Imaging prices at Community Hospital, Torrington (Banner Health)

Torrington, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $286.53 $407 2.7×
Acute gastrointestinal blood loss imaging (78278) $1,134.11 $1,786 2.8×
Ankle 2 views (73600) $186.56 $265 2.1×
Antegrade urography radiological supvj & interpj (74425) $499.14 $709 1.4×
Arthrogram elbow (73085) $431.31 $601 1.2×
Arthrogram hip (73525) $693.98 $967 1.9×
Arthrogram shoulder (73040) $658.81 $918 1.8×
Arthrogram wrist (73115) $490.88 $684 1.4×
Arthrography knee lt (73580) $400.45 $558 1.1×
Bone &/Joint Imaging Limited Area (78300) $712.47 $1,122 1.7×
Bone &/Joint Imaging Multiple Areas (78305) $845.82 $1,332 2.1×
Bone &/joint imaging whole body (78306) $1,531.62 $2,412 3.8×
Bone age studies (77072) $168.96 $240 1.6×
Bone Imaging 3 Phase (78315) $1,760.86 $2,773 4.3×
Bone survey complete (77075) $347.07 $493 3.2×
Cervical spine 2 or 3 views (72040) $330.88 $470 3.7×
Chest 1 view (71045) $134.20 $220 1.5×
Chest 3 views (71047) $290.36 $476 3.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $432.96 $615 2.4×
Clavicle complete (73000) $249.22 $354 2.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $329.40 $549 3.1×
CT abdomen and pelvis without and with contrast (74178) $1,911.60 $3,186 5.4×
CT abdomen and pelvis without contrast (74176) $1,274.40 $2,124 5.2×
CT abdomen w contrast (74160) $1,022.40 $1,704 5.7×
CT abdomen w wo contrast (74170) $1,227 $2,045 6.8×
CT abdomen w/o contrast (74150) $817.80 $1,363 7.7×
CT angio hrt w/3d image (75574) $1,611.27 $3,242 4.5×
CT angiography upper extremity lt (73206) $2,139.60 $3,566 11.9×
CT c-spine w/o contrast (72125) $1,777.20 $2,962 16.6×
CT cervical spine w&w/o contrast (72127) $2,665.80 $4,443 14.9×
CT cervical spine with contrast (72126) $2,221.80 $3,703 6.2×
CT chest w/wo contrast (71270) $1,367.40 $2,279 7.6×
CT chest with contrast (71260) $1,139.40 $1,899 6.4×
CT colonography screening (74263) $873.23 $1,757 3.6×
CT colonography w/dye (74262) $1,081.97 $2,177 6.0×
CT colonography w/o cntrst (74261) $865.28 $1,741 8.1×
CT head/brain with contrast (70460) $1,126.27 $1,874 6.3×
CT head/brain without and with contrast (70470) $1,351.65 $2,249 7.5×
CT heart no contrast quant eval coronry calcium (75571) $82.50 $166 0.9×
CT iac w contrast (70481) $1,837.26 $3,057 10.3×
CT limited/localized follow up study (76380) $493.52 $993 5.6×
CT lower ext w/o (73700) $983.40 $1,639 9.2×
CT lower extremity w wo contrast (73702) $1,475.40 $2,459 8.2×
CT lower extremity with contrast (73701) $1,229.40 $2,049 6.9×
CT lumbar spine w & w/o contrast (72133) $2,813.40 $4,689 15.7×
CT lumbar spine w/o contrast (72131) $1,875.60 $3,126 17.6×
CT lumbar spine with contrast (72132) $2,344.80 $3,908 6.6×
CT maxillofacial w contrast (70487) $1,845.07 $3,070 10.3×
CT maxillofacial w/o contrast (70486) $1,476.06 $2,456 13.8×
CT maxillofacial w/wo contrast (70488) $2,214.08 $3,684 12.4×
CT neck soft tissue w contrast (70491) $1,237.46 $2,059 6.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,204.47 $3,668 12.3×
CT orbits w/o contrast (70480) $1,469.44 $2,445 13.8×
CT pelvis w & w/o contrast (72194) $2,685 $4,475 15.0×
CT pelvis w/o contrast (72192) $1,789.80 $2,983 16.8×
CT scan for measuring calcium and other minerals in bone (77078) $390 $650 4.4×
CT soft tissue neck w/o & w/contrast material (70492) $1,485.07 $2,471 8.3×
CT soft tissue neck w/o contrast (70490) $989.85 $1,647 9.3×
CT thoracic spine w/contrast (72129) $2,362.80 $3,938 13.2×
CT thoracic spine w/o contrast (72128) $1,890 $3,150 17.7×
CT thoracic spine w/wo contrast (72130) $2,835 $4,725 15.8×
CT thorax w/o contrast (71250) $911.40 $1,519 8.5×
CT upper extremity w/o & w/contrast material (73202) $2,037.60 $3,396 11.4×
CT upper extremity w/o contrast rt (73200) $1,358.40 $2,264 12.7×
CT upper extremity with contrast (73201) $1,698 $2,830 4.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,484.54 $2,987 8.3×
Cta Abdomen (74175) $1,288.80 $2,148 7.2×
CTA abdomen pelvis (74174) $2,007.60 $3,346 5.6×
CTA chest (71275) $1,435.80 $2,393 8.0×
Cta Head (70496) $1,419.56 $2,362 7.9×
CTA lwr ext w&w/o contrast (73706) $1,549.20 $2,582 8.6×
