Imaging prices at Westfield Memorial Hospital, Inc
Westfield, NY · every code in this section with a posted price and a Medicare benchmark.
519 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) | $140.36 | $638 | 0.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$6.82–$342.42 | $31–$439 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $28.38 | $129 | 0.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $28.60 | $130 | 0.0× |
| Adrenal Cortex & Medulla Img (78075) | $21.78 | $99 | 0.0× |
| Angio internal mammary (75756) | $33.66 | $153 | 0.0× |
| Angio pulmonary bilat (75743) | $47.52 | $216 | 0.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 2 matching MRF lines |
$10,126.74 | $170–$12,983 | 2.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$20,254.26 | $257–$25,967 | 5.1× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$10,126.74 | $228–$12,983 | 2.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $36.74 | $167 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $32.12 | $146 | 0.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Aortography thoracic serialography rs&i (75605) | $17,392.44 | $22,298 | 2.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $14.30 | $65 | 0.0× |
| Artery X-Rays Abdomen (75726) | $17,392.44 | $22,298 | 2.5× |
| Artery X-Rays Adrenal Gland (75731) | $10,126.74 | $12,983 | 2.6× |
| Artery X-Rays Pelvis (75736) | $17,392.44 | $22,298 | 2.5× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$72.38 | $329 | 0.0× |
| Arthrogram ankle (73615) | $16.72 | $76 | 0.0× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,148.94 | $78–$1,473 | 2.6× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$1,148.94 | $76–$1,473 | 2.6× |
| Basic radiation dosimetry calculation (77300) | $20.46 | $93 | 0.1× |
| Bone age studies (77072) range across 2 matching MRF lines |
$5.50–$342.42 | $25–$439 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$29.26–$822.90 | $133–$1,055 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$822.90 | $82–$1,055 | 1.6× |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$23.98–$822.90 | $109–$1,055 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$24.64–$822.90 | $112–$1,055 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$822.90 | $70–$1,055 | 1.6× |
| Bone marrow imaging; multiple areas (78103) | $18.48 | $84 | 0.0× |
| Bone marrow imaging; whole body (78104) | $22.44 | $102 | 0.0× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$20.68–$342.42 | $94–$439 | varies |
| Brachytx isodose complex (77318) | $95.04 | $432 | 0.2× |
| Brachytx isodose intermed (77317) | $60.06 | $273 | 0.1× |
| Brachytx Isodose Plan Simple (77316) | $45.76 | $208 | 0.1× |
| Brain Flow Imaging Only (78610) | $8.58 | $39 | 0.0× |
| Brain Image W/Flow < 4 Views (78601) | $14.52 | $66 | 0.0× |
| Brain imaging < 4 static views (78600) | $12.54 | $57 | 0.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $18.48 | $84 | 0.0× |
| Brain Imaging Minimum 4 Static Views (78605) | $15.62 | $71 | 0.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $42.24 | $192 | 0.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $34.10 | $155 | 0.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $41.80 | $190 | 0.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $75.46 | $343 | 0.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $86.24 | $392 | 0.1× |
| Cardiac Shunt Detection (78428) | $22.22 | $101 | 0.0× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$27.72–$747.24 | $126–$958 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $16.28 | $74 | 0.0× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $17.82 | $81 | 0.0× |
| Cerebrospinal Fluid Scan (78630) | $19.58 | $89 | 0.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$6.38–$354.12 | $29–$454 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$8.14–$354.12 | $37–$454 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$9.02–$342.42 | $41–$439 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $35.64 | $162 | 0.3× |
| Cholecystography Oral Contrast (74290) | $9.46 | $43 | 0.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $11.66 | $53 | 0.1× |
| Cisternography Positive Contrast Rs&I (70015) | $34.76 | $158 | 0.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$31.46–$902.46 | $143–$1,157 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$10,126.74 | $188–$12,983 | 2.6× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$1,148.94 | $42–$1,473 | 2.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,148.94 | $72–$1,473 | 2.6× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$18.70–$1,148.94 | $85–$1,473 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $17.16 | $78 | 0.1× |
| Corpora cavernosography (74445) | $33 | $150 | 0.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$58.52–$3,786.90 | $266–$4,855 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$50.82–$2,050.62 | $231–$2,629 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$37.18–$1,510.08 | $169–$1,936 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$40.70–$1,887.60 | $185–$2,420 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$34.54–$902.46 | $157–$1,157 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$64.24–$3,029.52 | $292–$3,884 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$53.24–$1,887.60 | $242–$2,420 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$51.04–$1,887.60 | $232–$2,420 | varies |
