Imaging prices at University of WI Hospitals & Clinics Authority
Madison, WI · every code in this section with a posted price and a Medicare benchmark.
378 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) | $5,362.20 | $8,937 | 4.0× |
| Abdomen 1 View (74018) | $237.60 | $396 | 2.8× |
| Abdomen 2 views (74019) | $286.20 | $477 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,117.20 | $1,862 | 2.9× |
| Angio internal mammary (75756) | $3,153 | $5,255 | 1.0× |
| Angio pulmonary bilat (75743) | $3,912.60 | $6,521 | 1.3× |
| Angiography extremity bilateral rs&i (75716) | $4,526.40 | $7,544 | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $3,563.40 | $5,939 | 1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,218 | $7,030 | 1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,389.20 | $3,982 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$276–$552 | $460–$920 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,940.20 | $6,567 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,284 | $7,140 | 1.4× |
| Artery X-Rays Abdomen (75726) | $4,545 | $7,575 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $2,603.40 | $4,339 | 0.8× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$4,192.80–$8,385.60 | $6,988–$13,976 | varies |
| Artery X-Rays Spine (75705) | $4,786.80 | $7,978 | 0.9× |
| Arthrogram hip (73525) | $818.40 | $1,364 | 2.4× |
| Basic radiation dosimetry calculation (77300) | $618.60 | $1,031 | 4.7× |
| Bone age studies (77072) | $316.20 | $527 | 3.1× |
| Bone Imaging 3 Phase (78315) | $1,548 | $2,580 | 4.0× |
| Bone Imaging Limited Area (78300) | $679.20 | $1,132 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,350 | $2,250 | 3.5× |
| Bone survey infant (77076) | $887.40 | $1,479 | 8.7× |
| Brachytx isodose intermed (77317) | $2,442 | $4,070 | 6.7× |
| Brachytx Isodose Plan Simple (77316) | $2,281.20 | $3,802 | 6.3× |
| Brain Flow Imaging Only (78610) | $667.20 | $1,112 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,677.20 | $9,462 | 4.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,260.40 | $5,434 | 9.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,465.60 | $5,776 | 4.6× |
| Cardiac Shunt Detection (78428) | $391.20 | $652 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $764.40 | $1,274 | 9.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,004.40 | $1,674 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $836.40 | $1,394 | 1.6× |
| Chest 1 view (71045) | $220.80 | $368 | 2.6× |
| Chest 2 views (71046) | $293.40 | $489 | 3.5× |
| Chest 3 views (71047) | $384.60 | $641 | 4.5× |
| Chest 4 or more views (71048) | $406.80 | $678 | 4.0× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $1,236.60 | $2,061 | 12.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$295.80–$591.60 | $493–$986 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $96.60 | $161 | 1.0× |
| Continuing medical physics consltj pr wk (77336) | $729 | $1,215 | 5.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,918 | $6,530 | 1.3× |
| Contrast X-Ray Bladder (74430) | $685.20 | $1,142 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $4,296 | $7,160 | 12.7× |
| CT abdomen and pelvis without contrast (74176) | $3,023.40 | $5,039 | 13.0× |
| CT abdomen w contrast (74160) | $2,126.40 | $3,544 | 12.5× |
| CT abdomen w wo contrast (74170) | $2,503.80 | $4,173 | 14.7× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,675.80–$1,785.60 | $2,793–$2,976 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,678 | $6,130 | 10.9× |
| CT Angio Chest (71275) | $2,361.60 | $3,936 | 13.9× |
| CT Angio Head (70496) | $2,307 | $3,845 | 13.5× |
| CT angio hrt w/3d image (75574) | $2,395.80 | $3,993 | 7.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,201.40–$4,402.80 | $3,669–$7,338 | varies |
| CT Angio Neck (70498) | $2,336.40 | $3,894 | 13.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,112 | $3,520 | 12.4× |
| CT bone density (77078) | $369.60 | $616 | 4.4× |
| CT cervical spine w/ contrast (72126) | $2,001 | $3,335 | 5.9× |
| CT cervical spine w/o contrast (72125) | $1,671 | $2,785 | 16.5× |
| CT cervical spine w/wo cont (72127) | $2,545.80 | $4,243 | 14.9× |
| CT chest w contrast (71260) | $1,995 | $3,325 | 11.7× |
| CT chest w/wo contrast (71270) | $2,335.20 | $3,892 | 13.7× |
| CT colonography screening (74263) | $1,404 | $2,340 | 6.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,046 | $3,410 | 12.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,396.20 | $2,327 | 13.7× |
