Imaging prices at UVA Health Culpeper Medical Center
Culpeper, VA · every code in this section with a posted price and a Medicare benchmark.
458 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) range across 2 matching MRF lines |
$4,474–$6,036 | $8,948–$12,072 | varies |
| Abdomen 1 View (74018) | $233.50 | $467 | 2.6× |
| Abdomen 2 views (74019) | $284 | $568 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,319.50 | $4,639 | 5.6× |
| Angio internal mammary (75756) | $1,728 | $3,456 | 0.5× |
| Angio pulmonary bilat (75743) | $2,168.50 | $4,337 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $2,274.50 | $4,549 | 0.7× |
| Angiography extremity unilateral rs&i (75710) | $2,244.50 | $4,489 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,741.50 | $3,483 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,397 | $4,794 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$312.50–$469 | $625–$938 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,460.50 | $6,921 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,282 | $2,564 | 0.4× |
| Artery X-Rays Abdomen (75726) | $7,257.52 | $14,515.05 | 1.3× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$13,953.81–$14,869.08 | $27,907.62–$29,738.16 | varies |
| Artery X-Rays Spine (75705) | $10,173.50 | $20,347 | 1.8× |
| Arthrogram ankle (73615) | $664.50 | $1,329 | 1.8× |
| Arthrogram hip (73525) | $2,164.49 | $4,328.99 | 6.0× |
| Arthrogram Wrist (73115) | $586 | $1,172 | 1.6× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$501.50–$633.50 | $1,003–$1,267 | varies |
| Bone age studies (77072) | $374 | $748 | 3.5× |
| Bone Imaging 3 Phase (78315) | $1,610 | $3,220 | 3.9× |
| Bone Imaging Limited Area (78300) | $1,122 | $2,244 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,482.50 | $2,965 | 3.6× |
| Bone marrow imaging limited area (78102) | $548 | $1,096 | 1.3× |
| Bone marrow imaging; multiple areas (78103) | $798 | $1,596 | 1.9× |
| Bone marrow imaging; whole body (78104) | $547 | $1,094 | 1.3× |
| Bone survey infant (77076) | $741 | $1,482 | 6.9× |
| Brachytx isodose complex (77318) | $682.50 | $1,365 | 1.8× |
| Brachytx isodose intermed (77317) | $682 | $1,364 | 1.8× |
| Brachytx Isodose Plan Simple (77316) | $290 | $580 | 0.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,426 | $2,852 | 2.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,029.50 | $8,059 | 2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,090.50 | $2,181 | 3.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,148.50 | $2,297 | 1.4× |
| Cat Scan Follow-Up Study (76380) | $431.50 | $863 | 4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,217.50 | $2,435 | 2.2× |
| Cerebrospinal Fluid Scan (78630) | $418.50 | $837 | 0.7× |
| Chest 1 view (71045) | $188 | $376 | 2.1× |
| Chest 2 views (71046) | $292.50 | $585 | 3.2× |
| Chest 3 views (71047) | $186.50 | $373 | 2.1× |
| Chest 4 or more views (71048) | $189 | $378 | 1.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $131.50 | $263 | 1.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $329.50 | $659 | 3.0× |
| Cisternography Positive Contrast Rs&I (70015) | $491 | $982 | 0.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$270–$405 | $540–$810 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $386.50 | $773 | 3.6× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$612.50–$957 | $1,225–$1,914 | varies |
| Contrast Exam Abdominl Aorta (75625) | $1,738.50 | $3,477 | 0.5× |
| Contrast X-Ray Bladder (74430) | $624.30 | $1,248.60 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $989.50 | $1,979 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $534 | $1,068 | 1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $896 | $1,792 | 4.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,890.20 | $5,780.40 | 8.0× |
| CT abdomen and pelvis without contrast (74176) | $1,470 | $2,940 | 6.0× |
| CT abdomen w contrast (74160) | $1,483.50 | $2,967 | 8.2× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,609.93–$2,641.70 | $5,219.86–$5,283.40 | varies |
| CT abdomen w/o contrast (74150) | $1,327.50 | $2,655 | 12.3× |
| CT Angio Abdomen and Pelvis (74174) | $3,315 | $6,630 | 9.2× |
| CT Angio Chest (71275) | $1,908 | $3,816 | 10.5× |
| CT Angio Head (70496) | $1,543 | $3,086 | 8.5× |
| CT angio hrt w/3d image (75574) | $1,115.50 | $2,231 | 3.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,163.50–$4,745.50 | $6,327–$9,491 | varies |
| CT Angio Neck (70498) | $1,577 | $3,154 | 8.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,941.50 | $3,883 | 10.7× |
