Imaging prices at UP Health System - Marquette
Marquette, MI · every code in this section with a posted price and a Medicare benchmark.
371 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) | $6,780.36 | $11,300.60 | 4.9× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$237.37–$356.07 | $395.62–$593.45 | varies |
| Abdomen 2 views (74019) | $411.46 | $685.76 | 3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$584.70–$895 | $974.50–$1,491.66 | varies |
| Angio pulmonary bilat (75743) | $5,207.11 | $8,678.52 | 1.7× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$3,816.94–$5,626.84 | $6,361.56–$9,378.07 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$4,846.78–$5,769.97 | $8,077.96–$9,616.61 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,671.95 | $9,453.25 | 1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,058.32 | $1,763.87 | 0.3× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$163.48–$462.60 | $272.47–$771 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,646.91 | $6,078.18 | 0.7× |
| Artery X-Rays Abdomen (75726) | $9,342.62 | $15,571.04 | 1.7× |
| Artery X-Rays Pelvis (75736) | $3,537.20 | $5,895.33 | 0.6× |
| Artery X-Rays Spine (75705) | $3,635.18 | $6,058.64 | 0.7× |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$469.66–$1,237.48 | $782.77–$2,062.46 | varies |
| Arthrogram Wrist (73115) range across 6 matching MRF lines |
$446.33–$928.81 | $743.88–$1,548.01 | varies |
| Basic radiation dosimetry calculation (77300) | $441.97 | $736.62 | 3.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$293.58–$496.57 | $489.30–$827.61 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$961.93–$2,052.66 | $1,603.22–$3,421.10 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$535.48–$910.33 | $892.47–$1,517.21 | varies |
| Bone Imaging Whole Body (78306) | $1,952.39 | $3,253.98 | 4.9× |
| Bone marrow imaging limited area (78102) | $779.14 | $1,298.56 | 2.0× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$506.20–$815.18 | $843.67–$1,358.64 | varies |
| Brain Flow Imaging Only (78610) | $1,440.82 | $2,401.36 | 2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$2,196.90–$4,211.14 | $3,661.50–$7,018.56 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,602.10 | $4,336.83 | 7.5× |
| Cardiac Shunt Detection (78428) | $510.18 | $850.30 | 1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $535.48 | $892.47 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $1,586.18 | $2,643.64 | 2.9× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$115.93–$245.65 | $193.21–$409.42 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$242.96–$481.18 | $404.94–$801.97 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$231.40–$476.75 | $385.66–$794.59 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$472.90–$677.62 | $788.17–$1,129.37 | varies |
| Cholecystography Oral Contrast (74290) | $304.30 | $507.16 | 1.7× |
| Cisternography Positive Contrast Rs&I (70015) | $909.07 | $1,515.12 | 1.2× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$160.65–$462.60 | $267.75–$771 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $460.03 | $766.72 | 4.4× |
| Continuing medical physics consltj pr wk (77336) | $892.65 | $1,487.75 | 6.7× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,619.01–$5,611.76 | $4,365.02–$9,352.94 | varies |
| Contrast X-Ray Bladder (74430) | $754.32 | $1,257.20 | 2.2× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$680.71–$1,150.59 | $1,134.52–$1,917.65 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,735.90 | $4,559.84 | 7.9× |
| CT abdomen and pelvis without contrast (74176) | $2,179.93 | $3,633.22 | 9.2× |
| CT abdomen w contrast (74160) | $2,372.67 | $3,954.45 | 13.6× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,507.42–$3,535.32 | $4,179.03–$5,892.20 | varies |
| CT abdomen w/o contrast (74150) | $2,179.93 | $3,633.22 | 20.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,989.13 | $3,315.22 | 5.7× |
| CT Angio Chest (71275) | $2,345.12 | $3,908.54 | 13.4× |
| CT Angio Head (70496) | $1,359.26 | $2,265.43 | 7.8× |
| CT angio hrt w/3d image (75574) | $1,040.93 | $1,734.89 | 3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,294.53 | $2,157.55 | 7.4× |
| CT Angio Neck (70498) | $1,359.26 | $2,265.43 | 7.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,597.88–$1,944.70 | $2,663.13–$3,241.17 | varies |
