Imaging prices at Burnett Medical Center
Grantsburg, WI · every code in this section with a posted price and a Medicare benchmark.
235 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) | $380.80 | $476 | 4.5× |
| Abdomen 2 views (74019) | $676.80 | $846 | 6.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,043.20 | $3,804 | 7.8× |
| Ankle 2 views (73600) | $516.80 | $646 | 6.1× |
| Arthrogram hip (73525) | $1,911.20 | $2,389 | 5.6× |
| Bone age studies (77072) | $345.60 | $432 | 3.4× |
| Bone Imaging 3 Phase (78315) | $3,024 | $3,780 | 7.8× |
| Bone Imaging Limited Area (78300) | $1,516 | $1,895 | 3.9× |
| Bone Imaging Multiple Areas (78305) | $1,992 | $2,490 | 5.1× |
| Bone Imaging Whole Body (78306) | $2,118.40 | $2,648 | 5.5× |
| Bone survey infant (77076) | $1,776.80 | $2,221 | 17.5× |
| Chest 1 view (71045) | $192 | $240 | 2.3× |
| Chest 2 views (71046) | $260.80 | $326 | 3.1× |
| Chest 3 views (71047) | $330.40 | $413 | 3.9× |
| Chest 4 or more views (71048) | $367.20 | $459 | 3.6× |
| Clavicle complete (73000) | $516.80 | $646 | 6.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,113.60 | $2,642 | 20.8× |
| Contrast X-Ray Bladder (74430) | $625.60 | $782 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $2,537.60 | $3,172 | 7.5× |
| CT abdomen and pelvis without and with contrast (74178) | $4,032 | $5,040 | 11.9× |
| CT abdomen and pelvis without contrast (74176) | $1,912.80 | $2,391 | 8.3× |
| CT abdomen w contrast (74160) | $2,856.80 | $3,571 | 16.8× |
| CT abdomen w wo contrast (74170) | $3,327.20 | $4,159 | 19.5× |
| CT abdomen w/o contrast (74150) | $1,578.40 | $1,973 | 15.5× |
| CT Angio Abdomen and Pelvis (74174) | $5,172.80 | $6,466 | 15.3× |
| CT Angio Chest (71275) | $4,090.40 | $5,113 | 24.0× |
| CT Angio Head (70496) | $5,474.40 | $6,843 | 32.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,644.80 | $5,806 | 27.3× |
| CT Angio Neck (70498) | $5,700 | $7,125 | 33.5× |
| CT cervical spine w/ contrast (72126) | $2,673.60 | $3,342 | 7.9× |
| CT cervical spine w/o contrast (72125) | $2,145.60 | $2,682 | 21.1× |
| CT cervical spine w/wo cont (72127) | $3,318.40 | $4,148 | 19.5× |
| CT chest w contrast (71260) | $2,659.20 | $3,324 | 15.6× |
| CT chest w/wo contrast (71270) | $3,311.20 | $4,139 | 19.4× |
| CT head/brain with contrast (70460) | $2,133.60 | $2,667 | 12.5× |
| CT head/brain without and with contrast (70470) | $2,072.80 | $2,591 | 12.2× |
| CT iac w contrast (70481) | $3,346.40 | $4,183 | 19.6× |
| CT l-spine w&w/o contrast (72133) | $3,321.60 | $4,152 | 19.5× |
| CT lower ext w/o (73700) | $2,113.60 | $2,642 | 20.8× |
| CT lower extremity w/contrast material (73701) | $2,681.60 | $3,352 | 15.7× |
| CT lumbar spine w contrast (72132) | $2,677.60 | $3,347 | 7.9× |
| CT lumbar spine w/o contrast (72131) | $2,124.80 | $2,656 | 20.9× |
| CT maxillofacial w contrast (70487) | $2,787.20 | $3,484 | 16.4× |
| CT maxillofacial wo contrast (70486) | $2,273.60 | $2,842 | 22.4× |
| CT neck tissue combo (70492) | $3,291.20 | $4,114 | 19.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,757.60 | $4,697 | 22.1× |
| CT orbits w/o contrast (70480) | $2,832 | $3,540 | 27.9× |
| CT pelvis w&w/o contrast (72194) | $3,264.80 | $4,081 | 19.2× |
| CT pelvis w/o contrast (72192) | $1,601.60 | $2,002 | 15.8× |
| CT scan of leg combo (73702) | $3,512 | $4,390 | 20.6× |
| CT soft tissue neck w contrast (70491) | $2,645.60 | $3,307 | 15.5× |
| CT soft tissue neck w/o contrast (70490) | $2,109.60 | $2,637 | 20.8× |
| CT thoracic spine w contrast (72129) | $2,687.20 | $3,359 | 15.8× |
| CT thoracic spine w/o contrast (72128) | $2,133.60 | $2,667 | 21.0× |
| CT thoracic spine w/wo cont (72130) | $3,343.20 | $4,179 | 19.6× |
| CT thorax w/o contrast (71250) | $2,113.60 | $2,642 | 20.8× |
| CT upper ext wo (73200) | $2,106.40 | $2,633 | 20.7× |
| CT upper extremity w/o & w/contrast material (73202) | $3,519.20 | $4,399 | 20.7× |
