Imaging prices at Valley View Medical Center
Fort Mohave, AZ · every code in this section with a posted price and a Medicare benchmark.
366 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) | $6,680.40 | $11,134 | 4.5× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$658.27–$725.74 | $1,097.11–$1,209.56 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$809.17–$849.63 | $1,348.62–$1,416.05 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$4,583.83–$4,813.03 | $7,639.72–$8,021.71 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) range across 2 matching MRF lines |
$1,048.76–$1,101.20 | $1,747.94–$1,835.34 | varies |
| Adrenal Cortex & Medulla Img (78075) | $2,002.80 | $3,338 | 1.4× |
| Angio pulmonary bilat (75743) | $3,879.60 | $6,466 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$6,740.76–$7,077.80 | $11,234.60–$11,796.33 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$1,629–$7,077.80 | $2,715–$11,796.33 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,879.60 | $6,466 | 1.2× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$49.80–$869.14 | $83–$1,448.56 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,629 | $2,715 | 0.3× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$1,501.19–$1,576.25 | $2,501.99–$2,627.09 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$2,240.32–$2,352.33 | $3,733.86–$3,920.55 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$582–$1,576.25 | $970–$2,627.09 | varies |
| Basic radiation dosimetry calculation (77300) | $489 | $815 | 3.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$646.46–$678.78 | $1,077.43–$1,131.30 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$3,699.81–$3,884.80 | $6,166.35–$6,474.67 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$3,251.54–$3,414.12 | $5,419.24–$5,690.20 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$4,086.57–$4,290.90 | $6,810.95–$7,151.50 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$3,439.18–$3,611.14 | $5,731.97–$6,018.57 | varies |
| Bone marrow imaging; multiple areas (78103) | $2,118 | $3,530 | 5.0× |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$4,413.92–$4,634.62 | $7,356.53–$7,724.36 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| Brachytx isodose complex (77318) | $1,303.20 | $2,172 | 3.3× |
| Brachytx isodose intermed (77317) | $978 | $1,630 | 2.4× |
| Brachytx Isodose Plan Simple (77316) | $651.60 | $1,086 | 1.6× |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$249.48–$1,336.20 | $415.80–$2,227 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$3,068.05–$3,221.45 | $5,113.41–$5,369.08 | varies |
| Brain imaging < 4 static views (78600) range across 2 matching MRF lines |
$2,840.79–$2,982.83 | $4,734.65–$4,971.38 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$3,286.98–$3,451.33 | $5,478.30–$5,752.22 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 2 matching MRF lines |
$3,068.05–$3,221.45 | $5,113.41–$5,369.08 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$5,050.80–$6,393.67 | $8,418–$10,656.11 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 2 matching MRF lines |
$1,636.72–$1,718.56 | $2,727.87–$2,864.26 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) range across 2 matching MRF lines |
$2,321.63–$2,437.71 | $3,869.38–$4,062.85 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$4,000.80–$4,200.84 | $6,668–$7,001.40 | varies |
| Cardiac Shunt Detection (78428) range across 2 matching MRF lines |
$3,695.63–$3,880.42 | $6,159.39–$6,467.36 | varies |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$1,140.60–$2,184.85 | $1,901–$3,641.42 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$3,121.22–$3,277.28 | $5,202.04–$5,462.14 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $2,403.60 | $4,006 | 4.1× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$2,656.28–$2,789.10 | $4,427.14–$4,648.50 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$297.73–$691.18 | $496.22–$1,151.97 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$809.17–$849.63 | $1,348.62–$1,416.05 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$809.17–$849.63 | $1,348.62–$1,416.05 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$809.17–$849.63 | $1,348.62–$1,416.05 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$455.38–$478.15 | $758.96–$796.91 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $574.20 | $957 | 5.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$42.60–$894.31 | $71–$1,490.51 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$213.73–$224.42 | $356.22–$374.03 | varies |
| Continuing medical physics consltj pr wk (77336) | $814.80 | $1,358 | 5.7× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$12,132.53–$12,739.16 | $20,220.89–$21,231.93 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$1,634.63–$1,716.37 | $2,724.39–$2,860.61 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$2,132.95–$2,239.60 | $3,554.91–$3,732.66 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$4,332–$4,548.60 | $7,220–$7,581 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,866.99–$3,010.34 | $4,778.32–$5,017.24 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$5,995.39–$6,295.16 | $9,992.31–$10,491.93 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$6,962.81–$7,310.95 | $11,604.68–$12,184.91 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$5,332.35–$5,598.97 | $8,887.25–$9,331.61 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$13,291.78–$13,956.37 | $22,152.97–$23,260.62 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$3,143.12–$3,300.28 | $5,238.53–$5,500.46 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$4,366.42–$7,431.36 | $7,277.36–$12,385.60 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$669.58–$703.06 | $1,115.97–$1,171.77 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,637.42–$4,341.36 | $6,062.37–$7,235.60 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$6,740.76–$7,077.80 | $11,234.60–$11,796.33 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,464.21–$3,637.42 | $5,773.69–$6,062.37 | varies |
