Imaging prices at Washington County Hospital and Nursing Home

Chatom, AL · every code in this section with a posted price and a Medicare benchmark.

552 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $54.17 — 0.0×
Abdomen 1 View (74018) $54.17 $186.36 0.7×
Abdomen 2 views (74019) $54.17 $343.38 0.6×
Acute Gastrointestinal Blood Loss Imaging (78278) $54.17 — 0.2×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $54.17 — 0.0×
Adrenal Cortex & Medulla Img (78075) $54.17 — 0.0×
Angio internal mammary (75756) $54.17 — 0.0×
Angio pulmonary bilat (75743) $54.17 — 0.0×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $54.17 — 0.0×
Angiography extremity bilateral rs&i (75716) $54.17 — 0.0×
Angiography extremity unilateral rs&i (75710) $54.17 — 0.0×
Angiography pulmonary unilateral slctv rs&i (75741) $54.17 — 0.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $54.17 — 0.0×
Ankle 2 views (73600) $54.17 — 0.7×
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Aortography thoracic w/o serialography rs&i (75600) $54.17 — 0.0×
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Artery X-Rays Adrenal Gland (75731) $54.17 — 0.0×
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Arthrogram ankle (73615) $54.17 — 0.2×
Arthrogram hip (73525) $54.17 — 0.2×
Arthrogram Wrist (73115) $54.17 — 0.2×
Basic radiation dosimetry calculation (77300) $54.17 — 0.4×
Bone age studies (77072) $54.17 $343.38 0.6×
Bone Imaging 3 Phase (78315) $54.17 — 0.2×
Bone Imaging Limited Area (78300) $54.17 — 0.2×
Bone Imaging Multiple Areas (78305) $54.17 — 0.2×
Bone Imaging Whole Body (78306) $54.17 — 0.2×
Bone marrow imaging limited area (78102) $54.17 — 0.2×
Bone marrow imaging; multiple areas (78103) $54.17 — 0.2×
Bone marrow imaging; whole body (78104) $54.17 — 0.2×
Bone survey infant (77076) $54.17 — 0.6×
Brachytx isodose complex (77318) $54.17 — 0.2×
Brachytx isodose intermed (77317) $54.17 — 0.2×
Brachytx Isodose Plan Simple (77316) $54.17 — 0.2×
Brain Flow Imaging Only (78610) $54.17 — 0.1×
Brain Image W/Flow < 4 Views (78601) $54.17 — 0.2×
Brain imaging < 4 static views (78600) $54.17 — 0.2×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $54.17 — 0.1×
Brain Imaging Minimum 4 Static Views (78605) $54.17 — 0.1×
Brain Imaging Pet Metabolic Evaluation (78608) $54.17 — 0.0×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $54.17 — 0.2×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $54.17 — 0.1×
Cardiac MRI w/w/o contrast & further seq (75561) $54.17 — 0.2×
Cardiac MRI w/w/o contrast w/stress (75563) $54.17 — 0.1×
Cardiac Shunt Detection (78428) $54.17 — 0.2×
Cardiovasc nucl exam unlisted (78499) $54.17 — 0.2×
Cat Scan Follow-Up Study (76380) $54.17 — 0.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $54.17 — 0.1×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $54.17 — 0.1×
Cerebrospinal Fluid Scan (78630) $54.17 — 0.1×
Chest 1 view (71045) $54.17 $186.36 0.7×
Chest 2 views (71046)
range across 2 matching MRF lines		 $54.17 $40–$186.36 0.7×
Chest 3 views (71047) $54.17 $186.36 0.7×
Chest 4 or more views (71048) $54.17 $343.38 0.6×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $54.17 — 0.6×
Cholecystography Oral Contrast (74290) $54.17 — 0.3×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $54.17 — 0.6×
Cisternography Positive Contrast Rs&I (70015) $54.17 — 0.1×
Clavicle complete (73000) $54.17 — 0.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $54.17 — 0.6×
Continuing medical physics consltj pr wk (77336) $54.17 — 0.4×
Contrast Exam Abdominl Aorta (75625) $54.17 — 0.0×
Contrast X-Ray Bladder (74430) $54.17 — 0.2×
Contrast X-Ray Of Elbow (73085) $54.17 — 0.2×
Contrast X-Ray Of Knee Joint (73580) $54.17 — 0.2×
Contrast Xray Throat/Cerv Esopha (74210) $54.17 — 0.3×
Corpora cavernosography (74445) $54.17 — 0.6×
CT abdomen and pelvis without and with contrast (74178) $54.17 $1,447.74 0.2×
