Imaging prices at Grisell Memorial Hospital
Ransom, KS · every code in this section with a posted price and a Medicare benchmark.
198 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) | $222.96 | $234.69 | 2.8× |
| Abdomen 2 views (74019) | $269.33 | $283.50 | 2.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$195.62–$197.51 | $205.92–$207.90 | varies |
| Bone age studies (77072) | $230.65 | $242.79 | 2.4× |
| Bone survey infant (77076) | $180.99 | $190.52 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $870.79 | $916.62 | 2.7× |
| Chest 1 view (71045) | $204.51 | $215.27 | 2.6× |
| Chest 2 views (71046) | $249.50 | $262.63 | 3.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$201.55–$203.49 | $212.16–$214.20 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $757.14 | $796.99 | 7.9× |
| CT abdomen and pelvis without and with contrast (74178) | $757.14 | $796.99 | 2.4× |
| CT abdomen and pelvis without contrast (74176) | $742.72 | $781.81 | 3.4× |
| CT abdomen w contrast (74160) | $936.62 | $985.92 | 5.8× |
| CT abdomen w wo contrast (74170) | $957.60 | $1,008 | 5.9× |
| CT abdomen w/o contrast (74150) | $915.88 | $964.08 | 9.5× |
| CT Angio Abdomen and Pelvis (74174) | $2,820.10 | $2,968.53 | 8.8× |
| CT Angio Chest (71275) | $1,825.43 | $1,921.50 | 11.3× |
| CT Angio Head (70496) | $1,825.43 | $1,921.50 | 11.3× |
| CT Angio Neck (70498) | $1,825.43 | $1,921.50 | 11.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,825.43–$1,898.48 | $1,921.50–$1,998.40 | varies |
| CT cervical spine w/ contrast (72126) | $957.60 | $1,008 | 3.0× |
| CT cervical spine w/o contrast (72125) | $945.63 | $995.40 | 9.8× |
| CT cervical spine w/wo cont (72127) | $987.53 | $1,039.50 | 6.1× |
| CT chest w contrast (71260) | $945.63 | $995.40 | 5.9× |
| CT chest w/wo contrast (71270) | $957.60 | $1,008 | 5.9× |
| CT head/brain without and with contrast (70470) | $957.60 | $1,008 | 5.9× |
| CT iac w contrast (70481) | $945.63 | $995.40 | 5.9× |
| CT l-spine w&w/o contrast (72133) | $957.60 | $1,008 | 5.9× |
| CT lower ext w/o (73700) | $933.66 | $982.80 | 9.7× |
| CT lower extremity w/contrast material (73701) | $948.48 | $998.40 | 5.9× |
| CT lumbar spine w contrast (72132) | $945.63 | $995.40 | 2.9× |
| CT lumbar spine w/o contrast (72131) | $933.66 | $982.80 | 9.7× |
| CT maxillofacial w contrast (70487) | $945.63 | $995.40 | 5.9× |
| CT maxillofacial wo contrast (70486) | $933.66 | $982.80 | 9.7× |
| CT neck tissue combo (70492) | $957.60 | $1,008 | 5.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $957.60 | $1,008 | 5.9× |
| CT orbits w/o contrast (70480) | $933.66 | $982.80 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $957.60 | $1,008 | 5.9× |
| CT pelvis w/o contrast (72192) | $933.66 | $982.80 | 9.7× |
| CT scan of leg combo (73702) | $957.60 | $1,008 | 5.9× |
| CT scans face/jaw combo (70488) | $957.60 | $1,008 | 5.9× |
| CT soft tissue neck w contrast (70491) | $945.63 | $995.40 | 5.9× |
| CT soft tissue neck w/o contrast (70490) | $933.66 | $982.80 | 9.7× |
| CT thoracic spine w contrast (72129) | $945.63 | $995.40 | 5.9× |
| CT thoracic spine w/o contrast (72128) | $933.66 | $982.80 | 9.7× |
| CT thoracic spine w/wo cont (72130) | $957.60 | $1,008 | 5.9× |
| CT thorax w/o contrast (71250) | $933.66 | $982.80 | 9.7× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$867.83–$957.60 | $913.50–$1,008 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $957.60 | $1,008 | 5.9× |
| CT upper extremity with contrast (73201) | $897.75 | $945 | 2.8× |
| Cta Abdomen (74175) | $1,615.65 | $1,700.68 | 10.0× |
| CTA pelvis (72191) | $302.98 | $318.93 | 1.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $180.99 | $190.52 | 1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $180.99 | $190.52 | 1.9× |
| Dxa Bone Density Axial (77080) | $363.89 | $383.04 | 3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $262.14 | $275.94 | 3.3× |
| Echo exam uterus (76831) | $654.60 | $689.05 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $215.46 | $226.80 | 2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $192.66 | $202.80 | 2.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$201.55–$203.49 | $212.16–$214.20 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$213.41–$215.46 | $224.64–$226.80 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$170.57–$172.22 | $179.55–$181.28 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $654.60 | $689.05 | 8.2× |
| Infant hip ultrasound, limited static exam (76886) | $149.85 | $157.74 | 1.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$245.20–$247.56 | $258.11–$260.59 | varies |
| Magnetic Image Jaw Joint (70336) | $870.79 | $916.62 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,047.95 | $1,103.11 | 3.3× |
