 | $241–$245 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$132.55–$168.30 | $241–$306 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $282.70 | $514 | 2.6× |
| Radiologic Examination Salivary Gland Calculus (70380) | $177.65 | $323 | 2.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,058.20 | $1,924 | 1.9× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $177.65 | $323 | 2.0× |
| Radiopharm Dacryocystography (78660) | $681.45 | $1,239 | 1.6× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $621.50 | $1,130 | 2.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $566.50 | $1,030 | 1.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $517 | $940 | 1.3× |
| Renal Cyst Study (74470) | $1,058.20 | $1,924 | 1.9× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $783.75 | $1,425 | 1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $849.20 | $1,544 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,239.50 | $5,890 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,967.90 | $3,578 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,813.25 | $5,115 | 5.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,647.25 | $2,995 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,647.25 | $2,995 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,647.25 | $2,995 | 1.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $588.50 | $1,070 | 2.4× |
| Rp Therapy Intravenous Administration (79101) | $605 | $1,100 | 2.5× |
| Salivary Gland Function Study (78232) | $732.60 | $1,332 | 1.8× |
| Scapula (73010) range across 2 matching MRF lines |
$163.35–$207.35 | $297–$377 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $136.40 | $248 | 5.8× |
| Sella turcica (70240) | $177.65 | $323 | 2.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$132.55–$161.70 | $241–$294 | varies |
| Shoulder Arthrography (73040) | $993.85 | $1,807 | 2.7× |
| Sialogram (70390) | $472.45 | $859 | 1.9× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Special dosimetry (77331) | $294.25 | $535 | 2.1× |
| Special Physics Consult (77370) | $489.50 | $890 | 3.5× |
| Special teletherapy port plan (77321) | $789.25 | $1,435 | 2.0× |
| Special treatment procedure (77470) | $1,259.50 | $2,290 | 2.2× |
| Speech evaluation, complex (70371) | $303.05 | $551 | 1.2× |
| Spleen Imaging (78185) | $783.75 | $1,425 | 1.9× |
| Stereotactic Body Radiation Delivery (77373) | $5,145.80 | $9,356 | 2.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| Superior sagittal sinus venogram (75870) | $6,506.50 | $11,830 | 2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,056 | $1,920 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $600.05 | $1,091 | 1.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $504.35 | $917 | 2.0× |
| Testicular Imaging W/Flow (78761) | $849.20 | $1,544 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $986.70 | $1,794 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $789.25 | $1,435 | 2.0× |
| Ther rad simulaj-aided field setting simple (77280) | $515.90 | $938 | 3.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $513.15 | $933 | 2.8× |
| Thoracic spine 2 views (72070) | $294.25 | $535 | 2.7× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$163.35–$265.65 | $297–$483 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $783.75 | $1,425 | 1.9× |
| Thyroid Met Imaging Body (78018) | $1,552.65 | $2,823 | 2.7× |
| Thyroid Uptake Measurement (78012) | $888.25 | $1,615 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,144.55 | $2,081 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $828.30 | $1,506 | 2.1× |
| Tx devices design & construction intermediate (77333) | $402.05 | $731 | 2.9× |
| Tx devices design & construction simple (77332) | $231.55 | $421 | 1.6× |
| Ultrasound Breast Limited (76642) | $332.75 | $605 | 3.7× |
| Ultrasound elastography first target lesion (76982) | $266.75 | $485 | 2.4× |
| Ultrasound Elastography Parenchyma (76981) | $266.75 | $485 | 2.4× |
| Ultrasound Exam Aaa Screen (76706) | $290.40 | $528 | 2.7× |
| Ultrasound, abdomen limited (76705) | $455.95 | $829 | 4.2× |
| Umbilical-artery Doppler (OB) (76820) | $245.30 | $446 | 2.2× |
| Unlisted Dx Radiographic Procedure (76499) | $177.65 | $323 | 2.0× |
| Unlisted fluoroscopic procedure (76496) | $134.75 | $245 | 1.5× |
| Unlisted magnetic resonance procedure (76498) | $153.45 | $279 | 1.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $264 | $480 | 2.5× |
| Unlisted us procedure (76999) | $184.80 | $336 | 2.0× |
| Upper gi w/o kub (74240) | $320.65 | $583 | 1.8× |
| Ureteral Reflux Study (78740) | $849.20 | $1,544 | 2.0× |
| Urethrocystogram voiding (74455) | $699.60 | $1,272 | 2.8× |
| Urethrocystography retrograde (74450) | $574.20 | $1,044 | 2.3× |
| Us breast unilateral complete (76641) | $450.45 | $819 | 4.1× |
