Imaging prices at UW Medical Center
Seattle, WA · every code in this section with a posted price and a Medicare benchmark.
489 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) | $6,341.76 | $9,059.65 | 4.0× |
| Abdomen 1 View (74018) | $296.58 | $423.68 | 2.9× |
| Abdomen 2 views (74019) | $361.28 | $516.12 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,533.17 | $2,190.24 | 3.3× |
| Adrenal Cortex & Medulla Img (78075) | $1,971.04 | $2,815.77 | 1.3× |
| Angio internal mammary (75756) | $2,450.42 | $3,500.60 | 0.7× |
| Angio pulmonary bilat (75743) | $7,726.93 | $11,038.47 | 2.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,553.33 | $5,076.19 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $6,895.64 | $9,850.91 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $6,770.83 | $9,672.62 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,342.79 | $7,632.56 | 1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,340.65 | $3,343.78 | 0.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$276.91–$415.37 | $395.59–$593.39 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,570.66 | $7,958.08 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,892.40 | $6,989.14 | 1.3× |
| Artery X-Rays Abdomen (75726) | $9,167.94 | $13,097.05 | 1.4× |
| Artery X-Rays Adrenal Gland (75731) | $3,360.34 | $4,800.48 | 0.9× |
| Artery X-Rays Pelvis (75736) | $6,064.24 | $8,663.20 | 0.9× |
| Artery X-Rays Spine (75705) | $6,579.66 | $9,399.52 | 1.0× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,073.39–$1,610.10 | $1,533.42–$2,300.14 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,057.78–$1,586.68 | $1,511.12–$2,266.68 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,103.40–$1,655.09 | $1,576.28–$2,364.41 | varies |
| Basic radiation dosimetry calculation (77300) | $462.13 | $660.19 | 3.0× |
| Bone age studies (77072) | $358.18 | $511.68 | 3.0× |
| Bone Imaging 3 Phase (78315) | $1,686.57 | $2,409.39 | 3.6× |
| Bone Imaging Limited Area (78300) | $1,316.22 | $1,880.32 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $1,350.45 | $1,929.21 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,472.51 | $2,103.58 | 3.2× |
| Bone marrow imaging limited area (78102) | $1,034.49 | $1,477.84 | 2.2× |
| Bone marrow imaging; whole body (78104) | $1,317.84 | $1,882.63 | 2.8× |
| Bone survey infant (77076) | $248.98 | $355.68 | 2.1× |
| Brachytx isodose complex (77318) | $1,776.13 | $2,537.33 | 4.1× |
| Brachytx isodose intermed (77317) | $1,383.05 | $1,975.79 | 3.2× |
| Brachytx Isodose Plan Simple (77316) | $997.52 | $1,425.03 | 2.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $4,680.70 | $6,686.72 | 7.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $871.18 | $1,244.55 | 1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,457.82 | $7,796.88 | 3.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,810.76 | $2,586.80 | 3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,316.77 | $3,309.67 | 5.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,085.26 | $4,407.52 | 3.4× |
| Cardiac Shunt Detection (78428) | $746.57 | $1,066.53 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $507.79 | $725.41 | 5.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,587.77 | $2,268.24 | 2.5× |
| Cerebrospinal Fluid Scan (78630) | $1,807.85 | $2,582.64 | 2.9× |
| Chest 1 view (71045) | $368.26 | $526.09 | 3.7× |
| Chest 2 views (71046) | $491.02 | $701.45 | 4.9× |
| Chest 3 views (71047) | $621.96 | $888.52 | 6.2× |
| Chest 4 or more views (71048) | $646.51 | $923.58 | 5.3× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $851.69 | $1,216.70 | 7.0× |
| Cholecystography Oral Contrast (74290) | $376.94 | $538.49 | 1.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $529.98 | $757.12 | 4.4× |
| Cisternography Positive Contrast Rs&I (70015) | $1,719.14 | $2,455.91 | 1.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$279.89–$419.83 | $399.84–$599.76 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $245.04 | $350.06 | 2.0× |
| Continuing medical physics consltj pr wk (77336) | $666.12 | $951.60 | 4.3× |
| Contrast Exam Abdominl Aorta (75625) | $6,412.03 | $9,160.04 | 1.8× |
| Contrast X-Ray Bladder (74430) | $818.02 | $1,168.60 | 2.0× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$792.98–$1,189.48 | $1,132.83–$1,699.25 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,042.91–$1,564.37 | $1,489.87–$2,234.81 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $482.66 | $689.52 | 2.4× |
