Imaging prices at Alton Memorial Hospital

Alton, IL · every code in this section with a posted price and a Medicare benchmark.

274 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) $8,195.40 $13,659 5.5×
Abdomen 1 View (74018) $159 $265 1.7×
Abdomen 2 views (74019) $208.20 $347 1.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $657 $1,095 1.5×
Angiography extremity bilateral rs&i (75716) $3,184.80 $5,308 0.9×
Angiography extremity unilateral rs&i (75710) $3,006 $5,010 0.9×
Ankle 2 views (73600) $148.20 $247 1.6×
Aortography thoracic serialography rs&i (75605) $5,200.20 $8,667 0.9×
Arthrogram Wrist (73115) $637.80 $1,063 1.7×
Basic radiation dosimetry calculation (77300) $995.40 $1,659 6.9×
Bone age studies (77072) $192 $320 1.7×
Bone Imaging 3 Phase (78315) $1,174.80 $1,958 2.7×
Bone Imaging Limited Area (78300) $480.60 $801 1.1×
Bone Imaging Whole Body (78306) $1,138.20 $1,897 2.7×
Bone survey infant (77076) $197.40 $329 1.8×
Brain Image W/Flow < 4 Views (78601) $582.60 $971 1.4×
Cerebrospinal Fluid Scan (78630) $666.60 $1,111 1.1×
Chest 1 view (71045) $261 $435 2.8×
Chest 2 views (71046) $274.20 $457 2.9×
Chest 3 views (71047) $288 $480 3.1×
Chest 4 or more views (71048) $302.40 $504 2.7×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $212.40 $354 1.9×
Clavicle complete (73000) $151.20 $252 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,148.40 $1,914 10.3×
Continuing medical physics consltj pr wk (77336) $966.60 $1,611 6.7×
Contrast Exam Abdominl Aorta (75625) $3,006 $5,010 0.9×
Contrast X-Ray Bladder (74430) $410.40 $684 1.1×
CT abdomen and pelvis without and with contrast (74178) $2,981.40 $4,969 8.0×
CT abdomen and pelvis without contrast (74176) $1,744.20 $2,907 6.8×
CT abdomen w contrast (74160) $885.60 $1,476 4.7×
CT abdomen w wo contrast (74170) $1,063.20 $1,772 5.7×
CT abdomen w/o contrast (74150) $811.80 $1,353 7.2×
CT Angio Abdomen and Pelvis (74174) $3,279.60 $5,466 8.8×
CT Angio Chest (71275) $1,071 $1,785 5.7×
CT Angio Head (70496) $1,341 $2,235 7.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,419.60 $2,366 7.6×
CT Angio Neck (70498) $1,069.80 $1,783 5.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,174.80 $1,958 6.3×
CT cervical spine w/ contrast (72126) $1,029.60 $1,716 2.8×
CT cervical spine w/o contrast (72125) $907.20 $1,512 8.1×
CT cervical spine w/wo cont (72127) $1,765.80 $2,943 9.4×
CT chest w contrast (71260) $925.80 $1,543 4.9×
CT chest w/wo contrast (71270) $973.80 $1,623 5.2×
CT head/brain with contrast (70460) $1,023 $1,705 5.4×
CT head/brain without and with contrast (70470) $1,219.20 $2,032 6.5×
CT iac w contrast (70481) $881.40 $1,469 4.7×
CT l-spine w&w/o contrast (72133) $1,122 $1,870 6.0×
CT lower ext w/o (73700)
range across 2 matching MRF lines		 $905.40–$1,810.80 $1,509–$3,018 varies
CT lower extremity w/contrast material (73701) $1,048.80 $1,748 5.6×
CT lumbar spine w contrast (72132) $912 $1,520 2.4×
CT lumbar spine w/o contrast (72131) $691.20 $1,152 6.2×
CT maxillofacial w contrast (70487) $915.60 $1,526 4.9×
CT maxillofacial wo contrast (70486) $792.60 $1,321 7.1×
CT neck tissue combo (70492) $972.60 $1,621 5.2×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,107 $1,845 5.9×
CT orbits w/o contrast (70480) $723.60 $1,206 6.5×
