Imaging prices at University of Michigan Health - West
Wyoming, MI · every code in this section with a posted price and a Medicare benchmark.
394 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) | $925.30 | $2,313.25 | 0.7× |
| Abdomen 1 View (74018) | $87.70 | $219.25 | 1.0× |
| Abdomen 2 views (74019) | $106 | $265 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $409.90 | $1,024.75 | 1.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $440.40 | $1,101 | 0.3× |
| Angio internal mammary (75756) | $698.20 | $1,745.50 | 0.2× |
| Angio pulmonary bilat (75743) | $2,639.90 | $6,599.75 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $1,973.40 | $4,933.50 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $1,973.40 | $4,933.50 | 0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,955.20 | $4,888 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,207.20 | $5,518 | 0.7× |
| Ankle 2 views (73600) | $118.80 | $297 | 1.4× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,973.40 | $4,933.50 | 0.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,973.40 | $4,933.50 | 0.6× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,973.40 | $4,933.50 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,973.40 | $4,933.50 | 0.4× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,973.40 | $4,933.50 | 0.4× |
| Arthrogram ankle (73615) | $362.40 | $906 | 1.0× |
| Arthrogram hip (73525) | $398.50 | $996.25 | 1.1× |
| Arthrogram Wrist (73115) | $403.10 | $1,007.75 | 1.2× |
| Basic radiation dosimetry calculation (77300) | $115.40 | $288.50 | 0.9× |
| Bone age studies (77072) | $148.60 | $371.50 | 1.4× |
| Bone Imaging 3 Phase (78315) | $722.20 | $1,805.50 | 1.8× |
| Bone Imaging Limited Area (78300) | $582.50 | $1,456.25 | 1.5× |
| Bone Imaging Multiple Areas (78305) | $722.20 | $1,805.50 | 1.8× |
| Bone Imaging Whole Body (78306) | $956.10 | $2,390.25 | 2.4× |
| Bone marrow imaging limited area (78102) | $253.90 | $634.75 | 0.6× |
| Bone marrow imaging; multiple areas (78103) | $281.50 | $703.75 | 0.7× |
| Bone marrow imaging; whole body (78104) | $358.70 | $896.75 | 0.9× |
| Bone survey infant (77076) | $177.50 | $443.75 | 1.7× |
| Brachytx isodose complex (77318) | $262.40 | $656 | 0.7× |
| Brachytx isodose intermed (77317) | $262.40 | $656 | 0.7× |
| Brachytx Isodose Plan Simple (77316) | $115.40 | $288.50 | 0.3× |
| Brain Flow Imaging Only (78610) | $335.10 | $837.75 | 0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $582 | $1,455 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,292.90 | $5,732.25 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $431.90 | $1,079.75 | 5.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $839.90 | $2,099.75 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $839.90 | $2,099.75 | 1.6× |
| Chest 1 view (71045) | $60.20 | $150.50 | 0.7× |
| Chest 2 views (71046) | $177.40 | $443.50 | 2.0× |
| Chest 3 views (71047) | $187.10 | $467.75 | 2.2× |
| Chest 4 or more views (71048) | $197.10 | $492.75 | 1.9× |
| Cholecystography Oral Contrast (74290) | $134.40 | $336 | 0.8× |
| Cisternography Positive Contrast Rs&I (70015) | $489.90 | $1,224.75 | 0.6× |
| Clavicle complete (73000) | $108.40 | $271 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $119.60 | $299 | 1.1× |
| Continuing medical physics consltj pr wk (77336) | $115.40 | $288.50 | 0.9× |
| Contrast Exam Abdominl Aorta (75625) | $1,973.40 | $4,933.50 | 0.6× |
| Contrast X-Ray Bladder (74430) | $198.30 | $495.75 | 0.6× |
| Contrast X-Ray Of Elbow (73085) | $403.10 | $1,007.75 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $410.20 | $1,025.50 | 1.2× |
| Contrast Xray Throat/Cerv Esopha (74210) | $163.90 | $409.75 | 0.9× |
| Corpora cavernosography (74445) | $382.10 | $955.25 | 3.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,884.70 | $4,711.75 | 5.4× |
| CT abdomen and pelvis without contrast (74176) | $1,450.30 | $3,625.75 | 6.1× |
