Imaging prices at University of Iowa Health Care Medical Center Downtown
Iowa City, IA · every code in this section with a posted price and a Medicare benchmark.
465 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) | $7,993.30 | $11,419 | 6.0× |
| Abdomen 1 View (74018) | $323.40 | $462 | 3.9× |
| Abdomen 2 views (74019) | $413 | $590 | 4.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,338.40 | $1,912 | 3.5× |
| Angio internal mammary (75756) | $2,286.90 | $3,267 | 0.8× |
| Angio pulmonary bilat (75743) | $3,164.70 | $4,521 | 1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,746 | $6,780 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $5,691 | $8,130 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $3,150 | $4,500 | 1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,935.80 | $4,194 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,919 | $4,170 | 1.0× |
| Ankle 2 views (73600) | $365.40 | $522 | 4.4× |
| Aortography thoracic serialography rs&i (75605) | $3,183.60 | $4,548 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,746 | $6,780 | 1.6× |
| Artery X-Rays Abdomen (75726) | $6,512.10 | $9,303 | 1.2× |
| Artery X-Rays Adrenal Gland (75731) | $3,175.90 | $4,537 | 1.0× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$3,084.20–$5,596.50 | $4,406–$7,995 | varies |
| Artery X-Rays Spine (75705) | $6,512.10 | $9,303 | 1.2× |
| Arthrogram ankle (73615) | $862.40 | $1,232 | 2.6× |
| Arthrogram hip (73525) | $1,250.20 | $1,786 | 3.7× |
| Arthrogram Wrist (73115) | $914.20 | $1,306 | 2.7× |
| Basic radiation dosimetry calculation (77300) | $823.90 | $1,177 | 6.4× |
| Bone age studies (77072) | $310.10 | $443 | 3.1× |
| Bone Imaging 3 Phase (78315) | $2,238.60 | $3,198 | 5.8× |
| Bone Imaging Limited Area (78300) | $742 | $1,060 | 1.9× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$1,964.20–$2,075.50 | $2,806–$2,965 | varies |
| Bone marrow imaging limited area (78102) | $1,376.90 | $1,967 | 3.6× |
| Bone marrow imaging; whole body (78104) | $1,883.70 | $2,691 | 4.9× |
| Bone survey infant (77076) | $912.10 | $1,303 | 9.1× |
| Brachytx isodose complex (77318) | $2,482.90 | $3,547 | 6.9× |
| Brachytx isodose intermed (77317) | $2,333.10 | $3,333 | 6.5× |
| Brachytx Isodose Plan Simple (77316) | $1,526 | $2,180 | 4.2× |
| Brain imaging < 4 static views (78600) | $1,017.10 | $1,453 | 2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,917.30 | $2,739 | 3.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,205.90 | $7,437 | 3.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,162.90 | $5,947 | 12.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,573.50 | $5,105 | 4.7× |
| Cardiac Shunt Detection (78428) | $816.20 | $1,166 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $751.10 | $1,073 | 9.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$1,026.90–$1,085 | $1,467–$1,550 | varies |
| Cerebrospinal Fluid Scan (78630) range across 3 matching MRF lines |
$2,198–$2,321.90 | $3,140–$3,317 | varies |
| Chest 1 view (71045) | $326.90 | $467 | 3.9× |
| Chest 2 views (71046) | $365.40 | $522 | 4.4× |
| Chest 3 views (71047) | $511 | $730 | 6.1× |
| Chest 4 or more views (71048) | $545.30 | $779 | 5.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $462.70 | $661 | 4.6× |
| Clavicle complete (73000) | $357.70 | $511 | 4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,123.10 | $3,033 | 21.1× |
| Continuing medical physics consltj pr wk (77336) | $879.90 | $1,257 | 6.8× |
| Contrast Exam Abdominl Aorta (75625) | $5,804.40 | $8,292 | 1.9× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$851.20–$899.50 | $1,216–$1,285 | varies |
| Contrast X-Ray Of Elbow (73085) | $669.90 | $957 | 2.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,250.20 | $1,786 | 3.7× |
| Corpora cavernosography (74445) | $693 | $990 | 6.9× |
| CT abdomen and pelvis without and with contrast (74178) | $5,685.40 | $8,122 | 17.0× |
| CT abdomen and pelvis without contrast (74176) | $3,903.90 | $5,577 | 17.0× |
| CT abdomen w contrast (74160) | $2,679.60 | $3,828 | 15.9× |
| CT abdomen w wo contrast (74170) | $3,155.60 | $4,508 | 18.7× |
