Imaging prices at Bob Wilson Memorial Hospital
Ulysses, KS · every code in this section with a posted price and a Medicare benchmark.
213 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) | $89.47 | $223.67 | 1.1× |
| Abdomen 2 views (74019) | $70.99 | $177.46 | 0.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$72.55–$94.31 | $181.36–$235.76 | varies |
| Bone age studies (77072) | $90.18 | $225.43 | 0.9× |
| Bone Imaging 3 Phase (78315) | $547 | $1,367.48 | 1.5× |
| Bone Imaging Limited Area (78300) | $243.62 | $609.05 | 0.7× |
| Bone Imaging Multiple Areas (78305) | $249.23 | $623.06 | 0.7× |
| Bone Imaging Whole Body (78306) | $555.62 | $1,389.05 | 1.5× |
| Chest 1 view (71045) | $123.41 | $308.52 | 1.5× |
| Chest 2 views (71046) | $119.74 | $299.35 | 1.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$94.19–$122.44 | $235.46–$306.09 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $117.89 | $294.71 | 1.2× |
| Contrast X-Ray Bladder (74430) | $570.22 | $1,425.54 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $2,406.36 | $6,015.89 | 7.5× |
| CT abdomen and pelvis without contrast (74176) | $1,818.42 | $4,546.04 | 8.3× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$500.94–$1,121.86 | $1,252.33–$2,804.64 | varies |
| CT abdomen w wo contrast (74170) | $1,107.26 | $2,768.15 | 6.9× |
| CT abdomen w/o contrast (74150) | $1,093.31 | $2,733.27 | 11.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,228.74 | $3,071.83 | 3.8× |
| CT Angio Chest (71275) | $989.84 | $2,474.58 | 6.1× |
| CT Angio Head (70496) | $1,116.55 | $2,791.36 | 6.9× |
| CT Angio Neck (70498) | $750.25 | $1,875.61 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,093.31 | $2,733.27 | 11.4× |
| CT cervical spine w/wo cont (72127) | $905.45 | $2,263.62 | 5.6× |
| CT chest w contrast (71260) | $1,019.85 | $2,549.61 | 6.3× |
| CT chest w/wo contrast (71270) | $1,157.55 | $2,893.87 | 7.2× |
| CT head/brain with contrast (70460) | $923.93 | $2,309.81 | 5.7× |
| CT head/brain without and with contrast (70470) | $1,192.22 | $2,980.55 | 7.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$451.08–$923.93 | $1,127.68–$2,309.81 | varies |
| CT l-spine w&w/o contrast (72133) | $802.69 | $2,006.72 | 5.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$898.82–$1,168.46 | $2,247.03–$2,921.15 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$919.22–$1,194.98 | $2,298.03–$2,987.44 | varies |
| CT lumbar spine w contrast (72132) | $1,202.85 | $3,007.11 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,093.31 | $2,733.27 | 11.4× |
| CT maxillofacial w contrast (70487) | $526.39 | $1,315.96 | 3.3× |
| CT maxillofacial wo contrast (70486) | $974.19 | $2,435.46 | 10.1× |
| CT neck tissue combo (70492) | $947.28 | $2,368.18 | 5.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$451.08–$1,060.79 | $1,127.68–$2,651.97 | varies |
| CT orbits w/o contrast (70480) | $1,005.69 | $2,514.21 | 10.5× |
| CT pelvis w&w/o contrast (72194) | $1,299.11 | $3,247.76 | 8.1× |
| CT pelvis w/o contrast (72192) | $957.90 | $2,394.74 | 10.0× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$923.93–$1,201.10 | $2,309.81–$3,002.75 | varies |
| CT scans face/jaw combo (70488) | $444.01 | $1,110.02 | 2.8× |
| CT soft tissue neck w contrast (70491) | $1,042.21 | $2,605.51 | 6.5× |
| CT soft tissue neck w/o contrast (70490) | $782.10 | $1,955.24 | 8.1× |
| CT thoracic spine w/o contrast (72128) | $1,182.27 | $2,955.67 | 12.3× |
| CT thorax w/o contrast (71250) | $994.54 | $2,486.34 | 10.3× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$778.01–$1,011.40 | $1,945.01–$2,528.49 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,036.90 | $2,592.23 | 6.4× |
| CT upper extremity with contrast (73201) | $799.75 | $1,999.36 | 2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,116.55 | $2,791.36 | 6.9× |
| Cta Abdomen (74175) | $1,228.74 | $3,071.83 | 7.6× |
| Dxa Bone Density Axial (77080) | $195.17 | $487.91 | 2.0× |
| Dxa bone density study (77085) | $337.25 | $843.12 | 3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $63.60 | $158.99 | 0.8× |
| Esophagram (74220) | $304.03 | $760.07 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $106.40 | $266 | 1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $545.66 | $1,364.14 | 5.7× |
| Fluoroscopy up to 1 hr (76000) | $145.57 | $363.91 | 0.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$79.57–$103.46 | $198.92–$258.63 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$94.12–$122.36 | $235.29–$305.89 | varies |
| Gastric emptying imaging study (78264) | $481.94 | $1,204.85 | 1.3× |
| Gated Heart Planar Single (78472) | $315.42 | $788.55 | 0.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$70.30–$91.39 | $175.73–$228.46 | varies |
| Hepatobil Syst Image W/Drug (78227) | $342.66 | $856.65 | 0.7× |
| Hepatobiliary System Imaging (78226) | $342.66 | $856.65 | 0.9× |
| Hysterosalpingogram (74740) | $464.02 | $1,160.04 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $424.86 | $1,062.13 | 0.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$112.64–$146.44 | $281.60–$366.09 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$452.71–$905.41 | $1,131.77–$2,263.51 | varies |
