Imaging prices at UnityPoint Health Des Moines Iowa Methodist Medical Center
Des Moines, IA · every code in this section with a posted price and a Medicare benchmark.
419 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) | $7,805.70 | $9,757.12 | 5.9× |
| Abdomen 1 View (74018) | $279.42 | $349.27 | 3.3× |
| Abdomen 2 views (74019) | $338.61 | $423.26 | 3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,336.08 | $1,670.10 | 3.5× |
| Angio internal mammary (75756) | $2,221.12 | $2,776.40 | 0.7× |
| Angio pulmonary bilat (75743) | $4,767.36 | $5,959.19 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $5,941.96 | $7,427.45 | 2.0× |
| Angiography extremity unilateral rs&i (75710) | $5,918.53 | $7,398.16 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,934.73 | $4,918.41 | 1.3× |
| Ankle 2 views (73600) | $326.53 | $408.16 | 3.9× |
| Aortography thoracic serialography rs&i (75605) | $4,250.72 | $5,313.39 | 0.8× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,771.61 | $4,714.51 | 1.2× |
| Artery X-Rays Abdomen (75726) | $5,002.46 | $6,253.07 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $3,263.92 | $4,079.89 | 1.1× |
| Artery X-Rays Pelvis (75736) | $4,046.75 | $5,058.43 | 0.8× |
| Artery X-Rays Spine (75705) | $4,550.74 | $5,688.42 | 0.9× |
| Arthrogram hip (73525) | $983.28 | $1,229.09 | 2.9× |
| Arthrogram Wrist (73115) | $830.24 | $1,037.80 | 2.5× |
| Basic radiation dosimetry calculation (77300) | $501.04 | $626.29 | 3.9× |
| Bone age studies (77072) | $282.93 | $353.66 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,577.14 | $1,971.42 | 4.1× |
| Bone Imaging Limited Area (78300) | $874.76 | $1,093.45 | 2.3× |
| Bone Imaging Multiple Areas (78305) | $1,071.62 | $1,339.52 | 2.8× |
| Bone Imaging Whole Body (78306) | $1,489.56 | $1,861.95 | 3.9× |
| Bone marrow imaging; multiple areas (78103) | $880.91 | $1,101.13 | 2.3× |
| Bone survey infant (77076) | $303.87 | $379.83 | 3.0× |
| Brachytx isodose complex (77318) | $1,862.29 | $2,327.86 | 5.2× |
| Brachytx isodose intermed (77317) | $1,668 | $2,085 | 4.6× |
| Brachytx Isodose Plan Simple (77316) | $1,190.92 | $1,488.65 | 3.3× |
| Brain Image W/Flow < 4 Views (78601) | $782.13 | $977.66 | 2.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,309.53 | $1,636.91 | 2.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,664.44 | $5,830.54 | 3.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,055.57 | $3,819.46 | 9.1× |
| Cat Scan Follow-Up Study (76380) | $305.11 | $381.38 | 3.6× |
| Cerebrospinal Fluid Scan (78630) | $1,466.97 | $1,833.71 | 2.8× |
| Chest 1 view (71045) | $293.39 | $366.73 | 3.5× |
| Chest 2 views (71046) | $338.61 | $423.26 | 4.0× |
| Chest 3 views (71047) | $350.30 | $437.87 | 4.2× |
| Chest 4 or more views (71048) | $364.80 | $455.99 | 3.6× |
| Cholecystography Oral Contrast (74290) | $340.43 | $425.53 | 2.0× |
| Cisternography Positive Contrast Rs&I (70015) | $614.78 | $768.47 | 0.8× |
| Clavicle complete (73000) | $348.10 | $435.12 | 4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $199.17 | $248.96 | 2.0× |
| Continuing medical physics consltj pr wk (77336) | $637.18 | $796.47 | 4.9× |
| Contrast Exam Abdominl Aorta (75625) | $4,688.16 | $5,860.19 | 1.5× |
| Contrast X-Ray Bladder (74430) | $668.06 | $835.07 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $854.13 | $1,067.66 | 2.5× |
| Contrast X-Ray Of Knee Joint (73580) | $914.80 | $1,143.49 | 2.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $400.13 | $500.16 | 2.4× |
| CT abdomen and pelvis without and with contrast (74178) | $6,054.30 | $7,567.87 | 18.1× |
| CT abdomen and pelvis without contrast (74176) | $4,743.40 | $5,929.24 | 20.7× |
| CT abdomen w contrast (74160) | $2,583.24 | $3,229.05 | 15.3× |
