Imaging prices at Washington Regional Medical Center
Fayetteville, AR · every code in this section with a posted price and a Medicare benchmark.
489 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) | $790.50 | $1,054 | 0.6× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$46.50–$394.50 | $62–$526 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$59.25–$394.50 | $79–$526 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$603–$1,591.50 | $804–$2,122 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $349.50 | $466 | 0.3× |
| Adrenal Cortex & Medulla Img (78075) range across 2 matching MRF lines |
$588.75–$3,429.75 | $785–$4,573 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$333.75–$2,775 | $445–$3,700 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$291–$5,736 | $388–$7,648 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$378–$6,309.75 | $504–$8,413 | varies |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$316.50–$8,954.25 | $422–$11,939 | varies |
| Angiography extremity unilateral rs&i (75710) range across 12 matching MRF lines |
$275.25–$8,954.25 | $367–$11,939 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$258.75–$5,736 | $345–$7,648 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$313.50–$3,052.50 | $418–$4,070 | varies |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$50.25–$591.75 | $67–$789 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$8,954.25 | $315–$11,939 | 1.7× |
| Aortography thoracic w/o serialography rs&i (75600) range across 2 matching MRF lines |
$330–$8,023.50 | $440–$10,698 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$13,201.50 | $340–$17,602 | 2.5× |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$329.25–$6,309.75 | $439–$8,413 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$6,309.75 | $363–$8,413 | 1.2× |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$421.50–$8,604 | $562–$11,472 | varies |
| Arthrogram ankle (73615) range across 4 matching MRF lines |
$145.50–$2,452.50 | $194–$3,270 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$171.75–$2,452.50 | $229–$3,270 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$153–$2,452.50 | $204–$3,270 | varies |
| Basic radiation dosimetry calculation (77300) | $98.25 | $131 | 0.8× |
| Bone age studies (77072) range across 2 matching MRF lines |
$39–$320.25 | $52–$427 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$599.25–$1,592.25 | $799–$2,123 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$314.25–$1,592.25 | $419–$2,123 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$402.75–$1,314.75 | $537–$1,753 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$436.50–$1,592.25 | $582–$2,123 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$294.75–$1,702.50 | $393–$2,270 | varies |
| Bone marrow imaging; multiple areas (78103) | $303.75 | $405 | 0.8× |
| Bone marrow imaging; whole body (78104) | $345.75 | $461 | 0.9× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$165–$493.50 | $220–$658 | varies |
| Brain Flow Imaging Only (78610) | $245.25 | $327 | 0.5× |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$370.50–$2,547 | $494–$3,396 | varies |
| Brain imaging < 4 static views (78600) range across 2 matching MRF lines |
$249–$1,326.75 | $332–$1,769 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$448.50–$2,303.25 | $598–$3,071 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 2 matching MRF lines |
$273–$1,326.75 | $364–$1,769 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,545 | $2,060 | 1.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $373.50 | $498 | 1.0× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $407.25 | $543 | 0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$847.50–$1,586.25 | $1,130–$2,115 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $960.75 | $1,281 | 1.3× |
| Cardiac Shunt Detection (78428) | $269.25 | $359 | 0.7× |
| Cat Scan Follow-Up Study (76380) range across 6 matching MRF lines |
$186.75–$447 | $249–$596 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$372–$1,197 | $496–$1,596 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $444 | $592 | 0.9× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$584.25–$2,620.50 | $779–$3,494 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$39–$384 | $52–$512 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$51.75–$384 | $69–$512 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$66–$621 | $88–$828 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$71.25–$394.50 | $95–$526 | varies |
| Cholecystography Oral Contrast (74290) range across 3 matching MRF lines |
$95.25–$576 | $127–$768 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $107.25 | $143 | 1.1× |
| Cisternography Positive Contrast Rs&I (70015) | $207 | $276 | 0.3× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$46.50–$588 | $62–$784 | varies |
| Continuing medical physics consltj pr wk (77336) | $72 | $96 | 0.6× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$234–$8,954.25 | $312–$11,939 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$64.50–$1,157.25 | $86–$1,543 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$49.50–$2,452.50 | $66–$3,270 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$183.75–$2,452.50 | $245–$3,270 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$109.50–$572.25 | $146–$763 | varies |
