Imaging prices at UVA Health University Medical Center
Charlottesville, 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) | $7,243.20 | $12,072 | 5.2× |
| Abdomen 1 View (74018) | $268.80 | $448 | 3.1× |
| Abdomen 2 views (74019) | $340.80 | $568 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $370.20 | $617 | 0.9× |
| Angio internal mammary (75756) | $2,073.60 | $3,456 | 0.7× |
| Angio pulmonary bilat (75743) | $9,767.64 | $16,279.40 | 3.1× |
| Angiography extremity bilateral rs&i (75716) | $13,666.03 | $22,776.72 | 4.3× |
| Angiography extremity unilateral rs&i (75710) | $12,819.14 | $21,365.23 | 4.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $67,521.41 | $112,535.69 | 21.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,876.40 | $4,794 | 0.9× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$463.80–$696 | $773–$1,160 | varies |
| Aortography thoracic serialography rs&i (75605) | $17,815.63 | $29,692.72 | 3.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $13,674.19 | $22,790.32 | 4.3× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$27,050.55–$28,642.12 | $45,084.25–$47,736.86 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$18,684.47–$24,093.40 | $31,140.79–$40,155.66 | varies |
| Artery X-Rays Spine (75705) | $110,238.70 | $183,731.16 | 19.7× |
| Arthrogram ankle (73615) | $797.40 | $1,329 | 2.3× |
| Arthrogram hip (73525) | $4,194.59 | $6,990.98 | 12.0× |
| Arthrogram Wrist (73115) | $703.20 | $1,172 | 2.0× |
| Basic radiation dosimetry calculation (77300) | $760.20 | $1,267 | 5.6× |
| Bone age studies (77072) | $825.60 | $1,376 | 7.9× |
| Bone Imaging 3 Phase (78315) | $2,220 | $3,700 | 5.5× |
| Bone Imaging Limited Area (78300) | $2,999.40 | $4,999 | 7.5× |
| Bone Imaging Whole Body (78306) | $1,953 | $3,255 | 4.9× |
| Bone marrow imaging limited area (78102) | $657.60 | $1,096 | 1.6× |
| Bone marrow imaging; multiple areas (78103) | $957.60 | $1,596 | 2.4× |
| Bone marrow imaging; whole body (78104) | $656.40 | $1,094 | 1.6× |
| Bone survey infant (77076) | $830.40 | $1,384 | 7.9× |
| Brachytx isodose complex (77318) | $819 | $1,365 | 2.2× |
| Brachytx isodose intermed (77317) | $818.40 | $1,364 | 2.2× |
| Brachytx Isodose Plan Simple (77316) | $348 | $580 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $431.40 | $719 | 0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $10,191 | $16,985 | 7.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,308.60 | $2,181 | 3.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,378.20 | $2,297 | 1.8× |
| Cat Scan Follow-Up Study (76380) | $631 | $1,051.67 | 7.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,461 | $2,435 | 2.7× |
| Cerebrospinal Fluid Scan (78630) | $502.20 | $837 | 0.9× |
| Chest 1 view (71045) | $217.20 | $362 | 2.5× |
| Chest 2 views (71046) | $220.80 | $368 | 2.5× |
| Chest 3 views (71047) | $223.80 | $373 | 2.6× |
| Chest 4 or more views (71048) | $226.80 | $378 | 2.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $157.80 | $263 | 1.5× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $59,726.65 | $99,544.42 | 569.4× |
| Cisternography Positive Contrast Rs&I (70015) | $589.20 | $982 | 0.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$588.60–$883.20 | $981–$1,472 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $126.60 | $211 | 1.2× |
| Continuing medical physics consltj pr wk (77336) | $1,148.40 | $1,914 | 8.5× |
| Contrast Exam Abdominl Aorta (75625) | $13,666.03 | $22,776.72 | 4.3× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$1,640.22–$1,814.22 | $2,733.70–$3,023.70 | varies |
| Contrast X-Ray Of Elbow (73085) | $745.80 | $1,243 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $640.80 | $1,068 | 1.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $1,075.20 | $1,792 | 6.1× |
| CT abdomen and pelvis without and with contrast (74178) | $6,093.24 | $10,155.40 | 17.4× |
| CT abdomen and pelvis without contrast (74176) | $3,082.80 | $5,138 | 12.9× |
| CT abdomen w contrast (74160) | $1,666.80 | $2,778 | 9.5× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,248.04–$3,251.46 | $5,413.40–$5,419.10 | varies |
