Imaging prices at Childrens Hospital of Wisconsin Fox Valley
Neenah, WI · every code in this section with a posted price and a Medicare benchmark.
53 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) | $136.54 | $248.25 | 1.6× |
| Abdomen 2 views (74019) | $141.76 | $257.75 | 1.4× |
| Ankle 2 views (73600) | $150.98 | $274.50 | 1.8× |
| Bone survey infant (77076) | $683.38 | $1,242.50 | 6.7× |
| Chest 1 view (71045) | $94.05 | $171 | 1.1× |
| Chest 2 views (71046) | $136.54 | $248.25 | 1.6× |
| Clavicle complete (73000) | $289.03 | $525.50 | 3.4× |
| CT abdomen and pelvis without contrast (74176) | $788.01 | $1,432.75 | 3.4× |
| CT abdomen w contrast (74160) | $1,492.56 | $2,713.75 | 8.8× |
| CT Angio Chest (71275) | $1,965.70 | $3,574 | 11.5× |
| CT Angio Neck (70498) | $1,826.83 | $3,321.50 | 10.7× |
| CT cervical spine w/o contrast (72125) | $767.11 | $1,394.75 | 7.6× |
| CT chest w contrast (71260) | $1,509.34 | $2,744.25 | 8.9× |
| CT head/brain with contrast (70460) | $1,186.35 | $2,157 | 7.0× |
| CT lower ext w/o (73700) | $495 | $900 | 4.9× |
| CT maxillofacial wo contrast (70486) | $1,157.48 | $2,104.50 | 11.4× |
| CT soft tissue neck w contrast (70491) | $962.09 | $1,749.25 | 5.6× |
| CT thorax w/o contrast (71250) | $1,279.58 | $2,326.50 | 12.6× |
| Esophagram (74220) | $410.16 | $745.75 | 2.4× |
| Fluoroscopy up to 1 hr (76000) | $271.70 | $494 | 1.2× |
| Forearm 2 views (73090) | $181.91 | $330.75 | 2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,866.60 | $5,212 | 8.5× |
| MRI cervical spine w/o cont (72141) | $1,992.38 | $3,622.50 | 8.6× |
| MRI spectroscopy (76390) | $1,997.46 | $3,631.75 | 23.6× |
| Pelvis 1 or 2 views (72170) | $183.15 | $333 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $201.44 | $366.25 | 2.4× |
| Radex foot complete minimum 3 views (73630) | $262.35 | $477 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $239.53 | $435.50 | 2.8× |
| Radex lower extremity infant minimum 2 views (73592) | $416.90 | $758 | 4.9× |
| Radex Spine 1 View Specify Level (72020) | $158.68 | $288.50 | 1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $92.95 | $169 | 1.1× |
| Radiologic exam colon single contrast study (74270) | $444.26 | $807.75 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) | $223.71 | $406.75 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $407 | $740 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $379.91 | $690.75 | 4.5× |
| Radiologic examination knee 1/2 views (73560) | $176.14 | $320.25 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $269.50 | $490 | 3.2× |
| Ribs bilateral 3 views (71110) | $318.45 | $579 | 3.1× |
| Thoracic spine 2 views (72070) | $281.33 | $511.50 | 2.8× |
| Ultrasound, abdomen limited (76705) | $432.71 | $786.75 | 4.3× |
| Upper gi w/o kub (74240) | $532.81 | $968.75 | 3.1× |
| Urethrocystogram voiding (74455) | $161.84 | $294.25 | 0.7× |
| Us chest (76604) | $278.85 | $507 | 2.7× |
| Us exam, pelvic, limited (76857) | $229.21 | $416.75 | 2.3× |
| Us head (76506) | $220.69 | $401.25 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $330.83 | $601.50 | 3.3× |
| Us pelvic non ob complete (76856) | $366.71 | $666.75 | 3.6× |
| Us retroperitoneal complete (76770) | $357.23 | $649.50 | 3.5× |
| Us scrotum and contents (76870) | $357.23 | $649.50 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $159.23 | $289.50 | 1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $273.90 | $498 | 2.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $187.41 | $340.75 | 2.2× |
| X-ray humerus (73060) | $133.65 | $243 | 1.6× |