| CT head/brain with contrast (70460) | $1,689.60 | $2,816 | 9.9× |
| CT head/brain without and with contrast (70470) | $2,065.20 | $3,442 | 12.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,449.60 | $2,416 | 4.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $109 | $181.67 | 1.3× |
| CT hrt w/3d image congen (75573) | $1,451.40 | $2,419 | 4.3× |
| CT iac w contrast (70481) | $2,011.20 | $3,352 | 11.8× |
| CT l-spine w&w/o contrast (72133) | $2,830.80 | $4,718 | 16.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,606.80–$3,213.60 | $2,678–$5,356 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,846.20–$3,692.40 | $3,077–$6,154 | varies |
| CT lumbar spine w contrast (72132) | $2,010.60 | $3,351 | 5.9× |
| CT lumbar spine w/o contrast (72131) | $1,758.60 | $2,931 | 17.3× |
| CT maxillofacial w contrast (70487) | $1,963.80 | $3,273 | 11.5× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,512.60–$1,923 | $2,521–$3,205 | varies |
| CT neck tissue combo (70492) | $2,332.20 | $3,887 | 13.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,525.40 | $4,209 | 14.8× |
| CT orbits w/o contrast (70480) | $1,737.60 | $2,896 | 17.1× |
| CT pelvis w&w/o contrast (72194) | $2,325 | $3,875 | 13.6× |
| CT pelvis w/o contrast (72192) | $1,488 | $2,480 | 14.7× |
| CT scan of leg combo (73702) | $1,879.80 | $3,133 | 11.0× |
| CT scans face/jaw combo (70488) | $2,974.20 | $4,957 | 17.5× |
| CT soft tissue neck w contrast (70491) | $1,838.40 | $3,064 | 10.8× |
| CT soft tissue neck w/o contrast (70490) | $1,745.40 | $2,909 | 17.2× |
| CT thoracic spine w contrast (72129) | $1,774.80 | $2,958 | 10.4× |
| CT thoracic spine w/o contrast (72128) | $1,590.60 | $2,651 | 15.7× |
| CT thoracic spine w/wo cont (72130) | $2,846.40 | $4,744 | 16.7× |
| CT thorax w/o contrast (71250) | $1,660.20 | $2,767 | 16.3× |
| CT unlisted procedure (76497) range across 4 matching MRF lines |
$273.60–$1,111.20 | $456–$1,852 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,659.60–$3,319.20 | $2,766–$5,532 | varies |
| CT upper extremity with contrast (73201) | $2,016 | $3,360 | 5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,249.40 | $3,749 | 13.2× |
| Cta Abdomen (74175) | $2,484.60 | $4,141 | 14.6× |
| CTA pelvis (72191) | $2,714.40 | $4,524 | 15.9× |
| Dilation ureters/urethra rs&i (74485) | $1,533 | $2,555 | 0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $516 | $860 | 5.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $669 | $1,115 | 6.6× |
| Dxa Bone Density Axial (77080) | $429.60 | $716 | 4.2× |
| Dxa bone density study (77085) | $438 | $730 | 4.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $204 | $340 | 2.4× |
| Echo exam of fetal heart (76825) | $1,423.80 | $2,373 | 2.7× |
| Echo exam uterus (76831) | $827.40 | $1,379 | 3.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $907.20 | $1,512 | 3.9× |
| Echograp Trans R Pros Study (76873) | $689.40 | $1,149 | 6.8× |
| Esophagram (74220) | $585 | $975 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $756.60 | $1,261 | 7.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $156.60 | $261 | 1.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $3,059.40 | $5,099 | 13.2× |
| Fluoroscopy up to 1 hr (76000) | $604.20 | $1,007 | 2.6× |
| Follow-Up Angiography (75898) | $1,888.80 | $3,148 | 0.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$280.80–$561.60 | $468–$936 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$272.40–$544.80 | $454–$908 | varies |
| Gastric emptying imaging study (78264) | $1,586.40 | $2,644 | 4.1× |
| Gated Heart Planar Single (78472) | $1,412.40 | $2,354 | 3.6× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$208.80–$492 | $348–$820 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,616 | $9,360 | 8.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,616 | $9,360 | 8.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,254 | $7,090 | 6.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,085 | $8,475 | 1.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,035 | $6,725 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,453.20 | $2,422 | 2.8× |
| Hepatobiliary System Imaging (78226) | $966.60 | $1,611 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $3,323.40 | $5,539 | 2.6× |
| Hysterosalpingogram (74740) | $1,034.40 | $1,724 | 4.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $487.20 | $812 | 5.8× |
| Infant hip ultrasound, limited static exam (76886) | $346.80 | $578 | 4.1× |
