Imaging prices at Boys Town National Research Hospital
Boys Town, NE · every code in this section with a posted price and a Medicare benchmark.
210 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) | $336 | $420 | 3.7× |
| Abdomen 2 views (74019) | $412.80 | $516 | 3.8× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$330.40–$660.80 | $413–$826 | varies |
| Arthrogram ankle (73615) | $764.80 | $956 | 2.1× |
| Arthrogram hip (73525) | $798.40 | $998 | 2.2× |
| Bone age studies (77072) | $321.60 | $402 | 3.0× |
| Bone survey infant (77076) | $503.20 | $629 | 4.6× |
| Cat Scan Follow-Up Study (76380) | $900.80 | $1,126 | 10.0× |
| Chest 1 view (71045) | $415.20 | $519 | 4.6× |
| Chest 2 views (71046) | $415.20 | $519 | 4.6× |
| Chest 3 views (71047) | $415.20 | $519 | 4.6× |
| Chest 4 or more views (71048) | $415.20 | $519 | 3.8× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$370.40–$740.80 | $463–$926 | varies |
| Contrast X-Ray Bladder (74430) | $701.60 | $877 | 1.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $498.40 | $623 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,948.80 | $3,686 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $2,428.80 | $3,036 | 9.8× |
| CT abdomen w contrast (74160) | $1,820.80 | $2,276 | 10.0× |
| CT abdomen w wo contrast (74170) | $1,820.80 | $2,276 | 10.0× |
| CT abdomen w/o contrast (74150) | $1,089.60 | $1,362 | 10.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,811.20 | $4,764 | 10.5× |
| CT Angio Chest (71275) | $1,820.80 | $2,276 | 10.0× |
| CT Angio Head (70496) | $1,820.80 | $2,276 | 10.0× |
| CT Angio Neck (70498) | $1,820.80 | $2,276 | 10.0× |
| CT cervical spine w/ contrast (72126) | $1,759.20 | $2,199 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,089.60 | $1,362 | 10.0× |
| CT chest w contrast (71260) | $1,820.80 | $2,276 | 10.0× |
| CT chest w/wo contrast (71270) | $1,820.80 | $2,276 | 10.0× |
| CT head/brain with contrast (70460) | $1,820.80 | $2,276 | 10.0× |
| CT head/brain without and with contrast (70470) | $1,820.80 | $2,276 | 10.0× |
| CT iac w contrast (70481) | $1,820.80 | $2,276 | 10.0× |
| CT l-spine w&w/o contrast (72133) | $840 | $1,050 | 4.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,089.60–$2,179.20 | $1,362–$2,724 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,820.80–$3,641.60 | $2,276–$4,552 | varies |
| CT lumbar spine w/o contrast (72131) | $1,089.60 | $1,362 | 10.0× |
| CT maxillofacial w contrast (70487) | $1,820.80 | $2,276 | 10.0× |
| CT maxillofacial wo contrast (70486) | $1,089.60 | $1,362 | 10.0× |
| CT neck tissue combo (70492) | $1,820.80 | $2,276 | 10.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,820.80 | $2,276 | 10.0× |
| CT orbits w/o contrast (70480) | $1,089.60 | $1,362 | 10.0× |
| CT pelvis w&w/o contrast (72194) | $840 | $1,050 | 4.6× |
| CT pelvis w/o contrast (72192) | $1,089.60 | $1,362 | 10.0× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,820.80–$3,641.60 | $2,276–$4,552 | varies |
| CT scans face/jaw combo (70488) | $1,820.80 | $2,276 | 10.0× |
| CT soft tissue neck w contrast (70491) | $1,820.80 | $2,276 | 10.0× |
| CT soft tissue neck w/o contrast (70490) | $1,089.60 | $1,362 | 10.0× |
| CT thoracic spine w contrast (72129) | $1,759.20 | $2,199 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,089.60 | $1,362 | 10.0× |
| CT thorax w/o contrast (71250) | $1,089.60 | $1,362 | 10.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,089.60–$2,179.20 | $1,362–$2,724 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,820.80–$3,641.60 | $2,276–$4,552 | varies |
| CT upper extremity with contrast (73201) | $2,129.60 | $2,662 | 5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $840 | $1,050 | 4.6× |
| Esophagram (74220) | $651.20 | $814 | 3.6× |
| Fluoroscopy up to 1 hr (76000) | $506.40 | $633 | 2.0× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$305.60–$611.20 | $382–$764 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$382.40–$764.80 | $478–$956 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$316.80–$633.60 | $396–$792 | varies |
| Hysterosalpingogram (74740) | $1,120.80 | $1,401 | 4.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $416 | $520 | 4.6× |
| Infant hip ultrasound, limited static exam (76886) | $416 | $520 | 4.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$408.80–$817.60 | $511–$1,022 | varies |
| Magnetic Image Jaw Joint (70336) | $2,428.80 | $3,036 | 9.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,811.20 | $4,764 | 10.5× |
| MRA head w/o contrast (70544) | $2,428.80 | $3,036 | 9.8× |
| MRA head with contrast (70545) | $3,810.40 | $4,763 | 10.5× |
| MRA neck w contrast (70548) | $3,810.40 | $4,763 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,811.20 | $4,764 | 10.5× |
| MRA neck w/o contrast (70547) | $2,428.80 | $3,036 | 9.8× |
| MRI abdomen w contrast (74182) | $3,810.40 | $4,763 | 10.5× |
