Imaging prices at Ed Fraser Memorial Hospital

Macclenny, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $398 $398 3.6×
Ankle 2 views (73600) $413.50 $413.50 4.5×
Bone &/joint imaging whole body (78306) $1,709 $1,709 4.1×
Bone age studies (77072) $764 $764 7.0×
Cervical spine 2 or 3 views (72040) $791 $791 8.7×
Clavicle complete (73000) $567.50 $567.50 6.2×
CT abdomen and pelvis without and with contrast (74178) $4,405 $4,405 12.1×
CT abdomen w wo contrast (74170) $2,785 $2,785 15.2×
CT abdomen w/o contrast (74150) $2,835 $2,835 26.0×
CT angio hrt w/3d image (75574) $2,275 $2,275 6.2×
CT angio lwr extr w/o&w/dye (73706) $5,667 $5,667 30.9×
CT angiography upper extremity lt (73206) $2,897 $2,897 15.8×
CT c-spine w/o contrast (72125) $2,785 $2,785 25.5×
CT head/brain without and with contrast (70470) $2,295 $2,295 12.5×
CT lower ext w/o (73700) $2,373 $2,373 21.7×
CT lower extremity w/contrast material (73701) $2,444 $2,444 13.3×
CT lumbar spine w/o contrast (72131) $2,785 $2,785 25.5×
CT maxillofacial wo contrast (70486) $2,939.50 $2,939.50 26.9×
CT orbits w/o contrast (70480) $2,295 $2,295 21.0×
CT pelvis w/o contrast (72192) $2,535 $2,535 23.2×
CT thoracic spine w/contrast (72129) $2,373 $2,373 13.0×
CT thoracic spine w/o contrast (72128) $2,365 $2,365 21.7×
CT upper ext wo (73200) $2,517.50 $2,517.50 23.1×
CT upper extremity with contrast (73201) $2,373 $2,373 6.5×
Cta Abdomen (74175) $2,909 $2,909 15.9×
CTA abdomen pelvis (74174) $5,794 $5,794 15.9×
CTA chest (71275) $5,032 $5,032 27.5×
Dxa bone density study 1/> sites axial skel (77080) $770 $770 7.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $398 $398 4.4×
Facial bones min 3 views (70150) $417 $417 3.8×
Fluoroscopy up to 1 hr (76000) $787 $787 3.2×
Foot 2 views (73620) $408 $408 4.5×
Forearm 2 views (73090) $402 $402 4.4×
Hand 2 views (73120) $235 $235 2.2×
Hepatobiliary syst imaging including gallbladder (78226) $1,557 $1,557 3.7×
Knee 3 views (73562) $876 $876 9.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,400 $4,400 12.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,645 $3,645 10.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,400 $4,400 12.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,759 $5,759 23.1×
MRI up ext w/o contrast (73218) $3,458 $3,458 13.9×
MRI upper ext joint w/o contrast (73221) $5,759 $5,759 23.1×
Myocardial Spect Multiple Studies (78452) $2,192 $2,192 1.6×
Nm gastric emptying study (78264) $2,009 $2,009 4.8×
Pelvis 1 or 2 views (72170) $530 $530 4.9×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,715 $1,715 3.0×
Radex Ankle Compl Minimum 3 Views (73610) $514 $514 5.7×
Radex Calcaneus Minimum 2 Views (73650) $398 $398 4.4×
Radex Elbw Compl Minimum 3 Views (73080) $403 $403 4.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $909 $909 10.0×
Radex fingr minimum 2 views (73140) $480 $480 5.3×
Radex Foot Compl Minimum 3 Views (73630) $398 $398 4.4×
Radex Hand Minimum 3 Views (73130) $398 $398 4.4×
Radex Hips Bilateral With Pelvis 2 Views (73521) $523.50 $523.50 4.8×
Radex Humerus Minimum 2 Views (73060) $424 $424 4.7×
Radex Kne 1/2 Views (73560) $617.50 $617.50 6.8×
Radex Kne Compl 4/More Views (73564) $398 $398 3.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $742 $742 8.2×
Radex Sho Compl Minimum 2 Views (73030) $417 $417 4.6×
Radex upper extremity infant minimum 2 views (73092) $709.50 $709.50 6.5×
Radex Wrst Compl Minimum 3 Views (73110) $406 $406 4.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $529 $529 5.8×
Radiologic examination tibia & fibula 2 views (73590) $683 $683 7.5×
Sacroiliac Joints < 3 Views (72200) $837 $837 7.7×
Screening Digital Breast Tomosynthesis Bi (77063) $112 $112 4.8×
Shoulder 1 view (73020) $398 $398 4.4×
Thoracolumbar 2 views (72080) $398 $398 4.4×
Ultrasound breast complete (76641) $1,695 $1,695 15.5×
Ultrasound Exam Aaa Screen (76706) $863 $863 7.9×
Ultrasound, abdomen limited (76705) $453 $453 4.1×
Us breast unilateral limited (76642) $670 $670 7.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $453 $453 4.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $453 $453 4.1×
Wrist 2 views (73100) $289 $289 3.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $491 $491 4.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $375 $375 4.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $528.50 $528.50 5.8×
X-ray exam of femur 2/> (73552) $514 $514 5.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $439 $439 4.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $500 $500 4.6×
X-ray nose-rectum child f.b. (76010) $627 $627 6.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $398 $398 3.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $884 $884 9.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $477 $477 4.4×
Xr c-spine 4 or 5 views (72050) $994 $994 9.1×