| K Flow/Funct Image W/Drug (78708) | $1,882.20 | $3,137 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,257 | $2,095 | 2.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $880.20 | $1,467 | 2.3× |
| Kidney Imaging Morphol (78700) | $799.20 | $1,332 | 2.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$349.80–$699.60 | $583–$1,166 | varies |
| Liver imaging static only (78201) | $2,141.40 | $3,569 | 4.1× |
| Lung perfusion differential (78597) | $1,125 | $1,875 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,275 | $2,125 | 2.4× |
| Lymph System Imaging (78195) | $1,722.60 | $2,871 | 3.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,206.60 | $2,011 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $492.60 | $821 | 0.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,188.20 | $3,647 | 0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,970.40 | $3,284 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $2,304.60 | $3,841 | 9.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $4,228.80 | $7,048 | 24.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $3,490.20 | $5,817 | 6.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $5,128.20 | $8,547 | 30.1× |
| Magnetic Resonance Elastography (76391) | $1,286.40 | $2,144 | 5.6× |
| Meckels Divert Exam (78290) | $948.60 | $1,581 | 2.4× |
| Mlc imrt design & construction per imrt plan (77338) | $2,251.20 | $3,752 | 6.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,359.40 | $5,599 | 9.9× |
| MRA head w/o contrast (70544) | $2,431.20 | $4,052 | 10.5× |
| MRA head with contrast (70545) | $2,982 | $4,970 | 8.8× |
| MRA neck w contrast (70548) | $2,800.80 | $4,668 | 8.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,268.80 | $5,448 | 9.6× |
| MRA neck w/o contrast (70547) | $2,223 | $3,705 | 9.6× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$1,351.20–$2,690.40 | $2,252–$4,484 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,680.40–$7,360.80 | $6,134–$12,268 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,389.40–$6,778.80 | $5,649–$11,298 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,169.80 | $5,283 | 4.2× |
| MRI brain functional w/o physician admnistration (70554) | $2,688.60 | $4,481 | 11.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,655.80 | $6,093 | 15.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,324.40 | $3,874 | 10.0× |
| MRI cardiac w/o contrast (75557) | $2,169 | $3,615 | 9.4× |
| MRI cervical spine w contrast (72142) | $3,639.60 | $6,066 | 10.7× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,086.80–$2,684.40 | $3,478–$4,474 | varies |
| MRI chest w/o contrast (71550) | $2,967.60 | $4,946 | 12.8× |
| MRI chest wo w contrast (71552) | $3,300 | $5,500 | 9.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,619.60 | $4,366 | 7.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,382.20–$6,764.40 | $5,637–$11,274 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,331.60–$5,233.20 | $3,886–$8,722 | varies |
| MRI lumbar spine w contrast (72149) | $3,224.40 | $5,374 | 9.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,893.40 | $6,489 | 11.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,904.60 | $4,841 | 12.5× |
| MRI orbit face neck w contrast (70542) | $3,108 | $5,180 | 9.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,727.20 | $6,212 | 11.0× |
| MRI pelvis w contrast (72196) | $2,794.20 | $4,657 | 8.2× |
| MRI pelvis w/o & w contrast (72197) | $3,602.40 | $6,004 | 10.6× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,351.20–$2,703.60 | $2,252–$4,506 | varies |
| MRI spectroscopy (76390) | $2,037 | $3,395 | 24.1× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,262–$2,757.60 | $3,770–$4,596 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,321.40–$4,642.80 | $3,869–$7,738 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,128.40–$6,256.80 | $5,214–$10,428 | varies |
| MRI, abdomen, combo (74183) | $3,463.20 | $5,772 | 10.2× |
| MRI, dorsal spine combo (72157) | $3,753 | $6,255 | 11.1× |
| MRI, dorsal spine contrast (72147) | $3,255.60 | $5,426 | 9.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,564.40–$5,128.80 | $4,274–$8,548 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,328.80–$6,657.60 | $5,548–$11,096 | varies |
| MRI, lumbar spine combo (72158) | $3,608.40 | $6,014 | 10.6× |
| Myelogram cervical (72240) | $1,228.80 | $2,048 | 1.6× |