| MRI abdomen w/o contrast (74181) | $2,428.80 | $3,036 | 9.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,184.80–$2,369.60 | $1,481–$2,962 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,811.20 | $4,764 | 10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,727.20–$5,454.40 | $3,409–$6,818 | varies |
| MRI brain functional w/o physician admnistration (70554) | $2,428 | $3,035 | 9.8× |
| MRI brain functional w/physician admnistration (70555) | $2,428 | $3,035 | 9.8× |
| MRI cervical spine w contrast (72142) | $3,810.40 | $4,763 | 10.5× |
| MRI cervical spine w/o cont (72141) | $2,428.80 | $3,036 | 9.8× |
| MRI chest w/o contrast (71550) | $2,428 | $3,035 | 9.8× |
| MRI chest with contrast (71551) | $3,469.60 | $4,337 | 4.3× |
| MRI chest wo w contrast (71552) | $3,811.20 | $4,764 | 10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,738.40–$5,476.80 | $3,423–$6,846 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,727.20 | $4,659 | 10.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,428.80–$4,857.60 | $3,036–$6,072 | varies |
| MRI lumbar spine w contrast (72149) | $3,371.20 | $4,214 | 9.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,811.20 | $4,764 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,428.80 | $3,036 | 9.8× |
| MRI orbit face neck w contrast (70542) | $3,810.40 | $4,763 | 10.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,810.40–$3,811.20 | $4,763–$4,764 | varies |
| MRI pelvis w contrast (72196) | $3,810.40 | $4,763 | 10.5× |
| MRI pelvis w/o & w contrast (72197) | $3,811.20 | $4,764 | 10.5× |
| MRI pelvis w/o contrast (72195) | $2,428.80 | $3,036 | 9.8× |
| MRI spectroscopy (76390) | $900.80 | $1,126 | 10.0× |
| MRI thoracic spine w/o contrast (72146) | $2,428.80 | $3,036 | 9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,340–$6,679.20 | $4,175–$8,349 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,428.80–$4,856 | $3,036–$6,070 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,811.20 | $4,764 | 10.5× |
| MRI, abdomen, combo (74183) | $3,811.20 | $4,764 | 10.5× |
| MRI, dorsal spine combo (72157) | $3,811.20 | $4,764 | 10.5× |
| MRI, dorsal spine contrast (72147) | $3,810.40 | $4,763 | 10.5× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,428.80–$4,856 | $3,036–$6,070 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,587.20–$7,174.40 | $4,484–$8,968 | varies |
| MRI, lumbar spine combo (72158) | $3,811.20 | $4,764 | 10.5× |
| Neck soft tissue (70360) | $288.80 | $361 | 3.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $503.20 | $629 | 4.6× |
| Pelvis 1 or 2 views (72170) | $351.20 | $439 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $498.40 | $623 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $664 | $830 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$412–$824 | $515–$1,030 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$238.40–$476.80 | $298–$596 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$391.20–$782.40 | $489–$978 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $503.20 | $629 | 4.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$287.20–$574.40 | $359–$718 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$393.60–$787.20 | $492–$984 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$386.40–$772.80 | $483–$966 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$328.80–$657.60 | $411–$822 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $399.20 | $499 | 4.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $93.60 | $117 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $415.20 | $519 | 4.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$397.60–$795.20 | $497–$994 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $349.60 | $437 | 3.9× |
| Radex Spine 1 View Specify Level (72020) | $306.40 | $383 | 3.4× |
| Radex Sternum Minimum 2 Views (71120) | $382.40 | $478 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $187.20 | $234 | 2.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$282.40–$564.80 | $353–$706 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $297.60 | $372 | 3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $503.20 | $629 | 4.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $503.20 | $629 | 4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $503.20 | $629 | 4.6× |
| Radiologic exam colon double contrast study (74280) | $840 | $1,050 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $834.40 | $1,043 | 4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $840 | $1,050 | 4.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$503.20–$1,006.40 | $629–$1,258 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $300.80 | $376 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $677.60 | $847 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $724.80 | $906 | 4.0× |