| Corpora cavernosography (74445) | $646.57 | $923.67 | 5.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,765.74 | $3,951.06 | 6.8× |
| CT abdomen and pelvis without contrast (74176) | $1,896.01 | $2,708.58 | 6.9× |
| CT abdomen w contrast (74160) | $1,013.55 | $1,447.93 | 5.0× |
| CT abdomen w wo contrast (74170) | $1,714.20 | $2,448.85 | 8.4× |
| CT abdomen w/o contrast (74150) | $1,285.65 | $1,836.64 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,302.21 | $4,717.44 | 8.2× |
| CT Angio Chest (71275) | $2,027.27 | $2,896.10 | 10.0× |
| CT Angio Head (70496) | $2,447.94 | $3,497.05 | 12.1× |
| CT angio hrt w/3d image (75574) | $1,893 | $2,704.29 | 4.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,493.40–$3,740.10 | $3,562–$5,343 | varies |
| CT Angio Neck (70498) | $2,344.58 | $3,349.40 | 11.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,067.52 | $2,953.60 | 10.2× |
| CT cervical spine w/ contrast (72126) | $1,374.11 | $1,963.01 | 3.4× |
| CT cervical spine w/o contrast (72125) | $1,455.41 | $2,079.16 | 12.0× |
| CT cervical spine w/wo cont (72127) | $1,706.66 | $2,438.08 | 8.4× |
| CT chest w contrast (71260) | $1,911.71 | $2,731.02 | 9.4× |
| CT chest w/wo contrast (71270) | $2,335.96 | $3,337.09 | 11.5× |
| CT colonography screening (74263) | $1,305.30 | $1,864.72 | 4.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,305.82 | $1,865.46 | 6.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,157.52 | $1,653.60 | 9.6× |
| CT head/brain with contrast (70460) | $1,307.68 | $1,868.11 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,417.37 | $2,024.82 | 7.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $938.60 | $1,340.86 | 2.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $132.48 | $189.26 | 1.3× |
| CT hrt w/3d image congen (75573) | $1,624.75 | $2,321.07 | 4.0× |
| CT iac w contrast (70481) | $1,059.40 | $1,513.43 | 5.2× |
| CT l-spine w&w/o contrast (72133) | $1,830.14 | $2,614.48 | 9.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,214.09–$1,821.13 | $1,734.41–$2,601.61 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,166.35–$1,749.52 | $1,666.21–$2,499.32 | varies |
| CT lumbar spine w contrast (72132) | $1,483.78 | $2,119.68 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,556.79 | $2,223.99 | 12.9× |
| CT maxillofacial w contrast (70487) | $2,206.11 | $3,151.58 | 10.9× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$695.79–$1,739.46 | $993.98–$2,484.94 | varies |
| CT neck tissue combo (70492) | $1,585.14 | $2,264.49 | 7.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,168.07 | $1,668.67 | 5.8× |
| CT orbits w/o contrast (70480) | $1,116 | $1,594.29 | 9.2× |
| CT pelvis w&w/o contrast (72194) | $2,690.90 | $3,844.15 | 13.2× |
| CT pelvis w/o contrast (72192) | $1,334.88 | $1,906.97 | 11.0× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,482.50–$2,223.74 | $2,117.85–$3,176.77 | varies |
| CT scans face/jaw combo (70488) | $2,740.16 | $3,914.51 | 13.5× |
| CT soft tissue neck w contrast (70491) | $1,293.79 | $1,848.27 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $1,311.13 | $1,873.04 | 10.8× |
| CT thoracic spine w contrast (72129) | $1,288.22 | $1,840.32 | 6.3× |
| CT thoracic spine w/o contrast (72128) | $1,350.09 | $1,928.70 | 11.2× |
| CT thoracic spine w/wo cont (72130) | $1,586.54 | $2,266.49 | 7.8× |
| CT thorax w/o contrast (71250) | $1,118.10 | $1,597.28 | 9.2× |
| CT unlisted procedure (76497) range across 7 matching MRF lines |
$203.66–$5,302.88 | $290.94–$7,575.55 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$981.49–$1,472.23 | $1,402.13–$2,103.19 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,225.85–$1,838.77 | $1,751.21–$2,626.82 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$931–$1,396.51 | $1,330–$1,995.01 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,450.61 | $3,500.87 | 12.1× |
| Cta Abdomen (74175) | $2,595.50 | $3,707.86 | 12.8× |
| CTA pelvis (72191) | $1,880.50 | $2,686.43 | 9.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,082.14 | $1,545.91 | 3.9× |
| Dilation ureters/urethra rs&i (74485) | $3,232.73 | $4,618.19 | 1.3× |
| Discography Cerv/Thor Spine (72285) | $1,820 | $2,600 | 0.8× |
| Diskography lumbar (72295) | $2,883.07 | $4,118.67 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $195.29 | $278.99 | 1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $415.69 | $593.84 | 3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $388.02 | $554.32 | 3.2× |
| Dxa Bone Density Axial (77080) | $419.64 | $599.48 | 3.5× |
