Imaging prices at George E Weems Memorial Hospital

Apalachicola, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $243.60 $348 2.7×
Abdomen 2 views (74019) $258.30 $369 2.4×
Ankle 2 views (73600) $100.80 $144 1.1×
Bone age studies (77072) $177.80 $254 1.6×
Chest 1 view (71045) $145.60 $208 1.6×
Chest 2 views (71046) $200.20 $286 2.2×
Clavicle complete (73000) $104.30 $149 1.1×
CT abdomen and pelvis without and with contrast (74178) $2,233.70 $3,191 6.1×
CT abdomen and pelvis without contrast (74176) $1,372 $1,960 5.5×
CT abdomen w contrast (74160) $2,020.90 $2,887 11.0×
CT abdomen w wo contrast (74170) $2,220.40 $3,172 12.1×
CT abdomen w/o contrast (74150) $1,372 $1,960 12.6×
CT cervical spine w/ contrast (72126) $1,382.50 $1,975 3.8×
CT cervical spine w/o contrast (72125) $1,297.80 $1,854 11.9×
CT cervical spine w/wo cont (72127) $1,696.80 $2,424 9.3×
CT chest w contrast (71260) $1,647.80 $2,354 9.0×
CT chest w/wo contrast (71270) $1,845.90 $2,637 10.1×
CT head/brain with contrast (70460) $936.60 $1,338 5.1×
CT head/brain without and with contrast (70470) $2,020.90 $2,887 11.0×
CT iac w contrast (70481) $1,183 $1,690 6.5×
CT l-spine w&w/o contrast (72133) $1,382.50 $1,975 7.5×
CT lower ext w/o (73700) $861.70 $1,231 7.9×
CT lower extremity w/contrast material (73701) $1,019.20 $1,456 5.6×
CT lumbar spine w contrast (72132) $1,248.10 $1,783 3.4×
CT lumbar spine w/o contrast (72131) $1,099 $1,570 10.1×
CT maxillofacial w contrast (70487) $1,073.10 $1,533 5.9×
CT maxillofacial wo contrast (70486) $974.40 $1,392 8.9×
CT neck tissue combo (70492) $1,180.90 $1,687 6.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,397.20 $1,996 7.6×
CT orbits w/o contrast (70480) $987 $1,410 9.0×
CT pelvis w&w/o contrast (72194) $1,796.90 $2,567 9.8×
CT pelvis w/o contrast (72192) $998.20 $1,426 9.1×
CT scan of leg combo (73702) $1,195.60 $1,708 6.5×
CT scans face/jaw combo (70488) $1,248.10 $1,783 6.8×
CT soft tissue neck w contrast (70491) $998.20 $1,426 5.4×
CT soft tissue neck w/o contrast (70490) $842.80 $1,204 7.7×
CT thoracic spine w contrast (72129) $1,136.10 $1,623 6.2×
CT thoracic spine w/o contrast (72128) $981.40 $1,402 9.0×
CT thoracic spine w/wo cont (72130) $1,376.20 $1,966 7.5×
CT thorax w/o contrast (71250) $1,397.20 $1,996 12.8×
CT upper ext wo (73200) $842.80 $1,204 7.7×
CT upper extremity w/o & w/contrast material (73202) $1,187.90 $1,697 6.5×
CT upper extremity with contrast (73201) $981.40 $1,402 2.7×
Doppler Echo Fetal Spectral Display Complete (76827) $98 $140 0.9×
Fetal Biophys Profile W/Nst (76818) $142.11 $203.02 1.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $142.11 $203.02 1.3×
Foot 2 views (73620) $275.10 $393 3.0×
Forearm 2 views (73090) $249.90 $357 2.7×
Hand 2 views (73120) $101.50 $145 0.9×
Knee 3 Views (73562) $231.70 $331 2.5×
Neck soft tissue (70360) $99.40 $142 1.1×
Pelvis 1 or 2 views (72170) $249.90 $357 2.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $424.90 $607 3.9×
Radex Ankle Complete Minimum 3 Views (73610) $299.60 $428 3.3×
Radex Calcaneus Minimum 2 Views (73650) $81.20 $116 0.9×
Radex elbow complete minimum 3 views (73080) $275.10 $393 3.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $156.10 $223 1.4×
Radex fingr minimum 2 views (73140) $225.40 $322 2.5×
Radex foot complete minimum 3 views (73630) $275.10 $393 3.0×
Radex Hand Minimum 3 Views (73130) $325.50 $465 3.6×
Radex lower extremity infant minimum 2 views (73592) $283.50 $405 3.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $419.30 $599 4.6×
Radex Ribs Unilateral 2 Views (71100) $145.60 $208 1.6×
Radex shoulder complete minimum 2 views (73030) $299.60 $428 3.3×
