Imaging prices at Wesley Medical Center
Wichita, KS · every code in this section with a posted price and a Medicare benchmark.
378 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $6,465 | $6,465 | 5.1× |
| Abdomen 1 View (74018) | $2,186 | $2,186 | 27.3× |
| Abdomen 2 views (74019) | $2,483 | $2,483 | 25.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $6,427 | $6,427 | 17.4× |
| Angio internal mammary (75756) | $18,865 | $18,865 | 6.5× |
| Angio pulmonary bilat (75743) | $22,223 | $22,223 | 7.6× |
| Angiography extremity bilateral rs&i (75716) | $37,731 | $37,731 | 13.0× |
| Angiography extremity unilateral rs&i (75710) | $18,865 | $18,865 | 6.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $24,547 | $24,547 | 8.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $29,444 | $29,444 | 10.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$1,780–$3,555 | $1,780–$3,555 | varies |
| Aortography thoracic serialography rs&i (75605) | $18,865 | $18,865 | 3.7× |
| Artery X-Rays Abdomen (75726) | $18,865 | $18,865 | 3.7× |
| Artery X-Rays Pelvis (75736) | $18,865 | $18,865 | 3.7× |
| Artery X-Rays Spine (75705) | $18,865 | $18,865 | 3.7× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$3,446–$6,895 | $3,446–$6,895 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$3,446–$6,895 | $3,446–$6,895 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$3,064–$6,131 | $3,064–$6,131 | varies |
| Basic radiation dosimetry calculation (77300) | $1,559 | $1,559 | 12.6× |
| Bone age studies (77072) | $1,616 | $1,616 | 16.8× |
| Bone Imaging 3 Phase (78315) | $4,322 | $4,322 | 11.7× |
| Bone Imaging Limited Area (78300) | $3,816 | $3,816 | 10.4× |
| Bone Imaging Multiple Areas (78305) | $4,767 | $4,767 | 12.9× |
| Bone Imaging Whole Body (78306) | $4,829 | $4,829 | 13.1× |
| Bone marrow imaging; multiple areas (78103) | $6,021 | $6,021 | 16.3× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$2,917–$5,840 | $2,917–$5,840 | varies |
| Brachytx isodose complex (77318) | $7,371 | $7,371 | 21.4× |
| Brachytx isodose intermed (77317) | $6,224 | $6,224 | 18.0× |
| Brachytx Isodose Plan Simple (77316) | $4,861 | $4,861 | 14.1× |
| Brain Flow Imaging Only (78610) | $6,525 | $6,525 | 13.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $38,468 | $38,468 | 119.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $38,468 | $38,468 | 53.3× |
| Cat Scan Follow-Up Study (76380) | $10,242 | $10,242 | 127.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $4,367 | $4,367 | 8.7× |
| Cerebrospinal Fluid Scan (78630) | $5,872 | $5,872 | 11.7× |
| Chest 1 view (71045) | $2,186 | $2,186 | 27.3× |
| Chest 2 views (71046) | $2,382 | $2,382 | 29.7× |
| Chest 3 views (71047) | $3,524 | $3,524 | 43.9× |
| Chest 4 or more views (71048) | $6,753 | $6,753 | 70.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $2,860 | $2,860 | 29.7× |
| Cisternography Positive Contrast Rs&I (70015) | $2,427 | $2,427 | 3.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$1,906–$3,809 | $1,906–$3,809 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,026 | $2,026 | 21.0× |
| Continuing medical physics consltj pr wk (77336) | $2,127 | $2,127 | 17.2× |
| Contrast Exam Abdominl Aorta (75625) | $22,595 | $22,595 | 7.8× |
| Contrast X-Ray Bladder (74430) | $5,476 | $5,476 | 17.0× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$3,446–$6,895 | $3,446–$6,895 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$5,083–$10,171 | $5,083–$10,171 | varies |
| Corpora cavernosography (74445) | $7,206 | $7,206 | 74.8× |
| CT abdomen and pelvis without and with contrast (74178) | $32,740 | $32,740 | 101.8× |
| CT abdomen and pelvis without contrast (74176) | $27,707 | $27,707 | 126.0× |
| CT abdomen w contrast (74160) | $13,851 | $13,851 | 85.7× |
| CT abdomen w wo contrast (74170) | $15,115 | $15,115 | 93.5× |