| Dxa bone density study (77085) | $289.70 | $413.86 | 2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $118.43 | $169.18 | 1.2× |
| Echo exam of fetal heart (76825) | $1,277.29 | $1,824.70 | 2.0× |
| Echo exam uterus (76831) | $645.28 | $921.83 | 2.3× |
| Echo Guide For Artery Repair (76936) | $988.62 | $1,412.32 | 4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $805.22 | $1,150.31 | 2.9× |
| Echograp Trans R Pros Study (76873) | $697.38 | $996.25 | 5.8× |
| Esophageal Motility Study (78258) | $600.82 | $858.31 | 1.3× |
| Esophagram (74220) | $493.32 | $704.75 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $707.76 | $1,011.09 | 5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $495.16 | $707.37 | 4.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,028.01 | $1,468.58 | 3.7× |
| Fluoroscopy up to 1 hr (76000) | $756.85 | $1,081.21 | 2.7× |
| Follow-Up Angiography (75898) | $2,444.47 | $3,492.10 | 0.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$285.01–$427.52 | $407.16–$610.74 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$329.23–$493.84 | $470.33–$705.49 | varies |
| Gastric emptying imaging study (78264) | $1,712.91 | $2,447.02 | 3.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,490.14 | $2,128.77 | 3.2× |
| Gastroesophageal Reflux Exam (78262) | $1,181.22 | $1,687.45 | 2.6× |
| Gated Heart Planar Single (78472) | $1,787.97 | $2,554.24 | 3.9× |
| Gated Heart, Multiple (78473) | $1,606.93 | $2,295.61 | 3.5× |
| GI Endoscopic US S&I (76975) | $522.39 | $746.27 | 1.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,644.77 | $2,349.67 | 2.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$409.21–$613.82 | $584.59–$876.89 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,586.43 | $9,409.19 | 8.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,239.29 | $6,056.13 | 5.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,472.29 | $3,531.84 | 3.1× |
| Heart first pass single,planar (78481) | $940.84 | $1,344.05 | 1.5× |
| Heart Image (Pet) Multiple (78492) | $4,386.89 | $6,266.99 | 2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,977.23 | $7,110.33 | 1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,912.31 | $7,017.58 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,354.51 | $1,935.02 | 2.2× |
| Hepatobiliary System Imaging (78226) | $1,233.96 | $1,762.80 | 2.7× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $2,031.75 | $2,902.50 | 3.2× |
| Ht Musc Image Planar Mult (78454) | $4,049.86 | $5,785.52 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $2,511.79 | $3,588.27 | 1.7× |
| Hysterosalpingogram (74740) | $818.94 | $1,169.91 | 3.0× |
| Image fusion (77399) | $695.02 | $992.88 | 4.5× |
| Infusion Ivp (74410) | $183.09 | $261.56 | 0.9× |
| Interstitial radiation source applic complex (77778) | $4,401.49 | $6,287.84 | 5.5× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) | $6,886.11 | $9,837.30 | 0.8× |
| Joint Survey Single View (77077) | $316.68 | $452.40 | 2.6× |
| K Flow/Funct Image Multiple (78709) | $1,754.73 | $2,506.76 | 2.8× |
| K Flow/Funct Image W/Drug (78708) | $1,302.36 | $1,860.51 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,076.26 | $1,537.52 | 1.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,241.07 | $1,772.96 | 2.7× |
| Kidney Imaging Morphol (78700) | $864.14 | $1,234.48 | 1.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$284.12–$426.17 | $405.88–$608.82 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,059.35 | $1,513.36 | 2.3× |
| Leveen/Shunt Patency Exam (78291) | $740.64 | $1,058.06 | 1.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,101.93 | $1,574.18 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,382.21 | $1,974.59 | 3.0× |
| Liver imaging static only (78201) | $1,982.67 | $2,832.38 | 3.2× |
| Liver imaging w/vascular flow (78202) | $2,358.68 | $3,369.55 | 3.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,844.75 | $2,635.36 | 2.9× |
| Lung perfusion differential (78597) | $1,414.50 | $2,020.72 | 3.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,103.19 | $3,004.56 | 3.3× |
| Lung Ventilation Imaging (78579) | $1,211.64 | $1,730.91 | 2.6× |
| Lymph System Imaging (78195) | $1,613.85 | $2,305.50 | 2.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,585.09 | $2,264.41 | 0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,291.40 | $1,844.86 | 1.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,346.04 | $3,351.48 | 0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,130.88 | $1,615.54 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $2,011.25 | $2,873.21 | 7.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $1,302.69 | $1,860.98 | 6.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $1,157.74 | $1,653.91 | 1.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $2,689.11 | $3,841.58 | 13.2× |
