Imaging prices at Bitterroot Health - Daly Hospital
Hamilton, MT · every code in this section with a posted price and a Medicare benchmark.
238 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) | $308 | $308 | 3.5× |
| Abdomen 2 views (74019) | $372 | $372 | 3.5× |
| Ankle 2 views (73600) | $308 | $308 | 3.5× |
| Arthrogram ankle (73615) | $1,250 | $1,250 | 3.5× |
| Arthrogram hip (73525) | $1,250 | $1,250 | 3.5× |
| Arthrogram Wrist (73115) | $1,250 | $1,250 | 3.5× |
| Bone age studies (77072) | $372 | $372 | 3.5× |
| Bone survey infant (77076) | $372 | $372 | 3.5× |
| Chest 1 view (71045) | $308 | $308 | 3.5× |
| Chest 2 views (71046) | $308 | $308 | 3.5× |
| Chest 3 views (71047) | $308 | $308 | 3.5× |
| Chest 4 or more views (71048) | $372 | $372 | 3.5× |
| Clavicle complete (73000) | $308 | $308 | 3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,223 | $1,223 | 11.5× |
| Contrast X-Ray Bladder (74430) | $1,250 | $1,250 | 3.5× |
| Contrast X-Ray Of Elbow (73085) | $1,250 | $1,250 | 3.5× |
| Contrast X-Ray Of Knee Joint (73580) | $1,250 | $1,250 | 3.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$4,107–$4,214 | $4,107–$4,214 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,780 | $2,780 | 11.4× |
| CT abdomen w contrast (74160) | $2,047 | $2,047 | 11.4× |
| CT abdomen w wo contrast (74170) | $2,047 | $2,047 | 11.4× |
| CT abdomen w/o contrast (74150) | $1,223 | $1,223 | 11.5× |
| CT Angio Abdomen and Pelvis (74174) | $4,214 | $4,214 | 11.8× |
| CT Angio Chest (71275) | $2,047 | $2,047 | 11.4× |
| CT Angio Head (70496) | $2,047 | $2,047 | 11.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,047 | $2,047 | 11.4× |
| CT Angio Neck (70498) | $2,047 | $2,047 | 11.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,047 | $2,047 | 11.4× |
| CT cervical spine w/ contrast (72126) | $4,107 | $4,107 | 11.5× |
| CT cervical spine w/o contrast (72125) | $1,223 | $1,223 | 11.5× |
| CT cervical spine w/wo cont (72127) | $2,047 | $2,047 | 11.4× |
| CT chest w contrast (71260) | $2,047 | $2,047 | 11.4× |
| CT chest w/wo contrast (71270) | $2,047 | $2,047 | 11.4× |
| CT colonography screening (74263) | $2,780 | $2,780 | 11.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,223 | $1,223 | 11.5× |
| CT head/brain with contrast (70460) | $2,047 | $2,047 | 11.4× |
| CT head/brain without and with contrast (70470) | $2,047 | $2,047 | 11.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,013 | $1,013 | 11.4× |
| CT iac w contrast (70481) | $2,047 | $2,047 | 11.4× |
| CT l-spine w&w/o contrast (72133) | $2,047 | $2,047 | 11.4× |
| CT lower ext w/o (73700) | $1,223 | $1,223 | 11.5× |
| CT lower extremity w/contrast material (73701) | $2,047 | $2,047 | 11.4× |
| CT lumbar spine w contrast (72132) | $4,107 | $4,107 | 11.5× |
| CT lumbar spine w/o contrast (72131) | $1,223 | $1,223 | 11.5× |
| CT maxillofacial w contrast (70487) | $2,047 | $2,047 | 11.4× |
| CT maxillofacial wo contrast (70486) | $1,223 | $1,223 | 11.5× |
| CT neck tissue combo (70492) | $2,047 | $2,047 | 11.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,047 | $2,047 | 11.4× |
| CT orbits w/o contrast (70480) | $1,223 | $1,223 | 11.5× |
| CT pelvis w&w/o contrast (72194) | $2,047 | $2,047 | 11.4× |
| CT pelvis w/o contrast (72192) | $1,223 | $1,223 | 11.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,013–$2,047 | $2,013–$2,047 | varies |
| CT scans face/jaw combo (70488) | $2,047 | $2,047 | 11.4× |
| CT soft tissue neck w contrast (70491) | $2,047 | $2,047 | 11.4× |
| CT soft tissue neck w/o contrast (70490) | $1,223 | $1,223 | 11.5× |
| CT thoracic spine w contrast (72129) | $2,047 | $2,047 | 11.4× |
| CT thoracic spine w/o contrast (72128) | $1,223 | $1,223 | 11.5× |
| CT thoracic spine w/wo cont (72130) | $2,047 | $2,047 | 11.4× |
| CT thorax w/o contrast (71250) | $1,223 | $1,223 | 11.5× |
| CT upper ext wo (73200) | $1,223 | $1,223 | 11.5× |
