Imaging prices at University of Michigan Health - Sparrow Carson
Carson City, MI · every code in this section with a posted price and a Medicare benchmark.
381 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) | $214 | $428 | 0.2× |
| Abdomen 1 View (74018) | $37.50 | $150 | 0.4× |
| Abdomen 2 views (74019) | $89 | $356 | 0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $390.75 | $1,563 | 1.0× |
| Angio internal mammary (75756) range across 3 matching MRF lines |
$54.50–$162 | $109–$324 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$71–$147.50 | $142–$295 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$71–$162 | $142–$324 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$67–$148 | $134–$296 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $59 | $118 | 0.0× |
| Ankle 2 views (73600) | $45.50 | $182 | 0.5× |
| Aortography thoracic serialography rs&i (75605) range across 3 matching MRF lines |
$52.50–$120 | $105–$240 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 3 matching MRF lines |
$23–$173 | $46–$346 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$77–$170.50 | $154–$341 | varies |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$51–$144 | $102–$288 | varies |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$117–$256.50 | $234–$513 | varies |
| Arthrogram ankle (73615) | $164.50 | $658 | 0.5× |
| Arthrogram hip (73525) | $167.75 | $671 | 0.5× |
| Arthrogram Wrist (73115) | $164.50 | $658 | 0.5× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$33–$67 | $66–$134 | varies |
| Bone age studies (77072) | $72.50 | $290 | 0.7× |
| Bone Imaging 3 Phase (78315) | $330.50 | $1,322 | 0.8× |
| Bone Imaging Limited Area (78300) | $166.25 | $665 | 0.4× |
| Bone Imaging Multiple Areas (78305) | $284 | $1,136 | 0.7× |
| Bone Imaging Whole Body (78306) | $283.25 | $1,133 | 0.7× |
| Bone marrow imaging limited area (78102) | $224.75 | $899 | 0.6× |
| Bone survey infant (77076) | $74 | $296 | 0.7× |
| Brachytx isodose intermed (77317) | $97 | $194 | 0.3× |
| Brachytx Isodose Plan Simple (77316) | $74 | $148 | 0.2× |
| Brain Flow Imaging Only (78610) | $224.75 | $899 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $23.50 | $47 | 0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $929 | $3,716 | 0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$121–$365 | $242–$730 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 3 matching MRF lines |
$138.50–$425 | $277–$850 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$56–$145 | $224–$580 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $26 | $52 | 0.0× |
| Cerebrospinal Fluid Scan (78630) | $397 | $1,588 | 0.7× |
| Chest 1 view (71045) | $45.50 | $182 | 0.5× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$16.75–$62.75 | $67–$251 | varies |
| Chest 3 views (71047) | $82 | $328 | 0.9× |
| Chest 4 or more views (71048) | $97.50 | $390 | 0.9× |
| Clavicle complete (73000) | $83.50 | $334 | 1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $231 | $924 | 2.2× |
| Continuing medical physics consltj pr wk (77336) | $91 | $182 | 0.7× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$58.50–$125 | $117–$250 | varies |
| Contrast X-Ray Bladder (74430) | $99.50 | $398 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $164.50 | $658 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $249 | $996 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $885 | $3,540 | 2.5× |
| CT abdomen and pelvis without contrast (74176) | $623.75 | $2,495 | 2.6× |
| CT abdomen w contrast (74160) | $401.50 | $1,606 | 2.3× |
| CT abdomen w wo contrast (74170) | $440.75 | $1,763 | 2.5× |
| CT abdomen w/o contrast (74150) | $412 | $1,648 | 4.0× |
| CT Angio Abdomen and Pelvis (74174) | $335.50 | $1,342 | 1.0× |
| CT Angio Chest (71275) | $518.50 | $2,074 | 3.0× |
| CT Angio Head (70496) | $442.50 | $1,770 | 2.5× |
| CT angio hrt w/3d image (75574) | $363.75 | $1,455 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $432 | $1,728 | 2.5× |
| CT Angio Neck (70498) | $547.75 | $2,191 | 3.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $531.50 | $2,126 | 3.0× |
| CT cervical spine w/ contrast (72126) | $307.25 | $1,229 | 0.9× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$66–$398 | $264–$1,592 | varies |
| CT cervical spine w/wo cont (72127) | $340 | $1,360 | 1.9× |
