Imaging prices at Grant Regional Health Center
Lancaster, WI · every code in this section with a posted price and a Medicare benchmark.
176 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) | $266.50 | $410 | 3.2× |
| Abdomen 2 views (74019) | $390.65 | $601 | 3.8× |
| Ankle 2 views (73600) | $195 | $300 | 2.3× |
| Arthrogram hip (73525) | $157.30 | $242 | 0.5× |
| Bone age studies (77072) | $139.75 | $215 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,947.40 | $2,996 | 5.0× |
| Bone Imaging Limited Area (78300) | $915.85 | $1,409 | 2.4× |
| Bone Imaging Whole Body (78306) | $1,375.40 | $2,116 | 3.5× |
| Chest 1 view (71045) | $215.80 | $332 | 2.6× |
| Chest 2 views (71046) | $296.40 | $456 | 3.5× |
| Chest 4 or more views (71048) | $114.40 | $176 | 1.1× |
| Clavicle complete (73000) | $234 | $360 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $304.20 | $468 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,464.50 | $5,330 | 10.2× |
| CT abdomen and pelvis without contrast (74176) | $2,655.25 | $4,085 | 11.5× |
| CT abdomen w contrast (74160) | $2,294.50 | $3,530 | 13.5× |
| CT abdomen w wo contrast (74170) | $2,832.05 | $4,357 | 16.6× |
| CT abdomen w/o contrast (74150) | $2,294.50 | $3,530 | 22.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,965.65 | $6,101 | 11.7× |
| CT Angio Chest (71275) | $2,107.30 | $3,242 | 12.4× |
| CT Angio Head (70496) | $1,807.65 | $2,781 | 10.6× |
| CT Angio Neck (70498) | $1,826.50 | $2,810 | 10.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $661.05 | $1,017 | 3.9× |
| CT cervical spine w/ contrast (72126) | $386.10 | $594 | 1.1× |
| CT cervical spine w/o contrast (72125) | $1,620.45 | $2,493 | 16.0× |
| CT chest w contrast (71260) | $1,807.65 | $2,781 | 10.6× |
| CT chest w/wo contrast (71270) | $1,756.30 | $2,702 | 10.3× |
| CT head/brain with contrast (70460) | $1,532.70 | $2,358 | 9.0× |
| CT head/brain without and with contrast (70470) | $1,806.35 | $2,779 | 10.6× |
| CT l-spine w&w/o contrast (72133) | $1,550.25 | $2,385 | 9.1× |
| CT lower ext w/o (73700) | $1,558.05 | $2,397 | 15.3× |
| CT lower extremity w/contrast material (73701) | $1,620.45 | $2,493 | 9.5× |
| CT lumbar spine w contrast (72132) | $1,300 | $2,000 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $1,028.95 | $1,583 | 10.1× |
| CT maxillofacial w contrast (70487) | $1,604.85 | $2,469 | 9.4× |
| CT maxillofacial wo contrast (70486) | $1,604.85 | $2,469 | 15.8× |
| CT neck tissue combo (70492) | $1,807.65 | $2,781 | 10.6× |
| CT orbits w/o contrast (70480) | $1,806.35 | $2,779 | 17.8× |
| CT pelvis w&w/o contrast (72194) | $2,052.70 | $3,158 | 12.0× |
| CT pelvis w/o contrast (72192) | $1,289.60 | $1,984 | 12.7× |
| CT scan of leg combo (73702) | $1,620.45 | $2,493 | 9.5× |
| CT soft tissue neck w contrast (70491) | $1,506.70 | $2,318 | 8.8× |
| CT soft tissue neck w/o contrast (70490) | $1,206.40 | $1,856 | 11.9× |
| CT thoracic spine w contrast (72129) | $1,023.75 | $1,575 | 6.0× |
| CT thoracic spine w/o contrast (72128) | $1,620.45 | $2,493 | 16.0× |
| CT thorax w/o contrast (71250) | $1,289.60 | $1,984 | 12.7× |
| CT upper ext wo (73200) | $926.90 | $1,426 | 9.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,620.45 | $2,493 | 9.5× |
| CT upper extremity with contrast (73201) | $1,260.35 | $1,939 | 3.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,814.50 | $4,330 | 16.5× |
| Cta Abdomen (74175) | $2,632.50 | $4,050 | 15.5× |
| Dxa Bone Density Axial (77080) | $573.30 | $882 | 5.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $252.85 | $389 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $338 | $520 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $381.55 | $587 | 3.8× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$241.15–$275.60 | $371–$424 | varies |
| Foot 2 views (73620) | $180.70 | $278 | 2.1× |
| Forearm 2 views (73090) | $269.75 | $415 | 3.2× |
