Imaging prices at Froedtert Community Hospital
New Berlin, WI · every code in this section with a posted price and a Medicare benchmark.
203 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $263.73 | $479.50 | 3.0× |
| Abdomen 2 views (74019) | $279.13 | $507.50 | 2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $843.43 | $1,533.50 | 2.1× |
| Angiography extremity bilateral rs&i (75716) | $3,598.38 | $6,542.50 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,284.60 | $5,972 | 1.0× |
| Ankle 2 views (73600) | $228.53 | $415.50 | 2.6× |
| Bone age studies (77072) | $209.55 | $381 | 2.0× |
| Bone Imaging 3 Phase (78315) | $1,735.25 | $3,155 | 4.4× |
| Bone Imaging Limited Area (78300) | $760.10 | $1,382 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $687.23 | $1,249.50 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,550.73 | $2,819.50 | 3.9× |
| Bone survey infant (77076) | $528.83 | $961.50 | 5.1× |
| Chest 1 view (71045) | $154.28 | $280.50 | 1.8× |
| Chest 2 views (71046) | $193.05 | $351 | 2.2× |
| Chest 3 views (71047) | $218.90 | $398 | 2.5× |
| Chest 4 or more views (71048) | $257.13 | $467.50 | 2.5× |
| Clavicle complete (73000) | $238.43 | $433.50 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $509.58 | $926.50 | 4.9× |
| Contrast X-Ray Bladder (74430) | $504.90 | $918 | 1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $281.88 | $512.50 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $3,260.40 | $5,928 | 9.4× |
| CT abdomen and pelvis without contrast (74176) | $2,060.85 | $3,747 | 8.7× |
| CT abdomen w contrast (74160) | $1,529.55 | $2,781 | 8.8× |
| CT abdomen w wo contrast (74170) | $2,024.83 | $3,681.50 | 11.6× |
| CT abdomen w/o contrast (74150) | $1,343.65 | $2,443 | 12.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,156.55 | $3,921 | 6.2× |
| CT Angio Chest (71275) | $1,797.13 | $3,267.50 | 10.3× |
| CT Angio Head (70496) | $1,677.50 | $3,050 | 9.6× |
| CT angio hrt w/3d image (75574) | $2,073.78 | $3,770.50 | 6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,075.15 | $3,773 | 11.9× |
| CT Angio Neck (70498) | $1,677.50 | $3,050 | 9.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,844.43 | $3,353.50 | 10.6× |
| CT cervical spine w/ contrast (72126) | $1,466.58 | $2,666.50 | 4.2× |
| CT cervical spine w/o contrast (72125) | $1,402.50 | $2,550 | 13.5× |
| CT cervical spine w/wo cont (72127) | $2,372.15 | $4,313 | 13.6× |
| CT chest w contrast (71260) | $1,487.20 | $2,704 | 8.5× |
| CT chest w/wo contrast (71270) | $1,999.53 | $3,635.50 | 11.4× |
| CT head/brain with contrast (70460) | $1,246.03 | $2,265.50 | 7.1× |
| CT head/brain without and with contrast (70470) | $1,695.10 | $3,082 | 9.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,914.83 | $3,481.50 | 5.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $27.50 | $50 | 0.3× |
| CT hrt w/3d image congen (75573) | $1,763.85 | $3,207 | 5.1× |
| CT iac w contrast (70481) | $1,571.35 | $2,857 | 9.0× |
| CT l-spine w&w/o contrast (72133) | $1,685.75 | $3,065 | 9.6× |
| CT lower ext w/o (73700) | $1,320.28 | $2,400.50 | 12.7× |
| CT lower extremity w/contrast material (73701) | $1,472.08 | $2,676.50 | 8.4× |
| CT lumbar spine w contrast (72132) | $1,447.88 | $2,632.50 | 4.2× |
| CT lumbar spine w/o contrast (72131) | $1,412.40 | $2,568 | 13.6× |
| CT maxillofacial w contrast (70487) | $1,486.65 | $2,703 | 8.5× |
| CT maxillofacial wo contrast (70486) | $1,265.55 | $2,301 | 12.2× |
| CT neck tissue combo (70492) | $2,136.48 | $3,884.50 | 12.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,069.65 | $3,763 | 11.8× |
| CT orbits w/o contrast (70480) | $1,358.50 | $2,470 | 13.0× |
| CT pelvis w&w/o contrast (72194) | $1,804 | $3,280 | 10.3× |
| CT pelvis w/o contrast (72192) | $1,308.18 | $2,378.50 | 12.6× |
| CT scan of leg combo (73702) | $1,814.73 | $3,299.50 | 10.4× |
| CT scans face/jaw combo (70488) | $1,556.23 | $2,829.50 | 8.9× |
| CT soft tissue neck w contrast (70491) | $1,654.13 | $3,007.50 | 9.5× |
| CT soft tissue neck w/o contrast (70490) | $1,312.30 | $2,386 | 12.6× |
| CT thoracic spine w contrast (72129) | $1,407.18 | $2,558.50 | 8.1× |
| CT thoracic spine w/o contrast (72128) | $1,345.85 | $2,447 | 12.9× |
| CT thoracic spine w/wo cont (72130) | $1,637.08 | $2,976.50 | 9.4× |
| CT thorax w/o contrast (71250) | $1,334.85 | $2,427 | 12.8× |
| CT upper ext wo (73200) | $1,301.03 | $2,365.50 | 12.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,733.60 | $3,152 | 9.9× |
| CT upper extremity with contrast (73201) | $1,527.90 | $2,778 | 4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,889.53 | $3,435.50 | 10.8× |
