Imaging prices at Ascension St. Vincent Jennings
North Vernon, IN · every code in this section with a posted price and a Medicare benchmark.
225 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) | $254.40 | $424 | 2.8× |
| Abdomen 2 views (74019) | $260.40 | $434 | 2.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$255.60–$511.20 | $426–$852 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$655.20–$1,310.40 | $1,092–$2,184 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$753–$1,506 | $1,255–$2,510 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$577.80–$1,155.60 | $963–$1,926 | varies |
| Bone age studies (77072) | $361.80 | $603 | 3.3× |
| Bone survey infant (77076) | $427.80 | $713 | 3.9× |
| Cat Scan Follow-Up Study (76380) | $265.20 | $442 | 2.9× |
| Chest 1 view (71045) | $201.60 | $336 | 2.2× |
| Chest 2 views (71046) | $246 | $410 | 2.7× |
| Chest 3 views (71047) | $299.40 | $499 | 3.3× |
| Chest 4 or more views (71048) | $321.60 | $536 | 2.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$306–$612 | $510–$1,020 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $562.80 | $938 | 5.1× |
| Contrast X-Ray Bladder (74430) | $527.40 | $879 | 1.4× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$679.80–$1,359.60 | $1,133–$2,266 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$838.20–$1,676.40 | $1,397–$2,794 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,658.80 | $6,098 | 9.9× |
| CT abdomen and pelvis without contrast (74176) | $2,194.20 | $3,657 | 8.7× |
| CT abdomen w contrast (74160) | $1,525.80 | $2,543 | 8.2× |
| CT abdomen w wo contrast (74170) | $1,906.80 | $3,178 | 10.3× |
| CT abdomen w/o contrast (74150) | $1,143.60 | $1,906 | 10.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,389.60 | $7,316 | 11.9× |
| CT Angio Chest (71275) | $2,154.60 | $3,591 | 11.6× |
| CT Angio Head (70496) | $2,244.60 | $3,741 | 12.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,253–$4,506 | $3,755–$7,510 | varies |
| CT Angio Neck (70498) | $2,388 | $3,980 | 12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,622.60 | $4,371 | 14.1× |
| CT cervical spine w/ contrast (72126) | $1,816.80 | $3,028 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,329.60 | $2,216 | 12.0× |
| CT cervical spine w/wo cont (72127) | $2,179.80 | $3,633 | 11.7× |
| CT chest w contrast (71260) | $1,435.80 | $2,393 | 7.7× |
| CT chest w/wo contrast (71270) | $1,795.80 | $2,993 | 9.7× |
| CT head/brain with contrast (70460) | $1,596 | $2,660 | 8.6× |
| CT head/brain without and with contrast (70470) | $1,771.20 | $2,952 | 9.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $322.80 | $538 | 3.5× |
| CT iac w contrast (70481) | $1,551 | $2,585 | 8.4× |
| CT l-spine w&w/o contrast (72133) | $1,866.60 | $3,111 | 10.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,208.40–$2,416.80 | $2,014–$4,028 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,609.20–$3,218.40 | $2,682–$5,364 | varies |
| CT lumbar spine w contrast (72132) | $1,497 | $2,495 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,245 | $2,075 | 11.3× |
| CT maxillofacial w contrast (70487) | $1,836 | $3,060 | 9.9× |
| CT maxillofacial wo contrast (70486) | $1,161.60 | $1,936 | 10.5× |
| CT neck tissue combo (70492) | $2,062.80 | $3,438 | 11.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,861.20 | $3,102 | 10.0× |
| CT orbits w/o contrast (70480) | $1,241.40 | $2,069 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $1,751.40 | $2,919 | 9.4× |
| CT pelvis w/o contrast (72192) | $1,051.20 | $1,752 | 9.5× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,930.80–$3,861.60 | $3,218–$6,436 | varies |
| CT scans face/jaw combo (70488) | $2,019 | $3,365 | 10.9× |
| CT soft tissue neck w contrast (70491) | $1,356.60 | $2,261 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $1,344.60 | $2,241 | 12.2× |
| CT thoracic spine w contrast (72129) | $1,573.20 | $2,622 | 8.5× |
| CT thoracic spine w/o contrast (72128) | $1,258.80 | $2,098 | 11.4× |
| CT thoracic spine w/wo cont (72130) | $1,887.60 | $3,146 | 10.2× |
| CT thorax w/o contrast (71250) | $1,078.80 | $1,798 | 9.8× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,240.80–$2,481.60 | $2,068–$4,136 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,860.60–$3,721.20 | $3,101–$6,202 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,550.40–$3,100.80 | $2,584–$5,168 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,750.40 | $4,584 | 14.8× |
| Cta Abdomen (74175) | $2,289.60 | $3,816 | 12.3× |
| CTA pelvis (72191) | $2,102.40 | $3,504 | 11.3× |
| Dxa Bone Density Axial (77080) | $463.20 | $772 | 4.2× |
| Dxa bone density study (77085) | $466.80 | $778 | 4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $225.60 | $376 | 2.5× |
| Esophagram (74220) | $484.80 | $808 | 2.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,303.80 | $2,173 | 5.2× |
| Fluoroscopy up to 1 hr (76000) | $426 | $710 | 1.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$238.80–$477.60 | $398–$796 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$253.20–$506.40 | $422–$844 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$250.80–$501.60 | $418–$836 | varies |
| Ht Muscle Image Spect Sing (78451) | $4,173 | $6,955 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $183.60 | $306 | 2.0× |