| Radiologic exam teeth complete full mouth (70320) | $184 | $230 | 0.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $166.40 | $208 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $796 | $995 | 4.4× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$235.20–$470.40 | $294–$588 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$348.80–$697.60 | $436–$872 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$369.60–$739.20 | $462–$924 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $503.20 | $629 | 4.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$372–$744 | $465–$930 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $95.20 | $119 | 1.1× |
| Ribs bilateral 3 views (71110) | $503.20 | $629 | 4.6× |
| Scapula (73010) range across 3 matching MRF lines |
$371.20–$742.40 | $464–$928 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$378.40–$756.80 | $473–$946 | varies |
| Shoulder Arthrography (73040) | $803.20 | $1,004 | 2.2× |
| Skull less than 4 views (70250) | $326.40 | $408 | 3.0× |
| Speech evaluation, complex (70371) | $197.60 | $247 | 0.8× |
| Thoracic spine 2 views (72070) | $397.60 | $497 | 3.7× |
| Thoracic spine 3 views (72072) | $448.80 | $561 | 4.1× |
| Thoracolumbar 2 views (72080) | $415.20 | $519 | 4.6× |
| Ultrasound Exam Aaa Screen (76706) | $503.20 | $629 | 4.6× |
| Ultrasound, abdomen limited (76705) | $503.20 | $629 | 4.6× |
| Unlisted magnetic resonance procedure (76498) | $1,801.60 | $2,252 | 19.9× |
| Upper gi w/o kub (74240) | $812 | $1,015 | 4.5× |
| Urethrocystogram voiding (74455) | $932.80 | $1,166 | 3.8× |
| Urethrocystography retrograde (74450) | $711.20 | $889 | 2.9× |
| Us chest (76604) | $503.20 | $629 | 4.6× |
| Us complete joint (76881) | $503.20 | $629 | 4.6× |
| Us exam, pelvic, limited (76857) | $503.20 | $629 | 4.6× |
| Us head (76506) | $503.20 | $629 | 4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $503.20 | $629 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $503.20 | $629 | 4.6× |
| Us ob transvaginal (76817) | $503.20 | $629 | 4.6× |
| Us pelvic non ob complete (76856) | $503.20 | $629 | 4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $503.20 | $629 | 4.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $503.20 | $629 | 4.6× |
| Us retroperitoneal complete (76770) | $503.20 | $629 | 4.6× |
| Us retroperitoneal limited (76775) | $582.40 | $728 | 5.4× |
| Us scrotum and contents (76870) | $503.20 | $629 | 4.6× |
| Us spinal canal and contents (76800) | $503.20 | $629 | 4.6× |
| Us thyroid (76536) | $503.20 | $629 | 4.6× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$297.60–$595.20 | $372–$744 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,606.40 | $2,008 | 17.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$331.20–$662.40 | $414–$828 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $241.60 | $302 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $324.80 | $406 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $488 | $610 | 4.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $415.20 | $519 | 4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $348 | $435 | 3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $503.20 | $629 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,006.40 | $1,258 | 9.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,006.40 | $1,258 | 9.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,006.40 | $1,258 | 9.3× |
| X-Ray Exam L-S Spine Bending (72114) | $503.20 | $629 | 4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $408 | $510 | 4.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $503.20 | $629 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $423.20 | $529 | 3.9× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$383.20–$766.40 | $479–$958 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $415.20 | $519 | 4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $259.20 | $324 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $485.60 | $607 | 4.5× |
| X-ray nose-rectum child f.b. (76010) | $340 | $425 | 3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $503.20 | $629 | 4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $418.40 | $523 | 3.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $503.20 | $629 | 4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $415.20 | $519 | 4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $415.20 | $519 | 4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $503.20 | $629 | 4.6× |
| X-ray thoracic spine 4 vw (72074) | $503.20 | $629 | 4.6× |
| X-Ray Tmj Unilat (70328) | $93.60 | $117 | 1.0× |
| X-Rays Bone Length Studies (77073) | $328 | $410 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $503.20 | $629 | 4.6× |
| Xr c-spine 4 or 5 views (72050) | $503.20 | $629 | 4.6× |
| Xr facial bones less than 3 views (70140) | $93.60 | $117 | 1.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $93.60 | $117 | 0.9× |
| Xr orbits complete 4 views (70200) | $503.20 | $629 | 4.6× |
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.