Imaging prices at Henry Ford Wyandotte Hospital

Wyandotte, MI · every code in this section with a posted price and a Medicare benchmark.

558 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $1,903.23 — 1.4×
Abdomen 1 View (74018)
range across 2 matching MRF lines		 $119.66 $211–$261 1.4×
Abdomen 2 views (74019)
range across 2 matching MRF lines		 $143.75 $251–$301 1.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $549.70 $2,159 1.4×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $1,780.19 — 1.4×
Adrenal Cortex & Medulla Img (78075) $1,780.19 — 1.4×
Angio internal mammary (75756) $4,341.66 $1,748 1.4×
Angio pulmonary bilat (75743) $4,341.66 $2,198 1.4×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $4,341.66 — 1.4×
Angiography extremity bilateral rs&i (75716) $4,341.66 $2,198 1.4×
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines		 $4,341.66 $1,479–$1,515 1.4×
Angiography pulmonary unilateral slctv rs&i (75741) $4,341.66 $1,366 1.4×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $4,341.66 $1,509 1.4×
Ankle 2 views (73600)
range across 3 matching MRF lines		 $119.66 $226–$276 1.4×
Aortography thoracic serialography rs&i (75605) $7,651.38 $2,794 1.4×
Aortography thoracic w/o serialography rs&i (75600) $4,341.66 $4,162 1.4×
Artery X-Rays Abdomen (75726) $7,651.38 $1,675 1.4×
Artery X-Rays Adrenal Gland (75731) $4,341.66 $1,809 1.4×
Artery X-Rays Pelvis (75736) $7,651.38 $1,431 1.4×
Artery X-Rays Spine (75705) $7,651.38 $1,931 1.4×
Arthrogram ankle (73615) $479.72 $1,222 1.4×
Arthrogram hip (73525) $479.72 $1,171 1.4×
Arthrogram Wrist (73115) $479.72 $1,236 1.4×
Basic radiation dosimetry calculation (77300) $184.82 — 1.4×
Bone age studies (77072)
range across 2 matching MRF lines		 $143.75 $214–$252 1.4×
Bone Imaging 3 Phase (78315) $549.70 $2,133 1.4×
Bone Imaging Limited Area (78300) $549.70 $1,431 1.4×
Bone Imaging Multiple Areas (78305) $549.70 — 1.4×
Bone Imaging Whole Body (78306) $549.70 $1,873 1.4×
Bone marrow imaging limited area (78102) $549.70 $1,029 1.4×
Bone marrow imaging; multiple areas (78103) $549.70 — 1.4×
Bone marrow imaging; whole body (78104) $549.70 — 1.4×
Bone survey infant (77076)
range across 2 matching MRF lines		 $143.75 $636–$650 1.4×
Brachytx isodose complex (77318) $514.85 — 1.4×
Brachytx isodose intermed (77317) $514.85 — 1.4×
Brachytx Isodose Plan Simple (77316) $514.85 — 1.4×
Brain Flow Imaging Only (78610) $746.61 — 1.4×
Brain Image W/Flow < 4 Views (78601) $549.70 — 1.4×
Brain imaging < 4 static views (78600) $549.70 $1,660 1.4×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $746.61 — 1.4×
Brain Imaging Minimum 4 Static Views (78605) $746.61 — 1.4×
Brain Imaging Pet Metabolic Evaluation (78608) $1,966.24 $6,440 1.4×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $549.70 — 1.4×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $746.61 — 1.4×
Cardiac MRI w/w/o contrast & further seq (75561) $479.72 $4,827 1.4×
Cardiac MRI w/w/o contrast w/stress (75563) $1,077.92 $5,815 1.4×
Cardiac Shunt Detection (78428) $549.70 — 1.4×
Cardiovasc nucl exam unlisted (78499) $549.70 — 1.4×
Cat Scan Follow-Up Study (76380) $119.66 — 1.4×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $746.61 — 1.4×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $746.61 — 1.4×
Cerebrospinal Fluid Scan (78630) $746.61 — 1.4×
Chest 1 view (71045)
range across 3 matching MRF lines		 $119.66 $179–$229 1.4×
Chest 2 views (71046)
range across 2 matching MRF lines		 $119.66 $258–$308 1.4×
Chest 3 views (71047)
range across 2 matching MRF lines		 $119.66 $296–$346 1.4×
Chest 4 or more views (71048)
range across 2 matching MRF lines		 $143.75 $337–$387 1.4×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $143.75 — 1.4×
Cholecystography Oral Contrast (74290) $241.18 $563 1.4×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $143.75 — 1.4×
Cisternography Positive Contrast Rs&I (70015) $1,077.92 $888 1.4×
Clavicle complete (73000)
range across 3 matching MRF lines		 $119.66 $207–$257 1.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $143.75 $1,668 1.4×
Continuing medical physics consltj pr wk (77336) $184.82 — 1.4×
Contrast Exam Abdominl Aorta (75625) $4,341.66 $2,794 1.4×
Contrast X-Ray Bladder (74430) $479.72 $349 1.4×
Contrast X-Ray Of Elbow (73085) $479.72 $1,055 1.4×
Contrast X-Ray Of Knee Joint (73580) $479.72 $1,392 1.4×
Contrast Xray Throat/Cerv Esopha (74210) $241.18 $441 1.4×
Corpora cavernosography (74445) $143.75 $417 1.4×
CT abdomen and pelvis without and with contrast (74178) $479.72 $4,501 1.4×
CT abdomen and pelvis without contrast (74176) $328.08 $2,732 1.4×
