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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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $687 $687 7.1×
Acute gastrointestinal blood loss imaging (78278) $1,181 $1,181 3.2×
Angiography pulmonary bilateral slctv rs&i (75743) $5,029 $5,029 1.7×
Ankle 2 views (73600) $760 $760 9.5×
Arthrogram elbow (73085) $833 $833 2.6×
Arthrogram hip (73525) $1,042 $1,042 3.2×
Arthrogram shoulder (73040) $2,523 $2,523 7.9×
Arthrogram wrist (73115) $743 $743 2.3×
Arthrography knee lt (73580) $1,083 $1,083 3.4×
Bone &/Joint Imaging Limited Area (78300) $1,325 $1,325 3.6×
Bone &/Joint Imaging Multiple Areas (78305) $1,205 $1,205 3.3×
Bone &/joint imaging whole body (78306) $1,205 $1,205 3.3×
Bone age studies (77072) $760 $760 7.9×
Bone Imaging 3 Phase (78315) $1,325 $1,325 3.6×
Bone survey complete (77075) $1,197 $1,197 12.4×
Brain Imaging Pet Metabolic Evaluation (78608) $5,124 $5,124 3.9×
Cervical spine 2 or 3 views (72040) $760 $760 9.5×
Chest 1 view (71045) $434 $434 5.4×
Chest 3 views (71047) $505 $505 6.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $736 $736 4.6×
Clavicle complete (73000) $434 $434 5.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $550 $550 5.7×
CT abdomen and pelvis without and with contrast (74178) $5,158.50 $5,158.50 16.1×
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 angiography upper extremity lt (73206) $1,673 $1,673 10.4×
CT c-spine w/o contrast (72125) $1,325 $1,325 13.8×
CT cervical spine w&w/o contrast (72127) $4,205 $4,205 26.1×
CT cervical spine with contrast (72126) $2,667 $2,667 8.3×
CT chest w/wo contrast (71270) $2,650 $2,650 16.4×
CT chest with contrast (71260) $2,288 $2,288 14.2×
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 limited/localized follow up study (76380) $1,309 $1,309 16.4×
CT lower ext w/o (73700) $1,325 $1,325 13.8×
CT lower extremity w wo contrast (73702) $2,201 $2,201 13.6×
CT lower extremity with contrast (73701) $2,013 $2,013 12.5×
CT lumbar spine w & w/o contrast (72133) $4,205 $4,205 26.1×
CT lumbar spine w/o contrast (72131) $1,325 $1,325 13.8×
CT lumbar spine with contrast (72132) $2,288 $2,288 7.1×
CT maxillofacial w contrast (70487) $2,529 $2,529 15.7×
CT maxillofacial w/o contrast (70486) $1,325 $1,325 13.8×
CT maxillofacial w/wo contrast (70488) $2,650 $2,650 16.4×
CT neck soft tissue w contrast (70491) $2,288 $2,288 14.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) $2,650 $2,650 16.4×
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 contrast (72130) $4,190 $4,190 26.0×
CT thorax w/o contrast (71250) $1,156 $1,156 12.0×
CT upper extremity w/o & w/contrast material (73202) $2,959 $2,959 18.3×
CT upper extremity w/o contrast rt (73200) $1,325 $1,325 13.8×
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 abdomen pelvis (74174) $3,451 $3,451 10.8×
CTA chest (71275) $1,785 $1,785 11.1×
Cta Head (70496) $4,075 $4,075 25.3×
Cta Neck (70498) $2,873 $2,873 17.8×
Cta Pelvis (72191) $1,673 $1,673 10.4×
Cystography minimum 3 views rs&i (74430) $795 $795 2.5×
Dxa bone density study 1/> sites axial skel (77080) $687 $687 7.1×
Echoencephalography real time imaging (76506) $683 $683 7.1×
Esophagus (74220) $808 $808 5.0×
Fetal biophysical profile non-stress testing (76818) $793.50 $793.50 8.3×
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×
Hand 2 views (73120) $760 $760 7.9×
Hand 3 views (73130) $471 $471 5.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,446 $1,446 2.9×
Ht muscle image spect sing (78451) $4,593 $4,593 3.9×
Humerus Min 2 Views Left (73060) $434 $434 5.4×
Hysterosalpingogram (74740) $2,409 $2,409 11.0×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $772 $772 8.0×
Kidney img morphology vascular flow 1 w/rx (78708) $1,943 $1,943 3.9×
Kidney Img Morphology Vascular Flow Multiple (78709) $2,540 $2,540 5.1×
Knee 3 views (73562) $760 $760 9.5×
Lymphoscintigraphy (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 Diverticulum (78290) $997 $997 2.7×