| CT abdomen w/o contrast (74150) | $1,389 | $2,315 | 13.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,337.20 | $5,562 | 9.5× |
| CT Angio Chest (71275) | $2,774.40 | $4,624 | 15.8× |
| CT Angio Head (70496) | $2,458.20 | $4,097 | 14.0× |
| CT angio hrt w/3d image (75574) | $1,622.61 | $2,704.35 | 4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$5,007–$7,510.80 | $8,345–$12,518 | varies |
| CT Angio Neck (70498) | $2,571 | $4,285 | 14.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,832.40 | $3,054 | 10.4× |
| CT bone density (77078) | $564.60 | $941 | 6.5× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,671 | $2,785 | 9.5× |
| CT cervical spine w/ contrast (72126) | $2,016 | $3,360 | 5.8× |
| CT cervical spine w/o contrast (72125) | $1,680 | $2,800 | 16.0× |
| CT cervical spine w/wo cont (72127) | $3,159 | $5,265 | 18.0× |
| CT chest w contrast (71260) | $1,749.60 | $2,916 | 9.9× |
| CT chest w/wo contrast (71270) | $2,740.80 | $4,568 | 15.6× |
| CT colonography screening (74263) | $332.40 | $554 | 1.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $316.80 | $528 | 1.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $297 | $495 | 2.8× |
| CT head/brain with contrast (70460) | $1,671 | $2,785 | 9.5× |
| CT head/brain without and with contrast (70470) | $2,617.80 | $4,363 | 14.9× |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$2,378.59–$2,415.79 | $3,964.32–$4,026.32 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $349.20 | $582 | 4.0× |
| CT hrt w/3d image congen (75573) | $3,732 | $6,220 | 10.7× |
| CT iac w contrast (70481) | $1,825.20 | $3,042 | 10.4× |
| CT l-spine w&w/o contrast (72133) | $2,139 | $3,565 | 12.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,196.40–$1,794.60 | $1,994–$2,991 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,435.80–$2,154 | $2,393–$3,590 | varies |
| CT lumbar spine w contrast (72132) | $1,365 | $2,275 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,137.60 | $1,896 | 10.8× |
| CT maxillofacial w contrast (70487) | $1,549.20 | $2,582 | 8.8× |
| CT maxillofacial wo contrast (70486) | $1,290.60 | $2,151 | 12.3× |
| CT neck tissue combo (70492) | $2,970.60 | $4,951 | 16.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,859 | $4,765 | 16.2× |
| CT orbits w/o contrast (70480) | $1,521 | $2,535 | 14.5× |
| CT pelvis w&w/o contrast (72194) | $1,526.40 | $2,544 | 8.7× |
| CT pelvis w/o contrast (72192) | $1,525.80 | $2,543 | 14.5× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,249.40–$3,374.40 | $3,749–$5,624 | varies |
| CT scans face/jaw combo (70488) | $2,427 | $4,045 | 13.8× |
| CT soft tissue neck w contrast (70491) | $1,896.60 | $3,161 | 10.8× |
| CT soft tissue neck w/o contrast (70490) | $1,579.80 | $2,633 | 15.1× |
| CT thoracic spine w contrast (72129) | $2,163.60 | $3,606 | 12.3× |
| CT thoracic spine w/o contrast (72128) | $1,803 | $3,005 | 17.2× |
| CT thoracic spine w/wo cont (72130) | $3,390 | $5,650 | 19.3× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$785.40–$1,504.81 | $1,309–$2,508.01 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,641.60–$2,462.40 | $2,736–$4,104 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $3,086.40 | $5,144 | 17.5× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,969.80–$2,955 | $3,283–$4,925 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,622 | $4,370 | 14.9× |
| Cta Abdomen (74175) | $2,469.60 | $4,116 | 14.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,671 | $2,785 | 4.8× |
| CTA pelvis (72191) | $4,083.60 | $6,806 | 23.2× |
| Dilation ureters/urethra rs&i (74485) | $1,449 | $2,415 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $2,344.20 | $3,907 | 1.2× |
| Diskography lumbar (72295) | $2,217.60 | $3,696 | 1.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $575.40 | $959 | 5.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,397.40 | $2,329 | 13.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $586.20 | $977 | 5.6× |
| Dxa Bone Density Axial (77080) | $904.80 | $1,508 | 8.6× |
