Imaging prices at Ascension St. Vincent Williamsport
Williamsport, IN · every code in this section with a posted price and a Medicare benchmark.
193 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) | $279.60 | $466 | 3.0× |
| Abdomen 2 views (74019) | $312 | $520 | 2.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$226.80–$453.60 | $378–$756 | varies |
| Bone age studies (77072) | $234.60 | $391 | 2.1× |
| Bone survey infant (77076) | $792 | $1,320 | 7.2× |
| Cat Scan Follow-Up Study (76380) | $273 | $455 | 3.0× |
| Chest 1 view (71045) | $169.20 | $282 | 1.8× |
| Chest 2 views (71046) | $248.40 | $414 | 2.7× |
| Chest 3 views (71047) | $250.80 | $418 | 2.7× |
| Chest 4 or more views (71048) | $300.60 | $501 | 2.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$297–$594 | $495–$990 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $579.60 | $966 | 5.2× |
| Contrast X-Ray Bladder (74430) | $428.40 | $714 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,956.40 | $6,594 | 10.7× |
| CT abdomen and pelvis without contrast (74176) | $2,636.40 | $4,394 | 10.4× |
| CT abdomen w contrast (74160) | $1,664.40 | $2,774 | 9.0× |
| CT abdomen w wo contrast (74170) | $1,997.40 | $3,329 | 10.8× |
| CT abdomen w/o contrast (74150) | $1,331.40 | $2,219 | 12.0× |
| CT Angio Abdomen and Pelvis (74174) | $4,496.40 | $7,494 | 12.2× |
| CT Angio Chest (71275) | $2,169.60 | $3,616 | 11.7× |
| CT Angio Head (70496) | $1,970.40 | $3,284 | 10.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,395.80–$4,791.60 | $3,993–$7,986 | varies |
| CT Angio Neck (70498) | $1,509.60 | $2,516 | 8.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,608.20 | $4,347 | 14.1× |
| CT cervical spine w/ contrast (72126) | $2,226.60 | $3,711 | 6.0× |
| CT cervical spine w/o contrast (72125) | $1,696.20 | $2,827 | 15.3× |
| CT cervical spine w/wo cont (72127) | $2,671.20 | $4,452 | 14.4× |
| CT chest w contrast (71260) | $1,549.80 | $2,583 | 8.4× |
| CT chest w/wo contrast (71270) | $1,953 | $3,255 | 10.5× |
| CT head/brain with contrast (70460) | $1,642.80 | $2,738 | 8.9× |
| CT head/brain without and with contrast (70470) | $1,970.40 | $3,284 | 10.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $288 | $480 | 3.1× |
| CT iac w contrast (70481) | $1,761.60 | $2,936 | 9.5× |
| CT l-spine w&w/o contrast (72133) | $2,451.60 | $4,086 | 13.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,304.40–$2,608.80 | $2,174–$4,348 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,711.80–$3,423.60 | $2,853–$5,706 | varies |
| CT lumbar spine w contrast (72132) | $2,043.60 | $3,406 | 5.5× |
| CT lumbar spine w/o contrast (72131) | $1,556.40 | $2,594 | 14.1× |
| CT maxillofacial w contrast (70487) | $1,700.40 | $2,834 | 9.2× |
| CT maxillofacial wo contrast (70486) | $1,241.40 | $2,069 | 11.2× |
| CT neck tissue combo (70492) | $2,158.80 | $3,598 | 11.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,113.80 | $3,523 | 11.4× |
| CT orbits w/o contrast (70480) | $1,342.20 | $2,237 | 12.1× |
| CT pelvis w&w/o contrast (72194) | $2,057.40 | $3,429 | 11.1× |
| CT pelvis w/o contrast (72192) | $1,305.60 | $2,176 | 11.8× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,053.20–$4,106.40 | $3,422–$6,844 | varies |
| CT scans face/jaw combo (70488) | $1,967.40 | $3,279 | 10.6× |
| CT soft tissue neck w contrast (70491) | $1,711.80 | $2,853 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,369.20 | $2,282 | 12.4× |
| CT thoracic spine w contrast (72129) | $2,051.40 | $3,419 | 11.1× |
| CT thoracic spine w/o contrast (72128) | $1,564.20 | $2,607 | 14.1× |
| CT thoracic spine w/wo cont (72130) | $2,463 | $4,105 | 13.3× |
| CT thorax w/o contrast (71250) | $1,240.80 | $2,068 | 11.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,420.80–$2,841.60 | $2,368–$4,736 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,236.80–$4,473.60 | $3,728–$7,456 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,863.60–$3,727.20 | $3,106–$6,212 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,555.60 | $5,926 | 19.2× |
| Cta Abdomen (74175) | $1,997.40 | $3,329 | 10.8× |
| CTA pelvis (72191) | $2,400 | $4,000 | 12.9× |
| Dxa Bone Density Axial (77080) | $438 | $730 | 4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $256.80 | $428 | 2.8× |
| Fluoroscopy up to 1 hr (76000) | $468 | $780 | 1.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$225.60–$451.20 | $376–$752 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$275.40–$550.80 | $459–$918 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$268.80–$537.60 | $448–$896 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$321.60–$643.20 | $536–$1,072 | varies |