CT abdomen w contrast (74160) $241.18 $2,524 1.4×
CT abdomen w wo contrast (74170) $241.18 $2,901 1.4×
CT abdomen w/o contrast (74150) $143.75 $1,353 1.4×
CT Angio Abdomen and Pelvis (74174) $479.72 $3,981 1.4×
CT Angio Chest (71275) $241.18 $3,147 1.4×
CT Angio Head (70496) $241.18 $3,095 1.4×
CT angio hrt w/3d image (75574) $479.72 $3,036 1.4×
Ct Angio Lwr Extr W/O&W/Dye (73706) $241.18 $3,147 1.4×
CT Angio Neck (70498) $241.18 $3,084 1.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $241.18 $3,056 1.4×
CT bone density (77078) $119.66 — 1.4×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $241.18 $1,638 1.4×
CT cervical spine w/ contrast (72126) $479.72 $2,263 1.4×
CT cervical spine w/o contrast (72125) $143.75 $1,575 1.4×
CT cervical spine w/wo cont (72127) $241.18 $3,110 1.4×
CT chest w contrast (71260) $241.18 $2,016 1.4×
CT chest w/wo contrast (71270) $241.18 $2,497 1.4×
CT colonography screening (74263) $328.08 — 1.4×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $241.18 — 1.4×
CT colonogrphy dx image postprocess w/o contrast (74261) $143.75 — 1.4×
CT head/brain with contrast (70460) $241.18 $1,602 1.4×
CT head/brain without and with contrast (70470) $241.18 $1,926 1.4×
CT heart contrast eval cardiac structure&morph (75572) $479.72 — 1.4×
CT heart no contrast quant eval coronry calcium (75571) $119.66 $364 1.4×
CT hrt w/3d image congen (75573) $479.72 — 1.4×
CT iac w contrast (70481) $241.18 $3,110 1.4×
CT l-spine w&w/o contrast (72133) $241.18 $3,095 1.4×
CT lower ext w/o (73700) $143.75 $1,560 1.4×
CT lower extremity w/contrast material (73701) $241.18 $2,278 1.4×
CT lumbar spine w contrast (72132) $479.72 $2,263 1.4×
CT lumbar spine w/o contrast (72131) $143.75 $1,560 1.4×
CT maxillofacial w contrast (70487) $241.18 $1,679 1.4×
CT maxillofacial wo contrast (70486) $143.75 $1,458 1.4×
CT neck tissue combo (70492) $241.18 $2,458 1.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $241.18 $3,434 1.4×
CT orbits w/o contrast (70480) $143.75 $2,029 1.4×
CT pelvis w&w/o contrast (72194) $241.18 $2,693 1.4×
CT pelvis w/o contrast (72192) $143.75 $1,379 1.4×
CT scan of leg combo (73702) $241.18 $2,576 1.4×
CT scans face/jaw combo (70488) $241.18 $2,121 1.4×
CT soft tissue neck w contrast (70491) $241.18 $2,016 1.4×
CT soft tissue neck w/o contrast (70490) $143.75 $1,560 1.4×
CT thoracic spine w contrast (72129) $241.18 $2,278 1.4×
CT thoracic spine w/o contrast (72128) $143.75 $1,575 1.4×
CT thoracic spine w/wo cont (72130) $241.18 — 1.4×
CT thorax w/o contrast (71250) $143.75 $1,418 1.4×
CT unlisted procedure (76497)
range across 2 matching MRF lines		 $119.66 $1,653–$1,908 1.4×
CT upper ext wo (73200) $143.75 $1,472 1.4×
CT upper extremity w/o & w/contrast material (73202) $241.18 $3,080 1.4×
CT upper extremity with contrast (73201) $479.72 $2,099 1.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $241.18 $4,864 1.4×
Cta Abdomen (74175) $241.18 $2,940 1.4×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $479.72 $4,380 1.4×
CTA pelvis (72191) $241.18 $3,252 1.4×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) $328.08 — 1.4×
Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) $746.61 — 1.4×
Dilation ureters/urethra rs&i (74485) $2,874.36 $596 1.4×
Discography Cerv/Thor Spine (72285) $2,685.07 $547 1.4×
Diskography lumbar (72295) $2,685.07 $566 1.4×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $143.75 $293 1.4×
Doppler Echo Fetal Spectral Display Complete (76827) $143.75 $495 1.4×
Doppler Fetal Mid Cerebral Artery (76821) $143.75 $605 1.4×
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines		 $143.75 $338–$369 1.4×
Dxa bone density study (77085) $143.75 — 1.4×
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 2 matching MRF lines		 $119.66 $193–$232 1.4×
Echo exam of fetal heart (76825)
range across 2 matching MRF lines		 $751.34 $1,444–$1,494 1.4×
Echo exam uterus (76831) $328.08 $615 1.4×
Echo Guide For Artery Repair (76936) $296.91 $1,665 1.4×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $328.08 $911 1.4×
Echograp Trans R Pros Study (76873) $143.75 $806 1.4×
Esophageal Motility Study (78258) $549.70 — 1.4×
Esophagram (74220) $241.18 $478 1.4×
Fetal Biophys Profile W/Nst (76818) $143.75 $588 1.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $143.75 $429 1.4×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $328.08 $3,771 1.4×
Fluoroscopy up to 1 hr (76000) $328.08 $616 1.4×
Follow-Up Angiography (75898) $4,341.66 $1,560 1.4×
Foot 2 views (73620)
range across 3 matching MRF lines		 $119.66 $244–$294 1.4×