| CT upper extremity with contrast (73201) | $2,638.40 | $3,298 | 7.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,396 | $5,495 | 25.8× |
| Cta Abdomen (74175) | $4,133.60 | $5,167 | 24.3× |
| CTA pelvis (72191) | $4,124.80 | $5,156 | 24.2× |
| Dxa Bone Density Axial (77080) | $566.40 | $708 | 5.6× |
| Dxa bone density study (77085) | $566.40 | $708 | 5.6× |
| Esophagram (74220) | $1,700 | $2,125 | 10.0× |
| Fetal Biophys Profile W/Nst (76818) | $775.20 | $969 | 7.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $560.80 | $701 | 5.5× |
| Fluoroscopy up to 1 hr (76000) | $1,057.60 | $1,322 | 4.6× |
| Foot 2 views (73620) | $500 | $625 | 5.9× |
| Forearm 2 views (73090) | $490.40 | $613 | 5.8× |
| Gastric emptying imaging study (78264) | $2,524.80 | $3,156 | 6.5× |
| Gated Heart Planar Single (78472) | $1,869.60 | $2,337 | 4.8× |
| Hand 2 views (73120) | $480.80 | $601 | 4.7× |
| Hepatobil Syst Image W/Drug (78227) | $4,135.20 | $5,169 | 7.8× |
| Hepatobiliary System Imaging (78226) | $2,979.20 | $3,724 | 7.7× |
| Ht Muscle Image Spect Sing (78451) | $1,880.80 | $2,351 | 1.5× |
| Hysterosalpingogram (74740) | $1,454.40 | $1,818 | 6.3× |
| K Flow/Funct Image W/Drug (78708) | $1,156 | $1,445 | 2.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$692.80–$1,385.60 | $866–$1,732 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,728 | $2,160 | 4.5× |
| Lung Ventilat&Perfus Imaging (78582) | $2,120.80 | $2,651 | 4.0× |
| Lymph System Imaging (78195) | $1,452 | $1,815 | 2.8× |
| Magnetic Image Jaw Joint (70336) | $3,412 | $4,265 | 14.7× |
| Meckels Divert Exam (78290) | $3,050.40 | $3,813 | 7.9× |
| Mra Head W/O & W/Contrast Material (70546) | $3,412 | $4,265 | 10.1× |
| MRA head w/o contrast (70544) | $3,412 | $4,265 | 14.7× |
| MRA neck w contrast (70548) | $3,412 | $4,265 | 10.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,412 | $4,265 | 10.1× |
| MRA neck w/o contrast (70547) | $3,412 | $4,265 | 14.7× |
| MRI abdomen w contrast (74182) | $3,412 | $4,265 | 10.1× |
| MRI abdomen w/o contrast (74181) | $3,412 | $4,265 | 14.7× |
| MRI any jt lower extrem w/contrast material (73722) | $3,412 | $4,265 | 4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,412 | $4,265 | 10.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,412 | $4,265 | 4.5× |
| MRI brain functional w/o physician admnistration (70554) | $3,412 | $4,265 | 14.7× |
| MRI brain functional w/physician admnistration (70555) | $3,412 | $4,265 | 14.7× |
| MRI cervical spine w contrast (72142) | $3,412 | $4,265 | 10.1× |
| MRI cervical spine w/o cont (72141) | $3,412 | $4,265 | 14.7× |
| MRI chest w/o contrast (71550) | $3,412 | $4,265 | 14.7× |
| MRI chest wo w contrast (71552) | $3,412 | $4,265 | 10.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,412 | $4,265 | 10.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,412 | $4,265 | 10.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,412 | $4,265 | 14.7× |
| MRI lumbar spine w contrast (72149) | $3,412 | $4,265 | 10.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,412 | $4,265 | 10.1× |
| MRI orbit face &/neck w/o contrast (70540) | $3,412 | $4,265 | 14.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,412 | $4,265 | 10.1× |
| MRI pelvis w contrast (72196) | $3,412 | $4,265 | 10.1× |
| MRI pelvis w/o & w contrast (72197) | $3,412 | $4,265 | 10.1× |
| MRI pelvis w/o contrast (72195) | $3,412 | $4,265 | 14.7× |
| MRI thoracic spine w/o contrast (72146) | $3,412 | $4,265 | 14.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,412 | $4,265 | 14.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,412 | $4,265 | 10.1× |
| MRI, abdomen, combo (74183) | $3,412 | $4,265 | 10.1× |
| MRI, dorsal spine combo (72157) | $3,412 | $4,265 | 10.1× |
| MRI, dorsal spine contrast (72147) | $3,412 | $4,265 | 10.1× |
| MRI, joint upper extrem (73221) range across 9 matching MRF lines |
$3,412–$4,264.80 | $4,265–$5,331 | varies |
| MRI, joint upper extrem combo (73223) | $3,412 | $4,265 | 10.1× |