CT pelvis w&w/o contrast (72194) $1,494 $2,490 7.9×
CT pelvis w/o contrast (72192) $705 $1,175 6.3×
CT scan of leg combo (73702) $1,290.60 $2,151 6.9×
CT scans face/jaw combo (70488) $1,144.80 $1,908 6.1×
CT soft tissue neck w contrast (70491) $857.40 $1,429 4.6×
CT soft tissue neck w/o contrast (70490) $757.80 $1,263 6.8×
CT thoracic spine w contrast (72129) $923.40 $1,539 4.9×
CT thoracic spine w/o contrast (72128) $754.80 $1,258 6.7×
CT thoracic spine w/wo cont (72130) $1,423.20 $2,372 7.6×
CT thorax w/o contrast (71250) $708.60 $1,181 6.3×
CT upper ext wo (73200) $701.40 $1,169 6.3×
CT upper extremity w/o & w/contrast material (73202) $1,068 $1,780 5.7×
CT upper extremity with contrast (73201) $912.60 $1,521 2.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,112.40 $1,854 5.9×
Cta Abdomen (74175) $1,169.40 $1,949 6.2×
CTA pelvis (72191) $1,643.40 $2,739 8.7×
Dxa Bone Density Axial (77080) $229.20 $382 2.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $130.20 $217 1.4×
Esophagram (74220) $252 $420 1.3×
Fetal Biophys Profile W/Nst (76818) $523.80 $873 4.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $309.60 $516 2.8×
Fluoroscopy up to 1 hr (76000) $299.40 $499 1.2×
Foot 2 views (73620) $155.40 $259 1.7×
Forearm 2 views (73090) $162 $270 1.7×
Gastric emptying imaging study (78264) $778.80 $1,298 1.8×
Gated Heart Planar Single (78472) $1,266 $2,110 3.0×
Gated Heart, Multiple (78473) $1,458.60 $2,431 3.4×
Hand 2 views (73120) $174 $290 1.6×
Hepatobil Syst Image W/Drug (78227) $880.20 $1,467 1.5×
Hepatobiliary System Imaging (78226) $760.20 $1,267 1.8×
Ht Muscle Image Spect Sing (78451) $1,500 $2,500 1.1×
Hysterosalpingogram (74740) $525.60 $876 2.1×
K Flow/Funct Image W/Drug (78708) $1,060.20 $1,767 1.8×
K Flow/Funct Image W/O Drug (78707) $853.80 $1,423 1.5×
Knee 3 Views (73562) $184.20 $307 2.0×
Liver & Spleen Imaging Static Only (78215) $828.60 $1,381 1.9×
Lung Perf&Ventilat Diferentl (78598) $945.60 $1,576 1.6×
Lung perfusion differential (78597) $724.20 $1,207 1.7×
Lung Ventilat&Perfus Imaging (78582) $756.60 $1,261 1.3×
Lymph System Imaging (78195) $650.40 $1,084 1.1×
Magnetic Image Jaw Joint (70336) $1,287 $2,145 5.0×
Mammary ductogram or galactogram single (77053) $277.80 $463 1.1×
Meckels Divert Exam (78290) $655.80 $1,093 1.5×
Mlc imrt design & construction per imrt plan (77338) $7,182 $11,970 17.9×
Mra Head W/O & W/Contrast Material (70546) $2,646.60 $4,411 7.1×
MRA head w/o contrast (70544) $1,758 $2,930 6.9×
MRA head with contrast (70545) $1,887 $3,145 5.0×
MRA neck w contrast (70548) $2,139.60 $3,566 5.7×
Mra Neck W/O &W/Contrast Material (70549) $2,452.20 $4,087 6.6×
MRA neck w/o contrast (70547) $989.40 $1,649 3.9×
MRI abdomen w contrast (74182) $1,725 $2,875 4.6×
MRI abdomen w/o contrast (74181) $1,442.40 $2,404 5.6×
MRI any jt lower extrem w/contrast material (73722) $1,748.40 $2,914 2.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,090.40 $3,484 5.6×
MRI any jt upper extremity w/contrast matrl (73222) $3,138 $5,230 3.7×
MRI Breast W/O Contrast Bilateral (77047) $1,132.80 $1,888 4.4×
MRI cervical spine w contrast (72142) $1,696.80 $2,828 4.5×
MRI cervical spine w/o cont (72141) $1,380.60 $2,301 5.4×
MRI chest w/o contrast (71550) $1,578.60 $2,631 6.2×
