Imaging prices at Harrison County Community Hospital

Bethany, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $162.50 $250 1.6×
Ankle 2 views (73600) $119.60 $184 1.4×
Antegrade urography radiological supvj & interpj (74425) $258.05 $397 0.7×
Arthrogram shoulder (73040) $429 $660 1.2×
Arthrography knee lt (73580) $520 $800 1.5×
Bone &/Joint Imaging Limited Area (78300) $495.88 $762.89 1.2×
Bone &/joint imaging whole body (78306) $742.62 $1,142.48 1.9×
Bone age studies (77072) $68.25 $105 0.7×
Bone Imaging 3 Phase (78315) $771.10 $1,186.30 1.9×
Bone survey complete (77075) $358.80 $552 3.4×
Cervical spine 2 or 3 views (72040) $172.25 $265 2.0×
Chest 1 view (71045) $162.50 $250 1.9×
Chest 3 views (71047) $138.12 $212.50 1.6×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $292.50 $450 1.7×
Clavicle complete (73000) $124.15 $191 1.4×
CT abdomen and pelvis without and with contrast (74178) $1,982.50 $3,050 5.7×
CT abdomen and pelvis without contrast (74176) $1,755 $2,700 7.3×
CT abdomen w contrast (74160) $1,202.50 $1,850 6.8×
CT abdomen w wo contrast (74170) $1,332.50 $2,050 7.6×
CT abdomen w/o contrast (74150) $1,105 $1,700 10.6×
CT angiography upper extremity lt (73206) $1,267.50 $1,950 7.2×
CT c-spine w/o contrast (72125) $975 $1,500 9.3×
CT cervical spine w&w/o contrast (72127) $1,170 $1,800 6.7×
CT chest w/wo contrast (71270) $1,137.50 $1,750 6.5×
CT chest with contrast (71260) $1,072.50 $1,650 6.1×
CT head/brain with contrast (70460) $1,007.50 $1,550 5.7×
CT head/brain without and with contrast (70470) $1,137.50 $1,750 6.5×
CT iac w contrast (70481) $845 $1,300 4.8×
CT limited/localized follow up study (76380) $542.75 $835 6.2×
CT lower ext w/o (73700) $910 $1,400 8.7×
CT lower extremity with contrast (73701) $1,007.50 $1,550 5.7×
CT lumbar spine w & w/o contrast (72133) $1,267.50 $1,950 7.2×
CT lumbar spine w/o contrast (72131) $1,040 $1,600 9.9×
CT lumbar spine with contrast (72132) $1,137.50 $1,750 3.3×
CT maxillofacial w contrast (70487) $926.25 $1,425 5.3×
CT maxillofacial w/o contrast (70486) $966.88 $1,487.50 9.2×
CT maxillofacial w/wo contrast (70488) $1,056.25 $1,625 6.0×
CT neck soft tissue w contrast (70491) $1,105 $1,700 6.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $942.50 $1,450 5.4×
CT orbits w/o contrast (70480) $780 $1,200 7.4×
CT pelvis w & w/o contrast (72194) $1,153.75 $1,775 6.6×
CT pelvis w/o contrast (72192) $958.75 $1,475 9.2×
CT soft tissue neck w/o & w/contrast material (70492) $1,235 $1,900 7.0×
CT soft tissue neck w/o contrast (70490) $1,007.50 $1,550 9.6×
CT thoracic spine w/contrast (72129) $1,170 $1,800 6.7×
CT thoracic spine w/o contrast (72128) $1,072.50 $1,650 10.2×
CT thorax w/o contrast (71250) $910 $1,400 8.7×
CT upper extremity w/o & w/contrast material (73202) $1,137.50 $1,750 6.5×
CT upper extremity w/o contrast rt (73200) $910 $1,400 8.7×
CT upper extremity with contrast (73201) $1,007.50 $1,550 2.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,145 $3,300 12.2×
Cta Abdomen (74175) $1,332.50 $2,050 7.6×
CTA abdomen pelvis (74174) $1,722.50 $2,650 4.9×
CTA chest (71275) $1,365 $2,100 7.8×
Cta Head (70496) $1,267.50 $1,950 7.2×
CTA lwr ext w&w/o contrast (73706) $1,267.50 $1,950 7.2×
Cta Neck (70498) $1,267.50 $1,950 7.2×
Cta Pelvis (72191) $1,267.50 $1,950 7.2×
Cystography minimum 3 views rs&i (74430) $427.70 $658 1.2×
Diskogram cervical (72285) $2,678 $4,120 1.4×
Diskography lumbar (72295) $2,678 $4,120 1.4×
Dxa bone density study 1/> sites axial skel (77080) $247 $380 2.4×
Esophagus (74220) $224.25 $345 1.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $195 $300 1.9×
Fluoroscopy up to 1 hr (76000) $254.15 $391 1.1×
Foot 2 views (73620) $109.20 $168 1.3×
Forearm 2 views (73090) $115.70 $178 1.3×
Gated Heart Planar Single (78472) $429 $660 1.1×
Hand 2 views (73120) $118.95 $183 1.1×
Hand 3 views (73130) $169 $260 1.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $709.16 $1,091.01 1.3×
Hepatobiliary syst imaging including gallbladder (78226) $709.16 $1,091.01 1.8×
Ht muscle image spect sing (78451) $1,365 $2,100 1.1×
Humerus Min 2 Views Left (73060) $130 $200 1.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $600.38 $923.65 1.1×
Kidney img morphology vascular flow 1 w/rx (78708) $678.96 $1,044.55 1.2×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,199.20 $1,844.92 2.2×
Knee 3 views (73562) $174.20 $268 2.0×
Liver & spleen imaging static only (78215) $436.51 $671.55 1.1×
Lung Ventilation Imaging (78579) $402.20 $618.76 1.0×
Mammary ductogram or galactogram multiple (77054) $315.03 $484.66 1.3×