| CT upper extremity w/o & w/contrast material (73202) | $2,047 | $2,047 | 11.4× |
| CT upper extremity with contrast (73201) | $4,107 | $4,107 | 11.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,047 | $2,047 | 11.4× |
| Cta Abdomen (74175) | $2,047 | $2,047 | 11.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $450 | $450 | 4.2× |
| Dxa Bone Density Axial (77080) | $372 | $372 | 3.5× |
| Dxa bone density study (77085) | $372 | $372 | 3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $308 | $308 | 3.5× |
| Echo exam uterus (76831) | $893 | $893 | 3.7× |
| Esophagram (74220) | $623 | $623 | 3.5× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$372–$457 | $372–$457 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$372–$459 | $372–$459 | varies |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$129–$846 | $129–$846 | varies |
| Foot 2 views (73620) | $308 | $308 | 3.5× |
| Forearm 2 views (73090) | $308 | $308 | 3.5× |
| Hand 2 views (73120) | $372 | $372 | 3.5× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$272–$846 | $272–$846 | varies |
| Joint Survey Single View (77077) | $372 | $372 | 3.5× |
| Knee 3 Views (73562) | $308 | $308 | 3.5× |
| Magnetic Image Jaw Joint (70336) | $2,538 | $2,538 | 10.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,750 | $3,750 | 10.5× |
| MRA head w/o contrast (70544) | $2,538 | $2,538 | 10.4× |
| MRA head with contrast (70545) | $3,750 | $3,750 | 10.5× |
| MRA neck w contrast (70548) | $3,750 | $3,750 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,750 | $3,750 | 10.5× |
| MRA neck w/o contrast (70547) | $2,538 | $2,538 | 10.4× |
| MRI abdomen w contrast (74182) | $3,750 | $3,750 | 10.5× |
| MRI abdomen w/o contrast (74181) | $2,538 | $2,538 | 10.4× |
| MRI any jt lower extrem w/contrast material (73722) | $3,950 | $3,950 | 4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,750 | $3,750 | 10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,950 | $3,950 | 4.9× |
| MRI bone marrow blood supply (77084) | $2,538 | $2,538 | 10.4× |
| MRI cervical spine w contrast (72142) | $3,750 | $3,750 | 10.5× |
| MRI cervical spine w/o cont (72141) | $2,538 | $2,538 | 10.4× |
| MRI chest w/o contrast (71550) | $2,538 | $2,538 | 10.4× |
| MRI chest with contrast (71551) | $3,950 | $3,950 | 4.9× |
| MRI chest wo w contrast (71552) | $3,750 | $3,750 | 10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,750 | $3,750 | 10.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,750 | $3,750 | 10.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,538 | $2,538 | 10.4× |
| MRI lumbar spine w contrast (72149) | $3,750 | $3,750 | 10.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,750 | $3,750 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,538 | $2,538 | 10.4× |
| MRI orbit face neck w contrast (70542) | $3,750 | $3,750 | 10.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,750 | $3,750 | 10.5× |
| MRI pelvis w contrast (72196) | $3,750 | $3,750 | 10.5× |
| MRI pelvis w/o & w contrast (72197) | $3,750 | $3,750 | 10.5× |
| MRI pelvis w/o contrast (72195) | $2,538 | $2,538 | 10.4× |
| MRI thoracic spine w/o contrast (72146) | $2,538 | $2,538 | 10.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,750 | $3,750 | 10.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,538 | $2,538 | 10.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,750 | $3,750 | 10.5× |
| MRI, abdomen, combo (74183) | $3,750 | $3,750 | 10.5× |
| MRI, dorsal spine combo (72157) | $3,750 | $3,750 | 10.5× |
| MRI, dorsal spine contrast (72147) | $3,750 | $3,750 | 10.5× |
| MRI, joint upper extrem (73221) | $2,538 | $2,538 | 10.4× |
| MRI, joint upper extrem combo (73223) | $3,750 | $3,750 | 10.5× |
| MRI, lumbar spine combo (72158) | $3,750 | $3,750 | 10.5× |
| Myelogram cervical (72240) | $3,950 | $3,950 | 4.9× |
| Myelogram Lumbar (72265) | $2,765 | $2,765 | 3.5× |