| CT abdomen w/o contrast (74150) | $2,186.10 | $3,123 | 21.8× |
| CT Angio Abdomen and Pelvis (74174) | $4,216.80 | $6,024 | 12.6× |
| CT Angio Chest (71275) | $3,185 | $4,550 | 18.9× |
| CT Angio Head (70496) range across 4 matching MRF lines |
$2,844.10–$3,885 | $4,063–$5,550 | varies |
| CT angio hrt w/3d image (75574) | $3,003.70 | $4,291 | 9.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,853.20 | $4,076 | 16.9× |
| CT Angio Neck (70498) | $2,921.10 | $4,173 | 17.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,363.90 | $3,377 | 14.0× |
| CT cervical spine w/ contrast (72126) | $2,898.70 | $4,141 | 8.6× |
| CT cervical spine w/o contrast (72125) | $2,326.10 | $3,323 | 23.1× |
| CT cervical spine w/wo cont (72127) | $2,959.60 | $4,228 | 17.6× |
| CT chest w contrast (71260) | $2,766.40 | $3,952 | 16.4× |
| CT chest w/wo contrast (71270) | $2,096.50 | $2,995 | 12.4× |
| CT colonography screening (74263) | $1,242.50 | $1,775 | 5.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,685.60 | $2,408 | 10.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,176 | $1,680 | 11.7× |
| CT head/brain with contrast (70460) | $2,498.30 | $3,569 | 14.8× |
| CT head/brain without and with contrast (70470) | $2,656.50 | $3,795 | 15.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,102.10 | $3,003 | 6.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $607.60 | $868 | 7.3× |
| CT hrt w/3d image congen (75573) | $3,604.30 | $5,149 | 10.7× |
| CT iac w contrast (70481) | $2,344.30 | $3,349 | 13.9× |
| CT l-spine w&w/o contrast (72133) | $2,663.50 | $3,805 | 15.8× |
| CT lower ext w/o (73700) | $2,055.20 | $2,936 | 20.4× |
| CT lower extremity w/contrast material (73701) | $2,345.70 | $3,351 | 13.9× |
| CT lumbar spine w contrast (72132) | $2,515.10 | $3,593 | 7.5× |
| CT lumbar spine w/o contrast (72131) | $2,326.10 | $3,323 | 23.1× |
| CT maxillofacial w contrast (70487) | $2,107 | $3,010 | 12.5× |
| CT maxillofacial wo contrast (70486) | $1,930.60 | $2,758 | 19.2× |
| CT neck tissue combo (70492) | $2,934.40 | $4,192 | 17.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,829.80 | $2,614 | 10.9× |
| CT orbits w/o contrast (70480) | $2,173.50 | $3,105 | 21.6× |
| CT pelvis w&w/o contrast (72194) | $2,130.80 | $3,044 | 12.6× |
| CT pelvis w/o contrast (72192) | $2,072.70 | $2,961 | 20.6× |
| CT scan of leg combo (73702) | $1,996.40 | $2,852 | 11.8× |
| CT scans face/jaw combo (70488) | $3,012.10 | $4,303 | 17.9× |
| CT soft tissue neck w contrast (70491) | $2,300.90 | $3,287 | 13.6× |
| CT soft tissue neck w/o contrast (70490) | $1,988 | $2,840 | 19.8× |
| CT thoracic spine w contrast (72129) | $1,852.90 | $2,647 | 11.0× |
| CT thoracic spine w/o contrast (72128) | $2,326.10 | $3,323 | 23.1× |
| CT thoracic spine w/wo cont (72130) | $2,811.90 | $4,017 | 16.7× |
| CT thorax w/o contrast (71250) | $2,132.20 | $3,046 | 21.2× |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$874.30–$6,036.10 | $1,249–$8,623 | varies |
| CT upper ext wo (73200) | $2,092.30 | $2,989 | 20.8× |
| CT upper extremity w/o & w/contrast material (73202) | $2,380 | $3,400 | 14.1× |
| CT upper extremity with contrast (73201) | $2,333.10 | $3,333 | 7.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,853.20 | $4,076 | 16.9× |
| Cta Abdomen (74175) | $3,155.60 | $4,508 | 18.7× |
| CTA pelvis (72191) | $2,984.10 | $4,263 | 17.7× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $582.40 | $832 | 2.5× |
| Dilation ureters/urethra rs&i (74485) | $1,305.50 | $1,865 | 0.6× |
| Discography Cerv/Thor Spine (72285) | $3,206.70 | $4,581 | 1.7× |
| Diskography lumbar (72295) | $3,152.10 | $4,503 | 1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $477.40 | $682 | 4.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $609.70 | $871 | 6.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $511.70 | $731 | 5.1× |
| Dxa Bone Density Axial (77080) | $543.20 | $776 | 5.4× |
| Dxa bone density study (77085) | $721 | $1,030 | 7.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $329 | $470 | 3.9× |
| Echo exam of fetal heart (76825) | $1,272.60 | $1,818 | 2.4× |
