Imaging prices at Avera Holy Family Hospital
Estherville, IA · every code in this section with a posted price and a Medicare benchmark.
126 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) | $375.39 | $387 | 4.5× |
| Abdomen 2 views (74019) | $509.25 | $525 | 5.1× |
| Ankle 2 views (73600) | $241.53 | $249 | 2.9× |
| Bone Imaging 3 Phase (78315) | $1,613.11 | $1,663 | 4.2× |
| Chest 1 view (71045) | $325.92 | $336 | 3.9× |
| Chest 2 views (71046) | $337.56 | $348 | 4.0× |
| Clavicle complete (73000) | $310.40 | $320 | 3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $416.13 | $429 | 4.1× |
| CT abdomen and pelvis without and with contrast (74178) | $5,949.98 | $6,134 | 17.7× |
| CT abdomen and pelvis without contrast (74176) | $4,097.28 | $4,224 | 17.9× |
| CT abdomen w contrast (74160) | $2,201.90 | $2,270 | 13.1× |
| CT abdomen w wo contrast (74170) | $2,695.63 | $2,779 | 16.0× |
| CT Angio Abdomen and Pelvis (74174) | $6,772.54 | $6,982 | 20.2× |
| CT Angio Chest (71275) | $3,040.95 | $3,135 | 18.0× |
| CT Angio Head (70496) | $3,390.15 | $3,495 | 20.1× |
| CT Angio Neck (70498) | $3,390.15 | $3,495 | 20.1× |
| CT cervical spine w/o contrast (72125) | $2,930.37 | $3,021 | 29.2× |
| CT chest w contrast (71260) | $3,009.91 | $3,103 | 17.9× |
| CT head/brain with contrast (70460) | $3,160.26 | $3,258 | 18.7× |
| CT head/brain without and with contrast (70470) | $3,765.54 | $3,882 | 22.3× |
| CT iac w contrast (70481) | $2,474.47 | $2,551 | 14.7× |
| CT l-spine w&w/o contrast (72133) | $3,324.19 | $3,427 | 19.7× |
| CT lower ext w/o (73700) | $2,823.67 | $2,911 | 28.1× |
| CT lower extremity w/contrast material (73701) | $3,273.75 | $3,375 | 19.4× |
| CT lumbar spine w contrast (72132) | $3,008.94 | $3,102 | 9.0× |
| CT lumbar spine w/o contrast (72131) | $2,693.69 | $2,777 | 26.8× |
| CT maxillofacial w contrast (70487) | $3,372.69 | $3,477 | 20.0× |
| CT maxillofacial wo contrast (70486) | $2,977.90 | $3,070 | 29.6× |
| CT orbits w/o contrast (70480) | $2,130.12 | $2,196 | 21.2× |
| CT pelvis w/o contrast (72192) | $1,410.38 | $1,454 | 14.0× |
| CT soft tissue neck w contrast (70491) | $2,780.02 | $2,866 | 16.5× |
| CT thoracic spine w contrast (72129) | $3,008.94 | $3,102 | 17.8× |
| CT thoracic spine w/o contrast (72128) | $2,373.59 | $2,447 | 23.6× |
| CT thoracic spine w/wo cont (72130) | $3,643.32 | $3,756 | 21.6× |
| CT thorax w/o contrast (71250) | $2,694.66 | $2,778 | 26.8× |
| CT upper ext wo (73200) | $2,741.22 | $2,826 | 27.3× |
| Dxa Bone Density Axial (77080) | $737.20 | $760 | 7.3× |
| Esophagram (74220) | $566.48 | $584 | 3.4× |
| Fluoroscopy up to 1 hr (76000) | $826.44 | $852 | 3.6× |
| Foot 2 views (73620) | $243.47 | $251 | 2.9× |
| Forearm 2 views (73090) | $292.94 | $302 | 3.5× |
| Hand 2 views (73120) | $243.47 | $251 | 2.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,142.66 | $1,178 | 2.2× |
| Knee 3 Views (73562) | $292.94 | $302 | 3.5× |
| MRA head w/o contrast (70544) | $3,202.94 | $3,302 | 14.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,547.36 | $4,688 | 13.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,056.54 | $4,182 | 5.4× |
| MRI cervical spine w/o cont (72141) | $3,764.57 | $3,881 | 16.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,416.48 | $5,584 | 16.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,101.16 | $4,228 | 17.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,785.98 | $4,934 | 14.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,914.99 | $5,067 | 14.7× |
| MRI pelvis w/o contrast (72195) | $2,780.02 | $2,866 | 12.1× |
| MRI thoracic spine w/o contrast (72146) | $4,149.66 | $4,278 | 18.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,905.22 | $4,026 | 17.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,648.24 | $4,792 | 13.9× |
| MRI, dorsal spine combo (72157) | $4,785.98 | $4,934 | 14.3× |
| MRI, joint upper extrem (73221) | $3,599.67 | $3,711 | 15.7× |
| MRI, joint upper extrem combo (73223) | $4,513.41 | $4,653 | 13.5× |
| MRI, lumbar spine combo (72158) | $4,816.05 | $4,965 | 14.4× |
| Myocardial Spect Multiple Studies (78452) | $4,714.20 | $4,860 | 3.8× |
| Neck soft tissue (70360) | $337.56 | $348 | 4.0× |