| CT abdomen w/o contrast (74150) | $12,599 | $12,599 | 130.8× |
| CT Angio Abdomen and Pelvis (74174) | $27,471 | $27,471 | 85.4× |
| CT Angio Chest (71275) | $19,356 | $19,356 | 119.8× |
| CT Angio Head (70496) | $14,240 | $14,240 | 88.1× |
| CT angio hrt w/3d image (75574) | $19,356 | $19,356 | 60.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $15,024 | $15,024 | 93.0× |
| CT Angio Neck (70498) | $15,701 | $15,701 | 97.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $15,024 | $15,024 | 93.0× |
| CT cervical spine w/ contrast (72126) | $17,159 | $17,159 | 53.4× |
| CT cervical spine w/o contrast (72125) | $16,449 | $16,449 | 170.7× |
| CT cervical spine w/wo cont (72127) | $19,959 | $19,959 | 123.5× |
| CT chest w contrast (71260) | $19,356 | $19,356 | 119.8× |
| CT chest w/wo contrast (71270) | $21,763 | $21,763 | 134.6× |
| CT head/brain with contrast (70460) | $14,240 | $14,240 | 88.1× |
| CT head/brain without and with contrast (70470) | $16,636 | $16,636 | 102.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $19,356 | $19,356 | 60.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $99 | $99 | 1.2× |
| CT hrt w/3d image congen (75573) | $19,356 | $19,356 | 60.2× |
| CT iac w contrast (70481) | $14,057 | $14,057 | 87.0× |
| CT l-spine w&w/o contrast (72133) | $19,779 | $19,779 | 122.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$13,933–$27,867 | $13,933–$27,867 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$15,024–$30,047 | $15,024–$30,047 | varies |
| CT lumbar spine w contrast (72132) | $16,997 | $16,997 | 52.9× |
| CT lumbar spine w/o contrast (72131) | $16,997 | $16,997 | 176.4× |
| CT maxillofacial w contrast (70487) | $13,329 | $13,329 | 82.5× |
| CT maxillofacial wo contrast (70486) | $11,615 | $11,615 | 120.6× |
| CT neck tissue combo (70492) | $17,637 | $17,637 | 109.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $17,859 | $17,859 | 110.5× |
| CT orbits w/o contrast (70480) | $12,229 | $12,229 | 126.9× |
| CT pelvis w&w/o contrast (72194) | $17,630 | $17,630 | 109.1× |
| CT pelvis w/o contrast (72192) | $15,115 | $15,115 | 156.9× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$16,884–$33,772 | $16,884–$33,772 | varies |
| CT scans face/jaw combo (70488) | $15,600 | $15,600 | 96.5× |
| CT soft tissue neck w contrast (70491) | $15,701 | $15,701 | 97.1× |
| CT soft tissue neck w/o contrast (70490) | $14,532 | $14,532 | 150.8× |
| CT thoracic spine w contrast (72129) | $16,449 | $16,449 | 101.8× |
| CT thoracic spine w/o contrast (72128) | $16,449 | $16,449 | 170.7× |
| CT thoracic spine w/wo cont (72130) | $19,959 | $19,959 | 123.5× |
| CT thorax w/o contrast (71250) | $17,922 | $17,922 | 186.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$13,933–$27,867 | $13,933–$27,867 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$16,884–$33,772 | $16,884–$33,772 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$15,024–$30,047 | $15,024–$30,047 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $13,851 | $13,851 | 85.7× |
| Cta Abdomen (74175) | $13,851 | $13,851 | 85.7× |
| CTA pelvis (72191) | $16,365 | $16,365 | 101.2× |
| Dilation ureters/urethra rs&i (74485) | $6,098 | $6,098 | 3.2× |
| Discography Cerv/Thor Spine (72285) | $13,851 | $13,851 | 7.7× |
| Diskography lumbar (72295) | $12,976 | $12,976 | 7.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $2,301 | $2,301 | 23.9× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$696–$1,525 | $696–$1,525 | varies |
| Echo exam of fetal heart (76825) | $2,687 | $2,687 | 5.3× |
| Echo exam uterus (76831) | $3,285 | $3,285 | 14.9× |
| Echo Guide For Artery Repair (76936) | $4,008 | $4,008 | 20.1× |
| Echograp Trans R Pros Study (76873) | $5,972 | $5,972 | 62.0× |
| Esophagram (74220) | $3,375 | $3,375 | 20.9× |