CT abdomen and pelvis without contrast (74176) $54.17 $918.15 0.3×
CT abdomen w contrast (74160) $54.17 $891.45 0.3×
CT abdomen w wo contrast (74170) $54.17 $988.02 0.3×
CT abdomen w/o contrast (74150) $54.17 $520.74 0.6×
CT Angio Abdomen and Pelvis (74174) $54.17 — 0.2×
CT Angio Chest (71275) $54.17 — 0.3×
CT Angio Head (70496) $54.17 — 0.3×
CT angio hrt w/3d image (75574) $54.17 — 0.2×
Ct Angio Lwr Extr W/O&W/Dye (73706) $54.17 — 0.3×
CT Angio Neck (70498) $54.17 — 0.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $54.17 — 0.3×
CT bone density (77078) $54.17 $307 0.7×
CT cervical spine w/ contrast (72126) $54.17 $1,369.11 0.2×
CT cervical spine w/o contrast (72125) $54.17 $520.74 0.6×
CT cervical spine w/wo cont (72127) $54.17 $988.02 0.3×
CT chest w contrast (71260) $54.17 $891.45 0.3×
CT chest w/wo contrast (71270) $54.17 $988.02 0.3×
CT colonography screening (74263) $54.17 — 0.3×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $54.17 — 0.3×
CT colonogrphy dx image postprocess w/o contrast (74261) $54.17 — 0.6×
CT head/brain with contrast (70460) $54.17 $891.45 0.3×
CT head/brain without and with contrast (70470) $54.17 $988.02 0.3×
CT heart contrast eval cardiac structure&morph (75572) $54.17 — 0.2×
CT heart no contrast quant eval coronry calcium (75571) $54.17 — 0.7×
CT hrt w/3d image congen (75573) $54.17 — 0.2×
CT iac w contrast (70481) $54.17 — 0.3×
CT l-spine w&w/o contrast (72133) $54.17 $809 0.3×
CT lower ext w/o (73700) $54.17 $520.74 0.6×
CT lower extremity w/contrast material (73701) $54.17 $901 0.3×
CT lumbar spine w contrast (72132) $54.17 $1,369.11 0.2×
CT lumbar spine w/o contrast (72131) $54.17 $520.74 0.6×
CT maxillofacial w contrast (70487) $54.17 $891.45 0.3×
CT maxillofacial wo contrast (70486) $54.17 $520.74 0.6×
CT neck tissue combo (70492) $54.17 $988.02 0.3×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $54.17 — 0.3×
CT orbits w/o contrast (70480) $54.17 $520.74 0.6×
CT pelvis w&w/o contrast (72194) $54.17 $988.02 0.3×
CT pelvis w/o contrast (72192) $54.17 $520.74 0.6×
CT scan of leg combo (73702) $54.17 $1,002 0.3×
CT scans face/jaw combo (70488) $54.17 $988.02 0.3×
CT soft tissue neck w contrast (70491) $54.17 $891.45 0.3×
CT soft tissue neck w/o contrast (70490) $54.17 $520.74 0.6×
CT thoracic spine w contrast (72129) $54.17 — 0.3×
CT thoracic spine w/o contrast (72128) $54.17 $520.74 0.6×
CT thoracic spine w/wo cont (72130) $54.17 — 0.3×
CT thorax w/o contrast (71250) $54.17 $520.74 0.6×
CT unlisted procedure (76497) $54.17 — 0.7×
CT upper ext wo (73200) $54.17 $520.74 0.6×
CT upper extremity w/o & w/contrast material (73202) $54.17 $809 0.3×
CT upper extremity with contrast (73201) $54.17 $758.22 0.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $54.17 — 0.3×
Cta Abdomen (74175) $54.17 — 0.3×
CTA pelvis (72191) $54.17 — 0.3×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) $54.17 — 0.3×
Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) $54.17 — 0.1×
Dilation ureters/urethra rs&i (74485) $54.17 — 0.0×
Discography Cerv/Thor Spine (72285) $54.17 — 0.0×
Diskography lumbar (72295) $54.17 — 0.0×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $54.17 — 0.6×
Doppler Echo Fetal Spectral Display Complete (76827) $54.17 — 0.6×
Doppler Fetal Mid Cerebral Artery (76821) $54.17 — 0.6×
Dxa Bone Density Axial (77080) $54.17 $343.38 0.6×
Dxa bone density study (77085) $54.17 — 0.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $54.17 $186.36 0.7×
Echo exam of fetal heart (76825) $54.17 — 0.1×
Echo exam uterus (76831) $54.17 — 0.3×
Echo Guide For Artery Repair (76936) $54.17 — 0.3×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $54.17 — 0.3×
Echograp Trans R Pros Study (76873) $54.17 $464.22 0.6×
Esophageal Motility Study (78258) $54.17 — 0.2×
Esophagram (74220) $54.17 — 0.3×
Fetal Biophys Profile W/Nst (76818) $54.17 — 0.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $54.17 $404 0.6×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $54.17 — 0.3×