| Mr safety determination physician/other qhp (76016) | $476 | $1,190 | 5.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $476 | $1,190 | 17.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $476 | $1,190 | 5.4× |
| Mr safety implt pos&/immoblj (76019) | $476 | $1,190 | 8.8× |
| Mr safety med physics xm customization plng&mntr (76017) | $476 | $1,190 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,258.33 | $3,145.81 | 3.9× |
| MRA head w/o contrast (70544) | $1,298.44 | $3,246.09 | 5.9× |
| MRA head with contrast (70545) | $1,196.39 | $2,990.96 | 3.7× |
| MRA neck w contrast (70548) | $1,196.39 | $2,990.96 | 3.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,633.67 | $4,084.17 | 5.1× |
| MRA neck w/o contrast (70547) | $1,298.44 | $3,246.09 | 5.9× |
| MRI abdomen w contrast (74182) | $1,196.39 | $2,990.96 | 3.7× |
| MRI abdomen w/o contrast (74181) | $1,298.44 | $3,246.09 | 5.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,633.67–$3,267.33 | $4,084.17–$8,168.32 | varies |
| MRI cervical spine w contrast (72142) | $1,196.39 | $2,990.96 | 3.7× |
| MRI cervical spine w/o cont (72141) | $1,298.44 | $3,246.09 | 5.9× |
| MRI chest w/o contrast (71550) | $1,349.55 | $3,373.87 | 6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,196.39–$2,392.78 | $2,990.96–$5,981.95 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,196.39–$2,392.78 | $2,990.96–$5,981.93 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,151.08–$2,302.16 | $2,877.70–$5,755.40 | varies |
| MRI lumbar spine w contrast (72149) | $1,196.39 | $2,990.96 | 3.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,633.67 | $4,084.17 | 5.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,349.55 | $3,373.87 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,633.67 | $4,084.17 | 5.1× |
| MRI pelvis w contrast (72196) | $1,196.39 | $2,990.96 | 3.7× |
| MRI pelvis w/o & w contrast (72197) | $1,633.67 | $4,084.17 | 5.1× |
| MRI pelvis w/o contrast (72195) | $524.42 | $1,311.03 | 2.4× |
| MRI thoracic spine w/o contrast (72146) | $1,298.44 | $3,246.09 | 5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,298.44–$1,947.67 | $3,246.09–$4,869.16 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,633.67–$3,267.33 | $4,084.17–$8,168.32 | varies |
| MRI, abdomen, combo (74183) | $1,633.67 | $4,084.17 | 5.1× |
| MRI, dorsal spine combo (72157) | $1,448.26 | $3,620.65 | 4.5× |
| MRI, dorsal spine contrast (72147) | $1,196.39 | $2,990.96 | 3.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,298.44–$2,596.88 | $3,246.09–$6,492.18 | varies |
| MRI, joint upper extrem combo (73223) | $1,633.67 | $4,084.17 | 5.1× |
| MRI, lumbar spine combo (72158) | $1,633.67 | $4,084.17 | 5.1× |
| Myocardial Spect Multiple Studies (78452) | $1,864.02 | $4,660.04 | 1.6× |
| N-invas est c ffr sw aly CTA (75580) | $6,755.83 | $16,889.57 | 8.6× |
| Neck soft tissue (70360) | $134.54 | $336.35 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $634.39 | $1,585.97 | 3.0× |
| Parathyroid Planar Imaging (78070) | $285.72 | $714.28 | 0.8× |
| Pelvis 1 or 2 views (72170) | $111.79 | $279.46 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $299.44 | $748.58 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$96.06–$124.88 | $240.14–$312.20 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$84.07–$109.28 | $210.17–$273.19 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$101.18–$131.54 | $252.95–$328.85 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $247.80 | $619.50 | 2.6× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$87.78–$265.87 | $219.43–$664.67 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$87.90–$114.28 | $219.75–$285.68 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$106.16–$138.01 | $265.40–$345.02 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $86.82 | $217.05 | 1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$104.28–$135.55 | $260.68–$338.87 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $119.17 | $297.92 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $158.42 | $396.05 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$91.75–$119.28 | $229.36–$298.18 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $69.14 | $172.85 | 0.9× |
| Radex Spine 1 View Specify Level (72020) | $131.82 | $329.55 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) | $97.82 | $244.54 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $110.78 | $276.93 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$95.96–$124.74 | $239.89–$311.85 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$67.05–$87.17 | $167.62–$217.91 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$115.72–$150.44 | $289.30–$376.10 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $147.82 | $369.54 | 1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $111.63 | $279.06 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $992.74 | $2,481.85 | 6.2× |
