Imaging prices at Wynn Hospital
Utica, NY · every code in this section with a posted price and a Medicare benchmark.
339 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) | $5,249.40 | $8,749 | 3.0× |
| Abdomen 1 View (74018) | $356.40 | $594 | 3.3× |
| Abdomen 2 views (74019) | $512.40 | $854 | 3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,336.20 | $2,227 | 2.7× |
| Angio pulmonary bilat (75743) | $6,388.20 | $10,647 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $2,160.60 | $3,601 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $2,149.80 | $3,583 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,295.20 | $10,492 | 1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,192.80 | $6,988 | 1.1× |
| Ankle 2 views (73600) | $225 | $375 | 2.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,875.20 | $4,792 | 0.4× |
| Artery X-Rays Abdomen (75726) | $5,395.80 | $8,993 | 0.8× |
| Artery X-Rays Adrenal Gland (75731) | $2,651.40 | $4,419 | 0.7× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,383.20 | $3,972 | 0.3× |
| Artery X-Rays Spine (75705) | $5,441.40 | $9,069 | 0.8× |
| Arthrogram hip (73525) | $702 | $1,170 | 1.6× |
| Basic radiation dosimetry calculation (77300) | $880.80 | $1,468 | 5.2× |
| Bone age studies (77072) | $322.80 | $538 | 2.5× |
| Bone Imaging 3 Phase (78315) | $1,384.80 | $2,308 | 2.8× |
| Bone Imaging Limited Area (78300) | $2,254.20 | $3,757 | 4.5× |
| Bone Imaging Multiple Areas (78305) | $1,326.60 | $2,211 | 2.7× |
| Bone Imaging Whole Body (78306) | $2,552.40 | $4,254 | 5.1× |
| Bone marrow imaging limited area (78102) | $866.40 | $1,444 | 1.7× |
| Bone survey infant (77076) | $286.20 | $477 | 2.2× |
| Brain Flow Imaging Only (78610) | $1,255.80 | $2,093 | 1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$2,962.80–$6,520.20 | $4,938–$10,867 | varies |
| Chest 1 view (71045) | $267.60 | $446 | 2.5× |
| Chest 2 views (71046) | $386.40 | $644 | 3.6× |
| Chest 3 views (71047) | $493.80 | $823 | 4.5× |
| Chest 4 or more views (71048) | $501.60 | $836 | 3.8× |
| Cholecystography Oral Contrast (74290) | $475.80 | $793 | 2.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $506.40 | $844 | 3.9× |
| Clavicle complete (73000) | $254.40 | $424 | 2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,930.80 | $3,218 | 14.8× |
| Continuing medical physics consltj pr wk (77336) | $895.80 | $1,493 | 5.3× |
| Contrast Exam Abdominl Aorta (75625) | $4,210.80 | $7,018 | 1.1× |
| Contrast X-Ray Bladder (74430) | $565.80 | $943 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,701.40 | $6,169 | 8.5× |
| CT abdomen and pelvis without contrast (74176) | $3,400.80 | $5,668 | 11.4× |
| CT abdomen w contrast (74160) | $2,385 | $3,975 | 10.9× |
| CT abdomen w wo contrast (74170) | $2,628 | $4,380 | 12.0× |
| CT abdomen w/o contrast (74150) | $2,040 | $3,400 | 15.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,056.80 | $3,428 | 4.7× |
| CT Angio Chest (71275) | $2,866.20 | $4,777 | 13.1× |
| CT Angio Head (70496) | $1,837.20 | $3,062 | 8.4× |
| CT angio hrt w/3d image (75574) | $1,598.40 | $2,664 | 3.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$2,512.80–$2,557.80 | $4,188–$4,263 | varies |
| CT Angio Neck (70498) | $2,400.60 | $4,001 | 11.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$2,221.80–$2,260.80 | $3,703–$3,768 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $423.60 | $706 | 1.9× |
| CT cervical spine w/ contrast (72126) | $2,071.20 | $3,452 | 4.8× |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$1,935.60–$1,969.20 | $3,226–$3,282 | varies |
| CT cervical spine w/wo cont (72127) | $2,275.80 | $3,793 | 10.4× |
| CT chest w contrast (71260) | $2,325.60 | $3,876 | 10.6× |
| CT chest w/wo contrast (71270) | $3,225 | $5,375 | 14.7× |
| CT colonography screening (74263) | $571.80 | $953 | 1.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,029 | $1,715 | 4.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$191.40–$531.60 | $319–$886 | varies |
