Imaging prices at Clinch Memorial Hospital

Homerville, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $80.85 $161.70 1.1×
Abdomen 2 views (74019) $142.50 $285 1.6×
Ankle 2 views (73600) $105 $210 1.4×
Bone age studies (77072) $142.50 $285 1.6×
Bone survey infant (77076) $142.50 $285 1.6×
Chest 1 view (71045) $80.85 $161.70 1.1×
Chest 2 views (71046) $136.50 $273 1.8×
Clavicle complete (73000) $105 $210 1.4×
CT abdomen and pelvis without and with contrast (74178) $1,414.50 $2,829 4.6×
CT abdomen and pelvis without contrast (74176) $1,144 $2,288 5.5×
CT abdomen w contrast (74160) $898 $1,796 5.8×
CT abdomen w wo contrast (74170) $943 $1,886 6.1×
CT abdomen w/o contrast (74150) $497.50 $995 5.4×
CT Angio Chest (71275) $810 $1,620 5.3×
CT cervical spine w/o contrast (72125) $689 $1,378 7.5×
CT cervical spine w/wo cont (72127) $628.50 $1,257 4.1×
CT chest w contrast (71260) $800 $1,600 5.2×
CT chest w/wo contrast (71270) $902 $1,804 5.9×
CT head/brain with contrast (70460) $572.50 $1,145 3.7×
CT head/brain without and with contrast (70470) $628.50 $1,257 4.1×
CT iac w contrast (70481) $515.37 $1,030.75 3.4×
CT l-spine w&w/o contrast (72133) $628.50 $1,257 4.1×
CT lower ext w/o (73700) $301 $602 3.3×
CT lower extremity w/contrast material (73701) $387.50 $775 2.5×
CT lumbar spine w/o contrast (72131) $640 $1,280 7.0×
CT maxillofacial w contrast (70487) $515.37 $1,030.75 3.4×
CT maxillofacial wo contrast (70486) $520 $1,040 5.7×
CT neck tissue combo (70492) $683.50 $1,367 4.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $528.50 $1,057 3.4×
CT orbits w/o contrast (70480) $543 $1,086 5.9×
CT pelvis w&w/o contrast (72194) $623 $1,246 4.1×
CT pelvis w/o contrast (72192) $497.50 $995 5.4×
CT scan of leg combo (73702) $422.50 $845 2.7×
CT scans face/jaw combo (70488) $578.50 $1,157 3.8×
CT soft tissue neck w contrast (70491) $623 $1,246 4.1×
CT soft tissue neck w/o contrast (70490) $497.50 $995 5.4×
CT thoracic spine w/o contrast (72128) $543 $1,086 5.9×
CT thoracic spine w/wo cont (72130) $628.50 $1,257 4.1×
CT thorax w/o contrast (71250) $720 $1,440 7.9×
CT upper ext wo (73200) $311 $622 3.4×
CT upper extremity w/o & w/contrast material (73202) $422.50 $845 2.7×
CT upper extremity with contrast (73201) $387.50 $775 1.3×
Foot 2 views (73620) $105 $210 1.4×
Forearm 2 views (73090) $105 $210 1.4×
Hand 2 views (73120) $142.50 $285 1.6×
Infant hip ultrasound, limited static exam (76886) $74.50 $149 1.0×
Neck soft tissue (70360) $105 $210 1.4×
Pelvis 1 or 2 views (72170) $142.50 $285 1.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $142.50 $285 1.6×
Radex Ankle Complete Minimum 3 Views (73610) $136.50 $273 1.8×
Radex Calcaneus Minimum 2 Views (73650) $105 $210 1.4×
Radex elbow complete minimum 3 views (73080) $105 $210 1.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $142.50 $285 1.6×
Radex fingr minimum 2 views (73140) $105 $210 1.4×
Radex foot complete minimum 3 views (73630) $136.50 $273 1.8×
Radex Hand Minimum 3 Views (73130) $136.50 $273 1.8×
Radex lower extremity infant minimum 2 views (73592) $105 $210 1.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $105 $210 1.4×
Radex Ribs Unilateral 2 Views (71100) $105 $210 1.4×
Radex shoulder complete minimum 2 views (73030) $136.50 $273 1.8×
Radex Sternum Minimum 2 Views (71120) $105 $210 1.4×
Radex Toe Minimum 2 Views (73660) $105 $210 1.4×
Radex upper extremity infant minimum 2 views (73092) $142.50 $285 1.6×
Radex Wrist Complete Minimum 3 Views (73110) $105 $210 1.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $142.50 $285 1.6×
Radiolog exam mandible compl minimum 4 views (70110) $142.50 $285 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $94.54 $189.09 1.0×
Radiologic exam knee complete 4/more views (73564) $185.25 $370.50 2.0×
Radiologic exam swallow function contrast study (74230) $232.50 $465 1.5×
Radiologic examination femur minimum 2 views (73552) $105 $210 1.4×
Radiologic examination knee 1/2 views (73560) $105 $210 1.4×
Radiologic examination tibia & fibula 2 views (73590) $105 $210 1.4×
Ribs bilateral 3 views (71110) $142.50 $285 1.6×
Scapula (73010) $142.50 $285 1.6×
Skull less than 4 views (70250) $142.50 $285 1.6×
Thoracic spine 3 views (72072) $142.50 $285 1.6×
Ultrasound Breast Limited (76642) $105 $210 1.4×
Ultrasound Exam Aaa Screen (76706) $142.50 $285 1.6×
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines		 $142.50–$185.25 $285–$370.50 varies
Us breast unilateral complete (76641) $142.50 $285 1.6×
Us chest (76604) $142.50 $285 1.6×
Us complete joint (76881)
range across 3 matching MRF lines		 $142.50–$374.08 $285–$748.16 varies
Us exam, pelvic, limited (76857) $142.50 $285 1.6×
Us kidney transplant (76776) $142.50 $285 1.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $142.50 $285 1.6×
Us ob detailed single fetus (76811) $300 $600 1.4×
Us ob transvaginal (76817) $142.50 $285 1.6×
Us pelvic non ob complete (76856) $142.50 $285 1.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $142.50 $285 1.6×
Us retroperitoneal complete (76770) $142.50 $285 1.6×
Us retroperitoneal limited (76775) $142.50 $285 1.6×
Us scrotum and contents (76870) $142.50 $285 1.6×
Us thyroid (76536) $142.50 $285 1.6×
Wrist 2 views (73100) $105 $210 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $105 $210 1.4×
X-Ray Bend Only L-S Spine (72120) $90.50 $181 1.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $105 $210 1.4×
X-Ray Exam Hip Uni 1 View (73501) $105 $210 1.4×
X-Ray Exam Hips Bi 2 Views (73521) $142.50 $285 1.6×
X-Ray Exam L-S Spine Bending (72114) $142.50 $285 1.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $105 $210 1.4×
X-Ray Exam Neck Spine 6/>Vws (72052) $142.50 $285 1.6×
X-Ray Exam Unilat Ribs/Chest (71101) $142.50 $285 1.6×
X-ray humerus (73060) $105 $210 1.4×
X-ray IV pyelogram (ivp) (74400) $232.50 $465 1.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $105 $210 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $90.50 $181 1.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $142.50 $285 1.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $142.50 $285 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $105 $210 1.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $105 $210 1.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $142.50 $285 1.6×
X-Rays Bone Length Studies (77073) $142.50 $285 1.6×
X-Rays Bone Survey Complete (77075) $142.50 $285 1.6×
Xr c-spine 4 or 5 views (72050) $142.50 $285 1.6×
Xr orbits complete 4 views (70200) $142.50 $285 1.6×

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.