Imaging prices at Clark Fork Valley Hospital
Plains, MT · every code in this section with a posted price and a Medicare benchmark.
208 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) | $187.77 | $187.77 | 2.1× |
| Abdomen 2 views (74019) | $226.62 | $226.62 | 2.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$151.01–$158.65 | $151.01–$158.65 | varies |
| Arthrogram hip (73525) | $495.40 | $495.40 | 1.4× |
| Bone age studies (77072) | $435.55 | $435.55 | 4.1× |
| Cat Scan Follow-Up Study (76380) | $850.77 | $850.77 | 9.6× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$127.92–$142.53 | $127.92–$142.53 | varies |
| Chest 2 views (71046) | $185.07 | $185.07 | 2.1× |
| Chest 3 views (71047) | $212.84 | $212.84 | 2.4× |
| Chest 4 or more views (71048) | $236.65 | $236.65 | 2.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,128.45 | $1,128.45 | 10.6× |
| Contrast X-Ray Bladder (74430) | $257.66 | $257.66 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $495.40 | $495.40 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $4,537.42 | $4,537.42 | 12.7× |
| CT abdomen and pelvis without contrast (74176) | $2,938.16 | $2,938.16 | 12.1× |
| CT abdomen w contrast (74160) | $1,659.74 | $1,659.74 | 9.3× |
| CT abdomen w wo contrast (74170) | $2,058.21 | $2,058.21 | 11.5× |
| CT abdomen w/o contrast (74150) | $1,319.45 | $1,319.45 | 12.4× |
| CT Angio Abdomen and Pelvis (74174) | $4,329.88 | $4,329.88 | 12.1× |
| CT Angio Chest (71275) | $2,106.31 | $2,106.31 | 11.8× |
| CT Angio Head (70496) | $1,849.85 | $1,849.85 | 10.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,433.91 | $2,433.91 | 13.6× |
| CT Angio Neck (70498) | $2,453.46 | $2,453.46 | 13.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,433.91 | $2,433.91 | 13.6× |
| CT bone density (77078) | $401.91 | $401.91 | 4.5× |
| CT cervical spine w/ contrast (72126) | $1,715.12 | $1,715.12 | 4.8× |
| CT cervical spine w/o contrast (72125) | $1,432.55 | $1,432.55 | 13.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,715.12–$4,616.82 | $1,715.12–$4,616.82 | varies |
| CT chest w/wo contrast (71270) | $2,143.80 | $2,143.80 | 12.0× |
| CT head/brain with contrast (70460) | $1,372.18 | $1,372.18 | 7.7× |
| CT head/brain without and with contrast (70470) | $1,715.12 | $1,715.12 | 9.6× |
| CT iac w contrast (70481) | $1,372.18 | $1,372.18 | 7.7× |
| CT l-spine w&w/o contrast (72133) | $2,144.01 | $2,144.01 | 12.0× |
| CT lower ext w/o (73700) | $1,200.68 | $1,200.68 | 11.2× |
| CT lower extremity w/contrast material (73701) | $1,432.55 | $1,432.55 | 8.0× |
| CT lumbar spine w contrast (72132) | $1,715.12 | $1,715.12 | 4.8× |
| CT lumbar spine w/o contrast (72131) | $1,432.55 | $1,432.55 | 13.4× |
| CT maxillofacial w contrast (70487) | $1,557.76 | $1,557.76 | 8.7× |
| CT maxillofacial wo contrast (70486) | $1,381.95 | $1,381.95 | 12.9× |
| CT neck tissue combo (70492) | $1,715.12 | $1,715.12 | 9.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,715.12 | $1,715.12 | 9.6× |
| CT orbits w/o contrast (70480) | $382.72 | $382.72 | 3.6× |
| CT pelvis w&w/o contrast (72194) | $2,058.21 | $2,058.21 | 11.5× |
| CT pelvis w/o contrast (72192) | $1,432.55 | $1,432.55 | 13.4× |
| CT scan of leg combo (73702) | $1,800.86 | $1,800.86 | 10.0× |
| CT scans face/jaw combo (70488) | $1,715.12 | $1,715.12 | 9.6× |
| CT soft tissue neck w contrast (70491) | $1,372.18 | $1,372.18 | 7.7× |
| CT soft tissue neck w/o contrast (70490) | $1,147.48 | $1,147.48 | 10.7× |
| CT thoracic spine w contrast (72129) | $1,715.12 | $1,715.12 | 9.6× |
| CT thoracic spine w/o contrast (72128) | $1,432.55 | $1,432.55 | 13.4× |
| CT thoracic spine w/wo cont (72130) | $2,143.80 | $2,143.80 | 12.0× |
| CT thorax w/o contrast (71250) | $1,432.55 | $1,432.55 | 13.4× |
| CT unlisted procedure (76497) | $2,852.82 | $2,852.82 | 32.1× |
| CT upper ext wo (73200) | $1,203.28 | $1,203.28 | 11.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,800.86 | $1,800.86 | 10.0× |
| CT upper extremity with contrast (73201) | $1,432.55 | $1,432.55 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,920.53 | $2,920.53 | 16.3× |
| Cta Abdomen (74175) | $2,161.28 | $2,161.28 | 12.1× |
| CTA pelvis (72191) | $2,161.28 | $2,161.28 | 12.1× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$305.24–$314.44 | $305.24–$314.44 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$279.50–$287.92 | $279.50–$287.92 | varies |
| Fetal Biophys Profile W/Nst (76818) | $394.32 | $394.32 | 3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $394.32 | $394.32 | 3.7× |
| Fluoroscopy up to 1 hr (76000) | $318.03 | $318.03 | 1.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$151.01–$158.65 | $151.01–$158.65 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$121–$126.98 | $121–$126.98 | varies |
| Joint Survey Single View (77077) | $259.32 | $259.32 | 2.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$212.42–$223.03 | $212.42–$223.03 | varies |
| Magnetic Image Jaw Joint (70336) | $1,822.24 | $1,822.24 | 7.5× |
| MRA head w/o contrast (70544) | $2,213.59 | $2,213.59 | 9.1× |