| Radiologic exam colon single contrast study (74270) | $992.74 | $2,481.85 | 6.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $304.03 | $760.07 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) | $135.76 | $339.40 | 1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $122.48 | $306.20 | 1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $328.59 | $821.47 | 2.0× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$49–$63.69 | $122.48–$159.22 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$105.55–$137.20 | $263.86–$343 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$101.23–$131.59 | $253.06–$328.97 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$108.90–$141.56 | $272.23–$353.89 | varies |
| Ribs bilateral 3 views (71110) | $125.48 | $313.70 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $502.60 | $1,256.48 | 1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $663.42 | $1,658.54 | 1.8× |
| Scapula (73010) range across 2 matching MRF lines |
$94.28–$122.56 | $235.69–$306.39 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$96.04–$124.85 | $240.08–$312.11 | varies |
| Skull less than 4 views (70250) | $109.59 | $273.97 | 1.1× |
| Sternoclavicular joints (71130) | $77.79 | $194.47 | 1.0× |
| Testicular Imaging W/Flow (78761) | $366.88 | $917.19 | 1.0× |
| Thoracic spine 2 views (72070) | $104.19 | $260.47 | 1.1× |
| Thoracic spine 3 views (72072) | $171.92 | $429.78 | 1.8× |
| Thoracolumbar 2 views (72080) | $91.41 | $228.52 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $191.86 | $479.65 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $285.72 | $714.28 | 0.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$148.04–$222.06 | $370.10–$555.13 | varies |
| Ultrasound, abdomen limited (76705) | $367.09 | $917.72 | 3.8× |
| Upper gi w/o kub (74240) | $262.80 | $656.98 | 1.6× |
| Urethrocystogram voiding (74455) | $570.22 | $1,425.54 | 2.6× |
| Urethrocystography retrograde (74450) | $503.84 | $1,259.59 | 2.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$148.04–$296.08 | $370.10–$740.18 | varies |
| Us chest (76604) | $311.90 | $779.73 | 3.2× |
| Us complete joint (76881) | $124.68 | $311.70 | 1.3× |
| Us exam, pelvic, limited (76857) | $314.66 | $786.64 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $128.12 | $320.29 | 1.3× |
| Us ob limited 1 or more fetuses (76815) | $175.26 | $438.13 | 1.8× |
| Us ob transvaginal (76817) | $279.48 | $698.68 | 2.9× |
| Us pelvic non ob complete (76856) | $413.57 | $1,033.92 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $339.88 | $849.69 | 3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $69.28 | $173.20 | 0.7× |
| Us retroperitoneal complete (76770) | $432.81 | $1,082.02 | 4.5× |
| Us retroperitoneal limited (76775) | $301.08 | $752.69 | 3.1× |
| Us scrotum and contents (76870) | $387 | $967.50 | 4.0× |
| Us thyroid (76536) | $497.88 | $1,244.68 | 5.2× |
| Us transrectal (76872) | $275.41 | $688.52 | 2.9× |
| Vertebral fracture assessment via dxa (77086) | $209.65 | $524.12 | 2.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$65.60–$85.27 | $163.99–$213.17 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $81.62 | $204.04 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $338.38 | $845.94 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$73.34–$95.35 | $183.35–$238.36 | varies |
| X-Ray Exam Breast Specimen (76098) | $305 | $762.48 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $56.22 | $140.53 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $102.22 | $255.53 | 1.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $50.55 | $126.36 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $101.98 | $254.93 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $78.35 | $195.86 | 0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $218.25 | $545.62 | 2.3× |
| X-Ray Exam L-S Spine Bending (72114) | $193.58 | $483.93 | 2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $169.79 | $424.46 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $235.44 | $588.60 | 2.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $290.58 | $726.43 | 3.0× |
| X-ray eye for foreign body (70030) | $54.10 | $135.25 | 0.7× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$108.27–$233.99 | $270.66–$584.97 | varies |
| X-ray IV pyelogram (ivp) (74400) | $530.40 | $1,326 | 3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $109.24 | $273.08 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $78.75 | $196.86 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $145.18 | $362.93 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $164.12 | $410.29 | 1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $172.27 | $430.67 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $91.98 | $229.95 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $116.85 | $292.11 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $303.37 | $758.41 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $313.88 | $784.69 | 3.3× |
| X-Ray Stress View (77071) | $256.24 | $640.59 | 3.2× |
| X-ray thoracic spine 4 vw (72074) | $101.23 | $253.06 | 1.1× |
| X-Ray Tmj Unilat (70328) | $49.10 | $122.75 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $398.41 | $996.02 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $688.39 | $1,720.96 | 7.2× |
| Xr c-spine 4 or 5 views (72050) | $280.14 | $700.33 | 2.9× |
| Xr facial bones less than 3 views (70140) | $116.02 | $290.05 | 1.4× |
| Xr orbits complete 4 views (70200) | $186.53 | $466.32 | 1.9× |
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.