Imaging prices at Cass County Memorial Hospital

Atlantic, IA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $135.80 $194 1.6×
Abdomen 2 views (74019) $200.90 $287 2.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,176 $1,680 3.1×
Ankle 2 views (73600) $135.80 $194 1.6×
Arthrogram hip (73525)
range across 2 matching MRF lines		 $246.40–$886.90 $352–$1,267 varies
Arthrogram Wrist (73115) $886.90 $1,267 2.6×
Bone age studies (77072) $261.80 $374 2.6×
Bone Imaging 3 Phase (78315) $988.40 $1,412 2.6×
Bone Imaging Limited Area (78300) $842.80 $1,204 2.2×
Bone Imaging Whole Body (78306) $863.80 $1,234 2.2×
Bone marrow imaging limited area (78102) $842.80 $1,204 2.2×
Bone survey infant (77076) $357.70 $511 3.6×
Chest 1 view (71045) $135.80 $194 1.6×
Chest 2 views (71046) $172.20 $246 2.1×
Chest 3 views (71047) $207.90 $297 2.5×
Chest 4 or more views (71048) $243.60 $348 2.4×
Clavicle complete (73000) $135.80 $194 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,066.10 $1,523 10.6×
Contrast X-Ray Of Knee Joint (73580) $886.90 $1,267 2.6×
CT abdomen and pelvis without and with contrast (74178) $2,885.40 $4,122 8.6×
CT abdomen and pelvis without contrast (74176) $2,015.30 $2,879 8.8×
CT abdomen w contrast (74160) $1,318.80 $1,884 7.8×
CT abdomen w wo contrast (74170) $1,633.80 $2,334 9.7×
CT abdomen w/o contrast (74150) $1,129.10 $1,613 11.2×
CT Angio Abdomen and Pelvis (74174) $2,616.60 $3,738 7.8×
CT Angio Chest (71275) $1,812.30 $2,589 10.7×
CT Angio Head (70496) $1,890 $2,700 11.2×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,845.90 $2,637 10.9×
CT Angio Neck (70498) $1,812.30 $2,589 10.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,653.40 $2,362 9.8×
CT cervical spine w/ contrast (72126) $1,568.70 $2,241 4.7×
CT cervical spine w/o contrast (72125) $1,183.70 $1,691 11.8×
CT chest w contrast (71260) $1,360.80 $1,944 8.1×
CT chest w/wo contrast (71270) $1,502.90 $2,147 8.9×
CT head/brain with contrast (70460) $1,124.90 $1,607 6.7×
CT head/brain without and with contrast (70470) $1,354.50 $1,935 8.0×
CT iac w contrast (70481) $1,187.20 $1,696 7.0×
CT l-spine w&w/o contrast (72133) $2,228.10 $3,183 13.2×
CT lower ext w/o (73700) $1,062.60 $1,518 10.6×
CT lower extremity w/contrast material (73701) $1,328.60 $1,898 7.9×
CT lumbar spine w contrast (72132) $1,540 $2,200 4.6×
CT lumbar spine w/o contrast (72131) $1,231.30 $1,759 12.3×
CT maxillofacial w contrast (70487) $1,327.20 $1,896 7.9×
CT maxillofacial wo contrast (70486) $1,126.30 $1,609 11.2×
CT neck tissue combo (70492) $1,415.40 $2,022 8.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,630.30 $2,329 9.7×
CT orbits w/o contrast (70480) $1,071 $1,530 10.7×
CT pelvis w&w/o contrast (72194) $1,375.50 $1,965 8.2×
CT pelvis w/o contrast (72192) $1,062.60 $1,518 10.6×
CT scan of leg combo (73702) $1,463.70 $2,091 8.7×
CT scans face/jaw combo (70488) $1,478.40 $2,112 8.8×
CT soft tissue neck w contrast (70491) $1,262.80 $1,804 7.5×
CT soft tissue neck w/o contrast (70490) $1,062.60 $1,518 10.6×
CT thoracic spine w contrast (72129) $1,297.80 $1,854 7.7×
CT thoracic spine w/o contrast (72128) $1,168.30 $1,669 11.6×
CT thoracic spine w/wo cont (72130) $2,065.70 $2,951 12.3×
CT thorax w/o contrast (71250) $1,129.80 $1,614 11.2×
CT upper ext wo (73200) $1,062.60 $1,518 10.6×