| MRA neck w contrast (70548) | $3,129.88 | $3,129.88 | 8.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,922.72 | $3,922.72 | 11.0× |
| MRA neck w/o contrast (70547) | $1,894.72 | $1,894.72 | 7.8× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,499.68–$1,811.68 | $1,499.68–$1,811.68 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,963.36 | $1,963.36 | 2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,073.14 | $2,073.14 | 2.6× |
| MRI cervical spine w contrast (72142) | $2,253.84 | $2,253.84 | 6.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$811.20–$1,879.75 | $811.20–$1,879.75 | varies |
| MRI chest w/o contrast (71550) | $1,879.75 | $1,879.75 | 7.7× |
| MRI chest wo w contrast (71552) | $4,052.36 | $4,052.36 | 11.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,561.43 | $3,561.43 | 10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,798.89 | $1,798.89 | 7.4× |
| MRI lumbar spine w contrast (72149) | $2,226.22 | $2,226.22 | 6.2× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$865.28–$3,965.42 | $865.28–$3,965.42 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,860.72 | $1,860.72 | 7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,625.28 | $3,625.28 | 10.2× |
| MRI pelvis w contrast (72196) | $1,881.88 | $1,881.88 | 5.3× |
| MRI pelvis w/o & w contrast (72197) | $4,099.21 | $4,099.21 | 11.5× |
| MRI pelvis w/o contrast (72195) | $1,816.10 | $1,816.10 | 7.5× |
| MRI thoracic spine w/o contrast (72146) | $2,051.92 | $2,051.92 | 8.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,841.63 | $1,841.63 | 5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,860.72 | $1,860.72 | 7.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,561.43 | $3,561.43 | 10.0× |
| MRI, abdomen, combo (74183) | $4,101.45 | $4,101.45 | 11.5× |
| MRI, dorsal spine combo (72157) | $3,965.42 | $3,965.42 | 11.1× |
| MRI, dorsal spine contrast (72147) | $1,890.04 | $1,890.04 | 5.3× |
| MRI, joint upper extrem (73221) | $1,824.58 | $1,824.58 | 7.5× |
| MRI, joint upper extrem combo (73223) | $3,561.43 | $3,561.43 | 10.0× |
| MRI, lumbar spine combo (72158) | $3,922.72 | $3,922.72 | 11.0× |
| Myelogram Lumbar (72265) | $657.18 | $657.18 | 0.8× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$102.34–$107.48 | $102.34–$107.48 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $271.49 | $271.49 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$162.66–$170.82 | $162.66–$170.82 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$116.32–$122.15 | $116.32–$122.15 | varies |
| Radex elbow complete minimum 3 views (73080) | $141.70 | $141.70 | 1.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$192.76–$202.38 | $192.76–$202.38 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$102.34–$107.48 | $102.34–$107.48 | varies |
| Radex foot complete minimum 3 views (73630) | $170.82 | $170.82 | 1.9× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$130.21–$136.71 | $130.21–$136.71 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$192.76–$202.38 | $192.76–$202.38 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$141.70–$148.93 | $141.70–$148.93 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$212.42–$223.03 | $212.42–$223.03 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$151.01–$158.65 | $151.01–$158.65 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$158.03–$165.83 | $158.03–$165.83 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$206.70–$217 | $206.70–$217 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$102.34–$107.48 | $102.34–$107.48 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $248.98 | $248.98 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$130.21–$136.71 | $130.21–$136.71 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $379.13 | $379.13 | 3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$151.01–$158.65 | $151.01–$158.65 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $266.24 | $266.24 | 2.5× |
| Radiologic exam colon double contrast study (74280) | $680.94 | $680.94 | 3.8× |
| Radiologic exam colon single contrast study (74270) | $521.87 | $521.87 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $300.40 | $300.40 | 2.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$162.66–$170.82 | $162.66–$170.82 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $397.33 | $397.33 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $419.28 | $419.28 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $501.02 | $501.02 | 2.8× |
| Radiologic examination femur 1 view (73551) | $148.93 | $148.93 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) | $188.60 | $188.60 | 2.1× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$191.52–$201.29 | $191.52–$201.29 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $535.29 | $535.29 | 5.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$159.69–$167.70 | $159.69–$167.70 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$192.76–$202.38 | $192.76–$202.38 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $69.63 | $69.63 | 3.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$174.25–$182.99 | $174.25–$182.99 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$510.28–$607.52 | $510.28–$607.52 | varies |
