Imaging prices at Fitzgibbon Hospital

Marshall, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $2,598.54 $3,248.18 1.9×
Abdomen 2 views (74019) $232.90 $291.12 2.2×
Acute gastrointestinal blood loss imaging (78278) $627.46 $784.34 1.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $446.90 $558.63 0.1×
Ankle 2 views (73600) $43.05 $53.81 0.5×
Arthrogram elbow (73085) $850.08 $1,062.60 2.4×
Arthrogram hip (73525) $641.76 $802.20 1.8×
Arthrogram shoulder (73040) $923.16 $1,153.95 2.6×
Arthrogram wrist (73115) $689.64 $862.05 2.0×
Arthrography knee lt (73580) $729.96 $912.45 2.1×
Basic radiation dosimetry calculation (77300) $482.16 $602.70 3.6×
Bone &/Joint Imaging Limited Area (78300) $535.30 $669.12 1.3×
Bone &/joint imaging whole body (78306) $765.51 $956.89 1.9×
Bone age studies (77072) $129.97 $162.46 1.2×
Bone Imaging 3 Phase (78315) $863.75 $1,079.68 2.2×
Bone survey complete (77075) $408.44 $510.56 3.9×
Brain image w/flow 4 + views (78606) $559.84 $699.80 1.0×
Brain Imaging Pet Metabolic Evaluation (78608) $2,216.98 $2,771.22 1.5×
Cervical spine 2 or 3 views (72040) $56.82 $71.03 0.7×
Chest 1 view (71045) $30.46 $38.08 0.3×
Chest 3 views (71047) $27.06 $33.83 0.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $265.62 $332.02 1.5×
Clavicle complete (73000) $162.30 $202.88 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $140.34 $175.43 1.3×
Continuing medical physics consltj pr wk (77336) $457.80 $572.25 3.4×
CT abdomen and pelvis without and with contrast (74178) $1,210.54 $1,513.18 3.5×
CT abdomen and pelvis without contrast (74176) $1,156.78 $1,445.97 4.8×
CT abdomen w contrast (74160) $929.76 $1,162.20 5.3×
CT abdomen w wo contrast (74170) $139.40 $174.25 0.8×
CT abdomen w/o contrast (74150) $786.56 $983.21 7.5×
CT angio hrt w/3d image (75574) $440.24 $550.30 1.3×
CT angiography upper extremity lt (73206) $675.36 $844.20 3.8×
CT c-spine w/o contrast (72125) $814.46 $1,018.08 7.8×
CT cervical spine w&w/o contrast (72127) $480.77 $600.96 2.7×
CT cervical spine with contrast (72126) $501.85 $627.32 1.4×
CT chest w/wo contrast (71270) $1,043.51 $1,304.39 5.9×
CT chest with contrast (71260) $114.39 $142.99 0.7×
CT head/brain with contrast (70460) $731.24 $914.04 4.2×
CT head/brain without and with contrast (70470) $934.06 $1,167.58 5.3×
CT heart no contrast quant eval coronry calcium (75571) $83.82 $104.78 1.0×
CT iac w contrast (70481) $111.52 $139.40 0.6×
CT lower ext w/o (73700) $645.92 $807.40 6.2×
CT lower extremity w wo contrast (73702) $137.76 $172.20 0.8×
CT lower extremity with contrast (73701) $608.05 $760.06 3.5×
CT lumbar spine w & w/o contrast (72133) $689.10 $861.38 3.9×
CT lumbar spine w/o contrast (72131) $869.78 $1,087.22 8.3×
CT lumbar spine with contrast (72132) $763.70 $954.63 2.2×
CT maxillofacial w contrast (70487) $1,470.59 $1,838.24 8.4×
CT maxillofacial w/o contrast (70486) $635.87 $794.84 6.1×
CT maxillofacial w/wo contrast (70488) $1,235.54 $1,544.42 7.0×
CT neck soft tissue w contrast (70491) $803.81 $1,004.76 4.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $126.28 $157.85 0.7×
CT orbits w/o contrast (70480) $687.34 $859.18 6.6×
CT pelvis w & w/o contrast (72194) $992.82 $1,241.02 5.7×
CT pelvis w/o contrast (72192) $786.87 $983.59 7.5×
CT soft tissue neck w/o & w/contrast material (70492) $1,049.48 $1,311.85 6.0×
CT soft tissue neck w/o contrast (70490) $680.25 $850.32 6.5×
CT thoracic spine w/contrast (72129) $421.89 $527.36 2.4×
CT thoracic spine w/o contrast (72128) $747.51 $934.39 7.1×
CT thoracic spine w/wo contrast (72130) $936.18 $1,170.22 5.3×
CT thorax w/o contrast (71250) $1,362.10 $1,702.63 13.0×
CT upper extremity w/o & w/contrast material (73202) $886.87 $1,108.59 5.0×
CT upper extremity w/o contrast rt (73200) $97.58 $121.98 0.9×
CT upper extremity with contrast (73201) $114.80 $143.50 0.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $718.73 $898.42 4.1×
Cta Abdomen (74175) $976.84 $1,221.05 5.6×
CTA abdomen pelvis (74174) $215.66 $269.58 0.6×
