Imaging prices at Cleveland Area Hospital

Cleveland, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $379.04 $473.80 3.8×
Ankle 2 views (73600) $231.74 $289.68 2.8×
Bone age studies (77072) $211.20 $264 2.1×
Bone survey complete (77075) $760 $950 7.6×
Cervical spine 2 or 3 views (72040) $352.67 $440.84 4.2×
Chest 1 view (71045) $261.12 $326.40 3.1×
Chest 3 views (71047) $263.41 $329.26 3.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $920 $1,150 5.5×
Clavicle complete (73000) $154.09 $192.61 1.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,194.22 $2,742.78 21.8×
CT abdomen and pelvis without and with contrast (74178) $3,100.71 $3,875.89 9.2×
CT abdomen and pelvis without contrast (74176) $2,058.35 $2,572.94 9.0×
CT abdomen w contrast (74160) $1,746.90 $2,183.62 10.4×
CT abdomen w wo contrast (74170) $2,228.50 $2,785.62 13.2×
CT abdomen w/o contrast (74150) $1,601.86 $2,002.32 15.9×
CT angiography upper extremity lt (73206) $2,556.87 $3,196.09 15.2×
CT c-spine w/o contrast (72125) $1,749.50 $2,186.88 17.4×
CT cervical spine w&w/o contrast (72127) $2,311.20 $2,889 13.7×
CT cervical spine with contrast (72126) $1,795.20 $2,244 5.4×
CT chest w/wo contrast (71270) $2,054.40 $2,568 12.2×
CT chest with contrast (71260) $1,967.71 $2,459.64 11.7×
CT head/brain with contrast (70460) $1,538.41 $1,923.01 9.1×
CT head/brain without and with contrast (70470) $1,809.50 $2,261.88 10.7×
CT iac w contrast (70481) $909.70 $1,137.12 5.4×
CT lower ext w/o (73700) $1,582.08 $1,977.60 15.7×
CT lower extremity w wo contrast (73702) $2,564.29 $3,205.36 15.2×
CT lower extremity with contrast (73701) $1,917.60 $2,397 11.4×
CT lumbar spine w & w/o contrast (72133) $1,747.20 $2,184 10.4×
CT lumbar spine w/o contrast (72131) $1,491.44 $1,864.30 14.8×
CT lumbar spine with contrast (72132) $1,513.68 $1,892.10 4.5×
CT maxillofacial w contrast (70487) $1,498.86 $1,873.57 8.9×
CT maxillofacial w/o contrast (70486) $1,364.54 $1,705.68 13.6×
CT maxillofacial w/wo contrast (70488) $1,587.02 $1,983.78 9.4×
CT neck soft tissue w contrast (70491) $1,904.26 $2,380.33 11.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $858.62 $1,073.28 5.1×
CT orbits w/o contrast (70480) $859.43 $1,074.29 8.5×
CT pelvis w & w/o contrast (72194) $1,932.80 $2,416 11.5×
CT pelvis w/o contrast (72192) $1,472.88 $1,841.10 14.6×
CT soft tissue neck w/o & w/contrast material (70492) $1,802.09 $2,252.61 10.7×
CT soft tissue neck w/o contrast (70490) $1,427.99 $1,784.99 14.2×
CT thoracic spine w/contrast (72129) $1,777.60 $2,222 10.5×
CT thoracic spine w/o contrast (72128) $1,522.56 $1,903.20 15.1×
CT thoracic spine w/wo contrast (72130) $2,307.20 $2,884 13.7×
CT thorax w/o contrast (71250) $1,570.54 $1,963.18 15.6×
CT upper extremity w/o & w/contrast material (73202) $2,264.40 $2,830.50 13.4×
CT upper extremity w/o contrast rt (73200) $1,825.16 $2,281.45 18.2×
CT upper extremity with contrast (73201) $1,752.04 $2,190.06 5.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,330.94 $5,413.68 25.7×
Cta Abdomen (74175) $2,714.26 $3,392.82 16.1×
CTA abdomen pelvis (74174) $3,293.89 $4,117.36 9.8×
CTA chest (71275) $3,246.38 $4,057.98 19.2×
Cta Head (70496) $2,336.86 $2,921.08 13.9×
CTA lwr ext w&w/o contrast (73706) $3,485.52 $4,356.90 20.7×
Cta Neck (70498) $2,332.74 $2,915.93 13.8×
Cta Pelvis (72191) $2,222.40 $2,778 13.2×
Dxa bone density study 1/> sites axial skel (77080) $352.77 $440.96 3.5×
Foot 2 views (73620) $163.15 $203.94 1.9×
Forearm 2 views (73090) $137.90 $172.38 1.6×
Hand 2 views (73120) $140.35 $175.44 1.4×
Hand 3 views (73130) $225.78 $282.22 2.7×
Humerus Min 2 Views Left (73060) $234.84 $293.55 2.8×
Knee 3 views (73562) $309 $386.25 3.7×
MRA head w & w/o contrast (70546) $2,142.40 $2,678 6.4×