| CT abdomen w wo contrast (74170) | $3,268.72 | $4,085.90 | 19.4× |
| CT abdomen w/o contrast (74150) | $2,224.56 | $2,780.69 | 22.1× |
| CT Angio Abdomen and Pelvis (74174) | $5,705.78 | $7,132.22 | 17.0× |
| CT Angio Chest (71275) | $3,497.03 | $4,371.28 | 20.7× |
| CT Angio Head (70496) | $3,234.49 | $4,043.11 | 19.2× |
| CT angio hrt w/3d image (75574) | $2,474.58 | $3,093.22 | 7.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,330.28 | $4,162.85 | 19.8× |
| CT Angio Neck (70498) | $2,850.89 | $3,563.61 | 16.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,513.08 | $3,141.34 | 14.9× |
| CT bone density (77078) | $524.12 | $655.15 | 6.3× |
| CT cervical spine w/ contrast (72126) | $2,896.28 | $3,620.34 | 8.6× |
| CT cervical spine w/o contrast (72125) | $2,794.80 | $3,493.50 | 27.8× |
| CT cervical spine w/wo cont (72127) | $2,921.09 | $3,651.36 | 17.3× |
| CT chest w contrast (71260) | $2,759.81 | $3,449.76 | 16.4× |
| CT chest w/wo contrast (71270) | $3,158.05 | $3,947.56 | 18.7× |
| CT colonography screening (74263) | $1,569.56 | $1,961.94 | 6.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,882.80 | $2,353.50 | 11.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,592.33 | $1,990.41 | 15.8× |
| CT head/brain with contrast (70460) | $2,227.89 | $2,784.86 | 13.2× |
| CT head/brain without and with contrast (70470) | $2,606.64 | $3,258.29 | 15.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,474.58 | $3,093.22 | 7.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $123.72 | $154.64 | 1.5× |
| CT hrt w/3d image congen (75573) | $2,474.58 | $3,093.22 | 7.4× |
| CT iac w contrast (70481) | $2,153.27 | $2,691.58 | 12.8× |
| CT l-spine w&w/o contrast (72133) | $3,071.44 | $3,839.29 | 18.2× |
| CT lower ext w/o (73700) | $1,991.73 | $2,489.66 | 19.8× |
| CT lower extremity w/contrast material (73701) | $1,999.08 | $2,498.85 | 11.9× |
| CT lumbar spine w contrast (72132) | $2,626.14 | $3,282.67 | 7.8× |
| CT lumbar spine w/o contrast (72131) | $2,427.55 | $3,034.43 | 24.2× |
| CT maxillofacial w contrast (70487) | $2,332.52 | $2,915.65 | 13.8× |
| CT maxillofacial wo contrast (70486) | $2,005.12 | $2,506.39 | 20.0× |
| CT neck tissue combo (70492) | $2,791.55 | $3,489.43 | 16.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,785.98 | $3,482.47 | 16.5× |
| CT orbits w/o contrast (70480) | $2,057.47 | $2,571.83 | 20.5× |
| CT pelvis w&w/o contrast (72194) | $3,110.69 | $3,888.36 | 18.4× |
| CT pelvis w/o contrast (72192) | $2,184.32 | $2,730.40 | 21.7× |
| CT scan of leg combo (73702) | $2,852.22 | $3,565.27 | 16.9× |
| CT scans face/jaw combo (70488) | $2,673.48 | $3,341.85 | 15.9× |
| CT soft tissue neck w contrast (70491) | $2,339.30 | $2,924.12 | 13.9× |
| CT soft tissue neck w/o contrast (70490) | $2,116.50 | $2,645.62 | 21.1× |
| CT thoracic spine w contrast (72129) | $2,630.41 | $3,288.01 | 15.6× |
| CT thoracic spine w/o contrast (72128) | $2,245.72 | $2,807.15 | 22.3× |
| CT thoracic spine w/wo cont (72130) | $3,123.93 | $3,904.91 | 18.5× |
| CT thorax w/o contrast (71250) | $2,078.63 | $2,598.28 | 20.7× |
| CT upper ext wo (73200) | $1,975.03 | $2,468.78 | 19.7× |
| CT upper extremity w/o & w/contrast material (73202) | $2,592.57 | $3,240.71 | 15.4× |
| CT upper extremity with contrast (73201) | $2,177.22 | $2,721.52 | 6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,199.80 | $3,999.74 | 19.0× |
| Cta Abdomen (74175) | $3,344.24 | $4,180.29 | 19.8× |
| CTA pelvis (72191) | $2,798.50 | $3,498.12 | 16.6× |
| Dilation ureters/urethra rs&i (74485) | $2,057.58 | $2,571.97 | 1.0× |
| Discography Cerv/Thor Spine (72285) | $3,165.08 | $3,956.35 | 1.7× |
