Imaging prices at Wellington Regional Medical Center
Wellington, FL · every code in this section with a posted price and a Medicare benchmark.
409 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$4,893–$10,543.50 | $6,524–$14,058 | varies |
| Abdomen 1 View (74018) | $963 | $1,284 | 10.6× |
| Abdomen 2 views (74019) | $1,437 | $1,916 | 13.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,394.25–$2,687.25 | $1,859–$3,583 | varies |
| Adrenal Cortex & Medulla Img (78075) | $1,709.25 | $2,279 | 1.3× |
| Angio internal mammary (75756) range across 3 matching MRF lines |
$1,998.75–$4,221 | $2,665–$5,628 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$6,915.75–$9,125.25 | $9,221–$12,167 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,915.75 | $9,221 | 2.1× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$12,456–$17,465.25 | $16,608–$23,287 | varies |
| Angiography extremity unilateral rs&i (75710) range across 11 matching MRF lines |
$6,566.25–$17,465.25 | $8,755–$23,287 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $8,295.75 | $11,061 | 2.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,221 | $5,628 | 1.3× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$377.25–$857.25 | $503–$1,143 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$6,207–$11,469.75 | $8,276–$15,293 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 2 matching MRF lines |
$4,221–$13,337.25 | $5,628–$17,783 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$3,312.75–$31,707.75 | $4,417–$42,277 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$4,221–$4,504.50 | $5,628–$6,006 | varies |
| Artery X-Rays Pelvis (75736) range across 6 matching MRF lines |
$3,074.25–$16,361.25 | $4,099–$21,815 | varies |
| Artery X-Rays Spine (75705) | $12,958.50 | $17,278 | 2.2× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$880.50–$1,029 | $1,174–$1,372 | varies |
| Arthrogram hip (73525) range across 9 matching MRF lines |
$1,613.25–$2,435.25 | $2,151–$3,247 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,029–$1,131 | $1,372–$1,508 | varies |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$592.50–$993.75 | $790–$1,325 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$336.75–$636 | $449–$848 | varies |
| Bone Imaging 3 Phase (78315) | $6,125.25 | $8,167 | 14.7× |
| Bone Imaging Limited Area (78300) | $1,431.75 | $1,909 | 3.4× |
| Bone Imaging Multiple Areas (78305) | $1,153.50 | $1,538 | 2.8× |
| Bone Imaging Whole Body (78306) | $4,398 | $5,864 | 10.5× |
| Bone marrow imaging limited area (78102) | $645.75 | $861 | 1.5× |
| Bone marrow imaging; whole body (78104) | $1,625.25 | $2,167 | 3.9× |
| Bone survey infant (77076) | $561.75 | $749 | 5.1× |
| Brain Flow Imaging Only (78610) | $708 | $944 | 1.2× |
| Brain Image W/Flow < 4 Views (78601) | $780.75 | $1,041 | 1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,987.25 | $3,983 | 5.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,798.25 | $3,731 | 4.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,970 | $7,960 | 4.0× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $2,476.50 | $3,302 | 4.4× |
| Cat Scan Follow-Up Study (76380) | $1,189.50 | $1,586 | 13.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,079.25 | $1,439 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $2,730 | $3,640 | 4.8× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$237.75–$739.50 | $317–$986 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$306.75–$1,142.25 | $409–$1,523 | varies |
| Chest 3 views (71047) | $337.50 | $450 | 3.7× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$732.75–$827.25 | $977–$1,103 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $442.50 | $590 | 0.5× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$365.25–$985.50 | $487–$1,314 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$2,942.25–$5,581.50 | $3,923–$7,442 | varies |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$454.50–$986.25 | $606–$1,315 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$4,608–$16,417.50 | $6,144–$21,890 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$555.75–$1,641 | $741–$2,188 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$807.75–$888.75 | $1,077–$1,185 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,071.75–$1,363.50 | $1,429–$1,818 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $381.75 | $509 | 2.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$8,736.75–$14,387.25 | $11,649–$19,183 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$7,720.50–$12,841.50 | $10,294–$17,122 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$2,892.75–$7,846.50 | $3,857–$10,462 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$2,771.25–$8,631 | $3,695–$11,508 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$207–$7,133.25 | $276–$9,511 | varies |