Mammary ductogram or galactogram single (77053) $164.38 $252.89 0.7×
Meckels Diverticulum (78290) $479.75 $738.07 1.2×
Mr safety determination physician/other qhp (76016) $100.75 $155 1.2×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $68.25 $105 1.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $29.25 $45 1.0×
Mr safety implt electronics prepj supvj phys/qhp (76018) $104 $160 1.1×
Mr safety med physics xm customization plng&mntr (76017) $273 $420 1.1×
MRA head w & w/o contrast (70546) $1,170 $1,800 3.3×
MRA head w/o contrast (70544) $1,040 $1,600 4.4×
MRA head with contrast (70545) $1,105 $1,700 3.2×
MRA neck w contrast (70548) $1,105 $1,700 3.2×
Mra Neck W/O &W/Contrast Material (70549) $1,202.50 $1,850 3.4×
MRA neck w/o contrast (70547) $1,040 $1,600 4.4×
MRI abdomen w/o & w/contrast material (74183) $1,722.50 $2,650 4.9×
MRI abdomen w/o contrast (74181) $1,105 $1,700 4.6×
MRI any jnt lwr ext with con lt (73722) $1,170 $1,800 1.5×
MRI any jt upper extremity w/contrast matrl (73222) $1,196 $1,840 1.5×
MRI c-spine with contrast (72142) $1,072.50 $1,650 3.1×
MRI cervical spine w/o contrast (72141) $1,007.50 $1,550 4.2×
MRI chest w/o & w/contrast material (71552) $1,235 $1,900 3.5×
MRI chest w/o contrast (71550) $975 $1,500 4.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,105 $1,700 4.6×
MRI orbit face &/neck w/o contrast (70540) $975 $1,500 4.1×
MRI orbit/face/neck w&w/o cont (70543) $1,235 $1,900 3.5×
MRI pelvis w/o & w/contrast material (72197) $1,365 $2,100 3.9×
MRI pelvis w/o contrast (72195) $1,040 $1,600 4.4×
MRI scan of arm joint before and after contrast (73223) $1,462.50 $2,250 4.2×
MRI scan of leg joint before and after contrast (73723) $1,430 $2,200 4.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,300 $2,000 3.7×
MRI spinal canal lumbar w/contrast material (72149) $1,072.50 $1,650 3.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,300 $2,000 3.7×
MRI spinal canal thoracic w/contrast matrl (72147) $1,072.50 $1,650 3.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,300 $2,000 3.7×
MRI thoracic spine w/o contrast (72146) $1,007.50 $1,550 4.2×
MRI tmj (70336) $975 $1,500 4.1×
MRI upper ext joint w/o contrast (73221) $1,131 $1,740 4.7×
MRI upper extrem other than jt w/o & w/contras (73220) $1,365 $2,100 3.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,105 $1,700 4.6×
Myocardial Spect Multiple Studies (78452) $1,641.72 $2,525.71 1.3×
Neck soft tissue (70360) $115.70 $178 1.3×
Nm gastric emptying study (78264) $785.86 $1,209.01 2.0×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $193.70 $298 1.8×
Osseous survey limited (77074) $265.85 $409 2.5×
Parathyroid imaging (78070) $445.44 $685.28 1.1×
Pelvis 1 or 2 views (72170) $139.75 $215 1.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,365 $2,100 3.9×
Pulmonary Perfusion Imaging Particulate (78580) $622.85 $958.23 1.6×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,159.91 $1,784.47 2.1×
Radex abscess/fistula/sinus tract rs&i (76080) $539.50 $830 1.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $89.70 $138 1.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $96.20 $148 0.9×
Radex hips bilateral with pelvis 2 views (73521) $211.90 $326 2.0×
Radex mastoids compl minimum 3 views pr side (70130) $123.50 $190 1.2×
Radiolog exam mandible compl minimum 4 views (70110) $185.25 $285 1.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $130 $200 1.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $151.45 $233 1.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $156 $240 1.8×
Radiologic exam colon single contrast study (74270) $351 $540 2.0×
Radiologic exam upr gi trc double contrast study (74246) $324.35 $499 1.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $133.25 $205 1.5×
Ribs bilateral 3 views (71110) $156.65 $241 1.5×
Rp loclzj tum spect 1 area single day imaging (78803) $1,300 $2,000 2.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,300 $2,000 1.0×
Sacroiliac Joints < 3 Views (72200) $129.35 $199 1.2×
Scanogram (77073) $215.15 $331 2.1×
Scapula complete (73010) $162.50 $250 1.6×
Screening digital breast tomosynthesis (77063) $45.50 $70 1.9×
Shuntogram indwelling nonvascular shunt rs&i (75809) $334.10 $514 3.2×
Small bowel series (74250) $328.90 $506 1.9×
Spine thoracic 3 views (72072) $191.75 $295 1.8×
Thoracolumbar 2 views (72080) $131.95 $203 1.5×
Thyroid Imaging With Vascular Flow (78013) $348.66 $536.40 0.9×
Thyroid uptake measurement (78012) $146.88 $225.96 0.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $606.90 $933.68 1.5×
Tmj unilateral (70328) $78 $120 0.9×
Tomogram (76100) $529.75 $815 5.1×