| Diskography lumbar (72295) | $2,942.49 | $3,678.11 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $455.44 | $569.29 | 4.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $662.62 | $828.27 | 6.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $682.71 | $853.38 | 6.8× |
| Dxa Bone Density Axial (77080) | $557.70 | $697.12 | 5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $305.54 | $381.92 | 3.7× |
| Echo exam of fetal heart (76825) | $1,214.33 | $1,517.91 | 2.3× |
| Echo exam uterus (76831) | $835.54 | $1,044.42 | 3.6× |
| Echo Guide For Artery Repair (76936) | $1,101.84 | $1,377.30 | 5.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $715.88 | $894.84 | 3.1× |
| Echograp Trans R Pros Study (76873) | $908.44 | $1,135.54 | 9.0× |
| Esophagram (74220) | $491.04 | $613.79 | 2.9× |
| Fetal Biophys Profile W/Nst (76818) | $843 | $1,053.75 | 8.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $723.42 | $904.27 | 7.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $3,856.15 | $4,820.18 | 16.8× |
| Fluoroscopy up to 1 hr (76000) | $632.53 | $790.66 | 2.8× |
| Follow-Up Angiography (75898) | $1,352.89 | $1,691.11 | 0.4× |
| Foot 2 views (73620) | $319.84 | $399.79 | 3.8× |
| Forearm 2 views (73090) | $367.89 | $459.86 | 4.4× |
| Gastric emptying imaging study (78264) | $1,442.98 | $1,803.72 | 3.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,804.31 | $2,255.38 | 4.7× |
| Gastroesophageal Reflux Exam (78262) | $1,377.85 | $1,722.31 | 3.6× |
| Gated Heart Planar Single (78472) | $1,423.54 | $1,779.42 | 3.7× |
| Gated Heart, Multiple (78473) | $1,903.96 | $2,379.95 | 5.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,309.73 | $2,887.16 | 4.4× |
| Hand 2 views (73120) | $320.27 | $400.33 | 3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,305.36 | $7,881.70 | 9.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,084.16 | $7,605.20 | 9.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,638.44 | $7,048.05 | 8.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,014.32 | $6,267.90 | 1.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,221.43 | $5,276.78 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,922.64 | $2,403.29 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,499.60 | $1,874.49 | 3.9× |
| Ht Musc Image Planar Mult (78454) | $2,632.22 | $3,290.27 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $2,233.48 | $2,791.84 | 1.8× |
| Hyperthermia external generated superficial (77600) | $1,729.41 | $2,161.76 | 4.7× |
| Hysterosalpingogram (74740) | $591.80 | $739.74 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,052.04 | $1,315.05 | 12.6× |
| Infant hip ultrasound, limited static exam (76886) | $506.15 | $632.68 | 6.1× |
| Infusion Ivp (74410) | $822.32 | $1,027.90 | 4.9× |
| Interstitial radiation source applic complex (77778) | $4,563.84 | $5,704.79 | 6.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,066.60 | $3,833.24 | 4.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,735 | $2,168.74 | 3.3× |
| Intracavitary radiation source applic simple (77761) | $880.20 | $1,100.25 | 1.7× |
| Joint Survey Single View (77077) | $448.92 | $561.15 | 4.5× |
| K Flow/Funct Image W/Drug (78708) | $1,722.34 | $2,152.92 | 3.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,557.32 | $1,946.64 | 3.0× |
| Kidney Imaging Morphol (78700) | $1,106.92 | $1,383.65 | 2.9× |
| Knee 3 Views (73562) | $427.32 | $534.15 | 5.1× |
| Leveen/Shunt Patency Exam (78291) | $636.16 | $795.19 | 1.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,237.38 | $1,546.72 | 3.2× |
| Liver imaging static only (78201) | $1,424.90 | $1,781.12 | 2.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,919.83 | $2,399.78 | 3.7× |
| Lung perfusion differential (78597) | $1,497.40 | $1,871.75 | 3.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,707.71 | $2,134.63 | 3.3× |