| Corpora cavernosography (74445) | $144 | $192 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$599.25–$1,725.75 | $799–$2,301 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$345.75–$1,069.50 | $461–$1,426 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$391.50–$1,101.75 | $522–$1,469 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$444–$1,240.50 | $592–$1,654 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$256.50–$639 | $342–$852 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$631.50–$1,917.75 | $842–$2,557 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$510–$1,291.50 | $680–$1,722 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$497.25–$1,291.50 | $663–$1,722 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$648–$1,091.25 | $864–$1,455 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 5 matching MRF lines |
$601.50–$1,937.25 | $802–$2,583 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$496.50–$1,291.50 | $662–$1,722 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$555.75–$1,291.50 | $741–$1,722 | varies |
| CT bone density (77078) | $114.75 | $153 | 1.4× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$386.25–$1,101.75 | $515–$1,469 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$281.25–$639 | $375–$852 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$524.25–$1,240.50 | $699–$1,654 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$388.50–$1,101.75 | $518–$1,469 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$464.25–$1,240.50 | $619–$1,654 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$276.75–$1,101.75 | $369–$1,469 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$327–$1,240.50 | $436–$1,654 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$482.25–$1,091.25 | $643–$1,455 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$41.25–$155.25 | $55–$207 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$612.75–$1,091.25 | $817–$1,455 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$465.75–$1,101.75 | $621–$1,469 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$455.25–$1,240.50 | $607–$1,654 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$274.50–$959.25 | $366–$1,279 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$381.75–$1,652.25 | $509–$2,203 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$386.25–$1,101.75 | $515–$1,469 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$274.50–$639 | $366–$852 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$285–$1,101.75 | $380–$1,469 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$236.25–$639 | $315–$852 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$469.50–$1,240.50 | $626–$1,654 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$507.75–$1,240.50 | $677–$1,654 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$300.75–$639 | $401–$852 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$438.75–$1,240.50 | $585–$1,654 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$249.75–$639 | $333–$852 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$461.25–$1,860.75 | $615–$2,481 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$347.25–$1,240.50 | $463–$1,654 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$399.75–$1,101.75 | $533–$1,469 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$300.75–$639 | $401–$852 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$388.50–$1,101.75 | $518–$1,469 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$274.50–$639 | $366–$852 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$457.50–$1,240.50 | $610–$1,654 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$276.75–$639 | $369–$852 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$274.50–$959.25 | $366–$1,279 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$466.50–$1,860.75 | $622–$2,481 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$375.75–$1,652.25 | $501–$2,203 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$648.75–$1,291.50 | $865–$1,722 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$521.25–$1,291.50 | $695–$1,722 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$519–$1,291.50 | $692–$1,722 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $70.50 | $94 | 0.3× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$156–$3,806.25 | $208–$5,075 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$207.75–$4,473 | $277–$5,964 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$167.25–$4,473 | $223–$5,964 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $69 | $92 | 0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $93.75 | $125 | 1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$136.50–$505.50 | $182–$674 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$69–$278.25 | $92–$371 | varies |
| Dxa bone density study (77085) | $476.25 | $635 | 4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$48–$252.75 | $64–$337 | varies |
| Echo exam of fetal heart (76825) | $306 | $408 | 0.6× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$204.75–$799.50 | $273–$1,066 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$465–$624 | $620–$832 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $175.50 | $234 | 0.8× |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$245.25–$888.75 | $327–$1,185 | varies |
| Esophageal Motility Study (78258) | $316.50 | $422 | 0.8× |
| Esophagram (74220) range across 3 matching MRF lines |
$149.25–$695.25 | $199–$927 | varies |