| CT cervical spine w/ contrast (72126) | $2,347.06 | $3,911.77 | 6.8× |
| CT cervical spine w/o contrast (72125) | $2,032.60 | $3,387.67 | 19.5× |
| CT cervical spine w/wo cont (72127) | $1,526.87 | $2,544.78 | 8.7× |
| CT chest w contrast (71260) | $2,813.67 | $4,689.45 | 16.1× |
| CT chest w/wo contrast (71270) | $3,040.22 | $5,067.03 | 17.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $727.45 | $1,212.42 | 4.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $751.60 | $1,252.66 | 7.2× |
| CT head/brain with contrast (70460) | $1,743.76 | $2,906.26 | 10.0× |
| CT head/brain without and with contrast (70470) | $3,272.56 | $5,454.26 | 18.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,014.37 | $1,690.61 | 2.9× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$146.69–$309.90 | $244.49–$516.50 | varies |
| CT hrt w/3d image congen (75573) | $945.29 | $1,575.49 | 2.7× |
| CT iac w contrast (70481) | $1,729.74 | $2,882.90 | 9.9× |
| CT l-spine w&w/o contrast (72133) | $2,212.30 | $3,687.16 | 12.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$847.81–$2,027.78 | $1,413.01–$3,379.63 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,661.63–$1,899.77 | $2,769.39–$3,166.28 | varies |
| CT lumbar spine w contrast (72132) | $2,212.30 | $3,687.16 | 6.4× |
| CT lumbar spine w/o contrast (72131) | $2,212.30 | $3,687.16 | 21.2× |
| CT maxillofacial w contrast (70487) | $1,729.74 | $2,882.90 | 9.9× |
| CT maxillofacial wo contrast (70486) | $1,729.74 | $2,882.90 | 16.6× |
| CT neck tissue combo (70492) | $2,343.19 | $3,905.31 | 13.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,535.93 | $4,226.55 | 14.5× |
| CT orbits w/o contrast (70480) | $1,727.33 | $2,878.89 | 16.6× |
| CT pelvis w&w/o contrast (72194) | $3,409.25 | $5,682.09 | 19.5× |
| CT pelvis w/o contrast (72192) | $2,537.87 | $4,229.78 | 24.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,486.30–$2,094.92 | $2,477.16–$3,491.53 | varies |
| CT scans face/jaw combo (70488) | $2,179.93 | $3,633.22 | 12.5× |
| CT soft tissue neck w contrast (70491) | $2,037.92 | $3,396.53 | 11.7× |
| CT soft tissue neck w/o contrast (70490) | $1,378.57 | $2,297.62 | 13.2× |
| CT thoracic spine w contrast (72129) | $2,152.40 | $3,587.33 | 12.3× |
| CT thoracic spine w/o contrast (72128) | $2,440.77 | $4,067.95 | 23.4× |
| CT thoracic spine w/wo cont (72130) | $1,726.37 | $2,877.28 | 9.9× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$945.29–$2,501.64 | $1,575.49–$4,169.40 | varies |
| CT unlisted procedure (76497) | $167.10 | $278.50 | 1.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,805.57–$2,252.88 | $3,009.29–$3,754.80 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,379.54–$1,944.70 | $2,299.23–$3,241.17 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,597.88–$1,944.70 | $2,663.13–$3,241.17 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,294.53 | $2,157.55 | 7.4× |
| Cta Abdomen (74175) | $1,306.61 | $2,177.68 | 7.5× |
| CTA pelvis (72191) | $2,015.69 | $3,359.48 | 11.5× |
| Dilation ureters/urethra rs&i (74485) | $1,550.40 | $2,584 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $2,893.16 | $4,821.93 | 1.5× |
| Diskography lumbar (72295) | $3,118.95 | $5,198.25 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $335.75 | $559.59 | 3.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$472.70–$472.90 | $787.84–$788.17 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$208.53–$415.70 | $347.55–$692.83 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$196.80–$712.59 | $328–$1,187.65 | varies |
| Dxa bone density study (77085) | $1,035.62 | $1,726.04 | 9.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$102–$322.48 | $170–$537.46 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$804.40–$804.60 | $1,340.66–$1,341 | varies |
| Echo exam uterus (76831) | $232.50 | $387.50 | 1.0× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$699.91–$735.13 | $1,166.52–$1,225.21 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $571.09 | $951.82 | 2.4× |
| Esophagram (74220) | $380.14 | $633.57 | 2.2× |
| Fetal Biophys Profile W/Nst (76818) | $282.55 | $470.92 | 2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $851.06 | $1,418.44 | 8.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$841.85–$884.18 | $1,403.09–$1,473.64 | varies |