Fluoroscopy up to 1 hr (76000) $54.17 — 0.3×
Follow-Up Angiography (75898) $54.17 — 0.0×
Foot 2 views (73620) $54.17 — 0.7×
Forearm 2 views (73090) $54.17 — 0.7×
Gastric emptying imaging study (78264) $54.17 — 0.2×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $54.17 — 0.2×
Gastric Mucosa Imaging (78261) $54.17 — 0.2×
Gastroesophageal Reflux Exam (78262) $54.17 — 0.2×
Gastrointestinal Protein Loss (78282) $54.17 — 0.2×
Gated Heart Planar Single (78472) $54.17 — 0.2×
Gated Heart, Multiple (78473) $54.17 — 0.2×
GI Endoscopic US S&I (76975) $54.17 — 0.3×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $54.17 — 0.1×
Hand 2 views (73120) $54.17 — 0.6×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $54.17 — 0.1×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $54.17 — 0.1×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $54.17 — 0.1×
Heart first pass single,planar (78481) $54.17 — 0.1×
Heart Image (Pet) Multiple (78492) $54.17 — 0.0×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $54.17 — 0.0×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $54.17 — 0.0×
Hepatobil Syst Image W/Drug (78227) $54.17 — 0.1×
Hepatobiliary System Imaging (78226) $54.17 — 0.2×
High energy neutron radj tx dlvr 1/> isocenter (77423) $54.17 — 0.1×
Ht Musc Image Planar Mult (78454) $54.17 — 0.0×
Ht Muscle Image Spect Sing (78451) $54.17 — 0.0×
Hyperthermia external generated superficial (77600) $54.17 — 0.2×
Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) $54.17 — 0.1×
Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) $54.17 — 0.1×
Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) $54.17 — 0.1×
Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) $54.17 — 0.1×
Hysterosalpingogram (74740) $54.17 — 0.3×
Image fusion (77399) $54.17 — 0.4×
Infant hip ultrasound with hip movement (dynamic) (76885) $54.17 — 0.7×
Infant hip ultrasound, limited static exam (76886) $54.17 — 0.7×
Infusion Ivp (74410) $54.17 — 0.3×
Interstitial radiation source applic complex (77778) $54.17 — 0.1×
Intracavitary Radiation Source Applic Complex (77763) $54.17 — 0.1×
Intracavitary Radiation Source Applic Intermed (77762) $54.17 — 0.1×
Intracavitary radiation source applic simple (77761) $54.17 — 0.1×
Intraop radiaj tx deliver electrons sngl tx sess (77425)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Intraop radiaj tx deliver xray single tx session (77424)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Joint Survey Single View (77077) $54.17 — 0.6×
K Flow/Funct Image Multiple (78709) $54.17 — 0.1×
K Flow/Funct Image W/Drug (78708) $54.17 — 0.1×
K Flow/Funct Image W/O Drug (78707) $54.17 — 0.1×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $54.17 — 0.2×
Kidney Imaging Morphol (78700) $54.17 — 0.2×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $54.17 — 0.2×
Knee 3 Views (73562) $54.17 — 0.7×
Labeled RBC Sequestration Differntl Organ/Tissue (78140) $54.17 — 0.2×
Leveen/Shunt Patency Exam (78291) $54.17 — 0.2×
Liver & Spleen Imaging Static Only (78215) $54.17 — 0.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $54.17 — 0.2×
Liver imaging static only (78201) $54.17 — 0.1×
Liver imaging w/vascular flow (78202) $54.17 — 0.1×
Lung Perf&Ventilat Diferentl (78598) $54.17 — 0.1×
Lung perfusion differential (78597) $54.17 — 0.2×
Lung Ventilat&Perfus Imaging (78582) $54.17 — 0.1×
Lung Ventilation Imaging (78579) $54.17 — 0.2×
Lymph System Imaging (78195) $54.17 — 0.1×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $54.17 — 0.0×
Lymphangiography extremity only unilateral rs&i (75801) $54.17 — 0.1×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $54.17 — 0.0×
Lymphangiography, pelvic/abdominal, unilateral (75805) $54.17 — 0.0×
