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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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $216 $327 2.4×
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 Wrist (73115) $393 $596 1.1×
Bone age studies (77072) $95 $144 0.9×
Bone Imaging 3 Phase (78315) $1,923 $2,914 4.6×
Bone Imaging Whole Body (78306) $1,002 $1,518 2.4×
Bone survey infant (77076) $218 $330 2.0×
Cat Scan Follow-Up Study (76380) $464 $703 5.1×
Chest 1 view (71045) $178 $270 2.0×
Chest 2 views (71046) $196 $297 2.2×
Chest 3 views (71047) $90 $136 1.0×
Cholecystography Oral Contrast (74290) $251 $380 1.4×
Clavicle complete (73000) $172 $260 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $457 $693 4.2×
Contrast X-Ray Bladder (74430) $354 $537 1.0×
Contrast X-Ray Of Elbow (73085) $745 $1,129 2.1×
Contrast Xray Throat/Cerv Esopha (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)
range across 2 matching MRF lines		 $1,228–$1,305 $1,860–$1,978 varies
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 Angio Abdomen and Pelvis (74174) $2,468 $3,740 6.8×
CT Angio Chest (71275) $2,375 $3,598 13.0×
CT Angio Head (70496) $1,424 $2,158 7.8×
CT Angio Neck (70498) $1,424 $2,158 7.8×
CT bone density (77078) $223 $338 2.5×
CT cervical spine w/ contrast (72126) $2,528 $3,830 7.0×
CT cervical spine w/o contrast (72125) $1,296 $1,964 11.9×
CT cervical spine w/wo cont (72127) $1,424 $2,158 7.8×
CT chest w contrast (71260) $1,330 $2,015 7.3×
CT chest w/wo contrast (71270) $1,424 $2,158 7.8×
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 l-spine w&w/o contrast (72133) $1,263 $1,913 6.9×
CT lower ext w/o (73700) $1,008 $1,527 9.3×
CT lower extremity w/contrast material (73701) $1,403 $2,125 7.7×
CT lumbar spine w contrast (72132) $1,814 $2,749 5.0×
CT lumbar spine w/o contrast (72131) $1,226 $1,857 11.3×
CT maxillofacial w contrast (70487) $1,166 $1,766 6.4×
CT maxillofacial wo contrast (70486) $921 $1,395 8.5×
CT neck tissue combo (70492) $1,554 $2,354 8.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (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 of leg combo (73702) $1,681 $2,547 9.2×
CT scans face/jaw combo (70488) $1,142 $1,731 6.3×
CT soft tissue neck w contrast (70491) $1,206 $1,827 6.6×
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)
range across 2 matching MRF lines		 $1,022–$1,201 $1,548–$1,819 varies
CT thoracic spine w/wo cont (72130) $1,424 $2,158 7.8×
CT thorax w/o contrast (71250) $1,210 $1,833 11.1×
CT upper ext wo (73200) $1,002 $1,518 9.2×
CT upper extremity w/o & w/contrast material (73202) $1,142 $1,731 6.3×
CT upper extremity with contrast (73201) $1,362 $2,063 3.8×
Cta Abdomen (74175) $1,577 $2,389 8.7×
Dxa Bone Density Axial (77080) $279 $423 2.6×
Esophagram (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×
Gastric emptying imaging study (78264) $1,002 $1,518 2.4×
Gated Heart Planar Single (78472) $1,034 $1,566 2.5×
Hand 2 views (73120)
range across 4 matching MRF lines		 $117–$126 $177–$191 varies
Hepatobil Syst Image W/Drug (78227) $1,172 $1,776 2.1×
Hepatobiliary System Imaging (78226) $1,092 $1,655 2.6×
Ht Muscle Image Spect Sing (78451)
range across 2 matching MRF lines		 $2,019–$2,020 $3,059–$3,060 varies
Hysterosalpingogram (74740) $317 $481 1.3×
Joint Survey Single View (77077) $157 $238 1.4×
K Flow/Funct Image W/Drug (78708) $1,778 $2,694 3.2×
Knee 3 Views (73562) $244 $370 2.7×
Lung Ventilat&Perfus Imaging (78582) $1,106 $1,675 2.0×
Magnetic Image Jaw Joint (70336) $1,201 $1,819 4.8×
Mra Head W/O & W/Contrast Material (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 contrast (74181) $1,642 $2,488 6.6×
MRI any jt lower extrem w/contrast material (73722) $1,909 $2,893 2.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,979 $2,999 5.5×
MRI any jt upper extremity w/contrast matrl (73222) $1,447 $2,193 1.8×
MRI cervical spine w contrast (72142) $1,642 $2,488 4.5×
MRI cervical spine w/o cont (72141) $1,549 $2,347 6.3×