| CT bone density (77078) | $218.40 | $364 | 2.4× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$3,093.07–$3,247.73 | $5,155.12–$5,412.88 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$7,464.25–$7,837.46 | $12,440.41–$13,062.43 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$5,532.52–$5,809.15 | $9,220.87–$9,681.91 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$5,332.35–$5,598.97 | $8,887.25–$9,331.61 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$7,995.93–$8,395.73 | $13,326.55–$13,992.88 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$4,902.85–$5,147.99 | $8,171.42–$8,579.99 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$5,596.10–$5,875.91 | $9,326.84–$9,793.18 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$913.54–$959.21 | $1,522.56–$1,598.69 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$95.20–$224.42 | $158.66–$374.03 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$692.10–$726.71 | $1,153.50–$1,211.18 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$4,161.64–$5,839.80 | $6,936.06–$9,733 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$3,719.62–$3,905.60 | $6,199.36–$6,509.33 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,269.62–$7,617.45 | $5,449.37–$12,695.75 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,653.94–$3,836.64 | $6,089.90–$6,394.40 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$3,719.62–$3,905.60 | $6,199.36–$6,509.33 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$7,464.25–$7,837.46 | $12,440.41–$13,062.43 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$5,561.71–$5,839.80 | $9,269.52–$9,733 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$1,792.20–$7,388.66 | $2,987–$12,314.44 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$3,467.34–$3,640.71 | $5,778.90–$6,067.85 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,810.57–$2,951.09 | $4,684.28–$4,918.49 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$3,269.26–$4,607.23 | $5,448.77–$7,678.72 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$4,007.40–$7,310.95 | $6,679–$12,184.91 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$5,332.35–$5,598.97 | $8,887.25–$9,331.61 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$4,246.06–$4,458.37 | $7,076.77–$7,430.61 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$1,595.53–$2,541.70 | $2,659.21–$4,236.17 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$6,242.44–$6,554.56 | $10,404.07–$10,924.27 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$5,197.88–$5,457.78 | $8,663.14–$9,096.30 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$7,700.90–$8,085.95 | $12,834.84–$13,476.58 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$7,457.99–$7,830.89 | $12,429.99–$13,051.49 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$7,700.90–$8,085.95 | $12,834.84–$13,476.58 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$6,330.02–$6,646.52 | $10,550.03–$11,077.53 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$7,254.71–$7,617.45 | $12,091.19–$12,695.75 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$7,729.05–$8,115.50 | $12,881.75–$13,525.84 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$4,385.77–$4,605.06 | $7,309.62–$7,675.10 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$1,993.80–$3,637.42 | $3,323–$6,062.37 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,140.23–$2,247.24 | $3,567.05–$3,745.40 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,929.67–$2,026.16 | $3,216.12–$3,376.93 | varies |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) range across 2 matching MRF lines |
$1,811.87–$1,902.46 | $3,019.78–$3,170.77 | varies |
| Dilation ureters/urethra rs&i (74485) | $1,197.60 | $1,996 | 0.5× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$285.62–$892.11 | $476.03–$1,486.85 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 3 matching MRF lines |
$236.50–$744.34 | $394.17–$1,240.56 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$1,068.55–$1,121.98 | $1,780.92–$1,869.97 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$796.56–$836.39 | $1,327.60–$1,393.98 | varies |
| Esophageal Motility Study (78258) range across 2 matching MRF lines |
