Imaging prices at Elmore Community Hospital

Wetumpka, AL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $227.16 $567.88 2.4×
Ankle 2 views (73600) $104.26 $260.64 1.3×
Bone age studies (77072) $69.11 $172.77 0.7×
Bone survey complete (77075) $78.51 $196.28 0.8×
Cervical spine 2 or 3 views (72040) $104.26 $260.64 1.3×
Chest 1 view (71045) $104.26 $260.64 1.3×
Chest 3 views (71047) $59.34 $148.34 0.8×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $122.03 $305.07 0.8×
Clavicle complete (73000) $104.26 $260.64 1.3×
CT abdomen and pelvis without and with contrast (74178) $273.32 $683.31 0.9×
CT abdomen and pelvis without contrast (74176) $185.40 $463.50 0.9×
CT abdomen w contrast (74160) $141.28 $353.20 0.9×
CT abdomen w wo contrast (74170) $144.48 $361.20 0.9×
CT abdomen w/o contrast (74150) $95.04 $237.58 1.0×
CT angio hrt w/3d image (75574) $171.86 $429.64 0.6×
CT angiography upper extremity lt (73206) $216.41 $541.02 1.4×
CT c-spine w/o contrast (72125) $90.06 $225.14 1.0×
CT cervical spine w&w/o contrast (72127) $141.12 $352.78 0.9×
CT chest w/wo contrast (71270) $140.72 $351.81 0.9×
CT chest with contrast (71260) $138.53 $346.32 0.9×
CT head/brain with contrast (70460) $134.13 $335.32 0.9×
CT head/brain without and with contrast (70470) $141.28 $353.20 0.9×
CT heart no contrast quant eval coronry calcium (75571) $64.73 $161.83 0.8×
CT iac w contrast (70481) $137.61 $344.02 0.9×
CT lower ext w/o (73700) $128.26 $320.64 1.4×
CT lower extremity w wo contrast (73702) $216.41 $541.02 1.4×
CT lower extremity with contrast (73701) $216.41 $541.02 1.4×
CT lumbar spine w & w/o contrast (72133) $141.12 $352.78 0.9×
CT lumbar spine w/o contrast (72131) $90.06 $225.14 1.0×
CT maxillofacial w contrast (70487) $137.61 $344.02 0.9×
CT maxillofacial w/o contrast (70486) $128.26 $320.64 1.4×
CT maxillofacial w/wo contrast (70488) $141.12 $352.78 0.9×
CT neck soft tissue w contrast (70491) $144.09 $360.22 0.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $216.41 $541.02 1.4×
CT orbits w/o contrast (70480) $128.26 $320.64 1.4×
CT pelvis w & w/o contrast (72194) $139.86 $349.65 0.9×
CT pelvis w/o contrast (72192) $92.42 $231.04 1.0×
CT soft tissue neck w/o & w/contrast material (70492) $150.21 $375.52 1.0×
CT soft tissue neck w/o contrast (70490) $97.57 $243.92 1.0×
CT thoracic spine w/o contrast (72128) $90.06 $225.14 1.0×
CT thoracic spine w/wo contrast (72130) $141.28 $353.20 0.9×
CT thorax w/o contrast (71250) $92.23 $230.56 1.0×
CT upper extremity w/o & w/contrast material (73202) $216.41 $541.02 1.4×
CT upper extremity w/o contrast rt (73200) $128.26 $320.64 1.4×
CT upper extremity with contrast (73201) $442.12 $1,105.29 1.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $169.90 $424.74 1.1×
Cta Abdomen (74175) $155.44 $388.59 1.0×
CTA abdomen pelvis (74174) $278.19 $695.48 0.9×
CTA chest (71275) $155.60 $389.01 1.0×
Cta Head (70496) $153.68 $384.21 1.0×
CTA lwr ext w&w/o contrast (73706) $216.41 $541.02 1.4×
Cta Neck (70498) $153.68 $384.21 1.0×
Cta Pelvis (72191) $154.90 $387.26 1.0×
Cystography minimum 3 views rs&i (74430) $16.57 $41.43 0.1×
Dxa bone density study 1/> sites axial skel (77080) $69.30 $173.25 0.7×
Esophagus (74220) $123.90 $309.74 0.8×
Fluoroscopy up to 1 hr (76000) $280.22 $700.56 1.3×
Foot 2 views (73620) $104.26 $260.64 1.3×
Forearm 2 views (73090) $104.26 $260.64 1.3×
Hand 2 views (73120) $128.26 $320.64 1.4×
Hand 3 views (73130) $104.26 $260.64 1.3×
Humerus Min 2 Views Left (73060) $104.26 $260.64 1.3×
Knee 3 views (73562) $104.26 $260.64 1.3×
MRA head w/o contrast (70544) $171.21 $428.02 0.8×
MRA neck w/o contrast (70547) $171.38 $428.44 0.8×
MRI abdomen w contrast (74182) $265.99 $664.96 0.9×
MRI abdomen w/o & w/contrast material (74183) $278.42 $696.04 0.9×
MRI abdomen w/o contrast (74181) $178 $444.99 0.8×
MRI any jnt lwr ext with con lt (73722) $888.90 $2,222.25 1.3×
MRI any jt upper extremity w/contrast matrl (73222) $888.90 $2,222.25 1.3×
MRI cervical spine w/o contrast (72141) $178.72 $446.80 0.8×
MRI chest w/o & w/contrast material (71552) $278.82 $697.06 0.9×
MRI chest w/o contrast (71550) $259.12 $647.79 1.2×
MRI chest with contrast (71551) $489.38 $1,223.44 0.7×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $84.35 $210.87 0.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $263.24 $658.08 0.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $280.22 $700.56 1.3×
MRI orbit/face/neck w&w/o cont (70543) $428.56 $1,071.39 1.4×
MRI pelvis w/o & w/contrast material (72197) $278.42 $696.04 0.9×
MRI pelvis w/o contrast (72195) $178.17 $445.42 0.8×
MRI scan of arm joint before and after contrast (73223) $277.28 $693.20 0.9×
MRI scan of leg joint before and after contrast (73723) $442.12 $1,105.29 1.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $280.95 $702.38 0.9×
MRI spinal canal lumbar w/contrast material (72149) $267.68 $669.21 0.9×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $280.95 $702.38 0.9×
MRI spinal canal thoracic w/contrast matrl (72147) $267.46 $668.66 0.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $280.95 $702.38 0.9×
MRI thoracic spine w/o contrast (72146) $178.72 $446.80 0.8×
MRI upper ext joint w/o contrast (73221) $280.22 $700.56 1.3×