| Echo exam uterus (76831) | $696.50 | $995 | 3.0× |
| Echo Guide For Artery Repair (76936) | $1,698.20 | $2,426 | 8.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $920.50 | $1,315 | 4.0× |
| Echograp Trans R Pros Study (76873) | $1,859.90 | $2,657 | 18.5× |
| Esophagram (74220) | $642.60 | $918 | 3.8× |
| Fetal Biophys Profile W/Nst (76818) | $872.90 | $1,247 | 8.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $639.80 | $914 | 6.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,290.30 | $6,129 | 18.7× |
| Fluoroscopy up to 1 hr (76000) | $763 | $1,090 | 3.3× |
| Follow-Up Angiography (75898) | $1,841 | $2,630 | 0.6× |
| Foot 2 views (73620) | $384.30 | $549 | 4.6× |
| Forearm 2 views (73090) | $352.80 | $504 | 4.2× |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,778.70–$1,970.50 | $2,541–$2,815 | varies |
| Gastric Mucosa Imaging (78261) | $1,572.20 | $2,246 | 4.1× |
| Gastroesophageal Reflux Exam (78262) | $1,359.40 | $1,942 | 3.5× |
| Gated Heart Planar Single (78472) range across 7 matching MRF lines |
$1,157.80–$1,459.50 | $1,654–$2,085 | varies |
| Gated Heart, Multiple (78473) | $3,137.40 | $4,482 | 8.2× |
| GI Endoscopic US S&I (76975) | $848.40 | $1,212 | 3.7× |
| Hand 2 views (73120) | $329.70 | $471 | 3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $7,848.40 | $11,212 | 11.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $7,848.40 | $11,212 | 11.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $7,848.40 | $11,212 | 11.7× |
| Heart first pass single,planar (78481) | $1,893.50 | $2,705 | 3.6× |
| Heart Image (Pet) Multiple (78492) | $4,956 | $7,080 | 3.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,708.90 | $6,727 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,380.20 | $7,686 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,995 | $2,850 | 3.8× |
| Hepatobiliary System Imaging (78226) | $1,995 | $2,850 | 5.2× |
| Ht Musc Image Planar Mult (78454) | $2,089.50 | $2,985 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $4,188.80 | $5,984 | 3.4× |
| Hysterosalpingogram (74740) | $888.30 | $1,269 | 3.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $711.90 | $1,017 | 8.5× |
| Infant hip ultrasound, limited static exam (76886) | $595.70 | $851 | 7.1× |
| Infusion Ivp (74410) | $608.30 | $869 | 3.6× |
| Interstitial radiation source applic complex (77778) | $7,835.10 | $11,193 | 11.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $9,459.80 | $13,514 | 14.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $8,596.70 | $12,281 | 16.2× |
| Intracavitary radiation source applic simple (77761) | $7,904.40 | $11,292 | 14.9× |
| Intraop radiaj tx deliver xray single tx session (77424) | $9,909.20 | $14,156 | 1.4× |
| Joint Survey Single View (77077) | $649.60 | $928 | 6.5× |
| K Flow/Funct Image Multiple (78709) | $2,014.60 | $2,878 | 3.9× |
| K Flow/Funct Image W/Drug (78708) | $2,041.20 | $2,916 | 3.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,292.90 | $1,847 | 2.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,158.50 | $1,655 | 3.0× |
| Kidney Imaging Morphol (78700) | $646.10 | $923 | 1.7× |
| Knee 3 Views (73562) | $466.20 | $666 | 5.6× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,297.80 | $1,854 | 3.4× |
| Leveen/Shunt Patency Exam (78291) | $1,554 | $2,220 | 4.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,358 | $1,940 | 3.5× |
| Liver imaging static only (78201) range across 3 matching MRF lines |
$1,136.10–$1,200.50 | $1,623–$1,715 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $2,057.30 | $2,939 | 3.9× |
| Lung perfusion differential (78597) | $1,764.70 | $2,521 | 4.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,995 | $2,850 | 3.8× |
| Lung Ventilation Imaging (78579) | $1,089.90 | $1,557 | 2.8× |
| Lymph System Imaging (78195) | $1,967.70 | $2,811 | 3.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $2,673.30 | $3,819 | 4.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,198.70 | $3,141 | 0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,066.40 | $2,952 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $3,070.90 | $4,387 | 13.4× |