| CT Angio Abdomen and Pelvis (74174) | $12,619.50 | $16,826 | 34.6× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$2,868.75–$7,890.75 | $3,825–$10,521 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$2,199.75–$6,536.25 | $2,933–$8,715 | varies |
| CT angio hrt w/3d image (75574) | $5,227.50 | $6,970 | 14.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 5 matching MRF lines |
$2,199.75–$5,517 | $2,933–$7,356 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,199.75–$7,867.50 | $2,933–$10,490 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,782.50 | $3,710 | 15.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$3,999.75–$8,199 | $5,333–$10,932 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$2,316–$6,918 | $3,088–$9,224 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$3,133.50–$8,694.75 | $4,178–$11,593 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$2,229.75–$8,067.75 | $2,973–$10,757 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$4,509.75–$8,409.75 | $6,013–$11,213 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $3,963 | $5,284 | 21.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $3,963 | $5,284 | 36.3× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$4,791.75–$7,509 | $6,389–$10,012 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$2,771.25–$8,259.75 | $3,695–$11,013 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $3,963 | $5,284 | 10.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $5,598 | $7,464 | 61.6× |
| CT hrt w/3d image congen (75573) | $3,963 | $5,284 | 10.9× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$2,068.50–$6,372 | $2,758–$8,496 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$4,718.25–$8,804.25 | $6,291–$11,739 | varies |
| CT lower ext w/o (73700) range across 8 matching MRF lines |
$1,983–$7,984.50 | $2,644–$10,646 | varies |
| CT lower extremity w/contrast material (73701) range across 8 matching MRF lines |
$2,177.25–$8,783.25 | $2,903–$11,711 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$4,435.50–$8,004 | $5,914–$10,672 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$2,538–$7,276.50 | $3,384–$9,702 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$2,161.50–$7,389 | $2,882–$9,852 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$1,949.25–$6,717 | $2,599–$8,956 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$3,626.25–$7,335.75 | $4,835–$9,781 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$3,304.50–$7,009.50 | $4,406–$9,346 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,677.50–$5,181 | $3,570–$6,908 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$3,982.50–$10,047 | $5,310–$13,396 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$3,966.75–$6,920.25 | $5,289–$9,227 | varies |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$3,639–$9,662.25 | $4,852–$12,883 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$3,447.75–$8,127.75 | $4,597–$10,837 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$2,167.50–$6,669 | $2,890–$8,892 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$1,872.75–$5,643 | $2,497–$7,524 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$3,999.75–$5,850 | $5,333–$7,800 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$2,328.75–$5,443.50 | $3,105–$7,258 | varies |
| CT thoracic spine w/wo cont (72130) | $6,651.75 | $8,869 | 36.3× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$3,235.50–$6,634.50 | $4,314–$8,846 | varies |
| CT upper ext wo (73200) range across 8 matching MRF lines |
$1,923–$5,280 | $2,564–$7,040 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines |
$3,639–$7,277.25 | $4,852–$9,703 | varies |
| CT upper extremity with contrast (73201) range across 5 matching MRF lines |
$3,108.75–$5,808 | $4,145–$7,744 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$3,300–$6,308.25 | $4,400–$8,411 | varies |
| Cta Abdomen (74175) | $6,308.25 | $8,411 | 34.4× |
| CTA pelvis (72191) | $3,090.75 | $4,121 | 16.9× |
| Diskography lumbar (72295) range across 5 matching MRF lines |
$1,203.75–$17,448.75 | $1,605–$23,265 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,694.25 | $2,259 | 15.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $855 | $1,140 | 7.8× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$531–$1,441.50 | $708–$1,922 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $297.75 | $397 | 3.3× |
| Echo exam of fetal heart (76825) | $4,274.25 | $5,699 | 7.5× |
| Echo exam uterus (76831) | $1,293.75 | $1,725 | 5.2× |
| Echo Guide For Artery Repair (76936) | $2,874 | $3,832 | 12.7× |
| Echograp Trans R Pros Study (76873) | $906.75 | $1,209 | 8.3× |
| Esophagram (74220) range across 3 matching MRF lines |