| CT bone density (77078) | $470.50 | $941 | 5.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,392.50 | $2,785 | 7.7× |
| CT cervical spine w/ contrast (72126) | $1,764 | $3,528 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,470 | $2,940 | 13.6× |
| CT cervical spine w/wo cont (72127) | $2,763.50 | $5,527 | 15.2× |
| CT chest w contrast (71260) | $1,669.50 | $3,339 | 9.2× |
| CT chest w/wo contrast (71270) | $2,615.50 | $5,231 | 14.4× |
| CT colonography screening (74263) | $277 | $554 | 1.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $264 | $528 | 1.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $247.50 | $495 | 2.3× |
| CT head/brain with contrast (70460) | $1,237 | $2,474 | 6.8× |
| CT head/brain without and with contrast (70470) | $1,937.50 | $3,875 | 10.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,090 | $2,180 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $472 | $944 | 5.2× |
| CT hrt w/3d image congen (75573) | $3,110 | $6,220 | 8.6× |
| CT iac w contrast (70481) | $1,539.50 | $3,079 | 8.5× |
| CT l-spine w&w/o contrast (72133) | $2,763.50 | $5,527 | 15.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,187.50–$1,781.50 | $2,375–$3,563 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,425–$2,137.50 | $2,850–$4,275 | varies |
| CT lumbar spine w contrast (72132) | $1,764 | $3,528 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,470 | $2,940 | 13.6× |
| CT maxillofacial w contrast (70487) | $1,634.50 | $3,269 | 9.0× |
| CT maxillofacial wo contrast (70486) | $1,362 | $2,724 | 12.6× |
| CT neck tissue combo (70492) | $2,475.50 | $4,951 | 13.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,411.50 | $4,823 | 13.3× |
| CT orbits w/o contrast (70480) | $1,282.50 | $2,565 | 11.9× |
| CT pelvis w&w/o contrast (72194) | $1,272 | $2,544 | 7.0× |
| CT pelvis w/o contrast (72192) | $1,195.50 | $2,391 | 11.1× |
| CT scan of leg combo (73702) | $2,233 | $4,466 | 12.3× |
| CT scans face/jaw combo (70488) | $2,560.50 | $5,121 | 14.1× |
| CT soft tissue neck w contrast (70491) | $1,580.50 | $3,161 | 8.7× |
| CT soft tissue neck w/o contrast (70490) | $1,316.50 | $2,633 | 12.2× |
| CT thoracic spine w contrast (72129) | $1,764 | $3,528 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,470 | $2,940 | 13.6× |
| CT thoracic spine w/wo cont (72130) | $2,763.50 | $5,527 | 15.2× |
| CT thorax w/o contrast (71250) | $1,391.50 | $2,783 | 12.9× |
| CT upper ext wo (73200) | $1,214 | $2,428 | 11.2× |
| CT upper extremity w/o & w/contrast material (73202) | $2,282 | $4,564 | 12.6× |
| CT upper extremity with contrast (73201) | $1,456.50 | $2,913 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,571.50 | $3,143 | 8.7× |
| Cta Abdomen (74175) | $2,559.50 | $5,119 | 14.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,392.50 | $2,785 | 3.9× |
| CTA pelvis (72191) | $3,403 | $6,806 | 18.8× |
| Dilation ureters/urethra rs&i (74485) | $1,207.50 | $2,415 | 0.6× |
| Discography Cerv/Thor Spine (72285) | $1,953.50 | $3,907 | 1.0× |
| Diskography lumbar (72295) | $1,848 | $3,696 | 0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $479.50 | $959 | 4.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,164.50 | $2,329 | 10.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $488.50 | $977 | 4.5× |
| Dxa Bone Density Axial (77080) | $754 | $1,508 | 7.0× |
| Dxa bone density study (77085) | $453.50 | $907 | 4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $673 | $1,346 | 7.5× |
| Echo exam of fetal heart (76825) | $1,361 | $2,722 | 2.4× |
| Echo exam uterus (76831) | $612.50 | $1,225 | 2.5× |
| Echo Guide For Artery Repair (76936) | $1,054.50 | $2,109 | 4.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,201 | $2,402 | 4.9× |
| Echograp Trans R Pros Study (76873) | $1,060 | $2,120 | 9.8× |
| Esophageal Motility Study (78258) | $524.50 | $1,049 | 1.3× |
| Esophagram (74220) | $445 | $890 | 2.5× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$664.50–$821 | $1,329–$1,642 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $652 | $1,304 | 6.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $746.50 | $1,493 | 3.0× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$6,670.47–$6,822.05 | $13,340.94–$13,644.11 | varies |
| Follow-Up Angiography (75898) | $1,935 | $3,870 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$311.50–$467.50 | $623–$935 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$313.50–$470.50 | $627–$941 | varies |