| CT abdomen w contrast (74160) | $877.70 | $2,194.25 | 5.0× |
| CT abdomen w wo contrast (74170) | $971.30 | $2,428.25 | 5.6× |
| CT abdomen w/o contrast (74150) | $725.80 | $1,814.50 | 7.0× |
| CT Angio Abdomen and Pelvis (74174) | $1,446.80 | $3,617 | 4.2× |
| CT Angio Chest (71275) | $1,446.80 | $3,617 | 8.3× |
| CT Angio Head (70496) | $1,155.80 | $2,889.50 | 6.6× |
| CT angio hrt w/3d image (75574) | $542.90 | $1,357.25 | 1.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,446.80 | $3,617 | 8.3× |
| CT Angio Neck (70498) | $1,155.80 | $2,889.50 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,446.80 | $3,617 | 8.3× |
| CT cervical spine w/ contrast (72126) | $919.20 | $2,298 | 2.6× |
| CT cervical spine w/o contrast (72125) | $791 | $1,977.50 | 7.6× |
| CT cervical spine w/wo cont (72127) | $982.80 | $2,457 | 5.6× |
| CT chest w contrast (71260) | $896 | $2,240 | 5.1× |
| CT chest w/wo contrast (71270) | $993.90 | $2,484.75 | 5.7× |
| CT head/brain with contrast (70460) | $645.20 | $1,613 | 3.7× |
| CT head/brain without and with contrast (70470) | $793 | $1,982.50 | 4.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $69.20 | $173 | 0.8× |
| CT iac w contrast (70481) | $994.10 | $2,485.25 | 5.7× |
| CT l-spine w&w/o contrast (72133) | $982.80 | $2,457 | 5.6× |
| CT lower ext w/o (73700) | $681.60 | $1,704 | 6.5× |
| CT lower extremity w/contrast material (73701) | $709.30 | $1,773.25 | 4.1× |
| CT lumbar spine w contrast (72132) | $919.20 | $2,298 | 2.6× |
| CT lumbar spine w/o contrast (72131) | $852 | $2,130 | 8.2× |
| CT maxillofacial w contrast (70487) | $609.90 | $1,524.75 | 3.5× |
| CT maxillofacial wo contrast (70486) | $577.70 | $1,444.25 | 5.5× |
| CT neck tissue combo (70492) | $838.80 | $2,097 | 4.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $882.50 | $2,206.25 | 5.0× |
| CT orbits w/o contrast (70480) | $472 | $1,180 | 4.5× |
| CT pelvis w&w/o contrast (72194) | $897.70 | $2,244.25 | 5.1× |
| CT pelvis w/o contrast (72192) | $724.40 | $1,811 | 7.0× |
| CT scan of leg combo (73702) | $777.70 | $1,944.25 | 4.4× |
| CT scans face/jaw combo (70488) | $676.60 | $1,691.50 | 3.9× |
| CT soft tissue neck w contrast (70491) | $644.80 | $1,612 | 3.7× |
| CT soft tissue neck w/o contrast (70490) | $538.40 | $1,346 | 5.2× |
| CT thoracic spine w contrast (72129) | $919.20 | $2,298 | 5.3× |
| CT thoracic spine w/o contrast (72128) | $791 | $1,977.50 | 7.6× |
| CT thoracic spine w/wo cont (72130) | $982.80 | $2,457 | 5.6× |
| CT thorax w/o contrast (71250) | $719.50 | $1,798.75 | 6.9× |
| CT upper ext wo (73200) | $520.30 | $1,300.75 | 5.0× |
| CT upper extremity w/o & w/contrast material (73202) | $722.20 | $1,805.50 | 4.1× |
| CT upper extremity with contrast (73201) | $650.80 | $1,627 | 1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,446.80 | $3,617 | 8.3× |
| Cta Abdomen (74175) | $1,446.80 | $3,617 | 8.3× |
| CTA pelvis (72191) | $1,446.80 | $3,617 | 8.3× |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$1,154.80–$1,362 | $2,887–$3,405 | varies |
| Discography Cerv/Thor Spine (72285) | $1,753 | $4,382.50 | 0.9× |
| Diskography lumbar (72295) | $1,753 | $4,382.50 | 0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $103.70 | $259.25 | 1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $125.80 | $314.50 | 1.2× |
| Dxa Bone Density Axial (77080) | $303.90 | $759.75 | 2.9× |
| Dxa bone density study (77085) | $159.50 | $398.75 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $174.60 | $436.50 | 2.0× |
| Echo exam of fetal heart (76825) | $478.50 | $1,196.25 | 0.9× |
| Echo exam uterus (76831) | $165.60 | $414 | 0.7× |
| Echo Guide For Artery Repair (76936) | $245.40 | $613.50 | 1.1× |
| Esophageal Motility Study (78258) | $321 | $802.50 | 0.8× |
| Esophagram (74220) | $163.90 | $409.75 | 0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $192.30 | $480.75 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $190 | $475 | 0.8× |
