Imaging prices at Franciscan Healthcare

West Point, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $498 $498 4.6×
Acute gastrointestinal blood loss imaging (78278) $2,710 $2,710 6.5×
Ankle 2 views (73600) $408 $408 4.5×
Arthrogram hip (73525) $927 $927 2.6×
Arthrogram shoulder (73040) $1,063 $1,063 2.9×
Bone &/Joint Imaging Limited Area (78300) $1,846 $1,846 4.4×
Bone &/Joint Imaging Multiple Areas (78305) $2,549 $2,549 6.1×
Bone &/joint imaging whole body (78306) $3,415 $3,415 8.2×
Bone age studies (77072) $277 $277 2.6×
Bone Imaging 3 Phase (78315) $3,822 $3,822 9.2×
Bone survey complete (77075) $1,528 $1,528 14.1×
Brain image w/flow 4 + views (78606) $1,867 $1,867 3.3×
Brain Imaging Minimum 4 Static Views (78605) $1,594 $1,594 2.8×
Brain Imaging Pet Metabolic Evaluation (78608) $7,851 $7,851 5.3×
Cervical spine 2 or 3 views (72040) $615 $615 6.8×
Chest 1 view (71045) $390 $390 4.3×
Chest 3 views (71047) $542 $542 6.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $879 $879 4.8×
Clavicle complete (73000) $541 $541 6.0×
CT abdomen and pelvis without and with contrast (74178) $8,208 $8,208 22.7×
CT abdomen and pelvis without contrast (74176) $6,612 $6,612 26.7×
CT abdomen w contrast (74160) $4,532 $4,532 24.9×
CT abdomen w wo contrast (74170) $5,709 $5,709 31.3×
CT abdomen w/o contrast (74150) $4,067 $4,067 37.5×
CT angiography upper extremity lt (73206) $3,839 $3,839 21.1×
CT c-spine w/o contrast (72125) $3,600 $3,600 33.2×
CT cervical spine with contrast (72126) $3,757 $3,757 10.4×
CT chest w/wo contrast (71270) $4,193 $4,193 23.0×
CT chest with contrast (71260) $4,168 $4,168 22.9×
CT head/brain with contrast (70460) $3,731 $3,731 20.5×
CT head/brain without and with contrast (70470) $4,548 $4,548 25.0×
CT heart no contrast quant eval coronry calcium (75571) $165 $165 1.8×
CT iac w contrast (70481) $3,959 $3,959 21.7×
CT limited/localized follow up study (76380) $1,928 $1,928 21.3×
CT lower ext w/o (73700) $3,239 $3,239 29.8×
CT lower extremity w wo contrast (73702) $3,765 $3,765 20.7×
CT lower extremity with contrast (73701) $3,319 $3,319 18.2×
CT lumbar spine w & w/o contrast (72133) $4,212 $4,212 23.1×
CT lumbar spine w/o contrast (72131) $3,792 $3,792 34.9×
CT lumbar spine with contrast (72132) $3,875 $3,875 10.7×
CT maxillofacial w contrast (70487) $3,338 $3,338 18.3×
CT maxillofacial w/o contrast (70486) $3,131 $3,131 28.8×
CT maxillofacial w/wo contrast (70488) $3,705 $3,705 20.3×
CT neck soft tissue w contrast (70491) $3,900 $3,900 21.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $4,230 $4,230 23.2×
CT orbits w/o contrast (70480) $3,591 $3,591 33.1×
CT pelvis w & w/o contrast (72194) $4,358 $4,358 23.9×
CT pelvis w/o contrast (72192) $4,150 $4,150 38.2×
CT soft tissue neck w/o & w/contrast material (70492) $4,073 $4,073 22.4×
CT soft tissue neck w/o contrast (70490) $3,607 $3,607 33.2×
CT thoracic spine w/contrast (72129) $3,973 $3,973 21.8×
CT thoracic spine w/o contrast (72128) $3,861 $3,861 35.6×
CT thoracic spine w/wo contrast (72130) $4,513 $4,513 24.8×
CT thorax w/o contrast (71250) $4,028 $4,028 37.1×
CT upper extremity w/o & w/contrast material (73202) $3,497 $3,497 19.2×
CT upper extremity w/o contrast rt (73200) $2,942 $2,942 27.1×
CT upper extremity with contrast (73201) $2,977 $2,977 8.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $5,554.50 $5,554.50 30.5×
Cta Abdomen (74175) $5,228 $5,228 28.7×
CTA abdomen pelvis (74174) $7,142 $7,142 19.7×
CTA chest (71275) $4,673 $4,673 25.7×
Cta Head (70496) $3,443 $3,443 18.9×
Cta Neck (70498) $3,904 $3,904 21.4×
Cystography minimum 3 views rs&i (74430) $785 $785 2.2×
Dxa bone density study 1/> sites axial skel (77080) $865 $865 8.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $339 $339 3.8×