| Gastric emptying imaging study (78264) | $1,546 | $3,092 | 3.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,448 | $4,896 | 5.9× |
| Gastric Mucosa Imaging (78261) | $749.50 | $1,499 | 1.8× |
| Gastroesophageal Reflux Exam (78262) | $885.50 | $1,771 | 2.1× |
| Gated Heart Planar Single (78472) | $1,606.50 | $3,213 | 3.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,284.50 | $4,569 | 4.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$271.50–$407.50 | $543–$815 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $551.50 | $1,103 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $551.50 | $1,103 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $551.50 | $1,103 | 0.8× |
| Heart Image (Pet) Multiple (78492) | $3,519 | $7,038 | 2.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,794.50 | $3,589 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,185 | $2,370 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,360.50 | $2,721 | 2.4× |
| Hepatobiliary System Imaging (78226) | $835.50 | $1,671 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $2,299 | $4,598 | 1.7× |
| Hysterosalpingogram (74740) | $1,144.70 | $2,289.40 | 4.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $988 | $1,976 | 11.0× |
| Infant hip ultrasound, limited static exam (76886) | $1,146 | $2,292 | 12.7× |
| Infusion Ivp (74410) | $732 | $1,464 | 4.0× |
| Interstitial radiation source applic complex (77778) | $2,165 | $4,330 | 3.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,407.50 | $4,815 | 3.3× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,008.50 | $4,017 | 3.5× |
| Intracavitary radiation source applic simple (77761) | $1,235 | $2,470 | 2.2× |
| Joint Survey Single View (77077) | $220.50 | $441 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $2,272 | $4,544 | 4.0× |
| K Flow/Funct Image W/Drug (78708) | $1,794.50 | $3,589 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,752 | $3,504 | 3.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$308–$462 | $616–$924 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,176 | $2,352 | 2.8× |
| Liver & Spleen Imaging Static Only (78215) | $760.50 | $1,521 | 1.8× |
| Liver imaging w/vascular flow (78202) | $482 | $964 | 0.9× |
| Lung Perf&Ventilat Diferentl (78598) | $337.50 | $675 | 0.6× |
| Lung perfusion differential (78597) | $1,470 | $2,940 | 3.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,123.50 | $2,247 | 2.0× |
| Lung Ventilation Imaging (78579) | $355 | $710 | 0.9× |
| Lymph System Imaging (78195) | $1,457 | $2,914 | 2.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $752 | $1,504 | 0.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $408.50 | $817 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $378.50 | $757 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $748 | $1,496 | 3.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $2,173 | $4,346 | 12.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $1,810.50 | $3,621 | 3.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $3,404 | $6,808 | 18.8× |
| Magnetic Resonance Elastography (76391) | $455.50 | $911 | 1.8× |
| Mammary ductogram or galactogram multiple (77054) | $505 | $1,010 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $201.50 | $403 | 0.8× |
| Meckels Divert Exam (78290) | $434.50 | $869 | 1.1× |
| Medical physics dose eval radiation expos w/rprt (76145) | $157 | $314 | 0.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,531.50 | $3,063 | 4.0× |
| Mr safety determination physician/other qhp (76016) | $115.50 | $231 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $65.50 | $131 | 2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $121 | $242 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $78 | $156 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $317 | $634 | 1.3× |
| Mra Head W/O & W/Contrast Material (70546) | $3,323.50 | $6,647 | 9.2× |
| MRA head w/o contrast (70544) | $1,767.50 | $3,535 | 7.2× |
| MRA head with contrast (70545) | $2,121 | $4,242 | 5.9× |
| MRA neck w contrast (70548) | $1,530.50 | $3,061 | 4.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,397.50 | $4,795 | 6.6× |
| MRA neck w/o contrast (70547) | $1,275 | $2,550 | 5.2× |
| MRI abdomen w contrast (74182) | $3,149.50 | $6,299 | 8.7× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,506.50–$2,624.50 | $3,013–$5,249 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,272.50 | $2,545 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,994 | $3,988 | 5.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,915.37 | $5,830.74 | 3.6× |