| Cta Abdomen (74175) | $1,938.75 | $3,525 | 11.1× |
| CTA pelvis (72191) | $1,667.05 | $3,031 | 9.5× |
| Dxa Bone Density Axial (77080) | $358.05 | $651 | 3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $287.65 | $523 | 3.3× |
| Esophagram (74220) | $393.53 | $715.50 | 2.3× |
| Fluoroscopy up to 1 hr (76000) | $415.25 | $755 | 1.7× |
| Foot 2 views (73620) | $301.68 | $548.50 | 3.5× |
| Forearm 2 views (73090) | $236.23 | $429.50 | 2.7× |
| Gated Heart Planar Single (78472) | $1,281.78 | $2,330.50 | 3.2× |
| Hand 2 views (73120) | $290.68 | $528.50 | 2.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,348.88 | $2,452.50 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,262.25 | $2,295 | 3.2× |
| Ht Musc Image Planar Mult (78454) | $1,731.68 | $3,148.50 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $2,384.25 | $4,335 | 1.8× |
| Hysterosalpingogram (74740) | $557.15 | $1,013 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $1,424.50 | $2,590 | 2.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,098.63 | $1,997.50 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $804.93 | $1,463.50 | 2.0× |
| Knee 3 Views (73562) | $300.03 | $545.50 | 3.5× |
| Lung Perf&Ventilat Diferentl (78598) | $1,389.03 | $2,525.50 | 2.6× |
| Lung perfusion differential (78597) | $801.90 | $1,458 | 2.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,461.90 | $2,658 | 2.7× |
| Lung Ventilation Imaging (78579) | $531.58 | $966.50 | 1.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,881.83 | $3,421.50 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $2,813.53 | $5,115.50 | 2.2× |
| Neck soft tissue (70360) | $235.68 | $428.50 | 2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $276.65 | $503 | 2.7× |
| Parathyroid Planar Imaging (78070) | $720.78 | $1,310.50 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,284.80 | $2,336 | 3.2× |
| Pelvis 1 or 2 views (72170) | $231.83 | $421.50 | 2.2× |
| Perineogram (74775) | $402.60 | $732 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,001.28 | $1,820.50 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $401.23 | $729.50 | 3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $467.50 | $850 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $269.23 | $489.50 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $225.23 | $409.50 | 2.6× |
| Radex elbow complete minimum 3 views (73080) | $257.68 | $468.50 | 3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $273.08 | $496.50 | 2.6× |
| Radex fingr minimum 2 views (73140) | $220.55 | $401 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $327.25 | $595 | 3.8× |
| Radex Hand Minimum 3 Views (73130) | $319.83 | $581.50 | 3.7× |
| Radex lower extremity infant minimum 2 views (73592) | $144.10 | $262 | 1.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $97.35 | $177 | 0.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $269.23 | $489.50 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $290.68 | $528.50 | 3.4× |
| Radex shoulder complete minimum 2 views (73030) | $277.75 | $505 | 3.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $138.05 | $251 | 1.6× |
| Radex Spine 1 View Specify Level (72020) | $188.38 | $342.50 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $251.90 | $458 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $281.88 | $512.50 | 3.3× |
| Radex Toe Minimum 2 Views (73660) | $205.15 | $373 | 2.4× |
| Radex upper extremity infant minimum 2 views (73092) | $175.45 | $319 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $240.35 | $437 | 2.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $415.53 | $755.50 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $297 | $540 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $300.03 | $545.50 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $840.95 | $1,529 | 4.8× |
| Radiologic exam colon single contrast study (74270) | $381.43 | $693.50 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $458.15 | $833 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) | $308.55 | $561 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $250.53 | $455.50 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $462.28 | $840.50 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $490.05 | $891 | 2.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $563.75 | $1,025 | 3.2× |
| Radiologic examination femur 1 view (73551) | $319.83 | $581.50 | 3.7× |
| Radiologic examination femur minimum 2 views (73552) | $351.45 | $639 | 4.1× |
| Radiologic examination knee 1/2 views (73560) | $273.90 | $498 | 3.2× |