| Pelvis 1 or 2 views (72170) | $280.33 | $289 | 2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $354.05 | $365 | 3.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $292.94 | $302 | 3.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $297.79 | $307 | 3.6× |
| Radex elbow complete minimum 3 views (73080) | $292.94 | $302 | 3.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $542.23 | $559 | 5.4× |
| Radex fingr minimum 2 views (73140) | $230.86 | $238 | 2.8× |
| Radex foot complete minimum 3 views (73630) | $278.39 | $287 | 3.3× |
| Radex Hand Minimum 3 Views (73130) | $278.39 | $287 | 3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $345.32 | $356 | 4.1× |
| Radex Ribs Unilateral 2 Views (71100) | $327.86 | $338 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) | $380.24 | $392 | 4.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $505.37 | $521 | 6.0× |
| Radex Toe Minimum 2 Views (73660) | $230.86 | $238 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $609.16 | $628 | 7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $401.58 | $414 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $1,056.33 | $1,089 | 6.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $914.71 | $943 | 5.4× |
| Radiologic exam knee complete 4/more views (73564) | $395.76 | $408 | 3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $435.53 | $449 | 4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $960.30 | $990 | 5.7× |
| Radiologic exam swallow function contrast study (74230) | $629.53 | $649 | 3.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $949.63 | $979 | 5.6× |
| Radiologic examination femur 1 view (73551) | $325.92 | $336 | 3.9× |
| Radiologic examination femur minimum 2 views (73552) | $396.73 | $409 | 4.7× |
| Radiologic examination knee 1/2 views (73560) | $345.32 | $356 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $289.06 | $298 | 3.5× |
| Scapula (73010) | $318.16 | $328 | 3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $76.63 | $79 | 3.3× |
| Shoulder 1 view (73020) | $230.86 | $238 | 2.8× |
| Shoulder Arthrography (73040) | $1,287.19 | $1,327 | 3.8× |
| Skull less than 4 views (70250) | $424.86 | $438 | 4.2× |
| Thoracic spine 2 views (72070) | $389.94 | $402 | 3.9× |
| Thoracic spine 3 views (72072) | $525.74 | $542 | 5.2× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$467.54–$701.31 | $482–$723 | varies |
| Ultrasound Exam Aaa Screen (76706) | $291.97 | $301 | 2.9× |
| Ultrasound, abdomen limited (76705) | $733.32 | $756 | 7.3× |
| Us chest (76604) | $628.56 | $648 | 6.3× |
| Us exam, pelvic, limited (76857) | $680.94 | $702 | 6.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $653.78 | $674 | 6.5× |
| Us ob transvaginal (76817) | $738.17 | $761 | 7.3× |
| Us pelvic non ob complete (76856) | $805.10 | $830 | 8.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $989.40 | $1,020 | 9.8× |
| Us retroperitoneal complete (76770) | $852.63 | $879 | 8.5× |
| Us retroperitoneal limited (76775) | $1,048.57 | $1,081 | 10.4× |
| Us scrotum and contents (76870) | $638.26 | $658 | 6.4× |
| Us thyroid (76536) | $880.76 | $908 | 8.8× |
| Wrist 2 views (73100) | $292.94 | $302 | 3.5× |
| X-Ray Bend Only L-S Spine (72120) | $459.78 | $474 | 4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $230.86 | $238 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $357.93 | $369 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$292.94–$567.45 | $302–$585 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $764.36 | $788 | 7.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,146.54 | $1,182 | 11.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $357.93 | $369 | 4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $528.65 | $545 | 5.3× |
| X-ray eye for foreign body (70030) | $318.16 | $328 | 3.8× |
| X-ray humerus (73060) | $289.06 | $298 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $453.96 | $468 | 4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $499.55 | $515 | 5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $370.54 | $382 | 3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $467.54 | $482 | 5.6× |
| X-Rays Bone Survey Complete (77075) | $1,219.29 | $1,257 | 12.1× |
| Xr c-spine 4 or 5 views (72050) | $530.59 | $547 | 5.3× |
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.