| Fetal Biophys Profile W/Nst (76818) | $3,990 | $3,990 | 41.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,711 | $1,711 | 17.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $17,232 | $17,232 | 78.4× |
| Fluoroscopy up to 1 hr (76000) | $2,746 | $2,746 | 12.5× |
| Follow-Up Angiography (75898) | $12,618 | $12,618 | 4.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$1,968–$3,935 | $1,968–$3,935 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$1,887–$3,771 | $1,887–$3,771 | varies |
| Gastric emptying imaging study (78264) | $11,088 | $11,088 | 30.1× |
| Gastroesophageal Reflux Exam (78262) | $10,677 | $10,677 | 29.0× |
| Gated Heart Planar Single (78472) | $8,606 | $8,606 | 23.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$1,704–$3,407 | $1,704–$3,407 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $6,800 | $6,800 | 10.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $6,332 | $6,332 | 9.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,882 | $5,882 | 9.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $18,865 | $18,865 | 6.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $18,865 | $18,865 | 6.5× |
| Hepatobil Syst Image W/Drug (78227) | $5,201 | $5,201 | 10.4× |
| Hepatobiliary System Imaging (78226) | $5,201 | $5,201 | 14.1× |
| Ht Muscle Image Spect Sing (78451) | $8,494 | $8,494 | 7.1× |
| Hysterosalpingogram (74740) | $3,517 | $3,517 | 16.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,860 | $2,860 | 35.7× |
| Infusion Ivp (74410) | $3,937 | $3,937 | 24.4× |
| Interstitial radiation source applic complex (77778) | $1,528 | $1,528 | 2.4× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,528 | $1,528 | 2.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,980 | $2,980 | 5.9× |
| Intracavitary radiation source applic simple (77761) | $2,980 | $2,980 | 5.9× |
| Intraop radiaj tx deliver xray single tx session (77424) | $7,814 | $7,814 | 1.2× |
| Joint Survey Single View (77077) | $1,345 | $1,345 | 14.0× |
| K Flow/Funct Image Multiple (78709) | $10,660 | $10,660 | 21.3× |
| K Flow/Funct Image W/Drug (78708) | $11,824 | $11,824 | 23.6× |
| K Flow/Funct Image W/O Drug (78707) | $7,916 | $7,916 | 15.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$1,859–$3,716 | $1,859–$3,716 | varies |
| Leveen/Shunt Patency Exam (78291) | $5,872 | $5,872 | 15.9× |
| Liver & Spleen Imaging Static Only (78215) | $6,021 | $6,021 | 16.3× |
| Liver imaging static only (78201) | $6,103 | $6,103 | 12.2× |
| Lung Perf&Ventilat Diferentl (78598) | $6,530 | $6,530 | 13.1× |
| Lung perfusion differential (78597) | $4,897 | $4,897 | 13.3× |
| Lung Ventilat&Perfus Imaging (78582) | $5,614 | $5,614 | 11.2× |
| Lymph System Imaging (78195) | $5,603 | $5,603 | 11.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $19,809 | $19,809 | 13.7× |
| Lymphangiography extremity only unilateral rs&i (75801) | $11,675 | $11,675 | 20.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $23,363 | $23,363 | 8.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $19,809 | $19,809 | 6.8× |
| Magnetic Image Jaw Joint (70336) | $16,786 | $16,786 | 76.3× |
| Mammary ductogram or galactogram multiple (77054) | $4,844 | $4,844 | 22.0× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$3,329–$3,462 | $3,329–$3,462 | varies |
| Meckels Divert Exam (78290) | $4,927 | $4,927 | 13.4× |
| Mlc imrt design & construction per imrt plan (77338) | $13,220 | $13,220 | 38.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $95 | $95 | 3.6× |
| Mra Head W/O & W/Contrast Material (70546) | $16,088 | $16,088 | 50.0× |
| MRA head w/o contrast (70544) | $14,198 | $14,198 | 64.6× |
| MRA head with contrast (70545) | $15,137 | $15,137 | 47.1× |
| MRA neck w contrast (70548) | $15,137 | $15,137 | 47.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $16,088 | $16,088 | 50.0× |
| MRA neck w/o contrast (70547) | $14,198 | $14,198 | 64.6× |