MRI upper extrem other than jt w/o & w/contras (73220) $442.12 $1,105.29 1.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $280.22 $700.56 1.3×
Neck soft tissue (70360) $56.92 $142.29 0.7×
Pelvis 1 or 2 views (72170) $68.72 $171.80 0.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $442.12 $1,105.29 1.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $104.26 $260.64 1.3×
Radex hips bilateral with pelvis 2 views (73521) $70.03 $175.06 0.8×
Radex mastoids compl minimum 3 views pr side (70130) $73.14 $182.85 0.8×
Radiolog exam mandible compl minimum 4 views (70110) $70.78 $176.94 0.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $144.90 $362.25 1.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $280.22 $700.56 3.0×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $104.26 $260.64 1.3×
Radiologic exam colon single contrast study (74270) $216.41 $541.02 1.4×
Radiologic exam upr gi trc double contrast study (74246) $92.82 $232.05 0.6×
Radiologic exam upr gi trc single contrast study (74240) $129.24 $323.08 0.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $104.26 $260.64 1.3×
Radiological examination surgical specimen (76098) $603.76 $775.35 1.2×
Scapula complete (73010) $128.26 $320.64 1.4×
Screening digital breast tomosynthesis (77063) $45.28 $113.19 1.9×
Small bowel series (74250) $129.26 $323.16 0.8×
Spine thoracic 3 views (72072) $70.05 $175.12 0.8×
Thyroid uptake measurement (78012) $301.60 $754 0.8×
Ultrasound elastography first target lesion (76982) $128.26 $320.64 1.4×
Ultrasound, abdomen limited (76705) $128.26 $320.64 1.4×
Upper Extremity Infant (73092) $128.26 $320.64 1.4×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $216.41 $541.02 1.4×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $120.92 $302.30 0.8×
Us breast unilateral complete (76641) $83.30 $208.24 0.9×
Us breast unilateral limited (76642) $104.26 $260.64 1.3×
Us chest (76604) $79.12 $197.79 0.8×
Us compl joint r-t w/image documentation (76881) $87.78 $219.44 0.9×
Us pelvic non ob complete (76856) $82.07 $205.17 0.9×
Us pregnancy ltd (76815) $81.13 $202.82 0.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $90.03 $225.08 1.0×
Us retroperitoneal complete (76770) $83.32 $208.30 0.9×
Us retroperitoneal limited (76775) $79.26 $198.15 0.8×
Us scrotum and contents (76870) $80.76 $201.90 0.9×
Us soft tissue head/neck (76536) $78.87 $197.18 0.8×
Us spinal canal and contents (76800) $97.52 $243.78 1.0×
Us transrectal (76872) $128.26 $320.64 1.4×
Us xtr non-vasc lmtd (76882) $82.18 $205.46 0.9×
Vertebral fracture assessment via dxa (77086) $8.84 $22.11 0.1×
Wrist 2 views (73100) $104.26 $260.64 1.3×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $72.26 $180.66 0.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $104.26 $260.64 1.3×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $104.26 $260.64 1.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $140.92 $352.29 0.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $104.26 $260.64 1.3×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $104.26 $260.64 1.3×
X-ray exam hip uni 1 view (73501) $104.26 $260.64 1.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $104.26 $260.64 1.3×
X-ray exam of femur 1 (73551) $8.80 $21.99 0.1×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $70.98 $177.44 0.8×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $104.26 $260.64 1.3×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $104.26 $260.64 1.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $104.26 $260.64 1.3×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $128.26 $320.64 1.4×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $104.26 $260.64 1.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $70.03 $175.06 0.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $56.72 $141.80 0.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $71.54 $178.83 0.8×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $70.78 $176.94 0.8×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $128.26 $320.64 1.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $72.59 $181.47 0.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $70.05 $175.12 0.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $56.72 $141.80 0.7×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $104.26 $260.64 1.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $57.86 $144.64 0.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $71.54 $178.83 0.8×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $68.92 $172.29 0.7×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $57.86 $144.64 0.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $57.30 $143.25 0.7×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $104.26 $260.64 1.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $104.26 $260.64 1.3×
Xr chest 4+ views (71048) $72.28 $180.70 0.8×
Xr Cholecystography Oral Contrast (74290) $116.66 $291.66 0.7×
Xr finger(s) 2+ views (73140) $104.26 $260.64 1.3×
Xr internal auditory meati complete (70134) $603.76 $778.17 1.2×
Xr shoulder 1 view (73020) $104.26 $260.64 1.3×
Xr spine cervical 4 or 5 views (72050) $128.26 $320.64 1.4×
Xr tibia/fibula 2 views (73590) $104.26 $260.64 1.3×
Xr tmj bilateral (70330) $58.42 $146.04 0.8×
Xray knee 1 or 2 views rt (73560) $104.26 $260.64 1.3×