| Fetal Biophys Profile W/Nst (76818) | $213.75 | $285 | 2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$156–$756 | $208–$1,008 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,320.75 | $1,761 | 5.9× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$80.25–$920.25 | $107–$1,227 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$221.25–$1,497 | $295–$1,996 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$43.50–$588 | $58–$784 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$43.50–$591.75 | $58–$789 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$581.25–$1,591.50 | $775–$2,122 | varies |
| Gastric Mucosa Imaging (78261) | $346.50 | $462 | 0.9× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$420–$1,290 | $560–$1,720 | varies |
| Gastrointestinal Protein Loss (78282) | $111 | $148 | 0.3× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$350.25–$1,883.25 | $467–$2,511 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$463.50–$1,552.50 | $618–$2,070 | varies |
| GI Endoscopic US S&I (76975) | $139.50 | $186 | 0.6× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$44.25–$588 | $59–$784 | varies |
| Heart first pass single,planar (78481) | $293.25 | $391 | 0.6× |
| Heart Image (Pet) Multiple (78492) | $1,667.25 | $2,223 | 1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$246–$5,736 | $328–$7,648 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$249–$5,736 | $332–$7,648 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$774.75–$1,830.75 | $1,033–$2,441 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$571.50–$1,830.75 | $762–$2,441 | varies |
| High energy neutron radj tx dlvr 1/> isocenter (77423) | $349.50 | $466 | 0.7× |
| Ht Musc Image Planar Mult (78454) range across 2 matching MRF lines |
$749.25–$2,927.25 | $999–$3,903 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$474.75–$2,927.25 | $633–$3,903 | varies |
| Hyperthermia external generated superficial (77600) | $567 | $756 | 1.6× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $1,175.25 | $1,567 | 2.3× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $1,347.75 | $1,797 | 2.6× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $668.25 | $891 | 1.3× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $1,285.50 | $1,714 | 2.0× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$126–$1,401 | $168–$1,868 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$165–$370.50 | $220–$494 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$152.25–$371.25 | $203–$495 | varies |
| Infusion Ivp (74410) range across 3 matching MRF lines |
$160.50–$1,277.25 | $214–$1,703 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,191–$2,085 | $1,588–$2,780 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $989.25 | $1,319 | 1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $697.50 | $930 | 1.3× |
| Intracavitary radiation source applic simple (77761) | $518.25 | $691 | 1.0× |
| Joint Survey Single View (77077) | $58.50 | $78 | 0.6× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$633.75–$2,049.75 | $845–$2,733 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$309–$2,049.75 | $412–$2,733 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$405–$1,672.50 | $540–$2,230 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $142.50 | $190 | 0.4× |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$244.50–$1,672.50 | $326–$2,230 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $294.75 | $393 | 0.8× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$60–$588 | $80–$784 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $192.75 | $257 | 0.5× |
| Leveen/Shunt Patency Exam (78291) | $350.25 | $467 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$266.25–$1,579.50 | $355–$2,106 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $181.50 | $242 | 0.5× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$256.50–$1,830.75 | $342–$2,441 | varies |
| Liver imaging w/vascular flow (78202) | $280.50 | $374 | 0.5× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$529.50–$2,118 | $706–$2,824 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$351–$1,503.75 | $468–$2,005 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$580.50–$2,118 | $774–$2,824 | varies |
| Lung Ventilation Imaging (78579) | $1,110 | $1,480 | 2.9× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$618–$1,702.50 | $824–$2,270 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 2 matching MRF lines |
$362.25–$5,524.50 | $483–$7,366 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) | $336 | $448 | 0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $9,386.25 | $12,515 | 3.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $370.50 | $494 | 0.1× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$578.25–$1,431.75 | $771–$1,909 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $217.50 | $290 | 1.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $217.50 | $290 | 0.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $220.50 | $294 | 1.3× |
| Mammary ductogram or galactogram multiple (77054) | $127.50 | $170 | 0.6× |
| Mammary ductogram or galactogram single (77053) | $94.50 | $126 | 0.4× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$573–$1,290 | $764–$1,720 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$859.50–$2,180.25 | $1,146–$2,907 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$477.75–$1,304.25 | $637–$1,739 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$541.50–$1,886.25 | $722–$2,515 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$541.50–$1,886.25 | $722–$2,515 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$859.50–$2,180.25 | $1,146–$2,907 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$477.75–$1,304.25 | $637–$1,739 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$763.50–$1,886.25 | $1,018–$2,515 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$501–$1,304.25 | $668–$1,739 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$642–$2,829.75 | $856–$3,773 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$793.50–$3,270.75 | $1,058–$4,361 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$636.75–$2,829.75 | $849–$3,773 | varies |
