Imaging prices at Community Hospital of Bremen Inc
Bremen, IN · every code in this section with a posted price and a Medicare benchmark.
182 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) | $179.40 | $276 | 1.9× |
| Abdomen 2 views (74019) | $254.15 | $391 | 2.3× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$159.90–$319.80 | $246–$492 | varies |
| Bone age studies (77072) | $159.90 | $246 | 1.4× |
| Bone survey infant (77076) | $191.10 | $294 | 1.7× |
| Chest 1 view (71045) | $220.35 | $339 | 2.4× |
| Chest 2 views (71046) | $196.30 | $302 | 2.1× |
| Chest 3 views (71047) | $209.30 | $322 | 2.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$187.85–$376.35 | $289–$579 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $141.70 | $218 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,179.15 | $4,891 | 8.6× |
| CT abdomen and pelvis without contrast (74176) | $2,155.40 | $3,316 | 8.5× |
| CT abdomen w contrast (74160) | $1,543.75 | $2,375 | 8.3× |
| CT abdomen w wo contrast (74170) | $1,970.15 | $3,031 | 10.6× |
| CT abdomen w/o contrast (74150) | $1,140.75 | $1,755 | 10.3× |
| CT Angio Abdomen and Pelvis (74174) | $2,337.40 | $3,596 | 6.3× |
| CT Angio Chest (71275) | $1,695.85 | $2,609 | 9.1× |
| CT Angio Head (70496) | $1,408.55 | $2,167 | 7.6× |
| CT Angio Neck (70498) | $1,132.30 | $1,742 | 6.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,276.60 | $1,964 | 6.9× |
| CT cervical spine w/ contrast (72126) | $1,718.60 | $2,644 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,543.75 | $2,375 | 14.0× |
| CT cervical spine w/wo cont (72127) | $1,776.45 | $2,733 | 9.6× |
| CT chest w contrast (71260) | $1,474.20 | $2,268 | 7.9× |
| CT chest w/wo contrast (71270) | $1,712.10 | $2,634 | 9.2× |
| CT head/brain with contrast (70460) | $1,220.05 | $1,877 | 6.6× |
| CT head/brain without and with contrast (70470) | $1,584.05 | $2,437 | 8.5× |
| CT iac w contrast (70481) | $1,297.40 | $1,996 | 7.0× |
| CT l-spine w&w/o contrast (72133) | $1,584.05 | $2,437 | 8.5× |
| CT lower ext w/o (73700) | $1,207.05 | $1,857 | 10.9× |
| CT lower extremity w/contrast material (73701) | $1,459.25 | $2,245 | 7.9× |
| CT lumbar spine w contrast (72132) | $1,407.90 | $2,166 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $1,083.55 | $1,667 | 9.8× |
| CT maxillofacial w contrast (70487) | $1,337.05 | $2,057 | 7.2× |
| CT maxillofacial wo contrast (70486) | $966.55 | $1,487 | 8.7× |
| CT neck tissue combo (70492) | $1,463.80 | $2,252 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,543.10 | $2,374 | 8.3× |
| CT orbits w/o contrast (70480) | $989.95 | $1,523 | 8.9× |
| CT pelvis w&w/o contrast (72194) | $1,155.70 | $1,778 | 6.2× |
| CT pelvis w/o contrast (72192) | $926.90 | $1,426 | 8.4× |
| CT scan of leg combo (73702) | $1,463.15 | $2,251 | 7.9× |
| CT scans face/jaw combo (70488) | $1,452.10 | $2,234 | 7.8× |
| CT soft tissue neck w contrast (70491) | $1,368.90 | $2,106 | 7.4× |
| CT soft tissue neck w/o contrast (70490) | $1,199.25 | $1,845 | 10.8× |
| CT thoracic spine w contrast (72129) | $1,632.15 | $2,511 | 8.8× |
| CT thoracic spine w/o contrast (72128) | $1,543.75 | $2,375 | 14.0× |
| CT thoracic spine w/wo cont (72130) | $2,252.25 | $3,465 | 12.1× |
| CT thorax w/o contrast (71250) | $1,199.25 | $1,845 | 10.8× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,207.05–$1,218.75 | $1,857–$1,875 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,276.60 | $1,964 | 6.9× |
| CT upper extremity with contrast (73201) | $1,368.90 | $2,106 | 3.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,478.45 | $3,813 | 13.4× |
| Cta Abdomen (74175) | $1,672.45 | $2,573 | 9.0× |
| Dxa Bone Density Axial (77080) | $217.10 | $334 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $84.50 | $130 | 0.9× |
| Esophagram (74220) | $310.05 | $477 | 1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $666.90 | $1,026 | 6.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$141.70–$284.05 | $218–$437 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$188.50–$377.65 | $290–$581 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$184.60–$369.85 | $284–$569 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$210.60–$421.85 | $324–$649 | varies |
