Imaging prices at West Chester Hospital
West Chester, OH · every code in this section with a posted price and a Medicare benchmark.
441 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 |
$6,282–$7,401 | $10,470–$12,335 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$188.40–$288 | $314–$480 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$217.20–$444.60 | $362–$741 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$816.60–$1,826.40 | $1,361–$3,044 | varies |
| Adrenal Cortex & Medulla Img (78075) range across 3 matching MRF lines |
$915.60–$2,155.80 | $1,526–$3,593 | varies |
| Angio internal mammary (75756) range across 3 matching MRF lines |
$531.60–$1,006.80 | $886–$1,678 | varies |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$2,387.40–$4,390.80 | $3,979–$7,318 | varies |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$2,272.80–$6,061.20 | $3,788–$10,102 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$2,103–$4,647.60 | $3,505–$7,746 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$1,792.80–$3,296.40 | $2,988–$5,494 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$1,491.60–$1,506 | $2,486–$2,510 | varies |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$281.40–$441.60 | $469–$736 | varies |
| Aortography thoracic serialography rs&i (75605) range across 3 matching MRF lines |
$2,110.80–$3,985.20 | $3,518–$6,642 | varies |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$2,321.40–$6,257.40 | $3,869–$10,429 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$1,898.40–$1,974 | $3,164–$3,290 | varies |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$2,192.40–$4,380.60 | $3,654–$7,301 | varies |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$2,251.20–$5,551.80 | $3,752–$9,253 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$743.40–$750.60 | $1,239–$1,251 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$735.60–$1,036.80 | $1,226–$1,728 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$423–$842.40 | $705–$1,404 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$615–$888 | $1,025–$1,480 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$552.60–$556.80 | $921–$928 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$1,186.80–$2,016 | $1,978–$3,360 | varies |
| Bone Imaging Limited Area (78300) range across 3 matching MRF lines |
$671.40–$1,290.60 | $1,119–$2,151 | varies |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$1,170.60–$1,988.40 | $1,951–$3,314 | varies |
| Bone marrow imaging limited area (78102) | $1,126.20 | $1,877 | 2.9× |
| Bone marrow imaging; whole body (78104) | $1,518 | $2,530 | 3.9× |
| Bone survey infant (77076) range across 3 matching MRF lines |
$132–$258.60 | $220–$431 | varies |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$1,446.60–$1,567.20 | $2,411–$2,612 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$1,446.60–$1,567.20 | $2,411–$2,612 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$924.60–$934.20 | $1,541–$1,557 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$1,746–$1,761.60 | $2,910–$2,936 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$640.20–$644.40 | $1,067–$1,074 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$943.20–$1,903.20 | $1,572–$3,172 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$2,731.20–$6,765.60 | $4,552–$11,276 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) range across 2 matching MRF lines |
$2,023.20–$2,041.20 | $3,372–$3,402 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$1,611.60–$2,667.60 | $2,686–$4,446 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,718.80 | $6,198 | 4.9× |
| Cardiac Shunt Detection (78428) range across 3 matching MRF lines |
$397.20–$844.20 | $662–$1,407 | varies |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$421.20–$552.60 | $702–$921 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 3 matching MRF lines |
$618.60–$1,533.60 | $1,031–$2,556 | varies |
| Cerebrospinal Fluid Scan (78630) range across 3 matching MRF lines |
$864–$2,137.20 | $1,440–$3,562 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$258–$442.20 | $430–$737 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$239.40–$324 | $399–$540 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$288.60–$397.20 | $481–$662 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$299.40–$405 | $499–$675 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $231.60 | $386 | 2.3× |
| Cholecystography Oral Contrast (74290) | $324 | $540 | 1.9× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$294–$511.20 | $490–$852 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$77.40–$101.40 | $129–$169 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$760.20–$1,020 | $1,267–$1,700 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$2,311.20–$4,131 | $3,852–$6,885 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$588–$685.20 | $980–$1,142 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$667.20–$673.80 | $1,112–$1,123 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$1,129.20–$1,173.60 | $1,882–$1,956 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 3 matching MRF lines |