| MRI bone marrow blood supply (77084) | $588.75 | $785 | 2.6× |
| MRI brain functional w/o physician admnistration (70554) | $758.25 | $1,011 | 3.4× |
| MRI brain functional w/physician admnistration (70555) | $173.25 | $231 | 0.8× |
| MRI cardiac w/o cont stress (75559) | $691.50 | $922 | 1.3× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$627–$1,005 | $836–$1,340 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$550.50–$1,886.25 | $734–$2,515 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$381.75–$1,304.25 | $509–$1,739 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$501–$1,304.25 | $668–$1,739 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$726–$1,886.25 | $968–$2,515 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$900.75–$2,180.25 | $1,201–$2,907 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$719.25–$2,829.75 | $959–$3,773 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$846–$3,270.75 | $1,128–$4,361 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$491.25–$1,956 | $655–$2,608 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$544.50–$1,886.25 | $726–$2,515 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$645–$2,180.25 | $860–$2,907 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$490.50–$1,304.25 | $654–$1,739 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$719.25–$1,886.25 | $959–$2,515 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$704.25–$2,180.25 | $939–$2,907 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$726.75–$1,886.25 | $969–$2,515 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$852–$2,180.25 | $1,136–$2,907 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$501.75–$1,304.25 | $669–$1,739 | varies |
| MRI spectroscopy (76390) | $159.75 | $213 | 1.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$382.50–$1,304.25 | $510–$1,739 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$675.75–$2,829.75 | $901–$3,773 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$492–$1,956 | $656–$2,608 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$842.25–$3,270.75 | $1,123–$4,361 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$853.50–$2,180.25 | $1,138–$2,907 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$646.50–$2,180.25 | $862–$2,907 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$546.75–$1,886.25 | $729–$2,515 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$402–$1,956 | $536–$2,608 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$792.75–$3,270.75 | $1,057–$4,361 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$642.75–$2,180.25 | $857–$2,907 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$169.50–$2,795.25 | $226–$3,727 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$159–$2,795.25 | $212–$3,727 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$169.50–$2,795.25 | $226–$3,727 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$220.50–$2,741.25 | $294–$3,655 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$251.25–$1,552.50 | $335–$2,070 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,636.50 | $2,182 | 1.3× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 2 matching MRF lines |
$303.75–$1,552.50 | $405–$2,070 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$522.75–$2,927.25 | $697–$3,903 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$830.25–$2,927.25 | $1,107–$3,903 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$47.25–$394.50 | $63–$526 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $499.50 | $666 | 1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$75.75–$1,138.50 | $101–$1,518 | varies |
| Nm csf leak detection (78650) | $456 | $608 | 0.4× |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$381–$1,883.25 | $508–$2,511 | varies |
| Nm red cell survival study (78130) | $215.25 | $287 | 0.6× |
| Nm whole blood volume (78122) | $156 | $208 | 0.3× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$136.50–$606 | $182–$808 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,899.50 | $3,866 | 2.2× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$171–$1,257 | $228–$1,676 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$202.50–$1,116.75 | $270–$1,489 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$179.25–$599.25 | $239–$799 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $108.75 | $145 | 1.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $123.75 | $165 | 1.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $231 | $308 | 1.8× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $100.50 | $134 | 1.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $103.50 | $138 | 1.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $129.75 | $173 | 1.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $19.50 | $26 | 0.7× |
| Ophthalmic us dx quantitative a-scan only (76511) | $141 | $188 | 1.4× |
| Optic foramina (70190) | $50.25 | $67 | 0.6× |
| Panoramic X-ray of jaws (70355) | $30.75 | $41 | 0.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$131.25–$2,413.50 | $175–$3,218 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$519.75–$1,410 | $693–$1,880 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$620.25–$1,618.50 | $827–$2,158 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$54–$394.50 | $72–$526 | varies |
