Imaging prices at Avera Queen of Peace
Mitchell, SD · every code in this section with a posted price and a Medicare benchmark.
201 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $9,575.84 | $9,872 | 6.8× |
| Abdomen 1 View (74018) | $589.76 | $608 | 6.6× |
| Abdomen 2 views (74019) | $967.09 | $997 | 9.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,880.97 | $4,001 | 9.5× |
| Ankle 2 views (73600) | $658.63 | $679 | 7.4× |
| Basic radiation dosimetry calculation (77300) | $995.22 | $1,026 | 7.2× |
| Bone age studies (77072) | $752.72 | $776 | 7.0× |
| Bone Imaging 3 Phase (78315) | $4,332.99 | $4,467 | 10.6× |
| Bone Imaging Whole Body (78306) | $4,199.13 | $4,329 | 10.3× |
| Bone survey infant (77076) | $1,083.49 | $1,117 | 10.1× |
| Cat Scan Follow-Up Study (76380) | $42.12 | $43 | 0.5× |
| Chest 1 view (71045) | $547.08 | $564 | 6.2× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$420.01–$908.89 | $433–$937 | varies |
| Clavicle complete (73000) | $651.84 | $672 | 7.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $654.75 | $675 | 6.1× |
| Continuing medical physics consltj pr wk (77336) | $1,151.39 | $1,187 | 8.4× |
| Contrast X-Ray Bladder (74430) | $1,561.70 | $1,610 | 4.4× |
| CT abdomen and pelvis without and with contrast (74178) | $9,048.16 | $9,328 | 25.4× |
| CT abdomen and pelvis without contrast (74176) | $7,151.81 | $7,373 | 29.3× |
| CT abdomen w contrast (74160) | $3,785.91 | $3,903 | 21.1× |
| CT abdomen w wo contrast (74170) | $4,098.25 | $4,225 | 22.9× |
| CT abdomen w/o contrast (74150) | $3,475.51 | $3,583 | 32.5× |
| CT Angio Abdomen and Pelvis (74174) | $8,156.73 | $8,409 | 22.9× |
| CT Angio Chest (71275) | $5,194.35 | $5,355 | 29.0× |
| CT Angio Head (70496) | $5,038.18 | $5,194 | 28.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,967.37 | $5,121 | 27.7× |
| CT Angio Neck (70498) | $5,038.18 | $5,194 | 28.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,967.37 | $5,121 | 27.7× |
| CT cervical spine w/o contrast (72125) | $4,884.92 | $5,036 | 45.7× |
| CT chest w contrast (71260) | $4,594.89 | $4,737 | 25.6× |
| CT chest w/wo contrast (71270) | $4,769.49 | $4,917 | 26.6× |
| CT head/brain without and with contrast (70470) | $4,280.61 | $4,413 | 23.9× |
| CT iac w contrast (70481) | $2,905.15 | $2,995 | 16.2× |
| CT lower ext w/o (73700) | $4,627.87 | $4,771 | 43.3× |
| CT lower extremity w/contrast material (73701) | $5,505.72 | $5,676 | 30.7× |
| CT lumbar spine w contrast (72132) | $5,323.36 | $5,488 | 14.9× |
| CT lumbar spine w/o contrast (72131) | $4,374.70 | $4,510 | 41.0× |
| CT maxillofacial w contrast (70487) | $3,984.76 | $4,108 | 22.2× |
| CT maxillofacial wo contrast (70486) | $3,657.87 | $3,771 | 34.2× |
| CT neck tissue combo (70492) | $5,991.69 | $6,177 | 33.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,361.05 | $3,465 | 18.8× |
| CT orbits w/o contrast (70480) | $2,449.25 | $2,525 | 22.9× |
| CT pelvis w&w/o contrast (72194) | $5,851.04 | $6,032 | 32.7× |
| CT pelvis w/o contrast (72192) | $4,256.36 | $4,388 | 39.8× |
| CT scan of leg combo (73702) | $6,383.57 | $6,581 | 35.6× |
| CT scans face/jaw combo (70488) | $4,280.61 | $4,413 | 23.9× |
| CT soft tissue neck w contrast (70491) | $5,373.80 | $5,540 | 30.0× |
| CT soft tissue neck w/o contrast (70490) | $4,755.91 | $4,903 | 44.5× |
| CT thoracic spine w/o contrast (72128) | $4,394.10 | $4,530 | 41.1× |
| CT thorax w/o contrast (71250) | $4,397.98 | $4,534 | 41.2× |