| Follow-Up Angiography (75898) | $268.30 | $670.75 | 0.1× |
| Foot 2 views (73620) | $161.70 | $404.25 | 1.9× |
| Forearm 2 views (73090) | $111 | $277.50 | 1.3× |
| Gastric emptying imaging study (78264) | $573.50 | $1,433.75 | 1.4× |
| Gastroesophageal Reflux Exam (78262) | $421.90 | $1,054.75 | 1.1× |
| Gated Heart Planar Single (78472) | $516 | $1,290 | 1.3× |
| Hand 2 views (73120) | $111 | $277.50 | 1.1× |
| Heart first pass single,planar (78481) | $525 | $1,312.50 | 1.0× |
| Heart Image (Pet) Multiple (78492) | $2,730.70 | $6,826.75 | 1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,973.40 | $4,933.50 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,808.80 | $4,522 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $834.50 | $2,086.25 | 1.5× |
| Hepatobiliary System Imaging (78226) | $834.50 | $2,086.25 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $779.30 | $1,948.25 | 0.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$191.80–$223.80 | $479.50–$559.50 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $224.80 | $562 | 2.6× |
| Infant hip ultrasound, limited static exam (76886) | $217.60 | $544 | 2.5× |
| Infusion Ivp (74410) | $454.30 | $1,135.75 | 2.6× |
| Interstitial radiation source applic complex (77778) | $660.70 | $1,651.75 | 1.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $371.10 | $927.75 | 0.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $371.10 | $927.75 | 0.7× |
| Intracavitary radiation source applic simple (77761) | $371.10 | $927.75 | 0.7× |
| K Flow/Funct Image Multiple (78709) | $470.60 | $1,176.50 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $387.50 | $968.75 | 0.7× |
| K Flow/Funct Image W/O Drug (78707) | $806.60 | $2,016.50 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $743.70 | $1,859.25 | 1.9× |
| Knee 3 Views (73562) | $117.10 | $292.75 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $380.20 | $950.50 | 1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $559.50 | $1,398.75 | 1.4× |
| Liver imaging static only (78201) | $353.90 | $884.75 | 0.7× |
| Lung perfusion differential (78597) | $334.30 | $835.75 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $589.70 | $1,474.25 | 1.1× |
| Lymph System Imaging (78195) | $1,165.40 | $2,913.50 | 2.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,349.70 | $5,874.25 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,160.20 | $2,900.50 | 4.9× |
| Mammary ductogram or galactogram multiple (77054) | $258.30 | $645.75 | 1.1× |
| Mammary ductogram or galactogram single (77053) | $216.60 | $541.50 | 0.9× |
| Meckels Divert Exam (78290) | $409.90 | $1,024.75 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $278.70 | $696.75 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,369.10 | $3,422.75 | 3.9× |
| MRA head w/o contrast (70544) | $950.90 | $2,377.25 | 4.0× |
| MRA head with contrast (70545) | $1,188.70 | $2,971.75 | 3.4× |
| MRA neck w contrast (70548) | $1,188.70 | $2,971.75 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,369.10 | $3,422.75 | 3.9× |
| MRA neck w/o contrast (70547) | $950.90 | $2,377.25 | 4.0× |
| MRI abdomen w contrast (74182) | $1,403.70 | $3,509.25 | 4.0× |
| MRI abdomen w/o contrast (74181) | $1,123.70 | $2,809.25 | 4.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,160.20 | $2,900.50 | 1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,604.60 | $4,011.50 | 4.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,160.20 | $2,900.50 | 1.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,986 | $4,965 | 8.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,308.40 | $3,271 | 5.5× |
| MRI cervical spine w contrast (72142) | $1,311.10 | $3,277.75 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,202.70 | $3,006.75 | 5.1× |
| MRI chest w/o contrast (71550) | $1,116.50 | $2,791.25 | 4.7× |