| Mr safety determination physician/other qhp (76016) | $157.30 | $242 | 1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $43.55 | $67 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $163.80 | $252 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $1,651.65 | $2,541 | 4.5× |
| MRA head w/o contrast (70544) | $1,320.80 | $2,032 | 5.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,651.65 | $2,541 | 4.5× |
| MRA neck w/o contrast (70547) | $1,320.80 | $2,032 | 5.2× |
| MRI abdomen w/o contrast (74181) | $1,320.80 | $2,032 | 5.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,651.65 | $2,541 | 2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,651.65 | $2,541 | 4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,651.65 | $2,541 | 2.0× |
| MRI cervical spine w/o cont (72141) | $1,320.80 | $2,032 | 5.2× |
| MRI chest w/o contrast (71550) | $1,320.80 | $2,032 | 5.2× |
| MRI chest wo w contrast (71552) | $1,651.65 | $2,541 | 4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,651.65 | $2,541 | 4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,320.80 | $2,032 | 5.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,651.65 | $2,541 | 4.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,320.80 | $2,032 | 5.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,651.65 | $2,541 | 4.5× |
| MRI pelvis w/o & w contrast (72197) | $1,651.65 | $2,541 | 4.5× |
| MRI pelvis w/o contrast (72195) | $1,320.80 | $2,032 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $1,320.80 | $2,032 | 5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,320.80 | $2,032 | 5.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,651.65 | $2,541 | 4.5× |
| MRI, abdomen, combo (74183) | $1,651.65 | $2,541 | 4.5× |
| MRI, dorsal spine combo (72157) | $1,651.65 | $2,541 | 4.5× |
| MRI, joint upper extrem (73221) | $1,320.80 | $2,032 | 5.2× |
| MRI, joint upper extrem combo (73223) | $1,651.65 | $2,541 | 4.5× |
| MRI, lumbar spine combo (72158) | $1,651.65 | $2,541 | 4.5× |
| Neck soft tissue (70360) | $147.55 | $227 | 1.6× |
| Pelvis 1 or 2 views (72170) | $163.80 | $252 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $328.90 | $506 | 3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$190.45–$380.25 | $293–$585 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$180.70–$361.40 | $278–$556 | varies |
| Radex elbow complete minimum 3 views (73080) | $209.95 | $323 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $273 | $420 | 2.5× |
| Radex fingr minimum 2 views (73140) | $160.55 | $247 | 1.7× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$190.45–$380.25 | $293–$585 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$203.45–$406.90 | $313–$626 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $158.60 | $244 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $189.15 | $291 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $199.55 | $307 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) | $197.60 | $304 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $170.95 | $263 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $150.15 | $231 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) | $212.55 | $327 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $160.55 | $247 | 1.7× |
| Radex upper extremity infant minimum 2 views (73092) | $162.50 | $250 | 1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$203.45–$406.90 | $313–$626 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $451.10 | $694 | 4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $237.25 | $365 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $241.80 | $372 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $371.15 | $571 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$243.10–$486.20 | $374–$748 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $224.90 | $346 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $373.10 | $574 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $588.25 | $905 | 3.2× |