| CT upper ext wo (73200) | $4,451.33 | $4,589 | 41.7× |
| CT upper extremity with contrast (73201) | $5,417.45 | $5,585 | 15.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,440.66 | $4,578 | 24.8× |
| Cta Abdomen (74175) | $5,155.55 | $5,315 | 28.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $157.14 | $162 | 1.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,132.96 | $1,168 | 10.6× |
| Dxa Bone Density Axial (77080) | $913.74 | $942 | 8.6× |
| Echo exam of fetal heart (76825) | $2,502.60 | $2,580 | 4.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,414.33 | $2,489 | 9.9× |
| Echograp Trans R Pros Study (76873) | $335.62 | $346 | 3.1× |
| Esophagram (74220) | $1,144.60 | $1,180 | 6.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,444.33 | $1,489 | 13.5× |
| Fluoroscopy up to 1 hr (76000) | $1,036.93 | $1,069 | 4.3× |
| Foot 2 views (73620) | $658.63 | $679 | 7.4× |
| Forearm 2 views (73090) | $658.63 | $679 | 7.4× |
| Gastric emptying imaging study (78264) | $4,144.81 | $4,273 | 10.1× |
| Hand 2 views (73120) | $658.63 | $679 | 6.2× |
| Hepatobil Syst Image W/Drug (78227) | $3,356.20 | $3,460 | 6.1× |
| Hepatobiliary System Imaging (78226) | $2,647.13 | $2,729 | 6.5× |
| Hysterosalpingogram (74740) | $573.27 | $591 | 2.4× |
| Image fusion (77399) | $894.34 | $922 | 6.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,145.57 | $1,181 | 12.9× |
| K Flow/Funct Image W/Drug (78708) | $4,384.40 | $4,520 | 7.9× |
| Knee 3 Views (73562) | $714.89 | $737 | 8.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,762.56 | $2,848 | 5.0× |
| Lymph System Imaging (78195) | $3,584.15 | $3,695 | 6.5× |
| Mlc imrt design & construction per imrt plan (77338) | $2,069.01 | $2,133 | 5.4× |
| MRA head w/o contrast (70544) | $4,113.77 | $4,241 | 16.9× |
| MRI abdomen w/o contrast (74181) | $4,465.88 | $4,604 | 18.3× |
| MRI any jt lower extrem w/contrast material (73722) | $6,508.70 | $6,710 | 8.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,917.07 | $7,131 | 19.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,082.04 | $8,332 | 10.1× |
| MRI cervical spine w/o cont (72141) | $6,399.09 | $6,597 | 26.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $6,917.07 | $7,131 | 19.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,463.04 | $5,632 | 22.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,637.85 | $8,905 | 24.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $9,667.02 | $9,966 | 27.1× |
| MRI pelvis w/o & w contrast (72197) | $8,296.41 | $8,553 | 23.3× |
| MRI pelvis w/o contrast (72195) | $5,256.43 | $5,419 | 21.6× |
| MRI thoracic spine w/o contrast (72146) | $6,399.09 | $6,597 | 26.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $5,467.89 | $5,637 | 22.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,917.07 | $7,131 | 19.4× |
| MRI, dorsal spine combo (72157) | $8,637.85 | $8,905 | 24.2× |
| MRI, joint upper extrem (73221) | $6,827.83 | $7,039 | 28.0× |
| MRI, joint upper extrem combo (73223) | $9,337.22 | $9,626 | 26.2× |
| MRI, lumbar spine combo (72158) | $7,082.94 | $7,302 | 19.9× |
| Myocardial Spect Multiple Studies (78452) | $9,256.71 | $9,543 | 7.0× |
| Neck soft tissue (70360) | $576.18 | $594 | 6.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $20,546.54 | $21,182 | 14.5× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $33.95 | $35 | 1.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $5,073.10 | $5,230 | 12.4× |
| Pelvis 1 or 2 views (72170) | $619.83 | $639 | 5.8× |