| Radiologic Examination Osseous Survey Limited (77074) | $352.55 | $641 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $282.43 | $513.50 | 3.3× |
| Ribs bilateral 3 views (71110) | $341.28 | $620.50 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,055.08 | $3,736.50 | 3.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,970.10 | $3,582 | 1.5× |
| Scapula (73010) | $250.53 | $455.50 | 2.4× |
| Shoulder 1 view (73020) | $198.28 | $360.50 | 2.3× |
| Shoulder Arthrography (73040) | $644.33 | $1,171.50 | 1.9× |
| Skull less than 4 views (70250) | $256.58 | $466.50 | 2.5× |
| Sternoclavicular joints (71130) | $339.35 | $617 | 3.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $446.88 | $812.50 | 2.6× |
| Thoracic spine 2 views (72070) | $237.60 | $432 | 2.3× |
| Thoracic spine 3 views (72072) | $257.13 | $467.50 | 2.5× |
| Thoracolumbar 2 views (72080) | $265.65 | $483 | 3.1× |
| Ultrasound Breast Limited (76642) | $402.60 | $732 | 4.6× |
| Ultrasound Exam Aaa Screen (76706) | $545.60 | $992 | 5.2× |
| Ultrasound, abdomen limited (76705) | $487.03 | $885.50 | 4.7× |
| Upper gi w/o kub (74240) | $478.78 | $870.50 | 2.7× |
| Urethrocystogram voiding (74455) | $512.33 | $931.50 | 2.2× |
| Urethrocystography retrograde (74450) | $402.60 | $732 | 1.7× |
| Us chest (76604) | $430.65 | $783 | 4.1× |
| Us exam, pelvic, limited (76857) | $454.03 | $825.50 | 4.4× |
| Us kidney transplant (76776) | $684.48 | $1,244.50 | 6.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $292.60 | $532 | 2.8× |
| Us ob limited 1 or more fetuses (76815) | $381.43 | $693.50 | 3.7× |
| Us ob transvaginal (76817) | $398.75 | $725 | 3.8× |
| Us pelvic non ob complete (76856) | $561 | $1,020 | 5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $395.45 | $719 | 3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $359.43 | $653.50 | 3.5× |
| Us retroperitoneal complete (76770) | $553.58 | $1,006.50 | 5.3× |
| Us retroperitoneal limited (76775) | $473 | $860 | 4.5× |
| Us scrotum and contents (76870) | $430.65 | $783 | 4.1× |
| Us thyroid (76536) | $506.28 | $920.50 | 4.9× |
| Wrist 2 views (73100) | $232.38 | $422.50 | 2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $203.78 | $370.50 | 2.4× |
| X-ray antegrade pyelogram tube (74425) | $567.05 | $1,031 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $275.83 | $501.50 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $233.20 | $424 | 2.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $261.25 | $475 | 3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $350.63 | $637.50 | 3.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $345.95 | $629 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $298.38 | $542.50 | 3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $359.98 | $654.50 | 4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $396 | $720 | 3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $315.15 | $573 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $365.48 | $664.50 | 3.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $223.03 | $405.50 | 2.1× |
| X-Ray Exam L-S Spine Bending (72114) | $409.48 | $744.50 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $268.40 | $488 | 3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $322.58 | $586.50 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $314.60 | $572 | 3.0× |
| X-ray eye for foreign body (70030) | $175.73 | $319.50 | 2.0× |
| X-ray humerus (73060) | $257.95 | $469 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $240.35 | $437 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $219.73 | $399.50 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $286.55 | $521 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $148.23 | $269.50 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $347.33 | $631.50 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $261.80 | $476 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $274.45 | $499 | 3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $329.18 | $598.50 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $282.43 | $513.50 | 2.7× |
| X-ray thoracic spine 4 vw (72074) | $282.98 | $514.50 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $536.80 | $976 | 1.5× |
| X-Rays Bone Length Studies (77073) | $262.35 | $477 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $522.23 | $949.50 | 5.0× |
| Xr c-spine 4 or 5 views (72050) | $303.05 | $551 | 2.9× |
| Xr facial bones less than 3 views (70140) | $249.70 | $454 | 2.9× |
| Xr orbits complete 4 views (70200) | $190.85 | $347 | 1.8× |