Imaging prices at Dallas County Hospital
Perry, IA · every code in this section with a posted price and a Medicare benchmark.
211 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) range across 2 matching MRF lines |
$226–$244 | $348–$376 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$140–$295 | $216–$454 | varies |
| Ankle 2 views (73600) | $284 | $437 | 3.4× |
| Bone Imaging 3 Phase (78315) | $3,493 | $5,374 | 9.0× |
| Bone Imaging Limited Area (78300) | $2,343 | $3,604 | 6.1× |
| Bone Imaging Multiple Areas (78305) | $2,792 | $4,295 | 7.2× |
| Bone Imaging Whole Body (78306) | $3,238 | $4,982 | 8.4× |
| Bone survey infant (77076) | $669 | $1,029 | 6.6× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$181–$199 | $278–$306 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$247–$266 | $380–$409 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$268–$310 | $413–$477 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$326–$332 | $502–$510 | varies |
| Cholecystography Oral Contrast (74290) | $651 | $1,001 | 3.8× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$209–$277 | $321–$426 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$1,193–$1,265 | $1,835–$1,946 | varies |
| Contrast X-Ray Bladder (74430) | $237 | $364 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $3,374 | $5,191 | 10.0× |
| CT abdomen and pelvis without contrast (74176) | $1,418 | $2,181 | 6.2× |
| CT abdomen w contrast (74160) | $2,314 | $3,560 | 13.7× |
| CT abdomen w wo contrast (74170) | $2,632 | $4,049 | 15.5× |
| CT abdomen w/o contrast (74150) | $1,065 | $1,638 | 10.5× |
| CT Angio Abdomen and Pelvis (74174) | $2,971 | $4,571 | 8.8× |
| CT Angio Chest (71275) | $2,672 | $4,110 | 15.8× |
| CT Angio Head (70496) | $1,034 | $1,590 | 6.1× |
| CT Angio Neck (70498) | $1,096 | $1,686 | 6.5× |
| CT cervical spine w/o contrast (72125) | $1,327 | $2,042 | 13.1× |
| CT chest w contrast (71260) | $1,684 | $2,591 | 9.9× |
| CT chest w/wo contrast (71270) | $1,942 | $2,988 | 11.5× |
| CT head/brain with contrast (70460) | $1,344 | $2,068 | 7.9× |
| CT head/brain without and with contrast (70470) | $1,519 | $2,337 | 9.0× |
| CT lower ext w/o (73700) | $1,321 | $2,032 | 13.1× |
| CT lower extremity w/contrast material (73701) | $1,616 | $2,486 | 9.5× |
| CT lumbar spine w contrast (72132) | $773 | $1,189 | 2.3× |
| CT lumbar spine w/o contrast (72131) | $1,321 | $2,032 | 13.1× |
| CT maxillofacial w contrast (70487) | $1,396 | $2,147 | 8.2× |
| CT maxillofacial wo contrast (70486) | $1,214 | $1,868 | 12.0× |
| CT neck tissue combo (70492) | $1,942 | $2,988 | 11.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,193 | $3,374 | 12.9× |
| CT orbits w/o contrast (70480) | $1,620 | $2,493 | 16.0× |
| CT pelvis w&w/o contrast (72194) | $2,514 | $3,868 | 14.8× |
| CT pelvis w/o contrast (72192) | $1,146 | $1,763 | 11.3× |
| CT scan of leg combo (73702) | $2,049 | $3,152 | 12.1× |
| CT scans face/jaw combo (70488) | $1,664 | $2,560 | 9.8× |
| CT soft tissue neck w contrast (70491) | $1,678 | $2,582 | 9.9× |
| CT soft tissue neck w/o contrast (70490) | $1,265 | $1,946 | 12.5× |
| CT thoracic spine w/o contrast (72128) | $1,327 | $2,042 | 13.1× |
| CT thorax w/o contrast (71250) | $1,265 | $1,946 | 12.5× |
| CT upper ext wo (73200) | $1,622 | $2,495 | 16.1× |
| CT upper extremity w/o & w/contrast material (73202) | $2,578 | $3,966 | 15.2× |
| CT upper extremity with contrast (73201) | $1,958 | $3,012 | 5.8× |
| Cta Abdomen (74175) | $2,766 | $4,255 | 16.3× |
| CTA pelvis (72191) | $2,771 | $4,263 | 16.4× |
| Dxa Bone Density Axial (77080) | $363 | $558 | 3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $295 | $454 | 3.5× |
| Esophagram (74220) | $324 | $499 | 1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $551 | $848 | 5.5× |
| Fluoroscopy up to 1 hr (76000) | $187 | $287 | 0.8× |
| Foot 2 views (73620) | $244 | $376 | 2.9× |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$231–$250 | $356–$384 | varies |
| Gastric emptying imaging study (78264) | $3,472 | $5,341 | 9.0× |
| Gated Heart Planar Single (78472) | $2,119 | $3,260 | 5.5× |
| Hand 2 views (73120) | $266 | $409 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $4,883 | $7,513 | 9.3× |
| Hepatobiliary System Imaging (78226) | $3,370 | $5,184 | 8.7× |
| Hysterosalpingogram (74740) | $701 | $1,078 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $257 | $396 | 3.1× |
| Infusion Ivp (74410) | $580 | $892 | 3.4× |
| K Flow/Funct Image W/Drug (78708) | $1,396 | $2,148 | 2.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$337–$363 | $518–$558 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,022 | $3,110 | 5.2× |
| Lung Ventilat&Perfus Imaging (78582) | $3,252 | $5,003 | 6.2× |