| CT head/brain with contrast (70460) | $2,005.80 | $3,343 | 9.2× |
| CT head/brain without and with contrast (70470) | $2,456.40 | $4,094 | 11.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $291.60 | $486 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $114.02 | $330 | 1.0× |
| CT iac w contrast (70481) | $2,202.60 | $3,671 | 10.1× |
| CT l-spine w&w/o contrast (72133) | $2,376.60 | $3,961 | 10.9× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$150–$2,002.20 | $250–$3,337 | varies |
| CT lower extremity w/contrast material (73701) | $2,223 | $3,705 | 10.2× |
| CT lumbar spine w contrast (72132) | $2,370.60 | $3,951 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,959 | $3,265 | 15.0× |
| CT maxillofacial w contrast (70487) | $2,100.60 | $3,501 | 9.6× |
| CT maxillofacial wo contrast (70486) | $1,890 | $3,150 | 14.5× |
| CT neck tissue combo (70492) | $2,319.60 | $3,866 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,800.20 | $4,667 | 12.8× |
| CT orbits w/o contrast (70480) | $1,900.20 | $3,167 | 14.6× |
| CT pelvis w&w/o contrast (72194) | $2,189.40 | $3,649 | 10.0× |
| CT pelvis w/o contrast (72192) | $2,038.80 | $3,398 | 15.6× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,062.20–$2,098.80 | $3,437–$3,498 | varies |
| CT scans face/jaw combo (70488) | $2,244.60 | $3,741 | 10.3× |
| CT soft tissue neck w contrast (70491) | $2,289.60 | $3,816 | 10.5× |
| CT soft tissue neck w/o contrast (70490) | $2,030.40 | $3,384 | 15.6× |
| CT thoracic spine w contrast (72129) | $2,520.60 | $4,201 | 11.5× |
| CT thoracic spine w/o contrast (72128) | $2,190.60 | $3,651 | 16.8× |
| CT thoracic spine w/wo cont (72130) | $890.40 | $1,484 | 4.1× |
| CT thorax w/o contrast (71250) | $2,053.80 | $3,423 | 15.7× |
| CT upper ext wo (73200) | $2,000.40 | $3,334 | 15.3× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$750.60–$2,062.20 | $1,251–$3,437 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,089.20–$2,124.60 | $3,482–$3,541 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,293.20 | $3,822 | 10.5× |
| Cta Abdomen (74175) | $2,864.40 | $4,774 | 13.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $841.80 | $1,403 | 1.9× |
| CTA pelvis (72191) | $2,802.60 | $4,671 | 12.8× |
| Discography Cerv/Thor Spine (72285) | $1,707 | $2,845 | 0.7× |
| Diskography lumbar (72295) | $2,467.80 | $4,113 | 1.0× |
| Dxa Bone Density Axial (77080) | $966 | $1,610 | 7.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $470.40 | $784 | 4.3× |
| Echo exam uterus (76831) | $507 | $845 | 1.7× |
| Echo Guide For Artery Repair (76936) | $687.60 | $1,146 | 2.6× |
| Echograp Trans R Pros Study (76873) | $291.60 | $486 | 2.2× |
| Esophagram (74220) | $568.80 | $948 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $776.40 | $1,294 | 5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$255.60–$293.40 | $426–$489 | varies |
| Fluoroscopy up to 1 hr (76000) | $961.20 | $1,602 | 3.2× |
| Follow-Up Angiography (75898) | $1,092.60 | $1,821 | 0.3× |
| Foot 2 views (73620) | $228.60 | $381 | 2.1× |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$305.40–$310.80 | $509–$518 | varies |
| Gastric emptying imaging study (78264) | $1,872.60 | $3,121 | 3.8× |
| Gated Heart Planar Single (78472) | $1,431 | $2,385 | 2.9× |
| Hand 2 views (73120) | $236.40 | $394 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$40.80–$96.60 | $68–$161 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,120.80 | $1,868 | 1.7× |
| Hepatobiliary System Imaging (78226) | $1,033.80 | $1,723 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $1,973.40 | $3,289 | 1.2× |
| Hysterosalpingogram (74740) | $1,055.40 | $1,759 | 3.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $859.20 | $1,432 | 7.9× |
| K Flow/Funct Image Multiple (78709) | $2,523.60 | $4,206 | 3.7× |