$265.20–$423 | $442–$705 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$1,752–$2,046.60 | $2,920–$3,411 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$1,327.80–$1,492.20 | $2,213–$2,487 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$916.20–$1,156.80 | $1,527–$1,928 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$1,051.20–$1,378.80 | $1,752–$2,298 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$741–$936 | $1,235–$1,560 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$738–$931.20 | $1,230–$1,552 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$1,116.60–$1,465.80 | $1,861–$2,443 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$919.80–$1,154.40 | $1,533–$1,924 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$386.40–$828.60 | $644–$1,381 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,158.60–$1,506.60 | $1,931–$2,511 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$894.60–$1,146.60 | $1,491–$1,911 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,054.20–$1,382.40 | $1,757–$2,304 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$865.80–$1,136.40 | $1,443–$1,894 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$770.40–$972.60 | $1,284–$1,621 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$1,105.80–$1,452 | $1,843–$2,420 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$795–$1,003.20 | $1,325–$1,672 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$1,070.40–$1,405.20 | $1,784–$2,342 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$796.80–$1,000.20 | $1,328–$1,667 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$877.80–$1,125 | $1,463–$1,875 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 3 matching MRF lines |
$828.60–$1,087.20 | $1,381–$1,812 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 4 matching MRF lines |
$42–$142.80 | $70–$238 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$385.80–$389.40 | $643–$649 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$805.20–$1,032 | $1,342–$1,720 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$1,179–$1,546.80 | $1,965–$2,578 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$754.80–$951.60 | $1,258–$1,586 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$910.20–$1,194 | $1,517–$1,990 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$986.40–$1,293.60 | $1,644–$2,156 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$865.80–$1,093.80 | $1,443–$1,823 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$745.80–$974.40 | $1,243–$1,624 | varies |
| CT maxillofacial wo contrast (70486) range across 17 matching MRF lines |
$237.60–$954.60 | $396–$1,591 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,108.20–$1,119 | $1,847–$1,865 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$933–$1,197.60 | $1,555–$1,996 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$672.60–$844.20 | $1,121–$1,407 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$1,032–$1,206 | $1,720–$2,010 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$736.20–$966.60 | $1,227–$1,611 | varies |
| CT scan of leg combo (73702) | $1,224 | $2,040 | 7.2× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$912–$1,145.40 | $1,520–$1,909 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$775.80–$973.20 | $1,293–$1,622 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$674.40–$846 | $1,124–$1,410 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$1,005.60–$1,269.60 | $1,676–$2,116 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$833.40–$1,093.80 | $1,389–$1,823 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$1,030.20–$1,351.20 | $1,717–$2,252 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$693–$874.20 | $1,155–$1,457 | varies |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$678.60–$1,344 | $1,131–$2,240 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$728.40–$955.20 | $1,214–$1,592 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,143.60 | $1,906 | 6.7× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$832.20–$1,091.40 | $1,387–$1,819 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$1,244.40–$1,633.20 | $2,074–$2,722 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$1,170–$1,534.80 | $1,950–$2,558 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$1,076.40–$1,411.80 | $1,794–$2,353 | varies |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$738.60–$1,368.60 | $1,231–$2,281 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$2,199.60–$2,221.20 | $3,666–$3,702 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$520.80–$803.40 | $868–$1,339 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$325.80–$1,191.60 | $543–$1,986 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$321.60–$693 | $536–$1,155 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$507–$883.80 | $845–$1,473 | varies |
| Dxa bone density study (77085) range across 4 matching MRF lines |
$484.20–$736.80 | $807–$1,228 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$730.80–$844.80 | $1,218–$1,408 | varies |
| Echo exam of fetal heart (76825) range across 4 matching MRF lines |
$611.40–$1,143.60 | $1,019–$1,906 | varies |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$516–$874.20 | $860–$1,457 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$1,233–$1,246.80 | $2,055–$2,078 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 4 matching MRF lines |
$514.20–$870 | $857–$1,450 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$1,173–$1,344 | $1,955–$2,240 | varies |
| Esophageal Motility Study (78258) range across 2 matching MRF lines |
$942–$951.60 | $1,570–$1,586 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$383.40–$588 | $639–$980 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$487.80–$1,239 | $813–$2,065 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$487.80–$1,054.20 | $813–$1,757 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) range across 3 matching MRF lines |