Forearm 2 views (73090)
range across 3 matching MRF lines		 $119.66 $184–$234 1.4×
Gastric emptying imaging study (78264) $549.70 $1,990 1.4×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $549.70 — 1.4×
Gastric Mucosa Imaging (78261) $549.70 — 1.4×
Gastroesophageal Reflux Exam (78262) $549.70 — 1.4×
Gastrointestinal Protein Loss (78282) $549.70 — 1.4×
Gated Heart Planar Single (78472) $549.70 $1,392 1.4×
Gated Heart, Multiple (78473) $549.70 — 1.4×
GI Endoscopic US S&I (76975) $328.08 — 1.4×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $746.61 — 1.4×
Hand 2 views (73120)
range across 3 matching MRF lines		 $143.75 $211–$261 1.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $957.68 — 1.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $957.68 — 1.4×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $957.68 — 1.4×
Heart first pass single,planar (78481) $746.61 — 1.4×
Heart Image (Pet) Multiple (78492) $1,966.24 $6,132 1.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $4,341.66 $1,406 1.4×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $4,341.66 $1,406 1.4×
Hepatobil Syst Image W/Drug (78227) $746.61 $2,705 1.4×
Hepatobiliary System Imaging (78226) $549.70 $1,978 1.4×
High energy neutron radj tx dlvr 1/> isocenter (77423) $759.77 — 1.4×
Ht Musc Image Planar Mult (78454) $1,780.19 — 1.4×
Ht Muscle Image Spect Sing (78451) $1,780.19 $3,147 1.4×
Hyperthermia external generated superficial (77600) $530.35 — 1.4×
Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) $759.77 — 1.4×
Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) $759.77 — 1.4×
Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) $759.77 — 1.4×
Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) $957.68 — 1.4×
Hysterosalpingogram (74740) $328.08 $584 1.4×
Image fusion (77399) $184.82 — 1.4×
Infant hip ultrasound with hip movement (dynamic) (76885) $119.66 $682 1.4×
Infant hip ultrasound, limited static exam (76886) $119.66 $473 1.4×
Infusion Ivp (74410) $241.18 $906 1.4×
Interstitial radiation source applic complex (77778) $957.68 — 1.4×
Intracavitary Radiation Source Applic Complex (77763) $957.68 — 1.4×
Intracavitary Radiation Source Applic Intermed (77762) $759.77 — 1.4×
Intracavitary radiation source applic simple (77761) $759.77 — 1.4×
Intraop radiaj tx deliver electrons sngl tx sess (77425) $10,127.56 $19,511 1.4×
Intraop radiaj tx deliver xray single tx session (77424) $10,127.56 $19,511 1.4×
Joint Survey Single View (77077) $143.75 $275 1.4×
K Flow/Funct Image Multiple (78709) $746.61 — 1.4×
K Flow/Funct Image W/Drug (78708) $746.61 $1,353 1.4×
K Flow/Funct Image W/O Drug (78707) $746.61 $1,783 1.4×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $549.70 — 1.4×
Kidney Imaging Morphol (78700) $549.70 — 1.4×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $549.70 — 1.4×
Knee 3 Views (73562)
range across 3 matching MRF lines		 $119.66 $278–$328 1.4×
Labeled RBC Sequestration Differntl Organ/Tissue (78140) $549.70 — 1.4×
Leveen/Shunt Patency Exam (78291) $549.70 $1,848 1.4×
Liver & Spleen Imaging Static Only (78215) $549.70 — 1.4×
Liver & Spleen Imaging W/Vascular Flow (78216) $549.70 — 1.4×
Liver imaging static only (78201) $746.61 — 1.4×
Liver imaging w/vascular flow (78202) $746.61 — 1.4×
Lung Perf&Ventilat Diferentl (78598) $746.61 $1,900 1.4×
Lung perfusion differential (78597) $549.70 — 1.4×
Lung Ventilat&Perfus Imaging (78582) $746.61 $2,433 1.4×
Lung Ventilation Imaging (78579) $549.70 — 1.4×
Lymph System Imaging (78195) $746.61 $2,849 1.4×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $2,164.52 $1,118 1.4×
Lymphangiography extremity only unilateral rs&i (75801) $862.57 $875 1.4×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $4,341.66 $1,431 1.4×
Lymphangiography, pelvic/abdominal, unilateral (75805) $4,341.66 $1,001 1.4×
Magnetic Image Jaw Joint (70336) $328.08 $3,135 1.4×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $241.18 $6,270 1.4×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $751.34 $5,696 1.4×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $241.18 $7,492 1.4×
Magnetic Resonance Elastography (76391) $328.08 $2,834 1.4×
Mammary ductogram or galactogram multiple (77054) $328.08 — 1.4×
Mammary ductogram or galactogram single (77053) $328.08 $425 1.4×
Meckels Divert Exam (78290) $549.70 $2,133 1.4×
Medical physics dose eval radiation expos w/rprt (76145) $513.11 — 1.4×
Mlc imrt design & construction per imrt plan (77338) $514.85 — 1.4×
Mr safety determination physician/other qhp (76016) $119.66 $95 1.4×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $39.77 $95 1.4×