| MRI, lumbar spine combo (72158) | $3,412 | $4,265 | 10.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,638.40 | $2,048 | 4.2× |
| Myocardial Spect Multiple Studies (78452) | $3,148 | $3,935 | 2.5× |
| Neck soft tissue (70360) | $480.80 | $601 | 5.7× |
| Nuclear Rx Oral Admin (79005) | $484 | $605 | 2.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$304.80–$579.20 | $381–$724 | varies |
| Optic foramina (70190) | $635.20 | $794 | 7.5× |
| Parathyroid Planar Imaging (78070) | $1,240 | $1,550 | 3.2× |
| Pelvis 1 or 2 views (72170) | $490.40 | $613 | 4.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,988 | $3,735 | 2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,928 | $2,410 | 5.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $828 | $1,035 | 8.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $625.60 | $782 | 7.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $516.80 | $646 | 6.1× |
| Radex elbow complete minimum 3 views (73080) | $625.60 | $782 | 7.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $744.80 | $931 | 7.3× |
| Radex fingr minimum 2 views (73140) | $668 | $835 | 7.9× |
| Radex foot complete minimum 3 views (73630) | $584 | $730 | 6.9× |
| Radex Hand Minimum 3 Views (73130) | $600 | $750 | 7.1× |
| Radex lower extremity infant minimum 2 views (73592) | $500 | $625 | 5.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $625.60 | $782 | 7.4× |
| Radex Ribs Unilateral 2 Views (71100) | $296.80 | $371 | 3.5× |
| Radex shoulder complete minimum 2 views (73030) | $524 | $655 | 6.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $558.40 | $698 | 6.6× |
| Radex Spine 1 View Specify Level (72020) | $397.60 | $497 | 4.7× |
| Radex Sternum Minimum 2 Views (71120) | $540.80 | $676 | 6.4× |
| Radex Toe Minimum 2 Views (73660) | $600 | $750 | 7.1× |
| Radex upper extremity infant minimum 2 views (73092) | $608.80 | $761 | 6.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $725.60 | $907 | 8.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $676.80 | $846 | 6.7× |
| Radiologic exam colon double contrast study (74280) | $4,263.20 | $5,329 | 25.0× |
| Radiologic exam colon single contrast study (74270) | $3,062.40 | $3,828 | 18.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $384 | $480 | 2.3× |
| Radiologic exam knee complete 4/more views (73564) | $804.80 | $1,006 | 7.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $804.80 | $1,006 | 7.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,113.60 | $2,642 | 12.4× |
| Radiologic exam swallow function contrast study (74230) | $1,617.60 | $2,022 | 9.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,350.40 | $2,938 | 13.8× |
| Radiologic examination femur 1 view (73551) | $456 | $570 | 5.4× |
| Radiologic examination femur minimum 2 views (73552) | $480.80 | $601 | 5.7× |
| Radiologic examination knee 1/2 views (73560) | $540.80 | $676 | 6.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $1,184 | $1,480 | 11.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$473.60–$947.20 | $592–$1,184 | varies |
| Ribs bilateral 3 views (71110) | $362.40 | $453 | 3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,113.60 | $2,642 | 5.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,999.20 | $2,499 | 3.8× |
| Scapula (73010) | $565.60 | $707 | 5.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $70.40 | $88 | 3.0× |
| Shoulder 1 view (73020) | $406.40 | $508 | 4.8× |
| Shoulder Arthrography (73040) | $1,960.80 | $2,451 | 5.8× |
| Skull less than 4 views (70250) | $625.60 | $782 | 6.2× |
| Spleen Imaging (78185) | $1,940 | $2,425 | 5.0× |
| Sternoclavicular joints (71130) | $650.40 | $813 | 7.7× |
| Thoracic spine 2 views (72070) | $565.60 | $707 | 5.6× |
| Thoracic spine 3 views (72072) | $650.40 | $813 | 6.4× |
| Thoracolumbar 2 views (72080) | $625.60 | $782 | 7.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,131.20 | $2,664 | 5.5× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$388–$563.20 | $485–$704 | varies |