$1,866.07–$1,959.38 | $3,110.12–$3,265.63 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$297.60–$655.67 | $496–$1,092.79 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$1,486.60–$1,560.93 | $2,477.67–$2,601.55 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$171.60–$285.62 | $286–$476.03 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$1,416.43–$1,567.49 | $2,360.72–$2,612.49 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$562.95–$591.10 | $938.25–$985.16 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$53.40–$716.98 | $89–$1,194.96 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$4,588.02–$4,817.42 | $7,646.70–$8,029.04 | varies |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$3,919.77–$4,115.76 | $6,532.95–$6,859.60 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$8,642.28–$9,074.39 | $14,403.80–$15,123.99 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$8,610.98–$9,041.53 | $14,351.64–$15,069.22 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$49.80–$594.38 | $83–$990.63 | varies |
| Heart first pass single,planar (78481) range across 2 matching MRF lines |
$2,097.49–$2,202.37 | $3,495.82–$3,670.61 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,948.42–$2,045.84 | $3,247.36–$3,409.73 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,027.87–$1,079.27 | $1,713.12–$1,798.78 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$2,153.80–$2,261.48 | $3,589.66–$3,769.14 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$4,051.13–$4,253.69 | $6,751.89–$7,089.48 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$3,365.16–$3,533.42 | $5,608.60–$5,889.03 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$2,293.80–$3,287.14 | $3,823–$5,478.56 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,345.80 | $2,243 | 3.2× |
| Kidney Imaging Morphol (78700) | $1,402.80 | $2,338 | 3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$718.80–$1,326 | $1,198–$2,210 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$930.96–$977.51 | $1,551.60–$1,629.18 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$2,972.14–$3,120.75 | $4,953.57–$5,201.25 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$2,719.85–$2,855.84 | $4,533.09–$4,759.74 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,534.20 | $2,557 | 3.6× |
| Liver imaging static only (78201) | $1,348.80 | $2,248 | 2.3× |
| Liver imaging w/vascular flow (78202) | $1,465.80 | $2,443 | 2.5× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$2,100.64–$2,205.67 | $3,501.06–$3,676.11 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$1,027.87–$1,079.27 | $1,713.12–$1,798.78 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$2,100.64–$2,205.67 | $3,501.06–$3,676.11 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$3,591.39–$3,770.96 | $5,985.65–$6,284.93 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$2,221.80–$4,681.68 | $3,703–$7,802.80 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$618.31–$649.23 | $1,030.52–$1,082.05 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$1,175.92–$1,234.72 | $1,959.87–$2,057.86 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$2,942.97–$3,090.12 | $4,904.95–$5,150.20 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$211.32–$221.89 | $352.20–$369.81 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $58.78 | $97.96 | 1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$220.30–$231.31 | $367.16–$385.52 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$142.56–$149.69 | $237.60–$249.48 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$580.13–$609.13 | $966.88–$1,015.22 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$4,323.74–$7,472.95 | $7,206.23–$12,454.92 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$4,053.37–$4,681.68 | $6,755.62–$7,802.80 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$4,755.86–$4,993.65 | $7,926.43–$8,322.75 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$4,755.86–$4,993.65 | $7,926.43–$8,322.75 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$2,370–$4,993.65 | $3,950–$8,322.75 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$2,221.80–$4,681.68 | $3,703–$7,802.80 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$2,962.20–$6,242.60 | $4,937–$10,404.33 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$2,814–$5,930.65 | $4,690–$9,884.41 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$2,264.75–$4,636.80 | $3,774.58–$7,728 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 5 matching MRF lines |
$2,827.39–$3,545.47 | $4,712.32–$5,909.12 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$2,505.58–$4,611.60 | $4,175.96–$7,686 | varies |
| MRI bone marrow blood supply (77084) | $2,666.40 | $4,444 | 10.5× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$8,798.63–$9,238.57 | $14,664.39–$15,397.61 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$1,922.76–$7,009.93 | $3,204.60–$11,683.22 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$2,584.80–$2,714.04 | $4,308–$4,523.40 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$5,404.12–$6,242.60 | $9,006.86–$10,404.33 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,629–$3,432.73 | $2,715–$5,721.21 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$1,629–$3,432.73 | $2,715–$5,721.21 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$3,567.41–$3,745.78 | $5,945.69–$6,242.97 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,250.80–$5,133.76 | $5,418–$8,556.27 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,906.22–$3,357.19 | $4,843.70–$5,595.32 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,680.20–$5,930.65 | $4,467–$9,884.41 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 6 matching MRF lines |
