Imaging prices at Door County Medical Center
Sturgeon Bay, WI · every code in this section with a posted price and a Medicare benchmark.
162 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) | $247.50 | $330 | 2.9× |
| Abdomen 2 views (74019) | $325.50 | $434 | 3.2× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$216.75–$229.50 | $289–$306 | varies |
| Arthrogram hip (73525) | $761.25 | $1,015 | 2.2× |
| Bone age studies (77072) | $249.75 | $333 | 2.5× |
| Bone Imaging 3 Phase (78315) | $1,569.75 | $2,093 | 4.0× |
| Bone Imaging Limited Area (78300) | $960 | $1,280 | 2.5× |
| Bone Imaging Whole Body (78306) | $1,282.50 | $1,710 | 3.3× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$258–$261 | $344–$348 | varies |
| Chest 2 views (71046) | $294.75 | $393 | 3.5× |
| Clavicle complete (73000) | $237 | $316 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $851.25 | $1,135 | 8.4× |
| Contrast X-Ray Bladder (74430) | $477.75 | $637 | 1.4× |
| Contrast X-Ray Of Elbow (73085) | $1,031.25 | $1,375 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,422.25 | $4,563 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $2,623.50 | $3,498 | 11.3× |
| CT abdomen w contrast (74160) | $1,740 | $2,320 | 10.2× |
| CT abdomen w wo contrast (74170) | $2,328 | $3,104 | 13.7× |
| CT abdomen w/o contrast (74150) | $1,557.75 | $2,077 | 15.3× |
| CT Angio Abdomen and Pelvis (74174) | $3,786 | $5,048 | 11.2× |
| CT Angio Chest (71275) | $2,719.50 | $3,626 | 16.0× |
| CT Angio Head (70496) | $2,271 | $3,028 | 13.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,888.25 | $3,851 | 17.0× |
| CT Angio Neck (70498) | $2,110.50 | $2,814 | 12.4× |
| CT cervical spine w/o contrast (72125) | $1,174.50 | $1,566 | 11.6× |
| CT cervical spine w/wo cont (72127) | $2,071.50 | $2,762 | 12.2× |
| CT chest w contrast (71260) | $1,654.50 | $2,206 | 9.7× |
| CT chest w/wo contrast (71270) | $2,276.25 | $3,035 | 13.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $593.25 | $791 | 5.8× |
| CT head/brain with contrast (70460) | $1,341 | $1,788 | 7.9× |
| CT head/brain without and with contrast (70470) | $1,514.25 | $2,019 | 8.9× |
| CT iac w contrast (70481) | $1,443.75 | $1,925 | 8.5× |
| CT lower ext w/o (73700) | $1,380.75 | $1,841 | 13.6× |
| CT lower extremity w/contrast material (73701) | $1,650 | $2,200 | 9.7× |
| CT lumbar spine w contrast (72132) | $1,207.50 | $1,610 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $1,230 | $1,640 | 12.1× |
| CT maxillofacial w contrast (70487) | $1,477.50 | $1,970 | 8.7× |
| CT maxillofacial wo contrast (70486) | $1,282.50 | $1,710 | 12.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,268.25 | $1,691 | 7.4× |
| CT orbits w/o contrast (70480) | $1,185 | $1,580 | 11.7× |
| CT pelvis w/o contrast (72192) | $1,576.50 | $2,102 | 15.5× |
| CT soft tissue neck w contrast (70491) | $1,620.75 | $2,161 | 9.5× |
| CT soft tissue neck w/o contrast (70490) | $1,395 | $1,860 | 13.7× |
| CT thoracic spine w/o contrast (72128) | $1,136.25 | $1,515 | 11.2× |
| CT thorax w/o contrast (71250) | $1,532.25 | $2,043 | 15.1× |
| CT upper ext wo (73200) | $1,380.75 | $1,841 | 13.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,722 | $2,296 | 10.1× |
| CT upper extremity with contrast (73201) | $1,427.25 | $1,903 | 4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,238 | $2,984 | 13.1× |
| Cta Abdomen (74175) | $2,825.25 | $3,767 | 16.6× |
| Dxa Bone Density Axial (77080) | $417.75 | $557 | 4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $226.50 | $302 | 2.7× |
| Esophagram (74220) | $507.75 | $677 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $544.50 | $726 | 5.4× |
| Fluoroscopy up to 1 hr (76000) | $477.75 | $637 | 2.1× |
| Foot 2 views (73620) range across 12 matching MRF lines |
$217.50–$230.25 | $290–$307 | varies |
| Forearm 2 views (73090) | $237.75 | $317 | 2.8× |
| Gastric emptying imaging study (78264) | $1,565.25 | $2,087 | 4.0× |
| Gated Heart Planar Single (78472) | $1,551.75 | $2,069 | 4.0× |
| Hand 2 views (73120) | $161.25 | $215 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,402.50 | $1,870 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,127.25 | $1,503 | 2.9× |
| K Flow/Funct Image W/O Drug (78707) | $957 | $1,276 | 1.8× |
| Knee 3 Views (73562) | $276 | $368 | 3.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,863 | $2,484 | 3.5× |
| Lymph System Imaging (78195) | $1,215.75 | $1,621 | 2.3× |
| Meckels Divert Exam (78290) | $909.75 | $1,213 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $2,543.25 | $3,391 | 7.5× |
| MRA head w/o contrast (70544) | $2,235.75 | $2,981 | 9.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,522 | $4,696 | 10.4× |
| MRA neck w/o contrast (70547) | $2,018.25 | $2,691 | 8.7× |
| MRI abdomen w/o contrast (74181) | $1,984.50 | $2,646 | 8.6× |
| MRI any jt lower extrem w/contrast material (73722) | $2,376.75 | $3,169 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,225 | $4,300 | 9.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,416.50 | $3,222 | 3.2× |
| MRI cervical spine w/o cont (72141) | $2,358.75 | $3,145 | 10.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,985 | $3,980 | 8.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,095.50 | $2,794 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,248.25 | $4,331 | 9.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,957.75 | $5,277 | 11.7× |