| Mammary ductogram or galactogram multiple (77054) | $789.60 | $1,128 | 3.4× |
| Mammary ductogram or galactogram single (77053) | $550.90 | $787 | 2.4× |
| Meckels Divert Exam (78290) | $1,099 | $1,570 | 2.9× |
| Mlc imrt design & construction per imrt plan (77338) | $4,085.20 | $5,836 | 11.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $390.60 | $558 | 14.0× |
| Mra Head W/O & W/Contrast Material (70546) | $4,365.20 | $6,236 | 13.0× |
| MRA head w/o contrast (70544) | $2,795.10 | $3,993 | 12.2× |
| MRA head with contrast (70545) | $2,487.10 | $3,553 | 7.4× |
| MRA neck w contrast (70548) | $3,371.90 | $4,817 | 10.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,349.80 | $6,214 | 13.0× |
| MRA neck w/o contrast (70547) | $2,655.80 | $3,794 | 11.6× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$3,189.90–$4,534.60 | $4,557–$6,478 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$3,222.10–$4,636.10 | $4,603–$6,623 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,604 | $3,720 | 3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,533.90 | $6,477 | 13.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,694.60 | $5,278 | 4.9× |
| MRI bone marrow blood supply (77084) | $6,951 | $9,930 | 30.3× |
| MRI brain functional w/o physician admnistration (70554) | $5,295.50 | $7,565 | 23.1× |
| MRI brain functional w/physician admnistration (70555) | $5,267.50 | $7,525 | 23.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,766.40 | $3,952 | 12.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,682.10 | $2,403 | 7.3× |
| MRI cardiac w/o contrast (75557) | $2,892.40 | $4,132 | 12.6× |
| MRI cervical spine w contrast (72142) | $5,242.30 | $7,489 | 15.6× |
| MRI cervical spine w/o cont (72141) | $3,475.50 | $4,965 | 15.2× |
| MRI chest w/o contrast (71550) | $3,462.20 | $4,946 | 15.1× |
| MRI chest with contrast (71551) | $3,826.90 | $5,467 | 5.1× |
| MRI chest wo w contrast (71552) | $3,353 | $4,790 | 10.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,063.20 | $4,376 | 9.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,448.50 | $6,355 | 13.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,131.80 | $4,474 | 13.7× |
| MRI lumbar spine w contrast (72149) | $5,242.30 | $7,489 | 15.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,315.10 | $7,593 | 15.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,353 | $4,790 | 14.6× |
| MRI orbit face neck w contrast (70542) | $3,850.70 | $5,501 | 11.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,788.70 | $6,841 | 14.3× |
| MRI pelvis w contrast (72196) | $3,665.90 | $5,237 | 10.9× |
| MRI pelvis w/o & w contrast (72197) | $4,760 | $6,800 | 14.2× |
| MRI pelvis w/o contrast (72195) | $3,374.70 | $4,821 | 14.7× |
| MRI spectroscopy (76390) | $3,241 | $4,630 | 38.7× |
| MRI thoracic spine w/o contrast (72146) | $3,475.50 | $4,965 | 15.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,687.60 | $5,268 | 11.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,190.60 | $4,558 | 13.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,239.20 | $6,056 | 12.6× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$4,918.90–$4,996.60 | $7,027–$7,138 | varies |
| MRI, dorsal spine combo (72157) | $5,315.10 | $7,593 | 15.8× |
| MRI, dorsal spine contrast (72147) | $5,242.30 | $7,489 | 15.6× |
| MRI, joint upper extrem (73221) | $3,231.90 | $4,617 | 14.1× |
| MRI, joint upper extrem combo (73223) | $4,340 | $6,200 | 12.9× |
| MRI, lumbar spine combo (72158) | $5,315.10 | $7,593 | 15.8× |
| Myelogram cervical (72240) | $1,374.80 | $1,964 | 1.8× |
| Myelogram Lumbar (72265) | $1,865.50 | $2,665 | 2.5× |
| Myelography thoracic (72255) | $2,098.60 | $2,998 | 2.8× |
| Myelograpy 2/more regions rs&i (72270) | $2,865.10 | $4,093 | 3.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$1,339.10–$1,600.90 | $1,913–$2,287 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,467 | $7,810 | 4.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,376.90 | $1,967 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $5,245.80 | $7,494 | 4.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,713.50 | $5,305 | 2.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,713.50 | $5,305 | 2.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $6,796.30 | $9,709 | 3.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $8,599.50 | $12,285 | 4.1× |
