Imaging prices at Arbuckle Memorial Hospital Authority
Sulphur, OK · every code in this section with a posted price and a Medicare benchmark.
154 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$160–$463 | $200–$579 | varies |
| Abdomen 2 views (74019) | $258 | $322 | 2.6× |
| Ankle 2 views (73600) | $183 | $229 | 2.2× |
| Bone age studies (77072) | $258 | $322 | 2.6× |
| Bone Imaging Whole Body (78306) | $687 | $859 | 1.8× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$204–$258 | $255–$322 | varies |
| Cat Scan Follow-Up Study (76380) | $488 | $610 | 5.8× |
| Chest 1 view (71045) | $143 | $179 | 1.7× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$106–$235 | $133–$294 | varies |
| Cholecystography Oral Contrast (74290) | $121 | $151 | 0.7× |
| Clavicle complete (73000) | $258 | $322 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,932 | $3,665 | 8.7× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$777–$1,961 | $971–$2,451 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$589–$963 | $736–$1,204 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$670–$1,275 | $837–$1,594 | varies |
| CT abdomen w/o contrast (74150) | $346 | $432 | 3.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,484 | $3,105 | 7.4× |
| CT Angio Chest (71275) | $1,284 | $1,605 | 7.6× |
| CT Angio Neck (70498) | $428 | $535 | 2.5× |
| CT cervical spine w/ contrast (72126) | $1,225 | $1,531 | 3.7× |
| CT cervical spine w/o contrast (72125) | $1,106 | $1,382 | 11.0× |
| CT cervical spine w/wo cont (72127) | $1,274 | $1,593 | 7.6× |
| CT chest w contrast (71260) | $1,225 | $1,531 | 7.3× |
| CT chest w/wo contrast (71270) | $1,274 | $1,593 | 7.6× |
| CT head/brain with contrast (70460) | $1,082 | $1,352 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,314 | $1,642 | 7.8× |
| CT iac w contrast (70481) | $1,082 | $1,352 | 6.4× |
| CT l-spine w&w/o contrast (72133) | $1,198 | $1,497 | 7.1× |
| CT lower ext w/o (73700) | $1,106 | $1,382 | 11.0× |
| CT lower extremity w/contrast material (73701) | $1,067 | $1,334 | 6.3× |
| CT lumbar spine w contrast (72132) | $1,008 | $1,260 | 3.0× |
| CT lumbar spine w/o contrast (72131) | $1,106 | $1,382 | 11.0× |
| CT maxillofacial w contrast (70487) | $920 | $1,150 | 5.5× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,106–$1,192 | $1,382–$1,490 | varies |
| CT neck tissue combo (70492) | $1,198 | $1,497 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,290 | $1,612 | 7.6× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$874 | $1,092–$1,093 | 8.7× |
| CT pelvis w&w/o contrast (72194) | $1,466 | $1,832 | 8.7× |
| CT pelvis w/o contrast (72192) | $1,067 | $1,334 | 10.6× |
| CT scan of leg combo (73702) | $1,159 | $1,449 | 6.9× |
| CT scans face/jaw combo (70488) | $1,198 | $1,497 | 7.1× |
| CT soft tissue neck w contrast (70491) | $1,067 | $1,334 | 6.3× |
| CT soft tissue neck w/o contrast (70490) | $1,106 | $1,382 | 11.0× |
| CT thoracic spine w contrast (72129) | $1,225 | $1,531 | 7.3× |
| CT thoracic spine w/o contrast (72128) | $1,067 | $1,334 | 10.6× |
| CT thoracic spine w/wo cont (72130) | $1,274 | $1,593 | 7.6× |
| CT thorax w/o contrast (71250) | $1,067 | $1,334 | 10.6× |
| CT upper ext wo (73200) | $920 | $1,150 | 9.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,159 | $1,449 | 6.9× |
| CT upper extremity with contrast (73201) | $1,067 | $1,334 | 3.2× |
| Cta Abdomen (74175) | $1,375 | $1,719 | 8.2× |
| Echo Guide For Artery Repair (76936) | $415 | $519 | 2.0× |
| Esophagram (74220) | $188 | $235 | 1.1× |
| Fetal Biophys Profile W/Nst (76818) | $232 | $290 | 2.3× |
| Fluoroscopy up to 1 hr (76000) | $113 | $141 | 0.5× |
| Foot 2 views (73620) | $183 | $229 | 2.2× |
| Forearm 2 views (73090) | $183 | $229 | 2.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$32–$258 | $40–$322 | varies |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$189–$212 | $236–$265 | varies |
| Joint Survey Single View (77077) | $258 | $322 | 2.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$36–$276 | $45–$345 | varies |
| Magnetic Image Jaw Joint (70336) | $12 | $15 | 0.1× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$63–$85 | $79–$106 | varies |
| Nm red cell survival study (78130) | $30 | $38 | 0.1× |
| Nm whole blood volume (78122) range across 2 matching MRF lines |
$6–$9 | $7–$11 | varies |
| Nonvascular Shunt X-Ray (75809) | $181 | $226 | 1.8× |
| Pelvis 1 or 2 views (72170) | $183 | $229 | 1.8× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) range across 3 matching MRF lines |
$2 | $2–$3 | 0.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$167–$258 | $209–$322 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$32–$276 | $40–$345 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$5–$96 | $6–$120 | varies |
| Radex elbow complete minimum 3 views (73080) | $760 | $950 | 9.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $147 | $184 | 1.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$26–$215 | $32–$269 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$32–$286 | $40–$357 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$75–$350 | $94–$437 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $116 | $145 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $136 | $170 | 1.6× |
