Imaging prices at Floyd Valley Healthcare

Le Mars, IA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $122 $122 1.5×
Abdomen 2 views (74019) $160 $160 1.6×
Ankle 2 views (73600) $122 $122 1.5×
Arthrogram hip (73525) $440 $440 1.3×
Bone age studies (77072) $87 $87 0.9×
Bone Imaging Whole Body (78306) $1,121 $1,121 2.9×
Bone survey infant (77076) $244 $244 2.4×
Chest 1 view (71045)
range across 2 matching MRF lines		 $112–$137 $112–$137 varies
Chest 2 views (71046) $172 $172 2.1×
Clavicle complete (73000) $122 $122 1.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $560 $560 5.6×
CT abdomen and pelvis without and with contrast (74178) $2,530 $2,530 7.5×
CT abdomen and pelvis without contrast (74176) $1,590 $1,590 6.9×
CT abdomen w contrast (74160) $1,490 $1,490 8.8×
CT abdomen w wo contrast (74170) $1,910 $1,910 11.3×
CT abdomen w/o contrast (74150) $1,170 $1,170 11.6×
CT Angio Abdomen and Pelvis (74174) $2,160 $2,160 6.4×
CT Angio Chest (71275) $2,000 $2,000 11.9×
CT Angio Head (70496) $1,200 $1,200 7.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $790 $790 4.7×
CT Angio Neck (70498) $1,220 $1,220 7.2×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,390 $1,390 8.2×
CT cervical spine w/o contrast (72125) $1,230 $1,230 12.2×
CT chest w contrast (71260) $1,490 $1,490 8.8×
CT chest w/wo contrast (71270) $1,870 $1,870 11.1×
CT head/brain without and with contrast (70470) $1,480 $1,480 8.8×
CT lower ext w/o (73700) $1,080 $1,080 10.7×
CT lower extremity w/contrast material (73701) $1,300 $1,300 7.7×
CT lumbar spine w contrast (72132) $1,490 $1,490 4.4×
CT lumbar spine w/o contrast (72131) $1,230 $1,230 12.2×
CT maxillofacial w contrast (70487) $1,290 $1,290 7.7×
CT maxillofacial wo contrast (70486) $1,060 $1,060 10.5×
CT neck tissue combo (70492) $1,580 $1,580 9.4×
CT orbits w/o contrast (70480) $1,140 $1,140 11.3×
CT pelvis w&w/o contrast (72194) $1,810 $1,810 10.7×
CT pelvis w/o contrast (72192) $1,210 $1,210 12.0×
CT scan of leg combo (73702) $1,680 $1,680 10.0×
CT scans face/jaw combo (70488) $1,600 $1,600 9.5×
CT soft tissue neck w contrast (70491) $1,260 $1,260 7.5×
CT soft tissue neck w/o contrast (70490) $1,050 $1,050 10.4×
CT thoracic spine w/o contrast (72128) $1,230 $1,230 12.2×
CT thorax w/o contrast (71250) $1,230 $1,230 12.2×
CT upper ext wo (73200) $1,080 $1,080 10.7×
CT upper extremity with contrast (73201) $1,300 $1,300 3.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,290 $1,290 7.7×
Cta Abdomen (74175) $1,670 $1,670 9.9×
Dxa Bone Density Axial (77080) $229 $229 2.3×
Esophagram (74220) $331 $331 2.0×
Fetal Biophys Profile W/Nst (76818) $219 $219 2.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $390 $390 3.9×
Fluoroscopy up to 1 hr (76000) $403 $403 1.8×
Foot 2 views (73620) $122 $122 1.5×
Forearm 2 views (73090) $122 $122 1.5×
Hand 2 views (73120) $122 $122 1.2×
Hepatobil Syst Image W/Drug (78227) $1,146 $1,146 2.2×
Hepatobiliary System Imaging (78226) $1,146 $1,146 3.0×
K Flow/Funct Image W/Drug (78708) $1,011 $1,011 1.9×
Knee 3 Views (73562) $147 $147 1.8×
MRA head w/o contrast (70544) $2,520 $2,520 11.0×
Mra Neck W/O &W/Contrast Material (70549) $4,600 $4,600 13.7×
MRA neck w/o contrast (70547) $2,520 $2,520 11.0×
MRI abdomen w/o contrast (74181) $2,340 $2,340 10.2×
MRI any jt lower extrem w/contrast material (73722) $2,780 $2,780 3.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,700 $4,700 14.0×
MRI any jt upper extremity w/contrast matrl (73222) $2,770 $2,770 3.7×
MRI cervical spine w/o cont (72141) $2,360 $2,360 10.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,770 $4,770 14.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,420 $2,420 10.6×
Mri Neck Spine W/O & W/Dye (72156) $4,770 $4,770 14.2×
MRI orbit face &/neck w/o contrast (70540) $2,420 $2,420 10.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,760 $4,760 14.2×
MRI pelvis w/o & w contrast (72197) $4,770 $4,770 14.2×
MRI pelvis w/o contrast (72195) $2,430 $2,430 10.6×
MRI thoracic spine w/o contrast (72146) $2,560 $2,560 11.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,440 $2,440 10.6×
Mri Uppr Extremity W/O&W/Dye (73220) $4,770 $4,770 14.2×
MRI, abdomen, combo (74183) $4,780 $4,780 14.3×
MRI, dorsal spine combo (72157) $4,680 $4,680 14.0×
MRI, joint upper extrem (73221) $2,390 $2,390 10.4×
MRI, joint upper extrem combo (73223) $4,710 $4,710 14.0×
MRI, lumbar spine combo (72158) $4,770 $4,770 14.2×
Neck soft tissue (70360) $112 $112 1.3×
Parathyroid Planar Imaging (78070) $964 $964 2.5×
Parathyroid planar imaging w/wo subtraction (78071) $1,560 $1,560 4.1×
Pelvis 1 or 2 views (72170) $122 $122 1.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $185 $185 1.8×