| Neck soft tissue (70360) | $305.90 | $437 | 3.7× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,698.90 | $2,427 | 4.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $889.70 | $1,271 | 2.3× |
| Nm csf leak detection (78650) | $1,866.20 | $2,666 | 1.5× |
| Nm myocard infarct spect (78469) | $2,665.60 | $3,808 | 5.1× |
| Nm red cell survival study (78130) | $951.30 | $1,359 | 2.5× |
| Nonvascular Shunt X-Ray (75809) | $511.70 | $731 | 5.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,720.90 | $13,887 | 7.3× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$701.40–$1,929.20 | $1,002–$2,756 | varies |
| Ob us nuchal meas 1 gest (76813) | $513.80 | $734 | 5.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $347.90 | $497 | 3.5× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $567.70 | $811 | 5.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $889 | $1,270 | 7.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $448.70 | $641 | 4.5× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $860.30 | $1,229 | 10.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $860.30 | $1,229 | 8.6× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $198.80 | $284 | 7.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $471.10 | $673 | 4.7× |
| Optic foramina (70190) | $582.40 | $832 | 7.0× |
| Panoramic X-ray of jaws (70355) | $378.70 | $541 | 4.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $5,457.90 | $7,797 | 10.5× |
| Parathyroid Planar Imaging (78070) | $1,187.90 | $1,697 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $4,412.80 | $6,304 | 11.5× |
| Pelvis 1 or 2 views (72170) | $372.40 | $532 | 3.7× |
| Peritoneogram Rs&I (74190) | $667.80 | $954 | 1.3× |
| Pet Image Skull-Thigh (78812) | $7,469.70 | $10,671 | 5.4× |
| Pet Image W/Ct Lmtd (78814) | $5,451.60 | $7,788 | 4.0× |
| PET image w/CT, full body (78816) | $8,754.90 | $12,507 | 6.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,457.40 | $12,082 | 6.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $5,048.40 | $7,212 | 4.1× |
| Pet Myocardial Sngl Study (78491) | $3,886.40 | $5,552 | 2.8× |
| PET whole body (78813) | $8,059.10 | $11,513 | 5.9× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $1,204.70 | $1,721 | 1.0× |
| Platelet survival study Non-Facility (78191) | $2,090.20 | $2,986 | 5.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,724.70 | $5,321 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,670.20–$1,764.70 | $2,386–$2,521 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $385.70 | $551 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $498.40 | $712 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $433.30 | $619 | 5.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $311.50 | $445 | 3.7× |
| Radex elbow complete minimum 3 views (73080) | $387.10 | $553 | 4.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $511.70 | $731 | 5.1× |
| Radex fingr minimum 2 views (73140) | $301 | $430 | 3.6× |
| Radex foot complete minimum 3 views (73630) | $464.80 | $664 | 5.6× |
| Radex Hand Minimum 3 Views (73130) | $413 | $590 | 4.9× |
| Radex lower extremity infant minimum 2 views (73592) | $361.20 | $516 | 4.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $546.70 | $781 | 5.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $387.10 | $553 | 4.6× |
| Radex Ribs Unilateral 2 Views (71100) | $410.20 | $586 | 4.9× |
| Radex shoulder complete minimum 2 views (73030) | $445.20 | $636 | 5.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $275.10 | $393 | 3.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $855.40 | $1,222 | 5.1× |
| Radex Spine 1 View Specify Level (72020) | $353.50 | $505 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $518.70 | $741 | 6.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $406 | $580 | 4.9× |