CTA chest (71275) $1,060.16 $1,325.20 6.0×
Cta Head (70496) $971.01 $1,213.76 5.5×
CTA lwr ext w&w/o contrast (73706) $893.41 $1,116.76 5.1×
Cta Neck (70498) $957.80 $1,197.26 5.5×
Cta Pelvis (72191) $1,055.92 $1,319.90 6.0×
Cystography minimum 3 views rs&i (74430) $204.14 $255.18 0.6×
Dxa bone density study 1/> sites axial skel (77080) $109.20 $136.50 1.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $77.28 $96.61 0.9×
Dxa bone density study axial skeleton (77085) $91.26 $114.08 0.9×
Esophagus (74220) $276.60 $345.76 1.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $185.66 $232.08 1.8×
Fluoroscopy up to 1 hr (76000) $572.57 $715.71 2.4×
Foot 2 views (73620) $43.05 $53.81 0.5×
Forearm 2 views (73090) $42.18 $52.74 0.5×
Gated Heart Planar Single (78472) $732.94 $916.18 1.8×
Hand 2 views (73120) $43.05 $53.81 0.4×
Hand 3 views (73130) $49.08 $61.35 0.6×
Heart Infarct Image (78466) $658.68 $823.36 1.6×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $809.77 $1,012.22 1.5×
Hepatobiliary syst imaging including gallbladder (78226) $396.41 $495.51 1.0×
Ht muscle image spect sing (78451) $940.38 $1,175.47 0.7×
Humerus Min 2 Views Left (73060) $48.22 $60.27 0.6×
Hysterosalpingogram (74740) $414.49 $518.11 1.7×
Image fusion (77399) $248.80 $311 1.8×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $768.28 $960.35 1.4×
Kidney img morphology vascular flow 1 w/rx (78708) $741.90 $927.37 1.4×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,123.24 $1,404.05 2.1×
Knee 3 views (73562) $53.38 $66.73 0.6×
Liver & spleen imaging static only (78215) $666.95 $833.68 1.7×
Lung Ventilation Imaging (78579) $554.59 $693.24 1.4×
Lymphoscintigraphy (78195) $781.93 $977.42 1.4×
Meckels Diverticulum (78290) $419.82 $524.78 1.0×
Mlc imrt design & construction per imrt plan (77338) $2,142 $2,677.50 5.7×
MRA head w & w/o contrast (70546) $1,899.37 $2,374.21 5.4×
MRA head w/o contrast (70544) $901.98 $1,127.48 3.8×
MRA neck w contrast (70548) $1,153.96 $1,442.46 3.3×
Mra Neck W/O &W/Contrast Material (70549) $1,020.55 $1,275.69 2.9×
MRA neck w/o contrast (70547) $1,055.86 $1,319.82 4.4×
MRI abdomen w contrast (74182) $1,206.30 $1,507.88 3.5×
MRI abdomen w/o & w/contrast material (74183) $1,272.76 $1,590.96 3.6×
MRI abdomen w/o contrast (74181) $1,147.14 $1,433.92 4.8×
MRI any jnt lwr ext with con lt (73722) $1,117.02 $1,396.28 1.4×
MRI any jt upper extremity w/contrast matrl (73222) $159.90 $199.88 0.2×
MRI c-spine with contrast (72142) $1,329.65 $1,662.06 3.8×
MRI cervical spine w/o contrast (72141) $1,183.24 $1,479.05 5.0×
MRI chest w/o & w/contrast material (71552) $426.82 $533.52 1.2×
MRI chest w/o contrast (71550) $1,233.67 $1,542.09 5.2×
MRI chest with contrast (71551) $1,235.58 $1,544.47 1.6×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,075.74 $1,344.68 3.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,126.10 $1,407.64 3.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $133.66 $167.08 0.6×
MRI orbit face &/neck w/o contrast (70540) $133.66 $167.08 0.6×
MRI orbit/face/neck w&w/o cont (70543) $211.56 $264.45 0.6×
MRI orbit/face/neck w/contrast (70542) $159.08 $198.85 0.5×
MRI pelvis w/o & w/contrast material (72197) $1,140.60 $1,425.75 3.3×
MRI pelvis w/o contrast (72195) $924.14 $1,155.18 3.9×
MRI scan of arm joint before and after contrast (73223) $213.20 $266.50 0.6×
MRI scan of leg joint before and after contrast (73723) $1,426.56 $1,783.20 4.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,472.27 $1,840.34 4.2×
MRI spinal canal lumbar w/contrast material (72149) $1,306.46 $1,633.08 3.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,471.41 $1,839.26 4.2×
MRI spinal canal thoracic w/contrast matrl (72147) $1,173.01 $1,466.26 3.4×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,511.44 $1,889.31 4.3×
MRI thoracic spine w/o contrast (72146) $1,188.40 $1,485.50 5.0×
MRI tmj (70336) $1,141.98 $1,427.47 4.8×
MRI upper ext joint w/o contrast (73221) $1,802.07 $2,252.59 7.5×
