Imaging prices at Avera St. Anthony's Hospital

O'Neill, NE · every code in this section with a posted price and a Medicare benchmark.

156 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $517.01 $533 4.8×
Ankle 2 views (73600) $377.33 $389 4.2×
Bone &/joint imaging whole body (78306) $1,624.75 $1,675 3.9×
Bone age studies (77072) $513.13 $529 4.7×
Bone Imaging 3 Phase (78315) $1,618.93 $1,669 3.9×
Cervical spine 2 or 3 views (72040) $452.99 $467 5.0×
Chest 1 view (71045) $355.02 $366 3.9×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $685.79 $707 3.8×
Clavicle complete (73000) $373.45 $385 4.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $3,362.99 $3,467 31.0×
CT abdomen and pelvis without and with contrast (74178) $7,004.37 $7,221 19.3×
CT abdomen and pelvis without contrast (74176) $5,783.14 $5,962 23.3×
CT abdomen w contrast (74160) $4,031.32 $4,156 22.1×
CT abdomen w wo contrast (74170) $4,434.84 $4,572 24.3×
CT abdomen w/o contrast (74150) $3,531.77 $3,641 32.5×
CT c-spine w/o contrast (72125) $3,531.77 $3,641 32.5×
CT chest w/wo contrast (71270) $4,277.70 $4,410 23.5×
CT chest with contrast (71260) $4,002.22 $4,126 22.0×
CT head/brain with contrast (70460) $3,206.82 $3,306 17.6×
CT head/brain without and with contrast (70470) $3,531.77 $3,641 19.4×
CT iac w contrast (70481) $3,171.90 $3,270 17.4×
CT lower ext w/o (73700) $3,215.55 $3,315 29.6×
CT lower extremity w wo contrast (73702) $3,906.19 $4,027 21.4×
CT lower extremity with contrast (73701) $3,560.87 $3,671 19.6×
CT lumbar spine w/o contrast (72131) $3,531.77 $3,641 32.5×
CT maxillofacial w contrast (70487) $3,171.90 $3,270 17.4×
CT maxillofacial w/o contrast (70486) $2,723.76 $2,808 25.1×
CT neck soft tissue w contrast (70491) $3,437.68 $3,544 18.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $3,362.99 $3,467 18.5×
CT orbits w/o contrast (70480) $2,982.75 $3,075 27.5×
CT pelvis w & w/o contrast (72194) $4,159.36 $4,288 22.8×
CT pelvis w/o contrast (72192) $3,531.77 $3,641 32.5×
CT soft tissue neck w/o & w/contrast material (70492) $3,659.81 $3,773 20.1×
CT thoracic spine w/contrast (72129) $4,751.06 $4,898 26.1×
CT thoracic spine w/o contrast (72128) $3,241.74 $3,342 29.9×
CT thorax w/o contrast (71250) $3,726.74 $3,842 34.3×
CT upper extremity w/o contrast rt (73200) $2,684.96 $2,768 24.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,473.64 $4,612 24.6×
Cta Abdomen (74175) $3,026.40 $3,120 16.6×
CTA abdomen pelvis (74174) $6,597.94 $6,802 18.2×
CTA chest (71275) $3,202.94 $3,302 17.6×
Cta Head (70496) $3,531.77 $3,641 19.4×
Cta Neck (70498) $3,150.56 $3,248 17.3×
Cystography minimum 3 views rs&i (74430) $1,256.15 $1,295 3.5×
Dxa bone density study 1/> sites axial skel (77080) $786.67 $811 7.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $480.15 $495 5.3×
Echoencephalography real time imaging (76506) $845.84 $872 7.8×
Esophagus (74220) $569.39 $587 3.1×
Fetal biophysical profile non-stress testing (76818) $683.85 $705 6.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $595.58 $614 5.5×
Fluoroscopy up to 1 hr (76000) $971.94 $1,002 3.9×
Foot 2 views (73620) $365.69 $377 4.0×
Forearm 2 views (73090) $370.54 $382 4.1×
Hand 2 views (73120) $370.54 $382 3.4×
Hand 3 views (73130) $431.65 $445 4.8×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,335.76 $2,408 4.1×
Hepatobiliary syst imaging including gallbladder (78226) $2,346.43 $2,419 5.7×
Ht muscle image spect sing (78451) $7,365.21 $7,593 5.5×
Humerus Min 2 Views Left (73060) $434.56 $448 4.8×
Kidney img morphology vascular flow 1 w/rx (78708) $1,707.20 $1,760 3.0×
Knee 3 views (73562) $454.93 $469 5.0×
Manual appl stress pfrmd phys/qhp joint films (77071) $226.01 $233 2.5×
MRA head w & w/o contrast (70546) $5,117.72 $5,276 14.1×
MRA head w/o contrast (70544) $3,354.26 $3,458 13.5×
Mra Neck W/O &W/Contrast Material (70549) $4,876.19 $5,027 13.5×
MRI abdomen w/o & w/contrast material (74183) $7,112.04 $7,332 19.6×
MRI abdomen w/o contrast (74181) $5,268.07 $5,431 21.3×
MRI any jt upper extremity w/contrast matrl (73222) $4,852.91 $5,003 6.0×
MRI cervical spine w/o contrast (72141) $4,743.30 $4,890 19.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,540.50 $3,650 14.3×
MRI orbit/face/neck w&w/o cont (70543) $4,469.76 $4,608 12.3×
MRI pelvis w/o & w/contrast material (72197) $4,734.57 $4,881 13.1×
MRI pelvis w/o contrast (72195) $2,572.44 $2,652 10.4×
MRI scan of arm joint before and after contrast (73223) $5,923.79 $6,107 16.4×
MRI scan of leg joint before and after contrast (73723) $4,537.66 $4,678 12.5×
MRI spinal canal cervical w/o & w/contr matrl (72156) $5,160.40 $5,320 14.2×
MRI spinal canal lumbar w/contrast material (72149) $5,283.59 $5,447 14.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $5,479.53 $5,649 15.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $5,160.40 $5,320 14.2×