| MRI chest with contrast (71551) | $1,116.50 | $2,791.25 | 1.4× |
| MRI chest wo w contrast (71552) | $1,312.90 | $3,282.25 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,008.70 | $2,521.75 | 2.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,224.80 | $3,062 | 3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,160.20 | $2,900.50 | 4.9× |
| MRI lumbar spine w contrast (72149) | $1,624.30 | $4,060.75 | 4.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,428.90 | $3,572.25 | 4.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,043.70 | $2,609.25 | 4.4× |
| MRI orbit face neck w contrast (70542) | $1,043.70 | $2,609.25 | 3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,252.70 | $3,131.75 | 3.6× |
| MRI pelvis w contrast (72196) | $1,007.70 | $2,519.25 | 2.9× |
| MRI pelvis w/o & w contrast (72197) | $1,574.80 | $3,937 | 4.5× |
| MRI pelvis w/o contrast (72195) | $1,007.70 | $2,519.25 | 4.2× |
| MRI thoracic spine w/o contrast (72146) | $1,109.50 | $2,773.75 | 4.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,160.20 | $2,900.50 | 3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,160.20 | $2,900.50 | 4.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$843.40–$1,224.80 | $2,108.50–$3,062 | varies |
| MRI, abdomen, combo (74183) | $1,560.10 | $3,900.25 | 4.5× |
| MRI, dorsal spine combo (72157) | $1,584 | $3,960 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,452.90 | $3,632.25 | 4.2× |
| MRI, joint upper extrem (73221) | $1,078.90 | $2,697.25 | 4.5× |
| MRI, joint upper extrem combo (73223) | $1,604.60 | $4,011.50 | 4.6× |
| MRI, lumbar spine combo (72158) | $1,804.50 | $4,511.25 | 5.2× |
| Myelogram cervical (72240) | $533 | $1,332.50 | 0.7× |
| Myelogram Lumbar (72265) | $729.40 | $1,823.50 | 0.9× |
| Myelography thoracic (72255) | $450.10 | $1,125.25 | 0.6× |
| Myelograpy 2/more regions rs&i (72270) | $876.10 | $2,190.25 | 1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,292.90 | $5,732.25 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $1,967.40 | $4,918.50 | 1.5× |
| Neck soft tissue (70360) | $111.20 | $278 | 1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $175 | $437.50 | 0.4× |
| Nm csf leak detection (78650) | $582 | $1,455 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $326.70 | $816.75 | 3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,947.40 | $4,868.50 | 1.4× |
| Nuclear Rx Oral Admin (79005) | $393.60 | $984 | 1.7× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $88.80 | $222 | 0.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $78.80 | $197 | 0.8× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $31.30 | $78.25 | 1.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $102 | $255 | 1.0× |
| Parathyroid Planar Imaging (78070) | $265.60 | $664 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $503.40 | $1,258.50 | 1.3× |
| Pelvis 1 or 2 views (72170) | $118.80 | $297 | 1.1× |
| Peritoneogram Rs&I (74190) | $213 | $532.50 | 0.4× |
| Pet Image W/Ct Lmtd (78814) | $1,989.70 | $4,974.25 | 1.4× |
| PET image w/CT, full body (78816) | $1,989.70 | $4,974.25 | 1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,989.70 | $4,974.25 | 1.4× |
| Pet Myocardial Sngl Study (78491) | $1,441.10 | $3,602.75 | 1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,973.40 | $4,933.50 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $589.70 | $1,474.25 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $220.10 | $550.25 | 2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $296.40 | $741 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $118.80 | $297 | 1.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $152 | $380 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $117.10 | $292.75 | 1.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $177.50 | $443.75 | 1.7× |
| Radex fingr minimum 2 views (73140) | $66.60 | $166.50 | 0.8× |