| MRI abdomen w contrast (74182) | $21,307 | $21,307 | 66.3× |
| MRI abdomen w/o contrast (74181) | $19,895 | $19,895 | 90.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$18,409–$36,816 | $18,409–$36,816 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$19,344–$38,687 | $19,344–$38,687 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$19,961–$39,918 | $19,961–$39,918 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $25,815 | $25,815 | 117.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $12,907 | $12,907 | 58.7× |
| MRI cardiac w/o contrast (75557) | $38,468 | $38,468 | 175.0× |
| MRI cervical spine w contrast (72142) | $19,682 | $19,682 | 61.2× |
| MRI cervical spine w/o cont (72141) | $18,753 | $18,753 | 85.3× |
| MRI chest w/o contrast (71550) | $19,231 | $19,231 | 87.5× |
| MRI chest with contrast (71551) | $20,170 | $20,170 | 27.9× |
| MRI chest wo w contrast (71552) | $21,100 | $21,100 | 65.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$18,796–$37,591 | $18,796–$37,591 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$19,735–$39,468 | $19,735–$39,468 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$17,871–$35,738 | $17,871–$35,738 | varies |
| MRI lumbar spine w contrast (72149) | $19,375 | $19,375 | 60.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $20,638 | $20,638 | 64.2× |
| MRI orbit face &/neck w/o contrast (70540) | $16,786 | $16,786 | 76.3× |
| MRI orbit face neck w contrast (70542) | $17,733 | $17,733 | 55.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $18,670 | $18,670 | 58.1× |
| MRI pelvis w contrast (72196) | $20,361 | $20,361 | 63.3× |
| MRI pelvis w/o & w contrast (72197) | $19,117 | $19,117 | 59.5× |
| MRI pelvis w/o contrast (72195) | $17,232 | $17,232 | 78.4× |
| MRI thoracic spine w/o contrast (72146) | $18,158 | $18,158 | 82.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$20,935–$41,868 | $20,935–$41,868 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$19,993–$39,987 | $19,993–$39,987 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$21,877–$43,753 | $21,877–$43,753 | varies |
| MRI, abdomen, combo (74183) | $22,252 | $22,252 | 69.2× |
| MRI, dorsal spine combo (72157) | $20,026 | $20,026 | 62.3× |
| MRI, dorsal spine contrast (72147) | $19,091 | $19,091 | 59.4× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$19,006–$38,009 | $19,006–$38,009 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$20,901–$41,801 | $20,901–$41,801 | varies |
| MRI, lumbar spine combo (72158) | $20,306 | $20,306 | 63.2× |
| Myelogram cervical (72240) | $8,740 | $8,740 | 12.1× |
| Myelogram Lumbar (72265) | $8,986 | $8,986 | 12.4× |
| Myocardial Spect Multiple Studies (78452) | $10,240 | $10,240 | 8.6× |
| Neck soft tissue (70360) | $1,906 | $1,906 | 23.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $5,267 | $5,267 | 14.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $3,735 | $3,735 | 10.1× |
| Nm myocard infarct spect (78469) | $8,357 | $8,357 | 16.7× |
| Nonvascular Shunt X-Ray (75809) | $3,075 | $3,075 | 31.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $13,220 | $13,220 | 10.4× |
| Nuclear Rx Intra-Arterial (79445) | $1,162 | $1,162 | 5.4× |
| Nuclear Rx Oral Admin (79005) | $2,180 | $2,180 | 10.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $14,363 | $14,363 | 28.7× |
| Parathyroid Planar Imaging (78070) | $8,393 | $8,393 | 22.8× |
| Pelvis 1 or 2 views (72170) | $2,914 | $2,914 | 30.2× |
| Perineogram (74775) | $7,081 | $7,081 | 32.2× |
