Imaging prices at Boone County Health Center

Albion, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $278 $278 3.1×
Abdomen 2 views (74019) $368 $368 3.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,906 $1,906 4.6×
Arthrogram hip (73525) $853 $853 2.4×
Bone age studies (77072) $184 $184 1.7×
Bone Imaging 3 Phase (78315) $2,122 $2,122 5.1×
Bone Imaging Whole Body (78306) $1,920 $1,920 4.6×
Bone marrow imaging; multiple areas (78103) $370 $370 0.9×
Bone marrow imaging; whole body (78104) $403 $403 1.0×
Chest 1 view (71045) $249 $249 2.8×
Chest 2 views (71046) $328 $328 3.6×
Chest 3 views (71047) $372 $372 4.1×
Chest 4 or more views (71048) $429 $429 4.0×
Clavicle complete (73000) $275 $275 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,706 $1,706 15.7×
CT abdomen and pelvis without and with contrast (74178) $5,418 $5,418 15.0×
CT abdomen and pelvis without contrast (74176) $3,913 $3,913 15.8×
CT abdomen w contrast (74160) $2,609 $2,609 14.3×
CT abdomen w wo contrast (74170) $3,111 $3,111 17.1×
CT abdomen w/o contrast (74150) $2,308 $2,308 21.3×
CT Angio Abdomen and Pelvis (74174) $5,418 $5,418 15.0×
CT Angio Chest (71275) $3,311 $3,311 18.2×
CT Angio Head (70496) $3,010 $3,010 16.5×
CT angio hrt w/3d image (75574) $1,204 $1,204 3.3×
CT Angio Neck (70498) $3,010 $3,010 16.5×
CT cervical spine w/o contrast (72125) $2,433 $2,433 22.4×
CT cervical spine w/wo cont (72127) $2,659 $2,659 14.6×
CT chest w contrast (71260) $2,600 $2,600 14.3×
CT chest w/wo contrast (71270) $2,910 $2,910 16.0×
CT head/brain with contrast (70460) $2,308 $2,308 12.7×
CT head/brain without and with contrast (70470) $2,609 $2,609 14.3×
CT heart no contrast quant eval coronry calcium (75571) $100 $100 1.1×
CT iac w contrast (70481) $2,483 $2,483 13.6×
CT l-spine w&w/o contrast (72133) $2,900 $2,900 15.9×
CT lower ext w/o (73700) $2,207 $2,207 20.3×
CT lower extremity w/contrast material (73701) $2,408 $2,408 13.2×
CT lumbar spine w contrast (72132) $2,659 $2,659 7.3×
CT lumbar spine w/o contrast (72131) $2,408 $2,408 22.2×
CT maxillofacial w contrast (70487) $2,207 $2,207 12.1×
CT maxillofacial wo contrast (70486) $1,906 $1,906 17.6×
CT neck tissue combo (70492) $2,709 $2,709 14.9×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,609 $2,609 14.3×
CT orbits w/o contrast (70480) $2,308 $2,308 21.3×
CT pelvis w&w/o contrast (72194) $2,910 $2,910 16.0×
CT pelvis w/o contrast (72192) $2,308 $2,308 21.3×
CT scan of leg combo (73702) $3,010 $3,010 16.5×
CT scans face/jaw combo (70488) $2,408 $2,408 13.2×
CT soft tissue neck w contrast (70491) $2,408 $2,408 13.2×
CT soft tissue neck w/o contrast (70490) $2,107 $2,107 19.4×
CT thoracic spine w/o contrast (72128) $2,408 $2,408 22.2×
CT thoracic spine w/wo cont (72130) $2,640 $2,640 14.5×
CT thorax w/o contrast (71250) $2,308 $2,308 21.3×
CT upper ext wo (73200) $2,107 $2,107 19.4×
CT upper extremity with contrast (73201) $2,308 $2,308 6.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,562 $3,562 19.6×
Cta Abdomen (74175) $3,311 $3,311 18.2×
Dxa Bone Density Axial (77080) $452 $452 4.2×
Dxa bone density study (77085) $350 $350 3.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $153 $153 1.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $485 $485 4.5×
Fluoroscopy up to 1 hr (76000) $652 $652 2.6×
Foot 2 views (73620) $308 $308 3.4×
Forearm 2 views (73090) $209 $209 2.3×
Gastric emptying imaging study (78264) $1,906 $1,906 4.6×
Gated Heart Planar Single (78472) $1,204 $1,204 2.9×
Hepatobil Syst Image W/Drug (78227) $1,906 $1,906 3.4×
Hepatobiliary System Imaging (78226) $1,806 $1,806 4.4×
Ht Muscle Image Spect Sing (78451) $3,612 $3,612 2.7×
Infant hip ultrasound, limited static exam (76886) $814 $814 9.0×
K Flow/Funct Image Multiple (78709) $2,107 $2,107 3.7×
K Flow/Funct Image W/Drug (78708) $1,605 $1,605 2.8×