Magnetic Image Jaw Joint (70336) $54.17 — 0.3×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $54.17 — 0.3×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $54.17 — 0.1×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $54.17 — 0.3×
Magnetic Resonance Elastography (76391) $54.17 — 0.3×
Mammary ductogram or galactogram multiple (77054) $54.17 — 0.3×
Mammary ductogram or galactogram single (77053) $54.17 — 0.3×
Meckels Divert Exam (78290) $54.17 — 0.2×
Medical physics dose eval radiation expos w/rprt (76145) $54.17 — 0.2×
Mlc imrt design & construction per imrt plan (77338) $54.17 — 0.2×
Mr safety determination physician/other qhp (76016) $54.17 — 0.7×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $54.17 — 2.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $54.17 — 0.6×
Mr safety implt pos&/immoblj (76019) $54.17 — 1.0×
Mr safety med physics xm customization plng&mntr (76017) $54.17 — 0.3×
Mra Head W/O & W/Contrast Material (70546) $54.17 — 0.2×
MRA head w/o contrast (70544) $54.17 — 0.3×
MRA head with contrast (70545) $54.17 — 0.2×
MRA neck w contrast (70548) $54.17 — 0.2×
Mra Neck W/O &W/Contrast Material (70549) $54.17 — 0.2×
MRA neck w/o contrast (70547) $54.17 — 0.3×
MRI abdomen w contrast (74182) $54.17 — 0.2×
MRI abdomen w/o contrast (74181) $54.17 — 0.3×
MRI any jt lower extrem w/contrast material (73722) $54.17 — 0.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $54.17 — 0.2×
MRI any jt upper extremity w/contrast matrl (73222) $54.17 — 0.1×
MRI bone marrow blood supply (77084) $54.17 — 0.3×
MRI brain functional w/o physician admnistration (70554) $54.17 — 0.3×
MRI brain functional w/physician admnistration (70555) $54.17 — 0.3×
MRI Breast W/O Contrast Bilateral (77047) $54.17 — 0.3×
MRI Breast Without Contrast Material Unilateral (77046) $54.17 — 0.3×
MRI cardiac w/o cont stress (75559) $54.17 — 0.1×
MRI cardiac w/o contrast (75557) $54.17 — 0.3×
MRI cervical spine w contrast (72142) $54.17 — 0.2×
MRI cervical spine w/o cont (72141) $54.17 — 0.3×
MRI chest w/o contrast (71550) $54.17 — 0.3×
MRI chest with contrast (71551) $54.17 — 0.1×
MRI chest wo w contrast (71552) $54.17 — 0.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $54.17 — 0.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $54.17 — 0.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $54.17 — 0.3×
MRI lumbar spine w contrast (72149) $54.17 — 0.2×
Mri Neck Spine W/O & W/Dye (72156) $54.17 — 0.2×
MRI orbit face &/neck w/o contrast (70540) $54.17 — 0.3×
MRI orbit face neck w contrast (70542) $54.17 — 0.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $54.17 — 0.2×
MRI pelvis w contrast (72196) $54.17 — 0.2×
MRI pelvis w/o & w contrast (72197) $54.17 — 0.2×
MRI pelvis w/o contrast (72195) $54.17 — 0.3×
MRI spectroscopy (76390) $54.17 — 0.7×
MRI thoracic spine w/o contrast (72146) $54.17 — 0.3×
MRI upper extremity oth than jt w/contr matrl (73219) $54.17 — 0.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $54.17 — 0.3×
Mri Uppr Extremity W/O&W/Dye (73220) $54.17 — 0.2×
MRI, abdomen, combo (74183) $54.17 — 0.2×
MRI, dorsal spine combo (72157) $54.17 — 0.2×
MRI, dorsal spine contrast (72147) $54.17 — 0.2×
MRI, joint upper extrem (73221) $54.17 — 0.3×
MRI, joint upper extrem combo (73223) $54.17 — 0.2×
MRI, lumbar spine combo (72158) $54.17 — 0.2×
Musculoskeletal Nuclear Exam (78399) $54.17 — 0.2×
Myelogram cervical (72240) $54.17 — 0.1×
Myelogram Lumbar (72265) $54.17 — 0.1×
Myelography thoracic (72255) $54.17 — 0.1×
Myelograpy 2/more regions rs&i (72270) $54.17 — 0.1×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $54.17 — 0.2×
Myocardial Imaging Pet Metabolic Evaluation (78459) $54.17 — 0.0×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $54.17 — 0.1×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $54.17 — 0.0×
Myocardial Spect Multiple Studies (78452) $54.17 — 0.0×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $54.17 — 0.0×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $54.17 — 0.0×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $54.17 — 0.0×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $54.17 — 0.0×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $54.17 — 0.0×
