Imaging prices at Amberwell Hiawatha

Hiawatha, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $434 $434 5.4×
Abdomen 2 views (74019) $687 $687 7.1×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,181 $1,181 3.2×
Angio pulmonary bilat (75743) $5,029 $5,029 1.7×
Ankle 2 views (73600) $760 $760 9.5×
Arthrogram ankle (73615) $743 $743 2.3×
Arthrogram hip (73525) $1,042 $1,042 3.2×
Arthrogram Wrist (73115) $743 $743 2.3×
Bone age studies (77072) $760 $760 7.9×
Bone Imaging 3 Phase (78315) $1,325 $1,325 3.6×
Bone Imaging Limited Area (78300) $1,325 $1,325 3.6×
Bone Imaging Multiple Areas (78305) $1,205 $1,205 3.3×
Bone Imaging Whole Body (78306) $1,205 $1,205 3.3×
Brain Imaging Pet Metabolic Evaluation (78608) $5,124 $5,124 3.9×
Cat Scan Follow-Up Study (76380) $1,309 $1,309 16.4×
Chest 1 view (71045) $434 $434 5.4×
Chest 2 views (71046) $434 $434 5.4×
Chest 3 views (71047) $505 $505 6.3×
Chest 4 or more views (71048) $436 $436 4.5×
Clavicle complete (73000) $434 $434 5.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $550 $550 5.7×
Contrast X-Ray Bladder (74430) $795 $795 2.5×
Contrast X-Ray Of Elbow (73085) $833 $833 2.6×
Contrast X-Ray Of Knee Joint (73580)
range across 2 matching MRF lines		 $1,031–$1,135 $1,031–$1,135 varies
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines		 $3,613–$6,704 $3,613–$6,704 varies
CT abdomen and pelvis without contrast (74176) $2,288 $2,288 10.4×
CT abdomen w contrast (74160) $2,288 $2,288 14.2×
CT abdomen w wo contrast (74170) $2,890 $2,890 17.9×
CT abdomen w/o contrast (74150) $1,156 $1,156 12.0×
CT Angio Abdomen and Pelvis (74174) $3,451 $3,451 10.8×
CT Angio Chest (71275) $1,785 $1,785 11.1×
CT Angio Head (70496) $4,075 $4,075 25.3×
CT Angio Neck (70498)
range across 2 matching MRF lines		 $1,671–$4,075 $1,671–$4,075 varies
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,673 $1,673 10.4×
CT cervical spine w/ contrast (72126) $2,667 $2,667 8.3×
CT cervical spine w/o contrast (72125) $1,325 $1,325 13.8×
CT cervical spine w/wo cont (72127) $4,205 $4,205 26.1×
CT chest w contrast (71260) $2,288 $2,288 14.2×
CT chest w/wo contrast (71270) $2,650 $2,650 16.4×
CT head/brain with contrast (70460) $2,288 $2,288 14.2×
CT head/brain without and with contrast (70470) $2,650 $2,650 16.4×
CT heart no contrast quant eval coronry calcium (75571) $50 $50 0.6×
CT iac w contrast (70481) $2,288 $2,288 14.2×
CT l-spine w&w/o contrast (72133) $4,205 $4,205 26.1×
CT lower ext w/o (73700) $1,325 $1,325 13.8×
CT lower extremity w/contrast material (73701) $2,013 $2,013 12.5×
CT lumbar spine w contrast (72132) $2,288 $2,288 7.1×
CT lumbar spine w/o contrast (72131) $1,325 $1,325 13.8×
CT maxillofacial w contrast (70487) $2,529 $2,529 15.7×
CT maxillofacial wo contrast (70486) $1,325 $1,325 13.8×
CT neck tissue combo (70492) $2,650 $2,650 16.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,650 $2,650 16.4×
CT orbits w/o contrast (70480) $1,156 $1,156 12.0×
CT pelvis w&w/o contrast (72194) $3,890 $3,890 24.1×
CT pelvis w/o contrast (72192) $1,156 $1,156 12.0×
CT scan of leg combo (73702) $2,201 $2,201 13.6×
CT scans face/jaw combo (70488) $2,650 $2,650 16.4×
CT soft tissue neck w contrast (70491) $2,288 $2,288 14.2×
CT soft tissue neck w/o contrast (70490) $1,325 $1,325 13.8×
CT thoracic spine w contrast (72129) $2,288 $2,288 14.2×
CT thoracic spine w/o contrast (72128) $1,325 $1,325 13.8×
CT thoracic spine w/wo cont (72130) $4,190 $4,190 26.0×
CT thorax w/o contrast (71250) $1,156 $1,156 12.0×
