Imaging prices at University Health System
San Antonio, TX · every code in this section with a posted price and a Medicare benchmark.
439 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) | $885 | $3,540 | 0.6× |
| Abdomen 1 View (74018) | $207 | $828 | 2.4× |
| Abdomen 2 views (74019) | $262.25 | $1,049 | 2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $711.50 | $2,846 | 1.8× |
| Angio internal mammary (75756) | $2,805.75 | $11,223 | 0.9× |
| Angio pulmonary bilat (75743) | $2,805.75 | $11,223 | 0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,805.75 | $11,223 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $2,805.75 | $11,223 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $2,805.75 | $11,223 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,805.75 | $11,223 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,135.25 | $4,541 | 0.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$120–$166.50 | $480–$666 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,653.50 | $18,614 | 0.8× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,805.75 | $11,223 | 0.9× |
| Artery X-Rays Abdomen (75726) | $4,653.50 | $18,614 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $850 | $3,400 | 0.3× |
| Artery X-Rays Pelvis (75736) | $4,653.50 | $18,614 | 0.8× |
| Artery X-Rays Spine (75705) | $4,653.50 | $18,614 | 0.8× |
| Arthrogram ankle (73615) | $386.50 | $1,546 | 1.1× |
| Arthrogram hip (73525) | $386.50 | $1,546 | 1.1× |
| Arthrogram Wrist (73115) | $392.75 | $1,571 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $222.50 | $890 | 1.6× |
| Bone age studies (77072) | $117 | $468 | 1.1× |
| Bone Imaging 3 Phase (78315) | $677.75 | $2,711 | 1.7× |
| Bone Imaging Limited Area (78300) | $209.75 | $839 | 0.5× |
| Bone Imaging Multiple Areas (78305) | $475.75 | $1,903 | 1.2× |
| Bone Imaging Whole Body (78306) | $637.25 | $2,549 | 1.6× |
| Bone marrow imaging limited area (78102) | $345.25 | $1,381 | 0.9× |
| Bone marrow imaging; whole body (78104) | $591 | $2,364 | 1.5× |
| Bone survey infant (77076) | $113.25 | $453 | 1.1× |
| Brain Flow Imaging Only (78610) | $301 | $1,204 | 0.6× |
| Brain Image W/Flow < 4 Views (78601) | $201.75 | $807 | 0.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $251.25 | $1,005 | 0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,623 | $6,492 | 1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $471.75 | $1,887 | 1.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $689.25 | $2,757 | 0.9× |
| Cardiac Shunt Detection (78428) | $311.50 | $1,246 | 0.8× |
| Cat Scan Follow-Up Study (76380) | $112.75 | $451 | 1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $332.75 | $1,331 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $422.75 | $1,691 | 0.8× |
| Chest 1 view (71045) | $168 | $672 | 1.9× |
| Chest 2 views (71046) range across 5 matching MRF lines |
$201.75–$245 | $807–$980 | varies |
| Chest 3 views (71047) | $276.25 | $1,105 | 3.2× |
| Chest 4 or more views (71048) | $243 | $972 | 2.3× |
| Cisternography Positive Contrast Rs&I (70015) | $689.25 | $2,757 | 0.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$166.75–$220.50 | $667–$882 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $104.50 | $418 | 1.0× |
| Continuing medical physics consltj pr wk (77336) | $105.50 | $422 | 0.8× |
| Contrast Exam Abdominl Aorta (75625) | $2,805.75 | $11,223 | 0.9× |
| Contrast X-Ray Bladder (74430) | $386.50 | $1,546 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $386.50 | $1,546 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $635.25 | $2,541 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $2,160 | $8,640 | 6.2× |
| CT abdomen and pelvis without contrast (74176) | $1,857.25 | $7,429 | 7.7× |
| CT abdomen w contrast (74160) | $1,269 | $5,076 | 7.2× |
| CT abdomen w wo contrast (74170) | $1,503.75 | $6,015 | 8.5× |
| CT abdomen w/o contrast (74150) | $1,113.50 | $4,454 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,494.75 | $9,979 | 7.1× |
| CT Angio Chest (71275) | $1,393.50 | $5,574 | 7.9× |
| CT Angio Head (70496) | $702 | $2,808 | 4.0× |
| CT angio hrt w/3d image (75574) | $1,383.75 | $5,535 | 3.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$766.75–$852.50 | $3,067–$3,410 | varies |
| CT Angio Neck (70498) | $673.50 | $2,694 | 3.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,137.50 | $4,550 | 6.5× |