| K Flow/Funct Image W/Drug (78708) | $586.80 | $978 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,373.40 | $2,289 | 2.0× |
| Kidney Imaging Morphol (78700) | $771 | $1,285 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,336.20 | $2,227 | 2.7× |
| Knee 3 Views (73562) | $277.80 | $463 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,326.60 | $2,211 | 2.7× |
| Liver imaging static only (78201) | $520.80 | $868 | 0.8× |
| Liver imaging w/vascular flow (78202) | $1,312.80 | $2,188 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,618.20 | $2,697 | 2.4× |
| Lung perfusion differential (78597) | $2,133.60 | $3,556 | 4.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,847.40 | $3,079 | 2.7× |
| Lung Ventilation Imaging (78579) | $1,618.20 | $2,697 | 3.2× |
| Lymph System Imaging (78195) | $1,222.80 | $2,038 | 1.8× |
| Magnetic Image Jaw Joint (70336) | $1,707 | $2,845 | 5.7× |
| Mammary ductogram or galactogram multiple (77054) | $957 | $1,595 | 3.2× |
| Mammary ductogram or galactogram single (77053) | $690 | $1,150 | 2.3× |
| Meckels Divert Exam (78290) | $1,297.20 | $2,162 | 2.6× |
| Mlc imrt design & construction per imrt plan (77338) | $2,412 | $4,020 | 5.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,032.80 | $3,388 | 4.7× |
| MRA head w/o contrast (70544) | $1,971.60 | $3,286 | 6.6× |
| MRA head with contrast (70545) | $1,707 | $2,845 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,971.60 | $3,286 | 4.5× |
| MRA neck w/o contrast (70547) | $1,971.60 | $3,286 | 6.6× |
| MRI abdomen w contrast (74182) | $1,707 | $2,845 | 3.9× |
| MRI abdomen w/o contrast (74181) | $1,527.60 | $2,546 | 5.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,313–$2,353.80 | $3,855–$3,923 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,854–$2,032.80 | $3,090–$3,388 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,353.80–$3,237.60 | $3,923–$5,396 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,273.80 | $2,123 | 4.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,273.80 | $2,123 | 4.3× |
| MRI cervical spine w contrast (72142) | $1,737 | $2,895 | 4.0× |
| MRI cervical spine w/o cont (72141) | $1,527.60 | $2,546 | 5.1× |
| MRI chest w/o contrast (71550) | $1,416 | $2,360 | 4.8× |
| MRI chest with contrast (71551) | $1,707 | $2,845 | 1.7× |
| MRI chest wo w contrast (71552) | $1,999.80 | $3,333 | 4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,707 | $2,845 | 3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,854–$1,999.80 | $3,090–$3,333 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,416–$1,527.60 | $2,360–$2,546 | varies |
| MRI lumbar spine w contrast (72149) | $1,737 | $2,895 | 4.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,854 | $3,090 | 4.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,440.60 | $2,401 | 4.8× |
| MRI orbit face neck w contrast (70542) | $1,662 | $2,770 | 3.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,854 | $3,090 | 4.3× |
| MRI pelvis w contrast (72196) | $1,707 | $2,845 | 3.9× |
| MRI pelvis w/o & w contrast (72197) | $1,854 | $3,090 | 4.3× |
| MRI pelvis w/o contrast (72195) | $1,527.60 | $2,546 | 5.1× |
| MRI thoracic spine w/o contrast (72146) | $1,527.60 | $2,546 | 5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,707 | $2,845 | 3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,416–$1,500.60 | $2,360–$2,501 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,717.80–$1,999.80 | $2,863–$3,333 | varies |
| MRI, abdomen, combo (74183) | $2,032.80 | $3,388 | 4.7× |
| MRI, dorsal spine combo (72157) | $1,854 | $3,090 | 4.3× |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,707–$1,911 | $2,845–$3,185 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,440.60–$2,160.60 | $2,401–$3,601 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,854–$2,032.80 | $3,090–$3,388 | varies |
| MRI, lumbar spine combo (72158) | $1,854 | $3,090 | 4.3× |
| Myelogram cervical (72240) | $1,707 | $2,845 | 1.7× |
