Imaging prices at Franklin County Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $284 $315 3.1×
Abdomen 2 views (74019) $356 $395 3.3×
Ankle 2 views (73600) $239 $265 2.6×
Bone age studies (77072) $246 $273 2.3×
Bone Imaging 3 Phase (78315) $2,084 $2,316 5.0×
Bone Imaging Multiple Areas (78305) $1,835 $2,039 4.4×
Bone Imaging Whole Body (78306) $1,771 $1,968 4.3×
Chest 1 view (71045) $261 $290 2.9×
Chest 2 views (71046)
range across 2 matching MRF lines		 $319–$329 $354–$366 varies
Chest 3 views (71047) $392 $436 4.3×
Chest 4 or more views (71048) $324 $360 3.0×
Cholecystography Oral Contrast (74290) $142 $158 0.8×
Clavicle complete (73000) $272 $302 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271)
range across 2 matching MRF lines		 $77–$1,890 $86–$2,100 varies
CT abdomen and pelvis without and with contrast (74178) $5,136 $5,707 14.2×
CT abdomen and pelvis without contrast (74176) $3,775 $4,194 15.2×
CT abdomen w contrast (74160) $2,550 $2,833 14.0×
CT abdomen w wo contrast (74170) $3,012 $3,347 16.5×
CT abdomen w/o contrast (74150) $2,196 $2,440 20.2×
CT Angio Abdomen and Pelvis (74174) $5,163 $5,737 14.3×
CT Angio Chest (71275) $3,224 $3,582 17.7×
CT Angio Head (70496) $2,919 $3,243 16.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $4,056 $4,507 22.3×
CT Angio Neck (70498) $2,918 $3,242 16.0×
CT cervical spine w/ contrast (72126) $2,748 $3,053 7.6×
CT cervical spine w/o contrast (72125) $2,343 $2,603 21.6×
CT chest w contrast (71260) $2,510 $2,789 13.8×
CT chest w/wo contrast (71270) $2,927 $3,252 16.1×
CT head/brain with contrast (70460) $2,225 $2,472 12.2×
CT head/brain without and with contrast (70470) $2,547 $2,830 14.0×
CT iac w contrast (70481) $2,378 $2,642 13.1×
CT l-spine w&w/o contrast (72133) $3,069 $3,410 16.8×
CT lower ext w/o (73700) $2,083 $2,314 19.2×
CT lower extremity w/contrast material (73701) $2,291 $2,545 12.6×
CT lumbar spine w contrast (72132) $2,933 $3,259 8.1×
CT lumbar spine w/o contrast (72131) $2,321 $2,579 21.4×
CT maxillofacial w contrast (70487) $2,168 $2,409 11.9×
CT maxillofacial wo contrast (70486) $1,820 $2,022 16.8×
CT neck tissue combo (70492) $2,701 $3,001 14.8×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,458 $2,731 13.5×
CT orbits w/o contrast (70480) $2,146 $2,384 19.8×
CT pelvis w&w/o contrast (72194) $2,929 $3,254 16.1×
CT pelvis w/o contrast (72192) $2,213 $2,459 20.4×
CT scan of leg combo (73702) $2,777 $3,086 15.2×
CT scans face/jaw combo (70488) $2,434 $2,704 13.4×
CT soft tissue neck w contrast (70491) $2,363 $2,626 13.0×
CT soft tissue neck w/o contrast (70490) $2,046 $2,273 18.8×
CT thoracic spine w contrast (72129) $2,383 $2,648 13.1×
CT thoracic spine w/o contrast (72128) $2,327 $2,586 21.4×
CT thoracic spine w/wo cont (72130) $2,544 $2,827 14.0×
CT thorax w/o contrast (71250) $2,251 $2,501 20.7×
CT upper ext wo (73200) $2,004 $2,227 18.5×
CT upper extremity w/o & w/contrast material (73202) $2,902 $3,224 15.9×
CT upper extremity with contrast (73201) $2,244 $2,493 6.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,259 $3,621 17.9×
Cta Abdomen (74175) $3,497 $3,885 19.2×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $5,859 $6,510 16.2×
Dxa Bone Density Axial (77080) $449 $499 4.1×
Esophagram (74220) $627 $697 3.4×
Foot 2 views (73620) $240 $267 2.7×
Forearm 2 views (73090) $257 $285 2.8×
Gated Heart Planar Single (78472) $1,996 $2,218 4.8×
Hand 2 views (73120) $248 $276 2.3×
Hepatobil Syst Image W/Drug (78227) $1,835 $2,039 3.3×
Ht Muscle Image Spect Sing (78451) $2,707 $3,008 2.0×
Joint Survey Single View (77077) $207 $230 1.9×
Knee 3 Views (73562) $359 $399 4.0×
Magnetic Image Jaw Joint (70336) $2,537 $2,819 10.2×
Mra Head W/O & W/Contrast Material (70546) $3,517 $3,908 9.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,404 $3,782 9.4×
MRI brain functional w/o physician admnistration (70554) $1,966 $2,184 7.9×
MRI cervical spine w/o cont (72141) $3,283 $3,648 13.3×
MRI chest wo w contrast (71552) $3,656 $4,062 10.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,266 $3,629 9.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,623 $2,914 10.6×
MRI lumbar spine w contrast (72149) $3,420 $3,800 9.4×
Mri Neck Spine W/O & W/Dye (72156) $4,108 $4,564 11.3×
MRI orbit face &/neck w/o contrast (70540) $3,226 $3,584 13.0×
MRI orbit face neck w contrast (70542) $3,147 $3,497 8.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,561 $3,957 9.8×
MRI pelvis w/o & w contrast (72197) $3,991 $4,434 11.0×
MRI pelvis w/o contrast (72195) $3,063 $3,403 12.4×
MRI thoracic spine w/o contrast (72146) $3,391 $3,768 13.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,573 $2,859 10.4×
Mri Uppr Extremity W/O&W/Dye (73220) $3,291 $3,657 9.1×