| Radex foot complete minimum 3 views (73630) | $167.30 | $418.25 | 1.9× |
| Radex Hand Minimum 3 Views (73130) | $117.10 | $292.75 | 1.4× |
| Radex lower extremity infant minimum 2 views (73592) | $106.20 | $265.50 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $145.60 | $364 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $117.10 | $292.75 | 1.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $123.30 | $308.25 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $141.40 | $353.50 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) | $165.80 | $414.50 | 1.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $93.50 | $233.75 | 1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $502.40 | $1,256 | 2.9× |
| Radex Spine 1 View Specify Level (72020) | $122.80 | $307 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $141.40 | $353.50 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $142.30 | $355.75 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $66.60 | $166.50 | 0.8× |
| Radex upper extremity infant minimum 2 views (73092) | $92.50 | $231.25 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $117.10 | $292.75 | 1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$890.90 | $2,227.25 | 0.1× |
| Radiation treatment delivery level 1 (77402) range across 3 matching MRF lines |
$132.40–$166.90 | $331–$417.25 | varies |
| Radiation treatment delivery level 2 (77407) range across 3 matching MRF lines |
$178.90–$212.10 | $447.25–$530.25 | varies |
| Radiation treatment delivery level 3 (77412) range across 4 matching MRF lines |
$234.20–$279.80 | $585.50–$699.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $146.50 | $366.25 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $123.90 | $309.75 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $376.40 | $941 | 2.2× |
| Radiologic exam colon single contrast study (74270) | $217.60 | $544 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $56.90 | $142.25 | 0.3× |
| Radiologic exam knee complete 4/more views (73564) | $192.90 | $482.25 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $177.50 | $443.75 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $223.20 | $558 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $351.70 | $879.25 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $179.10 | $447.75 | 1.0× |
| Radiologic examination femur 1 view (73551) | $64.70 | $161.75 | 0.7× |
| Radiologic examination femur minimum 2 views (73552) | $116.40 | $291 | 1.3× |
| Radiologic examination knee 1/2 views (73560) | $60.70 | $151.75 | 0.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $190.50 | $476.25 | 1.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $111.60 | $279 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $118.80 | $297 | 1.4× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $150.30 | $375.75 | 0.3× |
| Renal Cyst Study (74470) | $211.40 | $528.50 | 0.4× |
| Ribs bilateral 3 views (71110) | $187.70 | $469.25 | 1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $281.80 | $704.50 | 0.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $932 | $2,330 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $654.40 | $1,636 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$496–$895.50 | $1,240–$2,238.75 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,209.60 | $3,024 | 0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,373.50 | $3,433.75 | 1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,209.60 | $3,024 | 0.9× |
| Rp Therapy Intravenous Administration (79101) | $282.80 | $707 | 1.2× |
| Salivary Gland Imaging Serial Images (78231) | $426.20 | $1,065.50 | 1.1× |
| Scapula (73010) | $134.30 | $335.75 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $65.70 | $164.25 | 2.8× |
| Shoulder 1 view (73020) | $88.40 | $221 | 1.0× |
| Shoulder Arthrography (73040) | $403.10 | $1,007.75 | 1.2× |
| Sialogram (70390) | $211.40 | $528.50 | 0.9× |