| Perineogram (74775) | $150.75 | $201 | 0.7× |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$126.75–$1,478.25 | $169–$1,971 | varies |
| Pet Image Skull-Thigh (78812) | $1,577.25 | $2,103 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $1,596 | $2,128 | 1.2× |
| PET image w/CT, full body (78816) | $1,617 | $2,156 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,613.25 | $2,151 | 1.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,550.25 | $2,067 | 1.3× |
| Pet Myocardial Sngl Study (78491) | $1,638 | $2,184 | 1.2× |
| PET whole body (78813) | $1,582.50 | $2,110 | 1.2× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $121.50 | $162 | 0.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $114 | $152 | 0.1× |
| Platelet survival study Non-Facility (78191) | $246 | $328 | 0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$269.25–$5,736 | $359–$7,648 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$414–$1,503.75 | $552–$2,005 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$75.75–$621 | $101–$828 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$95.25–$1,406.25 | $127–$1,875 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$53.25–$588 | $71–$784 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$45.75–$588 | $61–$784 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$52.50–$588 | $70–$784 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$70.50–$621 | $94–$828 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$52.50–$591.75 | $70–$789 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$48.75–$588 | $65–$784 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$51.75–$588 | $69–$784 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 5 matching MRF lines |
$46.50–$480.75 | $62–$641 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$78.75–$480.75 | $105–$641 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$54.75–$394.50 | $73–$526 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$114–$798.75 | $152–$1,065 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$56.25–$394.50 | $75–$526 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$49.50–$588 | $66–$784 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$50.25–$394.50 | $67–$526 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$245.25–$856.50 | $327–$1,142 | varies |
| Radex Spine 1 View Specify Level (72020) range across 7 matching MRF lines |
$37.50–$394.50 | $50–$526 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$50.25–$394.50 | $67–$526 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$81–$320.25 | $108–$427 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$47.25–$480.75 | $63–$641 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$46.50–$480.75 | $62–$641 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$59.25–$588 | $79–$784 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$135.75–$1,285.50 | $181–$1,714 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$1,175.25 | $1,567 | 0.2× |
| Radiation treatment delivery level 1 (77402) | $243 | $324 | 2.5× |
| Radiation treatment delivery level 2 (77407) | $352.50 | $470 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $321 | $428 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$64.50–$546 | $86–$728 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$66–$629.25 | $88–$839 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$274.50–$1,029.75 | $366–$1,373 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$246.75–$1,029.75 | $329–$1,373 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$183.75–$987.75 | $245–$1,317 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$66.75–$741 | $89–$988 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$63.75–$394.50 | $85–$526 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$174.75–$695.25 | $233–$927 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$215.25–$695.25 | $287–$927 | varies |
| Radiologic exam teeth complete full mouth (70320) | $58.50 | $78 | 0.3× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $51.75 | $69 | 0.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$169.50–$494.25 | $226–$659 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$47.25–$414.75 | $63–$553 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$54.75–$414.75 | $73–$553 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$51.75–$588 | $69–$784 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $109.50 | $146 | 1.1× |
| Radiologic Examination Salivary Gland Calculus (70380) range across 3 matching MRF lines |
$55.50–$320.25 | $74–$427 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$48.75–$588 | $65–$784 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $65.25 | $87 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $19.50 | $26 | 0.2× |
| Radiopharm Dacryocystography (78660) | $245.25 | $327 | 0.7× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $115.50 | $154 | 0.5× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $223.50 | $298 | 1.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $236.25 | $315 | 1.1× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $121.50 | $162 | 0.3× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $139.50 | $186 | 0.3× |
| Renal Cyst Study (74470) range across 2 matching MRF lines |