| MRA head w/o contrast (70544) | $1,028 | $1,082.10 | 4.7× |
| MRA head with contrast (70545) | $1,037.98 | $1,092.61 | 3.2× |
| MRA neck w contrast (70548) | $1,037.98 | $1,092.61 | 3.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,047.95 | $1,103.11 | 3.3× |
| MRA neck w/o contrast (70547) | $1,028 | $1,082.10 | 4.7× |
| MRI abdomen w contrast (74182) | $1,065.33 | $1,121.40 | 3.3× |
| MRI abdomen w/o contrast (74181) | $870.79 | $916.62 | 4.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$889.20–$897.75 | $936–$945 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$948.14–$957.60 | $998.04–$1,008 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$948.48–$957.60 | $998.40–$1,008 | varies |
| MRI bone marrow blood supply (77084) | $837.90 | $882 | 3.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $752.30 | $791.89 | 3.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $752.30 | $791.89 | 3.4× |
| MRI cardiac w/o contrast (75557) | $862.50 | $907.89 | 3.9× |
| MRI cervical spine w contrast (72142) | $885.78 | $932.40 | 2.8× |
| MRI cervical spine w/o cont (72141) | $873.81 | $919.80 | 4.0× |
| MRI chest w/o contrast (71550) | $837.90 | $882 | 3.8× |
| MRI chest with contrast (71551) | $853.63 | $898.56 | 1.2× |
| MRI chest wo w contrast (71552) | $861.84 | $907.20 | 2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$877.34–$885.78 | $923.52–$932.40 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$938.98–$957.60 | $988.40–$1,008 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$865.49–$873.81 | $911.04–$919.80 | varies |
| MRI lumbar spine w contrast (72149) | $945.63 | $995.40 | 2.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $897.75 | $945 | 2.8× |
| MRI orbit face &/neck w/o contrast (70540) | $933.66 | $982.80 | 4.3× |
| MRI orbit face neck w contrast (70542) | $945.63 | $995.40 | 2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $957.60 | $1,008 | 3.0× |
| MRI pelvis w contrast (72196) | $945.63 | $995.40 | 2.9× |
| MRI pelvis w/o & w contrast (72197) | $957.60 | $1,008 | 3.0× |
| MRI pelvis w/o contrast (72195) | $933.66 | $982.80 | 4.3× |
| MRI thoracic spine w/o contrast (72146) | $933.66 | $982.80 | 4.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$889.20–$897.75 | $936–$945 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$865.49–$873.81 | $911.04–$919.80 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$948.48–$957.60 | $998.40–$1,008 | varies |
| MRI, abdomen, combo (74183) | $1,077.30 | $1,134 | 3.4× |
| MRI, dorsal spine combo (72157) | $957.60 | $1,008 | 3.0× |
| MRI, dorsal spine contrast (72147) | $945.63 | $995.40 | 2.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$877.34–$885.78 | $923.52–$932.40 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$948.48–$957.60 | $998.40–$1,008 | varies |
| MRI, lumbar spine combo (72158) | $957.60 | $1,008 | 3.0× |
| Neck soft tissue (70360) | $213.74 | $224.99 | 2.7× |
| Ob us nuchal meas 1 gest (76813) | $180.99 | $190.52 | 1.9× |
| Optic foramina (70190) | $149.85 | $157.74 | 1.9× |
| Pelvis 1 or 2 views (72170) | $219.34 | $230.88 | 2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $359.31 | $378.22 | 3.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$228.45–$230.65 | $240.47–$242.79 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$207.48–$209.48 | $218.40–$220.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$248.25–$250.64 | $261.32–$263.83 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $313.69 | $330.20 | 3.3× |
| Radex fingr minimum 2 views (73140) | $179.55 | $189 | 2.2× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$225.26–$227.43 | $237.12–$239.40 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$223.88–$226.03 | $235.66–$237.93 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$186.73–$188.50 | $196.56–$198.42 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $244.48 | $257.35 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $245.39 | $258.30 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$237.12–$239.40 | $249.60–$252 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $207.08 | $217.98 | 2.6× |
| Radex Sternum Minimum 2 Views (71120) | $239.88 | $252.51 | 3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $149.85 | $157.74 | 1.9× |
| Radex Toe Minimum 2 Views (73660) | $178.37 | $187.76 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $180.99 | $190.52 | 1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$259.64–$262.14 | $273.31–$275.94 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $287.19 | $302.31 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$354.85–$358.26 | $373.53–$377.12 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $184.71 | $194.43 | 1.9× |