N-invas est c ffr sw aly CTA (75580) $54.17 — 0.1×
Neck soft tissue (70360) $54.17 $186.36 0.7×
Nervous system nuclear exam (78699) $54.17 — 0.2×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $54.17 — 0.2×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $54.17 — 0.2×
Nm csf leak detection (78650) $54.17 — 0.0×
Nm myocard infarct spect (78469) $54.17 — 0.1×
Nm red cell survival study (78130) $54.17 — 0.2×
Nm unlisted gi procedure (78299) $54.17 — 0.2×
Nm whole blood volume (78122) $54.17 — 0.1×
Nonvascular Shunt X-Ray (75809) $54.17 — 0.6×
Ntsty modul radthx pln dose-vol histos (77301) $54.17 — 0.0×
Nuclear medicine study of endocrine organs (78099) $54.17 — 0.2×
Nuclear Rx Intra-Arterial (79445) $54.17 — 0.3×
Nuclear Rx Oral Admin (79005) $54.17 — 0.3×
Ob us nuchal meas 1 gest (76813) $54.17 — 0.6×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $54.17 — 0.6×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $54.17 — 0.6×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $54.17 — 0.5×
Ophthalmic Biometry US Echograpy a-Scan (76516) $54.17 — 0.6×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $54.17 — 0.7×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $54.17 — 0.6×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $54.17 — 2.1×
Ophthalmic us dx quantitative a-scan only (76511) $54.17 — 0.6×
Optic foramina (70190) $54.17 $186.36 0.7×
Panoramic X-ray of jaws (70355) $54.17 — 0.7×
Parathyroid imaging w/tomographic spect & CT (78072) $54.17 — 0.1×
Parathyroid Planar Imaging (78070) $54.17 — 0.2×
Parathyroid planar imaging w/wo subtraction (78071) $54.17 — 0.2×
Pelvis 1 or 2 views (72170) $54.17 $343.38 0.6×
Perineogram (74775) $54.17 — 0.3×
Peritoneogram Rs&I (74190) $54.17 — 0.1×
Pet Image Skull-Thigh (78812) $54.17 — 0.0×
Pet Image W/Ct Lmtd (78814) $54.17 — 0.0×
PET image w/CT, full body (78816) $54.17 — 0.0×
PET imaging CT attenuation skull base mid-thigh (78815) $54.17 — 0.0×
Pet Imaging Limited Area Chest Head/Neck (78811) $54.17 — 0.0×
Pet Myocardial Sngl Study (78491) $54.17 — 0.0×
PET whole body (78813) $54.17 — 0.0×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $54.17 — 0.0×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $54.17 — 0.0×
Platelet survival study Non-Facility (78191) $54.17 — 0.2×
Proton trmt simple w/comp (77522) $54.17 — 0.0×
Proton tx delivery complex (77525) $54.17 — 0.0×
Proton tx delivery intermediate (77523) $54.17 — 0.0×
Proton tx delivery simple w/o compensation (77520) $54.17 — 0.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $54.17 — 0.0×
Pulmonary Perfusion Imaging Particulate (78580) $54.17 — 0.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $54.17 $343.38 0.6×
Radex abscess/fistula/sinus tract rs&i (76080) $54.17 — 0.1×
Radex Ankle Complete Minimum 3 Views (73610) $54.17 — 0.7×
Radex Calcaneus Minimum 2 Views (73650) $54.17 — 0.7×
Radex elbow complete minimum 3 views (73080) $54.17 — 0.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $54.17 $343.38 0.6×
Radex fingr minimum 2 views (73140) $54.17 — 0.7×
Radex foot complete minimum 3 views (73630) $54.17 — 0.7×
Radex Hand Minimum 3 Views (73130) $54.17 — 0.7×
Radex lower extremity infant minimum 2 views (73592) $54.17 $186.36 0.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $54.17 — 0.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $54.17 $186.36 0.7×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $54.17 — 0.7×
Radex Ribs Unilateral 2 Views (71100) $54.17 — 0.7×
Radex shoulder complete minimum 2 views (73030) $54.17 — 0.7×
Radex Sinuses Paransl < 3 Views (70210) $54.17 $186.36 0.7×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $54.17 — 0.3×
Radex Spine 1 View Specify Level (72020) $54.17 $186.36 0.7×