Mr safety implt electronics prepj supvj phys/qhp (76018) $130.73 $225 1.4×
Mr safety implt pos&/immoblj (76019) $81.12 $345 1.4×
Mr safety med physics xm customization plng&mntr (76017) $328.08 $585 1.4×
Mra Head W/O & W/Contrast Material (70546) $479.72 $6,465 1.4×
MRA head w/o contrast (70544) $328.08 $3,370 1.4×
MRA head with contrast (70545) $479.72 $3,760 1.4×
MRA neck w contrast (70548) $479.72 $3,590 1.4×
Mra Neck W/O &W/Contrast Material (70549) $479.72 $4,553 1.4×
MRA neck w/o contrast (70547) $328.08 $3,395 1.4×
MRI abdomen w contrast (74182) $479.72 $4,670 1.4×
MRI abdomen w/o contrast (74181) $328.08 $3,292 1.4×
MRI any jt lower extrem w/contrast material (73722) $1,077.92 $3,785 1.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $479.72 $4,566 1.4×
MRI any jt upper extremity w/contrast matrl (73222) $1,077.92 $3,760 1.4×
MRI bone marrow blood supply (77084) $328.08 $3,890 1.4×
MRI brain functional w/o physician admnistration (70554) $328.08 $4,059 1.4×
MRI brain functional w/physician admnistration (70555) $328.08 $4,059 1.4×
MRI Breast W/O Contrast Bilateral (77047) $328.08 $4,136 1.4×
MRI Breast Without Contrast Material Unilateral (77046) $328.08 $2,757 1.4×
MRI cardiac w/o cont stress (75559) $751.34 $4,749 1.4×
MRI cardiac w/o contrast (75557) $328.08 $3,355 1.4×
MRI cervical spine w contrast (72142) $479.72 $3,733 1.4×
MRI cervical spine w/o cont (72141) $328.08 $2,719 1.4×
MRI chest w/o contrast (71550) $328.08 $4,310 1.4×
MRI chest with contrast (71551) $1,077.92 $4,670 1.4×
MRI chest wo w contrast (71552) $479.72 $5,878 1.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $479.72 $3,292 1.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $479.72 $4,007 1.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $328.08 $3,018 1.4×
MRI lumbar spine w contrast (72149) $479.72 $3,668 1.4×
Mri Neck Spine W/O & W/Dye (72156) $479.72 $4,189 1.4×
MRI orbit face &/neck w/o contrast (70540) $328.08 $3,200 1.4×
MRI orbit face neck w contrast (70542) $479.72 $3,785 1.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $479.72 $4,670 1.4×
MRI pelvis w contrast (72196) $479.72 $3,694 1.4×
MRI pelvis w/o & w contrast (72197) $479.72 $4,475 1.4×
MRI pelvis w/o contrast (72195) $328.08 $3,447 1.4×
MRI spectroscopy (76390) $119.66 $2,289 1.4×
MRI thoracic spine w/o contrast (72146) $328.08 $2,849 1.4×
MRI upper extremity oth than jt w/contr matrl (73219) $479.72 $4,059 1.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $328.08 $3,771 1.4×
Mri Uppr Extremity W/O&W/Dye (73220) $479.72 $4,944 1.4×
MRI, abdomen, combo (74183) $479.72 $4,996 1.4×
MRI, dorsal spine combo (72157) $479.72 $4,202 1.4×
MRI, dorsal spine contrast (72147) $479.72 $4,436 1.4×
MRI, joint upper extrem (73221) $328.08 $2,940 1.4×
MRI, joint upper extrem combo (73223) $479.72 $4,579 1.4×
MRI, lumbar spine combo (72158) $479.72 $4,176 1.4×
Musculoskeletal Nuclear Exam (78399) $549.70 — 1.4×
Myelogram cervical (72240) $1,077.92 $550 1.4×
Myelogram Lumbar (72265) $1,077.92 $531 1.4×
Myelography thoracic (72255) $1,077.92 — 1.4×
Myelograpy 2/more regions rs&i (72270) $1,077.92 $633 1.4×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $549.70 — 1.4×
Myocardial Imaging Pet Metabolic Evaluation (78459) $1,780.19 $5,352 1.4×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $746.61 — 1.4×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,780.19 — 1.4×
Myocardial Spect Multiple Studies (78452) $1,780.19 $4,032 1.4×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $1,966.24 $5,333 1.4×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $1,966.24 $6,270 1.4×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $3,028.92 $6,830 1.4×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $3,028.92 $7,154 1.4×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $2,086.79 $6,504 1.4×
N-invas est c ffr sw aly CTA (75580) $1,180.80 $13,078 1.4×
Neck soft tissue (70360)
range across 2 matching MRF lines		 $119.66 $211–$261 1.4×
Nervous system nuclear exam (78699) $549.70 — 1.4×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $530.35 — 1.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $549.70 — 1.4×
Nm csf leak detection (78650) $1,780.19 — 1.4×
Nm myocard infarct spect (78469) $746.61 — 1.4×
Nm red cell survival study (78130) $549.70 — 1.4×
Nm unlisted gi procedure (78299) $549.70 — 1.4×
Nm whole blood volume (78122) $746.61 — 1.4×
Nonvascular Shunt X-Ray (75809) $143.75 $550 1.4×
Ntsty modul radthx pln dose-vol histos (77301) $1,903.23 — 1.4×
Nuclear medicine study of endocrine organs (78099) $549.70 — 1.4×