| Myelogram Lumbar (72265) | $1,737 | $2,895 | 1.8× |
| Myelography thoracic (72255) | $1,707 | $2,845 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,707 | $2,845 | 1.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $803.40 | $1,339 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $3,469.20 | $5,782 | 2.1× |
| Neck soft tissue (70360) | $326.40 | $544 | 3.0× |
| Nm myocard infarct spect (78469) | $2,835 | $4,725 | 4.2× |
| Nonvascular Shunt X-Ray (75809) | $236.40 | $394 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,710.80 | $14,518 | 5.0× |
| Nuclear Rx Intra-Arterial (79445) | $677.40 | $1,129 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $581.40 | $969 | 2.0× |
| Ob us nuchal meas 1 gest (76813) | $237.60 | $396 | 1.8× |
| Panoramic X-ray of jaws (70355) | $349.80 | $583 | 3.2× |
| Parathyroid Planar Imaging (78070) | $1,216.20 | $2,027 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $957 | $1,595 | 1.9× |
| Pelvis 1 or 2 views (72170) | $374.40 | $624 | 2.9× |
| Peritoneogram Rs&I (74190) | $968.40 | $1,614 | 1.4× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$3,508.80–$6,882 | $5,848–$11,470 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$7,561.80–$8,181 | $12,603–$13,635 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$6,509.40–$6,996 | $10,849–$11,660 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $748.20 | $1,247 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $324.60 | $541 | 2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $820.20 | $1,367 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $370.80 | $618 | 3.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $217.80 | $363 | 2.0× |
| Radex elbow complete minimum 3 views (73080) | $405 | $675 | 3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $462.60 | $771 | 3.5× |
| Radex fingr minimum 2 views (73140) | $258.60 | $431 | 2.4× |
| Radex foot complete minimum 3 views (73630) | $400.20 | $667 | 3.7× |
| Radex Hand Minimum 3 Views (73130) | $383.40 | $639 | 3.5× |
| Radex lower extremity infant minimum 2 views (73592) | $276.60 | $461 | 2.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $390.60 | $651 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $363.60 | $606 | 3.3× |
| Radex Ribs Unilateral 2 Views (71100) | $452.40 | $754 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$378–$400.20 | $630–$667 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $335.40 | $559 | 3.1× |
| Radex Spine 1 View Specify Level (72020) | $147 | $245 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $384 | $640 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $335.40 | $559 | 3.1× |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$222–$226.20 | $370–$377 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $111 | $185 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $366 | $610 | 3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $383.40 | $639 | 2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $10,367.40 | $17,279 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $396 | $660 | 3.1× |
| Radiation treatment delivery level 2 (77407) | $931.80 | $1,553 | 1.9× |
| Radiation treatment delivery level 3 (77412) | $1,519.80 | $2,533 | 2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $574.80 | $958 | 4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $556.20 | $927 | 4.3× |
| Radiologic exam colon double contrast study (74280) | $875.40 | $1,459 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $761.40 | $1,269 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$431.40–$438.60 | $719–$731 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $531 | $885 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $490.80 | $818 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$1,018.20–$1,587 | $1,697–$2,645 | varies |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$285.60–$290.40 | $476–$484 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 9 matching MRF lines |
