Imaging prices at Gritman Medical Center
Moscow, ID · every code in this section with a posted price and a Medicare benchmark.
211 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) | $319 | $319 | 3.7× |
| Abdomen 2 views (74019) | $429 | $429 | 4.2× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$65–$319 | $65–$319 | varies |
| Arthrogram hip (73525) | $1,448 | $1,448 | 4.2× |
| Arthrogram Wrist (73115) | $1,448 | $1,448 | 4.2× |
| Bone age studies (77072) | $429 | $429 | 4.2× |
| Bone Imaging 3 Phase (78315) | $1,483 | $1,483 | 3.8× |
| Bone Imaging Limited Area (78300) | $1,483 | $1,483 | 3.8× |
| Bone Imaging Whole Body (78306) | $1,483 | $1,483 | 3.8× |
| Bone survey infant (77076) | $429 | $429 | 4.2× |
| Cerebrospinal Fluid Scan (78630) | $1,925 | $1,925 | 3.6× |
| Chest 1 view (71045) | $319 | $319 | 3.7× |
| Chest 2 views (71046) | $319 | $319 | 3.7× |
| Cisternography Positive Contrast Rs&I (70015) | $2,814 | $2,814 | 3.6× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$65–$319 | $65–$319 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $429 | $429 | 4.2× |
| Contrast X-Ray Bladder (74430) | $1,448 | $1,448 | 4.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,802 | $2,802 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $1,777 | $1,777 | 7.5× |
| CT abdomen w contrast (74160) | $1,064 | $1,064 | 6.1× |
| CT abdomen w wo contrast (74170) | $1,200 | $1,200 | 6.9× |
| CT abdomen w/o contrast (74150) | $784 | $784 | 7.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,848 | $1,848 | 5.4× |
| CT Angio Chest (71275) | $2,330 | $2,330 | 13.4× |
| CT Angio Head (70496) | $1,210 | $1,210 | 7.0× |
| CT angio hrt w/3d image (75574) | $888 | $888 | 2.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,210 | $1,210 | 7.0× |
| CT Angio Neck (70498) | $1,210 | $1,210 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,210 | $1,210 | 7.0× |
| CT cervical spine w/ contrast (72126) | $1,448 | $1,448 | 4.2× |
| CT cervical spine w/o contrast (72125) | $1,250 | $1,250 | 12.1× |
| CT chest w contrast (71260) | $1,725 | $1,725 | 10.0× |
| CT chest w/wo contrast (71270) | $1,200 | $1,200 | 6.9× |
| CT head/brain with contrast (70460) | $1,064 | $1,064 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,200 | $1,200 | 6.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $319 | $319 | 3.7× |
| CT iac w contrast (70481) | $1,064 | $1,064 | 6.1× |
| CT l-spine w&w/o contrast (72133) | $1,200 | $1,200 | 6.9× |
| CT lower ext w/o (73700) | $784 | $784 | 7.6× |
| CT lower extremity w/contrast material (73701) | $1,064 | $1,064 | 6.1× |
| CT lumbar spine w contrast (72132) | $1,448 | $1,448 | 4.2× |
| CT lumbar spine w/o contrast (72131) | $784 | $784 | 7.6× |
| CT maxillofacial w contrast (70487) | $1,064 | $1,064 | 6.1× |
| CT maxillofacial wo contrast (70486) | $784 | $784 | 7.6× |
| CT neck tissue combo (70492) | $1,200 | $1,200 | 6.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,200 | $1,200 | 6.9× |
| CT orbits w/o contrast (70480) | $784 | $784 | 7.6× |
| CT pelvis w&w/o contrast (72194) | $1,200 | $1,200 | 6.9× |
| CT pelvis w/o contrast (72192) | $784 | $784 | 7.6× |
| CT scan of leg combo (73702) | $1,200 | $1,200 | 6.9× |
| CT soft tissue neck w contrast (70491) | $1,064 | $1,064 | 6.1× |
| CT soft tissue neck w/o contrast (70490) | $784 | $784 | 7.6× |
| CT thoracic spine w contrast (72129) | $1,064 | $1,064 | 6.1× |
| CT thoracic spine w/o contrast (72128) | $784 | $784 | 7.6× |
| CT thorax w/o contrast (71250) | $784 | $784 | 7.6× |
| CT upper ext wo (73200) | $784 | $784 | 7.6× |
| CT upper extremity with contrast (73201) | $1,448 | $1,448 | 4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,210 | $1,210 | 7.0× |
| Cta Abdomen (74175) | $1,210 | $1,210 | 7.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,008 | $1,008 | 2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $429 | $429 | 4.2× |
| Dxa Bone Density Axial (77080) | $429 | $429 | 4.2× |
| Esophagram (74220) | $703 | $703 | 4.1× |
| Fetal Biophys Profile W/Nst (76818) | $449 | $449 | 4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $449 | $449 | 4.3× |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$85–$905 | $85–$905 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$57–$319 | $57–$319 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$59–$319 | $59–$319 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$601–$1,483 | $601–$1,483 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$63–$429 | $63–$429 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,925 | $1,925 | 3.6× |
| Ht Muscle Image Spect Sing (78451) | $5,139 | $5,139 | 4.0× |
| Hysterosalpingogram (74740) | $905 | $905 | 3.8× |