$654–$1,623.75 | $872–$2,165 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$425.25–$1,310.25 | $567–$1,747 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$855–$1,749 | $1,140–$2,332 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,407–$2,110.50 | $1,876–$2,814 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$2,235.75–$5,266.50 | $2,981–$7,022 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$477–$969.75 | $636–$1,293 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$545.25–$1,277.25 | $727–$1,703 | varies |
| Gastric emptying imaging study (78264) | $3,304.50 | $4,406 | 7.9× |
| Gastroesophageal Reflux Exam (78262) | $1,337.25 | $1,783 | 3.2× |
| Gated Heart Planar Single (78472) | $3,396.75 | $4,529 | 8.1× |
| Gated Heart, Multiple (78473) | $3,350.25 | $4,467 | 8.0× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$280.50–$775.50 | $374–$1,034 | varies |
| Heart first pass single,planar (78481) | $1,644.75 | $2,193 | 2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$3,381–$4,644 | $4,508–$6,192 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$3,166.50–$4,644 | $4,222–$6,192 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,123.75 | $4,165 | 5.5× |
| Hepatobiliary System Imaging (78226) | $3,473.25 | $4,631 | 8.3× |
| Ht Musc Image Planar Mult (78454) | $5,971.50 | $7,962 | 4.4× |
| Ht Muscle Image Spect Sing (78451) | $609.75 | $813 | 0.5× |
| Hyperthermia external generated superficial (77600) range across 2 matching MRF lines |
$786.75–$1,121.25 | $1,049–$1,495 | varies |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $674.25 | $899 | 1.2× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $1,011 | $1,348 | 1.8× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $337.50 | $450 | 0.6× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $1,250.25 | $1,667 | 1.7× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$1,603.50–$2,155.50 | $2,138–$2,874 | varies |
| Image fusion (77399) | $1,187.25 | $1,583 | 8.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $949.50 | $1,266 | 10.4× |
| Infant hip ultrasound, limited static exam (76886) | $459 | $612 | 5.1× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$1,119.75–$1,137 | $1,493–$1,516 | varies |
| Interstitial radiation source applic complex (77778) | $8,474.25 | $11,299 | 11.7× |
| Intracavitary Radiation Source Applic Complex (77763) | $2,052 | $2,736 | 2.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,945.50 | $2,594 | 3.4× |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$1,254–$1,793.25 | $1,672–$2,391 | varies |
| Intraop radiaj tx deliver xray single tx session (77424) | $46,524 | $62,032 | 6.0× |
| K Flow/Funct Image Multiple (78709) | $2,571 | $3,428 | 4.5× |
| K Flow/Funct Image W/Drug (78708) | $2,415 | $3,220 | 4.3× |
| K Flow/Funct Image W/O Drug (78707) | $2,802.75 | $3,737 | 4.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 2 matching MRF lines |
$423–$564 | $564–$752 | varies |
| Kidney Imaging Morphol (78700) | $2,187.75 | $2,917 | 5.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$837.75–$2,666.25 | $1,117–$3,555 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$1,154.25–$1,465.50 | $1,539–$1,954 | varies |
| Leveen/Shunt Patency Exam (78291) | $962.25 | $1,283 | 2.3× |
| Liver & Spleen Imaging Static Only (78215) | $2,152.50 | $2,870 | 5.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,095 | $1,460 | 2.6× |
| Liver imaging static only (78201) | $1,080 | $1,440 | 1.9× |
| Liver imaging w/vascular flow (78202) | $1,140 | $1,520 | 2.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,210.25 | $2,947 | 3.9× |
| Lung perfusion differential (78597) | $2,210.25 | $2,947 | 5.3× |
| Lung Ventilat&Perfus Imaging (78582) | $3,942.75 | $5,257 | 7.0× |
| Lung Ventilation Imaging (78579) | $819.75 | $1,093 | 2.0× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$2,593.50–$5,264.25 | $3,458–$7,019 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 2 matching MRF lines |
$1,362.75–$1,817.25 | $1,817–$2,423 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,817.25 | $2,423 | 2.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$1,689–$6,915.75 | $2,252–$9,221 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,045.25 | $2,727 | 0.6× |
| Magnetic Image Jaw Joint (70336) range across 8 matching MRF lines |
$3,854.25–$4,767.75 | $5,139–$6,357 | varies |
| Mammary ductogram or galactogram multiple (77054) | $1,186.50 | $1,582 | 4.8× |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$932.25–$2,019.75 | $1,243–$2,693 | varies |
| Meckels Divert Exam (78290) | $991.50 | $1,322 | 2.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,485.75 | $1,981 | 3.8× |
