Imaging prices at Avera St. Mary's Hospital
Pierre, SD · every code in this section with a posted price and a Medicare benchmark.
200 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) | $9,500.40 | $10,556 | 6.7× |
| Abdomen 1 View (74018) | $546.30 | $607 | 6.1× |
| Abdomen 2 views (74019) | $896.40 | $996 | 8.4× |
| Ankle 2 views (73600) | $611.10 | $679 | 6.9× |
| Arthrogram Wrist (73115) | $1,058.40 | $1,176 | 3.0× |
| Basic radiation dosimetry calculation (77300) | $903.60 | $1,004 | 6.6× |
| Bone Imaging 3 Phase (78315) | $2,653.20 | $2,948 | 6.5× |
| Bone Imaging Whole Body (78306) | $3,792.60 | $4,214 | 9.3× |
| Bone survey infant (77076) | $1,005.30 | $1,117 | 9.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$396.90–$507.60 | $441–$564 | varies |
| Chest 2 views (71046) | $842.40 | $936 | 9.5× |
| Clavicle complete (73000) | $604.80 | $672 | 6.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $289.80 | $322 | 2.7× |
| Continuing medical physics consltj pr wk (77336) | $990 | $1,100 | 7.2× |
| Contrast X-Ray Bladder (74430) | $1,448.10 | $1,609 | 4.1× |
| CT abdomen and pelvis without and with contrast (74178) | $8,394.30 | $9,327 | 23.6× |
| CT abdomen and pelvis without contrast (74176) | $6,635.70 | $7,373 | 27.2× |
| CT abdomen w contrast (74160) | $3,512.70 | $3,903 | 19.6× |
| CT abdomen w wo contrast (74170) | $3,802.50 | $4,225 | 21.2× |
| CT abdomen w/o contrast (74150) | $3,223.80 | $3,582 | 30.2× |
| CT Angio Abdomen and Pelvis (74174) | $7,568.10 | $8,409 | 21.2× |
| CT Angio Chest (71275) | $4,819.50 | $5,355 | 26.9× |
| CT Angio Head (70496) | $4,673.70 | $5,193 | 26.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,386.60 | $4,874 | 24.5× |
| CT Angio Neck (70498) | $4,673.70 | $5,193 | 26.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,781.70 | $5,313 | 26.7× |
| CT cervical spine w/ contrast (72126) | $5,326.20 | $5,918 | 14.9× |
| CT cervical spine w/o contrast (72125) | $4,532.40 | $5,036 | 42.4× |
| CT cervical spine w/wo cont (72127) | $6,119.10 | $6,799 | 34.1× |
| CT chest w contrast (71260) | $4,262.40 | $4,736 | 23.8× |
| CT chest w/wo contrast (71270) | $4,689 | $5,210 | 26.2× |
| CT head/brain with contrast (70460) | $3,486.60 | $3,874 | 19.5× |
| CT head/brain without and with contrast (70470) | $3,971.70 | $4,413 | 22.2× |
| CT iac w contrast (70481) | $3,564 | $3,960 | 19.9× |
| CT l-spine w&w/o contrast (72133) | $4,525.20 | $5,028 | 25.3× |
| CT lower ext w/o (73700) | $4,293 | $4,770 | 40.2× |
| CT lower extremity w/contrast material (73701) | $4,778.10 | $5,309 | 26.7× |
| CT lumbar spine w contrast (72132) | $4,292.10 | $4,769 | 12.0× |
| CT lumbar spine w/o contrast (72131) | $4,058.10 | $4,509 | 38.0× |
| CT maxillofacial w contrast (70487) | $3,697.20 | $4,108 | 20.6× |
| CT maxillofacial wo contrast (70486) | $3,393.90 | $3,771 | 31.8× |
| CT neck tissue combo (70492) | $4,852.80 | $5,392 | 27.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,920.40 | $4,356 | 21.9× |
| CT orbits w/o contrast (70480) | $3,026.70 | $3,363 | 28.3× |
| CT pelvis w&w/o contrast (72194) | $3,696.30 | $4,107 | 20.6× |
| CT pelvis w/o contrast (72192) | $2,567.70 | $2,853 | 24.0× |
| CT scan of leg combo (73702) | $5,263.20 | $5,848 | 29.4× |
| CT scans face/jaw combo (70488) | $3,971.70 | $4,413 | 22.2× |
| CT soft tissue neck w contrast (70491) | $4,632.30 | $5,147 | 25.8× |
| CT soft tissue neck w/o contrast (70490) | $4,411.80 | $4,902 | 41.3× |
| CT thoracic spine w contrast (72129) | $4,222.80 | $4,692 | 23.6× |
| CT thoracic spine w/o contrast (72128) | $4,077 | $4,530 | 38.2× |
| CT thoracic spine w/wo cont (72130) | $4,308.30 | $4,787 | 24.0× |
| CT thorax w/o contrast (71250) | $3,537 | $3,930 | 33.1× |
| CT upper ext wo (73200) | $4,130.10 | $4,589 | 38.7× |
| CT upper extremity with contrast (73201) | $4,257.90 | $4,731 | 11.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,185 | $4,650 | 23.4× |
| Cta Abdomen (74175) | $4,781.70 | $5,313 | 26.7× |
| Dxa Bone Density Axial (77080) | $508.50 | $565 | 4.8× |
| Echo exam uterus (76831) | $583.20 | $648 | 2.4× |
| Esophagram (74220) | $1,062 | $1,180 | 5.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,160.10 | $1,289 | 10.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,340.10 | $1,489 | 12.5× |
| Fluoroscopy up to 1 hr (76000) | $962.10 | $1,069 | 3.9× |
| Foot 2 views (73620) | $611.10 | $679 | 6.9× |
| Forearm 2 views (73090) | $611.10 | $679 | 6.9× |
| Hand 2 views (73120) | $611.10 | $679 | 5.7× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$2,620.80–$3,114 | $2,912–$3,460 | varies |