Dxa bone density study axial skeleton (77085) $1,035 $1,035 9.5×
Echoencephalography real time imaging (76506) $946 $946 8.7×
Esophagus (74220) $940 $940 5.2×
Fetal biophysical profile non-stress testing (76818) $1,022 $1,022 9.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $637 $637 5.9×
Fluoroscopy up to 1 hr (76000) $1,074 $1,074 4.3×
Foot 2 views (73620) $395 $395 4.4×
Forearm 2 views (73090) $494 $494 5.5×
Gated Heart Planar Single (78472) $3,434 $3,434 8.3×
Hand 2 views (73120) $450 $450 4.1×
Hand 3 views (73130) $563 $563 6.2×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $3,407 $3,407 6.0×
Hepatobiliary syst imaging including gallbladder (78226) $2,721 $2,721 6.6×
Ht muscle image spect sing (78451) $6,281 $6,281 4.7×
Humerus Min 2 Views Left (73060) $550 $550 6.1×
Hysterosalpingogram (74740) $1,371 $1,371 5.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $2,680 $2,680 4.8×
Kidney img morphology vascular flow 1 w/rx (78708) $3,144 $3,144 5.6×
Kidney Img Morphology Vascular Flow Multiple (78709) $3,437 $3,437 6.1×
Knee 3 views (73562) $634 $634 7.0×
Liver & spleen imaging static only (78215) $2,707 $2,707 6.5×
Liver & Spleen Imaging W/Vascular Flow (78216) $2,945 $2,945 7.1×
Lung perf&ventilat diferentl (78598) $5,377 $5,377 9.5×
Lung perfusion differential (78597) $2,349 $2,349 5.7×
Lung Ventilation Imaging (78579) $3,990 $3,990 9.6×
Lymphoscintigraphy (78195) $3,215 $3,215 5.7×
Manual appl stress pfrmd phys/qhp joint films (77071) $389 $389 4.3×
Meckels Diverticulum (78290) $2,384 $2,384 5.7×
MRA head w & w/o contrast (70546) $5,925 $5,925 16.4×
MRA head w/o contrast (70544) $5,094 $5,094 20.6×
MRA head with contrast (70545) $5,529 $5,529 15.3×
MRA neck w contrast (70548) $4,965 $4,965 13.7×
Mra Neck W/O &W/Contrast Material (70549) $5,392 $5,392 14.9×
MRA neck w/o contrast (70547) $4,355 $4,355 17.6×
MRI abdomen w/o & w/contrast material (74183) $6,161 $6,161 17.0×
MRI abdomen w/o contrast (74181) $4,079 $4,079 16.5×
MRI any jnt lwr ext with con lt (73722) $4,212 $4,212 5.2×
MRI any jt upper extremity w/contrast matrl (73222) $4,082 $4,082 5.0×
MRI bone marrow blood supply (77084) $3,595 $3,595 14.5×
MRI c-spine with contrast (72142) $6,572 $6,572 18.1×
MRI cervical spine w/o contrast (72141) $6,300 $6,300 25.4×
MRI chest w/o & w/contrast material (71552) $5,436 $5,436 15.0×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $4,243 $4,243 11.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $4,449 $4,449 12.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,139 $4,139 16.7×
MRI orbit face &/neck w/o contrast (70540) $6,002 $6,002 24.2×
MRI orbit/face/neck w&w/o cont (70543) $6,702 $6,702 18.5×
MRI pelvis w contrast (72196) $5,348 $5,348 14.8×
MRI pelvis w/o & w/contrast material (72197) $5,605 $5,605 15.5×
MRI pelvis w/o contrast (72195) $4,760 $4,760 19.2×
MRI scan of arm joint before and after contrast (73223) $4,448 $4,448 12.3×
MRI scan of leg joint before and after contrast (73723) $4,690 $4,690 12.9×
MRI spinal canal cervical w/o & w/contr matrl (72156) $7,162 $7,162 19.8×
MRI spinal canal lumbar w/contrast material (72149) $6,308 $6,308 17.4×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $7,027 $7,027 19.4×
MRI spinal canal thoracic w/contrast matrl (72147) $6,760 $6,760 18.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $7,162 $7,162 19.8×
MRI thoracic spine w/o contrast (72146) $6,417 $6,417 25.9×
MRI tmj (70336) $5,019 $5,019 20.3×
MRI upper ext joint w/o contrast (73221) $4,053 $4,053 16.4×
MRI upper extrem other than jt w/o & w/contras (73220) $5,010 $5,010 13.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,776 $3,776 15.2×
Myocardial Spect Multiple Studies (78452) $7,755 $7,755 5.8×
Neck soft tissue (70360) $492 $492 5.4×
Nm csf leak detection (78650) $1,867 $1,867 1.4×