$104.25–$1,155 | $139–$1,540 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$63.75–$621 | $85–$828 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$335.25–$1,446 | $447–$1,928 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$350.25–$747.75 | $467–$997 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$976.50–$4,063.50 | $1,302–$5,418 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$453–$2,525.25 | $604–$3,367 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$487.50–$2,525.25 | $650–$3,367 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,308.75 | $5,745 | 3.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$173.25–$5,088.75 | $231–$6,785 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$120.75–$4,535.25 | $161–$6,047 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $286.50 | $382 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $228 | $304 | 1.0× |
| Salivary Gland Function Study (78232) | $162.75 | $217 | 0.4× |
| Salivary Gland Imaging (78230) | $230.25 | $307 | 0.6× |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$178.50–$1,290 | $238–$1,720 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$51–$588 | $68–$784 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$42–$320.25 | $56–$427 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$39–$588 | $52–$784 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$168.75–$2,452.50 | $225–$3,270 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$141.75–$1,401 | $189–$1,868 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$61.50–$394.50 | $82–$526 | varies |
| Special dosimetry (77331) | $90 | $120 | 0.7× |
| Special Physics Consult (77370) | $159.75 | $213 | 1.3× |
| Special teletherapy port plan (77321) | $150.75 | $201 | 0.4× |
| Special treatment procedure (77470) | $285 | $380 | 0.5× |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$132.75–$798.75 | $177–$1,065 | varies |
| Spleen Imaging (78185) | $278.25 | $371 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $2,194.50 | $2,926 | 1.3× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$60.75–$320.25 | $81–$427 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$294–$2,775 | $392–$3,700 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $156.75 | $209 | 1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 4 matching MRF lines |
$120–$2,452.50 | $160–$3,270 | varies |
| Testicular Imaging W/Flow (78761) | $294.75 | $393 | 0.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $736.50 | $982 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $459.75 | $613 | 1.3× |
| Ther rad simulaj-aided field setting simple (77280) | $263.25 | $351 | 2.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$360–$1,029.75 | $480–$1,373 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$57.75–$394.50 | $77–$526 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$58.50–$621 | $78–$828 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$51.75–$394.50 | $69–$526 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $423 | $564 | 1.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $298.50 | $398 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$328.50–$861.75 | $438–$1,149 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$542.25–$1,507.50 | $723–$2,010 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$138.75–$655.50 | $185–$874 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$417–$1,410 | $556–$1,880 | varies |
| Tx Devices Design & Construction Complex (77334) | $216 | $288 | 0.6× |
| Tx devices design & construction intermediate (77333) | $84.75 | $113 | 0.7× |
| Tx devices design & construction simple (77332) | $110.25 | $147 | 0.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$151.50–$459.75 | $202–$613 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$159.75–$505.50 | $213–$674 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) range across 2 matching MRF lines |
$552.75–$1,073.25 | $737–$1,431 | varies |
| Ultrasound, abdomen limited (76705) range across 8 matching MRF lines |
$156.75–$513 | $209–$684 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$84–$371.25 | $112–$495 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$328.50–$414.75 | $438–$553 | varies |
| Unlisted fluoroscopic procedure (76496) | $333.75 | $445 | 4.1× |
| Unlisted us procedure (76999) | $505.50 | $674 | 6.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$156.75–$494.25 | $209–$659 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$306–$1,672.50 | $408–$2,230 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$137.25–$1,380 | $183–$1,840 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$123.75–$1,314 | $165–$1,752 | varies |
| Us bone density measurement (76977) | $14.25 | $19 | 0.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$183.75–$459.75 | $245–$613 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$150.75–$333.75 | $201–$445 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$201.75–$756 | $269–$1,008 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$84–$333.75 | $112–$445 | varies |
| Us head (76506) range across 2 matching MRF lines |
$201–$370.50 | $268–$494 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$267–$513 | $356–$684 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$63–$505.50 | $84–$674 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$319.50–$888.75 | $426–$1,185 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$146.25–$370.50 | $195–$494 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$168–$370.50 | $224–$494 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$189–$513 | $252–$684 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$213–$756 | $284–$1,008 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$199.50–$370.50 | $266–$494 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$194.25–$513 | $259–$684 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$101.25–$513 | $135–$684 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$117.75–$513 | $157–$684 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$204–$570 | $272–$760 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$198–$756 | $264–$1,008 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$163.50–$915 | $218–$1,220 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$314.25–$1,662.75 | $419–$2,217 | varies |