| Peritoneogram Rs&I (74190) | $4,235 | $4,235 | 8.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $24,547 | $24,547 | 8.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,767 | $2,767 | 7.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $3,584 | $3,584 | 37.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $3,120 | $3,120 | 6.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,968–$3,935 | $1,968–$3,935 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$1,780–$3,555 | $1,780–$3,555 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,918–$3,837 | $1,918–$3,837 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $3,422 | $3,422 | 35.5× |
| Radex fingr minimum 2 views (73140) | $1,296 | $1,296 | 16.2× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,918–$3,837 | $1,918–$3,837 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$1,918–$3,837 | $1,918–$3,837 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$2,746–$5,493 | $2,746–$5,493 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,968 | $1,968 | 24.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $3,375 | $3,375 | 42.1× |
| Radex Ribs Unilateral 2 Views (71100) | $2,382 | $2,382 | 29.7× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$2,396–$4,791 | $2,396–$4,791 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $1,253 | $1,253 | 15.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $7,392 | $7,392 | 45.7× |
| Radex Spine 1 View Specify Level (72020) | $1,906 | $1,906 | 23.8× |
| Radex Sternum Minimum 2 Views (71120) | $2,647 | $2,647 | 33.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $2,726 | $2,726 | 34.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$1,570–$3,137 | $1,570–$3,137 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$2,917–$5,840 | $2,917–$5,840 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,780–$3,555 | $1,780–$3,555 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $4,919 | $4,919 | 51.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $116,707 | $116,707 | 17.2× |
| Radiation treatment delivery level 1 (77402) | $1,934 | $1,934 | 20.6× |
| Radiation treatment delivery level 2 (77407) | $2,382 | $2,382 | 6.7× |
| Radiation treatment delivery level 3 (77412) | $2,786 | $2,786 | 5.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $2,906 | $2,906 | 30.2× |
| Radiologic exam colon double contrast study (74280) | $7,391 | $7,391 | 45.7× |
| Radiologic exam colon single contrast study (74270) | $4,138 | $4,138 | 25.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $4,338 | $4,338 | 26.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$2,129–$4,256 | $2,129–$4,256 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $4,164 | $4,164 | 25.8× |
| Radiologic exam swallow function contrast study (74230) | $3,924 | $3,924 | 24.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $4,338 | $4,338 | 26.8× |
| Radiologic examination femur 1 view (73551) | $2,237 | $2,237 | 27.9× |
| Radiologic examination femur minimum 2 views (73552) | $2,791 | $2,791 | 34.8× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$1,704–$3,407 | $1,704–$3,407 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $2,917 | $2,917 | 30.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$2,318–$4,637 | $2,318–$4,637 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,825 | $1,825 | 8.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,528 | $1,528 | 4.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,528 | $1,528 | 4.3× |
| Ribs bilateral 3 views (71110) | $3,097 | $3,097 | 32.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $6,886 | $6,886 | 18.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,615 | $6,615 | 13.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $6,615 | $6,615 | 13.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $8,345 | $8,345 | 16.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $8,345 | $8,345 | 7.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,345 | $8,345 | 6.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $8,345 | $8,345 | 7.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,773 | $1,773 | 8.2× |