| PET image w/CT, full body (78816) | $12,816.61 | $13,213 | 8.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $12,502.33 | $12,889 | 8.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,530.73 | $2,609 | 6.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,135.87 | $1,171 | 10.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $827.41 | $853 | 9.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $540.29 | $557 | 6.1× |
| Radex elbow complete minimum 3 views (73080) | $813.83 | $839 | 9.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,424.93 | $1,469 | 13.3× |
| Radex fingr minimum 2 views (73140) | $532.53 | $549 | 6.0× |
| Radex foot complete minimum 3 views (73630) | $813.83 | $839 | 9.2× |
| Radex Hand Minimum 3 Views (73130) | $813.83 | $839 | 9.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$29.10–$803.16 | $30–$828 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $864.27 | $891 | 9.7× |
| Radex shoulder complete minimum 2 views (73030) | $776 | $800 | 8.7× |
| Radex Spine 1 View Specify Level (72020) | $800.25 | $825 | 9.0× |
| Radex Sternum Minimum 2 Views (71120) | $662.51 | $683 | 7.5× |
| Radex Toe Minimum 2 Views (73660) | $549.02 | $566 | 6.2× |
| Radex upper extremity infant minimum 2 views (73092) | $822.56 | $848 | 7.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $813.83 | $839 | 9.2× |
| Radiation treatment delivery level 3 (77412) | $1,769.28 | $1,824 | 3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,068.94 | $1,102 | 10.0× |
| Radiologic exam colon double contrast study (74280) | $1,763.46 | $1,818 | 9.8× |
| Radiologic exam colon single contrast study (74270) | $1,250.33 | $1,289 | 7.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,049.54 | $1,082 | 5.9× |
| Radiologic exam knee complete 4/more views (73564) | $973.88 | $1,004 | 9.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $823.53 | $849 | 7.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,444.33 | $1,489 | 8.1× |
| Radiologic exam swallow function contrast study (74230) | $1,509.32 | $1,556 | 8.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,536.48 | $1,584 | 8.6× |
| Radiologic examination femur 1 view (73551) | $772.12 | $796 | 8.7× |
| Radiologic examination femur minimum 2 views (73552) | $772.12 | $796 | 8.7× |
| Radiologic examination knee 1/2 views (73560) | $669.30 | $690 | 7.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $679 | $700 | 7.6× |
| Ribs bilateral 3 views (71110) | $1,207.65 | $1,245 | 11.3× |
| Scapula (73010) | $658.63 | $679 | 6.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $76.63 | $79 | 3.3× |
| Shoulder 1 view (73020) | $658.63 | $679 | 7.4× |
| Skull less than 4 views (70250) | $913.74 | $942 | 8.6× |
| Special dosimetry (77331) | $619.83 | $639 | 4.5× |
| Special Physics Consult (77370) | $1,620.87 | $1,671 | 11.8× |
| Special teletherapy port plan (77321) | $2,897.39 | $2,987 | 7.6× |
| Special treatment procedure (77470) | $4,328.14 | $4,462 | 7.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $678.03 | $699 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,089.45 | $3,185 | 8.1× |
| Ther rad simulaj-aided field setting simple (77280) | $1,496.71 | $1,543 | 10.9× |
| Thoracic spine 2 views (72070) | $1,008.80 | $1,040 | 9.4× |
| Thoracic spine 3 views (72072) | $1,377.40 | $1,420 | 12.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,586.16 | $4,728 | 11.2× |
| Tx Devices Design & Construction Complex (77334) | $1,909.93 | $1,969 | 5.0× |