| CT chest w contrast (71260) | $455.50 | $1,822 | 2.6× |
| CT chest w/wo contrast (71270) | $505.50 | $2,022 | 2.9× |
| CT head/brain with contrast (70460) | $402.50 | $1,610 | 2.3× |
| CT head/brain without and with contrast (70470) | $478.25 | $1,913 | 2.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $236.50 | $946 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $67.50 | $270 | 0.8× |
| CT hrt w/3d image congen (75573) | $317.50 | $1,270 | 0.9× |
| CT iac w contrast (70481) | $356.75 | $1,427 | 2.0× |
| CT l-spine w&w/o contrast (72133) | $400.75 | $1,603 | 2.3× |
| CT lower ext w/o (73700) | $396 | $1,584 | 3.8× |
| CT lower extremity w/contrast material (73701) | $463.50 | $1,854 | 2.7× |
| CT lumbar spine w contrast (72132) | $415 | $1,660 | 1.2× |
| CT lumbar spine w/o contrast (72131) | $380 | $1,520 | 3.6× |
| CT maxillofacial w contrast (70487) | $468 | $1,872 | 2.7× |
| CT maxillofacial wo contrast (70486) | $358.25 | $1,433 | 3.4× |
| CT neck tissue combo (70492) | $400.50 | $1,602 | 2.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $338.50 | $1,354 | 1.9× |
| CT orbits w/o contrast (70480) | $358.25 | $1,433 | 3.4× |
| CT pelvis w&w/o contrast (72194) | $446.75 | $1,787 | 2.6× |
| CT pelvis w/o contrast (72192) | $398 | $1,592 | 3.8× |
| CT scan of leg combo (73702) | $276.75 | $1,107 | 1.6× |
| CT scans face/jaw combo (70488) | $290.75 | $1,163 | 1.7× |
| CT soft tissue neck w contrast (70491) | $460.75 | $1,843 | 2.6× |
| CT soft tissue neck w/o contrast (70490) | $372.75 | $1,491 | 3.6× |
| CT thoracic spine w contrast (72129) | $394.25 | $1,577 | 2.3× |
| CT thoracic spine w/o contrast (72128) | $400.75 | $1,603 | 3.8× |
| CT thoracic spine w/wo cont (72130) | $247 | $988 | 1.4× |
| CT thorax w/o contrast (71250) | $385.75 | $1,543 | 3.7× |
| CT unlisted procedure (76497) | $196 | $784 | 2.3× |
| CT upper ext wo (73200) | $379.25 | $1,517 | 3.6× |
| CT upper extremity w/o & w/contrast material (73202) | $326.25 | $1,305 | 1.9× |
| CT upper extremity with contrast (73201) | $402.50 | $1,610 | 1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $697.50 | $2,790 | 4.0× |
| Cta Abdomen (74175) | $547.75 | $2,191 | 3.1× |
| CTA pelvis (72191) | $596.50 | $2,386 | 3.4× |
| Dilation ureters/urethra rs&i (74485) | $38.50 | $77 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $829 | $3,316 | 0.4× |
| Diskography lumbar (72295) | $829 | $3,316 | 0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$22–$48 | $44–$96 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$27.50–$68.50 | $55–$137 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$33–$87.50 | $66–$175 | varies |
| Dxa Bone Density Axial (77080) | $83.25 | $333 | 0.8× |
| Dxa bone density study (77085) | $89.25 | $357 | 0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $38 | $152 | 0.4× |
| Echo exam of fetal heart (76825) range across 3 matching MRF lines |
$77.50–$255.50 | $155–$511 | varies |
| Echo exam uterus (76831) | $100.50 | $402 | 0.4× |
| Echo Guide For Artery Repair (76936) | $92.50 | $185 | 0.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 3 matching MRF lines |
$38.50–$153.50 | $77–$307 | varies |
| Esophagram (74220) | $103.50 | $414 | 0.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$59.25–$95.75 | $237–$383 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $56 | $224 | 0.5× |
| Fluoroscopy up to 1 hr (76000) | $116.25 | $465 | 0.5× |
| Follow-Up Angiography (75898) | $559.25 | $2,237 | 0.2× |
| Foot 2 views (73620) | $44.50 | $178 | 0.5× |
| Forearm 2 views (73090) | $57.75 | $231 | 0.7× |
| Gastric emptying imaging study (78264) | $387.50 | $1,550 | 1.0× |
| Gated Heart Planar Single (78472) | $292.25 | $1,169 | 0.7× |
| Gated Heart, Multiple (78473) | $241 | $964 | 0.6× |
| Hand 2 views (73120) | $54.25 | $217 | 0.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $201.50 | $403 | 0.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $103 | $206 | 0.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $51 | $102 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $51.50 | $103 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) | $527 | $2,108 | 1.0× |
| Hepatobiliary System Imaging (78226) | $384.50 | $1,538 | 1.0× |
| Ht Musc Image Planar Mult (78454) | $467 | $1,868 | 0.4× |
| Ht Muscle Image Spect Sing (78451) | $337.25 | $1,349 | 0.3× |