| Myelogram Lumbar (72265) | $1,137.60 | $1,896 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,504.80 | $2,508 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $3,196.20 | $5,327 | 2.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,682.80 | $6,138 | 2.7× |
| Neck soft tissue (70360) | $282 | $470 | 3.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $278.40 | $464 | 0.7× |
| Nm csf leak detection (78650) | $1,920 | $3,200 | 1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,962.20 | $14,937 | 6.7× |
| Nuclear Rx Intra-Arterial (79445) | $1,490.40 | $2,484 | 6.6× |
| Nuclear Rx Oral Admin (79005) | $865.20 | $1,442 | 3.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $302.40 | $504 | 3.0× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 3 matching MRF lines |
$343.20–$686.40 | $572–$1,144 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 3 matching MRF lines |
$565.80–$1,131.60 | $943–$1,886 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $251.40 | $419 | 2.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$475.80–$951.60 | $793–$1,586 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $111 | $185 | 4.0× |
| Ophthalmic us dx quantitative a-scan only (76511) range across 3 matching MRF lines |
$300–$600 | $500–$1,000 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,019 | $3,365 | 3.8× |
| Pelvis 1 or 2 views (72170) | $304.20 | $507 | 3.0× |
| Peritoneogram Rs&I (74190) | $488.40 | $814 | 0.9× |
| Pet Image W/Ct Lmtd (78814) | $4,371 | $7,285 | 3.1× |
| PET image w/CT, full body (78816) | $6,149.40 | $10,249 | 4.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,815.20 | $9,692 | 4.2× |
| PET whole body (78813) | $6,109.20 | $10,182 | 4.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,091.60 | $8,486 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,077.60 | $1,796 | 2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $420 | $700 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $641.40 | $1,069 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$331.20–$662.40 | $552–$1,104 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$241.80–$487.20 | $403–$812 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$309–$618 | $515–$1,030 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $459 | $765 | 4.5× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$241.80–$483.60 | $403–$806 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$331.80–$663.60 | $553–$1,106 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$326.40–$652.80 | $544–$1,088 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $231.60 | $386 | 2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $187.80 | $313 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $340.20 | $567 | 4.0× |
| Radex Ribs Unilateral 2 Views (71100) | $331.20 | $552 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$353.40–$706.80 | $589–$1,178 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $223.20 | $372 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $253.20 | $422 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $391.80 | $653 | 4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $276.60 | $461 | 3.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$232.20–$464.40 | $387–$774 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $231.60 | $386 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$301.20–$602.40 | $502–$1,004 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $519.60 | $866 | 5.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,480.40 | $24,134 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $1,102.80 | $1,838 | 11.1× |
| Radiation treatment delivery level 2 (77407) | $4,168.20 | $6,947 | 11.1× |
| Radiation treatment delivery level 3 (77412) | $5,436 | $9,060 | 10.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $418.80 | $698 | 4.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $318 | $530 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $706.20 | $1,177 | 4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $589.20 | $982 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$477.60–$955.20 | $796–$1,592 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $395.40 | $659 | 3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $998.40 | $1,664 | 5.9× |