Radex Ankle Complete Minimum 3 Views (73610) $137 $137 1.6×
Radex Calcaneus Minimum 2 Views (73650) $122 $122 1.5×
Radex elbow complete minimum 3 views (73080) $147 $147 1.8×
Radex Facial Bones Complete Minimum 3 Views (70150) $195 $195 1.9×
Radex fingr minimum 2 views (73140) $122 $122 1.5×
Radex foot complete minimum 3 views (73630) $137 $137 1.6×
Radex Hand Minimum 3 Views (73130) $137 $137 1.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $137 $137 1.6×
Radex Ribs Unilateral 2 Views (71100) $147 $147 1.8×
Radex shoulder complete minimum 2 views (73030) $137 $137 1.6×
Radex Sinuses Paransl < 3 Views (70210) $110 $110 1.3×
Radex Toe Minimum 2 Views (73660) $112 $112 1.3×
Radex Wrist Complete Minimum 3 Views (73110) $147 $147 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $184 $184 1.8×
Radiologic exam colon double contrast study (74280) $683 $683 4.1×
Radiologic exam knee complete 4/more views (73564) $172 $172 1.7×
Radiologic exam pelvis compl minimum 3 views (72190) $172 $172 1.7×
Radiologic Exam Small Int Single Contrast Study (74250) $379 $379 2.2×
Radiologic exam swallow function contrast study (74230) $342 $342 2.0×
Radiologic examination femur 1 view (73551) $137 $137 1.6×
Radiologic examination femur minimum 2 views (73552) $137 $137 1.6×
Radiologic examination knee 1/2 views (73560) $137 $137 1.6×
Radiologic examination tibia & fibula 2 views (73590) $122 $122 1.5×
Scapula (73010) $137 $137 1.4×
Screening Digital Breast Tomosynthesis Bi (77063) $29 $29 1.2×
Shoulder 1 view (73020) $112 $112 1.3×
Shoulder Arthrography (73040) $383 $383 1.1×
Skull less than 4 views (70250) $160 $160 1.6×
Thoracic spine 2 views (72070) $160 $160 1.6×
Thoracic spine 3 views (72072) $185 $185 1.8×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $305–$508 $305–$508 varies
Ultrasound Exam Aaa Screen (76706) $170 $170 1.7×
Ultrasound, abdomen limited (76705)
range across 5 matching MRF lines		 $301–$396 $301–$396 varies
Unlisted Dx Radiographic Procedure (76499) $52 $52 0.6×
Upper gi w/o kub (74240)
range across 2 matching MRF lines		 $390–$660 $390–$660 varies
Us breast unilateral complete (76641)
range across 3 matching MRF lines		 $305–$563 $305–$563 varies
Us chest (76604) $342 $342 3.4×
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines		 $150–$452 $150–$452 varies
Us head (76506) $415 $415 4.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $440 $440 4.4×
Us ob detailed single fetus (76811) $841 $841 3.7×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $348–$366 $348–$366 varies
Us ob transvaginal (76817) $390 $390 3.9×
Us pelvic non ob complete (76856) $440 $440 4.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $524 $524 5.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $342 $342 3.4×
Us retroperitoneal complete (76770) $524 $524 5.2×
Us retroperitoneal limited (76775) $390 $390 3.9×
Us scrotum and contents (76870) $866 $866 8.6×
Us thyroid (76536) $415 $415 4.1×
Wrist 2 views (73100) $122 $122 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $172 $172 2.1×
X-Ray Bend Only L-S Spine (72120) $203 $203 2.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $122 $122 1.5×
X-Ray Exam Entire Spi 2/3 Vw (72082) $185 $185 1.8×
X-Ray Exam Hip Uni 1 View (73501) $112 $112 1.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $147 $147 1.8×
X-Ray Exam Hip Uni 4/> Views (73503) $147 $147 1.5×
X-Ray Exam Hips Bi 2 Views (73521) $172 $172 1.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $172 $172 1.7×
X-Ray Exam Hips Bi 5/> Views (73523) $181 $181 1.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $160 $160 1.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $280 $280 2.8×
X-Ray Exam Unilat Ribs/Chest (71101) $172 $172 1.7×
X-ray eye for foreign body (70030) $112 $112 1.3×
X-ray humerus (73060) $137 $137 1.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $137 $137 1.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $172 $172 1.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $232 $232 2.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $160 $160 1.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $137 $137 1.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $137 $137 1.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $185 $185 2.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $210 $210 2.1×
X-Ray Stress View (77071) $52 $52 0.6×
X-ray thoracic spine 4 vw (72074) $156 $156 1.6×
X-Ray Tmj Unilat (70328) $122 $122 1.5×
X-Rays Bone Survey Complete (77075) $390 $390 3.9×
Xr c-spine 4 or 5 views (72050) $232 $232 2.3×
Xr facial bones less than 3 views (70140) $132 $132 1.6×
Xr orbits complete 4 views (70200) $195 $195 1.9×

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.