Cta Neck (70498) $1,559.60 $2,595 8.7×
Cta Pelvis (72191) $2,819.40 $4,699 15.7×
Cystography minimum 3 views rs&i (74430) $379.46 $539 1.1×
Doppler Echo Fetal Spectral Display Complete (76827) $426.87 $510 4.0×
Dxa bone density study 1/> sites axial skel (77080) $319.62 $454 3.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $332.99 $473 3.7×
Dxa bone density study axial skeleton (77085) $356.93 $507 3.3×
Echo exam of fetal heart (76825) $903.96 $1,080 1.6×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $415.99 $497 1.7×
Esophagus (74220) $307.65 $437 1.7×
Fetal biophysical profile non-stress testing (76818) $709.78 $848 6.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $653.70 $781 6.1×
Fluoroscopy up to 1 hr (76000) $528 $750 2.2×
Foot 2 views (73620) $218.24 $310 2.5×
Forearm 2 views (73090) $226.69 $322 2.5×
Gastric mucosa imaging (78261) $513.08 $808 1.3×
Gated Heart Planar Single (78472) $1,206.50 $1,900 3.0×
Hand 2 views (73120) $161.22 $229 1.5×
Hand 3 views (73130) $250.62 $356 2.8×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,645.29 $2,591 3.0×
Hepatobiliary syst imaging including gallbladder (78226) $1,201.42 $1,892 2.9×
Ht muscle image spect sing (78451) $2,619.38 $4,125 2.0×
Humerus Min 2 Views Left (73060) $301.31 $428 3.4×
Kidney imaging morphology (78700) $485.78 $765 1.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $664.84 $1,047 1.2×
Kidney img morphology vascular flow 1 w/rx (78708) $506.10 $797 0.9×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,054.10 $1,660 1.9×
Knee 3 views (73562) $270.34 $384 3.0×
Liver & spleen imaging static only (78215) $916.94 $1,444 2.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $434.98 $685 1.1×
Lung perf&ventilat diferentl (78598) $986.79 $1,554 1.8×
Lung perfusion differential (78597) $603.25 $950 1.5×
Lung Ventilation Imaging (78579) $518.16 $816 1.3×
Mammary ductogram or galactogram single (77053) $290.05 $412 1.2×
Meckels Diverticulum (78290) $1,077.60 $1,697 2.6×
Mr safety determination physician/other qhp (76016) $93.63 $133 1.1×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $220.35 $313 3.7×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $26.75 $38 0.9×
Mr safety implt electronics prepj supvj phys/qhp (76018) $144.32 $205 1.5×
Mr safety med physics xm customization plng&mntr (76017) $342.85 $487 1.4×
MRA head w & w/o contrast (70546) $2,431.94 $3,179 6.8×
MRA head w/o contrast (70544) $1,621.04 $2,119 6.6×
MRA head with contrast (70545) $2,026.49 $2,649 5.7×
MRA neck w contrast (70548) $3,513.64 $4,593 9.9×
Mra Neck W/O &W/Contrast Material (70549) $4,215.92 $5,511 11.8×
MRA neck w/o contrast (70547) $2,810.61 $3,674 11.5×
MRI abdomen w contrast (74182) $3,084.50 $3,980 8.7×
MRI abdomen w/o & w/contrast material (74183) $3,701.40 $4,776 10.4×
MRI abdomen w/o contrast (74181) $2,467.60 $3,184 10.1×
MRI any jnt lwr ext with con lt (73722) $2,315.70 $2,988 2.9×
MRI any jt upper extremity w/contrast matrl (73222) $1,839.85 $2,374 2.3×
MRI bone marrow blood supply (77084) $1,818.92 $2,347 7.5×
MRI breast w/o contrast bilateral (77047) $1,393.45 $1,798 5.7×
MRI breast w/o contrast unilat (77046) $885.05 $1,142 3.6×
MRI c-spine with contrast (72142) $1,534.19 $2,170 4.3×
MRI cervical spine w/o contrast (72141) $1,227.35 $1,736 5.0×
MRI chest w/o & w/contrast material (71552) $3,354.98 $4,329 9.4×
MRI chest w/o contrast (71550) $2,236.65 $2,886 9.2×
MRI chest with contrast (71551) $2,796.20 $3,608 3.5×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $2,247.50 $2,900 6.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,722.05 $2,222 4.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,377.17 $1,777 5.6×
MRI orbit face &/neck w/o contrast (70540) $2,044.51 $2,976 8.4×
MRI orbit/face/neck w&w/o cont (70543) $3,066.77 $4,464 8.6×
MRI orbit/face/neck w/contrast (70542) $2,555.64 $3,720 7.2×
MRI pelvis w contrast (72196) $2,002.60 $2,584 5.6×
MRI pelvis w/o & w/contrast material (72197) $2,403.28 $3,101 6.7×
MRI pelvis w/o contrast (72195) $1,601.92 $2,067 6.6×
MRI scan of arm joint before and after contrast (73223) $2,207.98 $2,849 6.2×