Radex Sternum Minimum 2 Views (71120) $54.17 $186.36 0.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $54.17 $186.36 0.7×
Radex Toe Minimum 2 Views (73660) $54.17 — 0.7×
Radex upper extremity infant minimum 2 views (73092) $54.17 $343.38 0.6×
Radex Wrist Complete Minimum 3 Views (73110) $54.17 — 0.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $54.17 — 0.6×
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Radiation treatment delivery level 1 (77402) $54.17 — 0.6×
Radiation treatment delivery level 2 (77407) $54.17 — 0.2×
Radiation treatment delivery level 3 (77412) $54.17 — 0.1×
Radiolog exam mandible compl minimum 4 views (70110) $54.17 $343.38 0.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $54.17 — 0.6×
Radiologic exam colon double contrast study (74280) $54.17 — 0.3×
Radiologic exam colon single contrast study (74270) $54.17 — 0.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $54.17 — 0.3×
Radiologic exam knee complete 4/more views (73564) $54.17 — 0.6×
Radiologic exam pelvis compl minimum 3 views (72190) $54.17 — 0.6×
Radiologic Exam Small Int Single Contrast Study (74250) $54.17 $343.38 0.3×
Radiologic exam swallow function contrast study (74230) $54.17 — 0.3×
Radiologic exam teeth complete full mouth (70320) $54.17 — 0.3×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $54.17 — 0.3×
Radiologic exam upr gi trc double contrast study (74246) $54.17 $758.22 0.3×
Radiologic examination femur 1 view (73551) $54.17 — 0.7×
Radiologic examination femur minimum 2 views (73552) $54.17 — 0.7×
Radiologic examination knee 1/2 views (73560) $54.17 — 0.7×
Radiologic Examination Osseous Survey Limited (77074) $54.17 — 0.6×
Radiologic Examination Salivary Gland Calculus (70380) $54.17 — 0.7×
Radiologic examination tibia & fibula 2 views (73590) $54.17 — 0.7×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $54.17 — 0.1×
Radiologic examination, teeth; single view Non-Facility (70300) $54.17 — 0.7×
Radiopharm Dacryocystography (78660) $54.17 — 0.2×
Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) $54.17 — 0.3×
Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) $54.17 — 0.3×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $54.17 — 0.3×
Red Cell Volume Determination Spx 1 Sampling (78120) $54.17 — 0.2×
Red Cell Volume Determination Spx Mult Samplings (78121) $54.17 — 0.1×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $54.17 — 0.2×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $54.17 — 0.2×
Renal Cyst Study (74470) $54.17 — 0.1×
Ribs bilateral 3 views (71110) $54.17 — 0.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $54.17 — 0.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $54.17 — 0.2×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $54.17 — 0.1×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $54.17 — 0.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $54.17 — 0.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $54.17 — 0.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $54.17 — 0.0×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $54.17 — 0.0×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $54.17 — 0.3×
Rp Therapy Intravenous Administration (79101) $54.17 — 0.3×
Rp Therapy Unlisted Procedure (79999) $54.17 — 0.3×
Salivary Gland Function Study (78232) $54.17 — 0.2×
Salivary Gland Imaging (78230) $54.17 — 0.2×
Salivary Gland Imaging Serial Images (78231) $54.17 — 0.2×
Scapula (73010) $54.17 — 0.6×
Screening Digital Breast Tomosynthesis Bi (77063) $54.17 — 2.3×
Sella turcica (70240) $54.17 — 0.7×
Shoulder 1 view (73020) $54.17 — 0.7×
Shoulder Arthrography (73040) $54.17 — 0.2×
Sialogram (70390) $54.17 — 0.3×
Skull less than 4 views (70250) $54.17 $343.38 0.6×
Special dosimetry (77331) $54.17 — 0.4×
Special Physics Consult (77370) $54.17 — 0.4×
Special teletherapy port plan (77321) $54.17 — 0.2×
Special treatment procedure (77470) $54.17 — 0.1×