| Lung Ventilation Imaging (78579) | $1,888 | $2,905 | 4.9× |
| Magnetic Image Jaw Joint (70336) | $3,755 | $5,777 | 16.3× |
| Meckels Divert Exam (78290) | $3,504 | $5,391 | 9.1× |
| Mra Head W/O & W/Contrast Material (70546) | $4,766 | $7,332 | 14.1× |
| MRA head w/o contrast (70544) | $3,147 | $4,842 | 13.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,803 | $7,389 | 14.3× |
| MRA neck w/o contrast (70547) | $2,980 | $4,584 | 12.9× |
| MRI abdomen w contrast (74182) | $4,247 | $6,534 | 12.6× |
| MRI abdomen w/o contrast (74181) | $2,581 | $3,971 | 11.2× |
| MRI any jt lower extrem w/contrast material (73722) | $4,563 | $7,020 | 6.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,847 | $8,996 | 17.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,552 | $7,003 | 6.0× |
| MRI cervical spine w contrast (72142) | $1,172 | $1,803 | 3.5× |
| MRI cervical spine w/o cont (72141) | $2,422 | $3,726 | 10.5× |
| MRI chest w/o contrast (71550) | $5,183 | $7,974 | 22.5× |
| MRI chest with contrast (71551) | $5,632 | $8,665 | 7.4× |
| MRI chest wo w contrast (71552) | $7,082 | $10,896 | 21.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,578 | $5,505 | 10.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,815 | $7,408 | 14.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,232 | $4,973 | 14.0× |
| MRI lumbar spine w contrast (72149) | $3,546 | $5,456 | 10.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,055 | $6,238 | 12.0× |
| MRI orbit face &/neck w/o contrast (70540) | $3,108 | $4,782 | 13.5× |
| MRI orbit face neck w contrast (70542) | $3,659 | $5,629 | 10.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,804 | $7,390 | 14.3× |
| MRI pelvis w contrast (72196) | $3,584 | $5,514 | 10.6× |
| MRI pelvis w/o & w contrast (72197) | $4,776 | $7,347 | 14.2× |
| MRI pelvis w/o contrast (72195) | $3,278 | $5,043 | 14.2× |
| MRI thoracic spine w/o contrast (72146) | $2,422 | $3,726 | 10.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,943 | $7,604 | 14.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,573 | $7,036 | 19.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,317 | $9,719 | 18.7× |
| MRI, abdomen, combo (74183) | $4,787 | $7,364 | 14.2× |
| MRI, dorsal spine combo (72157) | $4,066 | $6,255 | 12.1× |
| MRI, joint upper extrem (73221) | $2,739 | $4,214 | 11.9× |
| MRI, joint upper extrem combo (73223) | $5,859 | $9,014 | 17.4× |
| MRI, lumbar spine combo (72158) | $4,044 | $6,222 | 12.0× |
| Myocardial Spect Multiple Studies (78452) | $1,099 | $1,691 | 0.9× |
| Neck soft tissue (70360) | $261 | $402 | 3.1× |
| Parathyroid Planar Imaging (78070) | $3,227 | $4,964 | 8.4× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$221–$238 | $340–$366 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,364 | $3,637 | 6.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $319 | $490 | 3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$294–$319 | $453–$490 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$226–$244 | $348–$376 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$253–$272 | $389–$419 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $397 | $610 | 3.9× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$326–$352 | $502–$542 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$273–$295 | $420–$454 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$294–$319 | $453–$490 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $257 | $395 | 3.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $492 | $757 | 4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $335 | $515 | 4.0× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$273–$295 | $420–$454 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$268–$289 | $413–$444 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $257 | $395 | 3.1× |
| Radex Spine 1 View Specify Level (72020) | $122 | $188 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $262 | $403 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $387 | $595 | 4.6× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$242–$261 | $372–$402 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $257 | $395 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$342–$369 | $526–$568 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $363 | $558 | 3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$320–$326 | $493–$502 | varies |
| Radiologic exam colon double contrast study (74280) | $452 | $696 | 2.7× |
| Radiologic exam colon single contrast study (74270) | $1,006 | $1,547 | 5.9× |
| Radiologic exam knee complete 4/more views (73564) | $397 | $610 | 3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $256 | $394 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $312 | $480 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $320 | $492 | 1.9× |