| Lung Ventilation Imaging (78579) | $1,303.10 | $1,628.87 | 3.4× |
| Lymph System Imaging (78195) | $1,452.60 | $1,815.74 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,767.86 | $2,209.82 | 1.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,122.22 | $1,402.77 | 1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,442.52 | $5,553.15 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,751.84 | $2,189.80 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $3,007.68 | $3,759.60 | 13.1× |
| Mammary ductogram or galactogram multiple (77054) | $939.28 | $1,174.10 | 4.1× |
| Mammary ductogram or galactogram single (77053) | $488.56 | $610.69 | 2.1× |
| Meckels Divert Exam (78290) | $1,256.52 | $1,570.65 | 3.3× |
| Mlc imrt design & construction per imrt plan (77338) | $11,577.28 | $14,471.59 | 32.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,829.69 | $4,787.11 | 11.4× |
| MRA head w/o contrast (70544) | $3,174.75 | $3,968.43 | 13.8× |
| MRA head with contrast (70545) | $3,275.01 | $4,093.76 | 9.8× |
| MRA neck w contrast (70548) | $3,510.04 | $4,387.55 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,792.99 | $4,741.23 | 11.3× |
| MRA neck w/o contrast (70547) | $2,648.96 | $3,311.20 | 11.5× |
| MRI abdomen w contrast (74182) | $3,728.94 | $4,661.17 | 11.1× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$3,198.15–$3,553.49 | $3,997.68–$4,441.86 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,611.28 | $4,514.10 | 4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,166.61 | $5,208.26 | 12.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,564.64 | $4,455.79 | 4.7× |
| MRI cardiac w/o contrast (75557) | $2,606.08 | $3,257.59 | 11.4× |
| MRI cervical spine w contrast (72142) | $3,824.04 | $4,780.05 | 11.4× |
| MRI cervical spine w/o cont (72141) | $3,575.08 | $4,468.84 | 15.6× |
| MRI chest w/o contrast (71550) | $2,227.89 | $2,784.86 | 9.7× |
| MRI chest with contrast (71551) | $2,784.88 | $3,481.09 | 3.7× |
| MRI chest wo w contrast (71552) | $4,378.92 | $5,473.64 | 13.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,550.74 | $4,438.42 | 10.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,257.51 | $5,321.88 | 12.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,012.32 | $3,765.40 | 13.1× |
| MRI lumbar spine w contrast (72149) | $4,170.75 | $5,213.43 | 12.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,066.23 | $6,332.78 | 15.1× |
| MRI orbit face &/neck w/o contrast (70540) | $3,045.53 | $3,806.91 | 13.3× |
| MRI orbit face neck w contrast (70542) | $4,121.61 | $5,152.01 | 12.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,968.20 | $6,210.25 | 14.8× |
| MRI pelvis w contrast (72196) | $3,918.87 | $4,898.58 | 11.7× |
| MRI pelvis w/o & w contrast (72197) | $4,660.22 | $5,825.27 | 13.9× |
| MRI pelvis w/o contrast (72195) | $2,849.89 | $3,562.36 | 12.4× |
| MRI spectroscopy (76390) | $2,450.28 | $3,062.84 | 29.3× |
| MRI thoracic spine w/o contrast (72146) | $3,090.60 | $3,863.24 | 13.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,547.16 | $3,183.95 | 11.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,798.68 | $4,748.34 | 11.3× |
| MRI, abdomen, combo (74183) | $5,169.83 | $6,462.28 | 15.4× |
| MRI, dorsal spine combo (72157) | $5,086.24 | $6,357.79 | 15.2× |
| MRI, dorsal spine contrast (72147) | $4,053.38 | $5,066.72 | 12.1× |
| MRI, joint upper extrem (73221) | $3,476.19 | $4,345.23 | 15.2× |
| MRI, joint upper extrem combo (73223) | $3,953.68 | $4,942.10 | 11.8× |
| MRI, lumbar spine combo (72158) | $5,340.27 | $6,675.33 | 15.9× |
| Myelogram cervical (72240) | $1,582.36 | $1,977.95 | 2.1× |