| Neck soft tissue (70360) | $308 | $308 | 3.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 3 matching MRF lines |
$65–$441 | $65–$441 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $34 | $34 | 1.2× |
| Optic foramina (70190) | $308 | $308 | 3.5× |
| Pelvis 1 or 2 views (72170) | $372 | $372 | 3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $372 | $372 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,919 | $1,919 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $308 | $308 | 3.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $308 | $308 | 3.5× |
| Radex elbow complete minimum 3 views (73080) | $308 | $308 | 3.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $372 | $372 | 3.5× |
| Radex fingr minimum 2 views (73140) | $308 | $308 | 3.5× |
| Radex foot complete minimum 3 views (73630) | $308 | $308 | 3.5× |
| Radex Hand Minimum 3 Views (73130) | $308 | $308 | 3.5× |
| Radex lower extremity infant minimum 2 views (73592) | $308 | $308 | 3.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $372 | $372 | 3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $308 | $308 | 3.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $308 | $308 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) | $308 | $308 | 3.5× |
| Radex shoulder complete minimum 2 views (73030) | $308 | $308 | 3.5× |
| Radex Sinuses Paransl < 3 Views (70210) | $308 | $308 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $308 | $308 | 3.5× |
| Radex Sternum Minimum 2 Views (71120) | $308 | $308 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $308 | $308 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $308 | $308 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) | $372 | $372 | 3.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $308 | $308 | 3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $372 | $372 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $372 | $372 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $623 | $623 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $623 | $623 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) | $372 | $372 | 3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $372 | $372 | 3.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $623 | $623 | 3.5× |
| Radiologic exam swallow function contrast study (74230) | $623 | $623 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $623 | $623 | 3.5× |
| Radiologic examination femur minimum 2 views (73552) | $308 | $308 | 3.5× |
| Radiologic examination knee 1/2 views (73560) | $308 | $308 | 3.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $372 | $372 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $308 | $308 | 3.5× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,919 | $1,919 | 3.4× |
| Ribs bilateral 3 views (71110) | $372 | $372 | 3.5× |
| Scapula (73010) | $372 | $372 | 3.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $70 | $70 | 3.0× |
| Shoulder 1 view (73020) | $308 | $308 | 3.5× |
| Shoulder Arthrography (73040) | $1,250 | $1,250 | 3.5× |
| Skull less than 4 views (70250) | $372 | $372 | 3.5× |
| Sternoclavicular joints (71130) | $308 | $308 | 3.5× |
| Thoracic spine 3 views (72072) | $372 | $372 | 3.5× |
| Thoracolumbar 2 views (72080) | $308 | $308 | 3.5× |
| Ultrasound Breast Limited (76642) | $308 | $308 | 3.5× |
| Ultrasound Elastography Parenchyma (76981) | $372 | $372 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) | $372 | $372 | 3.5× |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$100–$372 | $100–$372 | varies |
| Umbilical-artery Doppler (OB) (76820) | $420 | $420 | 3.9× |
| Unlisted us procedure (76999) | $308 | $308 | 3.5× |
| Upper gi w/o kub (74240) | $623 | $623 | 3.5× |
| Urethrocystogram voiding (74455) | $846 | $846 | 3.5× |
| Urethrocystography retrograde (74450) | $846 | $846 | 3.5× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$372–$419 | $372–$419 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$86–$372 | $86–$372 | varies |