Nuclear Rx Intra-Arterial (79445)
range across 2 matching MRF lines		 $320.85 $1,110–$1,124 1.4×
Nuclear Rx Oral Admin (79005) $320.85 $878 1.4×
Ob us nuchal meas 1 gest (76813) $143.75 $586 1.4×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $143.75 $545 1.4×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $143.75 $633 1.4×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $182.95 — 1.4×
Ophthalmic Biometry US Echograpy a-Scan (76516) $143.75 $489 1.4×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $119.66 $275 1.4×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $143.75 $511 1.4×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $39.77 $93 1.4×
Ophthalmic us dx quantitative a-scan only (76511) $143.75 — 1.4×
Optic foramina (70190) $119.66 — 1.4×
Panoramic X-ray of jaws (70355) $119.66 $102 1.4×
Parathyroid imaging w/tomographic spect & CT (78072) $746.61 — 1.4×
Parathyroid Planar Imaging (78070) $549.70 $1,496 1.4×
Parathyroid planar imaging w/wo subtraction (78071) $549.70 $2,003 1.4×
Pelvis 1 or 2 views (72170)
range across 2 matching MRF lines		 $143.75 $243–$293 1.4×
Perineogram (74775) $328.08 — 1.4×
Peritoneogram Rs&I (74190) $751.34 $703 1.4×
Pet Image Skull-Thigh (78812) $1,966.24 $5,228 1.4×
Pet Image W/Ct Lmtd (78814) $1,966.24 $6,790 1.4×
PET image w/CT, full body (78816) $1,966.24 $6,790 1.4×
PET imaging CT attenuation skull base mid-thigh (78815) $1,966.24 $6,790 1.4×
Pet Imaging Limited Area Chest Head/Neck (78811) $1,780.19 $5,490 1.4×
Pet Myocardial Sngl Study (78491) $1,966.24 $6,132 1.4×
PET whole body (78813) $1,966.24 $5,228 1.4×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $1,780.19 — 1.4×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $1,780.19 — 1.4×
Platelet survival study Non-Facility (78191) $549.70 — 1.4×
Proton trmt simple w/comp (77522) $1,718.45 — 1.4×
Proton tx delivery complex (77525) $1,718.45 — 1.4×
Proton tx delivery intermediate (77523) $1,718.45 — 1.4×
Proton tx delivery simple w/o compensation (77520) $759.77 — 1.4×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $4,341.66 $1,392 1.4×
Pulmonary Perfusion Imaging Particulate (78580) $549.70 $1,743 1.4×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $1,279.26 — 1.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022)
range across 2 matching MRF lines		 $143.75 $330–$380 1.4×
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines		 $751.34 $367–$396 1.4×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines		 $119.66 $240–$290 1.4×
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines		 $119.66 $222–$272 1.4×
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines		 $119.66 $240–$290 1.4×
Radex Facial Bones Complete Minimum 3 Views (70150)
range across 3 matching MRF lines		 $143.75 $279–$346 1.4×
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines		 $119.66 $265–$315 1.4×
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines		 $119.66 $222–$272 1.4×
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $119.66 $243–$293 1.4×
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines		 $119.66 $195–$234 1.4×
Radex Mastoids Compl Minimum 3 Views PR Side (70130)
range across 2 matching MRF lines		 $143.75 $366–$388 1.4×
Radex Nasal Bones Complete Minimum 3 Views (70160)
range across 3 matching MRF lines		 $119.66 $241–$305 1.4×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $119.66 $588 1.4×
Radex Ribs Unilateral 2 Views (71100)
range across 2 matching MRF lines		 $119.66 $232–$282 1.4×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $119.66 $211–$261 1.4×
Radex Sinuses Paransl < 3 Views (70210)
range across 3 matching MRF lines		 $119.66 $222–$272 1.4×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $241.18 $4,020 1.4×
Radex Spine 1 View Specify Level (72020) $119.66 $155 1.4×
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines		 $119.66 $207–$257 1.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $119.66 $367 1.4×
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines		 $119.66 $229–$279 1.4×
Radex upper extremity infant minimum 2 views (73092)
range across 2 matching MRF lines		 $143.75 $204–$242 1.4×
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines		 $119.66 $278–$328 1.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $143.75 $520 1.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $10,127.56 — 1.4×
Radiation treatment delivery level 1 (77402) $140.29 — 1.4×
Radiation treatment delivery level 2 (77407) $530.35 $3,790 1.4×
Radiation treatment delivery level 3 (77412)
range across 3 matching MRF lines		 $759.77 $2,222–$3,790 1.4×