| CT angio hrt w/3d image (75574) | $69.74 | $317 | 0.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$55.22–$1,887.60 | $251–$2,420 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$51.04–$1,887.60 | $232–$2,420 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$52.36–$1,887.60 | $238–$2,420 | varies |
| CT bone density (77078) | $7.26 | $33 | 0.1× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$35.42–$3,029.52 | $161–$3,884 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$29.04–$902.46 | $132–$1,157 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$36.96–$1,887.60 | $168–$2,420 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$33.88–$1,510.08 | $154–$1,936 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$36.52–$1,887.60 | $166–$2,420 | varies |
| CT colonography screening (74263) | $69.52 | $316 | 0.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $73.26 | $333 | 0.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $70.40 | $320 | 0.5× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$33–$1,510.08 | $150–$1,936 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$37.18–$1,887.60 | $169–$2,420 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $50.60 | $230 | 0.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $16.94 | $77 | 0.2× |
| CT hrt w/3d image congen (75573) | $74.36 | $338 | 0.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$33–$1,510.08 | $150–$1,936 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$36.96–$1,887.60 | $168–$2,420 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$29.04–$902.46 | $132–$1,157 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$33.66–$1,510.08 | $153–$1,936 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$35.42–$3,029.52 | $161–$3,884 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$29.04–$902.46 | $132–$1,157 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$33–$1,510.08 | $150–$1,936 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$25.08–$902.46 | $114–$1,157 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$47.08–$1,887.60 | $214–$2,420 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$36.96–$1,887.60 | $168–$2,420 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$37.40–$902.46 | $170–$1,157 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$35.42–$1,887.60 | $161–$2,420 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$31.68–$902.46 | $144–$1,157 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$35.20–$1,887.60 | $160–$2,420 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$36.96–$1,887.60 | $168–$2,420 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$40.26–$1,510.08 | $183–$1,936 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$37.40–$902.46 | $170–$1,157 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$35.64–$1,510.08 | $162–$1,936 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$29.04–$902.46 | $132–$1,157 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$37.18–$1,887.60 | $169–$2,420 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$31.46–$902.46 | $143–$1,157 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$29.04–$902.46 | $132–$1,157 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$35.20–$1,887.60 | $160–$2,420 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$33.66–$3,029.52 | $153–$3,884 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$69.30–$1,887.60 | $315–$2,420 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$53.02–$1,887.60 | $241–$2,420 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$52.36–$1,887.60 | $238–$2,420 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $8.80 | $40 | 0.0× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) | $12.76 | $58 | 0.0× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$6,591 | $109–$8,450 | 2.5× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$6,282.90 | $156–$8,055 | 2.6× |
| Diskography lumbar (72295) | $24.42 | $111 | 0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $16.06 | $73 | 0.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $16.94 | $77 | 0.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $20.46 | $93 | 0.2× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$5.72–$342.42 | $26–$439 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$8.80–$342.42 | $40–$439 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$5.72–$283.14 | $26–$363 | varies |
| Echo exam of fetal heart (76825) | $48.18 | $219 | 0.1× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$21.12–$1,060.80 | $96–$1,360 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$57.64–$1,366.56 | $262–$1,752 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $23.98 | $109 | 0.1× |
| Echograp Trans R Pros Study (76873) | $46.86 | $213 | 0.4× |
| Esophageal Motility Study (78258) | $20.46 | $93 | 0.0× |
| Esophagram (74220) range across 2 matching MRF lines |
$17.60–$572.52 | $80–$734 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$30.58–$467.22 | $139–$599 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$22.44–$467.22 | $102–$599 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $88.22 | $401 | 0.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$777.66 | $42–$997 | 2.6× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$10,126.74 | $253–$12,983 | 2.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$4.62–$283.14 | $21–$363 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$22.88–$822.90 | $104–$1,055 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 2 matching MRF lines |