MRI chest w/o contrast (71550) $1,549 $2,347 6.3×
MRI chest with contrast (71551) $1,642 $2,488 2.0×
MRI chest wo w contrast (71552) $1,738 $2,633 4.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,360 $2,060 3.8×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,454 $2,203 4.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,266 $1,918 5.1×
MRI lumbar spine w contrast (72149) $1,642 $2,488 4.5×
Mri Neck Spine W/O & W/Dye (72156) $2,303 $3,489 6.4×
MRI orbit face &/neck w/o contrast (70540) $1,454 $2,203 5.9×
MRI orbit face neck w contrast (70542) $1,549 $2,347 4.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,022 $3,063 5.6×
MRI pelvis w contrast (72196) $1,549 $2,347 4.3×
MRI pelvis w/o & w contrast (72197) $1,642 $2,488 4.5×
MRI pelvis w/o contrast (72195) $1,454 $2,203 5.9×
MRI thoracic spine w/o contrast (72146) $1,549 $2,347 6.3×
MRI upper extremity oth than jt w/contr matrl (73219) $1,360 $2,060 3.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,266 $1,918 5.1×
Mri Uppr Extremity W/O&W/Dye (73220) $1,979 $2,999 5.5×
MRI, abdomen, combo (74183) $1,830 $2,772 5.1×
MRI, dorsal spine combo (72157) $2,144 $3,249 5.9×
MRI, dorsal spine contrast (72147) $1,642 $2,488 4.5×
MRI, joint upper extrem (73221) $1,360 $2,060 5.5×
MRI, joint upper extrem combo (73223) $1,454 $2,203 4.0×
MRI, lumbar spine combo (72158) $2,277 $3,450 6.3×
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×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $168 $255 1.5×
Ophthalmic Biometry US Echograpy a-Scan (76516) $172 $261 1.6×
Optic foramina (70190) $126 $191 1.4×
Pelvis 1 or 2 views (72170) $216 $327 2.0×
Peritoneogram Rs&I (74190) $400 $606 0.7×
Pet Image W/Ct Lmtd (78814) $3,817 $5,783 2.6×
PET image w/CT, full body (78816) $3,817 $5,783 2.6×
PET imaging CT attenuation skull base mid-thigh (78815) $4,324 $6,552 2.9×
Pulmonary Perfusion Imaging Particulate (78580) $785 $1,190 1.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $412 $624 3.8×
Radex Ankle Complete Minimum 3 Views (73610) $202 $306 2.2×
Radex Calcaneus Minimum 2 Views (73650)
range across 4 matching MRF lines		 $157–$213 $238–$322 varies
Radex elbow complete minimum 3 views (73080) $223 $338 2.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $269 $408 2.5×
Radex fingr minimum 2 views (73140) $170 $258 1.9×
Radex foot complete minimum 3 views (73630) $206 $312 2.3×
Radex Hand Minimum 3 Views (73130) $226 $342 2.5×
Radex lower extremity infant minimum 2 views (73592) $124 $188 1.4×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $205 $310 1.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $213 $322 2.4×
Radex Ribs Unilateral 2 Views (71100) $263 $399 2.9×
Radex shoulder complete minimum 2 views (73030) $211 $319 2.3×
Radex Sinuses Paransl < 3 Views (70210) $219 $332 2.4×
Radex Spine 1 View Specify Level (72020) $158 $239 1.7×
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines		 $158–$164 $240–$249 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $213 $322 2.4×
Radex Toe Minimum 2 Views (73660) $185 $281 2.0×
Radex upper extremity infant minimum 2 views (73092) $121 $183 1.1×
Radex Wrist Complete Minimum 3 Views (73110) $204 $309 2.3×
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 3+ Views - Xr Abdomen 3+ Views (74021) $298 $451 2.7×
Radiologic exam colon double contrast study (74280) $1,011 $1,532 5.6×
Radiologic exam colon single contrast study (74270) $539 $816 3.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $322 $488 1.8×
Radiologic exam knee complete 4/more views (73564) $259 $392 2.4×
Radiologic exam pelvis compl minimum 3 views (72190) $236 $357 2.2×
Radiologic Exam Small Int Single Contrast Study (74250) $646 $979 3.5×
Radiologic exam swallow function contrast study (74230) $479 $725 2.6×
Radiologic exam upr gi trc double contrast study (74246) $479 $725 2.6×
Radiologic examination femur 1 view (73551) $102 $155 1.1×
Radiologic examination femur minimum 2 views (73552) $228 $345 2.5×