| Dxa bone density study (77085) | $544.20 | $907 | 5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $807.60 | $1,346 | 9.2× |
| Echo exam of fetal heart (76825) | $1,633.20 | $2,722 | 3.0× |
| Echo exam uterus (76831) | $735 | $1,225 | 3.1× |
| Echo Guide For Artery Repair (76936) | $1,265.40 | $2,109 | 5.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,441.20 | $2,402 | 6.0× |
| Echograp Trans R Pros Study (76873) | $1,272 | $2,120 | 12.1× |
| Esophageal Motility Study (78258) | $629.40 | $1,049 | 1.6× |
| Esophagram (74220) | $534 | $890 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $797.40 | $1,329 | 7.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $756 | $1,260 | 7.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $895.80 | $1,493 | 3.7× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$19,329.16–$19,341.38 | $32,215.27–$32,235.64 | varies |
| Follow-Up Angiography (75898) | $2,322 | $3,870 | 0.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$579.60–$869.40 | $966–$1,449 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$375.60–$563.40 | $626–$939 | varies |
| Gastric emptying imaging study (78264) | $1,738.80 | $2,898 | 4.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,937.60 | $4,896 | 7.3× |
| Gastric Mucosa Imaging (78261) | $899.40 | $1,499 | 2.2× |
| Gastroesophageal Reflux Exam (78262) | $1,062.60 | $1,771 | 2.6× |
| Gated Heart Planar Single (78472) | $2,063.40 | $3,439 | 5.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,741.40 | $4,569 | 5.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$391.80–$588 | $653–$980 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $661.80 | $1,103 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $661.80 | $1,103 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $661.80 | $1,103 | 0.9× |
| Heart Image (Pet) Multiple (78492) | $4,222.80 | $7,038 | 2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $15,154.72 | $25,257.87 | 4.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $23,418.32 | $39,030.54 | 7.4× |
| Hepatobil Syst Image W/Drug (78227) | $2,111.40 | $3,519 | 3.9× |
| Hepatobiliary System Imaging (78226) | $953.40 | $1,589 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $2,659.20 | $4,432 | 2.0× |
| Hysterosalpingogram (74740) | $793.84 | $1,323.06 | 3.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,185.60 | $1,976 | 13.6× |
| Infant hip ultrasound, limited static exam (76886) | $1,375.20 | $2,292 | 15.8× |
| Infusion Ivp (74410) | $878.40 | $1,464 | 5.0× |
| Interstitial radiation source applic complex (77778) | $2,598 | $4,330 | 3.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,889 | $4,815 | 4.1× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,410.20 | $4,017 | 4.3× |
| Intracavitary radiation source applic simple (77761) | $1,482 | $2,470 | 2.7× |
| Joint Survey Single View (77077) | $301.20 | $502 | 2.9× |
| K Flow/Funct Image Multiple (78709) | $2,726.40 | $4,544 | 5.0× |
| K Flow/Funct Image W/Drug (78708) | $1,317.60 | $2,196 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $2,102.40 | $3,504 | 3.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$639.60–$959.40 | $1,066–$1,599 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,411.20 | $2,352 | 3.5× |
| Liver & Spleen Imaging Static Only (78215) | $912.60 | $1,521 | 2.3× |
| Liver imaging w/vascular flow (78202) | $578.40 | $964 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $405 | $675 | 0.7× |
| Lung perfusion differential (78597) | $1,764 | $2,940 | 4.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,872.60 | $3,121 | 3.4× |
| Lung Ventilation Imaging (78579) | $426 | $710 | 1.1× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$6,603.40–$7,449.07 | $11,005.66–$12,415.11 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $7,546.30 | $12,577.16 | 4.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,595.71 | $4,326.18 | 0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 3 matching MRF lines |
$6,739.81–$58,353.01 | $11,233.02–$97,255.01 | varies |