| Radiologic exam swallow function contrast study (74230) | $540 | $900 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $655.80 | $1,093 | 3.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$269.40–$538.80 | $449–$898 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$322.20–$644.40 | $537–$1,074 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$303.60–$607.20 | $506–$1,012 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $618 | $1,030 | 6.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$296.40–$592.80 | $494–$988 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,316.40 | $2,194 | 3.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,036.80 | $1,728 | 2.8× |
| Renal Cyst Study (74470) | $688.80 | $1,148 | 1.3× |
| Ribs bilateral 3 views (71110) | $541.80 | $903 | 5.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,008 | $1,680 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,133 | $3,555 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,711.80 | $2,853 | 3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,634 | $4,390 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$3,663.60–$5,072.40 | $6,106–$8,454 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$2,517.60–$2,911.20 | $4,196–$4,852 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,105.20–$4,504.80 | $1,842–$7,508 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$296.40–$592.80 | $494–$988 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $66.60 | $111 | 2.8× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$267.60–$535.20 | $446–$892 | varies |
| Skull less than 4 views (70250) | $338.40 | $564 | 3.3× |
| Special dosimetry (77331) | $478.80 | $798 | 3.7× |
| Special Physics Consult (77370) | $906 | $1,510 | 6.9× |
| Special teletherapy port plan (77321) | $1,314.60 | $2,191 | 3.6× |
| Special treatment procedure (77470) | $2,436 | $4,060 | 4.5× |
| Stereotactic Body Radiation Delivery (77373) | $7,899 | $13,165 | 4.5× |
| Sternoclavicular joints (71130) | $349.20 | $582 | 4.1× |
| Superior sagittal sinus venogram (75870) | $2,106.60 | $3,511 | 0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $106.80 | $178 | 1.1× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $58.20 | $97 | 0.7× |
| Tbs technical calculation only (77091) | $82.80 | $138 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,508 | $4,180 | 6.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,560 | $2,600 | 4.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,201.40 | $3,669 | 6.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,152.60 | $1,921 | 8.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,600.20 | $2,667 | 9.4× |
| Thoracic spine 2 views (72070) | $341.40 | $569 | 3.4× |
| Thoracic spine 3 views (72072) | $452.40 | $754 | 4.5× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$285.60–$293.40 | $476–$489 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $480 | $800 | 1.2× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,737–$5,409 | $2,895–$9,015 | varies |
| Thyroid Uptake Measurement (78012) | $607.80 | $1,013 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,327.80 | $2,213 | 3.4× |
| Tx Devices Design & Construction Complex (77334) | $1,503.60 | $2,506 | 4.1× |
| Tx devices design & construction intermediate (77333) | $646.80 | $1,078 | 5.0× |
| Tx devices design & construction simple (77332) | $573 | $955 | 4.4× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$486.60–$973.20 | $811–$1,622 | varies |
| Ultrasound elastography first target lesion (76982) | $301.80 | $503 | 3.0× |
| Ultrasound Elastography Parenchyma (76981) | $301.80 | $503 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $188.40 | $314 | 1.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,037.40 | $1,729 | 3.1× |
| Ultrasound, abdomen limited (76705) | $683.40 | $1,139 | 6.7× |
| Unlisted Dx Radiographic Procedure (76499) | $272.40 | $454 | 3.2× |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$277.80–$327.60 | $463–$546 | varies |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$2,574.60–$4,746 | $4,291–$7,910 | varies |
| Unlisted us procedure (76999) | $510.60 | $851 | 6.0× |
| Upper gi w/o kub (74240) | $663.60 | $1,106 | 3.9× |
| Ureteral Reflux Study (78740) | $945 | $1,575 | 2.4× |
| Urethrocystogram voiding (74455) | $611.40 | $1,019 | 2.6× |
| Urethrocystography retrograde (74450) | $639.60 | $1,066 | 2.8× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$592.80–$1,185.60 | $988–$1,976 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$437.40–$583.20 | $729–$972 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$703.80–$1,407.60 | $1,173–$2,346 | varies |