CT upper ext wo (73200) $1,325 $1,325 13.8×
CT upper extremity w/o & w/contrast material (73202) $2,959 $2,959 18.3×
CT upper extremity with contrast (73201) $2,569 $2,569 8.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,784 $3,784 23.5×
Cta Abdomen (74175) $3,925 $3,925 24.3×
CTA pelvis (72191) $1,673 $1,673 10.4×
Dxa Bone Density Axial (77080) $687 $687 7.1×
Esophagram (74220) $808 $808 5.0×
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines		 $514–$1,073 $514–$1,073 varies
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $977 $977 10.2×
Fluoroscopy up to 1 hr (76000) $606 $606 2.8×
Foot 2 views (73620) $471 $471 5.9×
Forearm 2 views (73090) $471 $471 5.9×
Gastric emptying imaging study (78264) $1,181 $1,181 3.2×
Hand 2 views (73120) $760 $760 7.9×
Hepatobil Syst Image W/Drug (78227) $1,446 $1,446 2.9×
Ht Muscle Image Spect Sing (78451) $4,593 $4,593 3.9×
Hysterosalpingogram (74740) $2,409 $2,409 11.0×
Joint Survey Single View (77077) $772 $772 8.0×
K Flow/Funct Image Multiple (78709) $2,540 $2,540 5.1×
K Flow/Funct Image W/Drug (78708) $1,943 $1,943 3.9×
Knee 3 Views (73562) $760 $760 9.5×
Lung Ventilat&Perfus Imaging (78582) $1,566 $1,566 3.1×
Lymph System Imaging (78195) $1,827 $1,827 3.7×
Mammary ductogram or galactogram multiple (77054) $555 $555 2.5×
Mammary ductogram or galactogram single (77053) $264 $264 1.2×
Meckels Divert Exam (78290) $997 $997 2.7×
Mra Head W/O & W/Contrast Material (70546) $1,977 $1,977 6.2×
MRA head w/o contrast (70544) $2,663 $2,663 12.1×
MRA head with contrast (70545) $1,733 $1,733 5.4×
MRA neck w contrast (70548) $2,171 $2,171 6.8×
Mra Neck W/O &W/Contrast Material (70549) $2,439 $2,439 7.6×
MRA neck w/o contrast (70547) $1,977 $1,977 9.0×
MRI abdomen w contrast (74182) $2,431 $2,431 7.6×
MRI abdomen w/o contrast (74181) $2,895 $2,895 13.2×
MRI any jt lower extrem w/contrast material (73722) $4,190 $4,190 5.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,977 $3,977 12.4×
MRI any jt upper extremity w/contrast matrl (73222) $4,400 $4,400 6.1×
MRI bone marrow blood supply (77084) $1,890 $1,890 8.6×
MRI cervical spine w contrast (72142) $3,247 $3,247 10.1×
MRI cervical spine w/o cont (72141) $2,895 $2,895 13.2×
MRI chest w/o contrast (71550) $1,610 $1,610 7.3×
MRI chest with contrast (71551) $2,703 $2,703 3.7×
MRI chest wo w contrast (71552) $4,515 $4,515 14.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,646 $2,646 8.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,979 $4,979 15.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,663 $2,663 12.1×
MRI lumbar spine w contrast (72149) $3,937 $3,937 12.3×
Mri Neck Spine W/O & W/Dye (72156) $4,979 $4,979 15.5×
MRI orbit face &/neck w/o contrast (70540) $2,594 $2,594 11.8×
MRI orbit face neck w contrast (70542) $3,164 $3,164 9.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,515 $4,515 14.1×
MRI pelvis w contrast (72196) $2,431 $2,431 7.6×
MRI pelvis w/o & w contrast (72197) $4,515 $4,515 14.1×
MRI pelvis w/o contrast (72195) $2,895 $2,895 13.2×
MRI thoracic spine w/o contrast (72146) $2,663 $2,663 12.1×
MRI upper extremity oth than jt w/contr matrl (73219) $2,646 $2,646 8.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,073 $2,073 9.4×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 2 matching MRF lines		 $4,089–$4,979 $4,089–$4,979 varies
MRI, abdomen, combo (74183) $4,979 $4,979 15.5×
MRI, dorsal spine combo (72157) $3,404 $3,404 10.6×
MRI, dorsal spine contrast (72147) $2,646 $2,646 8.2×