Radiolog exam mandible compl minimum 4 views (70110)
range across 2 matching MRF lines		 $143.75 $313–$363 1.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 2 matching MRF lines		 $143.75 $293–$343 1.4×
Radiologic exam colon double contrast study (74280) $241.18 $1,029 1.4×
Radiologic exam colon single contrast study (74270) $241.18 $726 1.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $241.18 $774 1.4×
Radiologic exam knee complete 4/more views (73564)
range across 2 matching MRF lines		 $143.75 $300–$350 1.4×
Radiologic exam pelvis compl minimum 3 views (72190)
range across 2 matching MRF lines		 $143.75 $283–$333 1.4×
Radiologic Exam Small Int Single Contrast Study (74250) $241.18 $669 1.4×
Radiologic exam swallow function contrast study (74230) $241.18 $752 1.4×
Radiologic exam teeth complete full mouth (70320) $328.08 — 1.4×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $328.08 — 1.4×
Radiologic exam upr gi trc double contrast study (74246) $241.18 $674 1.4×
Radiologic examination femur 1 view (73551)
range across 2 matching MRF lines		 $119.66 $207–$257 1.4×
Radiologic examination femur minimum 2 views (73552)
range across 2 matching MRF lines		 $119.66 $248–$298 1.4×
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines		 $119.66 $240–$290 1.4×
Radiologic Examination Osseous Survey Limited (77074) $143.75 $523 1.4×
Radiologic Examination Salivary Gland Calculus (70380) $119.66 — 1.4×
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines		 $119.66 $213–$263 1.4×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $751.34 — 1.4×
Radiologic examination, teeth; single view Non-Facility (70300) $119.66 — 1.4×
Radiopharm Dacryocystography (78660) $549.70 — 1.4×
Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) $320.85 — 1.4×
Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) $320.85 — 1.4×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $320.85 — 1.4×
Red Cell Volume Determination Spx 1 Sampling (78120) $549.70 — 1.4×
Red Cell Volume Determination Spx Mult Samplings (78121) $746.61 — 1.4×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $530.35 — 1.4×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $530.35 — 1.4×
Renal Cyst Study (74470) $751.34 $618 1.4×
Ribs bilateral 3 views (71110)
range across 2 matching MRF lines		 $143.75 $313–$363 1.4×
Rp loclzj tum plnr 1 area single day imaging (78800) $549.70 — 1.4×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $549.70 — 1.4×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $746.61 — 1.4×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $746.61 $2,433 1.4×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $746.61 — 1.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,780.19 $9,188 1.4×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $1,966.24 $3,306 1.4×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,780.19 $6,186 1.4×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $320.85 — 1.4×
Rp Therapy Intravenous Administration (79101)
range across 2 matching MRF lines		 $320.85 $1,070–$1,081 1.4×
Rp Therapy Unlisted Procedure (79999) $320.85 — 1.4×
Salivary Gland Function Study (78232) $549.70 — 1.4×
Salivary Gland Imaging (78230) $549.70 — 1.4×
Salivary Gland Imaging Serial Images (78231) $549.70 — 1.4×
Scapula (73010)
range across 3 matching MRF lines		 $143.75 $275–$325 1.4×
Screening Digital Breast Tomosynthesis Bi (77063) $31.13 $133 1.3×
Sella turcica (70240) $119.66 — 1.4×
Shoulder 1 view (73020)
range across 3 matching MRF lines		 $119.66 $158–$208 1.4×
Shoulder Arthrography (73040) $479.72 $1,159 1.4×
Sialogram (70390) $328.08 $788 1.4×
Skull less than 4 views (70250)
range across 3 matching MRF lines		 $143.75 $251–$301 1.4×
Special dosimetry (77331) $184.82 — 1.4×
Special Physics Consult (77370) $184.82 — 1.4×
Special teletherapy port plan (77321) $514.85 — 1.4×
Special treatment procedure (77470) $759.77 — 1.4×
Speech evaluation, complex (70371) $328.08 — 1.4×
Spleen Imaging (78185) $549.70 — 1.4×
Srs Multisource (77371) $10,127.56 — 1.4×
Stereotactic Body Radiation Delivery (77373) $2,458.64 $5,352 1.4×
Sternoclavicular joints (71130)
range across 2 matching MRF lines		 $119.66 $262–$312 1.4×
Superior sagittal sinus venogram (75870) $4,341.66 $1,431 1.4×
Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) $140.29 — 1.4×
Surf radj ther supfc dlvr<=150 kv per fraction (77437) $140.29 — 1.4×
Surf radj ther supfc/orthvlt treatment planning (77436) $51.36 — 1.4×
Surface Applic Low Dose Rate Radionuclide Source (77789) $140.29 — 1.4×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $119.66 — 1.4×