| MRI bone marrow blood supply (77084) | $992.50 | $1,985 | 4.0× |
| MRI brain functional w/o physician admnistration (70554) | $756.50 | $1,513 | 3.1× |
| MRI brain functional w/physician admnistration (70555) | $439.50 | $879 | 1.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,421.50 | $2,843 | 5.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,612.50 | $5,225 | 10.6× |
| MRI cardiac w/o cont stress (75559) | $548 | $1,096 | 1.0× |
| MRI cardiac w/o contrast (75557) | $924.50 | $1,849 | 3.7× |
| MRI cervical spine w contrast (72142) | $1,490 | $2,980 | 4.1× |
| MRI cervical spine w/o cont (72141) | $1,241.50 | $2,483 | 5.0× |
| MRI chest w/o contrast (71550) | $1,232.50 | $2,465 | 5.0× |
| MRI chest with contrast (71551) | $1,479.50 | $2,959 | 1.8× |
| MRI chest wo w contrast (71552) | $2,317.50 | $4,635 | 6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,272.50 | $2,545 | 3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,994 | $3,988 | 5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,060.50–$1,591 | $2,121–$3,182 | varies |
| MRI lumbar spine w contrast (72149) | $1,357.50 | $2,715 | 3.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,334 | $4,668 | 6.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,220.50 | $2,441 | 4.9× |
| MRI orbit face neck w contrast (70542) | $1,465 | $2,930 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,295 | $4,590 | 6.4× |
| MRI pelvis w contrast (72196) | $1,704.50 | $3,409 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $2,670.50 | $5,341 | 7.4× |
| MRI pelvis w/o contrast (72195) | $1,420.50 | $2,841 | 5.8× |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$463.50–$1,722 | $927–$3,444 | varies |
| MRI thoracic spine w/o contrast (72146) | $1,247 | $2,494 | 5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,572 | $3,144 | 4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,310 | $2,620 | 5.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,463 | $4,926 | 6.8× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,321.50–$4,934 | $4,643–$9,868 | varies |
| MRI, dorsal spine combo (72157) | $2,344 | $4,688 | 6.5× |
| MRI, dorsal spine contrast (72147) | $1,496.50 | $2,993 | 4.1× |
| MRI, joint upper extrem (73221) | $1,352 | $2,704 | 5.5× |
| MRI, joint upper extrem combo (73223) | $2,541.50 | $5,083 | 7.0× |
| MRI, lumbar spine combo (72158) | $2,127 | $4,254 | 5.9× |
| Myelogram cervical (72240) | $1,283.50 | $2,567 | 1.6× |
| Myelogram Lumbar (72265) | $1,226.50 | $2,453 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,536.50 | $3,073 | 1.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $736.50 | $1,473 | 1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,829 | $9,658 | 3.6× |
| Myocardial Spect Multiple Studies (78452) | $3,065 | $6,130 | 2.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,341 | $6,682 | 2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $6,515.50 | $13,031 | 4.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $9,377.50 | $18,755 | 4.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $8,752 | $17,504 | 3.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $5,209.50 | $10,419 | 3.3× |
| N-invas est c ffr sw aly CTA (75580) | $1,309 | $2,618 | 1.5× |
| Neck soft tissue (70360) | $282 | $564 | 3.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $637 | $1,274 | 1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $536.50 | $1,073 | 1.3× |
| Nm csf leak detection (78650) | $1,183.50 | $2,367 | 0.9× |
| Nm myocard infarct spect (78469) | $1,019 | $2,038 | 1.8× |
| Nonvascular Shunt X-Ray (75809) | $1,719.50 | $3,439 | 15.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,437.50 | $8,875 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $1,869.50 | $3,739 | 7.7× |
| Ob us nuchal meas 1 gest (76813) | $1,806.50 | $3,613 | 16.7× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $143 | $286 | 1.3× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $240.50 | $481 | 2.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $519 | $1,038 | 4.8× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $302.50 | $605 | 10.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $134 | $268 | 1.2× |
| Optic foramina (70190) | $138.50 | $277 | 1.5× |
| Panoramic X-ray of jaws (70355) | $619.50 | $1,239 | 6.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,996.50 | $3,993 | 3.6× |
| Parathyroid Planar Imaging (78070) | $953 | $1,906 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $939 | $1,878 | 2.3× |