| Radex Toe Minimum 2 Views (73660) | $301 | $430 | 3.6× |
| Radex upper extremity infant minimum 2 views (73092) | $217.70 | $311 | 2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $400.40 | $572 | 4.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,029.70 | $1,471 | 10.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $22,107.40 | $31,582 | 3.1× |
| Radiation treatment delivery level 1 (77402) | $646.10 | $923 | 6.6× |
| Radiation treatment delivery level 2 (77407) | $535.50 | $765 | 1.4× |
| Radiation treatment delivery level 3 (77412) | $936.60 | $1,338 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $337.40 | $482 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $464.10 | $663 | 4.6× |
| Radiologic exam colon double contrast study (74280) | $817.60 | $1,168 | 4.8× |
| Radiologic exam colon single contrast study (74270) | $951.30 | $1,359 | 5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $284.90 | $407 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) | $578.90 | $827 | 5.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $508.90 | $727 | 5.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $721.70 | $1,031 | 4.3× |
| Radiologic exam swallow function contrast study (74230) | $680.40 | $972 | 4.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $927.50 | $1,325 | 5.5× |
| Radiologic examination femur 1 view (73551) | $299.60 | $428 | 3.6× |
| Radiologic examination femur minimum 2 views (73552) | $416.50 | $595 | 5.0× |
| Radiologic examination knee 1/2 views (73560) | $408.80 | $584 | 4.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $553 | $790 | 5.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $365.40 | $522 | 4.4× |
| Radiopharm Dacryocystography (78660) | $742.70 | $1,061 | 1.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $931 | $1,330 | 2.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $9,460.50 | $13,515 | 25.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $9,460.50 | $13,515 | 25.5× |
| Renal Cyst Study (74470) | $782.60 | $1,118 | 1.5× |
| Ribs bilateral 3 views (71110) | $380.10 | $543 | 3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 7 matching MRF lines |
$949.90–$1,234.80 | $1,357–$1,764 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,919.40 | $2,742 | 5.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,448.10 | $7,783 | 10.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 14 matching MRF lines |
$1,635.90–$1,801.80 | $2,337–$2,574 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 29 matching MRF lines |
$1,644.30–$2,664.20 | $2,349–$3,806 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$2,683.10–$5,074.30 | $3,833–$7,249 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,130.60 | $8,758 | 4.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 4 matching MRF lines |
$2,533.30–$3,559.50 | $3,619–$5,085 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $948.50 | $1,355 | 4.2× |
| Rp Therapy Intravenous Administration (79101) range across 9 matching MRF lines |
$1,061.20–$1,602.30 | $1,516–$2,289 | varies |
| Salivary Gland Imaging Serial Images (78231) | $1,453.90 | $2,077 | 3.8× |
| Scapula (73010) | $462 | $660 | 4.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $82.60 | $118 | 3.5× |
| Sella turcica (70240) | $539 | $770 | 6.4× |
| Shoulder 1 view (73020) | $336.70 | $481 | 4.0× |
| Shoulder Arthrography (73040) | $796.60 | $1,138 | 2.4× |
| Sialogram (70390) | $746.20 | $1,066 | 3.3× |
| Skull less than 4 views (70250) | $410.20 | $586 | 4.1× |
| Special dosimetry (77331) | $630.70 | $901 | 4.9× |
| Special Physics Consult (77370) range across 4 matching MRF lines |
$815.50–$1,164.80 | $1,165–$1,664 | varies |
| Special teletherapy port plan (77321) | $1,991.50 | $2,845 | 5.5× |
| Special treatment procedure (77470) | $3,164.70 | $4,521 | 6.0× |
| Spleen Imaging (78185) | $1,170.40 | $1,672 | 3.0× |
| Srs Multisource (77371) | $28,739.20 | $41,056 | 4.1× |
| Stereotactic Body Radiation Delivery (77373) | $7,508.20 | $10,726 | 4.4× |
| Sternoclavicular joints (71130) | $471.10 | $673 | 5.6× |