CT upper extremity w/o & w/contrast material (73202) $1,563.10 $2,233 9.3×
CT upper extremity with contrast (73201) $1,169 $1,670 3.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,158.40 $4,512 18.7×
Cta Abdomen (74175) $1,759.10 $2,513 10.4×
CTA pelvis (72191) $1,918 $2,740 11.4×
Dxa Bone Density Axial (77080) $335.30 $479 3.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $249.20 $356 3.0×
Echo exam uterus (76831)
range across 2 matching MRF lines		 $169.40–$570.50 $242–$815 varies
Esophagram (74220) $259 $370 1.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $443.10 $633 4.4×
Fluoroscopy up to 1 hr (76000) $289.10 $413 1.3×
Foot 2 views (73620) $128.10 $183 1.5×
Forearm 2 views (73090) $135.80 $194 1.6×
Gastric emptying imaging study (78264) $953.40 $1,362 2.5×
Gated Heart Planar Single (78472) $1,010.80 $1,444 2.6×
Hand 2 views (73120) $112 $160 1.1×
Hepatobil Syst Image W/Drug (78227) $1,208.90 $1,727 2.3×
Hepatobiliary System Imaging (78226) $1,441.30 $2,059 3.8×
Ht Muscle Image Spect Sing (78451) $1,536.50 $2,195 1.2×
Hysterosalpingogram (74740) $240.80 $344 1.0×
K Flow/Funct Image W/Drug (78708) $989.80 $1,414 1.9×
K Flow/Funct Image W/O Drug (78707) $885.50 $1,265 1.7×
Knee 3 Views (73562) $163.80 $234 2.0×
Liver & Spleen Imaging W/Vascular Flow (78216) $705.60 $1,008 1.8×
Lung Perf&Ventilat Diferentl (78598) $1,703.80 $2,434 3.3×
Lung Ventilat&Perfus Imaging (78582) $1,085.70 $1,551 2.1×
Lymph System Imaging (78195) $848.40 $1,212 1.6×
Meckels Divert Exam (78290) $695.10 $993 1.8×
Mra Head W/O & W/Contrast Material (70546) $2,786 $3,980 8.3×
MRA head w/o contrast (70544) $1,892.10 $2,703 8.2×
MRA neck w contrast (70548) $2,088.10 $2,983 6.2×
Mra Neck W/O &W/Contrast Material (70549) $2,576 $3,680 7.7×
MRA neck w/o contrast (70547) $1,911 $2,730 8.3×
MRI abdomen w contrast (74182) $2,235.10 $3,193 6.7×
MRI abdomen w/o contrast (74181) $2,110.50 $3,015 9.2×
MRI any jt lower extrem w/contrast material (73722) $2,575.30 $3,679 3.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,718.80 $3,884 8.1×
MRI any jt upper extremity w/contrast matrl (73222) $2,086.70 $2,981 2.8×
MRI Breast W/O Contrast Bilateral (77047) $2,248.40 $3,212 9.8×
MRI Breast Without Contrast Material Unilateral (77046) $1,372.70 $1,961 6.0×
MRI cervical spine w contrast (72142) $1,866.90 $2,667 5.6×
MRI cervical spine w/o cont (72141) $1,740.90 $2,487 7.6×
MRI chest w/o contrast (71550) $1,428 $2,040 6.2×
MRI chest wo w contrast (71552) $2,231.60 $3,188 6.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,802.50 $2,575 5.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,712.50 $3,875 8.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,668.10 $2,383 7.3×
MRI lumbar spine w contrast (72149) $2,601.90 $3,717 7.8×
Mri Neck Spine W/O & W/Dye (72156) $2,788.80 $3,984 8.3×
MRI orbit face &/neck w/o contrast (70540) $2,409.40 $3,442 10.5×
MRI orbit face neck w contrast (70542) $2,667.70 $3,811 8.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,841.30 $4,059 8.5×
MRI pelvis w/o & w contrast (72197) $2,542.40 $3,632 7.6×
MRI pelvis w/o contrast (72195) $1,547.70 $2,211 6.7×
MRI thoracic spine w/o contrast (72146) $1,819.30 $2,599 7.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,766.80 $2,524 7.7×
Mri Uppr Extremity W/O&W/Dye (73220) $3,320.80 $4,744 9.9×
MRI, abdomen, combo (74183) $2,793 $3,990 8.3×