K Flow/Funct Image W/O Drug (78707) $1,806 $1,806 3.2×
Knee 3 Views (73562) $333 $333 3.7×
Lung Ventilat&Perfus Imaging (78582) $2,308 $2,308 4.1×
Lymph System Imaging (78195) $1,806 $1,806 3.2×
Magnetic Image Jaw Joint (70336) $2,510 $2,510 10.1×
MRA head w/o contrast (70544) $3,415 $3,415 13.8×
Mra Neck W/O &W/Contrast Material (70549) $3,815 $3,815 10.5×
MRA neck w/o contrast (70547) $2,710 $2,710 10.9×
MRI abdomen w/o contrast (74181) $3,210 $3,210 13.0×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,615 $3,615 10.0×
MRI any jt upper extremity w/contrast matrl (73222) $3,415 $3,415 4.2×
MRI bone marrow blood supply (77084) $1,605 $1,605 6.5×
MRI Breast W/O Contrast Bilateral (77047) $2,510 $2,510 10.1×
MRI Breast Without Contrast Material Unilateral (77046) $1,255 $1,255 5.1×
MRI cervical spine w contrast (72142) $3,660 $3,660 10.1×
MRI cervical spine w/o cont (72141) $3,415 $3,415 13.8×
MRI chest w/o contrast (71550) $3,515 $3,515 14.2×
MRI chest wo w contrast (71552) $4,015 $4,015 11.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,010 $2,010 5.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,310 $3,310 9.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,710 $2,710 10.9×
MRI lumbar spine w contrast (72149) $3,510 $3,510 9.7×
Mri Neck Spine W/O & W/Dye (72156) $4,315 $4,315 11.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,815 $3,815 10.5×
MRI pelvis w contrast (72196) $3,660 $3,660 10.1×
MRI pelvis w/o & w contrast (72197) $4,115 $4,115 11.4×
MRI pelvis w/o contrast (72195) $3,110 $3,110 12.6×
MRI thoracic spine w/o contrast (72146) $3,460 $3,460 14.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,710 $2,710 10.9×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 8 matching MRF lines		 $2,395–$3,415 $2,395–$3,415 varies
MRI, abdomen, combo (74183) $4,115 $4,115 11.4×
MRI, dorsal spine combo (72157) $4,165 $4,165 11.5×
MRI, dorsal spine contrast (72147) $3,715 $3,715 10.3×
MRI, joint upper extrem (73221) $2,610 $2,610 10.5×
MRI, joint upper extrem combo (73223) $3,815 $3,815 10.5×
MRI, lumbar spine combo (72158) $4,215 $4,215 11.6×
Myocardial Spect Multiple Studies (78452) $4,214 $4,214 3.1×
Neck soft tissue (70360) $217 $217 2.4×
Nuclear Rx Oral Admin (79005) $1,202 $1,202 5.0×
Parathyroid Planar Imaging (78070) $1,304 $1,304 3.1×
Pelvis 1 or 2 views (72170) $326 $326 3.0×
PET image w/CT, full body (78816) $7,676 $7,676 5.2×
PET imaging CT attenuation skull base mid-thigh (78815) $6,262 $6,262 4.2×
Pulmonary Perfusion Imaging Particulate (78580) $898 $898 2.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $383 $383 3.5×
Radex abscess/fistula/sinus tract rs&i (76080) $2,644 $2,644 4.7×
Radex Ankle Complete Minimum 3 Views (73610) $315 $315 3.5×
Radex Calcaneus Minimum 2 Views (73650) $175 $175 1.9×
Radex elbow complete minimum 3 views (73080) $241 $241 2.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $327 $327 3.0×
Radex fingr minimum 2 views (73140) $214 $214 2.4×
Radex foot complete minimum 3 views (73630) $303 $303 3.4×
Radex Hand Minimum 3 Views (73130) $235 $235 2.6×
Radex lower extremity infant minimum 2 views (73592) $161 $161 1.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $217 $217 2.4×
Radex Ribs Unilateral 2 Views (71100) $227 $227 2.5×
Radex shoulder complete minimum 2 views (73030) $328 $328 3.6×
Radex Sinuses Paransl < 3 Views (70210) $184 $184 2.0×
Radex Spine 1 View Specify Level (72020) $195 $195 2.2×
Radex Sternum Minimum 2 Views (71120) $241 $241 2.7×
Radex Toe Minimum 2 Views (73660) $165 $165 1.8×
Radex Wrist Complete Minimum 3 Views (73110) $230 $230 2.5×
Radiolog exam mandible compl minimum 4 views (70110) $276 $276 2.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $449 $449 4.1×
Radiologic exam knee complete 4/more views (73564) $376 $376 3.5×