Radiologic examination knee 1/2 views (73560) $199 $301 2.2×
Radiologic Examination Osseous Survey Limited (77074) $1,020 $1,545 9.4×
Radiologic examination tibia & fibula 2 views (73590) $220 $334 2.4×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $218 $330 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×
Scapula (73010) $209 $317 1.9×
Screening Digital Breast Tomosynthesis Bi (77063) $77 $116 3.3×
Shoulder 1 view (73020)
range across 2 matching MRF lines		 $150–$151 $227–$229 varies
Shoulder Arthrography (73040) $745 $1,129 2.1×
Skull less than 4 views (70250) $170 $257 1.6×
Speech evaluation, complex (70371) $279 $422 1.1×
Sternoclavicular joints (71130) $156 $237 1.7×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $269 $408 1.5×
Thoracic spine 2 views (72070) $295 $447 2.7×
Thoracic spine 3 views (72072) $342 $518 3.2×
Thoracolumbar 2 views (72080) $185 $281 2.0×
Ultrasound Breast Limited (76642) $343 $519 3.8×
Ultrasound, abdomen limited (76705) $523 $792 4.8×
Upper gi w/o kub (74240) $310 $469 1.7×
Urethrocystogram voiding (74455) $345 $522 1.4×
Urethrocystography retrograde (74450) $345 $522 1.4×
Us breast unilateral complete (76641) $328 $497 3.0×
Us chest (76604) $421 $638 3.9×
Us complete joint (76881) $460 $697 4.2×
Us exam, pelvic, limited (76857) $493 $747 4.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $391 $592 3.6×
Us ob limited 1 or more fetuses (76815) $432 $654 4.0×
Us ob transvaginal (76817) $473 $716 4.4×
Us pelvic non ob complete (76856) $554 $839 5.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $463 $702 4.3×
Us preg uterus real time f/u trnsabdl per fetus (76816) $292 $443 2.7×
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 thyroid (76536) $587 $890 5.4×
Wrist 2 views (73100)
range across 4 matching MRF lines		 $150–$151 $228–$229 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $154 $234 1.7×
X-Ray Bend Only L-S Spine (72120) $269 $407 2.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $232 $351 2.6×
X-Ray Exam Breast Specimen (76098) $241 $365 0.4×
X-Ray Exam Entire Spi 1 Vw (72081) $102 $155 1.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $168 $255 1.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $168 $255 1.5×
X-Ray Exam Hip Uni 1 View (73501)
range across 4 matching MRF lines		 $122–$147 $185–$222 varies
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 2 Views (73521) $174 $264 1.6×
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 L-S Spine Bending (72114) $392 $594 3.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $205 $311 2.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $640 $969 5.9×
X-Ray Exam Unilat Ribs/Chest (71101) $288 $436 2.7×
X-ray eye for foreign body (70030) $110 $167 1.2×
X-ray humerus (73060) $218 $331 2.4×
X-ray IV pyelogram (ivp) (74400) $465 $704 2.6×
X-ray IV pyelogram+tomography (74415) $482 $730 2.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $151 $229 1.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $193 $293 2.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $257 $390 2.4×
X-ray nose-rectum child f.b. (76010) $156 $237 1.7×
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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $172 $260 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $232 $351 2.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $281 $425 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $281 $425 2.6×
X-ray thoracic spine 4 vw (72074) $218 $331 2.0×
X-Ray Tmj Unilat (70328) $149 $226 1.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $490 $742 1.4×
X-Rays Bone Length Studies (77073) $139 $210 1.3×
X-Rays Bone Survey Complete (77075) $483 $732 4.4×
Xr c-spine 4 or 5 views (72050) $340 $515 3.1×
Xr facial bones less than 3 views (70140) $133 $202 1.5×
XR Mastoids < 3 Views Bilateral (70120) $172 $261 1.6×
Xr orbits complete 4 views (70200) $205 $310 1.9×
Xr Tomogram Single Plane (76100) $274 $415 2.5×

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.