MRA head w/o contrast (70544) $951.72 $1,189.65 4.1×
MRA head with contrast (70545) $951.72 $1,189.65 2.8×
MRA neck w contrast (70548) $2,472 $3,090 7.4×
Mra Neck W/O &W/Contrast Material (70549) $2,801.60 $3,502 8.3×
MRA neck w/o contrast (70547) $2,153.94 $2,692.42 9.4×
MRI abdomen w contrast (74182) $1,974.12 $2,467.65 5.9×
MRI abdomen w/o & w/contrast material (74183) $2,432.93 $3,041.16 7.3×
MRI abdomen w/o contrast (74181) $1,689.20 $2,111.50 7.4×
MRI any jnt lwr ext with con lt (73722) $1,915.82 $2,394.78 2.5×
MRI any jt upper extremity w/contrast matrl (73222) $1,978.42 $2,473.03 2.6×
MRI c-spine with contrast (72142) $1,974.12 $2,467.65 5.9×
MRI cervical spine w/o contrast (72141) $2,111.09 $2,638.86 9.2×
MRI chest w/o & w/contrast material (71552) $2,340.16 $2,925.20 7.0×
MRI chest w/o contrast (71550) $1,503.80 $1,879.75 6.6×
MRI chest with contrast (71551) $1,916.62 $2,395.78 2.5×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,935.23 $2,419.04 5.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,915.82 $2,394.78 5.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,079.78 $2,599.72 9.1×
MRI orbit face &/neck w/o contrast (70540) $1,609.27 $2,011.59 7.0×
MRI orbit/face/neck w&w/o cont (70543) $2,504.14 $3,130.17 7.5×
MRI orbit/face/neck w/contrast (70542) $1,900.62 $2,375.78 5.7×
MRI pelvis w contrast (72196) $1,915.82 $2,394.78 5.7×
MRI pelvis w/o & w/contrast material (72197) $2,504.14 $3,130.17 7.5×
MRI pelvis w/o contrast (72195) $1,609.27 $2,011.59 7.0×
MRI scan of arm joint before and after contrast (73223) $2,504.14 $3,130.17 7.5×
MRI scan of leg joint before and after contrast (73723) $2,504.14 $3,130.17 7.5×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,506.33 $3,132.91 7.5×
MRI spinal canal lumbar w/contrast material (72149) $1,915.82 $2,394.78 5.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,804.07 $3,505.09 8.4×
MRI spinal canal thoracic w/contrast matrl (72147) $1,974.12 $2,467.65 5.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,960 $3,700 8.8×
MRI thoracic spine w/o contrast (72146) $2,031.16 $2,538.95 8.9×
MRI tmj (70336) $1,503.80 $1,879.75 6.6×
MRI upper ext joint w/o contrast (73221) $2,301.43 $2,876.79 10.0×
MRI upper extrem other than jt w/o & w/contras (73220) $2,479.82 $3,099.78 7.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,609.27 $2,011.59 7.0×
Neck soft tissue (70360) $145.25 $181.56 1.7×
Pelvis 1 or 2 views (72170) $238.14 $297.67 2.4×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,504.14 $3,130.17 7.5×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $190.94 $238.68 2.3×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $355.14 $443.93 3.5×
Radex hips bilateral with pelvis 2 views (73521) $496.87 $621.09 4.9×
Radex mastoids compl minimum 3 views pr side (70130) $147.04 $183.80 1.5×
Radiolog exam mandible compl minimum 4 views (70110) $236.49 $295.61 2.4×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $212.59 $265.74 2.5×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $330.42 $413.03 3.9×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $332.11 $415.14 4.0×
Ribs bilateral 3 views (71110) $192.82 $241.02 1.9×
Sacroiliac Joints < 3 Views (72200) $141.73 $177.16 1.4×
Scapula complete (73010) $131.02 $163.77 1.3×
Screening digital breast tomosynthesis (77063) $193.60 $242 8.3×
Small bowel series (74250) $299 $373.75 1.8×
Spine thoracic 3 views (72072) $362.56 $453.20 3.6×
Ultrasound, abdomen limited (76705) $496.87 $621.09 4.9×
Upper Extremity Infant (73092) $152.59 $190.74 1.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $532.54 $665.68 3.2×
Us abdl aorta screen aaa (76706) $499.20 $624 5.0×
Us breast unilateral limited (76642) $336.19 $420.24 4.0×