| Mra Head W/O & W/Contrast Material (70546) | $8,073 | $10,764 | 22.2× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$2,119.50–$4,725 | $2,826–$6,300 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,078.25–$6,105.75 | $2,771–$8,141 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$3,641.25–$7,795.50 | $4,855–$10,394 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$5,010.75–$10,068 | $6,681–$13,424 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$2,119.50–$5,778 | $2,826–$7,704 | varies |
| MRI abdomen w contrast (74182) range across 4 matching MRF lines |
$2,483.25–$6,773.25 | $3,311–$9,031 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$2,483.25–$5,871 | $3,311–$7,828 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,771–$6,296.25 | $5,028–$8,395 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 5 matching MRF lines |
$4,025.25–$6,926.25 | $5,367–$9,235 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$2,133.75–$5,999.25 | $2,845–$7,999 | varies |
| MRI bone marrow blood supply (77084) | $3,839.25 | $5,119 | 15.4× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$3,327–$4,872 | $4,436–$6,496 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,963.50 | $2,618 | 7.9× |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$4,085.25–$8,295.75 | $5,447–$11,061 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$3,501–$7,704 | $4,668–$10,272 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$3,210–$5,800.50 | $4,280–$7,734 | varies |
| MRI chest with contrast (71551) | $5,046.75 | $6,729 | 6.2× |
| MRI chest wo w contrast (71552) | $7,326.75 | $9,769 | 20.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$4,320–$4,994.25 | $5,760–$6,659 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 5 matching MRF lines |
$5,845.50–$7,558.50 | $7,794–$10,078 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$3,024–$6,246.75 | $4,032–$8,329 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$3,367.50–$7,209 | $4,490–$9,612 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $9,515.25 | $12,687 | 26.1× |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$2,694–$7,278.75 | $3,592–$9,705 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,694–$3,849.75 | $3,592–$5,133 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$2,694–$8,808.75 | $3,592–$11,745 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$3,074.25–$7,407.75 | $4,099–$9,877 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$3,074.25–$7,880.25 | $4,099–$10,507 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$3,074.25–$6,734.25 | $4,099–$8,979 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$3,074.25–$4,392 | $4,099–$5,856 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$3,852.75–$6,927.75 | $5,137–$9,237 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 6 matching MRF lines |
$4,338.75–$4,801.50 | $5,785–$6,402 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 5 matching MRF lines |
$3,704.25–$6,164.25 | $4,939–$8,219 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 5 matching MRF lines |
$4,917–$7,458.75 | $6,556–$9,945 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$2,483.25–$6,438 | $3,311–$8,584 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$4,323–$9,446.25 | $5,764–$12,595 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$4,085.25–$8,295.75 | $5,447–$11,061 | varies |
| MRI, joint upper extrem (73221) range across 5 matching MRF lines |
$3,207–$6,020.25 | $4,276–$8,027 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$5,841–$7,284.75 | $7,788–$9,713 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$4,249.50–$8,686.50 | $5,666–$11,582 | varies |
| Myelogram cervical (72240) | $2,229.75 | $2,973 | 2.7× |
| Myelogram Lumbar (72265) | $2,229.75 | $2,973 | 2.7× |
| Myelography thoracic (72255) | $2,229.75 | $2,973 | 2.7× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$2,842.50–$3,216 | $3,790–$4,288 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $829.50 | $1,106 | 2.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $864.75 | $1,153 | 1.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,971.50 | $7,962 | 4.4× |
| Myocardial Spect Multiple Studies (78452) | $8,389.50 | $11,186 | 6.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$356.25–$1,019.25 | $475–$1,359 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $529.50 | $706 | 1.3× |
| Nm csf leak detection (78650) | $1,767 | $2,356 | 1.3× |
| Nm myocard infarct spect (78469) | $1,644.75 | $2,193 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $1,034.25 | $1,379 | 9.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,581.50 | $7,442 | 3.9× |
| Nuclear Rx Intra-Arterial (79445) | $1,271.25 | $1,695 | 5.2× |
| Nuclear Rx Oral Admin (79005) | $3,396.75 | $4,529 | 13.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $487.50 | $650 | 4.5× |