$2,539.80–$6,242.60 | $4,233–$10,404.33 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$5,674.50–$6,554.56 | $9,457.50–$10,924.27 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$4,679.49–$6,554.56 | $7,799.15–$10,924.27 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$5,945.33–$6,242.60 | $9,908.89–$10,404.33 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$5,945.33–$6,242.60 | $9,908.89–$10,404.33 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$4,864.49–$5,617.58 | $8,107.48–$9,362.63 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$4,889.30–$5,133.76 | $8,148.83–$8,556.27 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 5 matching MRF lines |
$2,680.20–$5,930.65 | $4,467–$9,884.41 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$5,404.12–$6,242.60 | $9,006.86–$10,404.33 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$2,962.20–$6,242.60 | $4,937–$10,404.33 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$2,680.20–$5,930.65 | $4,467–$9,884.41 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,906.22–$3,357.19 | $4,843.70–$5,595.32 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$5,133.76–$5,930.65 | $8,556.27–$9,884.41 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$3,186.89–$3,346.24 | $5,311.49–$5,577.06 | varies |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$1,746–$3,346.24 | $2,910–$5,577.06 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$2,886.66–$3,031 | $4,811.10–$5,051.66 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$3,186.89–$3,346.24 | $5,311.49–$5,577.06 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,578.60 | $2,631 | 3.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 3 matching MRF lines |
$5,050.80–$6,783.34 | $8,418–$11,305.57 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,336.20 | $2,227 | 2.3× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,474.03–$4,697.73 | $7,456.71–$7,829.55 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$53.40–$803.46 | $89–$1,339.10 | varies |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$3,395.39–$3,565.16 | $5,658.99–$5,941.94 | varies |
| Nm myocard infarct spect (78469) | $1,897.20 | $3,162 | 3.3× |
| Nm red cell survival study (78130) | $1,671 | $2,785 | 3.9× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,124.20 | $15,207 | 6.2× |
| Nuclear medicine study of endocrine organs (78099) | $437.40 | $729 | 1.0× |
| Nuclear Rx Oral Admin (79005) range across 4 matching MRF lines |
$2,242.88–$3,605.66 | $3,738.13–$6,009.44 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$278.59–$292.52 | $464.31–$487.53 | varies |
| Optic foramina (70190) | $739.20 | $1,232 | 8.0× |
| Panoramic X-ray of jaws (70355) | $454.80 | $758 | 4.9× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$4,207.50–$4,417.88 | $7,012.50–$7,363.13 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$419.40–$803.46 | $699–$1,339.10 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$6,089.21–$6,393.67 | $10,148.68–$10,656.11 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$6,089.21–$6,393.67 | $10,148.68–$10,656.11 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$6,089.21–$6,393.67 | $10,148.68–$10,656.11 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 3 matching MRF lines |
$5,050.80–$9,214.50 | $8,418–$15,357.50 | varies |
| PET whole body (78813) range across 3 matching MRF lines |
$5,050.80–$7,959.82 | $8,418–$13,266.37 | varies |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $1,336.20 | $2,227 | 1.0× |
| Platelet survival study Non-Facility (78191) | $1,336.20 | $2,227 | 3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$2,160.04–$2,268.04 | $3,600.07–$3,780.07 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,290.61–$1,355.14 | $2,151.02–$2,258.57 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$2,111.03–$2,216.59 | $3,518.39–$3,694.31 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$827.75–$869.14 | $1,379.58–$1,448.56 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$39–$591.10 | $65–$985.16 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$875.69–$919.48 | $1,459.49–$1,532.46 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$50.40–$1,370.47 | $84–$2,284.12 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$531.68–$558.27 | $886.14–$930.45 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$782.92–$822.06 | $1,304.86–$1,370.10 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$782.92–$822.06 | $1,304.86–$1,370.10 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$668.81–$749.81 | $1,114.69–$1,249.69 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,151.40 | $1,919 | 10.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$926.78–$973.12 | $1,544.63–$1,621.86 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$230.38–$1,258.82 | $383.97–$2,098.03 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$480–$1,039.90 | $800–$1,733.16 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$442.20–$1,039.90 | $737–$1,733.16 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,215 | $2,025 | 6.5× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$152.40–$1,023.48 | $254–$1,705.80 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$53.40–$1,081.49 | $89–$1,802.48 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$1,504.32–$1,579.54 | $2,507.20–$2,632.56 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$49.80–$561.53 | $83–$935.89 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$498.60–$909.63 | $831–$1,516.05 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$901.47–$946.54 | $1,502.45–$1,577.57 | varies |