$27.94–$822.90 | $127–$1,055 | varies |
| Gastric Mucosa Imaging (78261) | $16.94 | $77 | 0.0× |
| Gastroesophageal Reflux Exam (78262) | $19.80 | $90 | 0.0× |
| Gastrointestinal Protein Loss (78282) | $9.46 | $43 | 0.0× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$27.94–$822.90 | $127–$1,055 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$42.02–$822.90 | $191–$1,055 | varies |
| GI Endoscopic US S&I (76975) | $24.86 | $113 | 0.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) range across 2 matching MRF lines |
$29.92–$1,102.14 | $136–$1,413 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$342.42 | $23–$439 | 2.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $175.78 | $799 | 0.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $124.74 | $567 | 0.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $63.80 | $290 | 0.1× |
| Heart first pass single,planar (78481) | $27.72 | $126 | 0.0× |
| Heart Image (Pet) Multiple (78492) | $51.26 | $233 | 0.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $10,126.74 | $12,983 | 2.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $31.90 | $145 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,102.14 | $118–$1,413 | 1.6× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$21.34–$822.90 | $97–$1,055 | varies |
| Ht Musc Image Planar Mult (78454) | $38.94 | $177 | 0.0× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,673.06 | $178–$3,427 | 1.7× |
| Hyperthermia external generated superficial (77600) | $44 | $200 | 0.1× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $42.90 | $195 | 0.1× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $60.28 | $274 | 0.1× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $51.26 | $233 | 0.1× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $61.38 | $279 | 0.1× |
| Hysterosalpingogram (74740) | $11.22 | $51 | 0.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$21.78–$386.10 | $99–$495 | varies |
| Infant hip ultrasound, limited static exam (76886) | $18.26 | $83 | 0.2× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$14.30–$572.52 | $65–$734 | varies |
| Interstitial radiation source applic complex (77778) | $287.54 | $1,307 | 0.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $284.46 | $1,293 | 0.3× |
| Intracavitary Radiation Source Applic Intermed (77762) | $188.76 | $858 | 0.3× |
| Intracavitary radiation source applic simple (77761) | $126.28 | $574 | 0.2× |
| Joint Survey Single View (77077) | $10.12 | $46 | 0.1× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$39.82–$1,102.14 | $181–$1,413 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$34.32–$1,102.14 | $156–$1,413 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,102.14 | $124–$1,413 | 1.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $10.34 | $47 | 0.0× |
| Kidney Imaging Morphol (78700) | $12.76 | $58 | 0.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$822.90 | $65–$1,055 | 1.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$5.50–$354.12 | $25–$454 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $14.96 | $68 | 0.0× |
| Leveen/Shunt Patency Exam (78291) | $25.74 | $117 | 0.1× |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$822.90 | $64–$1,055 | 1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $16.72 | $76 | 0.0× |
| Liver imaging static only (78201) | $12.54 | $57 | 0.0× |
| Liver imaging w/vascular flow (78202) | $14.74 | $67 | 0.0× |
| Lung Perf&Ventilat Diferentl (78598) | $23.76 | $108 | 0.0× |
| Lung perfusion differential (78597) | $20.68 | $94 | 0.0× |
| Lung Ventilat&Perfus Imaging (78582) | $30.58 | $139 | 0.0× |
| Lung Ventilation Imaging (78579) | $13.86 | $63 | 0.0× |
| Lymph System Imaging (78195) | $34.10 | $155 | 0.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $34.10 | $155 | 0.0× |
| Lymphangiography extremity only unilateral rs&i (75801) range across 2 matching MRF lines |
$1,989 | $120–$2,550 | 2.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $10,126.74 | $12,983 | 2.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $23.76 | $108 | 0.0× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$42.90–$1,697.28 | $195–$2,176 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $102.74 | $467 | 0.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $92.84 | $422 | 0.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $97.46 | $443 | 0.4× |
| Magnetic Resonance Elastography (76391) | $32.12 | $146 | 0.1× |
| Mammary ductogram or galactogram multiple (77054) | $12.98 | $59 | 0.0× |
| Mammary ductogram or galactogram single (77053) | $10.56 | $48 | 0.0× |
| Meckels Divert Exam (78290) | $19.58 | $89 | 0.0× |
| Mlc imrt design & construction per imrt plan (77338) | $140.36 | $638 | 0.3× |
| Mr safety determination physician/other qhp (76016) | $17.38 | $79 | 0.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$6.60–$172.38 | $30–$221 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $21.78 | $99 | 0.2× |