MRI scan of leg joint before and after contrast (73723) $2,778.38 $3,585 7.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,841.03 $2,604 5.2×
MRI spinal canal lumbar w/contrast material (72149) $1,534.19 $2,170 4.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,841.03 $2,604 5.2×
MRI spinal canal thoracic w/contrast matrl (72147) $1,534.19 $2,170 4.3×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,841.03 $2,604 5.2×
MRI thoracic spine w/o contrast (72146) $1,227.35 $1,736 5.0×
MRI tmj (70336) $2,400.18 $3,097 9.8×
MRI upper ext joint w/o contrast (73221) $1,471.73 $1,899 6.0×
MRI upper extrem other than jt w/o & w/contras (73220) $2,697 $3,480 7.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,798 $2,320 7.4×
Myelogram Cervical (72240) $1,526.98 $2,169 1.9×
Myelogram Lumbar (72265) $1,548.10 $2,199 1.9×
Myelogram thoracic (72255) $1,217.22 $1,729 1.5×
Myocardial Spect Multiple Studies (78452) $3,383.92 $5,329 2.6×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $4,604.51 $6,416 5.2×
Neck soft tissue (70360) $218.94 $311 2.5×
Nm gastric emptying study (78264) $1,363.98 $2,148 3.3×
Nuclear medicine study of kidney and blood flow (78701) $513.08 $808 1.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $454.49 $543 4.3×
Osseous survey infant (77076) $349.89 $497 3.3×
Parathyroid imaging (78070) $730.88 $1,151 1.8×
Pelvis 1 or 2 views (72170) $173.89 $247 1.6×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,066.15 $2,666 5.8×
Pulmonary Perfusion Imaging Particulate (78580) $730.88 $1,151 1.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,156.97 $1,822 2.1×
Radex abscess/fistula/sinus tract rs&i (76080) $503.36 $715 0.9×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $244.29 $347 2.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $350.59 $498 3.3×
Radex hips bilateral with pelvis 2 views (73521) $192.19 $273 1.8×
Radex mastoids compl minimum 3 views pr side (70130) $230.91 $328 2.2×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $413.25 $587 3.9×
Radiolog exam mandible compl minimum 4 views (70110) $349.89 $497 3.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $158.40 $225 1.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $299.90 $426 2.8×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $281.82 $462 3.2×
Radiologic exam colon single contrast study (74270) $642.75 $913 3.6×
Radiologic exam upr gi trc double contrast study (74246) $622.34 $884 3.5×
Radiologic exam upr gi trc single contrast study (74240) $468.86 $666 2.6×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $194.30 $276 2.2×
Radiological examination surgical specimen (76098) $181.63 $258 0.3×
Ribs bilateral 3 views (71110) $321.73 $457 3.0×
Rp loclzj tum plnr whole body single day imaging (78802) $873.12 $1,375 1.6×
Rp loclzj tum spect 1 area single day imaging (78803) $1,042.04 $1,641 1.9×
Scanogram (77073) $400.58 $569 3.8×
Scapula complete (73010) $188.67 $268 1.8×
Screening digital breast tomosynthesis (77063) $40.82 $49 1.7×
Small bowel series (74250) $424.51 $603 2.4×
Spine thoracic 3 views (72072) $359.74 $511 3.4×
Testicular Imaging With Vascular Flow (78761) $584.20 $920 1.4×
Thyroid Imaging With Vascular Flow (78013) $617.22 $972 1.5×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $840.10 $1,323 2.1×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $521.34 $821 1.3×
Ultrasound elastography first target lesion (76982) $217.62 $260 2.0×
Ultrasound, abdomen limited (76705) $745.77 $891 7.0×
Upper Extremity Infant (73092) $247.81 $352 2.3×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $535.31 $843 1.3×
Urethrocystography retrograde rs&i (74450) $500.54 $711 2.1×
Urethrocystography voiding (74455) $566.72 $805 2.3×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,085.57 $1,542 6.1×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $980.67 $1,393 5.5×
Us abdl aorta screen aaa (76706) $321.41 $384 3.0×
Us breast unilateral complete (76641) $592.60 $708 5.5×
Us breast unilateral limited (76642) $486.30 $581 5.5×
Us chest (76604) $497.18 $594 4.7×
Us compl joint r-t w/image documentation (76881) $760.83 $909 7.1×
Us elastography parenchyma (76981) $252.77 $302 2.4×