MRI chest wo w contrast (71552) $2,149.20 $3,582 5.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,471.20 $2,452 3.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,170 $1,950 4.6×
MRI lumbar spine w contrast (72149) $1,470 $2,450 3.9×
Mri Neck Spine W/O & W/Dye (72156) $1,907.40 $3,179 5.1×
MRI orbit face &/neck w/o contrast (70540) $1,254 $2,090 4.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,895.40 $3,159 5.1×
MRI pelvis w/o & w contrast (72197) $1,928.40 $3,214 5.2×
MRI pelvis w/o contrast (72195) $1,446 $2,410 5.7×
MRI thoracic spine w/o contrast (72146) $1,152.60 $1,921 4.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,296 $2,160 5.1×
Mri Uppr Extremity W/O&W/Dye (73220) $1,672.80 $2,788 4.5×
MRI, abdomen, combo (74183) $1,960.80 $3,268 5.2×
MRI, dorsal spine combo (72157) $1,909.80 $3,183 5.1×
MRI, dorsal spine contrast (72147) $1,636.20 $2,727 4.4×
MRI, joint upper extrem (73221) $1,266 $2,110 5.0×
MRI, joint upper extrem combo (73223) $3,790.80 $6,318 10.1×
MRI, lumbar spine combo (72158) $1,668.60 $2,781 4.5×
Myocardial Spect Multiple Studies (78452) $2,061 $3,435 1.5×
Neck soft tissue (70360) $142.20 $237 1.5×
Ntsty modul radthx pln dose-vol histos (77301) $12,150 $20,250 8.2×
Parathyroid Planar Imaging (78070) $512.40 $854 1.2×
Parathyroid planar imaging w/wo subtraction (78071) $655.20 $1,092 1.5×
Pelvis 1 or 2 views (72170) $169.80 $283 1.5×
Peritoneogram Rs&I (74190) $630 $1,050 1.1×
PET image w/CT, full body (78816) $4,395.60 $7,326 2.9×
PET imaging CT attenuation skull base mid-thigh (78815) $3,396.60 $5,661 2.2×
Pulmonary Perfusion Imaging Particulate (78580) $601.80 $1,003 1.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $289.20 $482 2.6×
Radex abscess/fistula/sinus tract rs&i (76080) $750 $1,250 1.3×
Radex Ankle Complete Minimum 3 Views (73610) $166.20 $277 1.8×
Radex Calcaneus Minimum 2 Views (73650) $134.40 $224 1.4×
Radex elbow complete minimum 3 views (73080) $179.40 $299 1.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $327.60 $546 2.9×
Radex fingr minimum 2 views (73140) $141 $235 1.5×
Radex foot complete minimum 3 views (73630) $172.80 $288 1.9×
Radex Hand Minimum 3 Views (73130) $177.60 $296 1.9×
Radex lower extremity infant minimum 2 views (73592) $182.40 $304 2.0×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $175.20 $292 1.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $200.40 $334 2.1×
Radex Ribs Unilateral 2 Views (71100) $256.80 $428 2.8×
Radex shoulder complete minimum 2 views (73030) $199.20 $332 2.1×
Radex Sinuses Paransl < 3 Views (70210) $118.80 $198 1.3×
Radex Spine 1 View Specify Level (72020) $157.20 $262 1.7×
Radex Sternum Minimum 2 Views (71120) $199.20 $332 2.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $238.20 $397 2.6×
Radex Toe Minimum 2 Views (73660) $156 $260 1.7×
Radex upper extremity infant minimum 2 views (73092) $194.40 $324 1.7×
Radex Wrist Complete Minimum 3 Views (73110) $171 $285 1.8×
Radiation treatment delivery level 1 (77402) $2,296.20 $3,827 21.0×
Radiation treatment delivery level 2 (77407) $3,547.80 $5,913 8.6×
Radiation treatment delivery level 3 (77412) $3,961.80 $6,603 6.7×
Radiolog exam mandible compl minimum 4 views (70110) $322.20 $537 2.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $250.20 $417 2.2×