| Magnetic Image Jaw Joint (70336) | $897.60 | $1,496 | 3.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $2,607.60 | $4,346 | 14.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,172.60 | $3,621 | 4.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $4,084.80 | $6,808 | 23.2× |
| Magnetic Resonance Elastography (76391) | $546.60 | $911 | 2.3× |
| Mammary ductogram or galactogram multiple (77054) | $606 | $1,010 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $241.80 | $403 | 1.0× |
| Meckels Divert Exam (78290) | $521.40 | $869 | 1.3× |
| Medical physics dose eval radiation expos w/rprt (76145) | $188.40 | $314 | 0.5× |
| Mlc imrt design & construction per imrt plan (77338) | $2,400.60 | $4,001 | 6.4× |
| Mr safety determination physician/other qhp (76016) | $138.60 | $231 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $78.60 | $131 | 2.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $145.20 | $242 | 1.5× |
| Mr safety implt pos&/immoblj (76019) | $93.60 | $156 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $380.40 | $634 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,196.60 | $3,661 | 6.3× |
| MRA head w/o contrast (70544) | $1,168.80 | $1,948 | 4.9× |
| MRA head with contrast (70545) | $1,402.20 | $2,337 | 4.0× |
| MRA neck w contrast (70548) | $2,383.80 | $3,973 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,734.40 | $6,224 | 10.7× |
| MRA neck w/o contrast (70547) | $1,986.60 | $3,311 | 8.3× |
| MRI abdomen w contrast (74182) | $3,779.40 | $6,299 | 10.8× |
| MRI abdomen w/o contrast (74181) | $3,149.40 | $5,249 | 13.2× |
| MRI any jt lower extrem w/contrast material (73722) | $2,721 | $4,535 | 3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$4,262.40–$6,393.60 | $7,104–$10,656 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,339.18 | $7,231.96 | 5.5× |
| MRI bone marrow blood supply (77084) | $1,191 | $1,985 | 5.0× |
| MRI brain functional w/o physician admnistration (70554) | $907.80 | $1,513 | 3.8× |
| MRI brain functional w/physician admnistration (70555) | $527.40 | $879 | 2.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,705.80 | $2,843 | 7.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,135 | $5,225 | 13.1× |
| MRI cardiac w/o cont stress (75559) | $657.60 | $1,096 | 1.2× |
| MRI cardiac w/o contrast (75557) | $1,109.40 | $1,849 | 4.6× |
| MRI cervical spine w contrast (72142) | $1,360.80 | $2,268 | 3.9× |
| MRI cervical spine w/o cont (72141) | $1,134 | $1,890 | 4.7× |
| MRI chest w/o contrast (71550) | $1,479 | $2,465 | 6.2× |
| MRI chest with contrast (71551) | $1,775.40 | $2,959 | 2.3× |
| MRI chest wo w contrast (71552) | $2,781 | $4,635 | 7.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,177.40 | $3,629 | 6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,411–$5,116.80 | $5,685–$8,528 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,814.40–$2,721.60 | $3,024–$4,536 | varies |
| MRI lumbar spine w contrast (72149) | $1,089 | $1,815 | 3.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,131.80 | $3,553 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,162.40 | $3,604 | 9.0× |
| MRI orbit face neck w contrast (70542) | $2,594.40 | $4,324 | 7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,065 | $6,775 | 11.6× |
| MRI pelvis w contrast (72196) | $1,700.40 | $2,834 | 4.9× |
| MRI pelvis w/o & w contrast (72197) | $2,663.40 | $4,439 | 7.6× |
| MRI pelvis w/o contrast (72195) | $1,416.60 | $2,361 | 5.9× |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$556.20–$2,066.40 | $927–$3,444 | varies |
| MRI thoracic spine w/o contrast (72146) | $2,306.40 | $3,844 | 9.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,390.40 | $3,984 | 6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,992 | $3,320 | 8.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,745.20 | $6,242 | 10.7× |
| MRI, abdomen, combo (74183) | $5,920.80 | $9,868 | 16.9× |
| MRI, dorsal spine combo (72157) | $4,336.20 | $7,227 | 12.4× |
| MRI, dorsal spine contrast (72147) | $2,767.80 | $4,613 | 7.9× |
| MRI, joint upper extrem (73221) | $2,238 | $3,730 | 9.3× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$4,207.20–$6,310.80 | $7,012–$10,518 | varies |