| Hysterosalpingogram (74740) | $1,629.90 | $1,811 | 6.7× |
| Image fusion (77399) | $1,098 | $1,220 | 8.0× |
| K Flow/Funct Image W/Drug (78708) | $3,193.20 | $3,548 | 5.8× |
| Knee 3 Views (73562) | $661.50 | $735 | 7.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,564.10 | $2,849 | 4.6× |
| Lymph System Imaging (78195) | $2,559.60 | $2,844 | 4.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,902.60 | $2,114 | 5.0× |
| Mra Head W/O & W/Contrast Material (70546) | $6,417 | $7,130 | 18.0× |
| MRA head w/o contrast (70544) | $5,872.50 | $6,525 | 24.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,424.30 | $6,027 | 15.2× |
| MRA neck w/o contrast (70547) | $4,761.90 | $5,291 | 19.5× |
| MRI abdomen w/o contrast (74181) | $4,144.50 | $4,605 | 17.0× |
| MRI any jt lower extrem w/contrast material (73722) | $6,038.10 | $6,709 | 7.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,417 | $7,130 | 18.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $7,017.30 | $7,797 | 8.8× |
| MRI cervical spine w/o cont (72141) | $5,936.40 | $6,596 | 24.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $6,417 | $7,130 | 18.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,068.80 | $5,632 | 20.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,013.60 | $8,904 | 22.5× |
| MRI orbit face &/neck w/o contrast (70540) | $6,034.50 | $6,705 | 24.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $7,301.70 | $8,113 | 20.5× |
| MRI pelvis w/o & w contrast (72197) | $7,698.60 | $8,554 | 21.6× |
| MRI pelvis w/o contrast (72195) | $5,702.40 | $6,336 | 23.4× |
| MRI thoracic spine w/o contrast (72146) | $5,936.40 | $6,596 | 24.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $5,072.40 | $5,636 | 20.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,417 | $7,130 | 18.0× |
| MRI, abdomen, combo (74183) | $4,678.20 | $5,198 | 13.1× |
| MRI, dorsal spine combo (72157) | $8,013.60 | $8,904 | 22.5× |
| MRI, joint upper extrem (73221) | $6,335.10 | $7,039 | 26.0× |
| MRI, joint upper extrem combo (73223) | $7,700.40 | $8,556 | 21.6× |
| MRI, lumbar spine combo (72158) | $6,570.90 | $7,301 | 18.4× |
| Myocardial Spect Multiple Studies (78452) | $9,020.70 | $10,023 | 6.8× |
| Neck soft tissue (70360) | $583.20 | $648 | 6.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $18,822.60 | $20,914 | 13.3× |
| Parathyroid Planar Imaging (78070) | $2,517.30 | $2,797 | 6.2× |
| Pelvis 1 or 2 views (72170) | $975.60 | $1,084 | 9.1× |
| PET image w/CT, full body (78816) | $11,890.80 | $13,212 | 8.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $11,599.20 | $12,888 | 7.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $705.60 | $784 | 6.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $768.60 | $854 | 8.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $500.40 | $556 | 5.6× |
| Radex elbow complete minimum 3 views (73080) | $756 | $840 | 8.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $979.20 | $1,088 | 9.2× |
| Radex fingr minimum 2 views (73140) | $540 | $600 | 6.1× |
| Radex foot complete minimum 3 views (73630) | $769.50 | $855 | 8.7× |
| Radex Hand Minimum 3 Views (73130) | $756 | $840 | 8.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $744.30 | $827 | 8.4× |
| Radex Ribs Unilateral 2 Views (71100) | $801.90 | $891 | 9.0× |
| Radex shoulder complete minimum 2 views (73030) | $718.20 | $798 | 8.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $642.60 | $714 | 7.2× |
| Radex Spine 1 View Specify Level (72020) | $810 | $900 | 9.1× |
| Radex Toe Minimum 2 Views (73660) | $509.40 | $566 | 5.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $756 | $840 | 8.5× |
| Radiation treatment delivery level 3 (77412) | $4,857.30 | $5,397 | 8.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,081.80 | $1,202 | 10.1× |
| Radiologic exam colon double contrast study (74280) | $1,783.80 | $1,982 | 10.0× |
| Radiologic exam colon single contrast study (74270) | $1,783.80 | $1,982 | 10.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $873 | $970 | 4.9× |
| Radiologic exam knee complete 4/more views (73564) | $903.60 | $1,004 | 8.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,283.40 | $1,426 | 12.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $519.30 | $577 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $1,278 | $1,420 | 7.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,828.80 | $2,032 | 10.2× |
| Radiologic examination femur minimum 2 views (73552) | $716.40 | $796 | 8.1× |