| Hysterosalpingogram (74740) | $127 | $508 | 0.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $135.50 | $542 | 1.6× |
| Infant hip ultrasound, limited static exam (76886) | $88.75 | $355 | 1.0× |
| Interstitial radiation source applic complex (77778) range across 3 matching MRF lines |
$464.50–$934 | $929–$1,868 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 3 matching MRF lines |
$256–$561 | $512–$1,122 | varies |
| Joint Survey Single View (77077) | $16.50 | $33 | 0.2× |
| K Flow/Funct Image W/Drug (78708) | $317 | $1,268 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) | $212.50 | $850 | 0.4× |
| Kidney Imaging Morphol (78700) | $195.25 | $781 | 0.5× |
| Knee 3 Views (73562) | $29.75 | $119 | 0.3× |
| Liver & Spleen Imaging Static Only (78215) | $215.25 | $861 | 0.5× |
| Liver imaging static only (78201) range across 3 matching MRF lines |
$20–$175 | $40–$350 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $319.50 | $1,278 | 0.6× |
| Lung Ventilat&Perfus Imaging (78582) | $367.75 | $1,471 | 0.7× |
| Lung Ventilation Imaging (78579) | $211.75 | $847 | 0.5× |
| Lymph System Imaging (78195) | $388 | $1,552 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $51.50 | $103 | 0.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $38.50 | $77 | 0.0× |
| Magnetic Image Jaw Joint (70336) | $568.25 | $2,273 | 2.4× |
| Mammary ductogram or galactogram multiple (77054) | $157.50 | $630 | 0.7× |
| Mammary ductogram or galactogram single (77053) | $137.75 | $551 | 0.6× |
| Meckels Divert Exam (78290) | $388.25 | $1,553 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $214 | $428 | 0.6× |
| Mr safety determination physician/other qhp (76016) | $54 | $216 | 0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $56.25 | $225 | 0.6× |
| Mr safety implt pos&/immoblj (76019) | $36.50 | $146 | 0.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $148 | $592 | 0.6× |
| Mra Head W/O & W/Contrast Material (70546) | $776 | $3,104 | 2.2× |
| MRA head w/o contrast (70544) | $465.75 | $1,863 | 2.0× |
| MRA head with contrast (70545) | $634.75 | $2,539 | 1.8× |
| MRA neck w contrast (70548) | $571 | $2,284 | 1.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $776 | $3,104 | 2.2× |
| MRA neck w/o contrast (70547) | $517.50 | $2,070 | 2.2× |
| MRI abdomen w contrast (74182) | $571 | $2,284 | 1.6× |
| MRI abdomen w/o contrast (74181) | $372.25 | $1,489 | 1.6× |
| MRI any jt lower extrem w/contrast material (73722) | $782 | $3,128 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $993 | $3,972 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $697 | $2,788 | 0.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $75 | $150 | 0.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $146 | $584 | 0.6× |
| MRI cardiac w/o cont stress (75559) range across 3 matching MRF lines |
$135–$374.50 | $270–$749 | varies |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$109–$280.50 | $218–$561 | varies |
| MRI cervical spine w contrast (72142) | $517.50 | $2,070 | 1.5× |
| MRI cervical spine w/o cont (72141) | $568.25 | $2,273 | 2.4× |
| MRI chest w/o contrast (71550) | $394.75 | $1,579 | 1.7× |
| MRI chest wo w contrast (71552) | $776 | $3,104 | 2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $710.50 | $2,842 | 2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $940.25 | $3,761 | 2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $631 | $2,524 | 2.7× |
| MRI lumbar spine w contrast (72149) | $634.75 | $2,539 | 1.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,016 | $4,064 | 2.9× |
| MRI orbit face &/neck w/o contrast (70540) | $517.50 | $2,070 | 2.2× |
| MRI orbit face neck w contrast (70542) | $782 | $3,128 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,020.25 | $4,081 | 2.9× |
| MRI pelvis w contrast (72196) | $634.75 | $2,539 | 1.8× |
| MRI pelvis w/o & w contrast (72197) | $1,027.50 | $4,110 | 3.0× |
| MRI pelvis w/o contrast (72195) | $568.25 | $2,273 | 2.4× |
| MRI thoracic spine w/o contrast (72146) | $637.25 | $2,549 | 2.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $571 | $2,284 | 1.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $694.25 | $2,777 | 2.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,026.75 | $4,107 | 3.0× |
| MRI, abdomen, combo (74183) | $842.75 | $3,371 | 2.4× |
| MRI, dorsal spine combo (72157) | $683 | $2,732 | 2.0× |