| Myelogram Lumbar (72265) | $1,519.80 | $1,899.75 | 2.0× |
| Myelography thoracic (72255) | $1,669.96 | $2,087.44 | 2.2× |
| Myelograpy 2/more regions rs&i (72270) | $1,882.57 | $2,353.21 | 2.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,615.63 | $2,019.53 | 4.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,157.93 | $5,197.41 | 3.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,987.38 | $2,484.22 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $3,943.36 | $4,929.20 | 3.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,093.78 | $3,867.22 | 2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,093.78 | $3,867.22 | 2.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,670.96 | $5,838.69 | 2.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,048.31 | $5,060.38 | 1.9× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $3,840.76 | $4,800.94 | 2.6× |
| Neck soft tissue (70360) | $270.92 | $338.64 | 3.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $741.87 | $927.33 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $448.10 | $560.12 | 1.2× |
| Nm myocard infarct spect (78469) | $1,760.04 | $2,200.05 | 3.4× |
| Nonvascular Shunt X-Ray (75809) | $514.88 | $643.59 | 5.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,449.40 | $8,061.75 | 4.8× |
| Nuclear Rx Intra-Arterial (79445) | $905.56 | $1,131.95 | 4.0× |
| Nuclear Rx Oral Admin (79005) | $1,458.20 | $1,822.75 | 6.5× |
| Ob us nuchal meas 1 gest (76813) | $208.52 | $260.65 | 2.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $196.43 | $245.53 | 2.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $241.56 | $301.95 | 2.4× |
| Optic foramina (70190) | $371.13 | $463.91 | 4.4× |
| Panoramic X-ray of jaws (70355) | $295.20 | $369 | 3.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,303.26 | $1,629.07 | 2.5× |
| Parathyroid Planar Imaging (78070) | $1,129.91 | $1,412.38 | 2.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,214.14 | $1,517.67 | 3.2× |
| Pelvis 1 or 2 views (72170) | $354.54 | $443.17 | 3.5× |
| Peritoneogram Rs&I (74190) | $746.56 | $933.19 | 1.4× |
| Pet Image W/Ct Lmtd (78814) | $5,620.98 | $7,026.22 | 4.1× |
| PET image w/CT, full body (78816) | $6,700.40 | $8,375.50 | 4.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,511.55 | $8,139.43 | 4.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,712.56 | $4,640.69 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,303.10 | $1,628.87 | 3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $457.33 | $571.66 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $595.33 | $744.16 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $399.93 | $499.91 | 4.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $310.81 | $388.51 | 3.7× |
| Radex elbow complete minimum 3 views (73080) | $404.93 | $506.16 | 4.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $425.53 | $531.91 | 4.2× |
| Radex fingr minimum 2 views (73140) | $288.52 | $360.64 | 3.4× |
| Radex foot complete minimum 3 views (73630) | $389.57 | $486.96 | 4.7× |
| Radex Hand Minimum 3 Views (73130) | $389.88 | $487.34 | 4.7× |
| Radex lower extremity infant minimum 2 views (73592) | $113.68 | $142.10 | 1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $382.64 | $478.30 | 3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $389.88 | $487.34 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $413.84 | $517.29 | 4.9× |
| Radex shoulder complete minimum 2 views (73030) | $411.05 | $513.81 | 4.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $323.04 | $403.80 | 3.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $637.63 | $797.03 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $318.84 | $398.54 | 3.8× |