| Pelvis 1 or 2 views (72170) | $263.50 | $527 | 2.4× |
| Perineogram (74775) | $305.50 | $611 | 1.2× |
| Peritoneogram Rs&I (74190) | $371.50 | $743 | 0.7× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$2,650–$4,250 | $5,300–$8,500 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$1,150–$3,703 | $2,300–$7,406 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,150–$3,703 | $2,300–$7,406 | varies |
| Pet Myocardial Sngl Study (78491) | $4,740 | $9,480 | 3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,167.50 | $2,335 | 0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,033.50 | $2,067 | 2.5× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,188 | $2,376 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $510 | $1,020 | 4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,072.60–$1,133.68 | $2,145.20–$2,267.37 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$311–$466.50 | $622–$933 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$258.50–$388 | $517–$776 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$374.50–$562 | $749–$1,124 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $483.50 | $967 | 4.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$266–$399 | $532–$798 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$311–$466.50 | $622–$933 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$345.50–$518.50 | $691–$1,037 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $532 | $1,064 | 5.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $380.50 | $761 | 3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $439.50 | $879 | 4.9× |
| Radex Ribs Unilateral 2 Views (71100) | $270 | $540 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$380–$570 | $760–$1,140 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $171 | $342 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $765 | $1,530 | 4.2× |
| Radex Spine 1 View Specify Level (72020) | $227.50 | $455 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $340.50 | $681 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $746.50 | $1,493 | 8.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$265.50–$398.50 | $531–$797 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $357 | $714 | 3.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$332.50–$499 | $665–$998 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $551.50 | $1,103 | 5.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,762.50 | $27,525 | 1.8× |
| Radiation treatment delivery level 1 (77402) | $580 | $1,160 | 5.5× |
| Radiation treatment delivery level 2 (77407) | $511.50 | $1,023 | 1.3× |
| Radiation treatment delivery level 3 (77412) | $636.50 | $1,273 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $497 | $994 | 4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $325.50 | $651 | 3.0× |
| Radiologic exam colon double contrast study (74280) | $977 | $1,954 | 5.4× |
| Radiologic exam colon single contrast study (74270) | $612.50 | $1,225 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $464 | $928 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$351–$526.50 | $702–$1,053 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $395 | $790 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $563.50 | $1,127 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $388 | $776 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $584 | $1,168 | 3.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$161–$241.50 | $322–$483 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$247–$370.50 | $494–$741 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$273.50–$410.50 | $547–$821 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $224 | $448 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$271.50–$407.50 | $543–$815 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $168.50 | $337 | 0.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $86 | $172 | 1.0× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $3,282.50 | $6,565 | 13.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $340.50 | $681 | 0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $340.50 | $681 | 0.9× |
| Renal Cyst Study (74470) | $239.50 | $479 | 0.4× |
| Ribs bilateral 3 views (71110) | $371.50 | $743 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $265 | $530 | 0.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $253 | $506 | 0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,236 | $2,472 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,127 | $4,254 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,669.50 | $3,339 | 3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,739.50 | $3,479 | 1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,664.50 | $7,329 | 2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,230.50 | $6,461 | 2.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,093 | $4,186 | 8.7× |