| Mr safety implt pos&/immoblj (76019) | $17.16 | $78 | 0.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $22.22 | $101 | 0.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$43.12–$3,134.04 | $196–$4,018 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$34.76–$1,697.28 | $158–$2,176 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$34.76–$2,507.70 | $158–$3,215 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$43.78–$2,507.70 | $199–$3,215 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$52.36–$3,134.04 | $238–$4,018 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$34.98–$1,697.28 | $159–$2,176 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$50.38–$2,507.70 | $229–$3,215 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$42.46–$1,697.28 | $193–$2,176 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$47.52–$5,546.58 | $216–$7,111 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$63.14–$3,134.04 | $287–$4,018 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$47.52–$5,546.58 | $216–$7,111 | varies |
| MRI bone marrow blood supply (77084) | $46.86 | $213 | 0.2× |
| MRI brain functional w/o physician admnistration (70554) | $62.26 | $283 | 0.2× |
| MRI brain functional w/physician admnistration (70555) | $73.26 | $333 | 0.2× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$46.64–$1,697.28 | $212–$2,176 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$42.02–$1,697.28 | $191–$2,176 | varies |
| MRI cardiac w/o cont stress (75559) | $84.04 | $382 | 0.1× |
| MRI cardiac w/o contrast (75557) | $67.98 | $309 | 0.2× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$52.58–$2,507.70 | $239–$3,215 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$43.34–$1,697.28 | $197–$2,176 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$42.68–$1,697.28 | $194–$2,176 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$50.38–$2,542.02 | $229–$3,259 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$66.22–$3,134.04 | $301–$4,018 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$47.30–$2,507.70 | $215–$3,215 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$63.14–$3,134.04 | $287–$4,018 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$39.38–$1,697.28 | $179–$2,176 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$52.36–$2,507.70 | $238–$3,215 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$67.32–$3,134.04 | $306–$4,018 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$39.16–$1,697.28 | $178–$2,176 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$47.30–$2,507.70 | $215–$3,215 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$62.92–$3,134.04 | $286–$4,018 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$50.38–$2,507.70 | $229–$3,215 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$64.46–$3,134.04 | $293–$4,018 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$42.68–$1,697.28 | $194–$2,176 | varies |
| MRI spectroscopy (76390) | $618.54 | $793 | 5.7× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$43.34–$1,697.28 | $197–$2,176 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$47.30–$2,507.70 | $215–$3,215 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$39.60–$1,697.28 | $180–$2,176 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$63.14–$3,134.04 | $287–$4,018 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$64.46–$3,134.04 | $293–$4,018 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$67.32–$3,134.04 | $306–$4,018 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$51.92–$2,507.70 | $236–$3,215 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$39.60–$1,697.28 | $180–$2,176 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$63.14–$3,134.04 | $287–$4,018 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$67.32–$3,134.04 | $306–$4,018 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$2,542.02 | $121–$3,259 | 2.6× |
| Myelogram Lumbar (72265) | $24.64 | $112 | 0.0× |
| Myelography thoracic (72255) | $26.62 | $121 | 0.0× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$40.48–$2,542.02 | $184–$3,259 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $19.58 | $89 | 0.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $45.10 | $205 | 0.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $23.10 | $105 | 0.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $28.38 | $129 | 0.0× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,673.06 | $210–$3,427 | 1.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) range across 2 matching MRF lines |
$5,973.24 | $221–$7,658 | 3.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) range across 2 matching MRF lines |
$5,973.24 | $209–$7,658 | 3.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) range across 2 matching MRF lines |
$9,216.48 | $244–$11,816 | 3.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) range across 2 matching MRF lines |
$7,987.98 | $287–$10,241 | 2.9× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) range across 2 matching MRF lines |
$7,578.48 | $269–$9,716 | 4.0× |
| N-invas est c ffr sw aly CTA (75580) | $21.56 | $98 | 0.0× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $164.12 | $746 | 0.3× |
| Nm csf leak detection (78650) | $14.96 | $68 | 0.0× |
| Nm myocard infarct spect (78469) | $26.62 | $121 | 0.0× |
| Nm red cell survival study (78130) | $14.96 | $68 | 0.0× |
| Nm whole blood volume (78122) | $12.76 | $58 | 0.0× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$14.08–$342.42 | $64–$439 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $262.02 | $1,191 | 0.2× |
