Imaging prices at CHI St. Alexius Health Dickinson
Dickinson, ND · every code in this section with a posted price and a Medicare benchmark.
217 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) range across 2 matching MRF lines |
$20.79–$154.35 | $33–$245 | varies |
| Abdomen 2 views (74019) | $296.73 | $471 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $855.54 | $1,358 | 2.1× |
| Bone age studies (77072) | $155.61 | $247 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,159.83 | $1,841 | 2.8× |
| Bone Imaging Limited Area (78300) | $649.53 | $1,031 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $730.80 | $1,160 | 1.8× |
| Bone Imaging Whole Body (78306) | $1,055.25 | $1,675 | 2.6× |
| Bone marrow imaging limited area (78102) | $501.48 | $796 | 1.2× |
| Bone survey infant (77076) | $184.59 | $293 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) | $530.46 | $842 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $590.31 | $937 | 6.6× |
| Cerebrospinal Fluid Scan (78630) | $1,071 | $1,700 | 1.9× |
| Chest 1 view (71045) | $154.98 | $246 | 1.7× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$197.82–$243.18 | $314–$386 | varies |
| Chest 3 views (71047) | $215.46 | $342 | 2.4× |
| Chest 4 or more views (71048) | $215.46 | $342 | 2.0× |
| Cholecystography Oral Contrast (74290) | $277.20 | $440 | 1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $219.87 | $349 | 2.1× |
| Contrast X-Ray Bladder (74430) | $332.64 | $528 | 0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $624.96 | $992 | 3.5× |
| CT abdomen and pelvis without and with contrast (74178) | $2,894.85 | $4,595 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $2,372.58 | $3,766 | 9.7× |
| CT abdomen w contrast (74160) | $1,174.32 | $1,864 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,644.30 | $2,610 | 9.2× |
| CT abdomen w/o contrast (74150) | $1,174.32 | $1,864 | 11.0× |
| CT Angio Abdomen and Pelvis (74174) | $815.85 | $1,295 | 2.3× |
| CT Angio Chest (71275) | $2,222.64 | $3,528 | 12.4× |
| CT Angio Head (70496) | $1,976.94 | $3,138 | 11.0× |
| CT Angio Neck (70498) | $1,981.35 | $3,145 | 11.1× |
| CT cervical spine w/ contrast (72126) | $1,375.92 | $2,184 | 3.9× |
| CT cervical spine w/o contrast (72125) | $1,375.92 | $2,184 | 12.9× |
| CT cervical spine w/wo cont (72127) | $1,664.46 | $2,642 | 9.3× |
| CT chest w contrast (71260) | $1,223.46 | $1,942 | 6.8× |
| CT chest w/wo contrast (71270) | $1,920.24 | $3,048 | 10.7× |
| CT head/brain with contrast (70460) | $1,292.13 | $2,051 | 7.2× |
| CT head/brain without and with contrast (70470) | $1,821.96 | $2,892 | 10.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $534.87 | $849 | 6.0× |
| CT iac w contrast (70481) | $1,174.95 | $1,865 | 6.6× |
| CT l-spine w&w/o contrast (72133) | $1,570.59 | $2,493 | 8.8× |
| CT lumbar spine w contrast (72132) | $1,297.80 | $2,060 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $1,297.80 | $2,060 | 12.2× |
| CT maxillofacial w contrast (70487) | $1,115.10 | $1,770 | 6.2× |
| CT maxillofacial wo contrast (70486) | $1,115.10 | $1,770 | 10.4× |
| CT neck tissue combo (70492) | $1,801.17 | $2,859 | 10.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,762.11 | $2,797 | 9.8× |
| CT orbits w/o contrast (70480) | $1,174.95 | $1,865 | 11.0× |
| CT pelvis w&w/o contrast (72194) | $1,569.96 | $2,492 | 8.8× |
| CT pelvis w/o contrast (72192) | $1,365.21 | $2,167 | 12.8× |
| CT scans face/jaw combo (70488) | $1,795.50 | $2,850 | 10.0× |
| CT soft tissue neck w contrast (70491) | $1,154.79 | $1,833 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $1,154.79 | $1,833 | 10.8× |
| CT thoracic spine w contrast (72129) | $1,375.92 | $2,184 | 7.7× |
| CT thoracic spine w/o contrast (72128) | $1,375.92 | $2,184 | 12.9× |
| CT thoracic spine w/wo cont (72130) | $1,664.46 | $2,642 | 9.3× |
| CT thorax w/o contrast (71250) | $1,223.46 | $1,942 | 11.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,206.89 | $3,503 | 12.3× |
| Cta Abdomen (74175) | $2,822.40 | $4,480 | 15.8× |
| CTA pelvis (72191) | $1,706.67 | $2,709 | 9.5× |
| Dilation ureters/urethra rs&i (74485) | $1,869.84 | $2,968 | 0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $219.24 | $348 | 2.1× |
| Dxa Bone Density Axial (77080) | $371.70 | $590 | 3.5× |
| Echo exam uterus (76831) | $315 | $500 | 1.3× |
| Esophageal Motility Study (78258) | $684.18 | $1,086 | 1.7× |
| Esophagram (74220) | $345.24 | $548 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $296.10 | $470 | 2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $269.01 | $427 | 2.5× |
| Fluoroscopy up to 1 hr (76000) | $279.72 | $444 | 1.1× |
| Gastric emptying imaging study (78264) | $735.21 | $1,167 | 1.8× |
| Gated Heart Planar Single (78472) | $903.42 | $1,434 | 2.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,418.76 | $2,252 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,319.22 | $2,094 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $1,903.23 | $3,021 | 1.4× |