| Hand 2 views (73120) | $180.70 | $278 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $2,109.25 | $3,245 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,119.30 | $1,722 | 2.9× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$46.80–$438.10 | $72–$674 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $294.45 | $453 | 3.5× |
| K Flow/Funct Image W/Drug (78708) | $2,448.55 | $3,767 | 4.6× |
| Knee 3 Views (73562) | $292.50 | $450 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $2,328.30 | $3,582 | 4.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,157.35 | $3,319 | 6.4× |
| MRA head w/o contrast (70544) | $2,054 | $3,160 | 8.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,396.55 | $3,687 | 7.1× |
| MRA neck w/o contrast (70547) | $1,931.15 | $2,971 | 8.3× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,613–$2,832.05 | $4,020–$4,357 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,334.80 | $3,592 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,600 | $4,000 | 7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,180.75 | $3,355 | 2.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,275.70 | $6,578 | 18.4× |
| MRI cervical spine w contrast (72142) | $2,843.10 | $4,374 | 8.4× |
| MRI cervical spine w/o cont (72141) | $2,723.50 | $4,190 | 11.8× |
| MRI chest w/o contrast (71550) | $2,411.50 | $3,710 | 10.4× |
| MRI chest wo w contrast (71552) | $2,112.50 | $3,250 | 6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,580.50 | $3,970 | 7.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,177.50 | $3,350 | 9.4× |
| MRI lumbar spine w contrast (72149) | $2,839.85 | $4,369 | 8.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,012.75 | $4,635 | 8.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,984.45 | $3,053 | 5.9× |
| MRI pelvis w/o & w contrast (72197) | $2,600 | $4,000 | 7.7× |
| MRI pelvis w/o contrast (72195) | $1,898 | $2,920 | 8.2× |
| MRI thoracic spine w/o contrast (72146) | $2,516.15 | $3,871 | 10.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,180.75 | $3,355 | 9.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,297.75 | $3,535 | 6.8× |
| MRI, abdomen, combo (74183) | $2,665 | $4,100 | 7.9× |
| MRI, dorsal spine combo (72157) | $2,843.10 | $4,374 | 8.4× |
| MRI, joint upper extrem (73221) | $1,966.25 | $3,025 | 8.5× |
| MRI, joint upper extrem combo (73223) | $2,392 | $3,680 | 7.1× |
| MRI, lumbar spine combo (72158) | $3,201.90 | $4,926 | 9.4× |
| Myocardial Spect Multiple Studies (78452) | $3,649.10 | $5,614 | 2.9× |
| Neck soft tissue (70360) | $229.45 | $353 | 2.7× |
| Pelvis 1 or 2 views (72170) | $257.40 | $396 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,223.95 | $1,883 | 3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $292.50 | $450 | 3.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $233.35 | $359 | 2.8× |
| Radex elbow complete minimum 3 views (73080) | $269.75 | $415 | 3.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $367.25 | $565 | 3.6× |
| Radex fingr minimum 2 views (73140) | $209.95 | $323 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $232.05 | $357 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $203.45 | $313 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $257.40 | $396 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $222.30 | $342 | 2.6× |
| Radex shoulder complete minimum 2 views (73030) | $322.40 | $496 | 3.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $354.25 | $545 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $234 | $360 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $332.80 | $512 | 3.9× |
| Radex Toe Minimum 2 Views (73660) | $182 | $280 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $282.10 | $434 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $216.45 | $333 | 2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $380.90 | $586 | 3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $404.30 | $622 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) | $352.95 | $543 | 3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $298.35 | $459 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $638.30 | $982 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $451.10 | $694 | 2.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $761.80 | $1,172 | 4.5× |