MRI upper extrem other than jt w/o & w/contras (73220) $1,191.46 $1,489.32 3.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,053.96 $1,317.46 4.4×
Myelogram Cervical (72240) $666.31 $832.89 0.8×
Myelogram Lumbar (72265) $730.66 $913.32 0.9×
Myelogram thoracic (72255) $578.32 $722.90 0.7×
Myocardial Imaging Pet Metabolic Evaluation (78459) $1,134.49 $1,418.12 0.9×
Myocardial Spect Multiple Studies (78452) $1,759.43 $2,199.29 1.4×
Neck soft tissue (70360) $42.19 $52.74 0.5×
Nm gastric emptying study (78264) $705.80 $882.24 1.8×
Nm peritoneal-venous shunt patency (78291) $550.61 $688.26 1.4×
Ntsty modul radthx pln dose-vol histos (77301) $5,345.34 $6,681.68 3.9×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $178.92 $223.66 1.7×
Osseous survey infant (77076) $395.61 $494.52 3.8×
Parathyroid imaging (78070) $614.12 $767.65 1.5×
Pelvis 1 or 2 views (72170) $39.61 $49.51 0.4×
PET image w/CT, skull-thigh (78815) $2,366.68 $2,958.36 1.7×
PET imaging for CT attenuation whole body (78816) $2,366.68 $2,958.36 1.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,244.45 $1,555.56 3.6×
Pulmonary Perfusion Imaging Particulate (78580) $526.42 $658.02 1.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $873.94 $1,092.42 1.6×
Radex abscess/fistula/sinus tract rs&i (76080) $241.94 $302.43 0.4×
Radiation treatment delivery 1 mev >= complex (77412) $614.04 $767.55 1.1×
Radiation treatment delivery 1 mev >= simple (77402) $350.28 $437.85 3.4×
Radiation tx delivery 1 mev >= intermediate (77407) $330.96 $413.70 0.9×
Radiolog exam mandible compl minimum 4 views (70110) $201.29 $251.61 1.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $39.61 $49.51 0.5×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $46.79 $58.49 0.5×
Radiologic exam colon single contrast study (74270) $619.08 $773.85 3.5×
Radiologic exam upr gi trc double contrast study (74246) $250.74 $313.42 1.4×
Radiologic exam upr gi trc single contrast study (74240) $520.66 $650.82 3.0×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $49.94 $62.42 0.6×
Radiological examination surgical specimen (76098) $188.64 $235.80 0.3×
Ribs bilateral 3 views (71110) $52.52 $65.65 0.5×
Rp loclzj tum plnr whole body single day imaging (78802) $1,170.10 $1,462.62 2.2×
Rp loclzj tum spect 1 area single day imaging (78803) $104.96 $131.20 0.2×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $199.26 $249.08 0.1×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $1,845.12 $2,306.40 1.4×
Saline Infus Sonohysterography W/Color Doppler (76831) $380.05 $475.06 1.6×
Salivary gland imaging serial images (78231) $250.30 $312.88 0.6×
Scapula complete (73010) $186.82 $233.52 1.8×
Screening digital breast tomosynthesis (77063) $58.78 $73.47 2.5×
Simulation intermediate (77285) $511.56 $639.45 1.4×
Small bowel series (74250) $412.13 $515.16 2.3×
Spec medical radj physics consltj (77370) $434.28 $542.85 3.2×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,999.20 $2,499 5.3×
Special treatment procedure (77470) $2,016 $2,520 3.6×
Spine thoracic 3 views (72072) $43.91 $54.89 0.4×
Spleen imaging only (78185) $472.28 $590.35 1.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $926.52 $1,158.15 2.5×
Telethx isodose pln smpl w/dosimetry calculation (77306) $645.12 $806.40 1.7×
Ther rad simulaj-aided field setting complex (77290) $1,217.16 $1,521.45 3.2×
Ther rad simulaj-aided field setting simple (77280) $503.16 $628.95 3.7×
Thyroid Imaging With Vascular Flow (78013) $513.98 $642.47 1.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $579.12 $723.90 1.4×
Tmj unilateral (70328) $49.94 $62.42 0.6×
Treatment device intermediate (77333) $680.40 $850.50 5.1×
Treatment devices simple (77332) $716.52 $895.65 5.3×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $1,204.27 $1,505.34 2.2×
Tx devices design & construction complex (77334) $1,046.64 $1,308.30 2.8×
Ultrasound, abdomen limited (76705) $378.70 $473.37 3.6×
Umbilical-artery Doppler (OB) (76820) $140.28 $175.35 1.3×