| Skull less than 4 views (70250) | $123.80 | $309.50 | 1.2× |
| Special dosimetry (77331) | $115.40 | $288.50 | 0.9× |
| Special Physics Consult (77370) | $123.10 | $307.75 | 0.9× |
| Special teletherapy port plan (77321) | $262.40 | $656 | 0.7× |
| Special treatment procedure (77470) | $384.50 | $961.25 | 0.7× |
| Spleen Imaging (78185) | $293.50 | $733.75 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $1,654.40 | $4,136 | 0.9× |
| Sternoclavicular joints (71130) | $141.40 | $353.50 | 1.6× |
| Superior sagittal sinus venogram (75870) | $684.80 | $1,712 | 0.2× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $72.30 | $180.75 | 0.8× |
| Tbs technical calculation only (77091) | $72.30 | $180.75 | 0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $262.40 | $656 | 0.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $115.40 | $288.50 | 0.3× |
| Testicular Imaging W/Flow (78761) | $667.20 | $1,668 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $457.60 | $1,144 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $285.40 | $713.50 | 0.8× |
| Ther rad simulaj-aided field setting simple (77280) | $159.20 | $398 | 1.2× |
| Thoracic spine 2 views (72070) | $122.90 | $307.25 | 1.2× |
| Thoracic spine 3 views (72072) | $173.10 | $432.75 | 1.7× |
| Thoracolumbar 2 views (72080) | $148.60 | $371.50 | 1.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $441.30 | $1,103.25 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $281.60 | $704 | 0.7× |
| Thyroid Met Imaging Body (78018) | $714.60 | $1,786.50 | 1.3× |
| Thyroid Uptake Measurement (78012) | $113.50 | $283.75 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $626.70 | $1,566.75 | 1.6× |
| Tx Devices Design & Construction Complex (77334) | $188.10 | $470.25 | 0.5× |
| Tx devices design & construction intermediate (77333) | $188.10 | $470.25 | 1.4× |
| Tx devices design & construction simple (77332) | $188.10 | $470.25 | 1.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$96.90–$103.60 | $242.25–$259 | varies |
| Ultrasound Exam Aaa Screen (76706) | $378.10 | $945.25 | 3.6× |
| Ultrasound, abdomen limited (76705) | $378.10 | $945.25 | 3.6× |
| Umbilical-artery Doppler (OB) (76820) | $125.80 | $314.50 | 1.2× |
| Unlisted Dx Radiographic Procedure (76499) | $787.50 | $1,968.75 | 9.1× |
| Unlisted fluoroscopic procedure (76496) | $511.30 | $1,278.25 | 5.9× |
| Unlisted us procedure (76999) | $217.60 | $544 | 2.5× |
| Upper gi w/o kub (74240) | $127.40 | $318.50 | 0.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $71.20 | $178 | 6.4× |
| Ureteral Reflux Study (78740) | $326.80 | $817 | 0.8× |
| Urethrocystogram voiding (74455) | $216.90 | $542.25 | 0.9× |
| Urethrocystography retrograde (74450) | $177.70 | $444.25 | 0.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$92.40–$103.60 | $231–$259 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$42.80–$236.40 | $107–$591 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$60.40–$117.90 | $151–$294.75 | varies |
| Us exam, pelvic, limited (76857) | $217.60 | $544 | 2.1× |
| Us head (76506) | $194.30 | $485.75 | 1.9× |
| Us kidney transplant (76776) | $492.20 | $1,230.50 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$21.60–$217.60 | $54–$544 | varies |
| Us ob detailed single fetus (76811) | $624.70 | $1,561.75 | 2.6× |
| Us ob limited 1 or more fetuses (76815) | $257.30 | $643.25 | 2.5× |
| Us ob transvaginal (76817) | $151.20 | $378 | 1.5× |
| Us pelvic non ob complete (76856) | $295.80 | $739.50 | 2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $317.20 | $793 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $207.10 | $517.75 | 2.0× |
| Us retroperitoneal complete (76770) | $286.90 | $717.25 | 2.8× |
| Us retroperitoneal limited (76775) | $286.90 | $717.25 | 2.8× |
| Us scrotum and contents (76870) | $326.10 | $815.25 | 3.1× |
| Us spinal canal and contents (76800) | $217.60 | $544 | 2.1× |