| Superior sagittal sinus venogram (75870) | $4,237.80 | $6,054 | 1.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $879.20 | $1,256 | 9.0× |
| Tbs technical calculation only (77091) | $135.10 | $193 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,565.50 | $3,665 | 7.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,271.90 | $1,817 | 3.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $630.70 | $901 | 2.7× |
| Testicular Imaging W/Flow (78761) | $1,623.30 | $2,319 | 4.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,564.10 | $3,663 | 7.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,142 | $3,060 | 6.0× |
| Ther rad simulaj-aided field setting simple (77280) | $1,169.70 | $1,671 | 9.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,095.50 | $1,565 | 6.5× |
| Thoracic spine 2 views (72070) | $476.70 | $681 | 4.7× |
| Thoracic spine 3 views (72072) | $509.60 | $728 | 5.1× |
| Thoracolumbar 2 views (72080) | $490 | $700 | 5.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $956.20 | $1,366 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $714.70 | $1,021 | 1.9× |
| Thyroid Met Imaging Body (78018) range across 7 matching MRF lines |
$1,483.30–$2,238.60 | $2,119–$3,198 | varies |
| Thyroid Uptake Measurement (78012) | $586.60 | $838 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,052.10 | $1,503 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $1,616.30 | $2,309 | 4.5× |
| Tx devices design & construction intermediate (77333) | $939.40 | $1,342 | 7.3× |
| Tx devices design & construction simple (77332) | $788.90 | $1,127 | 6.1× |
| Ultrasound Breast Limited (76642) | $563.50 | $805 | 6.7× |
| Ultrasound Elastography Parenchyma (76981) | $843.50 | $1,205 | 8.4× |
| Ultrasound Exam Aaa Screen (76706) | $683.20 | $976 | 6.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,498.70 | $2,141 | 4.5× |
| Ultrasound, abdomen limited (76705) | $772.80 | $1,104 | 7.7× |
| Umbilical-artery Doppler (OB) (76820) | $487.90 | $697 | 4.9× |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$95.20–$1,599.50 | $136–$2,285 | varies |
| Unlisted fluoroscopic procedure (76496) range across 9 matching MRF lines |
$670.60–$6,782.30 | $958–$9,689 | varies |
| Unlisted magnetic resonance procedure (76498) range across 66 matching MRF lines |
$912.10–$10,630.20 | $1,303–$15,186 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $4,823 | $6,890 | 12.5× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 2 matching MRF lines |
$7,904.40–$8,596.70 | $11,292–$12,281 | varies |
| Upper gi w/o kub (74240) | $858.90 | $1,227 | 5.1× |
| Ureteral Reflux Study (78740) | $1,078.70 | $1,541 | 2.8× |
| Urethrocystogram voiding (74455) | $953.40 | $1,362 | 4.2× |
| Urethrocystography retrograde (74450) | $953.40 | $1,362 | 4.2× |
| Us breast unilateral complete (76641) | $593.60 | $848 | 5.9× |
| Us chest (76604) | $692.30 | $989 | 6.9× |
| Us complete joint (76881) | $942.20 | $1,346 | 9.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$351.40–$523.60 | $502–$748 | varies |
| Us head (76506) | $951.30 | $1,359 | 9.5× |
| Us kidney transplant (76776) | $1,015 | $1,450 | 10.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $731.50 | $1,045 | 7.3× |
| Us ob detailed single fetus (76811) | $1,168.30 | $1,669 | 5.1× |
| Us ob limited 1 or more fetuses (76815) | $490 | $700 | 4.9× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$584.50–$658.70 | $835–$941 | varies |
| Us pelvic non ob complete (76856) | $762.30 | $1,089 | 7.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $677.60 | $968 | 6.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $483 | $690 | 4.8× |
| Us retroperitoneal complete (76770) | $999.60 | $1,428 | 9.9× |
| Us retroperitoneal limited (76775) | $723.80 | $1,034 | 7.2× |
| Us scrotum and contents (76870) | $872.90 | $1,247 | 8.7× |
| Us spinal canal and contents (76800) | $811.30 | $1,159 | 8.1× |
| Us thyroid (76536) | $775.60 | $1,108 | 7.7× |
| Us transrectal (76872) | $886.90 | $1,267 | 8.8× |
| Vascular Flow Imaging (78445) | $1,150.80 | $1,644 | 3.0× |