| Magnetic Resonance Elastography (76391) | $831.10 | $1,187.28 | 3.0× |
| Mammary ductogram or galactogram multiple (77054) | $623.74 | $891.05 | 2.3× |
| Mammary ductogram or galactogram single (77053) | $474.39 | $677.70 | 1.7× |
| Meckels Divert Exam (78290) | $1,235.58 | $1,765.11 | 2.7× |
| Medical physics dose eval radiation expos w/rprt (76145) | $487.50 | $696.43 | 1.1× |
| Mlc imrt design & construction per imrt plan (77338) | $5,614.09 | $8,020.13 | 12.9× |
| Mr safety determination physician/other qhp (76016) | $1,860.28 | $2,657.54 | 18.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $89.33 | $127.62 | 2.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $95.44 | $136.35 | 0.9× |
| Mr safety implt pos&/immoblj (76019) | $90.62 | $129.45 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $604.80 | $864 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,256.42 | $3,223.46 | 5.6× |
| MRA head w/o contrast (70544) | $1,685.03 | $2,407.18 | 6.1× |
| MRA head with contrast (70545) | $1,488.91 | $2,127.01 | 3.7× |
| MRA neck w contrast (70548) | $1,608.81 | $2,298.30 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,411.78 | $3,445.40 | 6.0× |
| MRA neck w/o contrast (70547) | $1,820 | $2,600 | 6.6× |
| MRI abdomen w contrast (74182) | $3,040.56 | $4,343.66 | 7.5× |
| MRI abdomen w/o contrast (74181) | $2,193.96 | $3,134.23 | 7.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,810.14–$2,715.20 | $2,585.91–$3,878.86 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,486.41–$3,729.63 | $3,552.02–$5,328.04 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,001.53–$3,002.30 | $2,859.33–$4,289 | varies |
| MRI bone marrow blood supply (77084) | $1,402.13 | $2,003.04 | 5.1× |
| MRI brain functional w/o physician admnistration (70554) range across 2 matching MRF lines |
$2,013.05–$3,019.58 | $2,875.78–$4,313.68 | varies |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$1,601.60–$2,402.40 | $2,288–$3,432 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,687.05 | $3,838.64 | 9.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,594.76 | $3,706.80 | 9.4× |
| MRI cardiac w/o cont stress (75559) | $1,272.35 | $1,817.64 | 2.0× |
| MRI cardiac w/o contrast (75557) | $1,397.82 | $1,996.89 | 5.1× |
| MRI cervical spine w contrast (72142) | $2,212.60 | $3,160.85 | 5.5× |
| MRI cervical spine w/o cont (72141) | $2,158.42 | $3,083.45 | 7.8× |
| MRI chest w/o contrast (71550) | $1,672.22 | $2,388.88 | 6.1× |
| MRI chest with contrast (71551) | $1,345.32 | $1,921.89 | 1.5× |
| MRI chest wo w contrast (71552) | $1,691.23 | $2,416.04 | 4.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,200.77–$3,301.16 | $3,143.96–$4,715.94 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,534.22–$3,801.33 | $3,620.31–$5,430.47 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,183.39–$3,275.08 | $3,119.13–$4,678.69 | varies |
| MRI lumbar spine w contrast (72149) | $2,306.27 | $3,294.67 | 5.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,478.21 | $3,540.30 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,258.26 | $3,226.08 | 8.2× |
| MRI orbit face neck w contrast (70542) | $1,972.15 | $2,817.36 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,441.28 | $3,487.54 | 6.0× |
| MRI pelvis w contrast (72196) | $1,592.32 | $2,274.74 | 3.9× |
| MRI pelvis w/o & w contrast (72197) | $2,001.85 | $2,859.78 | 5.0× |
| MRI pelvis w/o contrast (72195) | $1,648.92 | $2,355.60 | 6.0× |
| MRI spectroscopy (76390) | $1,624.75 | $2,321.07 | 16.1× |
| MRI thoracic spine w/o contrast (72146) | $2,040.86 | $2,915.52 | 7.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,596.03–$2,394.04 | $2,280.04–$3,420.06 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,992.54–$2,988.80 | $2,846.48–$4,269.72 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,922.99–$2,884.49 | $2,747.13–$4,120.70 | varies |
| MRI, abdomen, combo (74183) | $3,233.68 | $4,619.54 | 8.0× |
| MRI, dorsal spine combo (72157) | $2,690.06 | $3,842.95 | 6.7× |
| MRI, dorsal spine contrast (72147) | $2,375.60 | $3,393.71 | 5.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,181.30–$3,271.95 | $3,116.14–$4,674.22 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,354.06–$3,531.10 | $3,362.95–$5,044.43 | varies |