Radiologic exam colon double contrast study (74280) $609.60 $1,016 3.2×
Radiologic exam colon single contrast study (74270) $424.20 $707 2.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $354.60 $591 1.9×
Radiologic exam knee complete 4/more views (73564) $233.40 $389 2.1×
Radiologic exam pelvis compl minimum 3 views (72190) $203.40 $339 1.8×
Radiologic Exam Small Int Single Contrast Study (74250) $293.40 $489 1.6×
Radiologic exam swallow function contrast study (74230) $305.40 $509 1.6×
Radiologic exam upr gi trc double contrast study (74246) $439.20 $732 2.3×
Radiologic examination femur 1 view (73551) $101.40 $169 1.1×
Radiologic examination femur minimum 2 views (73552) $125.40 $209 1.3×
Radiologic examination knee 1/2 views (73560) $157.20 $262 1.7×
Radiologic Examination Osseous Survey Limited (77074) $267.60 $446 2.4×
Radiologic examination tibia & fibula 2 views (73590) $208.80 $348 2.2×
Ribs bilateral 3 views (71110) $258 $430 2.3×
Rp loclzj tum plnr 1 area single day imaging (78800) $862.80 $1,438 2.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,989 $3,315 3.4×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,500 $2,500 2.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,362 $2,270 2.3×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,283 $3,805 1.6×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,692 $2,820 1.2×
Scapula (73010) $192.60 $321 1.7×
Screening Digital Breast Tomosynthesis Bi (77063) $30 $50 1.3×
Shoulder 1 view (73020) $101.40 $169 1.1×
Skull less than 4 views (70250) $172.20 $287 1.5×
Special dosimetry (77331) $239.40 $399 1.7×
Special Physics Consult (77370) $1,416 $2,360 9.8×
Special teletherapy port plan (77321) $724.20 $1,207 1.8×
Special treatment procedure (77470) $2,168.40 $3,614 3.7×
Speech evaluation, complex (70371) $277.80 $463 1.1×
Stereotactic Body Radiation Delivery (77373) $21,266.40 $35,444 11.1×
Sternoclavicular joints (71130) $254.40 $424 2.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,769.40 $2,949 4.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $827.40 $1,379 2.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $3,106.20 $5,177 7.7×
Ther rad simulaj-aided field setting simple (77280) $1,290.60 $2,151 9.0×
Thoracic spine 2 views (72070) $180.60 $301 1.6×
Thoracic spine 3 views (72072) $274.80 $458 2.5×
Thoracolumbar 2 views (72080) $190.80 $318 2.0×
Thyroid Imaging With Vascular Flow (78013) $475.80 $793 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $579.60 $966 1.4×
Tx Devices Design & Construction Complex (77334) $1,853.40 $3,089 4.6×
Tx devices design & construction intermediate (77333) $625.20 $1,042 4.3×
Tx devices design & construction simple (77332) $429.60 $716 3.0×
Ultrasound Breast Limited (76642)
range across 4 matching MRF lines		 $438–$876 $730–$1,460 varies
Ultrasound Exam Aaa Screen (76706) $186 $310 1.7×
Ultrasound, abdomen limited (76705) $447.60 $746 4.0×
Upper gi w/o kub (74240) $384.60 $641 2.0×
Urethrocystogram voiding (74455) $411 $685 1.6×
Urethrocystography retrograde (74450) $384.60 $641 1.5×
Us breast unilateral complete (76641)
range across 4 matching MRF lines		 $454.20–$908.40 $757–$1,514 varies
Us chest (76604) $341.40 $569 3.0×
Us complete joint (76881) $212.40 $354 1.9×