| Hysterosalpingogram (74740) | $510.93 | $811 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $855.54 | $1,358 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $803.88 | $1,276 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$776.79–$815.22 | $1,233–$1,294 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $776.79 | $1,233 | 1.9× |
| Kidney Imaging Morphol (78700) | $618.03 | $981 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $651.42 | $1,034 | 1.6× |
| Liver & Spleen Imaging Static Only (78215) | $659.61 | $1,047 | 1.6× |
| Liver imaging static only (78201) | $480.06 | $762 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,166.13 | $1,851 | 2.1× |
| Lung Ventilation Imaging (78579) | $675.99 | $1,073 | 1.7× |
| Lymph System Imaging (78195) | $700.56 | $1,112 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $1,455.93 | $2,311 | 6.0× |
| Meckels Divert Exam (78290) | $708.12 | $1,124 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,627.10 | $4,170 | 7.4× |
| MRA head w/o contrast (70544) | $1,863.54 | $2,958 | 7.6× |
| MRA head with contrast (70545) | $1,863.54 | $2,958 | 5.2× |
| MRA neck w contrast (70548) | $1,757.70 | $2,790 | 4.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,478.42 | $3,934 | 7.0× |
| MRA neck w/o contrast (70547) | $1,757.70 | $2,790 | 7.2× |
| MRI abdomen w contrast (74182) | $1,666.98 | $2,646 | 4.7× |
| MRI abdomen w/o contrast (74181) | $1,666.98 | $2,646 | 6.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,651.04 | $4,208 | 10.9× |
| MRI cervical spine w contrast (72142) | $2,053.80 | $3,260 | 5.8× |
| MRI cervical spine w/o cont (72141) | $1,993.95 | $3,165 | 8.2× |
| MRI chest w/o contrast (71550) | $1,428.84 | $2,268 | 5.9× |
| MRI chest with contrast (71551) | $1,427.58 | $2,266 | 1.8× |
| MRI chest wo w contrast (71552) | $2,282.49 | $3,623 | 6.4× |
| MRI lumbar spine w contrast (72149) | $1,951.74 | $3,098 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,369.24 | $5,348 | 9.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,755.18 | $2,786 | 7.2× |
| MRI orbit face neck w contrast (70542) | $1,755.18 | $2,786 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,079.44 | $4,888 | 8.6× |
| MRI pelvis w contrast (72196) | $1,788.57 | $2,839 | 5.0× |
| MRI pelvis w/o & w contrast (72197) | $2,933.28 | $4,656 | 8.2× |
| MRI pelvis w/o contrast (72195) | $1,788.57 | $2,839 | 7.3× |
| MRI thoracic spine w/o contrast (72146) | $1,993.95 | $3,165 | 8.2× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,901.78–$3,087 | $4,606–$4,900 | varies |
| MRI, dorsal spine combo (72157) | $3,369.24 | $5,348 | 9.5× |
| MRI, dorsal spine contrast (72147) | $1,993.95 | $3,165 | 5.6× |
| MRI, lumbar spine combo (72158) | $3,298.05 | $5,235 | 9.3× |
| Myelogram cervical (72240) | $944.37 | $1,499 | 1.2× |
| Myelogram Lumbar (72265) | $944.37 | $1,499 | 1.2× |
| Myelography thoracic (72255) | $944.37 | $1,499 | 1.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $796.95 | $1,265 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $2,293.20 | $3,640 | 1.7× |
| Neck soft tissue (70360) | $136.08 | $216 | 1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $231.84 | $368 | 0.6× |
| Ob us nuchal meas 1 gest (76813) | $282.24 | $448 | 2.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $798.84 | $1,268 | 1.4× |
| Parathyroid Planar Imaging (78070) | $569.52 | $904 | 1.4× |
| Pelvis 1 or 2 views (72170) | $164.43 | $261 | 1.5× |
| Peritoneogram Rs&I (74190) | $916.02 | $1,454 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $675.99 | $1,073 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $296.73 | $471 | 2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $391.86 | $622 | 0.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $221.13 | $351 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $164.43 | $261 | 1.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $164.43 | $261 | 1.8× |
| Radex Spine 1 View Specify Level (72020) | $144.27 | $229 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) | $127.26 | $202 | 1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $245.07 | $389 | 2.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $619.29 | $983 | 5.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $293.58 | $466 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $578.97 | $919 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $432.18 | $686 | 2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $231.84 | $368 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $309.96 | $492 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $669.06 | $1,062 | 3.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $592.20 | $940 | 3.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $184.59 | $293 | 1.7× |