| MRI, lumbar spine combo (72158) | $1,706.40 | $2,844 | 4.9× |
| Myelogram cervical (72240) | $1,540.20 | $2,567 | 2.0× |
| Myelogram Lumbar (72265) | $1,471.80 | $2,453 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $1,843.80 | $3,073 | 2.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $883.80 | $1,473 | 2.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $5,794.80 | $9,658 | 4.5× |
| Myocardial Spect Multiple Studies (78452) | $4,011.60 | $6,686 | 3.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $4,009.20 | $6,682 | 2.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $7,818.60 | $13,031 | 5.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $11,253 | $18,755 | 5.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $10,502.40 | $17,504 | 4.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $6,251.40 | $10,419 | 4.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,570.80 | $2,618 | 1.8× |
| Neck soft tissue (70360) | $334.20 | $557 | 3.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $764.40 | $1,274 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $643.80 | $1,073 | 1.6× |
| Nm csf leak detection (78650) | $1,420.20 | $2,367 | 1.1× |
| Nm myocard infarct spect (78469) | $1,222.80 | $2,038 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $1,643.40 | $2,739 | 15.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,145.20 | $15,242 | 6.6× |
| Nuclear Rx Oral Admin (79005) | $2,243.40 | $3,739 | 9.6× |
| Ob us nuchal meas 1 gest (76813) | $1,042.20 | $1,737 | 9.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $171.60 | $286 | 1.6× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $661.20 | $1,102 | 6.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$783–$1,094.40 | $1,305–$1,824 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $363 | $605 | 12.5× |
| Ophthalmic us dx quantitative a-scan only (76511) range across 2 matching MRF lines |
$419.40–$853.80 | $699–$1,423 | varies |
| Optic foramina (70190) | $166.20 | $277 | 1.9× |
| Panoramic X-ray of jaws (70355) | $743.40 | $1,239 | 8.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,395.80 | $3,993 | 4.4× |
| Parathyroid Planar Imaging (78070) | $303 | $505 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,126.80 | $1,878 | 2.8× |
| Pelvis 1 or 2 views (72170) | $334.20 | $557 | 3.2× |
| Perineogram (74775) | $366.60 | $611 | 1.5× |
| Peritoneogram Rs&I (74190) | $319.80 | $533 | 0.6× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$3,180–$5,100 | $5,300–$8,500 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$1,380–$5,661 | $2,300–$9,435 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,380–$5,661 | $2,300–$9,435 | varies |
| Pet Myocardial Sngl Study (78491) | $5,688 | $9,480 | 4.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $22,605.41 | $37,675.69 | 7.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $814.20 | $1,357 | 2.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,425.60 | $2,376 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $483 | $805 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$834.72–$856.86 | $1,391.20–$1,428.10 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$345.60–$518.40 | $576–$864 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$539.40–$809.40 | $899–$1,349 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$402.60–$604.20 | $671–$1,007 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,039.80 | $1,733 | 9.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$244.80–$367.20 | $408–$612 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$342–$513 | $570–$855 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$351.60–$527.40 | $586–$879 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$1,051.20–$1,576.80 | $1,752–$2,628 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $456.60 | $761 | 4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $322.80 | $538 | 3.7× |
| Radex Ribs Unilateral 2 Views (71100) | $316.80 | $528 | 3.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$336.60–$505.20 | $561–$842 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $205.20 | $342 | 2.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $918 | $1,530 | 5.2× |