| Magnetic Image Jaw Joint (70336) | $2,453.40 | $4,089 | 9.7× |
| Mra Head W/O & W/Contrast Material (70546) | $3,600.60 | $6,001 | 9.8× |
| MRA head w/o contrast (70544) | $2,572.20 | $4,287 | 10.2× |
| MRA head with contrast (70545) | $3,086.40 | $5,144 | 8.4× |
| MRA neck w contrast (70548) | $3,205.20 | $5,342 | 8.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,739.20 | $6,232 | 10.1× |
| MRA neck w/o contrast (70547) | $2,670.60 | $4,451 | 10.6× |
| MRI abdomen w contrast (74182) | $2,187.60 | $3,646 | 5.9× |
| MRI abdomen w/o contrast (74181) | $1,458 | $2,430 | 5.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,246.40–$4,492.80 | $3,744–$7,488 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,695.20–$5,390.40 | $4,492–$8,984 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,316.60–$4,633.20 | $3,861–$7,722 | varies |
| MRI cervical spine w contrast (72142) | $2,496 | $4,160 | 6.8× |
| MRI cervical spine w/o cont (72141) | $1,996.80 | $3,328 | 7.9× |
| MRI chest w/o contrast (71550) | $2,042.40 | $3,404 | 8.1× |
| MRI chest with contrast (71551) | $2,552.40 | $4,254 | 3.1× |
| MRI chest wo w contrast (71552) | $3,063.60 | $5,106 | 8.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,040–$4,080 | $3,400–$6,800 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,719.20–$5,438.40 | $4,532–$9,064 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,360.20–$2,720.40 | $2,267–$4,534 | varies |
| MRI lumbar spine w contrast (72149) | $2,559 | $4,265 | 6.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,994.60 | $4,991 | 8.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,137.20 | $3,562 | 8.5× |
| MRI orbit face neck w contrast (70542) | $2,670.60 | $4,451 | 7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,205.20 | $5,342 | 8.7× |
| MRI pelvis w contrast (72196) | $2,670.60 | $4,451 | 7.2× |
| MRI pelvis w/o & w contrast (72197) | $3,205.20 | $5,342 | 8.7× |
| MRI pelvis w/o contrast (72195) | $2,137.20 | $3,562 | 8.5× |
| MRI thoracic spine w/o contrast (72146) | $2,362.80 | $3,938 | 9.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,446.80–$4,893.60 | $4,078–$8,156 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,957.80–$3,915.60 | $3,263–$6,526 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,936.40–$5,872.80 | $4,894–$9,788 | varies |
| MRI, abdomen, combo (74183) | $2,917.20 | $4,862 | 7.9× |
| MRI, dorsal spine combo (72157) | $3,544.80 | $5,908 | 9.6× |
| MRI, dorsal spine contrast (72147) | $2,953.20 | $4,922 | 8.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,854–$3,708 | $3,090–$6,180 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,779.80–$5,559.60 | $4,633–$9,266 | varies |
| MRI, lumbar spine combo (72158) | $3,070.20 | $5,117 | 8.3× |
| Neck soft tissue (70360) | $212.40 | $354 | 2.3× |
| Pelvis 1 or 2 views (72170) | $234 | $390 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $416.40 | $694 | 3.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$303.60–$607.20 | $506–$1,012 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$238.80–$477.60 | $398–$796 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$280.80–$561.60 | $468–$936 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $369 | $615 | 3.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$188.40–$376.80 | $314–$628 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$300–$600 | $500–$1,000 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$312.60–$625.20 | $521–$1,042 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$206.40–$412.80 | $344–$688 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$260.40–$520.80 | $434–$868 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $247.80 | $413 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $278.40 | $464 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$263.40–$526.80 | $439–$878 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $235.20 | $392 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $232.20 | $387 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $262.80 | $438 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $466.20 | $777 | 5.1× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$181.20–$362.40 | $302–$604 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$135–$270 | $225–$450 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$300–$600 | $500–$1,000 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $629.40 | $1,049 | 5.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $351 | $585 | 3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $321.60 | $536 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$399.60–$799.20 | $666–$1,332 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $306 | $510 | 2.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$135–$270 | $225–$450 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$269.40–$538.80 | $449–$898 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$237.60–$475.20 | $396–$792 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $612 | $1,020 | 5.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$279.60–$559.20 | $466–$932 | varies |