| CT cervical spine w/ contrast (72126) | $1,106 | $4,424 | 3.2× |
| CT cervical spine w/o contrast (72125) | $1,261.25 | $5,045 | 12.0× |
| CT cervical spine w/wo cont (72127) | $1,493.75 | $5,975 | 8.5× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,393.50–$1,463 | $5,574–$5,852 | varies |
| CT chest w/wo contrast (71270) | $1,650.75 | $6,603 | 9.4× |
| CT colonography screening (74263) | $768.75 | $3,075 | 3.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $803.25 | $3,213 | 4.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $890.50 | $3,562 | 8.5× |
| CT head/brain with contrast (70460) | $1,077.25 | $4,309 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,276 | $5,104 | 7.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,079.50 | $4,318 | 3.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $854.50 | $3,418 | 9.8× |
| CT hrt w/3d image congen (75573) | $1,105.50 | $4,422 | 3.2× |
| CT iac w contrast (70481) | $851.25 | $3,405 | 4.8× |
| CT l-spine w&w/o contrast (72133) | $773.25 | $3,093 | 4.4× |
| CT lower ext w/o (73700) range across 15 matching MRF lines |
$643.75–$944.25 | $2,575–$3,777 | varies |
| CT lower extremity w/contrast material (73701) range across 23 matching MRF lines |
$679.25–$1,019.50 | $2,717–$4,078 | varies |
| CT lumbar spine w contrast (72132) | $652.75 | $2,611 | 1.9× |
| CT lumbar spine w/o contrast (72131) | $572.75 | $2,291 | 5.5× |
| CT maxillofacial w contrast (70487) | $851.25 | $3,405 | 4.8× |
| CT maxillofacial wo contrast (70486) | $746.50 | $2,986 | 7.1× |
| CT neck tissue combo (70492) | $706.50 | $2,826 | 4.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,008 | $4,032 | 5.7× |
| CT orbits w/o contrast (70480) | $746.50 | $2,986 | 7.1× |
| CT pelvis w&w/o contrast (72194) | $757.50 | $3,030 | 4.3× |
| CT pelvis w/o contrast (72192) | $561 | $2,244 | 5.3× |
| CT scan of leg combo (73702) range across 20 matching MRF lines |
$804.75–$1,107.75 | $3,219–$4,431 | varies |
| CT scans face/jaw combo (70488) | $1,008 | $4,032 | 5.7× |
| CT soft tissue neck w contrast (70491) | $675.75 | $2,703 | 3.8× |
| CT soft tissue neck w/o contrast (70490) | $523.25 | $2,093 | 5.0× |
| CT thoracic spine w contrast (72129) | $1,004.75 | $4,019 | 5.7× |
| CT thoracic spine w/o contrast (72128) | $881.25 | $3,525 | 8.4× |
| CT thoracic spine w/wo cont (72130) | $1,190 | $4,760 | 6.8× |
| CT thorax w/o contrast (71250) | $940.50 | $3,762 | 9.0× |
| CT unlisted procedure (76497) | $169.25 | $677 | 1.9× |
| CT upper ext wo (73200) range across 15 matching MRF lines |
$884–$1,219.25 | $3,536–$4,877 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 13 matching MRF lines |
$1,104.75–$1,267.25 | $4,419–$5,069 | varies |
| CT upper extremity with contrast (73201) range across 23 matching MRF lines |
$932.75–$1,399.75 | $3,731–$5,599 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,316.50 | $5,266 | 7.5× |
| Cta Abdomen (74175) | $1,432.50 | $5,730 | 8.1× |
| CTA pelvis (72191) | $608 | $2,432 | 3.5× |
| Dilation ureters/urethra rs&i (74485) | $1,793.50 | $7,174 | 0.9× |
| Diskography lumbar (72295) | $1,243.75 | $4,975 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $113.25 | $453 | 1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $113.25 | $453 | 1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $122.50 | $490 | 1.2× |
| Dxa Bone Density Axial (77080) | $90 | $360 | 0.9× |
| Dxa bone density study (77085) | $134.25 | $537 | 1.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $53.50 | $214 | 0.6× |
| Echo exam of fetal heart (76825) | $378 | $1,512 | 0.7× |
| Echo exam uterus (76831) | $235.75 | $943 | 1.0× |
| Echo Guide For Artery Repair (76936) | $419.75 | $1,679 | 1.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $189.75 | $759 | 0.8× |
| Echograp Trans R Pros Study (76873) | $98 | $392 | 0.9× |
| Esophageal Motility Study (78258) | $452.50 | $1,810 | 1.1× |
| Esophagram (74220) | $184.25 | $737 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $153.25 | $613 | 1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $125 | $500 | 1.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $780.50 | $3,122 | 3.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$264.75–$276 | $1,059–$1,104 | varies |
| Follow-Up Angiography (75898) | $1,107.25 | $4,429 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$80.75–$113.25 | $323–$453 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$127.25–$188.75 | $509–$755 | varies |