| MRI, lumbar spine combo (72158) | $2,630.37 | $3,757.67 | 6.5× |
| Myelogram cervical (72240) | $2,061.65 | $2,945.21 | 2.3× |
| Myelogram Lumbar (72265) | $1,549.91 | $2,214.16 | 1.7× |
| Myelography thoracic (72255) | $1,393.41 | $1,990.58 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,663.48 | $2,376.40 | 1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,361.66 | $6,230.95 | 2.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,163.93 | $3,091.33 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $2,691.55 | $3,845.07 | 1.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,419.69 | $6,313.84 | 2.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,625.49 | $5,179.27 | 2.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,169.80 | $5,956.85 | 1.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $2,924.43 | $4,177.76 | 1.1× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $2,840.84 | $4,058.35 | 1.6× |
| N-invas est c ffr sw aly CTA (75580) | $4,647.33 | $6,639.04 | 4.7× |
| Neck soft tissue (70360) | $282.46 | $403.52 | 2.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $693.06 | $990.08 | 1.5× |
| Nm csf leak detection (78650) | $1,085.41 | $1,550.58 | 0.7× |
| Nm red cell survival study (78130) | $820.29 | $1,171.84 | 1.8× |
| Nm whole blood volume (78122) | $1,952.54 | $2,789.34 | 3.1× |
| Nonvascular Shunt X-Ray (75809) | $526.34 | $751.92 | 4.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,847.11 | $11,210.16 | 4.9× |
| Nuclear Rx Intra-Arterial (79445) | $719.26 | $1,027.52 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $1,339.23 | $1,913.19 | 5.0× |
| Ob us nuchal meas 1 gest (76813) | $444.08 | $634.40 | 3.7× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $324.76 | $463.94 | 2.7× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$396.94–$595.40 | $567.05–$850.57 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $288.29 | $411.84 | 2.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$259.17–$388.75 | $370.24–$555.36 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $58.54 | $83.63 | 1.7× |
| Optic foramina (70190) range across 2 matching MRF lines |
$188.08–$282.11 | $268.68–$403.02 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,562.04 | $2,231.49 | 2.5× |
| Parathyroid Planar Imaging (78070) | $1,247.50 | $1,782.14 | 2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,247.55 | $1,782.22 | 2.7× |
| Pelvis 1 or 2 views (72170) | $388.16 | $554.51 | 3.2× |
| Perineogram (74775) | $609.70 | $871 | 2.2× |
| Peritoneogram Rs&I (74190) | $1,064.34 | $1,520.48 | 1.7× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$303.06–$3,030.68 | $432.95–$4,329.54 | varies |
| Pet Image W/Ct Lmtd (78814) | $5,192.10 | $7,417.28 | 3.1× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$3,008.70–$6,017.40 | $4,298.15–$8,596.28 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,223.95 | $7,462.78 | 3.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,835.41 | $5,479.16 | 2.6× |
| Pet Myocardial Sngl Study (78491) | $1,912.39 | $2,731.99 | 1.2× |
| PET whole body (78813) range across 2 matching MRF lines |
$1,783.35–$3,566.69 | $2,547.64–$5,095.27 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $3,172.02 | $4,531.45 | 2.1× |
| Proton tx delivery complex (77525) | $8,824.03 | $12,605.76 | 6.1× |
| Proton tx delivery intermediate (77523) | $3,968.57 | $5,669.38 | 2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,138.34 | $4,483.34 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,192.29 | $1,703.27 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $498.20 | $711.72 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,200.98 | $1,715.69 | 1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$279.01–$418.52 | $398.59–$597.88 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$216.31–$324.46 | $309.02–$463.52 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$265.90–$398.84 | $379.85–$569.77 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $348.10 | $497.28 | 2.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$331.08–$496.62 | $472.97–$709.46 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$308.83–$463.24 | $441.18–$661.77 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$363.74–$545.61 | $519.63–$779.44 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$199.62–$299.43 | $285.17–$427.76 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$404.67–$607 | $578.10–$867.15 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $289.38 | $413.40 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $242.89 | $346.99 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$193.34–$290.01 | $276.20–$414.30 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $288.29 | $411.84 | 2.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,305.86 | $1,865.52 | 6.4× |