MRI, joint upper extrem (73221) $2,895 $2,895 13.2×
MRI, joint upper extrem combo (73223) $3,300 $3,300 10.3×
MRI, lumbar spine combo (72158) $4,515 $4,515 14.1×
Myelogram cervical (72240) $1,777 $1,777 2.5×
Myelogram Lumbar (72265) $1,868 $1,868 2.6×
Myelography thoracic (72255) $1,479 $1,479 2.1×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $4,593 $4,593 3.9×
Myocardial Spect Multiple Studies (78452) $4,593 $4,593 3.9×
Neck soft tissue (70360) $434 $434 5.4×
Parathyroid Planar Imaging (78070) $834 $834 2.3×
Pelvis 1 or 2 views (72170) $687 $687 7.1×
PET image w/CT, full body (78816) $3,048 $3,048 2.3×
PET imaging CT attenuation skull base mid-thigh (78815) $4,696 $4,696 3.6×
Pulmonary Perfusion Imaging Particulate (78580) $759 $759 2.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $687 $687 7.1×
Radex abscess/fistula/sinus tract rs&i (76080) $2,409 $2,409 4.8×
Radex Ankle Complete Minimum 3 Views (73610) $760 $760 9.5×
Radex Calcaneus Minimum 2 Views (73650) $471 $471 5.9×
Radex elbow complete minimum 3 views (73080) $471 $471 5.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $760 $760 7.9×
Radex fingr minimum 2 views (73140) $471 $471 5.9×
Radex foot complete minimum 3 views (73630) $471 $471 5.9×
Radex Hand Minimum 3 Views (73130) $471 $471 5.9×
Radex lower extremity infant minimum 2 views (73592) $760 $760 9.5×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $573 $573 6.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $434 $434 5.4×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $384 $384 4.8×
Radex Ribs Unilateral 2 Views (71100) $471 $471 5.9×
Radex shoulder complete minimum 2 views (73030) $760 $760 9.5×
Radex Spine 1 View Specify Level (72020) $434 $434 5.4×
Radex Sternum Minimum 2 Views (71120) $434 $434 5.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $471 $471 5.9×
Radex Toe Minimum 2 Views (73660) $471 $471 5.9×
Radex upper extremity infant minimum 2 views (73092)
range across 2 matching MRF lines		 $310–$760 $310–$760 varies
Radex Wrist Complete Minimum 3 Views (73110) $471 $471 5.9×
Radiolog exam mandible compl minimum 4 views (70110) $760 $760 7.9×
Radiologic exam colon double contrast study (74280) $1,048 $1,048 6.5×
Radiologic exam colon single contrast study (74270) $823 $823 5.1×
Radiologic exam knee complete 4/more views (73564) $496 $496 5.2×
Radiologic exam pelvis compl minimum 3 views (72190) $563 $563 5.9×
Radiologic Exam Small Int Single Contrast Study (74250) $808 $808 5.0×
Radiologic exam swallow function contrast study (74230) $736 $736 4.6×
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines		 $967–$1,256 $967–$1,256 varies
Radiologic examination femur minimum 2 views (73552) $434 $434 5.4×
Radiologic examination knee 1/2 views (73560) $471 $471 5.9×
Radiologic Examination Osseous Survey Limited (77074) $687 $687 7.1×
Radiologic Examination Salivary Gland Calculus (70380) $303 $303 3.8×
Radiologic examination tibia & fibula 2 views (73590) $471 $471 5.9×
Ribs bilateral 3 views (71110) $687 $687 7.1×
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines		 $823–$1,325 $823–$1,325 varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,593 $4,593 9.2×
Scapula (73010)
range across 2 matching MRF lines		 $450–$471 $450–$471 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines		 $55–$109 $55–$109 varies
Sella turcica (70240) $235 $235 2.9×
Shoulder 1 view (73020) $471 $471 5.9×
Shoulder Arthrography (73040) $2,523 $2,523 7.9×
Sialogram (70390) $1,084 $1,084 4.9×