| Rp Therapy Intravenous Administration (79101) | $1,825 | $1,825 | 8.5× |
| Salivary Gland Imaging Serial Images (78231) | $5,201 | $5,201 | 14.1× |
| Scapula (73010) range across 3 matching MRF lines |
$2,133–$4,270 | $2,133–$4,270 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $102 | $102 | 4.4× |
| Sella turcica (70240) | $1,780 | $1,780 | 22.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$1,485–$2,966 | $1,485–$2,966 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$4,076–$8,154 | $4,076–$8,154 | varies |
| Sialogram (70390) | $3,497 | $3,497 | 15.9× |
| Skull less than 4 views (70250) | $2,449 | $2,449 | 25.4× |
| Special dosimetry (77331) | $1,982 | $1,982 | 16.0× |
| Special Physics Consult (77370) | $5,904 | $5,904 | 47.7× |
| Special teletherapy port plan (77321) | $5,522 | $5,522 | 16.0× |
| Special treatment procedure (77470) | $3,846 | $3,846 | 7.6× |
| Spleen Imaging (78185) | $6,021 | $6,021 | 16.3× |
| Stereotactic Body Radiation Delivery (77373) | $31,569 | $31,569 | 19.2× |
| Sternoclavicular joints (71130) | $2,647 | $2,647 | 33.0× |
| Superior sagittal sinus venogram (75870) | $9,716 | $9,716 | 3.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,279 | $1,279 | 13.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $8,182 | $8,182 | 23.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $4,913 | $4,913 | 14.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,654 | $5,654 | 16.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $4,607 | $4,607 | 13.4× |
| Ther rad simulaj-aided field setting simple (77280) | $3,421 | $3,421 | 27.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $4,488 | $4,488 | 27.8× |
| Thoracic spine 2 views (72070) | $2,917 | $2,917 | 30.3× |
| Thoracic spine 3 views (72072) | $3,155 | $3,155 | 32.7× |
| Thoracolumbar 2 views (72080) | $2,604 | $2,604 | 32.5× |
| Thyroid Imaging With Vascular Flow (78013) | $3,000 | $3,000 | 8.1× |
| Thyroid Met Imaging Body (78018) | $6,427 | $6,427 | 12.8× |
| Thyroid Uptake Measurement (78012) | $2,633 | $2,633 | 7.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,685 | $3,685 | 10.0× |
| Tx Devices Design & Construction Complex (77334) | $3,897 | $3,897 | 11.3× |
| Tx devices design & construction intermediate (77333) | $2,943 | $2,943 | 23.8× |
| Tx devices design & construction simple (77332) | $1,988 | $1,988 | 16.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,363–$2,727 | $1,363–$2,727 | varies |
| Ultrasound Exam Aaa Screen (76706) | $2,721 | $2,721 | 28.2× |
| Ultrasound, abdomen limited (76705) | $3,594 | $3,594 | 37.3× |
| Umbilical-artery Doppler (OB) (76820) | $1,711 | $1,711 | 17.8× |
| Unlisted us procedure (76999) | $3,327 | $3,327 | 41.5× |
| Upper gi w/o kub (74240) | $4,338 | $4,338 | 26.8× |
| Ureteral Reflux Study (78740) | $6,886 | $6,886 | 18.7× |
| Urethrocystogram voiding (74455) | $4,719 | $4,719 | 21.5× |
| Urethrocystography retrograde (74450) | $2,494 | $2,494 | 11.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$2,041–$4,079 | $2,041–$4,079 | varies |
| Us chest (76604) | $2,946 | $2,946 | 30.6× |
| Us complete joint (76881) | $3,043 | $3,043 | 31.6× |
| Us exam, pelvic, limited (76857) | $2,716 | $2,716 | 28.2× |
| Us head (76506) | $3,092 | $3,092 | 32.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $2,860 | $2,860 | 29.7× |
| Us ob detailed single fetus (76811) | $5,166 | $5,166 | 23.5× |
| Us ob limited 1 or more fetuses (76815) | $2,705 | $2,705 | 28.1× |
| Us ob transvaginal (76817) | $1,332 | $1,332 | 13.8× |
| Us pelvic non ob complete (76856) | $3,441 | $3,441 | 35.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $3,182 | $3,182 | 33.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $2,435 | $2,435 | 25.3× |
| Us retroperitoneal complete (76770) | $4,127 | $4,127 | 42.8× |
| Us retroperitoneal limited (76775) | $2,721 | $2,721 | 28.2× |