| Radex Spine 1 View Specify Level (72020) | $255.77 | $365.38 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $279.55 | $399.36 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $289.93 | $414.19 | 2.9× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$290.17–$435.26 | $414.53–$621.80 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$196.73–$295.09 | $281.04–$421.56 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$333.02–$499.53 | $475.74–$713.61 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $377.51 | $539.30 | 3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $22,872.30 | $32,674.72 | 2.7× |
| Radiation treatment delivery level 1 (77402) | $503.85 | $719.79 | 4.3× |
| Radiation treatment delivery level 2 (77407) | $586.24 | $837.49 | 1.3× |
| Radiation treatment delivery level 3 (77412) | $937.20 | $1,338.85 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $238.43 | $340.61 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $420.58 | $600.83 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $1,083.68 | $1,548.12 | 5.3× |
| Radiologic exam colon single contrast study (74270) | $696.48 | $994.97 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $689.96 | $985.65 | 3.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$311.84–$467.75 | $445.48–$668.21 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $409.98 | $585.69 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $625.06 | $892.94 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $768 | $1,097.14 | 3.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $717.54 | $1,025.06 | 3.5× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$274.83–$412.24 | $392.61–$588.91 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$250–$375 | $357.14–$535.71 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$322.75–$484.12 | $461.07–$691.60 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $427.81 | $611.16 | 3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $141.05 | $201.50 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$330.16–$495.24 | $471.66–$707.49 | varies |
| Radiopharm Dacryocystography (78660) | $644.71 | $921.02 | 1.4× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $1,259.96 | $1,799.95 | 4.7× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,259.96 | $1,799.95 | 4.7× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $2,831.79 | $4,045.42 | 4.5× |
| Renal Cyst Study (74470) | $750.23 | $1,071.76 | 1.2× |
| Ribs bilateral 3 views (71110) | $387.82 | $554.03 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,150.97 | $1,644.24 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,256.09 | $1,794.41 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,644.86 | $6,635.51 | 7.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,387.93 | $1,982.76 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,514.11 | $5,020.16 | 5.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $5,867.27 | $8,381.81 | 3.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $7,755.88 | $11,079.83 | 4.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,600.46 | $6,572.09 | 3.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $565.33 | $807.62 | 2.1× |
| Rp Therapy Intravenous Administration (79101) | $889.76 | $1,271.09 | 3.3× |
| Salivary Gland Function Study (78232) | $895.53 | $1,279.33 | 1.9× |
| Salivary Gland Imaging Serial Images (78231) | $590.99 | $844.27 | 1.3× |
| Scapula (73010) range across 2 matching MRF lines |
$342.16–$513.24 | $488.80–$733.20 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $72.61 | $103.73 | 3.1× |
| Sella turcica (70240) | $154.44 | $220.63 | 1.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$231.94–$347.91 | $331.34–$497.02 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$996.63–$1,494.95 | $1,423.76–$2,135.64 | varies |
| Sialogram (70390) | $566.48 | $809.25 | 2.1× |
| Skull less than 4 views (70250) | $330.22 | $471.74 | 2.7× |
| Special dosimetry (77331) | $461.26 | $658.94 | 3.0× |
| Special Physics Consult (77370) | $864.63 | $1,235.18 | 5.6× |
| Special teletherapy port plan (77321) | $1,245.61 | $1,779.44 | 2.9× |
| Special treatment procedure (77470) | $2,646.35 | $3,780.50 | 4.1× |
| Speech evaluation, complex (70371) | $680.62 | $972.32 | 2.5× |