| Follow-Up Angiography (75898) | $469.51 | $782.52 | 0.1× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$211.57–$436.19 | $352.62–$726.98 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$176.71–$436.19 | $294.52–$726.98 | varies |
| Gastric emptying imaging study (78264) | $1,754.57 | $2,924.28 | 4.4× |
| Gastroesophageal Reflux Exam (78262) | $900.38 | $1,500.64 | 2.3× |
| Gated Heart Planar Single (78472) | $1,186.43 | $1,977.38 | 3.0× |
| Hand 2 views (73120) range across 7 matching MRF lines |
$148.76–$471.53 | $247.94–$785.88 | varies |
| Heart Image (Pet) Multiple (78492) | $6,334.19 | $10,556.99 | 4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,624.54 | $9,374.23 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,048.28 | $6,747.14 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$330.60–$1,197.28 | $551–$1,995.47 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$330.60–$1,197.28 | $551–$1,995.47 | varies |
| Ht Musc Image Planar Mult (78454) | $1,815 | $3,025 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $4,425.50 | $7,375.84 | 3.4× |
| Hysterosalpingogram (74740) | $521.20 | $868.67 | 2.2× |
| Image fusion (77399) | $369.03 | $615.05 | 2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$1,176.67–$1,235.65 | $1,961.12–$2,059.41 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$450.19–$472.90 | $750.31–$788.17 | varies |
| Infusion Ivp (74410) | $466.47 | $777.45 | 2.7× |
| Interstitial radiation source applic complex (77778) | $3,988.84 | $6,648.07 | 5.7× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,645.24 | $2,742.07 | 3.0× |
| Intracavitary radiation source applic simple (77761) | $1,645.24 | $2,742.07 | 3.0× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$527.94–$850.14 | $879.90–$1,416.90 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,183.44 | $1,972.40 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$995.96–$1,095.56 | $1,659.94–$1,825.94 | varies |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$176.71–$415.41 | $294.52–$692.35 | varies |
| Liver & Spleen Imaging Static Only (78215) | $855.20 | $1,425.34 | 2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$471.30–$796.78 | $785.50–$1,327.96 | varies |
| Lung perfusion differential (78597) | $1,832.77 | $3,054.62 | 4.6× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$471.90–$1,247.15 | $786.50–$2,078.58 | varies |
| Lung Ventilation Imaging (78579) | $515.23 | $858.71 | 1.3× |
| Lymph System Imaging (78195) | $1,785.38 | $2,975.63 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $3,720.81 | $6,201.35 | 15.7× |
| Mammary ductogram or galactogram multiple (77054) range across 4 matching MRF lines |
$308.38–$496.39 | $513.97–$827.31 | varies |
| Mammary ductogram or galactogram single (77053) range across 4 matching MRF lines |
$308.38–$496.39 | $513.97–$827.31 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$794.94–$874.44 | $1,324.90–$1,457.40 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $2,741.22 | $4,568.70 | 7.3× |
| Mra Head W/O & W/Contrast Material (70546) | $5,316.28 | $8,860.47 | 15.3× |
| MRA head w/o contrast (70544) | $3,703.41 | $6,172.35 | 15.6× |
| MRA head with contrast (70545) | $2,393.92 | $3,989.86 | 6.9× |
| MRA neck w contrast (70548) | $2,778.41 | $4,630.68 | 8.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,795.80 | $4,659.67 | 8.0× |
| MRA neck w/o contrast (70547) | $2,113.76 | $3,522.93 | 8.9× |
| MRI abdomen w contrast (74182) | $2,716.58 | $4,527.64 | 7.8× |
| MRI abdomen w/o contrast (74181) | $4,266.64 | $7,111.07 | 17.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,009.79–$3,531.94 | $5,016.31–$5,886.57 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$4,682.53–$6,106.52 | $7,804.22–$10,177.54 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,929.60–$3,531.94 | $4,882.67–$5,886.57 | varies |
| MRI brain functional w/o physician admnistration (70554) range across 3 matching MRF lines |
$2,535.93–$3,043.11 | $4,226.55–$5,071.85 | varies |
| MRI cervical spine w contrast (72142) | $4,038.16 | $6,730.27 | 11.6× |
| MRI cervical spine w/o cont (72141) | $3,930.94 | $6,551.56 | 16.5× |
| MRI chest w/o contrast (71550) | $3,275.45 | $5,459.09 | 13.8× |
| MRI chest with contrast (71551) | $3,533.89 | $5,889.82 | 4.5× |