$253.80–$403.80 | $423–$673 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$213.60–$217.20 | $356–$362 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,108.20 | $1,847 | 8.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $279 | $465 | 2.6× |
| Ribs bilateral 3 views (71110) | $781.20 | $1,302 | 6.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $831 | $1,385 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,649.80 | $6,083 | 5.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,817 | $4,695 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,784.60 | $4,641 | 4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,016.20 | $5,027 | 1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,126.60 | $5,211 | 1.9× |
| Rp Therapy Intravenous Administration (79101) | $563.40 | $939 | 1.9× |
| Scapula (73010) range across 6 matching MRF lines |
$273.60–$277.80 | $456–$463 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $63 | $105 | 2.7× |
| Shoulder 1 view (73020) | $234 | $390 | 2.2× |
| Shoulder Arthrography (73040) | $653.40 | $1,089 | 1.5× |
| Skull less than 4 views (70250) | $325.20 | $542 | 2.5× |
| Special dosimetry (77331) | $161.40 | $269 | 1.0× |
| Special Physics Consult (77370) | $735 | $1,225 | 4.4× |
| Special teletherapy port plan (77321) | $2,900.40 | $4,834 | 6.2× |
| Special treatment procedure (77470) | $2,100 | $3,500 | 3.0× |
| Stereotactic Body Radiation Delivery (77373) | $22,026 | $36,710 | 9.9× |
| Sternoclavicular joints (71130) | $387.60 | $646 | 3.6× |
| Superior sagittal sinus venogram (75870) | $5,306.40 | $8,844 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $7,107 | $11,845 | 15.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $4,744.80 | $7,908 | 10.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,730 | $4,550 | 5.8× |
| Ther rad simulaj-aided field setting simple (77280) | $653.40 | $1,089 | 3.9× |
| Thoracic spine 2 views (72070) | $229.80 | $383 | 1.8× |
| Thoracic spine 3 views (72072) | $456.60 | $761 | 3.5× |
| Thyroid Imaging With Vascular Flow (78013) | $574.20 | $957 | 1.2× |
| Thyroid Met Imaging Body (78018) | $1,861.20 | $3,102 | 2.7× |
| Thyroid Uptake Measurement (78012) | $513.60 | $856 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $737.40 | $1,229 | 1.5× |
| Tx Devices Design & Construction Complex (77334) | $1,614.60 | $2,691 | 3.5× |
| Tx devices design & construction intermediate (77333) | $847.20 | $1,412 | 5.0× |
| Tx devices design & construction simple (77332) | $424.80 | $708 | 2.5× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$36.60–$688.20 | $61–$1,147 | varies |
| Ultrasound Elastography Parenchyma (76981) | $722.40 | $1,204 | 5.5× |
| Ultrasound Exam Aaa Screen (76706) | $415.80 | $693 | 3.2× |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$67.20–$1,030.20 | $112–$1,717 | varies |
| Umbilical-artery Doppler (OB) (76820) | $282.60 | $471 | 2.2× |
| Unlisted fluoroscopic procedure (76496) | $210.60 | $351 | 1.9× |
| Unlisted magnetic resonance procedure (76498) | $1,047 | $1,745 | 9.6× |
| Unlisted us procedure (76999) | $181.80 | $303 | 1.7× |
| Upper gi w/o kub (74240) | $904.20 | $1,507 | 4.1× |
| Urethrocystogram voiding (74455) | $1,070.40 | $1,784 | 3.6× |
| Urethrocystography retrograde (74450) | $390 | $650 | 1.3× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$115.20–$744 | $192–$1,240 | varies |
| Us chest (76604) | $840.60 | $1,401 | 6.4× |
| Us complete joint (76881) range across 3 matching MRF lines |
$764.40–$777.60 | $1,274–$1,296 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$629.40–$639.60 | $1,049–$1,066 | varies |
| Us head (76506) | $812.40 | $1,354 | 6.2× |
| Us kidney transplant (76776) | $492 | $820 | 3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$385.80–$391.20 | $643–$652 | varies |