| Skull less than 4 views (70250) | $151.01 | $151.01 | 1.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$188.19–$196.98 | $188.19–$196.98 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $891.59 | $891.59 | 5.0× |
| Thoracic spine 2 views (72070) | $247.73 | $247.73 | 2.3× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$271.49–$285.06 | $271.49–$285.06 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$203.22–$213.25 | $203.22–$213.25 | varies |
| Ultrasound Breast Limited (76642) | $241.85 | $241.85 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) | $381.06 | $381.06 | 3.6× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$312.36–$347.98 | $312.36–$347.98 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$317.41–$353.65 | $317.41–$353.65 | varies |
| Urethrocystogram voiding (74455) | $387.35 | $387.35 | 1.6× |
| Urethrocystography retrograde (74450) | $357.40 | $357.40 | 1.5× |
| Us breast unilateral complete (76641) | $303.58 | $303.58 | 2.8× |
| Us chest (76604) | $318.03 | $318.03 | 3.0× |
| Us complete joint (76881) | $428.12 | $428.12 | 4.0× |
| Us exam, pelvic, limited (76857) | $257.66 | $257.66 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$303.58–$428.12 | $303.58–$428.12 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$704.24–$784.63 | $704.24–$784.63 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$312.36–$347.98 | $312.36–$347.98 | varies |
| Us ob transvaginal (76817) | $597.58 | $597.58 | 5.6× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$420.26–$754.42 | $420.26–$754.42 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$256.31–$285.58 | $256.31–$285.58 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$430.87–$480.01 | $430.87–$480.01 | varies |
| Us retroperitoneal limited (76775) | $364.83 | $364.83 | 3.4× |
| Us scrotum and contents (76870) | $373.67 | $373.67 | 3.5× |
| Us spinal canal and contents (76800) | $204.57 | $204.57 | 1.9× |
| Us thyroid (76536) range across 2 matching MRF lines |
$312.36–$347.98 | $312.36–$347.98 | varies |
| Us transrectal (76872) | $373.67 | $373.67 | 3.5× |
| Venography extremity bilateral rs&i (75822) | $361.87 | $361.87 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $232.23 | $232.23 | 0.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$121–$126.98 | $121–$126.98 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$162.66–$170.82 | $162.66–$170.82 | varies |
| X-Ray Bend Only L-S Spine (72120) | $218.35 | $218.35 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$127.97–$134.37 | $127.97–$134.37 | varies |
| X-Ray Exam Breast Specimen (76098) | $916.86 | $916.86 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $188.60 | $188.60 | 1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $328.95 | $328.95 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $122.15 | $122.15 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $188.81 | $188.81 | 2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $260.26 | $260.26 | 2.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $352.14 | $352.14 | 3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $401.60 | $401.60 | 3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $439.56 | $439.56 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $373.88 | $373.88 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$222.98–$234 | $222.98–$234 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$410.38–$431.24 | $410.38–$431.24 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$162.66–$170.82 | $162.66–$170.82 | varies |
| X-ray eye for foreign body (70030) | $115.96 | $115.96 | 1.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$141.70–$148.93 | $141.70–$148.93 | varies |
| X-ray IV pyelogram (ivp) (74400) | $516.05 | $516.05 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $169.57 | $169.57 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $121 | $121 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$243.83–$256.05 | $243.83–$256.05 | varies |
| X-ray nose-rectum child f.b. (76010) | $134.11 | $134.11 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$218.35–$229.27 | $218.35–$229.27 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$151.01–$158.65 | $151.01–$158.65 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $169.57 | $169.57 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$141.70–$148.93 | $141.70–$148.93 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$192.76–$202.38 | $192.76–$202.38 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $218.35 | $218.35 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $637.78 | $637.78 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $633.20 | $633.20 | 5.9× |
| Xr c-spine 4 or 5 views (72050) | $321.62 | $321.62 | 3.0× |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$151.01–$364.99 | $151.01–$364.99 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$192.76–$202.38 | $192.76–$202.38 | varies |
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.