| Srs Multisource (77371) | $75,161.07 | $107,372.96 | 8.8× |
| Stereotactic Body Radiation Delivery (77373) | $8,794.87 | $12,564.10 | 4.2× |
| Sternoclavicular joints (71130) | $294.84 | $421.20 | 2.9× |
| Superior sagittal sinus venogram (75870) | $2,774.41 | $3,963.44 | 0.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $222.11 | $317.30 | 2.2× |
| Tbs technical calculation only (77091) | $169.04 | $241.49 | 1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,305.84 | $3,294.06 | 5.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,277.64 | $1,825.20 | 2.9× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$521.30–$781.95 | $744.71–$1,117.07 | varies |
| Testicular Imaging W/Flow (78761) | $919.25 | $1,313.21 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,611.30 | $2,301.86 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,474.85 | $2,106.93 | 3.4× |
| Ther rad simulaj-aided field setting simple (77280) | $932.35 | $1,331.93 | 6.0× |
| Thoracic spine 2 views (72070) | $359.91 | $514.16 | 3.0× |
| Thoracic spine 3 views (72072) | $334.39 | $477.70 | 2.8× |
| Thoracolumbar 2 views (72080) | $255.96 | $365.66 | 2.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,025.16 | $1,464.51 | 2.2× |
| Thyroid Imaging With Vascular Flow (78013) | $908.54 | $1,297.92 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,458.60 | $2,083.71 | 2.3× |
| Thyroid Uptake Measurement (78012) | $575.69 | $822.41 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,078.17 | $1,540.24 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $1,723.12 | $2,461.60 | 4.0× |
| Tx devices design & construction intermediate (77333) | $1,136.51 | $1,623.58 | 7.3× |
| Tx devices design & construction simple (77332) | $760.98 | $1,087.12 | 4.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$413.72–$620.58 | $591.03–$886.54 | varies |
| Ultrasound elastography first target lesion (76982) | $148.33 | $211.90 | 1.2× |
| Ultrasound Elastography Parenchyma (76981) | $422.48 | $603.54 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) | $450.63 | $643.76 | 3.7× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $647.92 | $925.60 | 1.6× |
| Ultrasound, abdomen limited (76705) | $601.30 | $859 | 5.0× |
| Umbilical-artery Doppler (OB) (76820) | $367.64 | $525.20 | 3.0× |
| Unlis px ther radiol clinical tx planning (77299) | $364.34 | $520.49 | 2.3× |
| Unlisted Dx Radiographic Procedure (76499) | $539.50 | $770.72 | 5.4× |
| Unlisted fluoroscopic procedure (76496) range across 3 matching MRF lines |
$2,136.83–$4,689.20 | $3,052.62–$6,698.86 | varies |
| Unlisted magnetic resonance procedure (76498) range across 5 matching MRF lines |
$692.42–$5,525.79 | $989.17–$7,893.98 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) range across 4 matching MRF lines |
$203.66–$509.28 | $290.94–$727.54 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $251.62 | $359.45 | 2.1× |
| Unlisted us procedure (76999) range across 5 matching MRF lines |
$192.78–$448.11 | $275.40–$640.16 | varies |
| Upper gi w/o kub (74240) | $671.93 | $959.90 | 3.3× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $202.02 | $288.60 | 18.3× |
| Urea breath test c-14 isotopic analysis (78268) | $245.86 | $351.23 | 2.6× |
| Ureteral Reflux Study (78740) | $800.82 | $1,144.03 | 1.7× |
| Urethrocystogram voiding (74455) | $908.31 | $1,297.59 | 3.3× |
| Urethrocystography retrograde (74450) | $833.20 | $1,190.29 | 3.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$404.54–$606.81 | $577.91–$866.87 | varies |
| Us chest (76604) | $505.96 | $722.80 | 4.2× |
| Us complete joint (76881) | $439.22 | $627.45 | 3.6× |
| Us exam, pelvic, limited (76857) | $474.81 | $678.30 | 3.9× |
| Us head (76506) | $478 | $682.85 | 3.9× |
| Us kidney transplant (76776) | $640.54 | $915.06 | 5.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $395.80 | $565.43 | 3.3× |
| Us ob detailed single fetus (76811) | $757.12 | $1,081.60 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $403.16 | $575.95 | 3.3× |
| Us ob transvaginal (76817) | $683.59 | $976.56 | 5.6× |
| Us pelvic non ob complete (76856) | $534.18 | $763.11 | 4.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $679.59 | $970.84 | 5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $443.49 | $633.56 | 3.7× |
| Us retroperitoneal complete (76770) | $645.21 | $921.73 | 5.3× |
| Us retroperitoneal limited (76775) | $514.36 | $734.80 | 4.2× |
| Us scrotum and contents (76870) | $703.98 | $1,005.68 | 5.8× |
| Us spinal canal and contents (76800) | $330.88 | $472.68 | 2.7× |
