Imaging prices at University of Iowa Health Care Medical Center

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.

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ProcedurePosted cashPosted 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.