| Vasogram (74440) | $497.70 | $711 | 2.2× |
| Vein X-Ray Chest (75827) | $3,448.20 | $4,926 | 2.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,867.90 | $4,097 | 0.9× |
| Vein X-Ray Skull Epidural (75872) | $3,679.90 | $5,257 | 6.1× |
| Vein X-Ray Spleen/Liver (75810) | $3,535.70 | $5,051 | 1.2× |
| Venogram Sinus/Jugular (75860) | $2,495.50 | $3,565 | 0.8× |
| Venography Adrenal Unilateral (75840) | $2,804.90 | $4,007 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $4,290.30 | $6,129 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $2,115.40 | $3,022 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $1,690.50 | $2,415 | 1.1× |
| Venography Orbital Rs&I (75880) | $3,152.10 | $4,503 | 5.2× |
| Venography Renal Bilateral (75833) | $4,169.90 | $5,957 | 1.4× |
| Venography Renal Unilateral (75831) | $2,464.70 | $3,521 | 0.8× |
| Venous sampling by catheter (75893) | $3,882.90 | $5,547 | 0.7× |
| Venous thrombosis imaging (78457) | $1,204.70 | $1,721 | 2.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$1,492.40–$1,666 | $2,132–$2,380 | varies |
| Vertebral fracture assessment via dxa (77086) | $336 | $480 | 4.0× |
| Wrist 2 views (73100) | $315.70 | $451 | 3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $498.40 | $712 | 6.0× |
| X-ray antegrade pyelogram tube (74425) | $554.40 | $792 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $4,975.60 | $7,108 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $535.50 | $765 | 5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $337.40 | $482 | 4.0× |
| X-Ray Exam Breast Specimen (76098) | $663.60 | $948 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $471.80 | $674 | 5.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $650.30 | $929 | 6.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $855.40 | $1,222 | 8.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $476.70 | $681 | 5.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $605.50 | $865 | 7.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $721 | $1,030 | 7.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $721 | $1,030 | 7.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $807.80 | $1,154 | 8.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $893.20 | $1,276 | 8.9× |
| X-Ray Exam L-S Spine Bending (72114) | $665.70 | $951 | 6.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $438.90 | $627 | 5.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $711.90 | $1,017 | 7.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $356.30 | $509 | 3.5× |
| X-ray eye for foreign body (70030) | $219.80 | $314 | 2.6× |
| X-ray humerus (73060) | $379.40 | $542 | 4.5× |
| X-ray IV pyelogram (ivp) (74400) | $1,051.40 | $1,502 | 6.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $416.50 | $595 | 5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $389.90 | $557 | 4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $497 | $710 | 4.9× |
| X-ray nose-rectum child f.b. (76010) | $221.90 | $317 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $469.70 | $671 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $477.40 | $682 | 4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $375.90 | $537 | 3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $408.10 | $583 | 4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $348.60 | $498 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $738.50 | $1,055 | 7.3× |
| X-Ray Stress View (77071) | $410.90 | $587 | 4.9× |
| X-ray thoracic spine 4 vw (72074) | $546 | $780 | 5.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,018.50 | $1,455 | 3.0× |
| X-Rays Bone Length Studies (77073) | $512.40 | $732 | 5.1× |
| X-Rays Bone Survey Complete (77075) | $1,187.20 | $1,696 | 11.8× |
| Xr c-spine 4 or 5 views (72050) | $635.60 | $908 | 6.3× |
| Xr facial bones less than 3 views (70140) | $270.20 | $386 | 3.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $359.10 | $513 | 3.6× |
| Xr orbits complete 4 views (70200) | $349.30 | $499 | 3.5× |
| Xr Tomogram Single Plane (76100) | $627.20 | $896 | 6.2× |
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.