Imaging prices at Community Medical Center, Inc

Falls City, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $358 $542 3.3×
Acute gastrointestinal blood loss imaging (78278) $890 $1,349 2.1×
Ankle 2 views (73600) $187 $284 2.1×
Arthrogram elbow (73085) $745 $1,129 2.1×
Arthrogram shoulder (73040) $745 $1,129 2.1×
Arthrogram wrist (73115) $393 $596 1.1×
Bone &/joint imaging whole body (78306) $1,002 $1,518 2.4×
Bone age studies (77072) $95 $144 0.9×
Bone Imaging 3 Phase (78315) $1,923 $2,914 4.6×
Bone survey complete (77075) $483 $732 4.4×
Cervical spine 2 or 3 views (72040) $205 $311 2.3×
Chest 1 view (71045) $178 $270 2.0×
Chest 3 views (71047) $90 $136 1.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $479 $725 2.6×
Clavicle complete (73000) $172 $260 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $457 $693 4.2×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $197 $298 1.1×
CT abdomen and pelvis without and with contrast (74178) $2,788 $4,224 7.7×
CT abdomen and pelvis without contrast (74176) $2,119 $3,210 8.6×
CT abdomen w contrast (74160) $1,266.50 $1,919 7.0×
CT abdomen w wo contrast (74170) $1,589 $2,407 8.7×
CT abdomen w/o contrast (74150) $1,239 $1,878 11.4×
CT c-spine w/o contrast (72125) $1,296 $1,964 11.9×
CT cervical spine w&w/o contrast (72127) $1,424 $2,158 7.8×
CT cervical spine with contrast (72126) $2,528 $3,830 7.0×
CT chest w/wo contrast (71270) $1,424 $2,158 7.8×
CT chest with contrast (71260) $1,330 $2,015 7.3×
CT head/brain with contrast (70460) $1,476 $2,236 8.1×
CT head/brain without and with contrast (70470) $1,424 $2,158 7.8×
CT heart no contrast quant eval coronry calcium (75571) $50 $75 0.6×
CT iac w contrast (70481) $1,574 $2,385 8.6×
CT limited/localized follow up study (76380) $464 $703 5.1×
CT lower ext w/o (73700) $1,008 $1,527 9.3×
CT lower extremity w wo contrast (73702) $1,681 $2,547 9.2×
CT lower extremity with contrast (73701) $1,403 $2,125 7.7×
CT lumbar spine w & w/o contrast (72133) $1,263 $1,913 6.9×
CT lumbar spine w/o contrast (72131) $1,226 $1,857 11.3×
CT lumbar spine with contrast (72132) $1,814 $2,749 5.0×
CT maxillofacial w contrast (70487) $1,166 $1,766 6.4×
CT maxillofacial w/o contrast (70486) $921 $1,395 8.5×
CT maxillofacial w/wo contrast (70488) $1,142 $1,731 6.3×
CT neck soft tissue w contrast (70491) $1,206 $1,827 6.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,236 $1,872 6.8×
CT orbits w/o contrast (70480) $1,014 $1,536 9.3×
CT pelvis w & w/o contrast (72194) $1,424 $2,158 7.8×
CT pelvis w/o contrast (72192) $1,081 $1,638 10.0×
CT scan for measuring calcium and other minerals in bone (77078) $223 $338 2.5×
CT soft tissue neck w/o & w/contrast material (70492) $1,554 $2,354 8.5×
CT soft tissue neck w/o contrast (70490) $1,014 $1,536 9.3×
CT thoracic spine w/contrast (72129) $1,362 $2,063 7.5×
CT thoracic spine w/o contrast (72128) $1,111.50 $1,683.50 10.2×
CT thoracic spine w/wo contrast (72130) $1,424 $2,158 7.8×
CT thorax w/o contrast (71250) $1,210 $1,833 11.1×
CT upper extremity w/o & w/contrast material (73202) $1,142 $1,731 6.3×
CT upper extremity w/o contrast rt (73200) $1,002 $1,518 9.2×
CT upper extremity with contrast (73201) $1,362 $2,063 3.8×
Cta Abdomen (74175) $1,577 $2,389 8.7×
CTA abdomen pelvis (74174) $2,468 $3,740 6.8×
CTA chest (71275) $2,375 $3,598 13.0×
Cta Head (70496) $1,424 $2,158 7.8×
Cta Neck (70498) $1,424 $2,158 7.8×
Cystography minimum 3 views rs&i (74430) $354 $537 1.0×
Dxa bone density study 1/> sites axial skel (77080) $279 $423 2.6×
Esophagus (74220) $348 $528 1.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $539 $817 5.0×
Fluoroscopy up to 1 hr (76000) $507 $768 2.0×
Foot 2 views (73620) $164 $248 1.8×
Forearm 2 views (73090) $259 $392 2.9×
Gated Heart Planar Single (78472) $1,034 $1,566 2.5×
Hand 2 views (73120) $121.50 $184 1.1×
Hand 3 views (73130) $226 $342 2.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,172 $1,776 2.1×
Hepatobiliary syst imaging including gallbladder (78226) $1,092 $1,655 2.6×
Ht muscle image spect sing (78451) $2,019.50 $3,059.50 1.5×
Humerus Min 2 Views Left (73060) $218 $331 2.4×
Hysterosalpingogram (74740) $317 $481 1.3×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $157 $238 1.4×
Kidney img morphology vascular flow 1 w/rx (78708) $1,778 $2,694 3.2×
Knee 3 views (73562) $244 $370 2.7×
MRA head w & w/o contrast (70546) $1,830 $2,772 5.1×
MRA head w/o contrast (70544) $1,642 $2,488 6.6×
MRA head with contrast (70545) $1,738 $2,633 4.8×
MRA neck w contrast (70548) $1,549 $2,347 4.3×
Mra Neck W/O &W/Contrast Material (70549) $1,682 $2,549 4.6×