| Panoramic X-ray of jaws (70355) | $223.50 | $298 | 2.5× |
| Parathyroid Planar Imaging (78070) | $2,320.50 | $3,094 | 5.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,443 | $1,924 | 3.5× |
| Pelvis 1 or 2 views (72170) | $1,077 | $1,436 | 9.9× |
| Perineogram (74775) | $492 | $656 | 2.0× |
| Peritoneogram Rs&I (74190) | $3,571.50 | $4,762 | 6.3× |
| Pet Image W/Ct Lmtd (78814) | $5,970 | $7,960 | 4.0× |
| PET image w/CT, full body (78816) | $5,970 | $7,960 | 4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,970 | $7,960 | 4.0× |
| Proton tx delivery complex (77525) | $1,097.25 | $1,463 | 0.8× |
| Proton tx delivery simple w/o compensation (77520) range across 2 matching MRF lines |
$552.75–$791.25 | $737–$1,055 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,644 | $6,192 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$825–$2,261.25 | $1,100–$3,015 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$1,049.25–$1,259.25 | $1,399–$1,679 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 7 matching MRF lines |
$1,521–$2,159.25 | $2,028–$2,879 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,188–$1,384.50 | $1,584–$1,846 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 8 matching MRF lines |
$171–$1,167.75 | $228–$1,557 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$690–$1,422.75 | $920–$1,897 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$896.25–$1,383.75 | $1,195–$1,845 | varies |
| Radex fingr minimum 2 views (73140) range across 24 matching MRF lines |
$112.50–$949.50 | $150–$1,266 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,161–$1,348.50 | $1,548–$1,798 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$1,090.50–$1,264.50 | $1,454–$1,686 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 7 matching MRF lines |
$370.50–$1,007.25 | $494–$1,343 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $818.25 | $1,091 | 7.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$483–$1,133.25 | $644–$1,511 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $469.50 | $626 | 5.2× |
| Radex Ribs Unilateral 2 Views (71100) | $477 | $636 | 5.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$717.75–$1,320.75 | $957–$1,761 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $348 | $464 | 3.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$398.25–$722.25 | $531–$963 | varies |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$429–$721.50 | $572–$962 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$396.75–$687 | $529–$916 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$568.50–$890.25 | $758–$1,187 | varies |
| Radex Toe Minimum 2 Views (73660) range across 21 matching MRF lines |
$252–$908.25 | $336–$1,211 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$256.50–$618 | $342–$824 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,133.25–$1,404.75 | $1,511–$1,873 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $365.25 | $487 | 3.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,656.50 | $23,542 | 2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$747–$964.50 | $996–$1,286 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$247.50–$957.75 | $330–$1,277 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$1,073.25–$2,176.50 | $1,431–$2,902 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$825–$1,668.75 | $1,100–$2,225 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,440.75 | $1,921 | 7.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,570.50–$2,289.75 | $2,094–$3,053 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$300–$353.25 | $400–$471 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$819–$1,593 | $1,092–$2,124 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$998.25–$1,485.75 | $1,331–$1,981 | varies |
| Radiologic exam teeth complete full mouth (70320) | $307.50 | $410 | 1.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $162 | $216 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 8 matching MRF lines |
$537–$1,994.25 | $716–$2,659 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$795–$1,438.50 | $1,060–$1,918 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$485.25–$694.50 | $647–$926 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $429 | $572 | 3.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$715.50–$1,324.50 | $954–$1,766 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $829.50 | $1,106 | 3.4× |
| Renal Cyst Study (74470) | $4,257.75 | $5,677 | 7.5× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$169.50–$868.50 | $226–$1,158 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,155.50 | $2,874 | 5.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,687 | $4,916 | 8.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,839.75 | $6,453 | 8.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,792 | $5,056 | 6.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 6 matching MRF lines |