Us ob detailed single fetus (76811) $522.29 $624 2.1×
Us ob transvaginal (76817) $576.69 $689 5.4×
Us pelvic non ob complete (76856) $874.66 $1,045 8.2×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $641.14 $766 6.0×
Us pregnancy ltd (76815) $446.96 $534 4.2×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $747.44 $893 7.0×
Us retroperitoneal complete (76770) $859.60 $1,027 8.0×
Us retroperitoneal limited (76775) $282.07 $337 2.6×
Us scrotum and contents (76870) $805.19 $962 7.5×
Us soft tissue head/neck (76536) $779.25 $931 7.3×
Us xtr non-vasc lmtd (76882) $490.48 $586 4.6×
Venogram extremity bilateral (75822) $555.46 $789 0.3×
Venography extremity unilateral rs&i (75820) $475.20 $675 0.3×
Wrist 2 views (73100) $218.24 $310 2.5×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $347.07 $493 3.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $265.41 $377 3.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $331.58 $471 3.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $713.15 $1,013 4.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $274.56 $390 3.1×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $338.62 $481 3.8×
X-ray exam entire spi 4/5 vw (72083) $398.46 $566 3.7×
X-ray exam hip uni 1 view (73501) $155.58 $221 1.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $292.16 $415 3.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $313.28 $445 2.9×
X-Ray Exam Hips Bi 5/> Views (73523) $495.62 $704 4.6×
X-ray exam of femur 1 (73551) $130.94 $186 1.5×
X-ray eye for foreign body (70030) $118.27 $168 1.3×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $322.43 $458 3.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $275.97 $392 3.1×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $312.58 $444 3.5×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $164.74 $234 1.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $330.88 $470 3.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $411.84 $585 3.9×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $130.94 $186 1.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $264 $375 2.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $599.81 $852 5.6×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $516.74 $734 4.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $242.18 $344 2.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $366.08 $520 3.4×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $260.48 $370 2.4×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $604.74 $859 1.7×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $276.67 $393 3.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $313.98 $446 2.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $394.94 $561 3.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $370.30 $526 3.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $223.87 $318 2.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $312.58 $444 3.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $306.24 $435 3.4×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $195.01 $277 2.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $332.29 $472 3.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $289.34 $411 2.7×
X-Ray Spine One View - Xr Spine (72020) $232.32 $330 2.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $259.07 $368 2.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $163.33 $232 1.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $347.07 $493 3.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $180.93 $257 2.0×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $311.17 $442 3.5×
Xr arthrogram ankle (73615) $457.15 $637 1.3×
Xr c-spine 6 or more views (72052) $537.15 $763 5.0×
Xr chest 4+ views (71048) $328.18 $538 3.1×
Xr finger(s) 2+ views (73140) $184.45 $262 2.1×
Xr internal auditory meati complete (70134) $345.66 $491 0.6×
Xr optic foramina (70190) $197.12 $280 2.2×
Xr shoulder 1 view (73020) $226.69 $322 2.5×
Xr spine cervical 4 or 5 views (72050) $455.49 $647 4.3×
Xr tibia/fibula 2 views (73590) $187.26 $266 2.1×
Xr tmj bilateral (70330) $274.56 $390 3.1×
Xray knee 1 or 2 views rt (73560) $221.76 $315 2.5×