| Radiation treatment delivery level 1 (77402) | $489 | $815 | 4.5× |
| Radiation treatment delivery level 2 (77407) | $651.60 | $1,086 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $814.80 | $1,358 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$46.80–$1,760.14 | $78–$2,933.56 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$809.17–$849.63 | $1,348.62–$1,416.05 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$2,146.49–$2,253.82 | $3,577.49–$3,756.36 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,715.95–$1,801.75 | $2,859.92–$3,002.92 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$64.20–$1,030.04 | $107–$1,716.73 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$71.40–$285.62 | $119–$476.03 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$2,111.03–$2,216.59 | $3,518.39–$3,694.31 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$1,637.75–$1,719.64 | $2,729.59–$2,866.07 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$517.07–$542.92 | $861.78–$904.87 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$253.54–$266.22 | $422.57–$443.70 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$665.12–$698.38 | $1,108.53–$1,163.96 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$1,353.16–$1,420.81 | $2,255.26–$2,368.02 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$714.11–$749.81 | $1,190.18–$1,249.69 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,882.20 | $3,137 | 7.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $2,073 | $3,455 | 8.3× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $1,212.60 | $2,021 | 2.1× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$64.20–$365.60 | $107–$609.34 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$2,228.86–$2,340.31 | $3,714.77–$3,900.51 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$3,113.93–$3,269.62 | $5,189.88–$5,449.37 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$4,273.18–$4,486.84 | $7,121.97–$7,478.07 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 6 matching MRF lines |
$1,497.44–$4,566.73 | $2,495.73–$7,611.22 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$573.31–$601.98 | $955.52–$1,003.30 | varies |
| Salivary Gland Function Study (78232) | $1,259.40 | $2,099 | 3.0× |
| Salivary Gland Imaging (78230) range across 2 matching MRF lines |
$2,188.20–$2,297.61 | $3,647–$3,829.35 | varies |
| Salivary Gland Imaging Serial Images (78231) | $1,516.20 | $2,527 | 3.6× |
| Scapula (73010) range across 3 matching MRF lines |
$49.80–$1,062.86 | $83–$1,771.44 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$119.26–$125.23 | $198.77–$208.71 | varies |
| Sella turcica (70240) | $440.40 | $734 | 4.7× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$225.24–$236.50 | $375.40–$394.17 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$2,353.96–$2,471.65 | $3,923.26–$4,119.42 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$85.80–$1,117.60 | $143–$1,862.66 | varies |
| Special dosimetry (77331) | $814.80 | $1,358 | 5.7× |
| Special Physics Consult (77370) | $651.60 | $1,086 | 4.5× |
| Special teletherapy port plan (77321) | $978 | $1,630 | 2.4× |
| Special treatment procedure (77470) | $1,629 | $2,715 | 2.8× |
| Spleen Imaging (78185) | $817.20 | $1,362 | 1.9× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$60.60–$1,124.17 | $101–$1,873.62 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $814.80 | $1,358 | 2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $489 | $815 | 1.2× |
| Testicular Imaging W/Flow (78761) range across 3 matching MRF lines |
$959.40–$2,848.21 | $1,599–$4,747.02 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,466.40 | $2,444 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $978 | $1,630 | 2.4× |
| Ther rad simulaj-aided field setting simple (77280) | $651.60 | $1,086 | 4.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$1,187.40–$1,246.77 | $1,979–$2,077.95 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$1,415.71–$1,486.49 | $2,359.51–$2,477.49 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$1,149.87–$1,207.36 | $1,916.45–$2,012.27 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $377.40 | $629 | 0.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $609 | $1,015 | 1.4× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,734.45–$2,871.17 | $4,557.42–$4,785.29 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$2,734.45–$2,871.17 | $4,557.42–$4,785.29 | varies |
| Tx Devices Design & Construction Complex (77334) | $1,140.60 | $1,901 | 2.9× |
| Tx devices design & construction intermediate (77333) | $814.80 | $1,358 | 5.7× |
| Tx devices design & construction simple (77332) | $325.80 | $543 | 2.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$225.24–$236.50 | $375.40–$394.17 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$278.59–$292.52 | $464.31–$487.53 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$569.18–$1,557.65 | $948.63–$2,596.08 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$478.15–$2,109.34 | $796.91–$3,515.56 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$2,972.14–$3,120.75 | $4,953.57–$5,201.25 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$1,846.27–$1,938.58 | $3,077.11–$3,230.97 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,846.27–$1,938.58 | $3,077.11–$3,230.97 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,415.45–$2,123.17 | $2,359.09–$3,538.62 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$292.52–$1,539.04 | $487.53–$2,565.07 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$829.80–$1,514.95 | $1,383–$2,524.91 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$648–$853.81 | $1,080–$1,423.02 | varies |