| Vasogram (74440) | $120.75 | $161 | 0.5× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$291–$3,135 | $388–$4,180 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 2 matching MRF lines |
$272.25–$2,775 | $363–$3,700 | varies |
| Vein X-Ray Skull Epidural (75872) | $396 | $528 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) | $722.25 | $963 | 0.2× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$245.25–$2,775 | $327–$3,700 | varies |
| Venography Adrenal Unilateral (75840) range across 2 matching MRF lines |
$291–$5,736 | $388–$7,648 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$231–$8,954.25 | $308–$11,939 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$234–$3,360 | $312–$4,480 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$195.75–$3,448.50 | $261–$4,598 | varies |
| Venography Orbital Rs&I (75880) | $239.25 | $319 | 0.4× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$339–$5,736 | $452–$7,648 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$297–$5,736 | $396–$7,648 | varies |
| Venous sampling by catheter (75893) | $5,736 | $7,648 | 1.1× |
| Venous thrombosis imaging (78457) | $270.75 | $361 | 0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $272.25 | $363 | 0.7× |
| Vertebral fracture assessment via dxa (77086) | $297.75 | $397 | 3.6× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$48.75–$591.75 | $65–$789 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$60–$320.25 | $80–$427 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$116.25–$1,380 | $155–$1,840 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$351.75–$8,954.25 | $469–$11,939 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$68.25–$621 | $91–$828 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$45.75–$591.75 | $61–$789 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,706.25 | $36–$2,275 | 3.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$66–$414.75 | $88–$553 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$105–$683.25 | $140–$911 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$114–$1,285.50 | $152–$1,714 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$50.25–$414.75 | $67–$553 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$69.75–$414.75 | $93–$553 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$87–$683.25 | $116–$911 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$66.75–$683.25 | $89–$911 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$82.50–$683.25 | $110–$911 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$96–$1,285.50 | $128–$1,714 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$104.25–$621 | $139–$828 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$56.25–$394.50 | $75–$526 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$95.25–$493.50 | $127–$658 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$62.25–$607.50 | $83–$810 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$46.50–$480.75 | $62–$641 | varies |
| X-ray head for orthodontia (70350) | $30 | $40 | 0.4× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$48.75–$588 | $65–$784 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$185.25–$1,536.75 | $247–$2,049 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$189.75–$1,277.25 | $253–$1,703 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $55.50 | $74 | 0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$60–$320.25 | $80–$427 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$59.25–$394.50 | $79–$526 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$38.25–$320.25 | $51–$427 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$81.75–$493.50 | $109–$658 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$55.50–$394.50 | $74–$526 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $48 | $64 | 0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$47.25–$394.50 | $63–$526 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$63.75–$493.50 | $85–$658 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$78–$493.50 | $104–$658 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$64.50–$320.25 | $86–$427 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$66–$320.25 | $88–$427 | varies |
| X-Ray Tmj Unilat (70328) | $43.50 | $58 | 0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$201–$1,536.75 | $268–$2,049 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$54–$493.50 | $72–$658 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$147.75–$621 | $197–$828 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$77.25–$621 | $103–$828 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$50.25–$320.25 | $67–$427 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $57 | $76 | 0.6× |
| Xr myelogram posterior fossa (70010) | $236.25 | $315 | 0.7× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$72–$493.50 | $96–$658 | varies |
| Xr Tomogram Single Plane (76100) range across 3 matching MRF lines |
$147.75–$493.50 | $197–$658 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.