| Radiologic examination femur 1 view (73551) | $241 | $370 | 2.9× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$289–$311 | $445–$479 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$289–$307 | $445–$472 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$257–$277 | $396–$426 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$320–$346 | $493–$532 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$214–$227 | $329–$349 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $51 | $78 | 2.2× |
| Shoulder 1 view (73020) | $155 | $239 | 1.8× |
| Skull less than 4 views (70250) | $294 | $452 | 2.9× |
| Sternoclavicular joints (71130) | $282 | $434 | 3.4× |
| Testicular Imaging W/Flow (78761) | $2,081 | $3,201 | 5.4× |
| Thoracic spine 2 views (72070) | $261 | $402 | 2.6× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$305–$329 | $469–$506 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $2,054 | $3,160 | 5.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,541 | $3,909 | 6.6× |
| Ultrasound Breast Limited (76642) | $646 | $994 | 7.7× |
| Ultrasound Exam Aaa Screen (76706) | $1,037 | $1,596 | 10.3× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$701–$743 | $1,078–$1,143 | varies |
| Unlisted us procedure (76999) | $136 | $209 | 1.6× |
| Upper gi w/o kub (74240) | $787 | $1,211 | 4.6× |
| Urethrocystogram voiding (74455) | $801 | $1,232 | 3.5× |
| Us chest (76604) | $601 | $924 | 6.0× |
| Us complete joint (76881) | $309 | $476 | 3.1× |
| Us exam, pelvic, limited (76857) | $272 | $419 | 2.7× |
| Us kidney transplant (76776) | $610 | $939 | 6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $163 | $250 | 1.6× |
| Us ob detailed single fetus (76811) | $941 | $1,448 | 4.1× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$142–$583 | $219–$897 | varies |
| Us pelvic non ob complete (76856) | $907 | $1,395 | 9.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $874 | $1,344 | 8.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $802 | $1,234 | 7.9× |
| Us retroperitoneal complete (76770) | $918 | $1,413 | 9.1× |
| Us retroperitoneal limited (76775) | $337 | $519 | 3.3× |
| Us scrotum and contents (76870) | $885 | $1,361 | 8.8× |
| Us thyroid (76536) | $1,056 | $1,624 | 10.5× |
| Us transrectal (76872) range across 2 matching MRF lines |
$252–$1,515 | $388–$2,330 | varies |
| Vascular Flow Imaging (78445) | $2,011 | $3,094 | 5.2× |
| Wrist 2 views (73100) | $295 | $454 | 3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $251 | $386 | 3.0× |
| X-Ray Bend Only L-S Spine (72120) | $326 | $502 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$230–$244 | $354–$376 | varies |
| X-Ray Exam Breast Specimen (76098) | $268 | $413 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $326 | $502 | 3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $594 | $914 | 5.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $696 | $1,070 | 6.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$257–$272 | $395–$419 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$384–$414 | $591–$637 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$294–$352 | $453–$542 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $545 | $838 | 5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$305–$329 | $469–$506 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $437 | $672 | 4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $335 | $515 | 3.3× |
| X-ray eye for foreign body (70030) | $277 | $426 | 3.3× |
| X-ray head for orthodontia (70350) | $94 | $144 | 1.1× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$257–$277 | $396–$426 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $316 | $486 | 3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$342–$348 | $526–$535 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$204–$329 | $314–$506 | varies |
| X-ray nose-rectum child f.b. (76010) | $173 | $266 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $256 | $394 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $268 | $412 | 2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $277 | $426 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$289–$294 | $445–$452 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$337–$342 | $518–$526 | varies |
| X-ray thoracic spine 4 vw (72074) | $108 | $166 | 1.1× |
| X-Ray Tmj Unilat (70328) | $237 | $364 | 2.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $285 | $438 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $829 | $1,275 | 8.2× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$415–$449 | $639–$690 | varies |
| Xr orbits complete 4 views (70200) | $374 | $576 | 3.7× |
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.