Imaging prices at Black River Memorial Hospital
Black River Falls, WI · 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) | $265.50 | $295 | 3.1× |
| Abdomen 2 views (74019) | $152.10 | $169 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,135.70 | $2,373 | 5.5× |
| Ankle 2 views (73600) | $334.80 | $372 | 4.0× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$1,017.90–$1,048.50 | $1,131–$1,165 | varies |
| Arthrogram Wrist (73115) | $1,310.40 | $1,456 | 3.9× |
| Bone Imaging 3 Phase (78315) | $2,010.60 | $2,234 | 5.2× |
| Bone Imaging Limited Area (78300) | $1,324.80 | $1,472 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,909.80 | $2,122 | 4.9× |
| Bone survey infant (77076) | $603.90 | $671 | 5.9× |
| Cat Scan Follow-Up Study (76380) | $1,602 | $1,780 | 19.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$150.30–$414.90 | $167–$461 | varies |
| Chest 2 views (71046) | $300.60 | $334 | 3.6× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$527.40–$543.60 | $586–$604 | varies |
| Chest 4 or more views (71048) | $773.10 | $859 | 7.6× |
| Clavicle complete (73000) | $375.30 | $417 | 4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $467.10 | $519 | 4.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$1,106.10–$1,139.40 | $1,229–$1,266 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$669.60–$689.40 | $744–$766 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,760.10 | $5,289 | 14.0× |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$2,718.90–$2,800.80 | $3,021–$3,112 | varies |
| CT abdomen w contrast (74160) | $2,833.20 | $3,148 | 16.6× |
| CT abdomen w wo contrast (74170) | $3,357 | $3,730 | 19.7× |
| CT abdomen w/o contrast (74150) | $1,976.40 | $2,196 | 19.5× |
| CT Angio Abdomen and Pelvis (74174) | $4,456.80 | $4,952 | 13.2× |
| CT Angio Chest (71275) | $3,235.50 | $3,595 | 19.0× |
| CT Angio Head (70496) | $2,982.60 | $3,314 | 17.5× |
| CT angio hrt w/3d image (75574) | $2,655 | $2,950 | 7.8× |
| CT Angio Neck (70498) | $2,969.10 | $3,299 | 17.4× |
| CT cervical spine w/ contrast (72126) | $4,044.60 | $4,494 | 11.9× |
| CT cervical spine w/o contrast (72125) | $2,044.80 | $2,272 | 20.1× |
| CT chest w contrast (71260) | $2,362.50 | $2,625 | 13.9× |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$2,646–$3,870.90 | $2,940–$4,301 | varies |
| CT head/brain with contrast (70460) | $2,019.60 | $2,244 | 11.9× |
| CT head/brain without and with contrast (70470) | $2,592.90 | $2,881 | 15.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,336.30 | $3,707 | 9.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $286.20 | $318 | 3.4× |
| CT hrt w/3d image congen (75573) | $3,336.30 | $3,707 | 9.8× |
| CT iac w contrast (70481) | $2,188.80 | $2,432 | 12.8× |
| CT lower ext w/o (73700) | $2,018.70 | $2,243 | 19.9× |
| CT lower extremity w/contrast material (73701) | $2,491.20 | $2,768 | 14.6× |
| CT lumbar spine w contrast (72132) | $4,505.40 | $5,006 | 13.3× |
| CT lumbar spine w/o contrast (72131) | $2,034.90 | $2,261 | 20.0× |
| CT maxillofacial w contrast (70487) | $2,059.20 | $2,288 | 12.1× |
| CT maxillofacial wo contrast (70486) | $1,708.20 | $1,898 | 16.8× |
| CT neck tissue combo (70492) | $2,879.10 | $3,199 | 16.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,547.80 | $3,942 | 20.8× |
| CT orbits w/o contrast (70480) | $1,857.60 | $2,064 | 18.3× |
| CT pelvis w&w/o contrast (72194) | $2,683.80 | $2,982 | 15.8× |
| CT pelvis w/o contrast (72192) | $1,905.30 | $2,117 | 18.8× |
| CT scans face/jaw combo (70488) | $3,794.40 | $4,216 | 22.3× |
| CT soft tissue neck w contrast (70491) | $2,201.40 | $2,446 | 12.9× |
| CT soft tissue neck w/o contrast (70490) | $1,813.50 | $2,015 | 17.9× |
| CT thoracic spine w contrast (72129) | $2,268.90 | $2,521 | 13.3× |
| CT thoracic spine w/o contrast (72128) | $2,102.40 | $2,336 | 20.7× |
| CT thorax w/o contrast (71250) | $1,953.90 | $2,171 | 19.2× |
| CT upper ext wo (73200) | $2,107.80 | $2,342 | 20.8× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,264.30–$3,362.40 | $3,627–$3,736 | varies |
| CT upper extremity with contrast (73201) range across 12 matching MRF lines |