| Radiologic examination femur 1 view (73551) | $239.40 | $252 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) | $263.34 | $277.20 | 3.3× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$213.41–$215.46 | $224.64–$226.80 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $180.99 | $190.52 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$233.03–$235.27 | $245.29–$247.65 | varies |
| Ribs bilateral 3 views (71110) | $269.33 | $283.50 | 2.8× |
| Scapula (73010) | $180.99 | $190.52 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $128.70 | $135.47 | 5.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$201.55–$203.49 | $212.16–$214.20 | varies |
| Skull less than 4 views (70250) | $240.60 | $253.26 | 2.5× |
| Sternoclavicular joints (71130) | $149.85 | $157.74 | 1.9× |
| Thoracic spine 2 views (72070) | $269.33 | $283.50 | 2.8× |
| Thoracic spine 3 views (72072) | $333.68 | $351.24 | 3.5× |
| Thoracolumbar 2 views (72080) | $261.88 | $275.66 | 3.3× |
| Ultrasound Breast Limited (76642) | $157.11 | $165.38 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $245.94 | $258.88 | 2.6× |
| Ultrasound, abdomen limited (76705) | $269.33 | $283.50 | 2.8× |
| Unlisted Dx Radiographic Procedure (76499) | $149.85 | $157.74 | 1.9× |
| Unlisted us procedure (76999) | $149.85 | $157.74 | 1.9× |
| Us bone density measurement (76977) | $180.99 | $190.52 | 1.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$162.03–$179.55 | $170.56–$189 | varies |
| Us chest (76604) | $183.84 | $193.52 | 1.9× |
| Us complete joint (76881) | $210.67 | $221.76 | 2.2× |
| Us exam, pelvic, limited (76857) | $209.48 | $220.50 | 2.2× |
| Us kidney transplant (76776) | $180.99 | $190.52 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $210.67 | $221.76 | 2.2× |
| Us ob detailed single fetus (76811) | $411.40 | $433.05 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $209.48 | $220.50 | 2.2× |
| Us ob transvaginal (76817) | $209.48 | $220.50 | 2.2× |
| Us pelvic non ob complete (76856) | $269.33 | $283.50 | 2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $215.46 | $226.80 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $192.66 | $202.80 | 2.0× |
| Us retroperitoneal complete (76770) | $250.71 | $263.90 | 2.6× |
| Us retroperitoneal limited (76775) | $209.48 | $220.50 | 2.2× |
| Us scrotum and contents (76870) | $209.48 | $220.50 | 2.2× |
| Us spinal canal and contents (76800) | $180.99 | $190.52 | 1.9× |
| Us thyroid (76536) | $795.58 | $837.45 | 8.3× |
| Us transrectal (76872) | $191.52 | $201.60 | 2.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$177.84–$179.55 | $187.20–$189 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $269.33 | $283.50 | 3.4× |
| X-Ray Bend Only L-S Spine (72120) | $317.56 | $334.27 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$207.48–$209.48 | $218.40–$220.50 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$232.76–$234.99 | $245.01–$247.36 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$283.96–$286.70 | $298.91–$301.79 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $395.01 | $415.80 | 4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $180.99 | $190.52 | 1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $180.99 | $190.52 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $407.39 | $428.83 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $269.33 | $283.50 | 3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $449.01 | $472.64 | 4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $330.61 | $348.01 | 3.4× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$171.91–$173.57 | $180.96–$182.70 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$225.41–$227.57 | $237.27–$239.55 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $215.46 | $226.80 | 2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $299.25 | $315 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $405.94 | $427.31 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $197.37 | $207.76 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $238.30 | $250.84 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $236.81 | $249.27 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $321.37 | $338.28 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $349.05 | $367.42 | 3.6× |
| X-Ray Tmj Unilat (70328) | $149.85 | $157.74 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $897.75 | $945 | 9.3× |
| Xr c-spine 4 or 5 views (72050) | $381.34 | $401.41 | 4.0× |
| Xr facial bones less than 3 views (70140) | $296.78 | $312.40 | 3.7× |
| Xr orbits complete 4 views (70200) | $247.96 | $261.01 | 2.6× |
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.