| Us ob limited 1 or more fetuses (76815) | $359.40 | $599 | 2.8× |
| Us ob transvaginal (76817) | $670.20 | $1,117 | 5.1× |
| Us pelvic non ob complete (76856) | $1,120.20 | $1,867 | 8.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $655.20 | $1,092 | 5.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $711.60 | $1,186 | 5.5× |
| Us retroperitoneal complete (76770) | $1,287 | $2,145 | 9.9× |
| Us retroperitoneal limited (76775) | $1,144.20 | $1,907 | 8.8× |
| Us scrotum and contents (76870) | $885.60 | $1,476 | 6.8× |
| Us spinal canal and contents (76800) | $361.20 | $602 | 2.8× |
| Us thyroid (76536) | $790.20 | $1,317 | 6.1× |
| Us transrectal (76872) | $249 | $415 | 1.9× |
| Vein X-Ray Chest (75827) | $2,448.60 | $4,081 | 1.2× |
| Venogram Sinus/Jugular (75860) | $4,326.60 | $7,211 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $5,152.80 | $8,588 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $1,588.20 | $2,647 | 0.8× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,121.40–$1,204.80 | $1,869–$2,008 | varies |
| Venography Renal Unilateral (75831) | $1,810.80 | $3,018 | 0.5× |
| Venous sampling by catheter (75893) | $12,751.80 | $21,253 | 1.8× |
| Wrist 2 views (73100) | $148.80 | $248 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $447.60 | $746 | 4.1× |
| X-ray antegrade pyelogram tube (74425) | $837 | $1,395 | 1.9× |
| X-Ray Aorta Leg Arteries (75630) | $3,319.20 | $5,532 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$229.80–$234.60 | $383–$391 | varies |
| X-Ray Exam Breast Specimen (76098) | $418.20 | $697 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $201 | $335 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $348 | $580 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $523.80 | $873 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $294.60 | $491 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $493.20 | $822 | 4.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $574.20 | $957 | 4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$706.20–$718.20 | $1,177–$1,197 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $487.20 | $812 | 3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $487.20 | $812 | 3.7× |
| X-Ray Exam L-S Spine Bending (72114) | $658.80 | $1,098 | 5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $296.40 | $494 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $591.60 | $986 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 12 matching MRF lines |
$391.20–$399 | $652–$665 | varies |
| X-ray eye for foreign body (70030) | $134.40 | $224 | 1.2× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$233.40–$236.40 | $389–$394 | varies |
| X-ray IV pyelogram (ivp) (74400) | $928.20 | $1,547 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $424.80 | $708 | 3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $139.80 | $233 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $491.40 | $819 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $350.40 | $584 | 3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $534.60 | $891 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $387 | $645 | 3.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $792.60 | $1,321 | 6.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $375 | $625 | 3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $416.40 | $694 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $594.60 | $991 | 4.6× |
| X-ray thoracic spine 4 vw (72074) | $508.80 | $848 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $940.80 | $1,568 | 2.2× |
| X-Rays Bone Length Studies (77073) | $28.80 | $48 | 0.2× |
| X-Rays Bone Survey Complete (77075) | $1,198.20 | $1,997 | 9.2× |
| Xr c-spine 4 or 5 views (72050) | $383.40 | $639 | 2.9× |
| Xr facial bones less than 3 views (70140) | $351 | $585 | 3.2× |
| Xr orbits complete 4 views (70200) | $440.40 | $734 | 3.4× |
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.