Tbs technical calculation only (77091) $119.66 — 1.4×
Telethx isodose pln cplx w/basic dosimetry (77307) $514.85 — 1.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $514.85 — 1.4×
Temporomandble Jt Arthrography Rs&I (70332) $328.08 — 1.4×
Testicular Imaging W/Flow (78761) $549.70 — 1.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $514.85 — 1.4×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $514.85 — 1.4×
Ther rad simulaj-aided field setting simple (77280) $184.82 — 1.4×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $241.18 $1,118 1.4×
Thoracic spine 2 views (72070)
range across 2 matching MRF lines		 $143.75 $240–$290 1.4×
Thoracic spine 3 views (72072)
range across 2 matching MRF lines		 $143.75 $251–$301 1.4×
Thoracolumbar 2 views (72080) $119.66 $236 1.4×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $549.70 — 1.4×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $549.70 — 1.4×
Thyroid Imaging With Vascular Flow (78013) $549.70 $1,171 1.4×
Thyroid Met Imaging Body (78018) $746.61 $1,821 1.4×
Thyroid Uptake Measurement (78012) $549.70 $772 1.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $549.70 $1,458 1.4×
Tx Devices Design & Construction Complex (77334) $514.85 — 1.4×
Tx devices design & construction intermediate (77333) $184.82 — 1.4×
Tx devices design & construction simple (77332) $184.82 — 1.4×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $119.66 $573–$623 1.4×
Ultrasound elastography first target lesion (76982) $143.75 $703 1.4×
Ultrasound Elastography Parenchyma (76981) $143.75 $820 1.4×
Ultrasound Exam Aaa Screen (76706) $143.75 $566 1.4×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $479.72 $2,549 1.4×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $143.75 $658–$708 1.4×
Umbilical-artery Doppler (OB) (76820) $143.75 $479 1.4×
Unlis px ther radiol clinical tx planning (77299) $184.82 — 1.4×
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines		 $119.66 $162–$1,717 1.4×
Unlisted fluoroscopic procedure (76496) $119.66 $1,171 1.4×
Unlisted genitourinary px dx nuclear medicine (78799) $549.70 — 1.4×
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) $549.70 — 1.4×
Unlisted magnetic resonance procedure (76498) $119.66 $8,226 1.4×
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $549.70 — 1.4×
Unlisted Procedure Clinical Brachytherapy (77799) $140.29 — 1.4×
Unlisted respiratory px dx nuclear medicine (78599) $549.70 — 1.4×
Unlisted us procedure (76999)
range across 3 matching MRF lines		 $119.66 $411–$1,301 1.4×
Upper gi w/o kub (74240) $241.18 $572 1.4×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $15.26 — 1.4×
Urea breath test c-14 isotopic analysis (78268) $130.29 — 1.4×
Ureteral Reflux Study (78740) $549.70 — 1.4×
Urethrocystogram voiding (74455) $328.08 $551 1.4×
Urethrocystography retrograde (74450) $328.08 $499 1.4×
Us bone density measurement (76977) $143.75 $127 1.4×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $143.75 $1,502–$1,552 1.4×
Us chest (76604)
range across 2 matching MRF lines		 $143.75 $561–$611 1.4×
Us complete joint (76881) $143.75 $776 1.4×
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $143.75 $501–$551 1.4×
Us head (76506) $143.75 $812 1.4×
Us kidney transplant (76776) $143.75 $1,132 1.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $143.75 $526–$579 1.4×
Us ob detailed single fetus (76811) $328.08 $905 1.4×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $143.75 $495–$545 1.4×
Us ob transvaginal (76817) $143.75 $536 1.4×
Us pelvic non ob complete (76856)
range across 2 matching MRF lines		 $143.75 $802–$852 1.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines		 $143.75 $623–$673 1.4×
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $143.75 $611–$661 1.4×
Us retroperitoneal complete (76770)
range across 2 matching MRF lines		 $143.75 $810–$860 1.4×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $143.75 $481–$531 1.4×
Us scrotum and contents (76870)
range across 2 matching MRF lines		 $143.75 $667–$717 1.4×
Us spinal canal and contents (76800) $143.75 $728 1.4×
Us thyroid (76536)
range across 2 matching MRF lines		 $143.75 $797–$847 1.4×
Us transrectal (76872) $143.75 $846 1.4×
Vascular Flow Imaging (78445) $549.70 $1,476 1.4×
Vasogram (74440) $328.08 $455 1.4×
Vein X-Ray Chest (75827) $2,164.52 $1,301 1.4×
Vein X-Ray Liver W/O Hemodyn (75887) $4,341.66 $1,392 1.4×
Vein X-Ray Skull Epidural (75872) $862.57 $1,431 1.4×
Vein X-Ray Spleen/Liver (75810) $4,341.66 $1,496 1.4×
Venogram Sinus/Jugular (75860) $4,341.66 $1,392 1.4×