| Radiologic examination femur 1 view (73551) | $212.55 | $327 | 2.5× |
| Radiologic examination femur minimum 2 views (73552) | $280.15 | $431 | 3.3× |
| Radiologic examination knee 1/2 views (73560) | $237.25 | $365 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $269.75 | $415 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,307.15 | $2,011 | 2.5× |
| Scapula (73010) | $280.80 | $432 | 2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $27.30 | $42 | 1.2× |
| Shoulder 1 view (73020) | $234 | $360 | 2.8× |
| Shoulder Arthrography (73040) | $867.10 | $1,334 | 2.6× |
| Skull less than 4 views (70250) | $281.45 | $433 | 2.8× |
| Thoracic spine 2 views (72070) | $341.90 | $526 | 3.4× |
| Thoracic spine 3 views (72072) | $388.05 | $597 | 3.8× |
| Thoracolumbar 2 views (72080) | $341.90 | $526 | 4.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,270.10 | $1,954 | 3.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$20.49–$271.70 | $31.52–$418 | varies |
| Ultrasound Exam Aaa Screen (76706) | $115.05 | $177 | 1.1× |
| Ultrasound, abdomen limited (76705) | $384.15 | $591 | 3.8× |
| Us chest (76604) | $377 | $580 | 3.7× |
| Us exam, pelvic, limited (76857) | $137.80 | $212 | 1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $388.05 | $597 | 3.8× |
| Us ob limited 1 or more fetuses (76815) | $237.90 | $366 | 2.3× |
| Us ob transvaginal (76817) | $464.10 | $714 | 4.6× |
| Us pelvic non ob complete (76856) | $772.85 | $1,189 | 7.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $377 | $580 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $415.35 | $639 | 4.1× |
| Us retroperitoneal complete (76770) | $385.45 | $593 | 3.8× |
| Us retroperitoneal limited (76775) | $384.15 | $591 | 3.8× |
| Us scrotum and contents (76870) | $829.40 | $1,276 | 8.2× |
| Us spinal canal and contents (76800) | $294.45 | $453 | 2.9× |
| Us thyroid (76536) | $465.40 | $716 | 4.6× |
| Wrist 2 views (73100) | $178.75 | $275 | 2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $280.80 | $432 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $180.05 | $277 | 2.1× |
| X-Ray Exam Breast Specimen (76098) | $185.25 | $285 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $298.35 | $459 | 2.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $256.10 | $394 | 3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $256.10 | $394 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $280.15 | $431 | 2.8× |
| X-Ray Exam L-S Spine Bending (72114) | $603.20 | $928 | 5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $390.65 | $601 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $427.70 | $658 | 4.2× |
| X-ray eye for foreign body (70030) | $395.20 | $608 | 4.7× |
| X-ray humerus (73060) | $234 | $360 | 2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $395.20 | $608 | 4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $237.25 | $365 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $395.85 | $609 | 3.9× |
| X-ray nose-rectum child f.b. (76010) | $280.15 | $431 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $427.70 | $658 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $208.65 | $321 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $208.65 | $321 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $280.80 | $432 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $429 | $660 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $371.15 | $571 | 3.7× |
| Xr facial bones less than 3 views (70140) | $380.90 | $586 | 4.5× |
| Xr orbits complete 4 views (70200) | $354.25 | $545 | 3.5× |
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.