| Nuclear Rx Intra-Arterial (79445) | $67.54 | $307 | 0.2× |
| Nuclear Rx Oral Admin (79005) | $51.70 | $235 | 0.2× |
| Ob us nuchal meas 1 gest (76813) | $34.32 | $156 | 0.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $18.48 | $84 | 0.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $19.80 | $90 | 0.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $23.76 | $108 | 0.1× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $13.86 | $63 | 0.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$19.14–$386.10 | $87–$495 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$18.48–$467.22 | $84–$599 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $4.84 | $22 | 0.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $21.56 | $98 | 0.2× |
| Optic foramina (70190) | $6.60 | $30 | 0.1× |
| Panoramic X-ray of jaws (70355) | $6.16 | $28 | 0.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $45.10 | $205 | 0.1× |
| Parathyroid Planar Imaging (78070) | $23.10 | $105 | 0.0× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$34.32–$822.90 | $156–$1,055 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$342.42 | $23–$439 | 2.6× |
| Perineogram (74775) | $18.26 | $83 | 0.1× |
| Peritoneogram Rs&I (74190) | $13.42 | $61 | 0.0× |
| Pet Image Skull-Thigh (78812) | $55 | $250 | 0.0× |
| Pet Image W/Ct Lmtd (78814) | $62.48 | $284 | 0.0× |
| PET image w/CT, full body (78816) | $70.40 | $320 | 0.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $69.96 | $318 | 0.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $43.78 | $199 | 0.0× |
| Pet Myocardial Sngl Study (78491) | $44.22 | $201 | 0.0× |
| PET whole body (78813) | $56.10 | $255 | 0.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $6.38 | $29 | 0.0× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $4.84 | $22 | 0.0× |
| Platelet survival study Non-Facility (78191) | $14.96 | $68 | 0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$10,126.74 | $183–$12,983 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $21.34 | $97 | 0.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$9.46–$342.42 | $43–$439 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,764.36 | $70–$2,262 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$5.06–$354.12 | $23–$454 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$5.06–$354.12 | $23–$454 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$7.70–$342.42 | $35–$439 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$283.14 | $19–$363 | 2.6× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$5.06–$354.12 | $23–$454 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$10.12–$342.42 | $46–$439 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $9.24 | $42 | 0.1× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$6.60–$283.14 | $30–$363 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$5.50–$354.12 | $25–$454 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $33.88 | $154 | 0.2× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$5.72–$283.14 | $26–$363 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$7.04–$283.14 | $32–$363 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$283.14 | $18–$363 | 2.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$342.42 | $22–$439 | 2.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$5.06–$354.12 | $23–$454 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$12.32–$427.44 | $56–$548 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$7.48–$342.42 | $34–$439 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$7.92–$342.42 | $36–$439 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$36.74–$572.52 | $167–$734 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$30.14–$572.52 | $137–$734 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$20.46–$572.52 | $93–$734 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$6.82–$342.42 | $31–$439 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$7.48–$427.44 | $34–$548 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$23.54–$572.52 | $107–$734 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$15.62–$572.52 | $71–$734 | varies |
| Radiologic exam teeth complete full mouth (70320) | $6.82 | $31 | 0.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $5.06 | $23 | 0.0× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$26.18–$572.52 | $119–$734 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$5.28–$354.12 | $24–$454 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$12.76–$342.42 | $58–$439 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $5.06 | $23 | 0.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $10.56 | $48 | 0.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $3.08 | $14 | 0.0× |
| Radiopharm Dacryocystography (78660) | $13.20 | $60 | 0.0× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $39.38 | $179 | 0.1× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $48.84 | $222 | 0.2× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $48.84 | $222 | 0.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $5.94 | $27 | 0.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $9.02 | $41 | 0.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $45.76 | $208 | 0.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $34.32 | $156 | 0.1× |