MRA neck w/o contrast (70547) $1,454 $2,203 5.9×
MRI abdomen w contrast (74182) $1,738 $2,633 4.8×
MRI abdomen w/o & w/contrast material (74183) $1,830 $2,772 5.1×
MRI abdomen w/o contrast (74181) $1,642 $2,488 6.6×
MRI any jnt lwr ext with con lt (73722) $1,909 $2,893 2.3×
MRI any jt upper extremity w/contrast matrl (73222) $1,447 $2,193 1.8×
MRI c-spine with contrast (72142) $1,642 $2,488 4.5×
MRI cervical spine w/o contrast (72141) $1,549 $2,347 6.3×
MRI chest w/o & w/contrast material (71552) $1,738 $2,633 4.8×
MRI chest w/o contrast (71550) $1,549 $2,347 6.3×
MRI chest with contrast (71551) $1,642 $2,488 2.0×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,360 $2,060 3.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,360 $2,060 3.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,266 $1,918 5.1×
MRI orbit face &/neck w/o contrast (70540) $1,454 $2,203 5.9×
MRI orbit/face/neck w&w/o cont (70543) $2,022 $3,063 5.6×
MRI orbit/face/neck w/contrast (70542) $1,549 $2,347 4.3×
MRI pelvis w contrast (72196) $1,549 $2,347 4.3×
MRI pelvis w/o & w/contrast material (72197) $1,642 $2,488 4.5×
MRI pelvis w/o contrast (72195) $1,454 $2,203 5.9×
MRI scan of arm joint before and after contrast (73223) $1,454 $2,203 4.0×
MRI scan of leg joint before and after contrast (73723) $1,979 $2,999 5.5×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,303 $3,489 6.4×
MRI spinal canal lumbar w/contrast material (72149) $1,642 $2,488 4.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,277 $3,450 6.3×
MRI spinal canal thoracic w/contrast matrl (72147) $1,642 $2,488 4.5×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,144 $3,249 5.9×
MRI thoracic spine w/o contrast (72146) $1,549 $2,347 6.3×
MRI tmj (70336) $1,201 $1,819 4.8×
MRI upper ext joint w/o contrast (73221) $1,360 $2,060 5.5×
MRI upper extrem other than jt w/o & w/contras (73220) $1,979 $2,999 5.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,266 $1,918 5.1×
Myelogram Lumbar (72265) $998 $1,512 1.2×
Myocardial Spect Multiple Studies (78452) $2,284 $3,461 1.7×
Neck soft tissue (70360) $182 $275 2.0×
Nm gastric emptying study (78264) $1,002 $1,518 2.4×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $292 $443 2.7×
Ophthalmic biometry us echograpy a-scan (76516) $172 $261 1.6×
Osseous survey infant (77076) $218 $330 2.0×
Osseous survey limited (77074) $1,020 $1,545 9.4×
Pelvis 1 or 2 views (72170) $216 $327 2.0×
Peritoneogram rs&i (74190) $400 $606 0.7×
PET image w/CT, skull-thigh (78815) $4,324 $6,552 2.9×
PET imaging CT for attenuation limited area (78814) $3,817 $5,783 2.6×
PET imaging for CT attenuation whole body (78816) $3,817 $5,783 2.6×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,454 $2,203 4.0×
Pulmonary Perfusion Imaging Particulate (78580) $785 $1,190 1.9×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,106 $1,675 2.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $102 $155 1.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $168 $255 1.5×
Radex hips bilateral with pelvis 2 views (73521) $174 $264 1.6×
Radex mastoids compl minimum 3 views pr side (70130) $205 $310 1.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $168 $255 1.5×
Radiolog exam mandible compl minimum 4 views (70110) $223 $338 2.1×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $216 $327 2.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $298 $451 2.7×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $196 $297 2.2×
Radiologic exam colon single contrast study (74270) $539 $816 3.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $322 $488 1.8×
Radiologic exam upr gi trc double contrast study (74246) $479 $725 2.6×
Radiologic exam upr gi trc single contrast study (74240) $310 $469 1.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $228 $345 2.5×
Radiological examination surgical specimen (76098) $241 $365 0.4×
Ribs bilateral 3 views (71110) $193 $292 1.8×
Rp loclzj tum spect 1 area single day imaging (78803) $1,764 $2,672 3.1×
Sacroiliac Joints < 3 Views (72200) $172 $260 1.6×
Scanogram (77073) $139 $210 1.3×
Scapula complete (73010) $209 $317 1.9×
Screening digital breast tomosynthesis (77063) $77 $116 3.3×
Small bowel series (74250) $646 $979 3.5×
Speech evaluation complex (70371) $279 $422 1.1×
Spine thoracic 3 views (72072) $342 $518 3.2×
Therapeutic Enema (74283) $269 $408 1.5×
Thoracolumbar 2 views (72080) $185 $281 2.0×
Tmj unilateral (70328) $149 $226 1.6×
Tomogram (76100) $274 $415 2.5×
Ultrasound scan to determine eye length and lens power (76519) $168 $255 1.5×
Ultrasound, abdomen limited (76705) $523 $792 4.8×