| Us thyroid (76536) | $679.22 | $970.32 | 5.6× |
| Us transrectal (76872) | $276.23 | $394.61 | 2.3× |
| Vascular Flow Imaging (78445) | $732.52 | $1,046.45 | 1.6× |
| Vein X-Ray Chest (75827) | $2,540.72 | $3,629.60 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,582.22 | $3,688.88 | 0.7× |
| Vein X-Ray Skull Epidural (75872) | $3,302.21 | $4,717.44 | 4.5× |
| Vein X-Ray Spleen/Liver (75810) | $2,604.20 | $3,720.29 | 0.7× |
| Venogram Sinus/Jugular (75860) | $3,373.10 | $4,818.72 | 0.9× |
| Venography Adrenal Unilateral (75840) | $4,829.93 | $6,899.90 | 1.3× |
| Venography caval inferior serialography rs&i (75825) | $4,497.58 | $6,425.12 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $2,169.43 | $3,099.18 | 1.2× |
| Venography extremity unilateral rs&i (75820) | $2,138.14 | $3,054.48 | 1.2× |
| Venography Orbital Rs&I (75880) | $1,453.33 | $2,076.18 | 2.0× |
| Venography Renal Bilateral (75833) | $5,231.82 | $7,474.03 | 1.4× |
| Venography Renal Unilateral (75831) | $4,746.16 | $6,780.23 | 1.3× |
| Venous sampling by catheter (75893) | $6,467.55 | $9,239.36 | 1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,121.25 | $1,601.79 | 2.4× |
| Vertebral fracture assessment via dxa (77086) | $196.56 | $280.80 | 2.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$362.92–$544.38 | $518.46–$777.69 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $288.29 | $411.84 | 2.9× |
| X-ray antegrade pyelogram tube (74425) | $780.42 | $1,114.88 | 1.9× |
| X-Ray Aorta Leg Arteries (75630) | $6,779.39 | $9,684.84 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) | $353.08 | $504.40 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$323.64–$485.46 | $462.35–$693.52 | varies |
| X-Ray Exam Breast Specimen (76098) | $856.54 | $1,223.63 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $196.78 | $281.12 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $267.25 | $381.78 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $313.96 | $448.52 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $321.52 | $459.32 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $367.02 | $524.31 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $456.81 | $652.59 | 3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $366.44 | $523.48 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $353.89 | $505.56 | 2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $412.29 | $588.99 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $591.61 | $845.16 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $379.45 | $542.07 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $467.20 | $667.43 | 3.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $204.10 | $291.57 | 1.7× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$347.98–$521.98 | $497.12–$745.68 | varies |
| X-ray humerus (73060) | $345.98 | $494.25 | 3.4× |
| X-ray IV pyelogram (ivp) (74400) | $1,151.72 | $1,645.31 | 5.7× |
| X-ray IV pyelogram+tomography (74415) | $1,079.11 | $1,541.59 | 5.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $298.32 | $426.17 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $151.91 | $217.01 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $355.94 | $508.48 | 2.9× |
| X-ray nose-rectum child f.b. (76010) | $289.68 | $413.83 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $357.26 | $510.37 | 3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $236.20 | $337.43 | 2.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $279.55 | $399.36 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $251.37 | $359.10 | 2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $245.07 | $350.10 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $292.29 | $417.56 | 2.4× |
| X-Ray Stress View (77071) | $174.38 | $249.12 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $384.10 | $548.71 | 3.2× |
| X-Ray Tmj Unilat (70328) | $240.60 | $343.72 | 2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,340.98 | $1,915.68 | 3.3× |
| X-Rays Bone Length Studies (77073) | $351.55 | $502.21 | 2.9× |
| X-Rays Bone Survey Complete (77075) | $522.61 | $746.58 | 4.3× |
| Xr c-spine 4 or 5 views (72050) | $387.43 | $553.47 | 3.2× |
| Xr facial bones less than 3 views (70140) | $302.85 | $432.64 | 3.0× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$260.62–$390.94 | $372.32–$558.48 | varies |
| Xr orbits complete 4 views (70200) | $304.68 | $435.25 | 2.5× |
| Xr Tomogram Single Plane (76100) | $436.02 | $622.89 | 3.6× |
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.