| MRI chest wo w contrast (71552) | $5,153.98 | $8,589.97 | 14.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,505.50–$3,267.25 | $4,175.83–$5,445.41 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$4,330.40–$4,682.53 | $7,217.34–$7,804.22 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,275.45–$4,269.53 | $5,459.09–$7,115.88 | varies |
| MRI lumbar spine w contrast (72149) | $4,673.36 | $7,788.93 | 13.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,659.24 | $9,432.06 | 16.3× |
| MRI orbit face &/neck w/o contrast (70540) | $4,145.88 | $6,909.80 | 17.4× |
| MRI orbit face neck w contrast (70542) | $2,939.74 | $4,899.57 | 8.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,974.29 | $8,290.49 | 14.3× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,158.32–$2,689.04 | $1,930.54–$4,481.73 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,052.66–$5,713.82 | $6,754.44–$9,523.03 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,158.32–$4,266.64 | $1,930.54–$7,111.07 | varies |
| MRI spectroscopy (76390) | $808.60 | $1,347.67 | 9.3× |
| MRI thoracic spine w/o contrast (72146) | $4,298.04 | $7,163.40 | 18.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$2,506.46–$3,533.89 | $4,177.43–$5,889.82 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,322.91–$3,296.70 | $3,871.52–$5,494.50 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$4,430.87–$4,669.97 | $7,384.78–$7,783.29 | varies |
| MRI, abdomen, combo (74183) | $5,553.94 | $9,256.56 | 16.0× |
| MRI, dorsal spine combo (72157) | $5,659.24 | $9,432.06 | 16.3× |
| MRI, dorsal spine contrast (72147) | $2,902.07 | $4,836.78 | 8.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$3,275.45–$4,271.47 | $5,459.09–$7,119.11 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,674.92–$4,669.97 | $6,124.87–$7,783.29 | varies |
| MRI, lumbar spine combo (72158) | $4,935.15 | $8,225.25 | 14.2× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,504.81–$2,673.26 | $2,508.02–$4,455.43 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,504.81–$2,673.26 | $2,508.02–$4,455.43 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$1,504.81–$1,895.80 | $2,508.02–$3,159.66 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$1,504.81–$2,673.26 | $2,508.02–$4,455.43 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,390.90 | $5,651.50 | 2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,815 | $3,025 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $4,498.67 | $7,497.78 | 3.5× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$184.59–$297.17 | $307.65–$495.29 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $634.41 | $1,057.35 | 1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $503.73 | $839.55 | 1.3× |
| Nm csf leak detection (78650) | $800 | $1,333.34 | 0.6× |
| Nm red cell survival study (78130) range across 2 matching MRF lines |
$720–$1,270.75 | $1,200–$2,117.92 | varies |
| Nonvascular Shunt X-Ray (75809) | $408.98 | $681.63 | 3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,424 | $9,040 | 3.9× |
| Nuclear Rx Oral Admin (79005) | $2,306.15 | $3,843.58 | 9.9× |
| Ob us nuchal meas 1 gest (76813) | $363.65 | $606.08 | 3.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$216.90–$640.49 | $361.50–$1,067.49 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,379.29 | $3,965.49 | 4.4× |
| Parathyroid Planar Imaging (78070) | $932.63 | $1,554.38 | 2.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$176.71–$341.15 | $294.52–$568.59 | varies |
| Peritoneogram Rs&I (74190) | $715.81 | $1,193.01 | 1.3× |
| Pet Image Skull-Thigh (78812) | $1,769.10 | $2,948.50 | 1.2× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$1,769.10–$3,191.04 | $2,948.50–$5,318.40 | varies |
| PET image w/CT, full body (78816) range across 5 matching MRF lines |
$1,769.10–$7,288.30 | $2,948.50–$12,147.17 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$1,769.10–$7,288.30 | $2,948.50–$12,147.17 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,818.90 | $3,031.50 | 1.4× |
| Pet Myocardial Sngl Study (78491) range across 2 matching MRF lines |
$1,818.90–$2,657.61 | $3,031.50–$4,429.35 | varies |