Speech evaluation, complex (70371) $54.17 — 0.3×
Spleen Imaging (78185) $54.17 — 0.2×
Srs Multisource (77371)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Stereotactic Body Radiation Delivery (77373) $54.17 — 0.0×
Sternoclavicular joints (71130) $54.17 $186.36 0.7×
Superior sagittal sinus venogram (75870) $54.17 — 0.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $54.17 — 0.6×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $54.17 — 0.7×
Tbs technical calculation only (77091) $54.17 — 0.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $54.17 — 0.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $54.17 — 0.2×
Temporomandble Jt Arthrography Rs&I (70332) $54.17 — 0.3×
Testicular Imaging W/Flow (78761) $54.17 — 0.2×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $54.17 — 0.2×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $54.17 — 0.2×
Ther rad simulaj-aided field setting simple (77280) $54.17 — 0.4×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $54.17 — 0.3×
Thoracic spine 2 views (72070) $54.17 — 0.6×
Thoracic spine 3 views (72072) $54.17 $343.38 0.6×
Thoracolumbar 2 views (72080) $54.17 $186.36 0.7×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $54.17 — 0.2×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $54.17 — 0.2×
Thyroid Imaging With Vascular Flow (78013) $54.17 — 0.2×
Thyroid Met Imaging Body (78018) $54.17 — 0.1×
Thyroid Uptake Measurement (78012) $54.17 — 0.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $54.17 — 0.2×
Tx Devices Design & Construction Complex (77334) $54.17 — 0.2×
Tx devices design & construction intermediate (77333) $54.17 — 0.4×
Tx devices design & construction simple (77332) $54.17 — 0.4×
Ultrasound Breast Limited (76642) $54.17 — 0.7×
Ultrasound elastography first target lesion (76982) $54.17 $281.28 0.6×
Ultrasound Elastography Parenchyma (76981) $54.17 $312.51 0.6×
Ultrasound Exam Aaa Screen (76706) $54.17 — 0.6×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $54.17 — 0.2×
Ultrasound, abdomen limited (76705) $54.17 $343.38 0.6×
Umbilical-artery Doppler (OB) (76820) $54.17 — 0.6×
Unlis px ther radiol clinical tx planning (77299) $54.17 — 0.4×
Unlisted Dx Radiographic Procedure (76499) $54.17 — 0.7×
Unlisted fluoroscopic procedure (76496) $54.17 — 0.7×
Unlisted genitourinary px dx nuclear medicine (78799) $54.17 — 0.2×
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) $54.17 — 0.2×
Unlisted magnetic resonance procedure (76498) $54.17 — 0.7×
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $54.17 — 0.2×
Unlisted Procedure Clinical Brachytherapy (77799) $54.17 — 0.6×
Unlisted respiratory px dx nuclear medicine (78599) $54.17 — 0.2×
Unlisted us procedure (76999) $54.17 — 0.7×
Upper gi w/o kub (74240) $54.17 $758.22 0.3×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $54.17 — 4.9×
Urea breath test c-14 isotopic analysis (78268) $54.17 — 0.6×
Ureteral Reflux Study (78740) $54.17 — 0.2×
Urethrocystogram voiding (74455) $54.17 — 0.3×
Urethrocystography retrograde (74450) $54.17 — 0.3×
Us bone density measurement (76977) $54.17 — 0.6×
Us breast unilateral complete (76641) $54.17 $290.07 0.6×
Us chest (76604) $54.17 — 0.6×
Us complete joint (76881) $54.17 $343.38 0.6×
Us exam, pelvic, limited (76857) $54.17 $343.38 0.6×
Us head (76506) $54.17 — 0.6×
Us kidney transplant (76776) $54.17 $343.38 0.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $54.17 — 0.6×
Us ob detailed single fetus (76811) $54.17 — 0.3×
Us ob limited 1 or more fetuses (76815) $54.17 $404 0.6×
Us ob transvaginal (76817) $54.17 — 0.6×
Us pelvic non ob complete (76856) $54.17 $343.38 0.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $54.17 $404 0.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $54.17 — 0.6×
Us retroperitoneal complete (76770) $54.17 — 0.6×
Us retroperitoneal limited (76775)
range across 4 matching MRF lines		 $54.17 $343.08–$343.38 0.6×