| Gastric emptying imaging study (78264) | $571.75 | $2,287 | 1.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $495.50 | $1,982 | 1.2× |
| Gastroesophageal Reflux Exam (78262) | $438.25 | $1,753 | 1.1× |
| Gated Heart Planar Single (78472) | $597.50 | $2,390 | 1.5× |
| Gated Heart, Multiple (78473) range across 6 matching MRF lines |
$551.25–$700.50 | $2,205–$2,802 | varies |
| GI Endoscopic US S&I (76975) | $235.75 | $943 | 1.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $605.25 | $2,421 | 1.1× |
| Hand 2 views (73120) | $113.25 | $453 | 1.1× |
| Heart first pass single,planar (78481) | $274.75 | $1,099 | 0.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,805.75 | $11,223 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,805.75 | $11,223 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $834.75 | $3,339 | 1.5× |
| Hepatobiliary System Imaging (78226) | $602.25 | $2,409 | 1.5× |
| Ht Musc Image Planar Mult (78454) | $1,010.50 | $4,042 | 0.8× |
| Ht Muscle Image Spect Sing (78451) | $1,455.50 | $5,822 | 1.1× |
| Hyperthermia external generated superficial (77600) | $468.25 | $1,873 | 1.2× |
| Hysterosalpingogram (74740) | $235.75 | $943 | 1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $195.50 | $782 | 2.2× |
| Infant hip ultrasound, limited static exam (76886) | $80.75 | $323 | 0.9× |
| Interstitial radiation source applic complex (77778) | $811.50 | $3,246 | 1.2× |
| Joint Survey Single View (77077) | $113.25 | $453 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $441.25 | $1,765 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $452.25 | $1,809 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) | $777.50 | $3,110 | 1.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $440 | $1,760 | 1.1× |
| Kidney Imaging Morphol (78700) | $457 | $1,828 | 1.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$232.75–$348.25 | $931–$1,393 | varies |
| Liver & Spleen Imaging Static Only (78215) | $341.75 | $1,367 | 0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $249 | $996 | 0.6× |
| Liver imaging static only (78201) | $386.50 | $1,546 | 0.7× |
| Lung Perf&Ventilat Diferentl (78598) | $685.25 | $2,741 | 1.3× |
| Lung perfusion differential (78597) | $495.25 | $1,981 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $431 | $1,724 | 0.8× |
| Lung Ventilation Imaging (78579) | $287 | $1,148 | 0.7× |
| Lymph System Imaging (78195) | $344.50 | $1,378 | 0.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,107.25 | $4,429 | 0.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $638.25 | $2,553 | 1.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,805.75 | $11,223 | 0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,107.25 | $4,429 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $274.75 | $1,099 | 1.1× |
| Magnetic Resonance Elastography (76391) | $275 | $1,100 | 1.1× |
| Mammary ductogram or galactogram multiple (77054) | $235.75 | $943 | 1.0× |
| Mammary ductogram or galactogram single (77053) | $235.75 | $943 | 1.0× |
| Meckels Divert Exam (78290) | $491.25 | $1,965 | 1.2× |
| Medical physics dose eval radiation expos w/rprt (76145) | $907.75 | $3,631 | 2.4× |
| Mlc imrt design & construction per imrt plan (77338) | $415.75 | $1,663 | 1.1× |
| Mr safety determination physician/other qhp (76016) | $112.50 | $450 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $31.25 | $125 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $115 | $460 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $75 | $300 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $212.50 | $850 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,291.50 | $5,166 | 3.7× |
| MRA head w/o contrast (70544) | $1,225.25 | $4,901 | 5.1× |
| MRA head with contrast (70545) | $1,193.50 | $4,774 | 3.4× |
| MRA neck w contrast (70548) | $1,404 | $5,616 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,291.50 | $5,166 | 3.7× |
| MRA neck w/o contrast (70547) | $1,095.50 | $4,382 | 4.6× |
| MRI abdomen w contrast (74182) | $1,440.75 | $5,763 | 4.1× |
| MRI abdomen w/o contrast (74181) | $1,297.50 | $5,190 | 5.4× |
| MRI any jt lower extrem w/contrast material (73722) | $803.25 | $3,213 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 9 matching MRF lines |