MRI, abdomen, combo (74183) $4,077 $4,530 11.3×
MRI, dorsal spine combo (72157) $4,051 $4,501 11.2×
MRI, joint upper extrem (73221) $2,457 $2,730 9.9×
MRI, joint upper extrem combo (73223) $3,549 $3,943 9.8×
MRI, lumbar spine combo (72158) $3,956 $4,396 10.9×
Myocardial Spect Multiple Studies (78452) $4,052 $4,502 3.0×
Neck soft tissue (70360) $298 $331 3.3×
Nm whole blood volume (78122) $5 $5 0.0×
Pelvis 1 or 2 views (72170) $298 $331 2.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $506 $562 4.7×
Radex Ankle Complete Minimum 3 Views (73610) $306 $340 3.4×
Radex Calcaneus Minimum 2 Views (73650) $235 $261 2.6×
Radex elbow complete minimum 3 views (73080) $318 $353 3.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $416 $462 3.8×
Radex fingr minimum 2 views (73140) $222 $247 2.5×
Radex foot complete minimum 3 views (73630) $304 $338 3.4×
Radex Hand Minimum 3 Views (73130) $297 $330 3.3×
Radex lower extremity infant minimum 2 views (73592) $289 $321 3.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $314 $349 3.5×
Radex Ribs Unilateral 2 Views (71100) $300 $333 3.3×
Radex shoulder complete minimum 2 views (73030) $327 $363 3.6×
Radex Sinuses Paransl < 3 Views (70210) $266 $296 2.9×
Radex Spine 1 View Specify Level (72020) $252 $280 2.8×
Radex Sternum Minimum 2 Views (71120) $303 $337 3.4×
Radex Toe Minimum 2 Views (73660) $221 $246 2.4×
Radex upper extremity infant minimum 2 views (73092) $240 $267 2.2×
Radex Wrist Complete Minimum 3 Views (73110) $291 $323 3.2×
Radiolog exam mandible compl minimum 4 views (70110) $418 $464 3.9×
Radiologic exam knee complete 4/more views (73564) $409 $454 3.8×
Radiologic exam pelvis compl minimum 3 views (72190) $439 $488 4.0×
Radiologic Exam Small Int Single Contrast Study (74250) $645 $717 3.5×
Radiologic examination femur 1 view (73551) $272 $302 3.0×
Radiologic examination femur minimum 2 views (73552) $320 $356 3.5×
Radiologic examination knee 1/2 views (73560) $295 $328 3.3×
Radiologic Examination Osseous Survey Limited (77074) $631 $701 5.8×
Radiologic examination tibia & fibula 2 views (73590) $286 $318 3.2×
Ribs bilateral 3 views (71110) $430 $478 4.0×
Scapula (73010) $334 $371 3.1×
Shoulder 1 view (73020) $243 $270 2.7×
Skull less than 4 views (70250) $273 $303 2.5×
Thoracic spine 2 views (72070) $337 $374 3.1×
Thoracolumbar 2 views (72080) $323 $359 3.6×
Ultrasound Breast Limited (76642) $395 $439 4.4×
Ultrasound, abdomen limited (76705) $646 $718 6.0×
Unlisted us procedure (76999) $532 $591 5.9×
Upper gi w/o kub (74240) $913 $1,014 5.0×
Us breast unilateral complete (76641) $559 $621 5.1×
Us chest (76604) $531 $590 4.9×
Us complete joint (76881) $611 $679 5.6×
Us exam, pelvic, limited (76857) $422 $469 3.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $518 $575 4.8×
Us pelvic non ob complete (76856) $773 $859 7.1×
Us retroperitoneal complete (76770) $770 $856 7.1×
Us retroperitoneal limited (76775) $378 $420 3.5×
Us scrotum and contents (76870) $644 $716 5.9×
Us thyroid (76536) $597 $663 5.5×
Wrist 2 views (73100) $238 $264 2.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $273 $303 3.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines		 $252–$342 $280–$380 varies
X-Ray Exam Entire Spi 1 Vw (72081) $398 $442 4.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $477 $530 4.4×
X-Ray Exam Hip Uni 1 View (73501) $277 $308 3.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $309 $343 3.4×
X-Ray Exam Hips Bi 2 Views (73521) $435 $483 4.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $564 $627 5.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $334 $371 3.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $611 $679 5.6×
X-Ray Exam Unilat Ribs/Chest (71101) $388 $431 3.6×
X-ray eye for foreign body (70030) $234 $260 2.6×
X-ray humerus (73060) $297 $330 3.3×
X-ray IV pyelogram (ivp) (74400) $845 $939 4.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $275 $305 3.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $232 $258 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $402 $447 3.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $517 $574 4.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $356 $395 3.3×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $351 $390 3.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $299 $332 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $382 $424 4.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $419 $466 3.9×
X-Ray Stress View (77071) $204 $227 2.3×
X-Rays Bone Survey Complete (77075) $809 $899 7.5×
Xr c-spine 4 or 5 views (72050) $491 $546 4.5×
Xr facial bones less than 3 views (70140) $275 $305 3.0×
Xr orbits complete 4 views (70200) $428 $475 3.9×

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.