$2,488.80–$2,588.40 | $4,148–$4,314 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$423.60–$729 | $706–$1,215 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$795.60–$2,980.80 | $1,326–$4,968 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$252.60–$441 | $421–$735 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$273–$474.60 | $455–$791 | varies |
| Gastric emptying imaging study (78264) range across 6 matching MRF lines |
$576.60–$1,903.80 | $961–$3,173 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 3 matching MRF lines |
$792–$1,961.40 | $1,320–$3,269 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$1,066.80–$1,941.60 | $1,778–$3,236 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$1,143.60–$2,155.80 | $1,906–$3,593 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) range across 3 matching MRF lines |
$815.40–$2,020.80 | $1,359–$3,368 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$247.20–$483.60 | $412–$806 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $11,373 | $18,955 | 16.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$9,597.60–$9,956.40 | $15,996–$16,594 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$6,869.40–$8,410.20 | $11,449–$14,017 | varies |
| Heart first pass single,planar (78481) range across 2 matching MRF lines |
$1,563.60–$1,578 | $2,606–$2,630 | varies |
| Heart Image (Pet) Multiple (78492) range across 3 matching MRF lines |
$3,400.80–$8,421 | $5,668–$14,035 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 3 matching MRF lines |
$1,921.80–$3,642 | $3,203–$6,070 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 3 matching MRF lines |
$1,747.20–$3,306.60 | $2,912–$5,511 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$849–$2,100.60 | $1,415–$3,501 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$849–$2,100.60 | $1,415–$3,501 | varies |
| Ht Musc Image Planar Mult (78454) range across 3 matching MRF lines |
$1,065.60–$2,638.80 | $1,776–$4,398 | varies |
| Ht Muscle Image Spect Sing (78451) range across 8 matching MRF lines |
$1,095–$5,196.60 | $1,825–$8,661 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$471.60–$832.20 | $786–$1,387 | varies |
| Image fusion (77399) range across 2 matching MRF lines |
$873.60–$882.60 | $1,456–$1,471 | varies |
| Infusion Ivp (74410) range across 3 matching MRF lines |
$477.60–$886.80 | $796–$1,478 | varies |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$5,478–$5,935.20 | $9,130–$9,892 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $3,385.80 | $5,643 | 5.0× |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$2,791.80–$3,026.40 | $4,653–$5,044 | varies |
| Intracavitary radiation source applic simple (77761) | $1,291.20 | $2,152 | 2.4× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$126.60–$249.60 | $211–$416 | varies |
| K Flow/Funct Image Multiple (78709) range across 3 matching MRF lines |
$958.20–$2,371.80 | $1,597–$3,953 | varies |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$783.60–$1,941.60 | $1,306–$3,236 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$754.20–$1,866.60 | $1,257–$3,111 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 2 matching MRF lines |
$1,218–$1,293 | $2,030–$2,155 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 3 matching MRF lines |
$565.80–$1,400.40 | $943–$2,334 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$329.40–$573 | $549–$955 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$1,412.40–$1,423.80 | $2,354–$2,373 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 3 matching MRF lines |
$475.20–$1,177.20 | $792–$1,962 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$1,764.60–$1,881.60 | $2,941–$3,136 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$1,509.60–$2,563.20 | $2,516–$4,272 | varies |
| Lung perfusion differential (78597) range across 3 matching MRF lines |
$609.60–$1,297.80 | $1,016–$2,163 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 6 matching MRF lines |
$1,046.40–$2,370.60 | $1,744–$3,951 | varies |
| Lung Ventilation Imaging (78579) range across 3 matching MRF lines |
$345–$730.80 | $575–$1,218 | varies |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$691.20–$1,751.40 | $1,152–$2,919 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) range across 2 matching MRF lines |
$864–$872.40 | $1,440–$1,454 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 2 matching MRF lines |
$864–$872.40 | $1,440–$1,454 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$1,487.40–$2,335.20 | $2,479–$3,892 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$471–$474.60 | $785–$791 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$379.20–$457.20 | $632–$762 | varies |
| Meckels Divert Exam (78290) range across 3 matching MRF lines |
$684.60–$1,530.60 | $1,141–$2,551 | varies |
| Medical physics dose eval radiation expos w/rprt (76145) | $222 | $370 | 0.6× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,029–$1,326 | $1,715–$2,210 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$130.20–$200.40 | $217–$334 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$36–$55.20 | $60–$92 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$136.20–$208.20 | $227–$347 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$88.20–$135 | $147–$225 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$357.60–$550.80 | $596–$918 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$1,807.80–$2,599.80 | $3,013–$4,333 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,443–$1,991.40 | $2,405–$3,319 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$1,639.20–$2,074.20 | $2,732–$3,457 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$1,537.20–$2,208.60 | $2,562–$3,681 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$1,674.60–$2,406 | $2,791–$4,010 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$1,386–$1,991.40 | $2,310–$3,319 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$1,670.40–$3,034.20 | $2,784–$5,057 | varies |