| Radex Sternum Minimum 2 Views (71120) | $389.88 | $487.34 | 4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $456.20 | $570.25 | 5.5× |
| Radex Toe Minimum 2 Views (73660) | $285.18 | $356.47 | 3.4× |
| Radex upper extremity infant minimum 2 views (73092) | $444.48 | $555.59 | 4.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $386.76 | $483.44 | 4.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $610.52 | $763.15 | 6.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,464.09 | $25,580.11 | 2.9× |
| Radiation treatment delivery level 1 (77402) | $481.16 | $601.44 | 4.9× |
| Radiation treatment delivery level 2 (77407) | $711.28 | $889.09 | 1.9× |
| Radiation treatment delivery level 3 (77412) | $873.04 | $1,091.29 | 1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $512.84 | $641.04 | 5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $357.56 | $446.94 | 3.6× |
| Radiologic exam colon double contrast study (74280) | $888.12 | $1,110.15 | 5.3× |
| Radiologic exam colon single contrast study (74270) | $708.04 | $885.04 | 4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $373.24 | $466.55 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) | $491.32 | $614.14 | 4.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $434.24 | $542.79 | 4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $591.28 | $739.10 | 3.5× |
| Radiologic exam swallow function contrast study (74230) | $511.10 | $638.87 | 3.0× |
| Radiologic exam teeth complete full mouth (70320) | $218.52 | $273.14 | 1.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $218.52 | $273.14 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $706.70 | $883.37 | 4.2× |
| Radiologic examination femur 1 view (73551) | $385.98 | $482.47 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $421.87 | $527.33 | 5.0× |
| Radiologic examination knee 1/2 views (73560) | $337.54 | $421.92 | 4.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $559.21 | $699.01 | 5.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $380.48 | $475.60 | 4.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $758.32 | $947.90 | 2.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $460.40 | $575.49 | 1.2× |
| Renal Cyst Study (74470) | $1,090.97 | $1,363.71 | 2.1× |
| Ribs bilateral 3 views (71110) | $540.20 | $675.25 | 5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,293.52 | $1,616.90 | 3.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,234.70 | $1,543.37 | 3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,372.50 | $2,965.62 | 4.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,898.74 | $2,373.42 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,840.02 | $2,300.02 | 3.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,746.19 | $3,432.73 | 2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,115.80 | $3,894.75 | 2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,746.19 | $3,432.73 | 2.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,598.31 | $1,997.88 | 7.1× |
| Rp Therapy Intravenous Administration (79101) | $1,347 | $1,683.75 | 6.0× |
| Scapula (73010) | $370.95 | $463.68 | 3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $45.04 | $56.29 | 1.9× |
| Sella turcica (70240) | $204.97 | $256.21 | 2.5× |
| Shoulder 1 view (73020) | $309.12 | $386.40 | 3.7× |
| Shoulder Arthrography (73040) | $962.40 | $1,203 | 2.9× |
| Sialogram (70390) | $534.40 | $668 | 2.3× |
| Skull less than 4 views (70250) | $401.18 | $501.47 | 4.0× |
| Special dosimetry (77331) | $490.14 | $612.67 | 3.8× |
| Special Physics Consult (77370) | $839.03 | $1,048.78 | 6.5× |
| Special teletherapy port plan (77321) | $2,030.70 | $2,538.37 | 5.6× |
| Special treatment procedure (77470) | $2,284.92 | $2,856.15 | 4.3× |