Radiologic exam pelvis compl minimum 3 views (72190) $376 $376 3.5×
Radiologic exam swallow function contrast study (74230) $421 $421 2.3×
Radiologic examination femur 1 view (73551) $165 $165 1.8×
Radiologic examination femur minimum 2 views (73552) $328 $328 3.6×
Radiologic examination knee 1/2 views (73560) $222 $222 2.5×
Radiologic examination tibia & fibula 2 views (73590) $326 $326 3.6×
Ribs bilateral 3 views (71110) $342 $342 3.2×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,906 $1,906 3.4×
Rp Therapy Intravenous Administration (79101) $633 $633 2.6×
Scapula (73010) $228 $228 2.1×
Screening Digital Breast Tomosynthesis Bi (77063) $85 $85 3.6×
Shoulder 1 view (73020) $166 $166 1.8×
Skull less than 4 views (70250) $203 $203 1.9×
Thoracic spine 2 views (72070) $376 $376 3.5×
Thoracic spine 3 views (72072) $433 $433 4.0×
Thoracolumbar 2 views (72080) $262 $262 2.9×
Thyroid Met Imaging Body (78018) $2,206 $2,206 3.9×
Thyroid Uptake Measurement (78012) $754 $754 1.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,405 $1,405 3.4×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $387–$775 $387–$775 varies
Ultrasound Exam Aaa Screen (76706) $548 $548 5.0×
Ultrasound, abdomen limited (76705) $702 $702 6.5×
Umbilical-artery Doppler (OB) (76820) $261 $261 2.4×
Unlisted us procedure (76999) $502 $502 5.6×
Us breast unilateral complete (76641) $575 $575 5.3×
Us chest (76604) $502 $502 4.6×
Us complete joint (76881) $702 $702 6.5×
Us exam, pelvic, limited (76857) $502 $502 4.6×
Us head (76506) $321 $321 3.0×
Us kidney transplant (76776) $770 $770 7.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $472 $472 4.3×
Us ob detailed single fetus (76811) $502 $502 2.0×
Us ob limited 1 or more fetuses (76815) $425 $425 3.9×
Us ob transvaginal (76817) $577 $577 5.3×
Us pelvic non ob complete (76856) $803 $803 7.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $700 $700 6.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $351 $351 3.2×
Us retroperitoneal complete (76770) $759 $759 7.0×
Us retroperitoneal limited (76775) $529 $529 4.9×
Us scrotum and contents (76870) $702 $702 6.5×
Us spinal canal and contents (76800) $727 $727 6.7×
Us thyroid (76536) $552 $552 5.1×
Us transrectal (76872) $652 $652 6.0×
Vertebral fracture assessment via dxa (77086) $100 $100 1.1×
Wrist 2 views (73100) $178 $178 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $217 $217 2.4×
X-Ray Bend Only L-S Spine (72120) $361 $361 3.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $196 $196 2.2×
X-Ray Exam Breast Specimen (76098) $143 $143 0.3×
X-Ray Exam Entire Spi 1 Vw (72081) $308 $308 3.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $331 $331 3.0×
X-Ray Exam Hip Uni 1 View (73501) $226 $226 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $306 $306 3.4×
X-Ray Exam Hips Bi 2 Views (73521) $477 $477 4.4×
X-Ray Exam L-S Spine Bending (72114) $627 $627 5.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $351 $351 3.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $419 $419 3.9×
X-Ray Exam Unilat Ribs/Chest (71101) $401 $401 3.7×
X-ray eye for foreign body (70030) $188 $188 2.1×
X-ray humerus (73060) $230 $230 2.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $180 $180 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $408 $408 3.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $420 $420 3.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $252 $252 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $222 $222 2.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $273 $273 3.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $335 $335 3.1×
Xr c-spine 4 or 5 views (72050) $484 $484 4.5×
Xr orbits complete 4 views (70200) $370 $370 3.4×

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.