| K Flow/Funct Image W/Drug (78708) | $1,925 | $1,925 | 3.6× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$82–$319 | $82–$319 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,925 | $1,925 | 3.6× |
| Lung Ventilation Imaging (78579) | $1,483 | $1,483 | 3.8× |
| Lymph System Imaging (78195) | $1,925 | $1,925 | 3.6× |
| Magnetic Image Jaw Joint (70336) | $1,527 | $1,527 | 6.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,210 | $2,210 | 6.4× |
| MRA head w/o contrast (70544) | $1,527 | $1,527 | 6.5× |
| MRA neck w contrast (70548) | $1,799 | $1,799 | 5.2× |
| MRA neck w/o contrast (70547) | $1,527 | $1,527 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,527 | $1,527 | 6.5× |
| MRI any jt lower extrem w/contrast material (73722) | $2,814 | $2,814 | 3.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,210 | $2,210 | 6.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,814 | $2,814 | 3.6× |
| MRI cervical spine w/o cont (72141) | $1,965 | $1,965 | 8.3× |
| MRI chest w/o contrast (71550) | $1,527 | $1,527 | 6.5× |
| MRI chest wo w contrast (71552) | $2,210 | $2,210 | 6.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,210 | $2,210 | 6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,527 | $1,527 | 6.5× |
| MRI lumbar spine w contrast (72149) | $1,448 | $1,448 | 4.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,210 | $2,210 | 6.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,210 | $2,210 | 6.4× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$215–$2,210 | $215–$2,210 | varies |
| MRI pelvis w/o contrast (72195) | $1,527 | $1,527 | 6.5× |
| MRI thoracic spine w/o contrast (72146) | $1,527 | $1,527 | 6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,527 | $1,527 | 6.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,137 | $2,137 | 6.2× |
| MRI, abdomen, combo (74183) | $2,210 | $2,210 | 6.4× |
| MRI, dorsal spine combo (72157) | $2,210 | $2,210 | 6.4× |
| MRI, joint upper extrem (73221) | $1,527 | $1,527 | 6.5× |
| MRI, joint upper extrem combo (73223) | $2,210 | $2,210 | 6.4× |
| MRI, lumbar spine combo (72158) | $2,210 | $2,210 | 6.4× |
| Myelogram cervical (72240) | $2,814 | $2,814 | 3.6× |
| Myelogram Lumbar (72265) | $2,814 | $2,814 | 3.6× |
| Myelography thoracic (72255) | $2,814 | $2,814 | 3.6× |
| Myocardial Spect Multiple Studies (78452) | $5,139 | $5,139 | 4.0× |
| Neck soft tissue (70360) | $319 | $319 | 3.7× |
| Ob us nuchal meas 1 gest (76813) | $236 | $236 | 2.3× |
| Parathyroid Planar Imaging (78070) | $1,483 | $1,483 | 3.8× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$56–$429 | $56–$429 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,483 | $1,483 | 3.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $429 | $429 | 4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,900 | $1,900 | 3.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$73–$319 | $73–$319 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $319 | $319 | 3.7× |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$66–$319 | $66–$319 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $429 | $429 | 4.2× |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$76–$319 | $76–$319 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$69–$319 | $69–$319 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$74–$319 | $74–$319 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $319 | $319 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $319 | $319 | 3.7× |
| Radex Ribs Unilateral 2 Views (71100) | $319 | $319 | 3.7× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$70–$319 | $70–$319 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $319 | $319 | 3.7× |
| Radex Sternum Minimum 2 Views (71120) | $319 | $319 | 3.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $319 | $319 | 3.7× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$58–$319 | $58–$319 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$82–$319 | $82–$319 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $429 | $429 | 4.2× |
| Radiologic exam colon double contrast study (74280) | $703 | $703 | 4.1× |
| Radiologic exam colon single contrast study (74270) | $703 | $703 | 4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $703 | $703 | 4.1× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$95–$429 | $95–$429 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$85–$428 | $85–$428 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $703 | $703 | 4.1× |
| Radiologic exam swallow function contrast study (74230) | $703 | $703 | 4.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $703 | $703 | 4.1× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$59–$319 | $59–$319 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$71–$319 | $71–$319 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$68–$319 | $68–$319 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $429 | $429 | 4.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$63–$319 | $63–$319 | varies |