Us scrotum and contents (76870) $54.17 $343.38 0.6×
Us spinal canal and contents (76800) $54.17 $685.68 0.6×
Us thyroid (76536)
range across 2 matching MRF lines		 $54.17 $343.38–$555.63 0.6×
Us transrectal (76872) $54.17 — 0.6×
Vascular Flow Imaging (78445) $54.17 — 0.2×
Vasogram (74440) $54.17 — 0.3×
Vein X-Ray Chest (75827) $54.17 — 0.0×
Vein X-Ray Liver W/O Hemodyn (75887) $54.17 — 0.0×
Vein X-Ray Skull Epidural (75872) $54.17 — 0.1×
Vein X-Ray Spleen/Liver (75810) $54.17 — 0.0×
Venogram Sinus/Jugular (75860) $54.17 — 0.0×
Venography Adrenal Unilateral (75840) $54.17 — 0.0×
Venography caval inferior serialography rs&i (75825) $54.17 — 0.0×
Venography extremity bilateral rs&i (75822) $54.17 — 0.0×
Venography extremity unilateral rs&i (75820) $54.17 — 0.0×
Venography Orbital Rs&I (75880) $54.17 — 0.1×
Venography Renal Bilateral (75833) $54.17 — 0.0×
Venography Renal Unilateral (75831) $54.17 — 0.0×
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Venous thrombosis imaging (78457) $54.17 — 0.1×
Venous Thrombosis Imaging Venogram Bilateral (78458) $54.17 — 0.2×
Vertebral fracture assessment via dxa (77086) $54.17 — 0.7×
Wrist 2 views (73100) $54.17 — 0.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $54.17 $186.36 0.7×
X-ray antegrade pyelogram tube (74425) $54.17 — 0.2×
X-Ray Aorta Leg Arteries (75630) $54.17 — 0.0×
X-Ray Bend Only L-S Spine (72120) $54.17 — 0.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $54.17 — 0.7×
X-Ray Exam Breast Specimen (76098) $54.17 — 0.1×
X-Ray Exam Entire Spi 1 Vw (72081) $54.17 $221.07 0.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $54.17 — 0.6×
X-Ray Exam Entire Spi 4/5 Vw (72083) $54.17 — 0.6×
X-Ray Exam Hip Uni 1 View (73501) $54.17 — 0.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $54.17 $186.36 0.7×
X-Ray Exam Hip Uni 4/> Views (73503) $54.17 — 0.6×
X-Ray Exam Hips Bi 2 Views (73521) $54.17 — 0.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $54.17 $343.38 0.6×
X-Ray Exam Hips Bi 5/> Views (73523) $54.17 — 0.6×
X-Ray Exam L-S Spine Bending (72114) $54.17 $343.38 0.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $54.17 $186.36 0.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $54.17 $343.38 0.6×
X-Ray Exam Unilat Ribs/Chest (71101) $54.17 — 0.6×
X-ray eye for foreign body (70030) $54.17 $186.36 0.7×
X-ray head for orthodontia (70350) $54.17 — 0.7×
X-ray humerus (73060) $54.17 — 0.7×
X-ray IV pyelogram (ivp) (74400) $54.17 $758.22 0.3×
X-ray IV pyelogram+tomography (74415) $54.17 — 0.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $54.17 $186.36 0.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $54.17 $186.36 0.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $54.17 $343.38 0.6×
X-ray nose-rectum child f.b. (76010) $54.17 $186.36 0.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $54.17 $343.38 0.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $54.17 $343.38 0.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $54.17 — 0.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $54.17 $343.38 0.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $54.17 $212.52 0.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $54.17 $343.38 0.6×
X-Ray Stress View (77071) $54.17 — 0.7×
X-ray thoracic spine 4 vw (72074) $54.17 — 0.6×
X-Ray Tmj Unilat (70328) $54.17 $186.36 0.7×
X-Ray Urinary Tract Exam With Contrast Material (74420) $54.17 — 0.2×
X-Rays Bone Length Studies (77073) $54.17 — 0.6×
X-Rays Bone Survey Complete (77075) $54.17 $480 0.6×
Xr c-spine 4 or 5 views (72050) $54.17 — 0.6×
Xr facial bones less than 3 views (70140) $54.17 $186.36 0.7×
XR Mastoids < 3 Views Bilateral (70120) $54.17 — 0.6×
Xr myelogram posterior fossa (70010) $54.17 — 0.2×
Xr orbits complete 4 views (70200) $54.17 $212.52 0.6×
Xr Tomogram Single Plane (76100) $54.17 — 0.6×

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.