MRI, dorsal spine combo (72157) $2,698.50 $3,855 8.0×
MRI, dorsal spine contrast (72147) $1,964.20 $2,806 5.9×
MRI, joint upper extrem (73221) $1,663.20 $2,376 7.3×
MRI, joint upper extrem combo (73223) $2,677.50 $3,825 8.0×
MRI, lumbar spine combo (72158) $2,689.40 $3,842 8.0×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $532.70 $761 1.4×
Myocardial Spect Multiple Studies (78452) $2,148.30 $3,069 1.7×
Neck soft tissue (70360) $126.70 $181 1.5×
Ob us nuchal meas 1 gest (76813) $357.70 $511 3.6×
Parathyroid Planar Imaging (78070) $603.40 $862 1.6×
Pelvis 1 or 2 views (72170) $144.20 $206 1.4×
PET image w/CT, full body (78816) $3,028.20 $4,326 2.2×
PET imaging CT attenuation skull base mid-thigh (78815) $3,067.40 $4,382 2.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $273 $390 2.7×
Radex abscess/fistula/sinus tract rs&i (76080) $628.60 $898 1.2×
Radex Ankle Complete Minimum 3 Views (73610) $165.90 $237 2.0×
Radex Calcaneus Minimum 2 Views (73650) $157.50 $225 1.9×
Radex elbow complete minimum 3 views (73080) $163.80 $234 2.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $226.80 $324 2.3×
Radex fingr minimum 2 views (73140) $116.20 $166 1.4×
Radex foot complete minimum 3 views (73630) $165.90 $237 2.0×
Radex Hand Minimum 3 Views (73130) $148.40 $212 1.8×
Radex lower extremity infant minimum 2 views (73592) $77 $110 0.9×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $191.80 $274 1.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $154.70 $221 1.8×
Radex Ribs Unilateral 2 Views (71100) $131.60 $188 1.6×
Radex shoulder complete minimum 2 views (73030) $152.60 $218 1.8×
Radex Sinuses Paransl < 3 Views (70210) $122.50 $175 1.5×
Radex Spine 1 View Specify Level (72020) $128.10 $183 1.5×
Radex Sternum Minimum 2 Views (71120) $175.70 $251 2.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $331.10 $473 4.0×
Radex Toe Minimum 2 Views (73660) $112 $160 1.3×
Radex Wrist Complete Minimum 3 Views (73110) $153.30 $219 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $165.90 $237 1.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $226.10 $323 2.2×
Radiologic exam colon double contrast study (74280) $425.60 $608 2.5×
Radiologic exam colon single contrast study (74270) $344.40 $492 2.0×
Radiologic exam knee complete 4/more views (73564) $329.70 $471 3.3×
Radiologic exam pelvis compl minimum 3 views (72190) $199.50 $285 2.0×
Radiologic Exam Small Int Single Contrast Study (74250) $247.80 $354 1.5×
Radiologic exam swallow function contrast study (74230) $329.70 $471 2.0×
Radiologic exam upr gi trc double contrast study (74246) $397.60 $568 2.4×
Radiologic examination femur minimum 2 views (73552) $157.50 $225 1.9×
Radiologic examination knee 1/2 views (73560) $148.40 $212 1.8×
Radiologic Examination Osseous Survey Limited (77074) $415.80 $594 4.1×
Radiologic examination tibia & fibula 2 views (73590) $157.50 $225 1.9×
Ribs bilateral 3 views (71110) $202.30 $289 2.0×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $960.40 $1,372 1.8×
Scapula (73010) $142.80 $204 1.4×
Screening Digital Breast Tomosynthesis Bi (77063) $23.10 $33 1.0×
Shoulder 1 view (73020) $105.70 $151 1.3×
Shoulder Arthrography (73040) $886.90 $1,267 2.6×
Skull less than 4 views (70250) $187.60 $268 1.9×
Sternoclavicular joints (71130) $154.70 $221 1.8×