| Us chest (76604) | $323.95 | $589 | 3.0× |
| Us complete joint (76881) | $566.50 | $1,030 | 5.2× |
| Us exam, pelvic, limited (76857) | $239.25 | $435 | 2.2× |
| Us head (76506) | $266.75 | $485 | 2.4× |
| Us kidney transplant (76776) | $466.95 | $849 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $290.95 | $529 | 2.7× |
| Us ob detailed single fetus (76811) | $398.20 | $724 | 1.6× |
| Us ob limited 1 or more fetuses (76815) | $376.20 | $684 | 3.4× |
| Us ob transvaginal (76817) | $466.95 | $849 | 4.3× |
| Us pelvic non ob complete (76856) | $566.50 | $1,030 | 5.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $245.30 | $446 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $239.25 | $435 | 2.2× |
| Us retroperitoneal complete (76770) | $546.70 | $994 | 5.0× |
| Us retroperitoneal limited (76775) | $455.95 | $829 | 4.2× |
| Us scrotum and contents (76870) | $566.50 | $1,030 | 5.2× |
| Us spinal canal and contents (76800) | $292.05 | $531 | 2.7× |
| Us thyroid (76536) | $566.50 | $1,030 | 5.2× |
| Us transrectal (76872) | $301.95 | $549 | 2.8× |
| Vein X-Ray Chest (75827) | $1,513.05 | $2,751 | 0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,999.80 | $3,636 | 0.6× |
| Vein X-Ray Spleen/Liver (75810) | $5,419.15 | $9,853 | 1.6× |
| Venogram Sinus/Jugular (75860) | $3,258.75 | $5,925 | 1.0× |
| Venography Adrenal Unilateral (75840) | $6,156.70 | $11,194 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $4,074.95 | $7,409 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $2,670.25 | $4,855 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $1,669.25 | $3,035 | 1.0× |
| Venography Renal Bilateral (75833) | $6,156.70 | $11,194 | 1.9× |
| Venography Renal Unilateral (75831) | $6,156.70 | $11,194 | 1.9× |
| Venous sampling by catheter (75893) | $6,194.65 | $11,263 | 1.1× |
| Venous thrombosis imaging (78457) | $1,261.15 | $2,293 | 2.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,261.15 | $2,293 | 3.0× |
| Vertebral fracture assessment via dxa (77086) | $177.65 | $323 | 2.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$132.55–$189.75 | $241–$345 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,144.55 | $2,081 | 3.1× |
| X-Ray Aorta Leg Arteries (75630) | $6,215 | $11,300 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$163.35–$408.65 | $297–$743 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| X-Ray Exam Breast Specimen (76098) | $707.30 | $1,286 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$132.55–$134.75 | $241–$245 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$163.35–$309.65 | $297–$563 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$163.35–$513.15 | $297–$933 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $168.30 | $306 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$132.55–$226.60 | $241–$412 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $248.05 | $451 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$163.35–$309.65 | $297–$563 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $309.65 | $563 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$163.35–$641.30 | $297–$1,166 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$163.35–$389.40 | $297–$708 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$132.55–$367.95 | $241–$669 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$163.35–$341 | $297–$620 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$36.85–$163.35 | $67–$297 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| X-ray IV pyelogram (ivp) (74400) | $390.50 | $710 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $221.65 | $403 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $331.10 | $602 | 3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| X-ray nose-rectum child f.b. (76010) | $443.30 | $806 | 4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$163.35–$341 | $297–$620 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$163.35–$309.65 | $297–$563 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$132.55–$204.05 | $241–$371 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$132.55–$171.60 | $241–$312 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$163.35–$370.70 | $297–$674 | varies |
| X-Ray Stress View (77071) | $134.75 | $245 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $282.70 | $514 | 2.6× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$132.55–$163.35 | $241–$297 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,086.25 | $1,975 | 3.0× |
| X-Rays Bone Length Studies (77073) | $166.10 | $302 | 1.5× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$132.55–$134.75 | $241–$245 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$163.35–$353.10 | $297–$642 | 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.