Radex Sinuses Paransl < 3 Views (70210) $143.50 $205 1.6×
Radex Spine 1 View Specify Level (72020) $201.60 $288 2.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $123.20 $176 1.4×
Radex Toe Minimum 2 Views (73660) $225.40 $322 2.5×
Radex upper extremity infant minimum 2 views (73092) $272.30 $389 2.5×
Radex Wrist Complete Minimum 3 Views (73110) $290.50 $415 3.2×
Radiolog exam mandible compl minimum 4 views (70110) $154 $220 1.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $280 $400 2.6×
Radiologic exam knee complete 4/more views (73564) $193.20 $276 1.8×
Radiologic exam pelvis compl minimum 3 views (72190) $231.70 $331 2.1×
Radiologic examination femur minimum 2 views (73552) $364 $520 4.0×
Radiologic examination knee 1/2 views (73560) $177.10 $253 1.9×
Radiologic examination tibia & fibula 2 views (73590) $299.60 $428 3.3×
Ribs bilateral 3 views (71110) $338.80 $484 3.1×
Scapula (73010) $100.80 $144 0.9×
Shoulder 1 view (73020) $104.30 $149 1.1×
Skull less than 4 views (70250) $109.90 $157 1.0×
Sternoclavicular joints (71130) $119 $170 1.3×
Thoracic spine 2 views (72070) $303.80 $434 2.8×
Thoracic spine 3 views (72072) $325.50 $465 3.0×
Ultrasound Breast Limited (76642) $78.69 $112.41 0.9×
Ultrasound Exam Aaa Screen (76706) $142.11 $203.01 1.3×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $69.99–$142.11 $99.99–$203.01 varies
Us complete joint (76881) $142.11 $203.01 1.3×
Us exam, pelvic, limited (76857) $142.11 $203.01 1.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $142.11 $203.01 1.3×
Us ob transvaginal (76817) $142.11 $203.01 1.3×
Us pelvic non ob complete (76856) $142.11 $203.01 1.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $142.11 $203.01 1.3×
Us retroperitoneal complete (76770) $142.11 $203.01 1.3×
Us retroperitoneal limited (76775) $142.11 $203.01 1.3×
Us scrotum and contents (76870) $142.11 $203.01 1.3×
Us thyroid (76536) $142.11 $203.01 1.3×
Wrist 2 views (73100) $249.90 $357 2.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $117.60 $168 1.3×
X-Ray Bend Only L-S Spine (72120) $233.80 $334 2.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $140 $200 1.5×
X-Ray Exam Entire Spi 1 Vw (72081) $147.70 $211 1.6×
X-Ray Exam Hip Uni 1 View (73501) $86.80 $124 1.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $177.10 $253 1.9×
X-Ray Exam Hip Uni 4/> Views (73503) $137.63 $196.62 1.3×
X-Ray Exam Hips Bi 2 Views (73521) $224 $320 2.1×
X-Ray Exam L-S Spine Bending (72114) $231.70 $331 2.1×
X-Ray Exam Neck Spine 2-3 Vw (72040) $154 $220 1.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $499.10 $713 4.6×
X-Ray Exam Unilat Ribs/Chest (71101) $177.10 $253 1.6×
X-ray eye for foreign body (70030) $117.60 $168 1.3×
X-ray humerus (73060) $249.90 $357 2.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $256.90 $367 2.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $117.60 $168 1.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $270.20 $386 2.5×
X-ray nose-rectum child f.b. (76010) $117.60 $168 1.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $338.80 $484 3.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $196 $280 1.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $163.80 $234 1.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $299.60 $428 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $368.90 $527 4.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $154 $220 1.4×
Xr c-spine 4 or 5 views (72050) $350 $500 3.2×
Xr facial bones less than 3 views (70140) $117.60 $168 1.3×
Xr orbits complete 4 views (70200) $143.50 $205 1.3×

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.