Thoracic spine 2 views (72070) $253.40 $362 2.5×
Thoracic spine 3 views (72072) $185.50 $265 1.8×
Thoracolumbar 2 views (72080) $263.20 $376 3.1×
Thyroid Imaging With Vascular Flow (78013) $418.60 $598 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $656.60 $938 1.7×
Ultrasound Breast Limited (76642) $215.60 $308 2.6×
Ultrasound Exam Aaa Screen (76706) $277.90 $397 2.8×
Ultrasound, abdomen limited (76705) $393.40 $562 3.9×
Upper gi w/o kub (74240) $288.40 $412 1.7×
Urethrocystogram voiding (74455) $377.30 $539 1.6×
Urethrocystography retrograde (74450) $631.40 $902 2.8×
Us breast unilateral complete (76641) $289.80 $414 2.9×
Us chest (76604) $422.80 $604 4.2×
Us exam, pelvic, limited (76857) $303.10 $433 3.0×
Us kidney transplant (76776) $627.90 $897 6.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $318.50 $455 3.2×
Us ob limited 1 or more fetuses (76815) $357.70 $511 3.6×
Us ob transvaginal (76817) $452.90 $647 4.5×
Us pelvic non ob complete (76856) $383.60 $548 3.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $357.70 $511 3.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $364 $520 3.6×
Us retroperitoneal complete (76770) $552.30 $789 5.5×
Us retroperitoneal limited (76775) $332.50 $475 3.3×
Us scrotum and contents (76870) $478.80 $684 4.8×
Us thyroid (76536) $370.30 $529 3.7×
Wrist 2 views (73100) $112 $160 1.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $151.90 $217 1.8×
X-ray antegrade pyelogram tube (74425) $648.90 $927 1.9×
X-Ray Bend Only L-S Spine (72120) $144.20 $206 1.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $135.80 $194 1.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $223.30 $319 2.2×
X-Ray Exam Hip Uni 1 View (73501) $125.30 $179 1.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $165.90 $237 2.0×
X-Ray Exam Hips Bi 2 Views (73521) $162.40 $232 1.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $162.40 $232 1.6×
X-Ray Exam Hips Bi 5/> Views (73523) $190.40 $272 1.9×
X-Ray Exam L-S Spine Bending (72114) $461.30 $659 4.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $193.90 $277 2.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $233.80 $334 2.3×
X-Ray Exam Unilat Ribs/Chest (71101) $175 $250 1.7×
X-ray eye for foreign body (70030) $122.50 $175 1.5×
X-ray humerus (73060) $135.80 $194 1.6×
X-ray IV pyelogram (ivp) (74400) $430.50 $615 2.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $89.60 $128 1.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $148.40 $212 1.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $195.30 $279 1.9×
X-ray nose-rectum child f.b. (76010) $141.40 $202 1.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $305.90 $437 3.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $156.80 $224 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $159.60 $228 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $178.50 $255 2.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $252.70 $361 2.5×
X-ray thoracic spine 4 vw (72074) $172.90 $247 1.7×
X-Ray Tmj Unilat (70328) $191.80 $274 2.3×
X-Rays Bone Length Studies (77073) $266.70 $381 2.7×
X-Rays Bone Survey Complete (77075) $476 $680 4.7×
Xr c-spine 4 or 5 views (72050) $217 $310 2.2×
Xr facial bones less than 3 views (70140) $216.30 $309 2.6×
Xr orbits complete 4 views (70200) $191.10 $273 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.