| Us scrotum and contents (76870) | $3,056 | $3,056 | 31.7× |
| Us spinal canal and contents (76800) | $2,575 | $2,575 | 26.7× |
| Us thyroid (76536) | $3,327 | $3,327 | 34.5× |
| Vascular Flow Imaging (78445) | $3,423 | $3,423 | 9.3× |
| Vein X-Ray Chest (75827) | $18,865 | $18,865 | 13.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $7,545 | $7,545 | 2.6× |
| Vein X-Ray Skull Epidural (75872) | $9,716 | $9,716 | 16.8× |
| Vein X-Ray Spleen/Liver (75810) | $7,545 | $7,545 | 2.6× |
| Venogram Sinus/Jugular (75860) | $4,033 | $4,033 | 1.4× |
| Venography Adrenal Unilateral (75840) | $18,865 | $18,865 | 6.5× |
| Venography caval inferior serialography rs&i (75825) | $20,543 | $20,543 | 7.1× |
| Venography extremity bilateral rs&i (75822) | $13,925 | $13,925 | 9.6× |
| Venography extremity unilateral rs&i (75820) | $7,206 | $7,206 | 5.0× |
| Venography Renal Bilateral (75833) | $37,730 | $37,730 | 13.0× |
| Venography Renal Unilateral (75831) | $18,865 | $18,865 | 6.5× |
| Venous sampling by catheter (75893) | $24,184 | $24,184 | 4.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $5,677 | $5,677 | 15.4× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$1,704–$3,407 | $1,704–$3,407 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $2,464 | $2,464 | 30.7× |
| X-ray antegrade pyelogram tube (74425) | $2,566 | $2,566 | 8.0× |
| X-Ray Aorta Leg Arteries (75630) | $19,702 | $19,702 | 6.8× |
| X-Ray Bend Only L-S Spine (72120) | $4,803 | $4,803 | 49.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$1,704–$3,407 | $1,704–$3,407 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,427 | $2,427 | 4.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,906 | $1,906 | 23.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $3,155 | $3,155 | 32.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $4,158 | $4,158 | 43.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $2,483 | $2,483 | 31.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $2,884 | $2,884 | 36.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $3,438 | $3,438 | 35.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $4,961 | $4,961 | 51.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $5,766 | $5,766 | 59.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $6,871 | $6,871 | 71.3× |
| X-Ray Exam L-S Spine Bending (72114) | $4,158 | $4,158 | 43.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,906 | $1,906 | 23.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $3,513 | $3,513 | 36.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $2,382 | $2,382 | 24.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$1,964–$3,924 | $1,964–$3,924 | varies |
| X-ray IV pyelogram (ivp) (74400) | $5,226 | $5,226 | 32.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $2,449 | $2,449 | 30.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,730 | $1,730 | 21.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $2,917 | $2,917 | 30.3× |
| X-ray nose-rectum child f.b. (76010) | $3,075 | $3,075 | 38.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $2,715 | $2,715 | 28.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $2,604 | $2,604 | 32.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $3,120 | $3,120 | 38.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,998 | $2,998 | 31.1× |
| X-Ray Stress View (77071) | $1,780 | $1,780 | 22.2× |
| X-ray thoracic spine 4 vw (72074) | $4,158 | $4,158 | 43.2× |
| X-Rays Bone Length Studies (77073) | $3,264 | $3,264 | 33.9× |
| X-Rays Bone Survey Complete (77075) | $6,805 | $6,805 | 70.6× |
| Xr c-spine 4 or 5 views (72050) | $3,513 | $3,513 | 36.5× |
| Xr facial bones less than 3 views (70140) | $1,503 | $1,503 | 18.7× |
| Xr orbits complete 4 views (70200) | $2,604 | $2,604 | 27.0× |
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.