$1,859.25–$3,174.75 | $2,479–$4,233 | varies |
| Rp Therapy Intravenous Administration (79101) | $881.25 | $1,175 | 3.6× |
| Salivary Gland Imaging (78230) | $689.25 | $919 | 1.7× |
| Scapula (73010) range across 5 matching MRF lines |
$365.25–$645 | $487–$860 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $123.75 | $165 | 5.3× |
| Sella turcica (70240) | $407.25 | $543 | 4.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$585–$824.25 | $780–$1,099 | varies |
| Shoulder Arthrography (73040) range across 8 matching MRF lines |
$1,950–$4,004.25 | $2,600–$5,339 | varies |
| Sialogram (70390) | $580.50 | $774 | 2.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$2,746.50–$2,922 | $3,662–$3,896 | varies |
| Special dosimetry (77331) | $1,203.75 | $1,605 | 8.6× |
| Special Physics Consult (77370) range across 4 matching MRF lines |
$794.25–$1,811.25 | $1,059–$2,415 | varies |
| Special teletherapy port plan (77321) | $1,445.25 | $1,927 | 3.7× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,455.50–$2,487.75 | $3,274–$3,317 | varies |
| Speech evaluation, complex (70371) | $627.75 | $837 | 2.5× |
| Stereotactic Body Radiation Delivery (77373) | $3,866.25 | $5,155 | 2.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$253.50–$544.50 | $338–$726 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$3,166.50–$3,183.75 | $4,222–$4,245 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 2 matching MRF lines |
$740.25–$1,113.75 | $987–$1,485 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,884 | $2,512 | 4.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $740.25 | $987 | 1.9× |
| Testicular Imaging W/Flow (78761) | $844.50 | $1,126 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,692.75–$2,695.50 | $2,257–$3,594 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,393.50 | $1,858 | 3.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 3 matching MRF lines |
$552–$1,539 | $736–$2,052 | varies |
| Thoracic spine 2 views (72070) | $1,362.75 | $1,817 | 12.5× |
| Thoracic spine 3 views (72072) | $1,428.75 | $1,905 | 13.1× |
| Thoracolumbar 2 views (72080) | $794.25 | $1,059 | 8.7× |
| Thyroid Imaging With Vascular Flow (78013) | $1,157.25 | $1,543 | 2.8× |
| Thyroid Met Imaging Body (78018) | $2,103.75 | $2,805 | 3.7× |
| Thyroid Uptake Measurement (78012) range across 3 matching MRF lines |
$306–$491.25 | $408–$655 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$755.25–$2,746.50 | $1,007–$3,662 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,713.75–$2,695.50 | $2,285–$3,594 | varies |
| Tx devices design & construction intermediate (77333) | $1,468.50 | $1,958 | 10.5× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$627–$993.75 | $836–$1,325 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,234.50–$1,543.50 | $1,646–$2,058 | varies |
| Ultrasound Exam Aaa Screen (76706) | $634.50 | $846 | 5.8× |
| Ultrasound, abdomen limited (76705) range across 10 matching MRF lines |
$1,086.75–$1,877.25 | $1,449–$2,503 | varies |
| Umbilical-artery Doppler (OB) (76820) | $1,104.75 | $1,473 | 10.1× |
| Unlis px ther radiol clinical tx planning (77299) | $1,683.75 | $2,245 | 12.0× |
| Unlisted magnetic resonance procedure (76498) | $2,286 | $3,048 | 25.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $674.25 | $899 | 6.3× |
| Upper gi w/o kub (74240) range across 9 matching MRF lines |
$362.25–$1,990.50 | $483–$2,654 | varies |
| Ureteral Reflux Study (78740) | $891 | $1,188 | 2.1× |
| Urethrocystogram voiding (74455) | $1,644 | $2,192 | 6.6× |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$588.75–$1,577.25 | $785–$2,103 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,352.25–$1,690.50 | $1,803–$2,254 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$552–$867.75 | $736–$1,157 | varies |
| Us complete joint (76881) | $937.50 | $1,250 | 8.6× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$1,162.50–$1,236.75 | $1,550–$1,649 | varies |
| Us head (76506) range across 2 matching MRF lines |
$605.25–$967.50 | $807–$1,290 | varies |
| Us kidney transplant (76776) | $898.50 | $1,198 | 8.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$541.50–$1,371.75 | $722–$1,829 | varies |
| Us ob detailed single fetus (76811) | $1,269.75 | $1,693 | 5.1× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$365.25–$932.25 | $487–$1,243 | varies |
| Us ob transvaginal (76817) | $1,289.25 | $1,719 | 11.8× |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$1,143.75–$1,983 | $1,525–$2,644 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,075.50 | $1,434 | 9.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$533.25–$651.75 | $711–$869 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$634.50–$1,740 | $846–$2,320 | varies |