Nm gastric emptying study (78264) $3,455 $3,455 8.3×
Nuclear medicine study of kidney and blood flow (78701) $2,393 $2,393 5.8×
Nuclear Rx Oral Admin (79005) $3,172 $3,172 13.1×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $512 $512 4.7×
Osseous survey infant (77076) $1,010 $1,010 9.3×
Osseous survey limited (77074) $1,283 $1,283 11.8×
Parathyrd planar w/wo subtrj (78071) $1,916 $1,916 4.6×
Parathyroid imaging (78070) $1,943 $1,943 4.7×
Pelvis 1 or 2 views (72170) $500 $500 4.6×
PET image w/CT, skull-thigh (78815) $9,935 $9,935 6.7×
PET imaging CT for attenuation limited area (78814) $10,219 $10,219 6.9×
PET imaging for CT attenuation whole body (78816) $9,462 $9,462 6.4×
PET imaging limited area chest head/neck (78811) $10,219 $10,219 7.6×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,890 $4,890 13.5×
Pulmonary Perfusion Imaging Particulate (78580) $2,220 $2,220 5.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $3,839 $3,839 6.8×
Radex abscess/fistula/sinus tract rs&i (76080) $2,653 $2,653 4.7×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $623 $623 6.9×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $597 $597 5.5×
Radex hips bilateral with pelvis 2 views (73521) $722 $722 6.7×
Radex mastoids compl minimum 3 views pr side (70130) $801 $801 7.4×
Radiolog exam mandible compl minimum 4 views (70110) $723 $723 6.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $491 $491 5.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $533 $533 5.9×
Radiologic exam colon single contrast study (74270) $1,004 $1,004 5.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,188 $1,188 6.5×
Radiologic exam upr gi trc double contrast study (74246) $1,368 $1,368 7.5×
Radiologic exam upr gi trc single contrast study (74240) $859 $859 4.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $548 $548 6.1×
Ribs bilateral 3 views (71110) $764 $764 7.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,153 $2,153 5.2×
Rp loclzj tum plnr whole body single day imaging (78802) $3,827 $3,827 6.8×
Rp loclzj tum spect 1 area single day imaging (78803) $4,673 $4,673 8.3×
Sacroiliac Joints < 3 Views (72200) $678 $678 6.2×
Scanogram (77073) $545 $545 5.0×
Scapula complete (73010) $523 $523 4.8×
Screening digital breast tomosynthesis (77063) $75 $75 3.2×
Sella turcica (70240) $338 $338 3.7×
Shuntogram indwelling nonvascular shunt rs&i (75809) $866 $866 8.0×
Small bowel series (74250) $1,014 $1,014 5.6×
Spine thoracic 3 views (72072) $806 $806 7.4×
Testicular Imaging With Vascular Flow (78761) $1,772 $1,772 4.3×
Thoracolumbar 2 views (72080) $919 $919 10.2×
Thyroid Imaging With Vascular Flow (78013) $1,257 $1,257 3.0×
Thyroid uptake measurement (78012) $1,035 $1,035 2.5×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,398 $2,398 5.8×
Ultrasound, abdomen limited (76705) $966 $966 8.9×
Umbilical-artery Doppler (OB) (76820) $399 $399 3.7×
Unlisted magnetic resonance procedure (76498) $6,192 $6,192 68.5×
Upper Extremity Infant (73092) $480 $480 4.4×
Urethrocystography voiding (74455) $784 $784 3.2×
Us abdl aorta screen aaa (76706) $1,138 $1,138 10.5×
Us breast unilateral complete (76641) $839 $839 7.7×
Us breast unilateral limited (76642) $591 $591 6.5×
Us chest (76604) $877 $877 8.1×
Us compl joint r-t w/image documentation (76881) $929 $929 8.6×
Us elastography parenchyma (76981) $400 $400 3.7×
Us fetal nuchal translucency 1st gestation (76813) $458 $458 4.2×
Us guided compression repair (76936) $925 $925 4.1×
Us infant hips dynamic (76885) $1,029 $1,029 11.4×
Us kidney transplant (76776) $1,190 $1,190 11.0×
Us ob detailed single fetus (76811) $1,224 $1,224 4.9×
Us ob transvaginal (76817) $801 $801 7.4×
Us pelvic non ob complete (76856) $1,397 $1,397 12.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $507 $507 4.7×