| PET whole body (78813) | $2,136.60 | $3,561 | 1.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $720 | $1,200 | 0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $10,135.97 | $16,893.29 | 3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $857.39 | $1,428.98 | 2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $717.47 | $1,195.79 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$176.71–$436.19 | $294.52–$726.98 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$176.71–$436.19 | $294.52–$726.98 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$223.02–$448.25 | $371.70–$747.09 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$269.32–$433.81 | $448.87–$723.02 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$124.42–$284.30 | $207.37–$473.83 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$197.82–$436.19 | $329.70–$726.98 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$176.71–$436.19 | $294.52–$726.98 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$138.28–$335.82 | $230.47–$559.70 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$245.38–$414.93 | $408.97–$691.55 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$245.38–$395.17 | $408.97–$658.61 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$343.35–$552.96 | $572.25–$921.60 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$239.40–$404.78 | $399–$674.63 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$184.59–$312.02 | $307.65–$520.04 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $765.03 | $1,275.05 | 4.4× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$158.13–$267.11 | $263.55–$445.18 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$305.55–$491.77 | $509.25–$819.62 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$272.47–$438.88 | $454.12–$731.46 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$103.32–$404.78 | $172.20–$674.63 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$96.07–$327.77 | $160.12–$546.29 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$176.71–$415.41 | $294.52–$692.35 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$482.89–$777.45 | $804.82–$1,295.75 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,806.10 | $23,010.16 | 1.9× |
| Radiation treatment delivery level 1 (77402) | $528.91 | $881.52 | 5.2× |
| Radiation treatment delivery level 2 (77407) | $589.29 | $982.15 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $648.71 | $1,081.18 | 1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$269.32–$433.81 | $448.87–$723.02 | varies |
| Radiologic exam colon double contrast study (74280) | $604.93 | $1,008.22 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $471.92 | $786.54 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$358.47–$606.19 | $597.45–$1,010.32 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $427.97 | $713.28 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $441.97 | $736.62 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $330.78 | $551.30 | 1.9× |
| Radiologic examination femur 1 view (73551) | $271.87 | $453.12 | 3.1× |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$168.84–$415.41 | $281.40–$692.35 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$164.74–$397.05 | $274.57–$661.75 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$277.83–$447.15 | $463.05–$745.25 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$198.45–$415.41 | $330.75–$692.35 | varies |
| Radiopharm Dacryocystography (78660) | $712.59 | $1,187.65 | 1.8× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $746.68 | $1,244.46 | 1.9× |
| Ribs bilateral 3 views (71110) | $719.03 | $1,198.38 | 6.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $920.06 | $1,533.44 | 2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$863.66–$2,767.93 | $1,439.44–$4,613.22 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 3 matching MRF lines |
$2,083.49–$2,854.37 | $3,472.48–$4,757.28 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,789.52–$2,767.56 | $2,982.53–$4,612.60 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$1,937.65–$2,993.45 | $3,229.41–$4,989.08 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 3 matching MRF lines |
$743.41–$2,789.87 | $1,239.02–$4,649.79 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,438.17 | $4,063.61 | 10.5× |
| Rp Therapy Intravenous Administration (79101) range across 3 matching MRF lines |
$740.64–$1,434.84 | $1,234.40–$2,391.40 | varies |