$543.75–$661.75 | $2,175–$2,647 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $803.25 | $3,213 | 1.0× |
| MRI brain functional w/o physician admnistration (70554) | $782 | $3,128 | 3.3× |
| MRI brain functional w/physician admnistration (70555) | $842.75 | $3,371 | 3.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,073.75 | $4,295 | 4.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $799.75 | $3,199 | 3.3× |
| MRI cardiac w/o cont stress (75559) | $487.50 | $1,950 | 0.9× |
| MRI cardiac w/o contrast (75557) | $774.50 | $3,098 | 3.2× |
| MRI cervical spine w contrast (72142) | $1,558.50 | $6,234 | 4.4× |
| MRI cervical spine w/o cont (72141) | $1,404 | $5,616 | 5.9× |
| MRI chest w/o contrast (71550) | $443.50 | $1,774 | 1.9× |
| MRI chest with contrast (71551) | $803.25 | $3,213 | 1.0× |
| MRI chest wo w contrast (71552) | $541.25 | $2,165 | 1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 9 matching MRF lines |
$494.75–$647.25 | $1,979–$2,589 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$450.50–$543.75 | $1,802–$2,175 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$445.50–$567.75 | $1,782–$2,271 | varies |
| MRI lumbar spine w contrast (72149) | $946.50 | $3,786 | 2.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,714 | $6,856 | 4.9× |
| MRI orbit face &/neck w/o contrast (70540) | $936 | $3,744 | 3.9× |
| MRI orbit face neck w contrast (70542) | $1,044 | $4,176 | 3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,142.75 | $4,571 | 3.3× |
| MRI pelvis w contrast (72196) | $1,279 | $5,116 | 3.6× |
| MRI pelvis w/o & w contrast (72197) | $1,480.75 | $5,923 | 4.2× |
| MRI pelvis w/o contrast (72195) | $1,039 | $4,156 | 4.3× |
| MRI spectroscopy (76390) | $526.75 | $2,107 | 6.0× |
| MRI thoracic spine w/o contrast (72146) | $1,540 | $6,160 | 6.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 7 matching MRF lines |
$499–$620.25 | $1,996–$2,481 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$570.75–$787.50 | $2,283–$3,150 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 9 matching MRF lines |
$696.50–$847.25 | $2,786–$3,389 | varies |
| MRI, abdomen, combo (74183) | $1,583.50 | $6,334 | 4.5× |
| MRI, dorsal spine combo (72157) | $1,879.50 | $7,518 | 5.4× |
| MRI, dorsal spine contrast (72147) | $1,709.75 | $6,839 | 4.9× |
| MRI, joint upper extrem (73221) range across 10 matching MRF lines |
$570.75–$727.75 | $2,283–$2,911 | varies |
| MRI, joint upper extrem combo (73223) range across 10 matching MRF lines |
$696.50–$847.25 | $2,786–$3,389 | varies |
| MRI, lumbar spine combo (72158) | $1,041 | $4,164 | 3.0× |
| Myelogram cervical (72240) | $689.25 | $2,757 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $689.25 | $2,757 | 0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,244.50 | $4,978 | 1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $756.75 | $3,027 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $1,455.50 | $5,822 | 1.1× |
| Neck soft tissue (70360) | $148 | $592 | 1.7× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $145.50 | $582 | 0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $372.50 | $1,490 | 0.9× |
| Nm csf leak detection (78650) | $566.75 | $2,267 | 0.4× |
| Nm whole blood volume (78122) | $497 | $1,988 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $113.25 | $453 | 1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,880.75 | $7,523 | 1.4× |
| Nuclear Rx Intra-Arterial (79445) | $471.50 | $1,886 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $483.25 | $1,933 | 2.1× |
| Ob us nuchal meas 1 gest (76813) | $113.25 | $453 | 1.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $206.50 | $826 | 2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 4 matching MRF lines |
$135.25–$196.75 | $541–$787 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $23.25 | $93 | 0.8× |
| Optic foramina (70190) | $80.75 | $323 | 0.9× |
| Panoramic X-ray of jaws (70355) | $101.25 | $405 | 1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $515 | $2,060 | 0.9× |
| Parathyroid Planar Imaging (78070) | $273.50 | $1,094 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $483.50 | $1,934 | 1.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$192.25–$222 | $769–$888 | varies |
| Peritoneogram Rs&I (74190) | $487.50 | $1,950 | 0.9× |
| Pet Image Skull-Thigh (78812) | $1,623 | $6,492 | 1.1× |
| Pet Image W/Ct Lmtd (78814) | $1,623 | $6,492 | 1.1× |