| MRI abdomen w/o contrast (74181) range across 6 matching MRF lines |
$1,250.40–$2,758.20 | $2,084–$4,597 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,356–$2,992.80 | $2,260–$4,988 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,490.40–$3,289.20 | $2,484–$5,482 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,162.80–$2,464.20 | $1,938–$4,107 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$1,834.80–$1,852.20 | $3,058–$3,087 | varies |
| MRI brain functional w/o physician admnistration (70554) | $1,798.80 | $2,998 | 7.7× |
| MRI brain functional w/physician admnistration (70555) | $1,798.80 | $2,998 | 7.7× |
| MRI Breast W/O Contrast Bilateral (77047) range across 3 matching MRF lines |
$1,860–$3,001.20 | $3,100–$5,002 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$1,528.20–$2,550 | $2,547–$4,250 | varies |
| MRI cardiac w/o cont stress (75559) | $2,429.40 | $4,049 | 4.6× |
| MRI cardiac w/o contrast (75557) range across 3 matching MRF lines |
$1,608–$2,661.60 | $2,680–$4,436 | varies |
| MRI cervical spine w contrast (72142) range across 6 matching MRF lines |
$1,309.80–$2,337 | $2,183–$3,895 | varies |
| MRI cervical spine w/o cont (72141) range across 6 matching MRF lines |
$1,161–$1,998 | $1,935–$3,330 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,608–$2,661.60 | $2,680–$4,436 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$1,753.20–$2,775.60 | $2,922–$4,626 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$2,100.60–$3,476.40 | $3,501–$5,794 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,319.40–$2,912.40 | $2,199–$4,854 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,467.60–$3,241.20 | $2,446–$5,402 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,116.60–$2,464.20 | $1,861–$4,107 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$1,710.60–$2,830.80 | $2,851–$4,718 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$1,822.80–$2,752.20 | $3,038–$4,587 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$1,386–$1,974.60 | $2,310–$3,291 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,956–$1,991.40 | $3,260–$3,319 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,915.20–$2,755.20 | $3,192–$4,592 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,269–$2,792.40 | $2,115–$4,654 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$1,447.80–$3,015.60 | $2,413–$5,026 | varies |
| MRI pelvis w/o contrast (72195) range across 6 matching MRF lines |
$836.40–$2,464.20 | $1,394–$4,107 | varies |
| MRI spectroscopy (76390) range across 3 matching MRF lines |
$1,147.20–$1,900.20 | $1,912–$3,167 | varies |
| MRI thoracic spine w/o contrast (72146) range across 6 matching MRF lines |
$1,116.60–$2,464.20 | $1,861–$4,107 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,101.20–$2,487.60 | $3,502–$4,146 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,116.60–$2,464.20 | $1,861–$4,107 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$1,398.60–$5,401.20 | $2,331–$9,002 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$2,226.60–$3,685.80 | $3,711–$6,143 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$2,050.80–$3,393.60 | $3,418–$5,656 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$1,710.60–$2,830.80 | $2,851–$4,718 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,116.60–$2,433 | $1,861–$4,055 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,527–$3,367.80 | $2,545–$5,613 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$2,050.80–$3,393.60 | $3,418–$5,656 | varies |
| Myelogram cervical (72240) range across 3 matching MRF lines |
$976.80–$2,307 | $1,628–$3,845 | varies |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$951.60–$2,412.60 | $1,586–$4,021 | varies |
| Myelography thoracic (72255) range across 3 matching MRF lines |
$999.60–$1,886.40 | $1,666–$3,144 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 3 matching MRF lines |
$1,231.20–$2,322 | $2,052–$3,870 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$1,282.80–$1,293.60 | $2,138–$2,156 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 3 matching MRF lines |
$2,278.20–$5,644.20 | $3,797–$9,407 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 2 matching MRF lines |
$2,178–$2,199 | $3,630–$3,665 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 3 matching MRF lines |
$774–$1,917.60 | $1,290–$3,196 | varies |
| Myocardial Spect Multiple Studies (78452) range across 6 matching MRF lines |
$1,810.80–$5,979.60 | $3,018–$9,966 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $2,841 | $4,735 | 2.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,841 | $4,735 | 2.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,429.80 | $7,383 | 2.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $5,415 | $9,025 | 2.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $5,701.80 | $9,503 | 3.9× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$2,350.20–$3,615.60 | $3,917–$6,026 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$163.80–$300 | $273–$500 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $953.40 | $1,589 | 2.5× |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$1,380.60–$1,467.60 | $2,301–$2,446 | varies |
| Nm whole blood volume (78122) range across 3 matching MRF lines |