| Us thyroid (76536) | $252.60 | $631.50 | 2.4× |
| Us transrectal (76872) | $129.90 | $324.75 | 1.2× |
| Vascular Flow Imaging (78445) | $281.60 | $704 | 0.7× |
| Vasogram (74440) | $192.30 | $480.75 | 0.8× |
| Vein X-Ray Chest (75827) | $922.70 | $2,306.75 | 0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,202.90 | $3,007.25 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $1,545.90 | $3,864.75 | 0.5× |
| Venogram Sinus/Jugular (75860) | $684.80 | $1,712 | 0.2× |
| Venography Adrenal Unilateral (75840) | $1,879.40 | $4,698.50 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $1,973.40 | $4,933.50 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $698.20 | $1,745.50 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $698.20 | $1,745.50 | 0.4× |
| Venography Renal Bilateral (75833) | $1,973.40 | $4,933.50 | 0.6× |
| Venography Renal Unilateral (75831) | $1,973.40 | $4,933.50 | 0.6× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$1,973.40 | $4,933.50 | 0.4× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$45.20–$62.80 | $113–$157 | varies |
| Wrist 2 views (73100) | $111 | $277.50 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $134.30 | $335.75 | 1.5× |
| X-ray antegrade pyelogram tube (74425) | $165.60 | $414 | 0.5× |
| X-Ray Aorta Leg Arteries (75630) | $1,973.40 | $4,933.50 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $167.20 | $418 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $108.60 | $271.50 | 1.3× |
| X-Ray Exam Breast Specimen (76098) | $379.80 | $949.50 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $216.60 | $541.50 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $252.60 | $631.50 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $141.40 | $353.50 | 1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $154.40 | $386 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $328.30 | $820.75 | 3.2× |
| X-Ray Exam L-S Spine Bending (72114) | $479.90 | $1,199.75 | 4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $155.60 | $389 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $328.30 | $820.75 | 3.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $145.30 | $363.25 | 1.4× |
| X-ray eye for foreign body (70030) | $97.10 | $242.75 | 1.1× |
| X-ray humerus (73060) | $108.60 | $271.50 | 1.3× |
| X-ray IV pyelogram (ivp) (74400) | $454.30 | $1,135.75 | 2.6× |
| X-ray IV pyelogram+tomography (74415) | $538.20 | $1,345.50 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $80 | $200 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $85.30 | $213.25 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $186.30 | $465.75 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $123.90 | $309.75 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $170.50 | $426.25 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $141.40 | $353.50 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $89.30 | $223.25 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $141.40 | $353.50 | 1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $199.30 | $498.25 | 2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $199.30 | $498.25 | 1.9× |
| X-Ray Stress View (77071) | $112.70 | $281.75 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $187.70 | $469.25 | 1.8× |
| X-Ray Tmj Unilat (70328) | $102 | $255 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $348.40 | $871 | 1.0× |
| X-Rays Bone Length Studies (77073) | $159.40 | $398.50 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $190.50 | $476.25 | 1.8× |
| Xr c-spine 4 or 5 views (72050) | $210.90 | $527.25 | 2.0× |
| Xr facial bones less than 3 views (70140) | $93.50 | $233.75 | 1.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $96.10 | $240.25 | 0.9× |
| Xr orbits complete 4 views (70200) | $123.90 | $309.75 | 1.2× |
| Xr Tomogram Single Plane (76100) | $214 | $535 | 2.1× |
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.