$2,570.40–$2,647.80 | $2,856–$2,942 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,981.60 | $4,424 | 23.4× |
| Cta Abdomen (74175) | $4,046.40 | $4,496 | 23.8× |
| Dxa Bone Density Axial (77080) | $997.20 | $1,108 | 9.8× |
| Dxa bone density study (77085) | $828 | $920 | 8.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $432.90 | $481 | 5.1× |
| Esophagram (74220) | $558.90 | $621 | 3.3× |
| Fetal Biophys Profile W/Nst (76818) | $1,194.30 | $1,327 | 11.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $614.70 | $683 | 6.1× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$629.10–$648 | $699–$720 | varies |
| Foot 2 views (73620) | $350.10 | $389 | 4.1× |
| Forearm 2 views (73090) | $364.50 | $405 | 4.3× |
| Gastric emptying imaging study (78264) | $1,878.30 | $2,087 | 4.8× |
| Gated Heart Planar Single (78472) | $3,160.80 | $3,512 | 8.1× |
| Hand 2 views (73120) | $326.70 | $363 | 3.2× |
| Hepatobil Syst Image W/Drug (78227) | $2,277.90 | $2,531 | 4.3× |
| Hepatobiliary System Imaging (78226) | $1,698.30 | $1,887 | 4.4× |
| Ht Muscle Image Spect Sing (78451) | $2,224.80 | $2,472 | 1.8× |
| Hysterosalpingogram (74740) | $1,020.60 | $1,134 | 4.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $729.90 | $811 | 8.6× |
| Infant hip ultrasound, limited static exam (76886) | $394.20 | $438 | 4.7× |
| Joint Survey Single View (77077) | $809.10 | $899 | 8.0× |
| K Flow/Funct Image W/Drug (78708) | $1,753.20 | $1,948 | 3.3× |
| K Flow/Funct Image W/O Drug (78707) | $2,304.90 | $2,561 | 4.4× |
| Kidney Imaging Morphol (78700) | $2,025 | $2,250 | 5.2× |
| Knee 3 Views (73562) | $460.80 | $512 | 5.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,960.20 | $2,178 | 5.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,387.70 | $2,653 | 4.5× |
| Lung Ventilation Imaging (78579) | $1,870.20 | $2,078 | 4.8× |
| Lymph System Imaging (78195) | $1,640.70 | $1,823 | 3.1× |
| Magnetic Image Jaw Joint (70336) | $2,870.10 | $3,189 | 12.4× |
| Meckels Divert Exam (78290) | $1,502.10 | $1,669 | 3.9× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$4,730.40–$4,872.60 | $5,256–$5,414 | varies |
| MRA head w/o contrast (70544) | $3,639.60 | $4,044 | 15.7× |
| MRA head with contrast (70545) | $4,135.50 | $4,595 | 12.2× |
| MRA neck w contrast (70548) | $4,135.50 | $4,595 | 12.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,202 | $5,780 | 15.4× |
| MRA neck w/o contrast (70547) | $3,157.20 | $3,508 | 13.6× |
| MRI abdomen w contrast (74182) | $3,410.10 | $3,789 | 10.1× |
| MRI abdomen w/o contrast (74181) | $3,358.80 | $3,732 | 14.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 8 matching MRF lines |
$3,419.10–$4,432.50 | $3,799–$4,925 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,011.20 | $5,568 | 14.8× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 12 matching MRF lines |
$4,238.10–$4,365 | $4,709–$4,850 | varies |
| MRI cervical spine w contrast (72142) | $4,517.10 | $5,019 | 13.3× |
| MRI cervical spine w/o cont (72141) | $3,305.70 | $3,673 | 14.3× |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$3,875.40–$3,991.50 | $4,306–$4,435 | varies |
| MRI chest with contrast (71551) | $3,926.70 | $4,363 | 5.2× |
| MRI chest wo w contrast (71552) | $4,461.30 | $4,957 | 13.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,241.80 | $3,602 | 9.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,310 | $5,900 | 15.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 8 matching MRF lines |
$2,653.20–$3,734.10 | $2,948–$4,149 | varies |
| MRI lumbar spine w contrast (72149) | $2,893.50 | $3,215 | 8.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,026.50 | $5,585 | 14.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,520.80 | $3,912 | 15.2× |
| MRI orbit face neck w contrast (70542) | $4,250.70 | $4,723 | 12.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,539.50 | $6,155 | 16.3× |
| MRI pelvis w contrast (72196) | $3,110.40 | $3,456 | 9.2× |
| MRI pelvis w/o & w contrast (72197) | $5,040.90 | $5,601 | 14.9× |
| MRI pelvis w/o contrast (72195) | $3,334.50 | $3,705 | 14.4× |