| Us exam, pelvic, limited (76857) | $500.40 | $834 | 4.9× |
| Us head (76506) | $589.80 | $983 | 5.8× |
| Us kidney transplant (76776) | $726 | $1,210 | 7.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$529.20–$1,058.40 | $882–$1,764 | varies |
| Us ob limited 1 or more fetuses (76815) | $445.80 | $743 | 4.4× |
| Us ob transvaginal (76817) | $454.80 | $758 | 4.5× |
| Us pelvic non ob complete (76856) | $867 | $1,445 | 8.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $531.60 | $886 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $431.40 | $719 | 4.2× |
| Us retroperitoneal complete (76770) | $793.20 | $1,322 | 7.8× |
| Us retroperitoneal limited (76775) | $691.20 | $1,152 | 6.8× |
| Us scrotum and contents (76870) | $721.80 | $1,203 | 7.1× |
| Us spinal canal and contents (76800) | $636.60 | $1,061 | 6.3× |
| Us thyroid (76536) | $694.80 | $1,158 | 6.8× |
| Us transrectal (76872) | $670.20 | $1,117 | 6.6× |
| Vascular Flow Imaging (78445) | $697.80 | $1,163 | 1.8× |
| Vein X-Ray Chest (75827) | $2,402.40 | $4,004 | 1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,179.80 | $3,633 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) | $2,908.80 | $4,848 | 0.9× |
| Venogram Sinus/Jugular (75860) | $3,010.20 | $5,017 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $3,706.80 | $6,178 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,819.80 | $3,033 | 1.2× |
| Venography extremity unilateral rs&i (75820) | $1,577.40 | $2,629 | 1.0× |
| Venography Orbital Rs&I (75880) | $933.60 | $1,556 | 1.5× |
| Venography Renal Bilateral (75833) | $3,676.20 | $6,127 | 1.2× |
| Venography Renal Unilateral (75831) | $3,454.20 | $5,757 | 1.1× |
| Venous sampling by catheter (75893) | $4,608 | $7,680 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $154.80 | $258 | 1.8× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$237.60–$543.60 | $396–$906 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $410.40 | $684 | 4.9× |
| X-ray antegrade pyelogram tube (74425) | $587.40 | $979 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $4,464 | $7,440 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $466.80 | $778 | 4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$255–$510 | $425–$850 | varies |
| X-Ray Exam Breast Specimen (76098) | $510.60 | $851 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $395.40 | $659 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $477.60 | $796 | 4.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $487.20 | $812 | 4.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $300 | $500 | 3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$366.60–$733.20 | $611–$1,222 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $424.20 | $707 | 4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $486.60 | $811 | 4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $477.60 | $796 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $622.80 | $1,038 | 6.1× |
| X-Ray Exam L-S Spine Bending (72114) | $353.40 | $589 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $320.40 | $534 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $429.60 | $716 | 4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $366 | $610 | 3.6× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$279–$558 | $465–$930 | varies |
| X-ray humerus (73060) | $301.20 | $502 | 3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $322.20 | $537 | 3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $264.60 | $441 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $386.40 | $644 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $224.40 | $374 | 2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $349.20 | $582 | 3.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $221.40 | $369 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $367.20 | $612 | 4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $372.60 | $621 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $598.20 | $997 | 5.9× |
| X-ray thoracic spine 4 vw (72074) | $472.20 | $787 | 4.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$759.60–$1,519.20 | $1,266–$2,532 | varies |
| X-Rays Bone Length Studies (77073) | $286.80 | $478 | 2.8× |
| X-Rays Bone Survey Complete (77075) | $802.20 | $1,337 | 7.9× |
| Xr c-spine 4 or 5 views (72050) | $510.60 | $851 | 5.0× |
| Xr facial bones less than 3 views (70140) | $288 | $480 | 3.4× |
| Xr orbits complete 4 views (70200) | $327 | $545 | 3.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.