Venography Adrenal Unilateral (75840) $4,341.66 $1,431 1.4×
Venography caval inferior serialography rs&i (75825) $4,341.66 $1,236 1.4×
Venography extremity bilateral rs&i (75822) $2,164.52 $877 1.4×
Venography extremity unilateral rs&i (75820) $2,164.52 $847 1.4×
Venography Orbital Rs&I (75880) $862.57 $1,431 1.4×
Venography Renal Bilateral (75833) $4,341.66 $1,469 1.4×
Venography Renal Unilateral (75831) $4,341.66 $1,341 1.4×
Venous sampling by catheter (75893) $7,651.38 $1,182 1.4×
Venous thrombosis imaging (78457) $746.61 — 1.4×
Venous Thrombosis Imaging Venogram Bilateral (78458) $549.70 — 1.4×
Vertebral fracture assessment via dxa (77086) $119.66 — 1.4×
Wrist 2 views (73100)
range across 3 matching MRF lines		 $119.66 $240–$290 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 3 matching MRF lines		 $119.66 $265–$315 1.4×
X-ray antegrade pyelogram tube (74425) $479.72 $417 1.4×
X-Ray Aorta Leg Arteries (75630) $4,341.66 $2,794 1.4×
X-Ray Bend Only L-S Spine (72120)
range across 2 matching MRF lines		 $143.75 $311–$361 1.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines		 $119.66 $204–$254 1.4×
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines		 $751.34 $293–$326 1.4×
X-Ray Exam Entire Spi 1 Vw (72081) $119.66 $265 1.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $143.75 $313 1.4×
X-Ray Exam Entire Spi 4/5 Vw (72083) $143.75 $417 1.4×
X-Ray Exam Hip Uni 1 View (73501)
range across 2 matching MRF lines		 $119.66 $217–$270 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 2 matching MRF lines		 $119.66 $317–$367 1.4×
X-Ray Exam Hip Uni 4/> Views (73503)
range across 2 matching MRF lines		 $143.75 $392–$442 1.4×
X-Ray Exam Hips Bi 2 Views (73521)
range across 2 matching MRF lines		 $143.75 $278–$328 1.4×
X-Ray Exam Hips Bi 3-4 Views (73522)
range across 2 matching MRF lines		 $143.75 $355–$405 1.4×
X-Ray Exam Hips Bi 5/> Views (73523)
range across 2 matching MRF lines		 $143.75 $425–$475 1.4×
X-Ray Exam L-S Spine Bending (72114)
range across 2 matching MRF lines		 $143.75 $473–$523 1.4×
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines		 $119.66 $232–$282 1.4×
X-Ray Exam Neck Spine 6/>Vws (72052)
range across 2 matching MRF lines		 $143.75 $395–$445 1.4×
X-Ray Exam Unilat Ribs/Chest (71101)
range across 2 matching MRF lines		 $143.75 $259–$309 1.4×
X-ray eye for foreign body (70030) $119.66 $207 1.4×
X-ray head for orthodontia (70350) $119.66 $102 1.4×
X-ray humerus (73060)
range across 3 matching MRF lines		 $119.66 $217–$267 1.4×
X-ray IV pyelogram (ivp) (74400) $241.18 $893 1.4×
X-ray IV pyelogram+tomography (74415) $241.18 $1,171 1.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100)
range across 2 matching MRF lines		 $119.66 $251–$301 1.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565)
range across 2 matching MRF lines		 $119.66 $283–$333 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines		 $143.75 $251–$301 1.4×
X-ray nose-rectum child f.b. (76010) $119.66 $181 1.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111)
range across 2 matching MRF lines		 $143.75 $364–$414 1.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202)
range across 2 matching MRF lines		 $143.75 $248–$298 1.4×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200)
range across 2 matching MRF lines		 $143.75 $207–$257 1.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 2 matching MRF lines		 $119.66 $207–$257 1.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220)
range across 3 matching MRF lines		 $119.66 $262–$312 1.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260)
range across 3 matching MRF lines		 $143.75 $364–$414 1.4×
X-Ray Stress View (77071) $119.66 $198 1.4×
X-ray thoracic spine 4 vw (72074)
range across 2 matching MRF lines		 $143.75 $296–$346 1.4×
X-Ray Tmj Unilat (70328) $119.66 $226 1.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $479.72 $1,181 1.4×
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines		 $143.75 $343–$374 1.4×
X-Rays Bone Survey Complete (77075)
range across 2 matching MRF lines		 $143.75 $696–$707 1.4×
Xr c-spine 4 or 5 views (72050)
range across 2 matching MRF lines		 $143.75 $311–$361 1.4×
Xr facial bones less than 3 views (70140)
range across 3 matching MRF lines		 $119.66 $192–$254 1.4×
XR Mastoids < 3 Views Bilateral (70120) $143.75 — 1.4×
Xr myelogram posterior fossa (70010) $479.72 — 1.4×
Xr orbits complete 4 views (70200)
range across 3 matching MRF lines		 $143.75 $296–$346 1.4×
Xr Tomogram Single Plane (76100) $143.75 — 1.4×

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.