MRA head w & w/o contrast (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 & w/contrast material (74183) $4,979 $4,979 15.5×
MRI abdomen w/o contrast (74181) $2,895 $2,895 13.2×
MRI any jnt lwr ext with con lt (73722) $4,190 $4,190 5.8×
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 c-spine with contrast (72142) $3,247 $3,247 10.1×
MRI cervical spine w/o contrast (72141) $2,895 $2,895 13.2×
MRI chest w/o & w/contrast material (71552) $4,515 $4,515 14.1×
MRI chest w/o contrast (71550) $1,610 $1,610 7.3×
MRI chest with contrast (71551) $2,703 $2,703 3.7×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $2,646 $2,646 8.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,646 $2,646 8.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,663 $2,663 12.1×
MRI orbit face &/neck w/o contrast (70540) $2,594 $2,594 11.8×
MRI orbit/face/neck w&w/o cont (70543) $4,515 $4,515 14.1×
MRI orbit/face/neck w/contrast (70542) $3,164 $3,164 9.9×
MRI pelvis w contrast (72196) $2,431 $2,431 7.6×
MRI pelvis w/o & w/contrast material (72197) $4,515 $4,515 14.1×
MRI pelvis w/o contrast (72195) $2,895 $2,895 13.2×
MRI scan of arm joint before and after contrast (73223) $3,300 $3,300 10.3×
MRI scan of leg joint before and after contrast (73723) $3,977 $3,977 12.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $4,979 $4,979 15.5×
MRI spinal canal lumbar w/contrast material (72149) $3,937 $3,937 12.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,515 $4,515 14.1×
MRI spinal canal thoracic w/contrast matrl (72147) $2,646 $2,646 8.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,404 $3,404 10.6×
MRI thoracic spine w/o contrast (72146) $2,663 $2,663 12.1×
MRI upper ext joint w/o contrast (73221) $2,895 $2,895 13.2×
MRI upper extrem other than jt w/o & w/contras (73220) $4,534 $4,534 14.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,073 $2,073 9.4×
Myelogram Cervical (72240) $1,777 $1,777 2.5×
Myelogram Lumbar (72265) $1,868 $1,868 2.6×
Myelogram thoracic (72255) $1,479 $1,479 2.1×
Myocardial Spect Multiple Studies (78452) $4,593 $4,593 3.9×
Neck soft tissue (70360) $434 $434 5.4×
Nm gastric emptying study (78264) $1,181 $1,181 3.2×
Nuclear medicine study of heart muscle at rest with stress (78453) $4,593 $4,593 3.9×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $994 $994 10.3×
Osseous survey limited (77074) $687 $687 7.1×
Parathyroid imaging (78070) $834 $834 2.3×
Pelvis 1 or 2 views (72170) $687 $687 7.1×
PET image w/CT, skull-thigh (78815) $4,696 $4,696 3.6×
PET imaging for CT attenuation whole body (78816) $3,048 $3,048 2.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,979 $4,979 15.5×
Pulmonary Perfusion Imaging Particulate (78580) $759 $759 2.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,566 $1,566 3.1×
Radex abscess/fistula/sinus tract rs&i (76080) $2,409 $2,409 4.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $766 $766 8.0×
Radex hips bilateral with pelvis 2 views (73521) $729 $729 7.6×
Radex mastoids compl minimum 3 views pr side (70130) $573 $573 6.0×
Radiolog exam mandible compl minimum 4 views (70110) $760 $760 7.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $434 $434 5.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $434 $434 5.4×
Radiologic exam colon single contrast study (74270) $823 $823 5.1×
Radiologic exam upr gi trc double contrast study (74246) $1,111.50 $1,111.50 6.9×
Radiologic exam upr gi trc single contrast study (74240) $1,097 $1,097 6.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $434 $434 5.4×
Radiologic Examination Salivary Gland Calculus (70380) $303 $303 3.8×
Radiological examination surgical specimen (76098) $2,650 $2,650 5.3×
Ribs bilateral 3 views (71110) $687 $687 7.1×
Rp loclzj tum spect 1 area single day imaging (78803) $4,593 $4,593 9.2×
Scanogram (77073) $364 $364 3.8×
Scapula complete (73010) $460.50 $460.50 4.8×
Screening digital breast tomosynthesis (77063) $82 $82 3.5×
Sella turcica (70240) $235 $235 2.9×
Sialogram (70390) $1,084 $1,084 4.9×
Small bowel series (74250) $808 $808 5.0×
Spine thoracic 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×