| Spleen Imaging (78185) | $554.90 | $693.62 | 1.4× |
| Stereotactic Body Radiation Delivery (77373) | $13,027.16 | $16,283.95 | 7.6× |
| Sternoclavicular joints (71130) | $306.35 | $382.93 | 3.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,403.75 | $5,504.68 | 12.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,402.04 | $3,002.55 | 6.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,800.15 | $2,250.18 | 5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $975.85 | $1,219.81 | 2.7× |
| Ther rad simulaj-aided field setting simple (77280) | $762.40 | $952.99 | 5.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $534.32 | $667.89 | 3.2× |
| Thoracic spine 2 views (72070) | $423.31 | $529.13 | 4.2× |
| Thoracic spine 3 views (72072) | $490.52 | $613.15 | 4.9× |
| Thoracolumbar 2 views (72080) | $413.62 | $517.02 | 4.9× |
| Thyroid Imaging With Vascular Flow (78013) | $987.10 | $1,233.87 | 2.6× |
| Thyroid Met Imaging Body (78018) | $1,662.67 | $2,078.33 | 3.2× |
| Thyroid Uptake Measurement (78012) | $523.72 | $654.64 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,645.14 | $2,056.42 | 4.3× |
| Tx Devices Design & Construction Complex (77334) | $1,157.72 | $1,447.15 | 3.2× |
| Tx devices design & construction intermediate (77333) | $708.04 | $885.04 | 5.5× |
| Tx devices design & construction simple (77332) | $515.09 | $643.86 | 4.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$502.34–$1,004.68 | $627.92–$1,255.84 | varies |
| Ultrasound elastography first target lesion (76982) | $408.76 | $510.95 | 4.1× |
| Ultrasound Elastography Parenchyma (76981) | $408.76 | $510.95 | 4.1× |
| Ultrasound Exam Aaa Screen (76706) | $545.28 | $681.59 | 5.4× |
| Ultrasound, abdomen limited (76705) | $888.34 | $1,110.42 | 8.8× |
| Umbilical-artery Doppler (OB) (76820) | $682.45 | $853.06 | 6.8× |
| Unlisted magnetic resonance procedure (76498) | $3,906.78 | $4,883.47 | 46.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,049.80 | $1,312.25 | 2.7× |
| Upper gi w/o kub (74240) | $640.09 | $800.11 | 3.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $225.47 | $281.83 | 20.4× |
| Urea breath test c-14 isotopic analysis (78268) | $348.35 | $435.43 | 3.7× |
| Ureteral Reflux Study (78740) | $986.29 | $1,232.86 | 2.6× |
| Urethrocystogram voiding (74455) | $657.24 | $821.54 | 2.9× |
| Urethrocystography retrograde (74450) | $658.01 | $822.51 | 2.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$659.58–$1,319.16 | $824.47–$1,648.94 | varies |
| Us chest (76604) | $665.80 | $832.24 | 6.6× |
| Us complete joint (76881) | $783.97 | $979.96 | 7.8× |
| Us exam, pelvic, limited (76857) | $560.05 | $700.06 | 5.6× |
| Us head (76506) | $503.20 | $628.99 | 5.0× |
| Us kidney transplant (76776) | $830.83 | $1,038.53 | 8.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $619.68 | $774.59 | 6.2× |
| Us ob detailed single fetus (76811) | $1,048.25 | $1,310.31 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $593.76 | $742.19 | 5.9× |
| Us ob transvaginal (76817) | $357.82 | $447.27 | 3.6× |
| Us pelvic non ob complete (76856) | $906.31 | $1,132.88 | 9.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $800.44 | $1,000.55 | 8.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $578.36 | $722.94 | 5.8× |
| Us retroperitoneal complete (76770) | $951.71 | $1,189.63 | 9.5× |
| Us retroperitoneal limited (76775) | $824.99 | $1,031.23 | 8.2× |
| Us scrotum and contents (76870) | $874.68 | $1,093.35 | 8.7× |
| Us spinal canal and contents (76800) | $640.80 | $800.99 | 6.4× |
| Us thyroid (76536) | $843.24 | $1,054.04 | 8.4× |
| Us transrectal (76872) | $779.15 | $973.93 | 7.8× |
| Vein X-Ray Chest (75827) | $2,693.99 | $3,367.48 | 1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,564.64 | $4,455.79 | 1.2× |