| Radiologic examination femur 1 view (73551) | $200.85 | $309 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$204.10–$408.20 | $314–$628 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$181.35–$362.70 | $279–$558 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $664.95 | $1,023 | 6.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$193.05–$385.45 | $297–$593 | varies |
| Ribs bilateral 3 views (71110) | $263.25 | $405 | 2.4× |
| Scapula (73010) | $176.15 | $271 | 1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.70 | $58 | 1.6× |
| Shoulder 1 view (73020) | $163.80 | $252 | 1.8× |
| Skull less than 4 views (70250) | $182 | $280 | 1.6× |
| Sternoclavicular joints (71130) | $335.40 | $516 | 3.6× |
| Tbs technical calculation only (77091) | $161.85 | $249 | 1.8× |
| Thoracic spine 2 views (72070) | $172.90 | $266 | 1.6× |
| Thoracic spine 3 views (72072) | $237.25 | $365 | 2.1× |
| Thoracolumbar 2 views (72080) | $204.10 | $314 | 2.2× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$156–$312 | $240–$480 | varies |
| Ultrasound Exam Aaa Screen (76706) | $187.20 | $288 | 1.7× |
| Ultrasound, abdomen limited (76705) | $417.30 | $642 | 3.8× |
| Umbilical-artery Doppler (OB) (76820) | $174.85 | $269 | 1.6× |
| Upper gi w/o kub (74240) | $435.50 | $670 | 2.3× |
| Us breast unilateral complete (76641) | $235.95 | $363 | 2.1× |
| Us chest (76604) | $274.30 | $422 | 2.5× |
| Us complete joint (76881) | $195 | $300 | 1.8× |
| Us exam, pelvic, limited (76857) | $235.95 | $363 | 2.1× |
| Us kidney transplant (76776) | $410.15 | $631 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $388.05 | $597 | 3.5× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$303.55–$312 | $467–$480 | varies |
| Us ob transvaginal (76817) | $458.25 | $705 | 4.1× |
| Us pelvic non ob complete (76856) | $464.10 | $714 | 4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $458.25 | $705 | 4.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $357.50 | $550 | 3.2× |
| Us retroperitoneal complete (76770) | $585.65 | $901 | 5.3× |
| Us retroperitoneal limited (76775) | $370.50 | $570 | 3.3× |
| Us scrotum and contents (76870) | $568.10 | $874 | 5.1× |
| Us thyroid (76536) | $352.95 | $543 | 3.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$172.25–$343.85 | $265–$529 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $241.80 | $372 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) | $280.80 | $432 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$176.80–$343.20 | $272–$528 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $153.40 | $236 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $233.35 | $359 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $147.55 | $227 | 1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $187.85 | $289 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $385.45 | $593 | 3.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $200.85 | $309 | 1.8× |
| X-Ray Exam L-S Spine Bending (72114) | $469.30 | $722 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $201.50 | $310 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $525.85 | $809 | 4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $260 | $400 | 2.4× |
| X-ray eye for foreign body (70030) | $239.20 | $368 | 2.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$186.55–$530.40 | $287–$816 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $183.30 | $282 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $280.80 | $432 | 2.5× |
| X-ray nose-rectum child f.b. (76010) | $179.40 | $276 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $360.75 | $555 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $204.75 | $315 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $196.30 | $302 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $247 | $380 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $288.60 | $444 | 2.6× |
| X-Rays Bone Length Studies (77073) | $261.30 | $402 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $1,036.10 | $1,594 | 9.4× |
| Xr c-spine 4 or 5 views (72050) | $325.65 | $501 | 2.9× |
| Xr facial bones less than 3 views (70140) | $189.15 | $291 | 2.1× |
| Xr orbits complete 4 views (70200) | $261.30 | $402 | 2.4× |
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.