Us chest (76604) $412 $515 4.1×
Us compl joint r-t w/image documentation (76881) $228 $285 2.3×
Us ob transvaginal (76817) $475.45 $594.31 4.7×
Us pelvic non ob complete (76856) $610.58 $763.23 6.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $201.06 $251.32 2.0×
Us pregnancy ltd (76815) $407.20 $509 4.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $575.28 $719.10 5.7×
Us retroperitoneal complete (76770) $615.53 $769.41 6.1×
Us retroperitoneal limited (76775) $387.28 $484.10 3.9×
Us scrotum and contents (76870) $579.26 $724.07 5.8×
Us soft tissue head/neck (76536) $455.67 $569.59 4.5×
Us xtr non-vasc lmtd (76882) $408 $510 4.1×
Wrist 2 views (73100) $168.91 $211.14 2.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $386.46 $483.07 3.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $140 $175 1.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $251.32 $314.15 3.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $137.90 $172.38 1.6×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $233.38 $291.72 2.8×
X-ray exam hip uni 1 view (73501) $274.99 $343.74 3.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $352.67 $440.84 4.2×
X-ray exam hip uni 4/> views (73503) $453.20 $566.50 4.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $254.62 $318.27 2.5×
X-Ray Exam Hips Bi 5/> Views (73523) $552 $690 5.5×
X-ray exam of femur 1 (73551) $242.40 $303 2.9×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $224.13 $280.16 2.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $145.25 $181.56 1.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $276.86 $346.08 3.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $268.62 $335.78 3.2×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $349.25 $436.56 3.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $374.40 $468 4.5×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $210.40 $263 2.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $183.60 $229.50 1.8×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $309 $386.25 3.1×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $189.07 $236.34 2.3×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $131.02 $163.77 1.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $164.80 $206 1.6×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $191.20 $239 1.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $252.97 $316.21 3.0×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $418.80 $523.50 4.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $454.85 $568.56 4.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $225.47 $281.84 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $154.09 $192.61 1.8×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $234.02 $292.52 2.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $294.17 $367.71 3.5×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $257.09 $321.36 3.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $238.96 $298.70 2.4×
X-Ray Spine One View - Xr Spine (72020) $285.60 $357 3.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $143.31 $179.14 1.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $136.78 $170.98 1.6×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $342.78 $428.48 3.4×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $177.89 $222.36 2.1×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $208.47 $260.59 2.5×
Xr c-spine 6 or more views (72052) $546 $682.50 5.4×
Xr finger(s) 2+ views (73140) $177.98 $222.48 2.1×
Xr shoulder 1 view (73020) $92.29 $115.36 1.1×
Xr spine cervical 4 or 5 views (72050) $463.09 $578.86 4.6×
Xr tibia/fibula 2 views (73590) $248.88 $311.10 3.0×
Xr tmj bilateral (70330) $135.24 $169.05 1.6×
Xray knee 1 or 2 views rt (73560) $259.37 $324.21 3.1×