| Venogram Sinus/Jugular (75860) | $2,221.12 | $2,776.40 | 0.7× |
| Venography Adrenal Unilateral (75840) | $2,901.30 | $3,626.62 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $5,982.08 | $7,477.59 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $2,023.66 | $2,529.57 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,606.56 | $2,008.20 | 1.1× |
| Venography Renal Bilateral (75833) | $4,554.60 | $5,693.24 | 1.5× |
| Venography Renal Unilateral (75831) | $3,402.49 | $4,253.11 | 1.1× |
| Venous sampling by catheter (75893) | $3,800.23 | $4,750.28 | 0.7× |
| Wrist 2 views (73100) | $315.81 | $394.76 | 3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $352.89 | $441.11 | 4.2× |
| X-ray antegrade pyelogram tube (74425) | $756.19 | $945.23 | 2.3× |
| X-Ray Aorta Leg Arteries (75630) | $4,450.50 | $5,563.12 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $573.32 | $716.65 | 5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $339.53 | $424.41 | 4.1× |
| X-Ray Exam Breast Specimen (76098) | $562.58 | $703.22 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $359.25 | $449.06 | 4.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $575.49 | $719.36 | 5.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $600.52 | $750.64 | 6.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $271.52 | $339.39 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $395.84 | $494.80 | 4.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $475.41 | $594.26 | 4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $551.38 | $689.22 | 5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $606.02 | $757.52 | 6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $661.20 | $826.50 | 6.6× |
| X-Ray Exam L-S Spine Bending (72114) | $705 | $881.25 | 7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $433.68 | $542.09 | 5.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $680.10 | $850.12 | 6.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $491.26 | $614.07 | 4.9× |
| X-ray eye for foreign body (70030) | $270.46 | $338.07 | 3.2× |
| X-ray humerus (73060) | $371.71 | $464.63 | 4.4× |
| X-ray IV pyelogram (ivp) (74400) | $825.88 | $1,032.35 | 4.9× |
| X-ray IV pyelogram+tomography (74415) | $884.04 | $1,105.04 | 5.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $311.90 | $389.87 | 3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $306.32 | $382.89 | 3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $456.72 | $570.89 | 4.5× |
| X-ray nose-rectum child f.b. (76010) | $272.95 | $341.18 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $632.72 | $790.89 | 6.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $371.72 | $464.64 | 3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $282.94 | $353.67 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $399.31 | $499.13 | 4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $438.16 | $547.70 | 5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $556.98 | $696.22 | 5.5× |
| X-ray thoracic spine 4 vw (72074) | $556.98 | $696.22 | 5.5× |
| X-Ray Tmj Unilat (70328) | $383.20 | $479 | 4.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $740.79 | $925.98 | 2.2× |
| X-Rays Bone Length Studies (77073) | $537.77 | $672.21 | 5.4× |
| X-Rays Bone Survey Complete (77075) | $916.79 | $1,145.98 | 9.1× |
| Xr c-spine 4 or 5 views (72050) | $613.91 | $767.38 | 6.1× |
| Xr facial bones less than 3 views (70140) | $357.87 | $447.33 | 4.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $382.64 | $478.30 | 3.8× |
| Xr orbits complete 4 views (70200) | $490.14 | $612.67 | 4.9× |
| Xr Tomogram Single Plane (76100) | $315.48 | $394.34 | 3.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.