Us exam, pelvic, limited (76857) $273.60 $456 2.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $156.60 $261 1.4×
Us ob detailed single fetus (76811) $402.60 $671 1.6×
Us ob limited 1 or more fetuses (76815) $237.60 $396 2.1×
Us ob transvaginal (76817) $296.40 $494 2.6×
Us pelvic non ob complete (76856) $614.40 $1,024 5.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $474 $790 4.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $329.40 $549 2.9×
Us retroperitoneal complete (76770) $525.60 $876 4.7×
Us retroperitoneal limited (76775) $395.40 $659 3.5×
Us scrotum and contents (76870) $820.20 $1,367 7.3×
Us thyroid (76536) $411 $685 3.7×
Us transrectal (76872) $440.40 $734 3.9×
Venography caval inferior serialography rs&i (75825) $3,006 $5,010 0.9×
Wrist 2 views (73100) $127.20 $212 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 2 matching MRF lines		 $145.80–$194.40 $243–$324 varies
X-Ray Aorta Leg Arteries (75630) $3,262.20 $5,437 1.0×
X-Ray Bend Only L-S Spine (72120) $191.40 $319 1.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $139.20 $232 1.5×
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines		 $178.20–$630 $297–$1,050 varies
X-Ray Exam Entire Spi 1 Vw (72081) $181.80 $303 1.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $192 $320 1.7×
X-Ray Exam Hip Uni 1 View (73501) $90.60 $151 1.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $115.20 $192 1.2×
X-Ray Exam Hip Uni 4/> Views (73503) $207.60 $346 1.9×
X-Ray Exam Hips Bi 2 Views (73521) $197.40 $329 1.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $219 $365 2.0×
X-Ray Exam Hips Bi 5/> Views (73523) $260.40 $434 2.3×
X-Ray Exam L-S Spine Bending (72114) $414 $690 3.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $236.40 $394 2.5×
X-Ray Exam Neck Spine 6/>Vws (72052) $369.60 $616 3.3×
X-Ray Exam Unilat Ribs/Chest (71101)
range across 4 matching MRF lines		 $159–$211.80 $265–$353 varies
X-ray eye for foreign body (70030) $101.40 $169 1.1×
X-ray humerus (73060) $168 $280 1.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $169.80 $283 1.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $178.80 $298 1.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $184.80 $308 1.6×
X-ray nose-rectum child f.b. (76010) $183.60 $306 2.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $313.20 $522 2.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $161.40 $269 1.4×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $123 $205 1.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 4 matching MRF lines		 $122.40–$163.20 $204–$272 varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $320.40 $534 3.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $305.40 $509 2.7×
X-Ray Stress View (77071) $143.40 $239 1.5×
X-ray thoracic spine 4 vw (72074) $313.20 $522 2.8×
X-Ray Tmj Unilat (70328) $127.80 $213 1.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $510 $850 1.4×
X-Rays Bone Length Studies (77073) $129 $215 1.2×
X-Rays Bone Survey Complete (77075) $301.20 $502 2.7×
Xr c-spine 4 or 5 views (72050) $350.40 $584 3.1×
Xr facial bones less than 3 views (70140) $115.80 $193 1.2×
Xr orbits complete 4 views (70200) $339.60 $566 3.0×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.