$865.80–$2,143.80 | $1,443–$3,573 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$728.40–$856.80 | $1,214–$1,428 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$5,499.60–$7,953 | $9,166–$13,255 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$1,752–$2,131.80 | $2,920–$3,553 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$2,730–$3,000.60 | $4,550–$5,001 | varies |
| Ob us nuchal meas 1 gest (76813) range across 4 matching MRF lines |
$476.40–$871.20 | $794–$1,452 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$562.20–$570 | $937–$950 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) range across 2 matching MRF lines |
$301.80–$454.20 | $503–$757 | varies |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 3 matching MRF lines |
$453.60–$838.80 | $756–$1,398 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $546.60 | $911 | 5.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 6 matching MRF lines |
$487.80–$1,471.80 | $813–$2,453 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 3 matching MRF lines |
$76.80–$240 | $128–$400 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) range across 3 matching MRF lines |
$385.80–$715.80 | $643–$1,193 | varies |
| Optic foramina (70190) range across 2 matching MRF lines |
$496.80–$501.60 | $828–$836 | varies |
| Panoramic X-ray of jaws (70355) | $228 | $380 | 2.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,064.60 | $3,441 | 3.9× |
| Parathyroid Planar Imaging (78070) range across 3 matching MRF lines |
$971.40–$1,959.60 | $1,619–$3,266 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,959.60–$2,534.40 | $3,266–$4,224 | varies |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$269.40–$466.80 | $449–$778 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$2,778–$4,794 | $4,630–$7,990 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$3,337.80–$5,758.20 | $5,563–$9,597 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 6 matching MRF lines |
$2,215.20–$5,014.80 | $3,692–$8,358 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$1,207.80–$1,277.40 | $2,013–$2,129 | varies |
| Pet Myocardial Sngl Study (78491) | $5,645.40 | $9,409 | 4.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $1,903.80 | $3,173 | 1.5× |
| Proton trmt simple w/comp (77522) | $3,642 | $6,070 | 3.0× |
| Proton tx delivery complex (77525) | $4,169.40 | $6,949 | 3.4× |
| Proton tx delivery intermediate (77523) | $4,169.40 | $6,949 | 3.4× |
| Proton tx delivery simple w/o compensation (77520) | $1,426.20 | $2,377 | 2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 3 matching MRF lines |
$2,214.60–$4,180.80 | $3,691–$6,968 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$595.20–$1,475.40 | $992–$2,459 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$265.80–$505.80 | $443–$843 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$330–$610.80 | $550–$1,018 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$291.60–$483.60 | $486–$806 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$255–$444 | $425–$740 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$310.20–$541.20 | $517–$902 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$403.20–$790.20 | $672–$1,317 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$228.60–$399.60 | $381–$666 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$273.60–$476.40 | $456–$794 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$294.60–$513 | $491–$855 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$204.60–$436.20 | $341–$727 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$522–$526.80 | $870–$878 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$295.20–$581.40 | $492–$969 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$311.40–$336.60 | $519–$561 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$281.40–$555.60 | $469–$926 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$314.40–$544.80 | $524–$908 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$246–$483.60 | $410–$806 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$628.20–$730.80 | $1,047–$1,218 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$294–$446.40 | $490–$744 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$294.60–$579 | $491–$965 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$384.60–$697.80 | $641–$1,163 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$198.60–$391.20 | $331–$652 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$156.60–$307.80 | $261–$513 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$273.60–$477 | $456–$795 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 4 matching MRF lines |
$787.80–$1,234.80 | $1,313–$2,058 | varies |
| Radiation treatment delivery level 1 (77402) | $900 | $1,500 | 9.1× |
| Radiation treatment delivery level 2 (77407) | $1,680 | $2,800 | 4.5× |
| Radiation treatment delivery level 3 (77412) | $2,580 | $4,300 | 4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$384.60–$759 | $641–$1,265 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$235.20–$449.40 | $392–$749 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$541.20–$864 | $902–$1,440 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$414.60–$787.20 | $691–$1,312 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $397.80 | $663 | 2.3× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$381.60–$661.80 | $636–$1,103 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$394.20–$684.60 | $657–$1,141 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$386.40–$657.60 | $644–$1,096 | varies |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$405.60–$657.60 | $676–$1,096 | varies |
| Radiologic exam teeth complete full mouth (70320) range across 4 matching MRF lines |