| Radex Spine 1 View Specify Level (72020) | $297.60 | $496 | 3.4× |
| Radex Sternum Minimum 2 Views (71120) | $298.80 | $498 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $895.80 | $1,493 | 10.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$261–$391.80 | $435–$653 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$198.60–$298.20 | $331–$497 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$326.40–$489.60 | $544–$816 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $661.80 | $1,103 | 6.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,515 | $27,525 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $696 | $1,160 | 6.8× |
| Radiation treatment delivery level 2 (77407) | $613.80 | $1,023 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $1,308 | $2,180 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $187.80 | $313 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $341.40 | $569 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $654.60 | $1,091 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $735 | $1,225 | 4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $556.80 | $928 | 3.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$454.20–$681.60 | $757–$1,136 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $530.40 | $884 | 5.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $586.80 | $978 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $624 | $1,040 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $700.80 | $1,168 | 4.0× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$397.80–$597 | $663–$995 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$663.60–$995.40 | $1,106–$1,659 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$455.40–$683.40 | $759–$1,139 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $268.80 | $448 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$314.40–$471.60 | $524–$786 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $202.20 | $337 | 0.4× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $103.20 | $172 | 1.2× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $3,939 | $6,565 | 16.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $408.60 | $681 | 1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $408.60 | $681 | 1.1× |
| Renal Cyst Study (74470) | $287.40 | $479 | 0.5× |
| Ribs bilateral 3 views (71110) | $337.80 | $563 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $318 | $530 | 0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $303.60 | $506 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,483.20 | $2,472 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,552.40 | $4,254 | 4.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,003.40 | $3,339 | 3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,087.40 | $3,479 | 1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,397.40 | $7,329 | 3.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,876.60 | $6,461 | 3.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,511.60 | $4,186 | 10.7× |
| Rp Therapy Intravenous Administration (79101) | $707.40 | $1,179 | 3.0× |
| Salivary Gland Imaging (78230) | $994.80 | $1,658 | 2.5× |
| Scapula (73010) range across 2 matching MRF lines |
$354–$531 | $590–$885 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $864.60 | $1,441 | 37.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$219–$328.80 | $365–$548 | varies |
| Shoulder Arthrography (73040) | $937.80 | $1,563 | 2.7× |
| Skull less than 4 views (70250) | $589.80 | $983 | 5.6× |
| Special dosimetry (77331) | $162 | $270 | 1.2× |
| Special Physics Consult (77370) | $768 | $1,280 | 5.7× |
| Special teletherapy port plan (77321) | $1,216.20 | $2,027 | 3.2× |
| Special treatment procedure (77470) | $2,392.80 | $3,988 | 4.3× |
| Speech evaluation, complex (70371) | $551.40 | $919 | 2.3× |
| Srs Multisource (77371) | $77,164.20 | $128,607 | 10.4× |
| Stereotactic Body Radiation Delivery (77373) | $43,899 | $73,165 | 24.5× |
| Sternoclavicular joints (71130) | $66 | $110 | 0.8× |