| Ultrasound Exam Aaa Screen (76706) | $867.20 | $1,084 | 8.5× |
| Ultrasound, abdomen limited (76705) | $856.80 | $1,071 | 8.4× |
| Umbilical-artery Doppler (OB) (76820) | $180.80 | $226 | 1.8× |
| Unlisted Dx Radiographic Procedure (76499) | $232 | $290 | 2.7× |
| Unlisted us procedure (76999) | $1,214.40 | $1,518 | 14.4× |
| Upper gi w/o kub (74240) | $1,988.80 | $2,486 | 11.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $220 | $275 | 19.9× |
| Urea breath test c-14 isotopic analysis (78268) | $220 | $275 | 2.3× |
| Urethrocystogram voiding (74455) | $1,692 | $2,115 | 7.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$521.60–$776 | $652–$970 | varies |
| Us chest (76604) | $660 | $825 | 6.5× |
| Us complete joint (76881) | $979.20 | $1,224 | 9.6× |
| Us exam, pelvic, limited (76857) | $797.60 | $997 | 7.9× |
| Us kidney transplant (76776) | $1,254.40 | $1,568 | 12.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $647.20 | $809 | 6.4× |
| Us ob detailed single fetus (76811) | $300 | $375 | 1.3× |
| Us ob limited 1 or more fetuses (76815) | $634.40 | $793 | 6.2× |
| Us ob transvaginal (76817) | $704 | $880 | 6.9× |
| Us pelvic non ob complete (76856) | $981.60 | $1,227 | 9.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $845.60 | $1,057 | 8.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $823.20 | $1,029 | 8.1× |
| Us retroperitoneal complete (76770) | $1,037.60 | $1,297 | 10.2× |
| Us retroperitoneal limited (76775) | $867.20 | $1,084 | 8.5× |
| Us scrotum and contents (76870) | $1,000 | $1,250 | 9.8× |
| Us thyroid (76536) | $1,019.20 | $1,274 | 10.0× |
| Wrist 2 views (73100) | $576 | $720 | 6.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $737.60 | $922 | 8.7× |
| X-ray antegrade pyelogram tube (74425) | $550.40 | $688 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $760 | $950 | 7.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $516.80 | $646 | 6.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $570.40 | $713 | 6.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $480.80 | $601 | 5.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $685.60 | $857 | 8.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $644.80 | $806 | 6.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $468 | $585 | 4.6× |
| X-Ray Exam L-S Spine Bending (72114) | $1,177.60 | $1,472 | 11.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $600 | $750 | 7.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,091.20 | $1,364 | 10.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $330.40 | $413 | 3.3× |
| X-ray eye for foreign body (70030) | $516.80 | $646 | 6.1× |
| X-ray humerus (73060) | $507.20 | $634 | 6.0× |
| X-ray IV pyelogram (ivp) (74400) | $2,199.20 | $2,749 | 12.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $635.20 | $794 | 7.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $650.40 | $813 | 7.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $608.80 | $761 | 6.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $412 | $515 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $268 | $335 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $524 | $655 | 5.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $507.20 | $634 | 6.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $660 | $825 | 7.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $754.40 | $943 | 7.4× |
| X-Ray Stress View (77071) | $1,244.80 | $1,556 | 14.7× |
| X-ray thoracic spine 4 vw (72074) | $828 | $1,035 | 8.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,199.20 | $2,749 | 6.5× |
| X-Rays Bone Survey Complete (77075) | $1,953.60 | $2,442 | 19.2× |
| Xr c-spine 4 or 5 views (72050) | $811.20 | $1,014 | 8.0× |
| Xr facial bones less than 3 views (70140) | $500 | $625 | 5.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $668 | $835 | 6.6× |
| Xr orbits complete 4 views (70200) | $744.80 | $931 | 7.3× |
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.