| Salivary Gland Imaging Serial Images (78231) | $643.12 | $1,071.87 | 1.6× |
| Scapula (73010) range across 5 matching MRF lines |
$160.65–$462.60 | $267.75–$771 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$53.93–$89.70 | $89.89–$149.50 | varies |
| Sella turcica (70240) | $414.93 | $691.55 | 4.8× |
| Shoulder 1 view (73020) range across 5 matching MRF lines |
$160.65–$462.60 | $267.75–$771 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$608.58–$979.87 | $1,014.30–$1,633.11 | varies |
| Sialogram (70390) | $1,348.82 | $2,248.03 | 5.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$222.39–$375.80 | $370.65–$626.33 | varies |
| Special dosimetry (77331) | $713.43 | $1,189.05 | 5.3× |
| Special Physics Consult (77370) | $896.99 | $1,494.99 | 6.7× |
| Special teletherapy port plan (77321) | $2,727.70 | $4,546.16 | 7.3× |
| Special treatment procedure (77470) | $2,538.83 | $4,231.38 | 4.6× |
| Stereotactic Body Radiation Delivery (77373) | $5,796.42 | $9,660.70 | 3.3× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$305.55–$491.77 | $509.25–$819.62 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $280.35 | $467.25 | 2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,187.67 | $3,646.11 | 5.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $785.89 | $1,309.82 | 2.1× |
| Testicular Imaging W/Flow (78761) | $910.33 | $1,517.21 | 2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,499.81 | $2,499.69 | 4.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,428.34 | $2,380.56 | 3.8× |
| Ther rad simulaj-aided field setting simple (77280) | $741.45 | $1,235.75 | 5.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$158.13–$356.16 | $263.55–$593.60 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$250.11–$422.65 | $416.85–$704.41 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$346.50–$558.02 | $577.50–$930.04 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $890.74 | $1,484.57 | 2.2× |
| Thyroid Met Imaging Body (78018) | $2,340.19 | $3,900.31 | 4.3× |
| Thyroid Uptake Measurement (78012) | $372.63 | $621.05 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $890.23 | $1,483.72 | 2.2× |
| Tx Devices Design & Construction Complex (77334) | $1,482.91 | $2,471.52 | 4.0× |
| Tx devices design & construction intermediate (77333) | $993.12 | $1,655.20 | 7.4× |
| Tx devices design & construction simple (77332) | $570.46 | $950.76 | 4.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$419.75–$599.41 | $699.59–$999.01 | varies |
| Ultrasound Elastography Parenchyma (76981) | $995.74 | $1,659.57 | 9.6× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$210–$355.02 | $350–$591.70 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$329.40–$1,090.69 | $549–$1,817.82 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$293.58–$472.90 | $489.30–$788.17 | varies |
| Unlisted magnetic resonance procedure (76498) | $1,981.88 | $3,303.13 | 22.9× |
| Unlisted us procedure (76999) | $322.66 | $537.76 | 3.7× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$513.46–$735.13 | $855.76–$1,225.21 | varies |
| Ureteral Reflux Study (78740) | $783.90 | $1,306.50 | 2.0× |
| Urethrocystogram voiding (74455) | $717.47 | $1,195.79 | 3.0× |
| Urethrocystography retrograde (74450) | $407.59 | $679.32 | 1.7× |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$43.78–$969.94 | $72.97–$1,616.56 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$591.60–$621.17 | $986–$1,035.29 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$571.41–$920.06 | $952.35–$1,533.44 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$131.70–$477.04 | $219.50–$795.07 | varies |
| Us head (76506) range across 2 matching MRF lines |
$828.76–$1,334.55 | $1,381.27–$2,224.25 | varies |
| Us kidney transplant (76776) | $903.75 | $1,506.25 | 8.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$405.40–$876.22 | $675.67–$1,460.37 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$481–$737.59 | $801.67–$1,229.31 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$269.95–$434.72 | $449.92–$724.53 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$217.66–$455.70 | $362.77–$759.50 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$68.67–$698.79 | $114.45–$1,164.65 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$398.79–$642.20 | $664.65–$1,070.33 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$416.11–$669.80 | $693.52–$1,116.34 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,579.45–$1,658.42 | $2,632.41–$2,764.03 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$96.30–$949.05 | $160.50–$1,581.75 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$722.92–$1,163.88 | $1,204.87–$1,939.80 | varies |