| Superior sagittal sinus venogram (75870) | $2,743.80 | $4,573 | 0.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $493.80 | $823 | 4.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,543.20 | $7,572 | 12.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,268.40 | $2,114 | 3.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,876.20 | $3,127 | 5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,384.80 | $2,308 | 3.7× |
| Ther rad simulaj-aided field setting simple (77280) | $904.20 | $1,507 | 6.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $363 | $605 | 2.1× |
| Thoracic spine 2 views (72070) | $406.80 | $678 | 3.9× |
| Thoracic spine 3 views (72072) | $366.60 | $611 | 3.5× |
| Thoracolumbar 2 views (72080) | $352.80 | $588 | 4.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $818.40 | $1,364 | 2.0× |
| Thyroid Imaging With Vascular Flow (78013) | $932.40 | $1,554 | 2.3× |
| Thyroid Met Imaging Body (78018) | $2,296.20 | $3,827 | 4.2× |
| Thyroid Uptake Measurement (78012) | $1,117.20 | $1,862 | 2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,530.20 | $4,217 | 6.3× |
| Tx Devices Design & Construction Complex (77334) | $1,575 | $2,625 | 4.2× |
| Tx devices design & construction intermediate (77333) | $1,092 | $1,820 | 8.1× |
| Tx devices design & construction simple (77332) | $408 | $680 | 3.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$2,982–$6,311.04 | $4,970–$10,518.40 | varies |
| Ultrasound elastography first target lesion (76982) | $745.80 | $1,243 | 7.1× |
| Ultrasound Elastography Parenchyma (76981) | $273.60 | $456 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$537–$572.40 | $895–$954 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,386 | $2,310 | 4.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,288.20–$1,293.60 | $2,147–$2,156 | varies |
| Umbilical-artery Doppler (OB) (76820) | $1,084.20 | $1,807 | 10.3× |
| Unlisted Dx Radiographic Procedure (76499) | $617.40 | $1,029 | 7.1× |
| Unlisted fluoroscopic procedure (76496) | $186 | $310 | 2.1× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $337.80 | $563 | 0.8× |
| Unlisted magnetic resonance procedure (76498) | $3,361.80 | $5,603 | 38.5× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,960.80 | $3,268 | 19.2× |
| Unlisted respiratory px dx nuclear medicine (78599) | $1,408.20 | $2,347 | 3.5× |
| Unlisted us procedure (76999) | $1,851 | $3,085 | 21.2× |
| Upper gi w/o kub (74240) | $705 | $1,175 | 4.0× |
| Ureteral Reflux Study (78740) | $1,148.40 | $1,914 | 2.9× |
| Urethrocystogram voiding (74455) | $368.40 | $614 | 1.5× |
| Urethrocystography retrograde (74450) | $10,169.08 | $16,948.47 | 42.5× |
| Us breast unilateral complete (76641) | $3,702 | $6,170 | 35.3× |
| Us chest (76604) | $499.20 | $832 | 4.8× |
| Us complete joint (76881) | $797.40 | $1,329 | 7.6× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$714.60–$3,220.18 | $1,191–$5,366.97 | varies |
| Us head (76506) | $1,090.20 | $1,817 | 10.4× |
| Us kidney transplant (76776) | $146.40 | $244 | 1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $530.40 | $884 | 5.1× |
| Us ob detailed single fetus (76811) | $1,008 | $1,680 | 4.2× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$1,497.60–$1,518 | $2,496–$2,530 | varies |
| Us ob transvaginal (76817) | $1,497.60 | $2,496 | 14.3× |
| Us pelvic non ob complete (76856) | $2,008.20 | $3,347 | 19.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$2,289.60–$2,308.80 | $3,816–$3,848 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$920.40–$946.20 | $1,534–$1,577 | varies |
| Us retroperitoneal complete (76770) | $928.80 | $1,548 | 8.9× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$8,660.39–$8,673.19 | $14,433.98–$14,455.32 | varies |
| Us scrotum and contents (76870) | $721.80 | $1,203 | 6.9× |
| Us spinal canal and contents (76800) | $1,444.80 | $2,408 | 13.8× |
| Us thyroid (76536) | $1,075.20 | $1,792 | 10.3× |
| Us transrectal (76872) range across 2 matching MRF lines |
$6,011.77–$6,018.68 | $10,019.62–$10,031.14 | varies |
| Vascular Flow Imaging (78445) | $1,155 | $1,925 | 2.9× |