MRI thoracic spine w/o contrast (72146) $3,624.89 $3,737 14.6×
MRI upper ext joint w/o contrast (73221) $3,782.03 $3,899 15.3×
MRI upper extrem other than jt w/o & w/contras (73220) $5,577.50 $5,750 15.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,540.50 $3,650 14.3×
Myocardial Spect Multiple Studies (78452) $6,961.69 $7,177 5.2×
Neck soft tissue (70360) $716.83 $739 7.9×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $464.63 $479 4.3×
Parathyrd planar w/wo subtrj (78071) $1,717.87 $1,771 4.1×
Pelvis 1 or 2 views (72170) $420.98 $434 3.9×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,244.72 $4,376 11.7×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,122.36 $2,188 3.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $565.51 $583 5.2×
Radex hips bilateral with pelvis 2 views (73521) $540.29 $557 5.0×
Radiolog exam mandible compl minimum 4 views (70110) $805.10 $830 7.4×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $385.09 $397 4.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $461.72 $476 5.1×
Radiologic exam colon single contrast study (74270) $928.29 $957 5.1×
Radiologic Exam Esophagus Double Contrast Study (74221) $952.54 $982 5.2×
Radiologic exam upr gi trc single contrast study (74240) $1,116.47 $1,151 6.1×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $539.32 $556 6.0×
Ribs bilateral 3 views (71110) $537.38 $554 5.0×
Scanogram (77073) $445.23 $459 4.1×
Screening digital breast tomosynthesis (77063) $76.63 $79 3.3×
Small bowel series (74250) $772.12 $796 4.2×
Spine thoracic 3 views (72072) $638.26 $658 5.9×
Thoracolumbar 2 views (72080) $154.23 $159 1.7×
Ultrasound, abdomen limited (76705) $940.90 $970 8.7×
Umbilical-artery Doppler (OB) (76820) $196.91 $203 1.8×
Us abdl aorta screen aaa (76706) $467.54 $482 4.3×
Us breast unilateral limited (76642) $380.24 $392 4.2×
Us chest (76604) $612.07 $631 5.6×
Us ob transvaginal (76817) $704.22 $726 6.5×
Us pelvic non ob complete (76856) $1,059.24 $1,092 9.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $319.13 $329 2.9×
Us pregnancy ltd (76815) $638.26 $658 5.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $848.75 $875 7.8×
Us retroperitoneal complete (76770) $1,026.26 $1,058 9.5×
Us retroperitoneal limited (76775) $697.43 $719 6.4×
Us scrotum and contents (76870) $807.04 $832 7.4×
Us soft tissue head/neck (76536) $822.56 $848 7.6×
Us transrectal (76872) $400.61 $413 3.7×
Us xtr non-vasc lmtd (76882) $606.25 $625 5.6×
Wrist 2 views (73100) $352.11 $363 3.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $767.27 $791 7.1×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $424.86 $438 4.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,210.56 $1,248 6.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $352.11 $363 3.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $420.98 $434 4.7×
X-ray exam hip uni 1 view (73501) $344.35 $355 3.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $434.56 $448 4.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $647.96 $668 6.0×
X-Ray Exam Hips Bi 5/> Views (73523) $777.94 $802 7.2×
X-ray eye for foreign body (70030) $495.67 $511 5.5×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $617.89 $637 6.8×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $456.87 $471 5.1×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $349.20 $360 3.9×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $511.19 $527 4.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $661.54 $682 6.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $1,339.57 $1,381 12.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $470.45 $485 4.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $397.70 $410 4.4×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $487.91 $503 5.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $267.72 $276 2.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $487.91 $503 4.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $549.02 $566 6.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $485 $500 5.4×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $242.50 $250 2.7×
X-Ray Spine One View - Xr Spine (72020) $345.32 $356 3.8×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $429.71 $443 4.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $540.29 $557 5.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $314.28 $324 3.5×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $417.10 $430 4.6×
Xr finger(s) 2+ views (73140) $298.76 $308 3.3×
Xr shoulder 1 view (73020) $337.56 $348 3.7×
Xr spine cervical 4 or 5 views (72050) $651.84 $672 6.0×
Xr tibia/fibula 2 views (73590) $420.01 $433 4.6×
Xray knee 1 or 2 views rt (73560) $396.73 $409 4.4×