| Tx devices design & construction simple (77332) | $886.58 | $914 | 6.5× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,694.59–$2,542.37 | $1,747–$2,621 | varies |
| Ultrasound Exam Aaa Screen (76706) | $517.01 | $533 | 4.8× |
| Ultrasound, abdomen limited (76705) | $1,870.16 | $1,928 | 17.5× |
| Upper gi w/o kub (74240) | $1,595.65 | $1,645 | 8.9× |
| Urethrocystogram voiding (74455) | $2,114.60 | $2,180 | 8.7× |
| Us chest (76604) | $1,196.98 | $1,234 | 11.2× |
| Us exam, pelvic, limited (76857) | $1,106.77 | $1,141 | 10.4× |
| Us head (76506) | $1,719.81 | $1,773 | 16.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,048.57 | $1,081 | 9.8× |
| Us ob limited 1 or more fetuses (76815) | $1,125.20 | $1,160 | 10.5× |
| Us ob transvaginal (76817) | $1,720.78 | $1,774 | 16.1× |
| Us pelvic non ob complete (76856) | $1,885.68 | $1,944 | 17.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,692.65 | $1,745 | 15.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,213.47 | $1,251 | 11.4× |
| Us retroperitoneal complete (76770) | $2,236.82 | $2,306 | 20.9× |
| Us retroperitoneal limited (76775) | $1,885.68 | $1,944 | 17.7× |
| Us scrotum and contents (76870) | $1,760.55 | $1,815 | 16.5× |
| Us spinal canal and contents (76800) | $1,629.60 | $1,680 | 15.3× |
| Us thyroid (76536) | $1,194.07 | $1,231 | 11.2× |
| Us transrectal (76872) | $194.97 | $201 | 1.8× |
| Wrist 2 views (73100) | $658.63 | $679 | 7.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $786.67 | $811 | 8.8× |
| X-Ray Bend Only L-S Spine (72120) | $1,037.90 | $1,070 | 9.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $658.63 | $679 | 7.4× |
| X-Ray Exam Breast Specimen (76098) | $883.67 | $911 | 1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $800.25 | $825 | 9.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,146.54 | $1,182 | 10.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $580.06 | $598 | 6.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$648.93–$1,152.36 | $669–$1,188 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,142.66 | $1,178 | 10.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,423.96 | $1,468 | 13.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,706.23 | $1,759 | 16.0× |
| X-Ray Exam L-S Spine Bending (72114) | $1,343.45 | $1,385 | 12.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,078.64 | $1,112 | 12.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,286.22 | $1,326 | 12.0× |
| X-ray eye for foreign body (70030) | $1,370.61 | $1,413 | 15.4× |
| X-ray humerus (73060) | $651.84 | $672 | 7.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $689.67 | $711 | 7.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,031.11 | $1,063 | 9.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,534.54 | $1,582 | 14.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$24.25–$727.50 | $25–$750 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,368.67 | $1,411 | 12.8× |
| X-ray thoracic spine 4 vw (72074) | $1,055.36 | $1,088 | 9.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $23.66 | $24 | 0.1× |
| X-Rays Bone Length Studies (77073) | $1,014.62 | $1,046 | 9.5× |
| X-Rays Bone Survey Complete (77075) | $2,487.08 | $2,564 | 23.3× |
| Xr c-spine 4 or 5 views (72050) | $1,576.25 | $1,625 | 14.8× |
| Xr facial bones less than 3 views (70140) | $890.46 | $918 | 10.0× |
| Xr orbits complete 4 views (70200) | $961.27 | $991 | 9.0× |
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.