| Rp Therapy Intravenous Administration (79101) | $589.50 | $1,179 | 2.4× |
| Salivary Gland Imaging (78230) | $829 | $1,658 | 2.0× |
| Scapula (73010) range across 2 matching MRF lines |
$267–$400.50 | $534–$801 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $354.50 | $709 | 15.2× |
| Shoulder 1 view (73020) | $205 | $410 | 2.3× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$2,915.37–$2,951.55 | $5,830.74–$5,903.10 | varies |
| Skull less than 4 views (70250) | $326.50 | $653 | 3.0× |
| Special dosimetry (77331) | $135 | $270 | 1.0× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$640–$704.50 | $1,280–$1,409 | varies |
| Special teletherapy port plan (77321) | $1,013.50 | $2,027 | 2.6× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,574–$1,994 | $3,148–$3,988 | varies |
| Speech evaluation, complex (70371) | $459.50 | $919 | 1.9× |
| Srs Multisource (77371) | $64,303.50 | $128,607 | 8.4× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$9,372–$36,582.50 | $18,744–$73,165 | varies |
| Sternoclavicular joints (71130) | $55 | $110 | 0.6× |
| Superior sagittal sinus venogram (75870) | $2,286.50 | $4,573 | 0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $411.50 | $823 | 3.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,063 | $2,126 | 2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,057 | $2,114 | 2.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,468–$1,563.50 | $2,936–$3,127 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,154 | $2,308 | 3.0× |
| Ther rad simulaj-aided field setting simple (77280) | $709 | $1,418 | 5.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $302.50 | $605 | 1.7× |
| Thoracic spine 2 views (72070) | $315.50 | $631 | 2.9× |
| Thoracic spine 3 views (72072) | $377 | $754 | 3.5× |
| Thoracolumbar 2 views (72080) | $294 | $588 | 3.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $682 | $1,364 | 1.6× |
| Thyroid Imaging With Vascular Flow (78013) | $678 | $1,356 | 1.6× |
| Thyroid Met Imaging Body (78018) | $1,913.50 | $3,827 | 3.4× |
| Thyroid Uptake Measurement (78012) | $931 | $1,862 | 2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $839.50 | $1,679 | 2.0× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$812–$1,312.50 | $1,624–$2,625 | varies |
| Tx devices design & construction intermediate (77333) | $408 | $816 | 2.9× |
| Tx devices design & construction simple (77332) | $340 | $680 | 2.4× |
| Ultrasound Breast Limited (76642) | $195 | $390 | 2.2× |
| Ultrasound elastography first target lesion (76982) | $621.50 | $1,243 | 5.7× |
| Ultrasound Elastography Parenchyma (76981) | $76 | $152 | 0.7× |
| Ultrasound Exam Aaa Screen (76706) | $359.50 | $719 | 3.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,155 | $2,310 | 3.2× |
| Ultrasound, abdomen limited (76705) | $714 | $1,428 | 6.6× |
| Umbilical-artery Doppler (OB) (76820) | $613 | $1,226 | 5.7× |
| Unlisted Dx Radiographic Procedure (76499) | $514.50 | $1,029 | 5.7× |
| Unlisted fluoroscopic procedure (76496) | $155 | $310 | 1.7× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $281.50 | $563 | 0.7× |
| Unlisted magnetic resonance procedure (76498) | $2,801.50 | $5,603 | 31.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,634 | $3,268 | 15.5× |
| Unlisted respiratory px dx nuclear medicine (78599) | $1,173.50 | $2,347 | 2.8× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$473.50–$1,542.50 | $947–$3,085 | varies |
| Upper gi w/o kub (74240) | $827 | $1,654 | 4.6× |
| Ureteral Reflux Study (78740) | $957 | $1,914 | 2.3× |
| Urethrocystogram voiding (74455) | $307 | $614 | 1.2× |
| Urethrocystography retrograde (74450) | $426 | $852 | 1.7× |
| Us breast unilateral complete (76641) | $541.50 | $1,083 | 5.0× |
| Us chest (76604) | $377 | $754 | 3.5× |
| Us complete joint (76881) | $571.50 | $1,143 | 5.3× |
| Us exam, pelvic, limited (76857) | $494.50 | $989 | 4.6× |
| Us head (76506) | $484.50 | $969 | 4.5× |
| Us kidney transplant (76776) | $408.50 | $817 | 3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$243.50–$864 | $487–$1,728 | varies |
| Us ob detailed single fetus (76811) | $513.50 | $1,027 | 2.1× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$988.50–$997 | $1,977–$1,994 | varies |