| MRI pelvis w/o & w contrast (72197) | $3,252.75 | $4,337 | 9.6× |
| MRI pelvis w/o contrast (72195) | $2,207.25 | $2,943 | 9.5× |
| MRI thoracic spine w/o contrast (72146) | $2,412 | $3,216 | 10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,782.75 | $2,377 | 7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,367 | $3,156 | 7.0× |
| MRI, abdomen, combo (74183) | $2,747.25 | $3,663 | 8.1× |
| MRI, dorsal spine combo (72157) | $3,374.25 | $4,499 | 10.0× |
| MRI, joint upper extrem (73221) | $2,250.75 | $3,001 | 9.7× |
| MRI, joint upper extrem combo (73223) | $3,272.25 | $4,363 | 9.7× |
| MRI, lumbar spine combo (72158) | $3,327 | $4,436 | 9.8× |
| Myocardial Spect Multiple Studies (78452) | $2,540.25 | $3,387 | 2.0× |
| Neck soft tissue (70360) | $213.75 | $285 | 2.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,110.75 | $1,481 | 2.1× |
| Pelvis 1 or 2 views (72170) | $282 | $376 | 2.8× |
| PET image w/CT, full body (78816) | $4,692.75 | $6,257 | 3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,692.75 | $6,257 | 3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $375 | $500 | 3.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $258.75 | $345 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $223.50 | $298 | 2.6× |
| Radex elbow complete minimum 3 views (73080) | $258.75 | $345 | 3.1× |
| Radex fingr minimum 2 views (73140) | $237 | $316 | 2.8× |
| Radex foot complete minimum 3 views (73630) | $259.50 | $346 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $262.50 | $350 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $276 | $368 | 3.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $263.25 | $351 | 3.1× |
| Radex Spine 1 View Specify Level (72020) | $213.75 | $285 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $297 | $396 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $196.50 | $262 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $213 | $284 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $272.25 | $363 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $311.25 | $415 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) | $264 | $352 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $567.75 | $757 | 3.3× |
| Radiologic examination femur minimum 2 views (73552) | $258 | $344 | 3.1× |
| Radiologic examination knee 1/2 views (73560) | $241.50 | $322 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $246.75 | $329 | 2.9× |
| Scapula (73010) | $210 | $280 | 2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$30–$45 | $40–$60 | varies |
| Shoulder 1 view (73020) | $219.75 | $293 | 2.6× |
| Shoulder Arthrography (73040) | $890.25 | $1,187 | 2.6× |
| Thoracic spine 2 views (72070) | $302.25 | $403 | 3.0× |
| Thoracic spine 3 views (72072) | $312.75 | $417 | 3.1× |
| Thoracolumbar 2 views (72080) | $327.75 | $437 | 3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $868.50 | $1,158 | 2.2× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$177.75–$266.25 | $237–$355 | varies |
| Ultrasound Exam Aaa Screen (76706) | $721.50 | $962 | 7.1× |
| Ultrasound, abdomen limited (76705) | $642 | $856 | 6.3× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$264–$392.25 | $352–$523 | varies |
| Us chest (76604) | $580.50 | $774 | 5.7× |
| Us complete joint (76881) | $695.25 | $927 | 6.8× |
| Us exam, pelvic, limited (76857) | $587.25 | $783 | 5.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $342.75 | $457 | 3.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$453–$474 | $604–$632 | varies |
| Us ob transvaginal (76817) | $513 | $684 | 5.1× |
| Us pelvic non ob complete (76856) | $705.75 | $941 | 6.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$590.25–$618.75 | $787–$825 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $431.25 | $575 | 4.2× |
| Us retroperitoneal limited (76775) | $534 | $712 | 5.3× |
| Us scrotum and contents (76870) | $674.25 | $899 | 6.6× |
| Us thyroid (76536) | $681 | $908 | 6.7× |
| Wrist 2 views (73100) | $226.50 | $302 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $361.50 | $482 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $234 | $312 | 2.8× |
| X-Ray Exam Breast Specimen (76098) | $217.50 | $290 | 0.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $388.50 | $518 | 3.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $226.50 | $302 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $287.25 | $383 | 3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $409.50 | $546 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $289.50 | $386 | 3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $453 | $604 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $330.75 | $441 | 3.3× |
| X-ray eye for foreign body (70030) | $215.25 | $287 | 2.5× |
| X-ray humerus (73060) | $294 | $392 | 3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $255 | $340 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $184.50 | $246 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $319.50 | $426 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $249.75 | $333 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $525.75 | $701 | 5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $280.50 | $374 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $260.25 | $347 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $424.50 | $566 | 4.2× |
| Xr facial bones less than 3 views (70140) | $240.75 | $321 | 2.8× |
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.