| Infant hip ultrasound, limited static exam (76886) | $91.80 | $153 | 1.0× |
| Joint Survey Single View (77077) | $235.20 | $392 | 2.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$352.80–$705.60 | $588–$1,176 | varies |
| Magnetic Image Jaw Joint (70336) | $2,727.60 | $4,546 | 10.8× |
| Mammary ductogram or galactogram multiple (77054) | $790.80 | $1,318 | 3.1× |
| Mammary ductogram or galactogram single (77053) | $552.60 | $921 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,110.40 | $5,184 | 8.4× |
| MRA head w/o contrast (70544) | $1,902 | $3,170 | 7.5× |
| MRA head with contrast (70545) | $2,489.40 | $4,149 | 6.7× |
| MRA neck w contrast (70548) | $2,657.40 | $4,429 | 7.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,321.60 | $5,536 | 9.0× |
| MRA neck w/o contrast (70547) | $1,993.20 | $3,322 | 7.9× |
| MRI abdomen w contrast (74182) | $1,947 | $3,245 | 5.3× |
| MRI abdomen w/o contrast (74181) | $1,297.20 | $2,162 | 5.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,547.60–$5,095.20 | $4,246–$8,492 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,923.20–$5,846.40 | $4,872–$9,744 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,583–$5,166 | $4,305–$8,610 | varies |
| MRI cervical spine w contrast (72142) | $2,312.40 | $3,854 | 6.3× |
| MRI cervical spine w/o cont (72141) | $1,850.40 | $3,084 | 7.3× |
| MRI chest w/o contrast (71550) | $2,455.20 | $4,092 | 9.7× |
| MRI chest with contrast (71551) | $3,069 | $5,115 | 3.7× |
| MRI chest wo w contrast (71552) | $3,682.20 | $6,137 | 10.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,548.20–$5,096.40 | $4,247–$8,494 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,805–$5,610 | $4,675–$9,350 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,870.80–$3,741.60 | $3,118–$6,236 | varies |
| MRI lumbar spine w contrast (72149) | $2,364 | $3,940 | 6.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,775 | $4,625 | 7.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,329 | $2,215 | 5.3× |
| MRI orbit face neck w contrast (70542) | $1,993.20 | $3,322 | 5.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,657.40 | $4,429 | 7.2× |
| MRI pelvis w contrast (72196) | $1,956 | $3,260 | 5.3× |
| MRI pelvis w/o & w contrast (72197) | $2,608.80 | $4,348 | 7.1× |
| MRI pelvis w/o contrast (72195) | $1,303.80 | $2,173 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $1,929.60 | $3,216 | 7.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,720.40–$5,440.80 | $4,534–$9,068 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,175.60–$4,351.20 | $3,626–$7,252 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,264–$6,528 | $5,440–$10,880 | varies |
| MRI, abdomen, combo (74183) | $2,594.40 | $4,324 | 7.0× |
| MRI, dorsal spine combo (72157) | $2,895.60 | $4,826 | 7.8× |
| MRI, dorsal spine contrast (72147) | $2,412.60 | $4,021 | 6.5× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,065.80–$4,131.60 | $3,443–$6,886 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,099.60–$6,199.20 | $5,166–$10,332 | varies |
| MRI, lumbar spine combo (72158) | $2,837.40 | $4,729 | 7.7× |
| Myocardial Spect Multiple Studies (78452) | $5,283 | $8,805 | 3.9× |
| Neck soft tissue (70360) | $195.60 | $326 | 2.1× |
| Pelvis 1 or 2 views (72170) | $232.80 | $388 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $536.40 | $894 | 4.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$290.40–$580.80 | $484–$968 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$222–$444 | $370–$740 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$278.40–$556.80 | $464–$928 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $399.60 | $666 | 3.6× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$187.20–$374.40 | $312–$624 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$286.80–$573.60 | $478–$956 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$278.40–$556.80 | $464–$928 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$204.60–$409.20 | $341–$682 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$298.20–$596.40 | $497–$994 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $244.80 | $408 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $202.80 | $338 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$260.40–$520.80 | $434–$868 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $216 | $360 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $252.60 | $421 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $284.40 | $474 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $384 | $640 | 4.2× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$175.20–$350.40 | $292–$584 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$162–$324 | $270–$540 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$276–$552 | $460–$920 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $673.20 | $1,122 | 6.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $377.40 | $629 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $357.60 | $596 | 3.2× |