$228–$424.80 | $380–$708 | varies |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $396 | $660 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$384–$729.60 | $640–$1,216 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$281.40–$501.60 | $469–$836 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$309.60–$555.60 | $516–$926 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$249–$431.40 | $415–$719 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$337.20–$669 | $562–$1,115 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$291.60–$506.40 | $486–$844 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 2 matching MRF lines |
$681.60–$690 | $1,136–$1,150 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 2 matching MRF lines |
$138–$139.80 | $230–$233 | varies |
| Radiopharm Dacryocystography (78660) range across 3 matching MRF lines |
$394.80–$930.60 | $658–$1,551 | varies |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) range across 2 matching MRF lines |
$727.20–$735 | $1,212–$1,225 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $707.40 | $1,179 | 1.3× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$373.20–$736.80 | $622–$1,228 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines |
$621–$1,537.80 | $1,035–$2,563 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$1,032–$2,085 | $1,720–$3,475 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,028.80 | $5,048 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$1,123.80–$2,784 | $1,873–$4,640 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 6 matching MRF lines |
$1,003.80–$2,486.40 | $1,673–$4,144 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,587.20 | $4,312 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,935.20 | $4,892 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,587.20 | $4,312 | 2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 2 matching MRF lines |
$1,202.40–$2,087.40 | $2,004–$3,479 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,262.40–$1,533.60 | $2,104–$2,556 | varies |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$908.40–$966 | $1,514–$1,610 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$316.80–$552.60 | $528–$921 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$31.80–$58.20 | $53–$97 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$262.80–$456 | $438–$760 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$564–$1,033.80 | $940–$1,723 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$277.20–$543 | $462–$905 | varies |
| Special dosimetry (77331) | $911.40 | $1,519 | 7.0× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$381–$549.60 | $635–$916 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,642.80–$2,115.60 | $2,738–$3,526 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,097–$3,043.20 | $3,495–$5,072 | varies |
| Stereotactic Body Radiation Delivery (77373) | $15,550.80 | $25,918 | 8.9× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$495–$500.40 | $825–$834 | varies |
| Superior sagittal sinus venogram (75870) range across 2 matching MRF lines |
$1,390.80–$2,302.20 | $2,318–$3,837 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $361.20 | $602 | 3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,446.60–$1,567.20 | $2,411–$2,612 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$924.60–$934.20 | $1,541–$1,557 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,996.20–$2,573.40 | $3,327–$4,289 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,425.60–$1,543.80 | $2,376–$2,573 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$978–$1,261.20 | $1,630–$2,102 | varies |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$335.40–$582.60 | $559–$971 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$349.20–$682.20 | $582–$1,137 | varies |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$360.60–$626.40 | $601–$1,044 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 3 matching MRF lines |
$684–$1,692 | $1,140–$2,820 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $598.80 | $998 | 1.5× |
| Thyroid Met Imaging Body (78018) range across 4 matching MRF lines |
$2,117.40–$2,579.40 | $3,529–$4,299 | varies |
| Thyroid Uptake Measurement (78012) | $781.20 | $1,302 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$550.20–$1,690.20 | $917–$2,817 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,778.40–$2,572.80 | $2,964–$4,288 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$973.20–$1,056 | $1,622–$1,760 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$661.20–$715.20 | $1,102–$1,192 | varies |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$343.80–$1,276.80 | $573–$2,128 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$596.40–$1,228.80 | $994–$2,048 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$560.40–$1,157.40 | $934–$1,929 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$321.60–$669.60 | $536–$1,116 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $51.60 | $86 | 0.6× |
| Unlisted fluoroscopic procedure (76496) | $598.20 | $997 | 7.1× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$364.80–$691.80 | $608–$1,153 | varies |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$444–$760.20 | $740–$1,267 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$760.20–$1,064.40 | $1,267–$1,774 | varies |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$457.20–$1,704 | $762–$2,840 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$512.40–$994.80 | $854–$1,658 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$573.60–$1,019.40 | $956–$1,699 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$470.40–$860.40 | $784–$1,434 | varies |