| PET image w/CT, full body (78816) | $1,623 | $6,492 | 1.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,623 | $6,492 | 1.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,450.50 | $5,802 | 1.1× |
| Pet Myocardial Sngl Study (78491) | $1,392.75 | $5,571 | 1.0× |
| PET whole body (78813) | $1,623 | $6,492 | 1.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $587.50 | $2,350 | 0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,805.75 | $11,223 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $432.75 | $1,731 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $396.75 | $1,587 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $487.50 | $1,950 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$128.25–$192 | $513–$768 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$171.25–$255.50 | $685–$1,022 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$160.50–$180 | $642–$720 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $113.25 | $453 | 1.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$149–$200 | $596–$800 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$80.75–$115.25 | $323–$461 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$80.75–$98 | $323–$392 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $80.75 | $323 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $113.25 | $453 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $80.75 | $323 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) | $116.50 | $466 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$208.75–$288 | $835–$1,152 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $165 | $660 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $184.25 | $737 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $175.25 | $701 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $100.75 | $403 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $84.25 | $337 | 1.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$84.25–$127 | $337–$508 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $113.25 | $453 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$178–$260.25 | $712–$1,041 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $208.25 | $833 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $170.50 | $682 | 1.7× |
| Radiation treatment delivery level 2 (77407) | $309.50 | $1,238 | 0.8× |
| Radiation treatment delivery level 3 (77412) | $293.75 | $1,175 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $113.25 | $453 | 1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $267.25 | $1,069 | 2.5× |
| Radiologic exam colon double contrast study (74280) | $361 | $1,444 | 2.0× |
| Radiologic exam colon single contrast study (74270) | $274.75 | $1,099 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$287.50–$412.50 | $1,150–$1,650 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $241.50 | $966 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $184.25 | $737 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $276.50 | $1,106 | 1.6× |
| Radiologic exam teeth complete full mouth (70320) | $235.75 | $943 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $392.25 | $1,569 | 2.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$129–$158 | $516–$632 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$176.75–$213.25 | $707–$853 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$217–$282.50 | $868–$1,130 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $113.25 | $453 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$190.50–$264.50 | $762–$1,058 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $107.25 | $429 | 0.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $127.50 | $510 | 0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $240.75 | $963 | 0.4× |
| Ribs bilateral 3 views (71110) | $113.25 | $453 | 1.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $584 | $2,336 | 1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $582.50 | $2,330 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $993 | $3,972 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$621.25–$860.50 | $2,485–$3,442 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 9 matching MRF lines |
$554–$951 | $2,216–$3,804 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $651.50 | $2,606 | 0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $860.25 | $3,441 | 0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $676.50 | $2,706 | 0.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $127.50 | $510 | 0.5× |