| MRI, dorsal spine contrast (72147) | $782 | $3,128 | 2.2× |
| MRI, joint upper extrem (73221) | $637.25 | $2,549 | 2.7× |
| MRI, joint upper extrem combo (73223) | $912 | $3,648 | 2.6× |
| MRI, lumbar spine combo (72158) | $1,015.25 | $4,061 | 2.9× |
| Myelogram cervical (72240) | $294.50 | $1,178 | 0.4× |
| Myelogram Lumbar (72265) | $317.75 | $1,271 | 0.4× |
| Myelography thoracic (72255) | $176.25 | $705 | 0.2× |
| Myelograpy 2/more regions rs&i (72270) | $175 | $700 | 0.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $208.75 | $835 | 0.5× |
| Myocardial Spect Multiple Studies (78452) | $550.75 | $2,203 | 0.4× |
| N-invas est c ffr sw aly CTA (75580) | $34.50 | $69 | 0.0× |
| Neck soft tissue (70360) | $57.25 | $229 | 0.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$20–$261.75 | $80–$1,047 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $398.50 | $797 | 0.3× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$108.50–$148 | $217–$296 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$51.50–$134.50 | $103–$269 | varies |
| Ob us nuchal meas 1 gest (76813) | $181.75 | $727 | 1.7× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 3 matching MRF lines |
$30–$68 | $60–$136 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 3 matching MRF lines |
$29.50–$67.50 | $59–$135 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 3 matching MRF lines |
$3.50–$11.50 | $7–$23 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$10–$19 | $20–$38 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $72 | $144 | 0.1× |
| Parathyroid Planar Imaging (78070) | $340 | $1,360 | 0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $389.75 | $1,559 | 1.0× |
| Pelvis 1 or 2 views (72170) | $49.75 | $199 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $100 | $200 | 0.1× |
| PET image w/CT, full body (78816) | $113 | $226 | 0.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $112 | $224 | 0.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 3 matching MRF lines |
$64.50–$137 | $129–$274 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $264.25 | $1,057 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $88.75 | $355 | 0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $101.50 | $406 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $80.50 | $322 | 0.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $44.50 | $178 | 0.5× |
| Radex elbow complete minimum 3 views (73080) | $80.50 | $322 | 0.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $66 | $264 | 0.6× |
| Radex fingr minimum 2 views (73140) | $62.50 | $250 | 0.7× |
| Radex foot complete minimum 3 views (73630) | $80.50 | $322 | 0.9× |
| Radex Hand Minimum 3 Views (73130) | $80.50 | $322 | 0.9× |
| Radex lower extremity infant minimum 2 views (73592) | $61.25 | $245 | 0.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $60 | $240 | 0.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $67.50 | $270 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) | $85.50 | $342 | 1.0× |
| Radex shoulder complete minimum 2 views (73030) | $80.50 | $322 | 0.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $54 | $216 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $51 | $204 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) | $92 | $368 | 1.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $73.25 | $293 | 0.8× |
| Radex Toe Minimum 2 Views (73660) | $44.50 | $178 | 0.5× |
| Radex upper extremity infant minimum 2 views (73092) | $7.50 | $15 | 0.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $80.50 | $322 | 0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $20 | $40 | 0.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$465.25 | $1,861 | 0.1× |
| Radiation treatment delivery level 3 (77412) | $127 | $254 | 0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $97.75 | $391 | 0.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$12.50–$42.50 | $25–$85 | varies |
| Radiologic exam colon double contrast study (74280) | $196.50 | $786 | 1.1× |
| Radiologic exam colon single contrast study (74270) | $163 | $652 | 0.9× |
| Radiologic exam knee complete 4/more views (73564) | $93.75 | $375 | 0.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $65.50 | $262 | 0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $96.25 | $385 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $146 | $584 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $137.50 | $550 | 0.8× |