| Us complete joint (76881) | $372 | $372 | 3.5× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$76–$420 | $76–$420 | varies |
| Us head (76506) | $372 | $372 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$86–$505 | $86–$505 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$846–$1,067 | $846–$1,067 | varies |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$98–$443 | $98–$443 | varies |
| Us ob transvaginal (76817) range across 6 matching MRF lines |
$115–$457 | $115–$457 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$372–$448 | $372–$448 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$372–$493 | $372–$493 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$372–$472 | $372–$472 | varies |
| Us retroperitoneal complete (76770) | $372 | $372 | 3.5× |
| Us retroperitoneal limited (76775) range across 8 matching MRF lines |
$92–$372 | $92–$372 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$97–$372 | $97–$372 | varies |
| Us spinal canal and contents (76800) | $543 | $543 | 5.1× |
| Us thyroid (76536) range across 3 matching MRF lines |
$85–$372 | $85–$372 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$372–$447 | $372–$447 | varies |
| Vascular Flow Imaging (78445) | $1,380 | $1,380 | 3.4× |
| Vein X-Ray Chest (75827) | $5,437 | $5,437 | 3.4× |
| Venography extremity bilateral rs&i (75822) | $5,437 | $5,437 | 3.4× |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$319–$5,437 | $319–$5,437 | varies |
| Wrist 2 views (73100) | $308 | $308 | 3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $308 | $308 | 3.5× |
| X-ray antegrade pyelogram tube (74425) | $1,250 | $1,250 | 3.5× |
| X-Ray Bend Only L-S Spine (72120) | $372 | $372 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $308 | $308 | 3.5× |
| X-Ray Exam Breast Specimen (76098) | $1,919 | $1,919 | 3.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $308 | $308 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $372 | $372 | 3.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $308 | $308 | 3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $308 | $308 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $372 | $372 | 3.5× |
| X-Ray Exam L-S Spine Bending (72114) | $372 | $372 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $308 | $308 | 3.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $372 | $372 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $372 | $372 | 3.5× |
| X-ray eye for foreign body (70030) | $308 | $308 | 3.5× |
| X-ray humerus (73060) | $308 | $308 | 3.5× |
| X-ray IV pyelogram (ivp) (74400) | $623 | $623 | 3.5× |
| X-ray IV pyelogram+tomography (74415) | $623 | $623 | 3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $308 | $308 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $308 | $308 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $372 | $372 | 3.5× |
| X-ray nose-rectum child f.b. (76010) | $308 | $308 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $372 | $372 | 3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $372 | $372 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $308 | $308 | 3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $308 | $308 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $372 | $372 | 3.5× |
| X-Ray Stress View (77071) | $308 | $308 | 3.5× |
| X-Ray Tmj Unilat (70328) | $308 | $308 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$235–$1,250 | $235–$1,250 | varies |
| X-Rays Bone Length Studies (77073) | $372 | $372 | 3.5× |
| X-Rays Bone Survey Complete (77075) | $372 | $372 | 3.5× |
| Xr c-spine 4 or 5 views (72050) | $372 | $372 | 3.5× |
| Xr facial bones less than 3 views (70140) | $308 | $308 | 3.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $372 | $372 | 3.5× |
| Xr orbits complete 4 views (70200) | $372 | $372 | 3.5× |
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.