| Renal Cyst Study (74470) | $481.32 | $764 | 0.9× |
| Ribs bilateral 3 views (71110) | $254.52 | $404 | 2.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $616.14 | $978 | 1.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$132.30–$1,091.79 | $210–$1,733 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $215.46 | $342 | 9.2× |
| Sella turcica (70240) | $123.48 | $196 | 1.4× |
| Sialogram (70390) | $895.23 | $1,421 | 3.7× |
| Skull less than 4 views (70250) | $166.32 | $264 | 1.6× |
| Speech evaluation, complex (70371) | $624.96 | $992 | 2.6× |
| Spleen Imaging (78185) | $480.06 | $762 | 1.2× |
| Sternoclavicular joints (71130) | $158.76 | $252 | 1.8× |
| Testicular Imaging W/Flow (78761) | $684.18 | $1,086 | 1.7× |
| Thoracic spine 2 views (72070) | $214.20 | $340 | 2.0× |
| Thoracic spine 3 views (72072) | $319.41 | $507 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $395.01 | $627 | 1.0× |
| Thyroid Met Imaging Body (78018) | $1,098.72 | $1,744 | 2.0× |
| Thyroid Uptake Measurement (78012) | $326.34 | $518 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $680.40 | $1,080 | 1.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$37.80–$153.09 | $60–$243 | varies |
| Ultrasound Exam Aaa Screen (76706) | $170.73 | $271 | 1.6× |
| Ultrasound, abdomen limited (76705) | $413.28 | $656 | 3.9× |
| Umbilical-artery Doppler (OB) (76820) | $180.81 | $287 | 1.7× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$291.69–$315 | $463–$500 | varies |
| Ureteral Reflux Study (78740) | $618.03 | $981 | 1.5× |
| Urethrocystogram voiding (74455) | $406.35 | $645 | 1.7× |
| Urethrocystography retrograde (74450) | $332.64 | $528 | 1.4× |
| Us chest (76604) | $253.89 | $403 | 2.4× |
| Us exam, pelvic, limited (76857) | $237.51 | $377 | 2.2× |
| Us head (76506) | $272.16 | $432 | 2.5× |
| Us kidney transplant (76776) | $309.96 | $492 | 2.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$28.98–$281.61 | $46–$447 | varies |
| Us ob detailed single fetus (76811) | $499.59 | $793 | 2.0× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$36.54–$252 | $58–$400 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$40.95–$268.38 | $65–$426 | varies |
| Us pelvic non ob complete (76856) | $338.94 | $538 | 3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$52.29–$298.62 | $83–$474 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $316.26 | $502 | 3.0× |
| Us retroperitoneal complete (76770) | $410.13 | $651 | 3.8× |
| Us retroperitoneal limited (76775) | $340.83 | $541 | 3.2× |
| Us scrotum and contents (76870) | $385.56 | $612 | 3.6× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$395.01–$569.52 | $627–$904 | varies |
| Us thyroid (76536) | $363.51 | $577 | 3.4× |
| Us transrectal (76872) | $318.78 | $506 | 3.0× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,220.31–$2,439.99 | $1,937–$3,873 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $155.61 | $247 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $481.32 | $764 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $213.57 | $339 | 2.0× |
| X-Ray Exam Breast Specimen (76098) | $261.45 | $415 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $372.33 | $591 | 4.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $432.81 | $687 | 4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $493.92 | $784 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$128.52–$210.42 | $204–$334 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $35.28 | $56 | 0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $202.23 | $321 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $449.19 | $713 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $338.31 | $537 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $446.04 | $708 | 4.2× |
| X-ray IV pyelogram+tomography (74415) | $481.32 | $764 | 2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $124.74 | $198 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $318.78 | $506 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $144.27 | $229 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $410.13 | $651 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $233.73 | $371 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $177.03 | $281 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $253.89 | $403 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $329.49 | $523 | 3.1× |
| X-Ray Stress View (77071) | $117.81 | $187 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $367.92 | $584 | 3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $578.97 | $919 | 1.6× |
| X-Rays Bone Length Studies (77073) | $147.42 | $234 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $968.94 | $1,538 | 9.1× |
| Xr c-spine 4 or 5 views (72050) | $388.71 | $617 | 3.6× |
| Xr facial bones less than 3 views (70140) | $123.48 | $196 | 1.4× |
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.