Ultrasound, abdomen limited (76705) $432.25 $665 4.1×
Unlisted Diagnostic Radiographic Procedure (76499) $16.25 $25 0.2×
Unlisted fluoroscopic procedure (76496) $144.30 $222 1.7×
Unlisted Ultrasound Procedure (76999) $126.10 $194 1.4×
Upper Extremity Infant (73092) $78 $120 0.7×
Urethrocystography voiding (74455) $267.80 $412 1.1×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $503.10 $774 2.9×
Us abdl aorta screen aaa (76706) $248.30 $382 2.4×
Us breast unilateral complete (76641) $325 $500 3.1×
Us breast unilateral limited (76642) $260 $400 3.0×
Us chest (76604) $308.75 $475 2.9×
Us ob transvaginal (76817) $260 $400 2.5×
Us pelvic non ob complete (76856) $429 $660 4.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $221 $340 2.1×
Us pregnancy ltd (76815) $214.50 $330 2.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $396.50 $610 3.8×
Us retroperitoneal complete (76770) $455 $700 4.3×
Us retroperitoneal limited (76775) $247 $380 2.4×
Us scrotum and contents (76870) $382.20 $588 3.7×
Us soft tissue head/neck (76536) $325 $500 3.1×
Us transrectal (76872) $250.90 $386 2.4×
Us xtr non-vasc lmtd (76882) $341.25 $525 3.3×
Wrist 2 views (73100) $117 $180 1.3×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $253.50 $390 2.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $120.25 $185 1.4×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $195 $300 2.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $502.45 $773 2.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $169 $260 1.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $156 $240 1.8×
X-ray exam hip uni 1 view (73501) $89.70 $138 1.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $169 $260 1.9×
X-ray exam hip uni 4/> views (73503) $125.45 $193 1.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $227.50 $350 2.2×
X-Ray Exam Hips Bi 5/> Views (73523) $224.90 $346 2.1×
X-ray exam of femur 1 (73551) $126.75 $195 1.5×
X-ray eye for foreign body (70030) $124.80 $192 1.4×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $174.20 $268 1.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $143.65 $221 1.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $169 $260 1.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $120.25 $185 1.4×
X-ray IV pyelogram+drip infusn (74410) $365.30 $562 2.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $210.60 $324 2.4×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $195 $300 1.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $95.55 $147 1.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $83.20 $128 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $191.75 $295 1.8×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $350.35 $539 3.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $125.45 $193 1.2×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $135.20 $208 1.6×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $89.70 $138 1.0×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $169.65 $261 1.6×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $427.70 $658 1.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $139.10 $214 1.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $163.15 $251 1.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $198.25 $305 1.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $197.60 $304 1.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $135.85 $209 1.6×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $151.45 $233 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $143.65 $221 1.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $89.70 $138 1.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $185.25 $285 1.8×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $123.50 $190 1.2×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $114.40 $176 1.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $113.10 $174 1.3×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $154.70 $238 1.5×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $246.35 $379 2.4×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $102.05 $157 1.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $175.50 $270 2.0×
Xr arthrogram ankle (73615) $429 $660 1.2×
Xr c-spine 6 or more views (72052) $266.50 $410 2.5×
Xr chest 4+ views (71048) $139.75 $215 1.3×
Xr finger(s) 2+ views (73140) $91 $140 1.0×
XR Mastoids < 3 Views Bilateral (70120) $97.50 $150 0.9×
Xr spine cervical 4 or 5 views (72050) $246.35 $379 2.4×
Xr tibia/fibula 2 views (73590) $125.45 $193 1.4×
Xr tmj bilateral (70330) $134.55 $207 1.5×
Xray knee 1 or 2 views rt (73560) $122.85 $189 1.4×