| MRI thoracic spine w/o contrast (72146) | $3,565.80 | $3,962 | 15.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,148.20 | $3,498 | 9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$3,220.20–$3,316.50 | $3,578–$3,685 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$3,404.70–$3,506.40 | $3,783–$3,896 | varies |
| MRI, abdomen, combo (74183) | $4,719.60 | $5,244 | 13.9× |
| MRI, dorsal spine combo (72157) | $5,137.20 | $5,708 | 15.2× |
| MRI, dorsal spine contrast (72147) | $4,523.40 | $5,026 | 13.3× |
| MRI, joint upper extrem (73221) | $3,775.50 | $4,195 | 16.3× |
| MRI, joint upper extrem combo (73223) | $4,960.80 | $5,512 | 14.6× |
| MRI, lumbar spine combo (72158) | $5,067 | $5,630 | 15.0× |
| Myocardial Spect Multiple Studies (78452) | $4,175.10 | $4,639 | 3.3× |
| Neck soft tissue (70360) | $304.20 | $338 | 3.6× |
| Parathyroid Planar Imaging (78070) | $910.80 | $1,012 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,460.70 | $1,623 | 3.8× |
| Pelvis 1 or 2 views (72170) | $307.80 | $342 | 3.0× |
| Pet Image W/Ct Lmtd (78814) | $3,119.40 | $3,466 | 2.2× |
| PET image w/CT, full body (78816) | $9,599.40 | $10,666 | 6.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,823.90 | $6,471 | 4.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,240.20 | $1,378 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $427.50 | $475 | 4.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $411.30 | $457 | 4.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $350.10 | $389 | 4.1× |
| Radex elbow complete minimum 3 views (73080) | $419.40 | $466 | 5.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $609.30 | $677 | 6.0× |
| Radex fingr minimum 2 views (73140) | $329.40 | $366 | 3.9× |
| Radex foot complete minimum 3 views (73630) | $415.80 | $462 | 4.9× |
| Radex Hand Minimum 3 Views (73130) | $398.70 | $443 | 4.7× |
| Radex lower extremity infant minimum 2 views (73592) | $223.20 | $248 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $352.80 | $392 | 4.2× |
| Radex Ribs Unilateral 2 Views (71100) | $340.20 | $378 | 4.0× |
| Radex shoulder complete minimum 2 views (73030) | $422.10 | $469 | 5.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $333 | $370 | 3.9× |
| Radex Spine 1 View Specify Level (72020) | $261 | $290 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $494.10 | $549 | 5.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $632.70 | $703 | 7.5× |
| Radex Toe Minimum 2 Views (73660) range across 12 matching MRF lines |
$277.20–$331.20 | $308–$368 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $401.40 | $446 | 4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $399.60 | $444 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $1,440.90 | $1,601 | 8.5× |
| Radiologic exam colon single contrast study (74270) | $1,073.70 | $1,193 | 6.3× |
| Radiologic exam knee complete 4/more views (73564) | $442.80 | $492 | 4.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $558.90 | $621 | 5.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $825.30 | $917 | 4.8× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$1,715.40–$1,766.70 | $1,906–$1,963 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $865.80 | $962 | 5.1× |
| Radiologic examination femur 1 view (73551) | $442.80 | $492 | 5.2× |
| Radiologic examination femur minimum 2 views (73552) | $403.20 | $448 | 4.8× |
| Radiologic examination knee 1/2 views (73560) | $346.50 | $385 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $393.30 | $437 | 4.7× |
| Ribs bilateral 3 views (71110) | $622.80 | $692 | 6.1× |
| Scapula (73010) | $459.90 | $511 | 4.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $81 | $90 | 3.5× |
| Shoulder 1 view (73020) | $354.60 | $394 | 4.2× |
| Skull less than 4 views (70250) | $361.80 | $402 | 3.6× |
| Sternoclavicular joints (71130) | $428.40 | $476 | 5.1× |
| Tbs technical calculation only (77091) | $202.50 | $225 | 2.4× |
| Thoracic spine 2 views (72070) | $324.90 | $361 | 3.2× |
| Thoracic spine 3 views (72072) | $428.40 | $476 | 4.2× |
| Thoracolumbar 2 views (72080) | $325.80 | $362 | 3.9× |
| Thyroid Imaging With Vascular Flow (78013) | $1,146.60 | $1,274 | 3.0× |