Us pregnancy ltd (76815) $772 $772 7.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $1,027 $1,027 9.5×
Us retroperitoneal complete (76770) $1,121 $1,121 10.3×
Us retroperitoneal limited (76775) $1,125 $1,125 10.4×
Us scrotum and contents (76870) $1,067 $1,067 9.8×
Us soft tissue head/neck (76536) $1,000 $1,000 9.2×
Us transrectal (76872) $1,019 $1,019 9.4×
Us xtr non-vasc lmtd (76882) $874 $874 8.1×
Vertebral fracture assessment via dxa (77086) $207 $207 2.3×
Wrist 2 views (73100) $378 $378 4.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $880 $880 8.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $492 $492 5.4×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $548 $548 6.1×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,632 $1,632 9.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $491 $491 5.4×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $562 $562 6.2×
X-ray exam hip uni 1 view (73501) $372 $372 4.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $545 $545 6.0×
X-ray exam of femur 1 (73551) $548 $548 6.1×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $1,193 $1,193 6.5×
X-ray eye for foreign body (70030) $345 $345 3.8×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $713 $713 6.6×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $458 $458 5.1×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $586 $586 6.5×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $410 $410 4.5×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $690 $690 6.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $421 $421 4.7×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $338 $338 3.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $809 $809 7.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $1,316 $1,316 12.1×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $916 $916 8.4×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $569 $569 6.3×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $544 $544 6.0×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $763 $763 7.0×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $664 $664 6.1×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $792 $792 2.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $559 $559 6.2×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $694 $694 6.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $920 $920 8.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $563 $563 5.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $509 $509 5.6×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $500 $500 5.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $638 $638 7.1×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $488 $488 5.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $723 $723 6.7×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $466 $466 4.3×
X-Ray Spine One View - Xr Spine (72020) $460 $460 5.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $503 $503 5.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $553 $553 6.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $721 $721 6.6×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $378 $378 4.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $554 $554 6.1×
Xr arthrogram ankle (73615) $1,264 $1,264 3.5×
Xr c-spine 6 or more views (72052) $1,369 $1,369 12.6×
Xr chest 4+ views (71048) $1,928 $1,928 17.8×
Xr finger(s) 2+ views (73140) $378 $378 4.2×
XR Mastoids < 3 Views Bilateral (70120) $547 $547 5.0×
Xr myelogram posterior fossa (70010) $798 $798 2.2×
Xr shoulder 1 view (73020) $420 $420 4.6×
Xr spine cervical 4 or 5 views (72050) $907 $907 8.4×
Xr tibia/fibula 2 views (73590) $567 $567 6.3×
Xr tmj bilateral (70330) $874 $874 9.7×
Xray knee 1 or 2 views rt (73560) $565 $565 6.3×