| Us ob transvaginal (76817) | $801.50 | $1,603 | 7.4× |
| Us pelvic non ob complete (76856) | $1,463 | $2,926 | 13.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $542 | $1,084 | 5.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$743–$751 | $1,486–$1,502 | varies |
| Us retroperitoneal complete (76770) | $807.50 | $1,615 | 7.5× |
| Us retroperitoneal limited (76775) | $407.50 | $815 | 3.8× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$601.50–$634.50 | $1,203–$1,269 | varies |
| Us spinal canal and contents (76800) | $1,204 | $2,408 | 11.1× |
| Us thyroid (76536) | $620.50 | $1,241 | 5.7× |
| Us transrectal (76872) | $5,423.76 | $10,847.52 | 50.1× |
| Vascular Flow Imaging (78445) | $962.50 | $1,925 | 2.3× |
| Vein X-Ray Chest (75827) | $1,130.50 | $2,261 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,483 | $2,966 | 0.5× |
| Vein X-Ray Spleen/Liver (75810) | $1,200.50 | $2,401 | 0.4× |
| Venogram Sinus/Jugular (75860) | $2,118.50 | $4,237 | 0.6× |
| Venography Adrenal Unilateral (75840) | $1,200.50 | $2,401 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,483 | $2,966 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $555.50 | $1,111 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $1,429 | $2,858 | 0.9× |
| Venography Orbital Rs&I (75880) | $371 | $742 | 0.6× |
| Venography Renal Bilateral (75833) | $1,741.50 | $3,483 | 0.5× |
| Venography Renal Unilateral (75831) | $1,741.50 | $3,483 | 0.5× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,004 | $2,008 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $369.50 | $739 | 4.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$312.50–$469 | $625–$938 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $369.50 | $739 | 4.1× |
| X-ray antegrade pyelogram tube (74425) | $183 | $366 | 0.5× |
| X-Ray Aorta Leg Arteries (75630) | $2,460.50 | $4,921 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $343 | $686 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$303.50–$455.50 | $607–$911 | varies |
| X-Ray Exam Breast Specimen (76098) | $412 | $824 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $246 | $492 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $377 | $754 | 3.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $538 | $1,076 | 5.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $188.50 | $377 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $264.50 | $529 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $682 | $1,364 | 6.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $388.50 | $777 | 3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $484.50 | $969 | 4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $466.50 | $933 | 4.3× |
| X-Ray Exam L-S Spine Bending (72114) | $468 | $936 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $377 | $754 | 4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $343 | $686 | 3.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $428.50 | $857 | 4.0× |
| X-ray eye for foreign body (70030) | $201 | $402 | 2.2× |
| X-ray humerus (73060) | $262.50 | $525 | 2.9× |
| X-ray IV pyelogram+tomography (74415) | $974.50 | $1,949 | 5.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $155.50 | $311 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $182.50 | $365 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $377 | $754 | 3.5× |
| X-ray nose-rectum child f.b. (76010) | $417.50 | $835 | 4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $450.50 | $901 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $376.50 | $753 | 3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $495 | $990 | 4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $281.50 | $563 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $409.50 | $819 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $503.50 | $1,007 | 4.7× |
| X-ray thoracic spine 4 vw (72074) | $359.50 | $719 | 3.3× |
| X-Ray Tmj Unilat (70328) | $117 | $234 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $599.50 | $1,199 | 1.7× |
| X-Rays Bone Length Studies (77073) | $511 | $1,022 | 4.7× |
| X-Rays Bone Survey Complete (77075) | $777.50 | $1,555 | 7.2× |
| Xr c-spine 4 or 5 views (72050) | $509.50 | $1,019 | 4.7× |
| Xr facial bones less than 3 views (70140) | $287.50 | $575 | 3.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $245.50 | $491 | 2.3× |
| Xr orbits complete 4 views (70200) | $542 | $1,084 | 5.0× |
| Xr Tomogram Single Plane (76100) | $520 | $1,040 | 4.8× |
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.