| Radiologic exam colon double contrast study (74280) | $856.20 | $1,427 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $674.40 | $1,124 | 3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $520.80 | $868 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$482.40–$964.80 | $804–$1,608 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $330 | $550 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $440.40 | $734 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $361.20 | $602 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $704.40 | $1,174 | 3.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$122.40–$244.80 | $204–$408 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$244.80–$489.60 | $408–$816 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$260.40–$520.80 | $434–$868 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $501 | $835 | 4.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$277.20–$554.40 | $462–$924 | varies |
| Ribs bilateral 3 views (71110) | $326.40 | $544 | 3.0× |
| Scapula (73010) range across 2 matching MRF lines |
$326.40–$652.80 | $544–$1,088 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $53.40 | $89 | 2.3× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$224.40–$448.80 | $374–$748 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$739.80–$1,479.60 | $1,233–$2,466 | varies |
| Skull less than 4 views (70250) | $341.40 | $569 | 3.1× |
| Sternoclavicular joints (71130) | $297.60 | $496 | 3.2× |
| Thoracic spine 2 views (72070) | $348 | $580 | 3.1× |
| Thoracic spine 3 views (72072) | $387.60 | $646 | 3.5× |
| Thoracolumbar 2 views (72080) | $294 | $490 | 3.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$296.40–$592.80 | $494–$988 | varies |
| Ultrasound Elastography Parenchyma (76981) | $419.40 | $699 | 3.8× |
| Ultrasound Exam Aaa Screen (76706) | $553.20 | $922 | 5.0× |
| Ultrasound, abdomen limited (76705) | $560.40 | $934 | 5.1× |
| Upper gi w/o kub (74240) | $659.40 | $1,099 | 3.6× |
| Urethrocystogram voiding (74455) | $543.60 | $906 | 2.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$588–$1,176 | $980–$1,960 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$196.80–$392.40 | $328–$654 | varies |
| Us complete joint (76881) | $529.80 | $883 | 4.8× |
| Us exam, pelvic, limited (76857) | $518.40 | $864 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $330 | $550 | 3.0× |
| Us ob limited 1 or more fetuses (76815) | $506.40 | $844 | 4.6× |
| Us ob transvaginal (76817) | $373.20 | $622 | 3.4× |
| Us pelvic non ob complete (76856) | $576 | $960 | 5.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $466.80 | $778 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $476.40 | $794 | 4.3× |
| Us retroperitoneal complete (76770) | $610.80 | $1,018 | 5.5× |
| Us retroperitoneal limited (76775) | $561.60 | $936 | 5.1× |
| Us scrotum and contents (76870) | $554.40 | $924 | 5.0× |
| Us thyroid (76536) | $505.20 | $842 | 4.6× |
| Us transrectal (76872) | $670.20 | $1,117 | 6.1× |
| Vertebral fracture assessment via dxa (77086) | $180.60 | $301 | 2.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$249.60–$499.20 | $416–$832 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $343.20 | $572 | 3.7× |
| X-Ray Bend Only L-S Spine (72120) | $509.40 | $849 | 4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$230.40–$460.80 | $384–$768 | varies |
| X-Ray Exam Breast Specimen (76098) | $682.80 | $1,138 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $252 | $420 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $502.80 | $838 | 4.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $517.80 | $863 | 4.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $166.80 | $278 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $265.20 | $442 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $362.40 | $604 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $265.20 | $442 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $362.40 | $604 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $461.40 | $769 | 4.2× |
| X-Ray Exam L-S Spine Bending (72114) | $544.80 | $908 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $277.20 | $462 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $535.20 | $892 | 4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $253.20 | $422 | 2.3× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$246.60–$493.20 | $411–$822 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$265.20–$530.40 | $442–$884 | varies |
| X-ray IV pyelogram (ivp) (74400) | $672.60 | $1,121 | 3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $198 | $330 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $260.40 | $434 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $302.40 | $504 | 2.7× |
| X-ray nose-rectum child f.b. (76010) | $254.40 | $424 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $343.20 | $572 | 3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $345.60 | $576 | 3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $285.60 | $476 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $315.60 | $526 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $448.80 | $748 | 4.1× |
| X-ray thoracic spine 4 vw (72074) | $598.20 | $997 | 5.4× |
| X-Rays Bone Length Studies (77073) | $256.80 | $428 | 2.3× |
| X-Rays Bone Survey Complete (77075) | $730.80 | $1,218 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $402 | $670 | 3.6× |
| Xr facial bones less than 3 views (70140) | $267.60 | $446 | 2.9× |
| Xr orbits complete 4 views (70200) | $362.40 | $604 | 3.3× |
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.