| Us spinal canal and contents (76800) | $897.95 | $1,496.58 | 8.6× |
| Us thyroid (76536) range across 5 matching MRF lines |
$466.51–$1,057.61 | $777.52–$1,762.68 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$181.82–$504.65 | $303.04–$841.09 | varies |
| Vascular Flow Imaging (78445) | $535.48 | $892.47 | 1.3× |
| Vein X-Ray Chest (75827) | $1,470.55 | $2,450.91 | 0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $10,135.97 | $16,893.29 | 3.2× |
| Vein X-Ray Skull Epidural (75872) | $1,049.33 | $1,748.88 | 1.7× |
| Venogram Sinus/Jugular (75860) | $1,312.01 | $2,186.68 | 0.4× |
| Venography Adrenal Unilateral (75840) | $3,349.96 | $5,583.26 | 1.1× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$4,466.62–$5,652.13 | $7,444.37–$9,420.21 | varies |
| Venography extremity bilateral rs&i (75822) | $2,267.69 | $3,779.48 | 1.4× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,429.31–$1,500.79 | $2,382.19–$2,501.31 | varies |
| Venography Renal Unilateral (75831) | $3,683.02 | $6,138.36 | 1.2× |
| Venous thrombosis imaging (78457) | $535.48 | $892.47 | 1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $597.58 | $995.97 | 1.5× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$307.76–$323.15 | $512.93–$538.59 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$239.40–$404.78 | $399–$674.63 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$265.23–$426.91 | $442.05–$711.51 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$162–$372.63 | $270–$621.05 | varies |
| X-Ray Aorta Leg Arteries (75630) | $4,632.29 | $7,720.49 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$411.39–$662.44 | $685.65–$1,104.06 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$233.06–$448.25 | $388.43–$747.09 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$210–$391.95 | $350–$653.25 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$158.13–$267.11 | $263.55–$445.18 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $356.16 | $593.60 | 3.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$147.42–$249.23 | $245.70–$415.39 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$184.59–$297.17 | $307.65–$495.29 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$305.55–$516.36 | $509.25–$860.60 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$558.18–$898.90 | $930.30–$1,498.16 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$190.57–$306.83 | $317.62–$511.39 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$310.27–$524.57 | $517.12–$874.28 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $562.62 | $937.70 | 5.4× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$176.71–$298.52 | $294.52–$497.53 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$466.47–$657.39 | $777.45–$1,095.65 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$176.71–$284.30 | $294.52–$473.83 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$382.41–$615.52 | $637.35–$1,025.86 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$494.23–$795.85 | $823.72–$1,326.41 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$176.71–$341.15 | $294.52–$568.59 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$156.87–$265.18 | $261.45–$441.96 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$246.01–$415.88 | $410.02–$693.14 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$310.27–$524.57 | $517.12–$874.28 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,182.92 | $1,971.54 | 3.4× |
| X-Rays Bone Length Studies (77073) | $577.33 | $962.22 | 5.5× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$607.32–$978.02 | $1,012.20–$1,630.04 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$281.92–$476.75 | $469.87–$794.59 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$269.32–$433.81 | $448.87–$723.02 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$253.89–$408.98 | $423.15–$681.63 | varies |
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.