| Us head (76506) range across 3 matching MRF lines |
$459–$1,024.20 | $765–$1,707 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$817.20–$1,720.80 | $1,362–$2,868 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$353.40–$792 | $589–$1,320 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$690.60–$1,407.60 | $1,151–$2,346 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$395.40–$724.80 | $659–$1,208 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$573.60–$1,051.80 | $956–$1,753 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$671.40–$1,127.40 | $1,119–$1,879 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$531.60–$974.40 | $886–$1,624 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$325.80–$869.40 | $543–$1,449 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$591.60–$1,257 | $986–$2,095 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$493.20–$1,051.80 | $822–$1,753 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$546.60–$1,162.80 | $911–$1,938 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$970.20–$980.40 | $1,617–$1,634 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$662.40–$1,215.60 | $1,104–$2,026 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$612.60–$1,123.80 | $1,021–$1,873 | varies |
| Vascular Flow Imaging (78445) range across 3 matching MRF lines |
$377.40–$887.40 | $629–$1,479 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,499.40–$3,160.20 | $2,499–$5,267 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 3 matching MRF lines |
$1,843.20–$3,479.40 | $3,072–$5,799 | varies |
| Vein X-Ray Spleen/Liver (75810) range across 2 matching MRF lines |
$1,270.80–$1,282.80 | $2,118–$2,138 | varies |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$1,318.80–$3,282 | $2,198–$5,470 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$1,654.80–$3,124.80 | $2,758–$5,208 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$916.20–$3,437.40 | $1,527–$5,729 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$724.80–$2,653.80 | $1,208–$4,423 | varies |
| Venography Renal Bilateral (75833) range across 3 matching MRF lines |
$1,341–$2,745.60 | $2,235–$4,576 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$2,442.60–$2,466 | $4,071–$4,110 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$1,315.20–$2,410.80 | $2,192–$4,018 | varies |
| Vertebral fracture assessment via dxa (77086) range across 3 matching MRF lines |
$205.20–$627.60 | $342–$1,046 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$247.20–$426 | $412–$710 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$297.60–$588 | $496–$980 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$397.20–$736.80 | $662–$1,228 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$2,611.80–$4,930.80 | $4,353–$8,218 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$350.40–$637.20 | $584–$1,062 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$252–$438 | $420–$730 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$317.40–$376.20 | $529–$627 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$486.60–$592.80 | $811–$988 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$597.60–$722.40 | $996–$1,204 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$430.80–$875.40 | $718–$1,459 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$310.20–$561 | $517–$935 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$381.60–$687 | $636–$1,145 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$420.60–$754.20 | $701–$1,257 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$573.60–$1,029 | $956–$1,715 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$632.40–$1,132.80 | $1,054–$1,888 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$612–$1,246.20 | $1,020–$2,077 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$509.40–$996.60 | $849–$1,661 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$300–$522.60 | $500–$871 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$484.20–$951 | $807–$1,585 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$285–$561 | $475–$935 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$279.60–$327.60 | $466–$546 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$283.80–$490.80 | $473–$818 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$787.80–$803.40 | $1,313–$1,339 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$286.80–$496.20 | $478–$827 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$314.40–$544.80 | $524–$908 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$486–$951.60 | $810–$1,586 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$297.60–$588 | $496–$980 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$329.40–$576.60 | $549–$961 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$392.40–$717.60 | $654–$1,196 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$458.40–$907.20 | $764–$1,512 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$423–$768 | $705–$1,280 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$444–$825 | $740–$1,375 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$364.20–$496.20 | $607–$827 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$576.60–$1,129.20 | $961–$1,882 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$466.20–$808.80 | $777–$1,348 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$303.60–$599.40 | $506–$999 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$381–$691.80 | $635–$1,153 | 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.