| Radiologic examination knee 1/2 views (73560) | $620.10 | $689 | 7.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $630 | $700 | 7.1× |
| Scapula (73010) | $611.10 | $679 | 5.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $71.10 | $79 | 3.0× |
| Shoulder 1 view (73020) | $611.10 | $679 | 6.9× |
| Skull less than 4 views (70250) | $549.90 | $611 | 5.1× |
| Special Physics Consult (77370) | $1,363.50 | $1,515 | 9.9× |
| Special teletherapy port plan (77321) | $2,637 | $2,930 | 6.9× |
| Special treatment procedure (77470) | $2,738.70 | $3,043 | 4.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,725.10 | $4,139 | 9.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,624.40 | $2,916 | 6.9× |
| Ther rad simulaj-aided field setting simple (77280) | $1,345.50 | $1,495 | 9.8× |
| Thoracic spine 2 views (72070) | $937.80 | $1,042 | 8.8× |
| Thoracic spine 3 views (72072) | $1,135.80 | $1,262 | 10.6× |
| Thoracolumbar 2 views (72080) | $565.20 | $628 | 6.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,556.80 | $3,952 | 8.7× |
| Tx Devices Design & Construction Complex (77334) | $1,836 | $2,040 | 4.8× |
| Tx devices design & construction simple (77332) | $592.20 | $658 | 4.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,524.60–$2,286.90 | $1,694–$2,541 | varies |
| Ultrasound, abdomen limited (76705) | $1,746.90 | $1,941 | 16.4× |
| Unlisted us procedure (76999) | $690.30 | $767 | 7.8× |
| Upper gi w/o kub (74240) | $1,495.80 | $1,662 | 8.3× |
| Urethrocystogram voiding (74455) | $1,985.40 | $2,206 | 8.1× |
| Urethrocystography retrograde (74450) | $1,124.10 | $1,249 | 4.6× |
| Us chest (76604) | $769.50 | $855 | 7.2× |
| Us complete joint (76881) | $1,067.40 | $1,186 | 10.0× |
| Us exam, pelvic, limited (76857) | $905.40 | $1,006 | 8.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $826.20 | $918 | 7.7× |
| Us ob detailed single fetus (76811) | $2,263.50 | $2,515 | 9.3× |
| Us ob limited 1 or more fetuses (76815) | $920.70 | $1,023 | 8.6× |
| Us ob transvaginal (76817) | $1,596.60 | $1,774 | 14.9× |
| Us pelvic non ob complete (76856) | $1,959.30 | $2,177 | 18.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,758.60 | $1,954 | 16.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,215 | $1,350 | 11.4× |
| Us retroperitoneal complete (76770) | $2,075.40 | $2,306 | 19.4× |
| Us retroperitoneal limited (76775) | $1,475.10 | $1,639 | 13.8× |
| Us scrotum and contents (76870) | $1,632.60 | $1,814 | 15.3× |
| Us thyroid (76536) | $1,107.90 | $1,231 | 10.4× |
| Us transrectal (76872) | $453.60 | $504 | 4.2× |
| Wrist 2 views (73100) | $608.40 | $676 | 6.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $905.40 | $1,006 | 10.2× |
| X-ray antegrade pyelogram tube (74425) | $1,269 | $1,410 | 3.6× |
| X-Ray Bend Only L-S Spine (72120) | $963 | $1,070 | 9.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $611.10 | $679 | 6.9× |
| X-Ray Exam Breast Specimen (76098) | $741.60 | $824 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $771.30 | $857 | 8.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,198.80 | $1,332 | 11.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $536.40 | $596 | 6.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$602.10–$1,069.20 | $669–$1,188 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,341 | $1,490 | 12.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,581.30 | $1,757 | 14.8× |
| X-Ray Exam L-S Spine Bending (72114) | $1,260.90 | $1,401 | 11.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $999.90 | $1,111 | 11.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,193.40 | $1,326 | 11.2× |
| X-ray humerus (73060) | $603.90 | $671 | 6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $897.30 | $997 | 10.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $647.10 | $719 | 7.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $956.70 | $1,063 | 9.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,440 | $1,600 | 13.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $593.10 | $659 | 5.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $703.80 | $782 | 7.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $854.10 | $949 | 9.6× |
| X-Ray Stress View (77071) | $381.60 | $424 | 4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,166.40 | $1,296 | 3.3× |
| X-Rays Bone Length Studies (77073) | $941.40 | $1,046 | 8.8× |
| X-Rays Bone Survey Complete (77075) | $2,515.50 | $2,795 | 23.6× |
| Xr c-spine 4 or 5 views (72050) | $1,462.50 | $1,625 | 13.7× |
| Xr facial bones less than 3 views (70140) | $664.20 | $738 | 7.5× |
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.