| Radiologic examination femur 1 view (73551) | $52 | $208 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) | $58.75 | $235 | 0.7× |
| Radiologic examination knee 1/2 views (73560) | $55.50 | $222 | 0.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $100.25 | $401 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $80.50 | $322 | 0.9× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$25–$328.50 | $50–$657 | varies |
| Ribs bilateral 3 views (71110) | $142.25 | $569 | 1.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $351.25 | $1,405 | 0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $395 | $1,580 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $567.25 | $2,269 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $355.75 | $1,423 | 0.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $355.75 | $1,423 | 0.7× |
| Scapula (73010) | $83.50 | $334 | 0.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $27 | $108 | 1.2× |
| Shoulder 1 view (73020) | $49.75 | $199 | 0.6× |
| Shoulder Arthrography (73040) | $174.50 | $698 | 0.5× |
| Skull less than 4 views (70250) | $65 | $260 | 0.6× |
| Special dosimetry (77331) | $46.50 | $93 | 0.3× |
| Special teletherapy port plan (77321) | $50.50 | $101 | 0.1× |
| Special treatment procedure (77470) | $107.50 | $215 | 0.2× |
| Stereotactic Body Radiation Delivery (77373) | $977 | $1,954 | 0.5× |
| Sternoclavicular joints (71130) | $66.25 | $265 | 0.8× |
| Superior sagittal sinus venogram (75870) range across 3 matching MRF lines |
$59.50–$164 | $119–$328 | varies |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $3 | $6 | 0.0× |
| Tbs technical calculation only (77091) | $27.50 | $55 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $154 | $308 | 0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $74 | $148 | 0.2× |
| Testicular Imaging W/Flow (78761) | $231.75 | $927 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $82.50 | $165 | 0.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $56.50 | $113 | 0.2× |
| Ther rad simulaj-aided field setting simple (77280) | $37.50 | $75 | 0.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $100 | $200 | 0.6× |
| Thoracic spine 2 views (72070) | $58.25 | $233 | 0.6× |
| Thoracic spine 3 views (72072) | $81.75 | $327 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) | $255.25 | $1,021 | 0.6× |
| Thyroid Met Imaging Body (78018) | $38.50 | $77 | 0.1× |
| Thyroid Uptake Measurement (78012) | $221 | $884 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $255.25 | $1,021 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $62 | $124 | 0.2× |
| Tx devices design & construction intermediate (77333) | $42 | $84 | 0.3× |
| Tx devices design & construction simple (77332) | $27.50 | $55 | 0.2× |
| Ultrasound Breast Limited (76642) | $70.75 | $283 | 0.8× |
| Ultrasound Elastography Parenchyma (76981) range across 3 matching MRF lines |
$28.50–$105.50 | $57–$211 | varies |
| Ultrasound Exam Aaa Screen (76706) | $188.50 | $754 | 1.8× |
| Ultrasound, abdomen limited (76705) | $168.25 | $673 | 1.6× |
| Umbilical-artery Doppler (OB) (76820) | $65.25 | $261 | 0.6× |
| Unlisted Dx Radiographic Procedure (76499) | $39 | $156 | 0.4× |
| Upper gi w/o kub (74240) | $198.75 | $795 | 1.1× |
| Ureteral Reflux Study (78740) | $315 | $1,260 | 0.8× |
| Urethrocystogram voiding (74455) | $77.50 | $310 | 0.3× |
| Urethrocystography retrograde (74450) | $184 | $736 | 0.8× |
| Us breast unilateral complete (76641) | $169.50 | $678 | 1.6× |
| Us chest (76604) | $139 | $556 | 1.3× |
| Us complete joint (76881) | $105 | $420 | 1.0× |
| Us exam, pelvic, limited (76857) | $149 | $596 | 1.4× |
| Us head (76506) | $92.25 | $369 | 0.9× |
| Us kidney transplant (76776) | $431.75 | $1,727 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$32–$170.25 | $128–$681 | varies |
| Us ob detailed single fetus (76811) | $253.25 | $1,013 | 1.1× |
| Us ob limited 1 or more fetuses (76815) | $108.75 | $435 | 1.0× |
| Us ob transvaginal (76817) | $200.25 | $801 | 1.9× |
| Us pelvic non ob complete (76856) | $251.25 | $1,005 | 2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $196.25 | $785 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $95.75 | $383 | 0.9× |