| Vein X-Ray Chest (75827) | $6,541.79 | $10,902.98 | 4.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $8,649.17 | $14,415.29 | 2.7× |
| Vein X-Ray Spleen/Liver (75810) | $23,418.32 | $39,030.54 | 7.4× |
| Venogram Sinus/Jugular (75860) | $11,173.44 | $18,622.40 | 3.5× |
| Venography Adrenal Unilateral (75840) | $14,064.88 | $23,441.47 | 4.4× |
| Venography caval inferior serialography rs&i (75825) | $15,597.14 | $25,995.23 | 4.9× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,923.60–$1,946.04 | $3,206–$3,243.40 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$7,098.74–$7,301.15 | $11,831.24–$12,168.58 | varies |
| Venography Orbital Rs&I (75880) | $445.20 | $742 | 0.7× |
| Venography Renal Bilateral (75833) | $2,089.80 | $3,483 | 0.7× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$9,095–$10,445.26 | $15,158.34–$17,408.76 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$14,034.02–$14,360.86 | $23,390.03–$23,934.77 | varies |
| Vertebral fracture assessment via dxa (77086) | $443.40 | $739 | 5.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$261–$391.80 | $435–$653 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $153 | $255 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $219.60 | $366 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $8,678.80 | $14,464.66 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $432 | $720 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$276.60–$415.20 | $461–$692 | varies |
| X-Ray Exam Breast Specimen (76098) | $494.40 | $824 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $614.40 | $1,024 | 7.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $630 | $1,050 | 6.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $645.60 | $1,076 | 6.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $400.80 | $668 | 4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $459 | $765 | 5.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $818.40 | $1,364 | 7.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $559.20 | $932 | 5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,534.80 | $2,558 | 14.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $559.80 | $933 | 5.3× |
| X-Ray Exam L-S Spine Bending (72114) | $517.80 | $863 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $360 | $600 | 4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $649.20 | $1,082 | 6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $378 | $630 | 3.6× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$238.80–$358.20 | $398–$597 | varies |
| X-ray humerus (73060) | $575.40 | $959 | 6.6× |
| X-ray IV pyelogram+tomography (74415) | $1,169.40 | $1,949 | 6.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $186.60 | $311 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $219 | $365 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $373.20 | $622 | 3.6× |
| X-ray nose-rectum child f.b. (76010) | $542.40 | $904 | 6.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $455.40 | $759 | 4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $427.80 | $713 | 4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $594 | $990 | 5.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $380.40 | $634 | 4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $797.40 | $1,329 | 9.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $604.20 | $1,007 | 5.8× |
| X-ray thoracic spine 4 vw (72074) | $370.20 | $617 | 3.5× |
| X-Ray Tmj Unilat (70328) | $140.40 | $234 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$13,928.96–$14,111.59 | $23,214.93–$23,519.32 | varies |
| X-Rays Bone Length Studies (77073) | $613.20 | $1,022 | 5.8× |
| X-Rays Bone Survey Complete (77075) | $931.80 | $1,553 | 8.9× |
| Xr c-spine 4 or 5 views (72050) | $469.20 | $782 | 4.5× |
| Xr facial bones less than 3 views (70140) | $1,005 | $1,675 | 11.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $294.60 | $491 | 2.8× |
| Xr orbits complete 4 views (70200) | $130.80 | $218 | 1.2× |
| Xr Tomogram Single Plane (76100) | $624 | $1,040 | 5.9× |
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.