| Radex Ribs Unilateral 2 Views (71100) | $222 | $278 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) | $235 | $294 | 2.8× |
| Radex Spine 1 View Specify Level (72020) | $183 | $229 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $117 | $146 | 1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $133 | $166 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $239 | $299 | 2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $350 | $437 | 4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $124 | $155 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $310 | $388 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $218 | $272 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$131–$392 | $164–$490 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $96 | $120 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $304 | $380 | 1.8× |
| Radiologic exam swallow function contrast study (74230) | $150 | $188 | 0.9× |
| Radiologic examination femur 1 view (73551) | $230 | $288 | 2.7× |
| Radiologic examination femur minimum 2 views (73552) | $460 | $575 | 5.5× |
| Radiologic examination knee 1/2 views (73560) | $106 | $132 | 1.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $258 | $322 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $239 | $299 | 2.9× |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 2 matching MRF lines |
$2–$3 | $2–$4 | varies |
| Ribs bilateral 3 views (71110) | $314 | $393 | 3.1× |
| Scapula (73010) | $97 | $121 | 1.0× |
| Sella turcica (70240) | $85 | $106 | 1.0× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$29–$143 | $36–$179 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$35–$122 | $44–$152 | varies |
| Thoracic spine 3 views (72072) | $438 | $547 | 4.4× |
| Ultrasound Breast Limited (76642) | $96 | $120 | 1.1× |
| Ultrasound Elastography Parenchyma (76981) | $224 | $280 | 2.2× |
| Ultrasound Exam Aaa Screen (76706) | $269 | $336 | 2.7× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$307–$352 | $384–$440 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $58 | $72 | 0.7× |
| Unlisted us procedure (76999) range across 4 matching MRF lines |
$135–$215 | $169–$269 | varies |
| Urethrocystogram voiding (74455) | $2 | $2 | 0.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$126–$214 | $157–$267 | varies |
| Us chest (76604) | $188 | $235 | 1.9× |
| Us complete joint (76881) | $330 | $413 | 3.3× |
| Us exam, pelvic, limited (76857) | $194 | $243 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$60–$434 | $75–$542 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$109–$158 | $136–$198 | varies |
| Us ob transvaginal (76817) | $182 | $228 | 1.8× |
| Us pelvic non ob complete (76856) | $534 | $668 | 5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $231 | $289 | 2.3× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$193–$490 | $241–$612 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$112–$344 | $140–$430 | varies |
| Us scrotum and contents (76870) | $592 | $740 | 5.9× |
| Us thyroid (76536) | $474 | $593 | 4.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$30–$258 | $37–$322 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $183 | $229 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $258 | $322 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $98 | $122 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $183 | $229 | 2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $94 | $118 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $104 | $130 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$140–$251 | $175–$314 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $472 | $590 | 4.7× |
| X-Ray Exam L-S Spine Bending (72114) | $258 | $322 | 2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $370 | $463 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$68–$258 | $85–$322 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$6–$376 | $8–$470 | varies |
| X-ray eye for foreign body (70030) | $368 | $460 | 4.4× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$34–$202 | $42–$253 | varies |
| X-ray IV pyelogram (ivp) (74400) | $194 | $243 | 1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $37 | $46 | 0.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $250 | $312 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $290 | $362 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $406 | $508 | 4.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $195 | $244 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $222 | $278 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $146 | $182 | 1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $174 | $218 | 1.7× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$17–$99 | $21–$124 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$143–$174 | $179–$218 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$213–$258 | $266–$322 | varies |
| Xr c-spine 4 or 5 views (72050) | $294 | $368 | 2.9× |
| Xr facial bones less than 3 views (70140) | $80 | $100 | 1.0× |
| Xr orbits complete 4 views (70200) | $116 | $145 | 1.2× |
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.