| Us retroperitoneal complete (76770) | $159 | $636 | 1.5× |
| Us retroperitoneal limited (76775) | $151.50 | $606 | 1.5× |
| Us scrotum and contents (76870) | $251.25 | $1,005 | 2.4× |
| Us spinal canal and contents (76800) | $103.50 | $414 | 1.0× |
| Us thyroid (76536) | $154.75 | $619 | 1.5× |
| Us transrectal (76872) range across 2 matching MRF lines |
$95.75–$100.50 | $383–$402 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$52.50–$117 | $105–$234 | varies |
| Vein X-Ray Skull Epidural (75872) range across 3 matching MRF lines |
$53.50–$128 | $107–$256 | varies |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$53.50–$126 | $107–$252 | varies |
| Venography Adrenal Unilateral (75840) range across 3 matching MRF lines |
$53.50–$128 | $107–$256 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$53–$114 | $106–$228 | varies |
| Venography extremity bilateral rs&i (75822) | $400 | $1,600 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $400 | $1,600 | 0.3× |
| Venography Orbital Rs&I (75880) range across 3 matching MRF lines |
$33.50–$107.50 | $67–$215 | varies |
| Venography Renal Bilateral (75833) | $68.50 | $137 | 0.0× |
| Venography Renal Unilateral (75831) range across 3 matching MRF lines |
$50.50–$119.50 | $101–$239 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$25–$105 | $50–$210 | varies |
| Venous thrombosis imaging (78457) range across 3 matching MRF lines |
$35.50–$156 | $71–$312 | varies |
| Vertebral fracture assessment via dxa (77086) | $32 | $128 | 0.4× |
| Wrist 2 views (73100) | $55.50 | $222 | 0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $80.50 | $322 | 0.9× |
| X-ray antegrade pyelogram tube (74425) | $24 | $48 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$63.50–$156 | $127–$312 | varies |
| X-Ray Bend Only L-S Spine (72120) | $49.25 | $197 | 0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $62.50 | $250 | 0.7× |
| X-Ray Exam Breast Specimen (76098) | $364 | $1,456 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $49.25 | $197 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $132 | $528 | 1.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $132 | $528 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $35.25 | $141 | 0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $71.75 | $287 | 0.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $85.75 | $343 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $92.25 | $369 | 0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $93 | $372 | 0.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $93 | $372 | 0.9× |
| X-Ray Exam L-S Spine Bending (72114) | $111.75 | $447 | 1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $69.25 | $277 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $132 | $528 | 1.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $158.25 | $633 | 1.5× |
| X-ray eye for foreign body (70030) | $53 | $212 | 0.6× |
| X-ray humerus (73060) | $64 | $256 | 0.7× |
| X-ray IV pyelogram (ivp) (74400) | $217.25 | $869 | 1.2× |
| X-ray IV pyelogram+tomography (74415) | $163.50 | $654 | 0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $39.25 | $157 | 0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $70.25 | $281 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $69.25 | $277 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $158.25 | $633 | 1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $66.25 | $265 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $65.50 | $262 | 0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $79 | $316 | 0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $126 | $504 | 1.2× |
| X-Ray Stress View (77071) | $54.50 | $109 | 0.6× |
| X-ray thoracic spine 4 vw (72074) | $92.25 | $369 | 0.9× |
| X-Ray Tmj Unilat (70328) | $36.75 | $147 | 0.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $367 | $1,468 | 1.1× |
| X-Rays Bone Length Studies (77073) | $58.25 | $233 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $200 | $800 | 1.9× |
| Xr c-spine 4 or 5 views (72050) | $90.25 | $361 | 0.9× |
| Xr facial bones less than 3 views (70140) | $53.75 | $215 | 0.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $48.50 | $194 | 0.5× |
| Xr orbits complete 4 views (70200) | $89.75 | $359 | 0.9× |
| Xr Tomogram Single Plane (76100) | $115.75 | $463 | 1.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.