Upper Extremity Infant (73092) $121 $183 1.1×
Urethrocystography retrograde rs&i (74450) $345 $522 1.4×
Urethrocystography voiding (74455) $345 $522 1.4×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $465 $704 2.6×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $482 $730 2.6×
Us breast unilateral complete (76641) $328 $497 3.0×
Us breast unilateral limited (76642) $343 $519 3.8×
Us chest (76604) $421 $638 3.9×
Us compl joint r-t w/image documentation (76881) $460 $697 4.2×
Us ob transvaginal (76817) $473 $716 4.4×
Us pelvic non ob complete (76856) $554 $839 5.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $493 $747 4.5×
Us pregnancy ltd (76815) $432 $654 4.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $463 $702 4.3×
Us retroperitoneal complete (76770) $509 $771 4.7×
Us retroperitoneal limited (76775) $449 $680 4.1×
Us scrotum and contents (76870) $418 $634 3.9×
Us soft tissue head/neck (76536) $587 $890 5.4×
Us xtr non-vasc lmtd (76882) $391 $592 3.6×
Wrist 2 views (73100) $150.50 $228.50 1.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $412 $624 3.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $154 $234 1.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $202 $306 2.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,011 $1,532 5.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $232 $351 2.6×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $223 $338 2.5×
X-ray exam entire spi 4/5 vw (72083) $168 $255 1.5×
X-ray exam hip uni 1 view (73501) $122 $185 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $194 $294 2.1×
X-ray exam hip uni 4/> views (73503) $102 $155 0.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $249 $377 2.3×
X-Ray Exam Hips Bi 5/> Views (73523) $259 $392 2.4×
X-ray exam of femur 1 (73551) $102 $155 1.1×
X-ray eye for foreign body (70030) $110 $167 1.2×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $269 $408 2.5×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $133 $202 1.5×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $206 $312 2.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $185 $280 2.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $151 $229 1.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $259 $392 2.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $193 $293 2.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $124 $188 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $257 $390 2.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $392 $594 3.6×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $269 $407 2.5×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $213 $322 2.4×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $156 $237 1.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $205 $310 1.9×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $236 $357 2.2×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $490 $742 1.4×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $263 $399 2.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $288 $436 2.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $343 $520 3.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $212 $321 2.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $232 $351 2.6×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $211 $319 2.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $281 $425 3.1×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $219 $332 2.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $281 $425 2.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $170 $257 1.6×
X-Ray Spine One View - Xr Spine (72020) $158 $239 1.7×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $156 $237 1.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $161 $244.50 1.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $295 $447 2.7×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $218 $331 2.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $185 $281 2.0×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $204 $309 2.3×
Xr c-spine 6 or more views (72052) $640 $969 5.9×
Xr Cholecystography Oral Contrast (74290) $251 $380 1.4×
Xr finger(s) 2+ views (73140) $170 $258 1.9×
Xr internal auditory meati complete (70134) $218 $330 0.4×
XR Mastoids < 3 Views Bilateral (70120) $172 $261 1.6×
Xr optic foramina (70190) $126 $191 1.4×
Xr shoulder 1 view (73020) $150.50 $228 1.7×
Xr spine cervical 4 or 5 views (72050) $340 $515 3.1×
Xr tibia/fibula 2 views (73590) $220 $334 2.4×
Xr tmj bilateral (70330) $213 $322 2.4×
Xray knee 1 or 2 views rt (73560) $199 $301 2.2×