| Rp Therapy Intravenous Administration (79101) | $127.50 | $510 | 0.5× |
| Salivary Gland Imaging Serial Images (78231) | $205.50 | $822 | 0.5× |
| Scapula (73010) | $193.25 | $773 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $192.50 | $770 | 8.2× |
| Sella turcica (70240) | $80.75 | $323 | 0.9× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$193.75–$217.50 | $775–$870 | varies |
| Shoulder Arthrography (73040) | $386.50 | $1,546 | 1.1× |
| Sialogram (70390) | $235.75 | $943 | 1.0× |
| Skull less than 4 views (70250) | $157.25 | $629 | 1.5× |
| Special dosimetry (77331) | $56.50 | $226 | 0.4× |
| Special Physics Consult (77370) | $188.25 | $753 | 1.4× |
| Special teletherapy port plan (77321) | $149.25 | $597 | 0.4× |
| Special treatment procedure (77470) | $326.75 | $1,307 | 0.6× |
| Speech evaluation, complex (70371) | $181.25 | $725 | 0.8× |
| Sternoclavicular joints (71130) | $110.25 | $441 | 1.3× |
| Superior sagittal sinus venogram (75870) | $952.75 | $3,811 | 0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $127.25 | $509 | 1.2× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $86.75 | $347 | 1.0× |
| Tbs technical calculation only (77091) | $87 | $348 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $268.50 | $1,074 | 0.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $149.50 | $598 | 0.4× |
| Testicular Imaging W/Flow (78761) | $208.75 | $835 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $527.50 | $2,110 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $495.25 | $1,981 | 1.3× |
| Ther rad simulaj-aided field setting simple (77280) | $295.50 | $1,182 | 2.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $229.75 | $919 | 1.3× |
| Thoracic spine 2 views (72070) | $140.25 | $561 | 1.3× |
| Thoracic spine 3 views (72072) | $113.25 | $453 | 1.1× |
| Thoracolumbar 2 views (72080) | $122.25 | $489 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $216.25 | $865 | 0.5× |
| Thyroid Met Imaging Body (78018) | $704.25 | $2,817 | 1.3× |
| Thyroid Uptake Measurement (78012) | $170.25 | $681 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $290.50 | $1,162 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $149.25 | $597 | 0.4× |
| Tx devices design & construction intermediate (77333) | $86.25 | $345 | 0.6× |
| Tx devices design & construction simple (77332) | $143 | $572 | 1.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$146–$157.25 | $584–$629 | varies |
| Ultrasound Elastography Parenchyma (76981) | $174.75 | $699 | 1.7× |
| Ultrasound, abdomen limited (76705) range across 9 matching MRF lines |
$237–$332.75 | $948–$1,331 | varies |
| Umbilical-artery Doppler (OB) (76820) | $159.75 | $639 | 1.5× |
| Unlisted Dx Radiographic Procedure (76499) | $80.75 | $323 | 0.9× |
| Unlisted fluoroscopic procedure (76496) | $80.75 | $323 | 0.9× |
| Unlisted magnetic resonance procedure (76498) | $898.50 | $3,594 | 10.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $372.50 | $1,490 | 0.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $148.25 | $593 | 1.4× |
| Upper gi w/o kub (74240) | $364.25 | $1,457 | 2.1× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $57.50 | $230 | 5.2× |
| Urea breath test c-14 isotopic analysis (78268) | $95.50 | $382 | 1.0× |
| Ureteral Reflux Study (78740) | $296.50 | $1,186 | 0.7× |
| Urethrocystogram voiding (74455) | $402 | $1,608 | 1.7× |
| Urethrocystography retrograde (74450) | $506.75 | $2,027 | 2.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$216.25–$257 | $865–$1,028 | varies |
| Us chest (76604) | $191 | $764 | 1.8× |
| Us complete joint (76881) | $230.50 | $922 | 2.2× |
| Us exam, pelvic, limited (76857) | $113.25 | $453 | 1.1× |
| Us head (76506) range across 2 matching MRF lines |
$165.50–$174.25 | $662–$697 | varies |
| Us kidney transplant (76776) | $212.50 | $850 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $157.50 | $630 | 1.5× |
| Us ob detailed single fetus (76811) | $185.50 | $742 | 0.8× |
| Us ob limited 1 or more fetuses (76815) | $113.25 | $453 | 1.1× |
| Us ob transvaginal (76817) | $125.50 | $502 | 1.2× |
| Us pelvic non ob complete (76856) | $182.25 | $729 | 1.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $138.75 | $555 | 1.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $161.50 | $646 | 1.5× |