| Thyroid Uptake Measurement (78012) | $1,010.70 | $1,123 | 2.6× |
| Ultrasound Breast Limited (76642) | $605.70 | $673 | 7.2× |
| Ultrasound Exam Aaa Screen (76706) | $549.90 | $611 | 5.4× |
| Ultrasound, abdomen limited (76705) | $640.80 | $712 | 6.3× |
| Umbilical-artery Doppler (OB) (76820) | $452.70 | $503 | 4.5× |
| Unlisted us procedure (76999) | $927 | $1,030 | 11.0× |
| Upper gi w/o kub (74240) | $946.80 | $1,052 | 5.6× |
| Ureteral Reflux Study (78740) | $1,243.80 | $1,382 | 3.2× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$910.80–$937.80 | $1,012–$1,042 | varies |
| Us breast unilateral complete (76641) | $542.70 | $603 | 5.3× |
| Us chest (76604) | $564.30 | $627 | 5.6× |
| Us complete joint (76881) | $752.40 | $836 | 7.4× |
| Us exam, pelvic, limited (76857) | $621.90 | $691 | 6.1× |
| Us head (76506) | $971.10 | $1,079 | 9.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $276.30 | $307 | 2.7× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$543.60–$590.40 | $604–$656 | varies |
| Us ob transvaginal (76817) | $640.80 | $712 | 6.3× |
| Us pelvic non ob complete (76856) | $764.10 | $849 | 7.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $724.50 | $805 | 7.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$545.40–$561.60 | $606–$624 | varies |
| Us retroperitoneal complete (76770) | $748.80 | $832 | 7.4× |
| Us retroperitoneal limited (76775) | $518.40 | $576 | 5.1× |
| Us scrotum and contents (76870) | $725.40 | $806 | 7.1× |
| Us spinal canal and contents (76800) | $605.70 | $673 | 6.0× |
| Us thyroid (76536) | $722.70 | $803 | 7.1× |
| Us transrectal (76872) | $1,139.40 | $1,266 | 11.2× |
| Wrist 2 views (73100) | $337.50 | $375 | 4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $437.40 | $486 | 5.2× |
| X-Ray Bend Only L-S Spine (72120) | $382.50 | $425 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $346.50 | $385 | 4.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$476.10–$490.50 | $529–$545 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $792 | $880 | 7.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $291.60 | $324 | 3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$424.80–$437.40 | $472–$486 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$630–$648.90 | $700–$721 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $396 | $440 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $425.70 | $473 | 4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $782.10 | $869 | 7.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $364.50 | $405 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $730.80 | $812 | 7.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $379.80 | $422 | 3.7× |
| X-ray eye for foreign body (70030) | $267.30 | $297 | 3.2× |
| X-ray humerus (73060) | $407.70 | $453 | 4.8× |
| X-ray IV pyelogram (ivp) (74400) | $1,686.60 | $1,874 | 9.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $472.50 | $525 | 5.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $325.80 | $362 | 3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $374.40 | $416 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $427.50 | $475 | 5.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $713.70 | $793 | 7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $514.80 | $572 | 5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $321.30 | $357 | 3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $555.30 | $617 | 6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$463.50–$638.10 | $515–$709 | varies |
| X-ray thoracic spine 4 vw (72074) | $597.60 | $664 | 5.9× |
| X-Ray Tmj Unilat (70328) | $432 | $480 | 5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $820.80 | $912 | 2.4× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$565.20–$582.30 | $628–$647 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$603.90–$621.90 | $671–$691 | varies |
| Xr c-spine 4 or 5 views (72050) | $492.30 | $547 | 4.8× |
| Xr facial bones less than 3 views (70140) | $334.80 | $372 | 4.0× |
| Xr orbits complete 4 views (70200) | $698.40 | $776 | 6.9× |
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.