Unlisted Diagnostic Radiographic Procedure (76499) $22.38 $27.98 0.3×
Upper Extremity Infant (73092) $103.34 $129.18 1.0×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $703.44 $879.30 1.8×
Urethrocystography voiding (74455) $226.08 $282.60 0.9×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $438.76 $548.46 2.5×
Us breast unilateral complete (76641) $164.45 $205.56 1.6×
Us breast unilateral limited (76642) $164.45 $205.56 1.9×
Us chest (76604) $286.57 $358.21 2.7×
Us ob transvaginal (76817) $133.60 $167 1.3×
Us pelvic non ob complete (76856) $187.20 $234 1.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $168.76 $210.95 1.6×
Us pregnancy ltd (76815) $133.56 $166.94 1.3×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $181.60 $227 1.7×
Us retroperitoneal complete (76770) $449.79 $562.24 4.3×
Us retroperitoneal limited (76775) $666.96 $833.70 6.4×
Us scrotum and contents (76870) $351.84 $439.80 3.4×
Us soft tissue head/neck (76536) $595.82 $744.77 5.7×
Us xtr non-vasc lmtd (76882) $94.71 $118.39 0.9×
Vertebral fracture assessment via dxa (77086) $169.62 $212.02 1.9×
Wrist 2 views (73100) $45.63 $57.04 0.5×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $31.98 $39.98 0.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $171.76 $214.71 2.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $49.08 $61.35 0.6×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $597.47 $746.84 3.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $43.05 $53.81 0.5×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $49.94 $62.42 0.6×
X-ray exam entire spi 4/5 vw (72083) $136.02 $170.02 1.3×
X-ray exam hip uni 1 view (73501) $18.86 $23.58 0.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $68.02 $85.02 0.8×
X-Ray Exam Hips Bi 5/> Views (73523) $63.71 $79.64 0.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $233.94 $292.44 2.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $151.46 $189.32 1.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $43.91 $54.89 0.5×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $42.19 $52.74 0.5×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $57.69 $72.11 0.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $46.50 $58.12 0.5×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $16.40 $20.50 0.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $55.97 $69.96 0.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $280.34 $350.42 2.7×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $145.94 $182.42 1.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $190.44 $238.06 1.8×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $168.55 $210.69 1.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $36.51 $45.64 0.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $69.74 $87.18 0.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $57.69 $72.11 0.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $45.63 $57.04 0.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $48.48 $60.60 0.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $207.83 $259.78 2.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $232.20 $290.26 2.2×
X-Ray Spine One View - Xr Spine (72020) $128.31 $160.38 1.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $131.24 $164.05 1.5×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $154.46 $193.08 1.5×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $42.19 $52.74 0.5×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $51.66 $64.58 0.6×
Xr arthrogram ankle (73615) $703.08 $878.85 2.0×
Xr c-spine 6 or more views (72052) $292.86 $366.08 2.8×
Xr finger(s) 2+ views (73140) $43.05 $53.81 0.5×
XR Mastoids < 3 Views Bilateral (70120) $140.74 $175.92 1.3×
Xr shoulder 1 view (73020) $118.45 $148.06 1.4×
Xr spine cervical 4 or 5 views (72050) $225.34 $281.68 2.2×
Xr tibia/fibula 2 views (73590) $45.63 $57.04 0.5×
Xr tmj bilateral (70330) $55.10 $68.88 0.6×
Xray knee 1 or 2 views rt (73560) $49.51 $61.88 0.6×