| Renal Cyst Study (74470) | $15.62 | $71 | 0.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$8.58–$684.84 | $39–$878 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $18.92 | $86 | 0.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $20.68 | $94 | 0.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $28.60 | $130 | 0.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $22.88 | $104 | 0.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $30.80 | $140 | 0.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$2,673.06 | $235–$3,427 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$2,986.62 | $270–$3,829 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$2,673.06 | $188–$3,427 | 1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $55.44 | $252 | 0.2× |
| Rp Therapy Intravenous Administration (79101) | $56.98 | $259 | 0.2× |
| Salivary Gland Function Study (78232) | $11.66 | $53 | 0.0× |
| Salivary Gland Imaging (78230) | $12.98 | $59 | 0.0× |
| Salivary Gland Imaging Serial Images (78231) | $12.98 | $59 | 0.0× |
| Scapula (73010) range across 2 matching MRF lines |
$342.42 | $24–$439 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$17.60–$119.34 | $80–$153 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$5.50–$283.14 | $25–$363 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$4.62–$283.14 | $21–$363 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,148.94 | $75–$1,473 | 2.6× |
| Sialogram (70390) range across 2 matching MRF lines |
$777.66 | $51–$997 | 2.6× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$342.42 | $24–$439 | 2.6× |
| Special dosimetry (77331) | $28.60 | $130 | 0.2× |
| Special teletherapy port plan (77321) | $31.02 | $141 | 0.1× |
| Special treatment procedure (77470) | $66.66 | $303 | 0.1× |
| Speech evaluation, complex (70371) | $25.74 | $117 | 0.1× |
| Spleen Imaging (78185) | $10.12 | $46 | 0.0× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$6.38–$354.12 | $29–$454 | varies |
| Superior sagittal sinus venogram (75870) | $36.96 | $168 | 0.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $37.40 | $170 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $95.26 | $433 | 0.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $45.76 | $208 | 0.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $15.84 | $72 | 0.1× |
| Testicular Imaging W/Flow (78761) | $20.90 | $95 | 0.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $51.04 | $232 | 0.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $34.98 | $159 | 0.1× |
| Ther rad simulaj-aided field setting simple (77280) | $23.32 | $106 | 0.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $62.04 | $282 | 0.3× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$5.94–$342.42 | $27–$439 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$6.60–$427.44 | $30–$548 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$6.16–$283.14 | $28–$363 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $20.24 | $92 | 0.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $19.58 | $89 | 0.0× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$822.90 | $48–$1,055 | 1.6× |
| Thyroid Met Imaging Body (78018) | $23.98 | $109 | 0.0× |
| Thyroid Uptake Measurement (78012) | $5.50 | $25 | 0.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $14.30 | $65 | 0.0× |
| Tx Devices Design & Construction Complex (77334) | $37.62 | $171 | 0.1× |
| Tx devices design & construction intermediate (77333) | $24.64 | $112 | 0.1× |
| Tx devices design & construction simple (77332) | $14.74 | $67 | 0.1× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$20.02–$386.10 | $91–$495 | varies |
| Ultrasound elastography first target lesion (76982) | $17.38 | $79 | 0.1× |
| Ultrasound Elastography Parenchyma (76981) | $17.60 | $80 | 0.1× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$16.06–$467.22 | $73–$599 | varies |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $47.30 | $215 | 0.1× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$17.16–$467.22 | $78–$599 | varies |
| Umbilical-artery Doppler (OB) (76820) | $14.52 | $66 | 0.1× |
| Unlisted Dx Radiographic Procedure (76499) | $283.14 | $363 | 2.6× |
| Unlisted fluoroscopic procedure (76496) | $24.20 | $110 | 0.2× |
| Unlisted magnetic resonance procedure (76498) | $34.54 | $157 | 0.3× |
| Unlisted respiratory px dx nuclear medicine (78599) | $822.90 | $1,055 | 1.6× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$23.54–$572.52 | $107–$734 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $7.48 | $34 | 0.7× |
| Urea breath test c-14 isotopic analysis (78268) | $62.48 | $284 | 0.7× |
| Ureteral Reflux Study (78740) | $16.50 | $75 | 0.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$777.66 | $43–$997 | 2.6× |
| Urethrocystography retrograde (74450) | $9.46 | $43 | 0.0× |
| Us bone density measurement (76977) | $1.76 | $8 | 0.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$21.56–$467.22 | $98–$599 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$16.72–$467.22 | $76–$599 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$26.40–$467.22 | $120–$599 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$14.52–$467.22 | $66–$599 | varies |
| Us head (76506) range across 2 matching MRF lines |