| Us retroperitoneal complete (76770) | $212.50 | $850 | 2.0× |
| Us retroperitoneal limited (76775) | $163 | $652 | 1.6× |
| Us scrotum and contents (76870) | $375.25 | $1,501 | 3.6× |
| Us spinal canal and contents (76800) | $113.25 | $453 | 1.1× |
| Us thyroid (76536) | $188.25 | $753 | 1.8× |
| Us transrectal (76872) | $144.50 | $578 | 1.4× |
| Vascular Flow Imaging (78445) | $170.25 | $681 | 0.4× |
| Vein X-Ray Chest (75827) | $830.50 | $3,322 | 0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $850 | $3,400 | 0.3× |
| Vein X-Ray Skull Epidural (75872) | $638.25 | $2,553 | 1.0× |
| Vein X-Ray Spleen/Liver (75810) | $1,107.25 | $4,429 | 0.3× |
| Venogram Sinus/Jugular (75860) | $2,805.75 | $11,223 | 0.9× |
| Venography Adrenal Unilateral (75840) | $2,805.75 | $11,223 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,805.75 | $11,223 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $952.75 | $3,811 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $638.25 | $2,553 | 0.4× |
| Venography Orbital Rs&I (75880) | $638.25 | $2,553 | 1.0× |
| Venography Renal Bilateral (75833) | $2,805.75 | $11,223 | 0.9× |
| Venography Renal Unilateral (75831) | $2,805.75 | $11,223 | 0.9× |
| Venous sampling by catheter (75893) | $4,653.50 | $18,614 | 0.8× |
| Vertebral fracture assessment via dxa (77086) | $80.75 | $323 | 0.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$156–$218.75 | $624–$875 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $154.50 | $618 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $386.50 | $1,546 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,805.75 | $11,223 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $159.25 | $637 | 1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$131.75–$154.25 | $527–$617 | varies |
| X-Ray Exam Breast Specimen (76098) | $487.50 | $1,950 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $95.50 | $382 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $222.25 | $889 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $197.75 | $791 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $82 | $328 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $126.75 | $507 | 1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $113.25 | $453 | 1.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $237.25 | $949 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $260.25 | $1,041 | 2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $282.75 | $1,131 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $187.50 | $750 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $250.25 | $1,001 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $284.50 | $1,138 | 2.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $127.50 | $510 | 1.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$161.75–$178 | $647–$712 | varies |
| X-ray IV pyelogram (ivp) (74400) | $153 | $612 | 0.9× |
| X-ray IV pyelogram+tomography (74415) | $183.50 | $734 | 1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $80.75 | $323 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $211.50 | $846 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $122.75 | $491 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $80.75 | $323 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $159.25 | $637 | 1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $143.25 | $573 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $113.25 | $453 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $80.75 | $323 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $274.25 | $1,097 | 3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $197.75 | $791 | 1.9× |
| X-Ray Stress View (77071) | $80.75 | $323 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $132 | $528 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $330.50 | $1,322 | 0.9× |
| X-Rays Bone Length Studies (77073) | $113.25 | $453 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $137.25 | $549 | 1.3× |
| Xr c-spine 4 or 5 views (72050) | $287.50 | $1,150 | 2.7× |
| Xr facial bones less than 3 views (70140) | $80.75 | $323 | 0.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $113.25 | $453 | 1.1× |
| Xr orbits complete 4 views (70200) | $120.50 | $482 | 1.1× |
| Xr Tomogram Single Plane (76100) | $191.75 | $767 | 1.8× |
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.