| Us retroperitoneal limited (76775) range across 7 matching MRF lines |
$634.50–$1,704.75 | $846–$2,273 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$679.50–$1,675.50 | $906–$2,234 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$345–$840 | $460–$1,120 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$601.50–$1,685.25 | $802–$2,247 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$634.50–$906.75 | $846–$1,209 | varies |
| Vascular Flow Imaging (78445) | $411.75 | $549 | 1.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$3,311.25–$6,471 | $4,415–$8,628 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,644 | $6,192 | 1.4× |
| Vein X-Ray Spleen/Liver (75810) | $4,644 | $6,192 | 1.4× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$4,221–$12,958.50 | $5,628–$17,278 | varies |
| Venography Adrenal Unilateral (75840) | $4,221 | $5,628 | 1.3× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$9,305.25–$16,417.50 | $12,407–$21,890 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$454.50–$5,499.75 | $606–$7,333 | varies |
| Venography extremity unilateral rs&i (75820) range across 9 matching MRF lines |
$289.50–$5,259.75 | $386–$7,013 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$3,483–$9,486.75 | $4,644–$12,649 | varies |
| Venography Renal Unilateral (75831) range across 3 matching MRF lines |
$3,166.50–$4,221 | $4,222–$5,628 | varies |
| Venous sampling by catheter (75893) | $4,221 | $5,628 | 0.7× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$216–$609.75 | $288–$813 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$364.50–$501 | $486–$668 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$586.50–$1,746 | $782–$2,328 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$17,313–$18,948.75 | $23,084–$25,265 | varies |
| X-Ray Bend Only L-S Spine (72120) | $620.25 | $827 | 5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$255–$593.25 | $340–$791 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$685.50–$1,898.25 | $914–$2,531 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$397.50–$481.50 | $530–$642 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $585.75 | $781 | 6.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,192.50 | $1,590 | 13.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $989.25 | $1,319 | 9.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$480–$2,190.75 | $640–$2,921 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$1,503–$1,899.75 | $2,004–$2,533 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,176 | $1,568 | 12.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,551 | $2,068 | 14.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,110 | $1,480 | 10.2× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$293.25–$588 | $391–$784 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$710.25–$1,317.75 | $947–$1,757 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$989.25–$1,881.75 | $1,319–$2,509 | varies |
| X-ray IV pyelogram+tomography (74415) range across 3 matching MRF lines |
$997.50–$1,137 | $1,330–$1,516 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$250.50–$323.25 | $334–$431 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $189.75 | $253 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,437 | $1,916 | 13.2× |
| X-ray nose-rectum child f.b. (76010) | $519 | $692 | 5.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$934.50–$1,134 | $1,246–$1,512 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$567.75–$666 | $757–$888 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $216 | $288 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,284.75 | $1,713 | 14.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,420.50 | $1,894 | 15.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$1,248.75–$1,333.50 | $1,665–$1,778 | varies |
| X-ray thoracic spine 4 vw (72074) | $1,236.75 | $1,649 | 11.3× |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$180–$273 | $240–$364 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$1,137–$1,897.50 | $1,516–$2,530 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$491.25–$588.75 | $655–$785 | varies |
| X-Rays Bone Survey Complete (77075) | $1,467 | $1,956 | 13.4× |
| Xr c-spine 4 or 5 views (72050) | $2,340 | $3,120 | 21.4× |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$333–$393 | $444–$524 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $241.50 | $322 | 2.2× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$489.75–$856.50 | $653–$1,142 | varies |
| Xr Tomogram Single Plane (76100) | $1,186.50 | $1,582 | 10.9× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.