$18.70–$467.22 | $85–$599 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$22.22–$467.22 | $101–$599 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$20.24–$467.22 | $92–$599 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$55.22–$1,060.80 | $251–$1,360 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$19.14–$467.22 | $87–$599 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$22–$467.22 | $100–$599 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$20.02–$467.22 | $91–$599 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$29.04–$467.22 | $132–$599 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$24.86–$467.22 | $113–$599 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$21.56–$467.22 | $98–$599 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$16.94–$467.22 | $77–$599 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$18.70–$467.22 | $85–$599 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$38.72–$467.22 | $176–$599 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$16.50–$467.22 | $75–$599 | varies |
| Us transrectal (76872) | $19.80 | $90 | 0.2× |
| Vascular Flow Imaging (78445) | $14.52 | $66 | 0.0× |
| Vasogram (74440) | $11 | $50 | 0.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$4,998.24 | $149–$6,408 | 2.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $40.70 | $185 | 0.0× |
| Vein X-Ray Skull Epidural (75872) | $33.44 | $152 | 0.0× |
| Vein X-Ray Spleen/Liver (75810) | $29.92 | $136 | 0.0× |
| Venogram Sinus/Jugular (75860) | $33.22 | $151 | 0.0× |
| Venography Adrenal Unilateral (75840) | $33.44 | $152 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $10,126.74 | $12,983 | 2.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$4,998.24 | $192–$6,408 | 2.5× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$4,998.24 | $136–$6,408 | 2.5× |
| Venography Orbital Rs&I (75880) | $20.68 | $94 | 0.0× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$20,254.26 | $194–$25,967 | 5.1× |
| Venography Renal Unilateral (75831) | $10,126.74 | $12,983 | 2.6× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$15.62 | $71 | 0.0× |
| Venous thrombosis imaging (78457) | $22.22 | $101 | 0.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $26.40 | $120 | 0.1× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$5.50–$283.14 | $25–$363 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,148.94 | $68–$1,473 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$10,126.74 | $261–$12,983 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$6.60–$342.42 | $30–$439 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,764.36 | $42–$2,262 | 2.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$7.70–$283.14 | $35–$363 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$9.24–$342.42 | $42–$439 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$10.56–$427.44 | $48–$548 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$5.50–$283.14 | $25–$363 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$6.60–$354.12 | $30–$454 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$8.36–$342.42 | $38–$439 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$6.60–$342.42 | $30–$439 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$8.80–$427.44 | $40–$548 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$9.24–$427.44 | $42–$548 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$9.02–$427.44 | $41–$548 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$6.60–$354.12 | $30–$454 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$8.80–$427.44 | $40–$548 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$7.92–$342.42 | $36–$439 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| X-ray head for orthodontia (70350) | $5.28 | $24 | 0.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$4.84–$283.14 | $22–$363 | varies |
| X-ray IV pyelogram (ivp) (74400) | $14.08 | $64 | 0.1× |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$14.30–$572.52 | $65–$734 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$6.60–$342.42 | $30–$439 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$9.46–$684.84 | $43–$878 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$6.60–$427.44 | $30–$548 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$342.42 | $23–$439 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$5.06–$283.14 | $23–$363 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$6.38–$354.12 | $29–$454 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$8.36–$427.44 | $38–$548 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$32.78–$283.14 | $149–$363 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$7.26–$427.44 | $33–$548 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$5.28–$283.14 | $24–$363 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $15.18 | $69 | 0.0× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$8.14–$342.42 | $37–$439 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$16.06–$427.44 | $73–$548 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$8.14–$342.42 | $37–$439 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$5.94–$283.14 | $27–$363 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $5.28 | $24 | 0.0× |
| Xr myelogram posterior fossa (70010) | $36.08 | $164 | 0.1× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$8.36–$342.42 | $38–$439 | varies |
| Xr Tomogram Single Plane (76100) | $16.94 | $77 | 0.1× |
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.