Tmj unilateral (70328) $266 $266 3.3×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,074 $1,074 2.9×
Ultrasound elastography first target lesion (76982) $693 $693 7.2×
Ultrasound, abdomen limited (76705) $737 $737 7.7×
Upper Extremity Infant (73092) $535 $535 5.6×
Urethrocystography voiding (74455) $1,099 $1,099 5.0×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,280 $1,280 7.9×
Us abdl aorta screen aaa (76706) $772 $772 8.0×
Us breast unilateral complete (76641) $766 $766 8.0×
Us breast unilateral limited (76642) $1,104.50 $1,104.50 13.8×
Us chest (76604) $666 $666 6.9×
Us compl joint r-t w/image documentation (76881) $1,073 $1,073 11.2×
Us elastography parenchyma (76981) $693 $693 7.2×
Us kidney transplant (76776) $766 $766 8.0×
Us ob detailed single fetus (76811) $1,094 $1,094 5.0×
Us ob transvaginal (76817) $977 $977 10.2×
Us pelvic non ob complete (76856) $977 $977 10.2×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $664 $664 6.9×
Us pregnancy ltd (76815) $1,073 $1,073 11.2×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $1,073 $1,073 11.2×
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 soft tissue head/neck (76536) $977 $977 10.2×
Us transrectal (76872) $825 $825 8.6×
Us xtr non-vasc lmtd (76882) $664 $664 6.9×
Wrist 2 views (73100) $471 $471 5.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $687 $687 7.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $760 $760 9.5×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $760 $760 9.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,048 $1,048 6.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $471 $471 5.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $471 $471 5.9×
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 3-4 Views (73522) $760 $760 7.9×
X-ray eye for foreign body (70030) $262 $262 3.3×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $760 $760 7.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $471 $471 5.9×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $471 $471 5.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $471 $471 5.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $386 $386 4.8×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $496 $496 5.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $471 $471 5.9×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $760 $760 9.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $760 $760 7.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $925 $925 9.6×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $434 $434 5.4×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $471 $471 5.9×
X-ray of voice box or throat (70370) $384 $384 4.8×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $687 $687 7.1×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $563 $563 5.9×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $1,238 $1,238 3.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $471 $471 5.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $687 $687 7.1×
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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $760 $760 9.5×
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 Skull <4 Vw - Xr Skull 1-3 Views (70250) $687 $687 7.1×
X-Ray Spine One View - Xr Spine (72020) $434 $434 5.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $303 $303 3.8×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $434 $434 5.4×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $760 $760 7.9×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $471 $471 5.9×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $471 $471 5.9×
Xr arthrogram ankle (73615) $743 $743 2.3×
Xr c-spine 6 or more views (72052) $687 $687 7.1×
Xr chest 4+ views (71048) $436 $436 4.5×
Xr finger(s) 2+ views (73140) $471 $471 5.9×
Xr shoulder 1 view (73020) $471 $471 5.9×
Xr spine cervical 4 or 5 views (72050) $760 $760 7.9×
Xr tibia/fibula 2 views (73590) $471 $471 5.9×
Xr tmj bilateral (70330) $471 $471 5.9×
Xray knee 1 or 2 views rt (73560) $471 $471 5.9×