| Us head (76506) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$1,486.60–$1,560.93 | $2,477.67–$2,601.55 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$278.59–$292.52 | $464.31–$487.53 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,625.26–$1,706.52 | $2,708.76–$2,844.20 | varies |
| Us ob limited 1 or more fetuses (76815) range across 6 matching MRF lines |
$285.62–$1,560.93 | $476.03–$2,601.55 | varies |
| Us pelvic non ob complete (76856) range across 5 matching MRF lines |
$597.65–$2,073.22 | $996.08–$3,455.36 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$292.52–$1,560.93 | $487.53–$2,601.55 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$285.62–$855.60 | $476.03–$1,426 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$1,073.52–$2,073.22 | $1,789.20–$3,455.36 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$292.52–$2,073.22 | $487.53–$3,455.36 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$843.60–$1,560.93 | $1,406–$2,601.55 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$1,303.13–$1,368.28 | $2,171.88–$2,280.47 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$569.19–$1,539.04 | $948.65–$2,565.07 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$325.80–$640.35 | $543–$1,067.25 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$1,276.51–$1,340.34 | $2,127.52–$2,233.90 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$2,156.90–$2,264.75 | $3,594.84–$3,774.58 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,567.65–$2,696.03 | $4,279.42–$4,493.39 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,372.71–$2,491.34 | $3,954.51–$4,152.24 | varies |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,629 | $2,715 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$1,680.49–$1,764.52 | $2,800.82–$2,940.86 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$627.60–$658.98 | $1,046–$1,098.30 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$49.80–$642.56 | $83–$1,070.93 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$42.60–$1,337.63 | $71–$2,229.38 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$913.54–$959.21 | $1,522.56–$1,598.69 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$2,830.37–$2,971.89 | $4,717.29–$4,953.15 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$1,101.91–$1,157.01 | $1,836.52–$1,928.35 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$46.80–$695.08 | $78–$1,158.47 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,357.34–$1,425.20 | $2,262.23–$2,375.34 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$253.54–$655.67 | $422.57–$1,092.79 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$253.54–$266.22 | $422.57–$443.70 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$419.88–$440.87 | $699.80–$734.79 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$89.40–$1,672.56 | $149–$2,787.60 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$1,070.64–$1,124.17 | $1,784.40–$1,873.62 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$1,600.24–$1,680.25 | $2,667.06–$2,800.41 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$1,198.87–$1,258.82 | $1,998.12–$2,098.03 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$848.60–$891.03 | $1,414.33–$1,485.05 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,383.40–$1,452.56 | $2,305.66–$2,420.94 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$455.38–$478.15 | $758.96–$796.91 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$225.24–$236.50 | $375.40–$394.17 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$930.96–$977.51 | $1,551.60–$1,629.18 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$1,136.33–$1,193.15 | $1,893.89–$1,988.58 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$298.15–$313.06 | $496.92–$521.77 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$89.40–$1,622.23 | $149–$2,703.72 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$1,415.71–$1,486.49 | $2,359.51–$2,477.49 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$49.80–$1,175.62 | $83–$1,959.36 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$60.60–$1,622.23 | $101–$2,703.72 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$1,497.02–$1,571.87 | $2,495.03–$2,619.78 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$272.02–$285.62 | $453.36–$476.03 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$2,376.89–$2,495.73 | $3,961.48–$4,159.55 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$1,482.67–$1,556.80 | $2,471.11–$2,594.67 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,353.16–$1,420.81 | $2,255.26–$2,368.02 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$78.60–$1,680.25 | $131–$2,800.41 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$36–$793.60 | $60–$1,322.67 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$57.60–$285.62 | $96–$476.03 | varies |
| Xr Tomogram Single Plane (76100) | $488.40 | $814 | 4.4× |
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.