| Ribs bilateral 3 views (71110) | $429 | $429 | 4.2× |
| Scapula (73010) range across 4 matching MRF lines |
$48–$429 | $48–$429 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $47 | $47 | 2.0× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$43–$319 | $43–$319 | varies |
| Shoulder Arthrography (73040) | $1,448 | $1,448 | 4.2× |
| Skull less than 4 views (70250) | $429 | $429 | 4.2× |
| Sternoclavicular joints (71130) | $319 | $319 | 3.7× |
| Thoracic spine 2 views (72070) | $429 | $429 | 4.2× |
| Thoracic spine 3 views (72072) | $429 | $429 | 4.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,483 | $1,483 | 3.8× |
| Ultrasound Breast Limited (76642) | $319 | $319 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $599 | $599 | 5.8× |
| Ultrasound, abdomen limited (76705) | $449 | $449 | 4.3× |
| Umbilical-artery Doppler (OB) (76820) | $429 | $429 | 4.2× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $125 | $125 | 0.3× |
| Upper gi w/o kub (74240) | $703 | $703 | 4.1× |
| Urethrocystography retrograde (74450) | $905 | $905 | 3.8× |
| Us breast unilateral complete (76641) | $429 | $429 | 4.2× |
| Us chest (76604) range across 3 matching MRF lines |
$116–$429 | $116–$429 | varies |
| Us complete joint (76881) | $449 | $449 | 4.3× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$100–$429 | $100–$429 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $429 | $429 | 4.2× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$362–$905 | $362–$905 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$164–$429 | $164–$429 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$187–$429 | $187–$429 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$212–$449 | $212–$449 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $449 | $449 | 4.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$223–$429 | $223–$429 | varies |
| Us retroperitoneal complete (76770) | $449 | $449 | 4.3× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$121–$449 | $121–$449 | varies |
| Us scrotum and contents (76870) | $449 | $449 | 4.3× |
| Us thyroid (76536) | $449 | $449 | 4.3× |
| Us transrectal (76872) range across 2 matching MRF lines |
$278–$428 | $278–$428 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$68–$319 | $68–$319 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $319 | $319 | 3.7× |
| X-Ray Bend Only L-S Spine (72120) | $429 | $429 | 4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$59–$319 | $59–$319 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,900 | $1,900 | 3.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $319 | $319 | 3.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $429 | $429 | 4.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$66–$319 | $66–$319 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$95–$319 | $95–$319 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $429 | $429 | 4.2× |
| X-Ray Exam L-S Spine Bending (72114) | $429 | $429 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$79–$319 | $79–$319 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $429 | $429 | 4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $429 | $429 | 4.2× |
| X-ray eye for foreign body (70030) | $319 | $319 | 3.7× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$64–$319 | $64–$319 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $319 | $319 | 3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$80–$319 | $80–$319 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $429 | $429 | 4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $429 | $429 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $429 | $429 | 4.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $429 | $429 | 4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $319 | $319 | 3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $320 | $320 | 3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $429 | $429 | 4.2× |
| X-Ray Stress View (77071) range across 26 matching MRF lines |
$109–$319 | $109–$319 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$157–$1,448 | $157–$1,448 | varies |
| X-Rays Bone Length Studies (77073) | $429 | $429 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $429 | $429 | 4.2× |
| Xr c-spine 4 or 5 views (72050) | $429 | $429 | 4.2× |
| Xr facial bones less than 3 views (70140) | $319 | $319 | 3.7× |
| Xr orbits complete 4 views (70200) | $429 | $429 | 4.2× |
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.