Skull less than 4 views (70250) $687 $687 7.1×
Sternoclavicular joints (71130) $303 $303 3.8×
Thoracic spine 2 views (72070) $760 $760 7.9×
Thoracic spine 3 views (72072) $760 $760 7.9×
Thoracolumbar 2 views (72080) $434 $434 5.4×
Thyroid Imaging With Vascular Flow (78013) $410 $410 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,024 $1,024 2.8×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $736–$1,473 $736–$1,473 varies
Ultrasound elastography first target lesion (76982) $693 $693 7.2×
Ultrasound Elastography Parenchyma (76981) $693 $693 7.2×
Ultrasound Exam Aaa Screen (76706) $772 $772 8.0×
Ultrasound, abdomen limited (76705) $737 $737 7.7×
Upper gi w/o kub (74240) $1,097 $1,097 6.8×
Urethrocystogram voiding (74455) $1,099 $1,099 5.0×
Us breast unilateral complete (76641) $766 $766 8.0×
Us chest (76604) $666 $666 6.9×
Us complete joint (76881) $1,073 $1,073 11.2×
Us exam, pelvic, limited (76857) $664 $664 6.9×
Us head (76506) $683 $683 7.1×
Us kidney transplant (76776) $766 $766 8.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $664 $664 6.9×
Us ob detailed single fetus (76811) $1,094 $1,094 5.0×
Us ob limited 1 or more fetuses (76815) $1,073 $1,073 11.2×
Us ob transvaginal (76817) $977 $977 10.2×
Us pelvic non ob complete (76856) $977 $977 10.2×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,073 $1,073 11.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $994 $994 10.3×
Us retroperitoneal complete (76770) $737 $737 7.7×
Us retroperitoneal limited (76775) $737 $737 7.7×
Us scrotum and contents (76870) $1,073 $1,073 11.2×
Us thyroid (76536) $977 $977 10.2×
Us transrectal (76872) $825 $825 8.6×
Wrist 2 views (73100) $471 $471 5.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $760 $760 9.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $471 $471 5.9×
X-Ray Exam Breast Specimen (76098) $2,650 $2,650 5.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $766 $766 8.0×
X-Ray Exam Hip Uni 1 View (73501) $471 $471 5.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $434 $434 5.4×
X-Ray Exam Hips Bi 2 Views (73521) $729 $729 7.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $760 $760 7.9×
X-Ray Exam L-S Spine Bending (72114) $925 $925 9.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $760 $760 9.5×
X-Ray Exam Neck Spine 6/>Vws (72052) $687 $687 7.1×
X-Ray Exam Unilat Ribs/Chest (71101) $687 $687 7.1×
X-ray eye for foreign body (70030) $262 $262 3.3×
X-ray humerus (73060) $434 $434 5.4×
X-ray IV pyelogram (ivp) (74400) $1,280 $1,280 7.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $386 $386 4.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $471 $471 5.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $760 $760 7.9×
X-ray nose-rectum child f.b. (76010) $471 $471 5.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $687 $687 7.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $687 $687 7.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $471 $471 5.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $687 $687 8.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $687 $687 7.1×
X-Ray Tmj Unilat (70328) $266 $266 3.3×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,238 $1,238 3.9×
X-Rays Bone Length Studies (77073) $364 $364 3.8×
X-Rays Bone Survey Complete (77075) $1,197 $1,197 12.4×
Xr c-spine 4 or 5 views (72050) $760 $760 7.9×
Xr facial bones less than 3 views (70140) $471 $471 5.9×
Xr orbits complete 4 views (70200) $687 $687 7.1×

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.