| Ribs bilateral 3 views (71110) | $361.20 | $602 | 3.3× |
| Scapula (73010) range across 2 matching MRF lines |
$301.80–$603.60 | $503–$1,006 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $57 | $95 | 2.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$208.80–$417.60 | $348–$696 | varies |
| Skull less than 4 views (70250) | $315 | $525 | 2.8× |
| Sternoclavicular joints (71130) | $277.20 | $462 | 3.0× |
| Thoracic spine 2 views (72070) | $290.40 | $484 | 2.6× |
| Thoracic spine 3 views (72072) | $390 | $650 | 3.5× |
| Thoracolumbar 2 views (72080) | $337.80 | $563 | 3.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$399.60–$799.20 | $666–$1,332 | varies |
| Ultrasound Exam Aaa Screen (76706) | $555 | $925 | 5.0× |
| Ultrasound, abdomen limited (76705) | $580.80 | $968 | 5.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$588–$1,176 | $980–$1,960 | varies |
| Us chest (76604) | $168 | $280 | 1.5× |
| Us exam, pelvic, limited (76857) | $451.80 | $753 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $432 | $720 | 3.9× |
| Us ob limited 1 or more fetuses (76815) | $403.20 | $672 | 3.6× |
| Us ob transvaginal (76817) | $488.40 | $814 | 4.4× |
| Us pelvic non ob complete (76856) | $602.40 | $1,004 | 5.4× |
| Us retroperitoneal complete (76770) | $637.20 | $1,062 | 5.8× |
| Us retroperitoneal limited (76775) | $541.20 | $902 | 4.9× |
| Us scrotum and contents (76870) | $589.80 | $983 | 5.3× |
| Us thyroid (76536) | $536.40 | $894 | 4.8× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$231.60–$463.20 | $386–$772 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $318 | $530 | 3.5× |
| X-Ray Bend Only L-S Spine (72120) | $375.60 | $626 | 3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$205.20–$410.40 | $342–$684 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $270 | $450 | 2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $469.80 | $783 | 4.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $484.20 | $807 | 4.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $186.60 | $311 | 2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $296.40 | $494 | 3.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $406.20 | $677 | 3.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $296.40 | $494 | 2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $406.20 | $677 | 3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $517.80 | $863 | 4.7× |
| X-Ray Exam L-S Spine Bending (72114) | $486 | $810 | 4.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $378 | $630 | 4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $631.20 | $1,052 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $308.40 | $514 | 2.8× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$231.60–$463.20 | $386–$772 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$272.40–$544.80 | $454–$908 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $210 | $350 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $415.80 | $693 | 4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $333.60 | $556 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $279.60 | $466 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $380.40 | $634 | 3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $320.40 | $534 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $288.60 | $481 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $345.60 | $576 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $414.60 | $691 | 3.7× |
| X-ray thoracic spine 4 vw (72074) | $486 | $810 | 4.4× |
| X-Rays Bone Length Studies (77073) | $325.80 | $543 | 2.9× |
| X-Rays Bone Survey Complete (77075) | $1,020 | $1,700 | 9.2× |
| Xr c-spine 4 or 5 views (72050) | $505.20 | $842 | 4.6× |
| Xr facial bones less than 3 views (70140) | $246.60 | $411 | 2.7× |
| Xr orbits complete 4 views (70200) | $336.60 | $561 | 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.