Imaging prices at HSHS Good Shepherd Hospital Inc

Shelbyville, IL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $418.32 $581 4.5×
Abdomen 2 views (74019) $509.04 $707 4.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,006.56 $1,398 2.3×
Ankle 2 views (73600) $282.96 $393 3.0×
Bone age studies (77072) $453.60 $630 4.0×
Bone Imaging 3 Phase (78315) $1,710 $2,375 4.0×
Bone Imaging Limited Area (78300) $1,006.56 $1,398 2.3×
Bone Imaging Multiple Areas (78305) $1,316.16 $1,828 3.1×
Bone Imaging Whole Body (78306) $1,531.44 $2,127 3.6×
Bone survey infant (77076) $1,149.84 $1,597 10.3×
Chest 1 view (71045) $232.56 $323 2.5×
Chest 2 views (71046) $293.04 $407 3.1×
Chest 3 views (71047) $529.92 $736 5.7×
Chest 4 or more views (71048) $232.56 $323 2.1×
Clavicle complete (73000) $383.04 $532 4.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $199.44 $277 1.8×
CT abdomen and pelvis without and with contrast (74178) $5,240.16 $7,278 14.0×
CT abdomen and pelvis without contrast (74176) $3,879.36 $5,388 15.2×
CT abdomen w contrast (74160) $2,255.04 $3,132 12.0×
CT abdomen w wo contrast (74170) $2,904.48 $4,034 15.5×
CT abdomen w/o contrast (74150) $2,024.64 $2,812 18.1×
CT Angio Abdomen and Pelvis (74174) $4,672.08 $6,489 12.5×
CT Angio Chest (71275) $2,521.44 $3,502 13.4×
CT Angio Head (70496) $2,561.04 $3,557 13.6×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,521.44 $3,502 13.4×
CT Angio Neck (70498) $2,131.92 $2,961 11.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,521.44 $3,502 13.4×
CT bone density (77078) $473.04 $657 5.1×
CT cervical spine w/ contrast (72126) $2,366.64 $3,287 6.3×
CT cervical spine w/o contrast (72125) $1,974.96 $2,743 17.6×
CT cervical spine w/wo cont (72127) $2,931.84 $4,072 15.6×
CT chest w contrast (71260) $2,456.64 $3,412 13.1×
CT chest w/wo contrast (71270) $2,872.80 $3,990 15.3×
CT head/brain with contrast (70460) $1,814.40 $2,520 9.7×
CT head/brain without and with contrast (70470) $2,004.48 $2,784 10.7×
CT iac w contrast (70481) $1,728 $2,400 9.2×
CT l-spine w&w/o contrast (72133) $3,057.84 $4,247 16.3×
CT lower ext w/o (73700) $1,779.12 $2,471 15.9×
CT lower extremity w/contrast material (73701) $1,965.60 $2,730 10.5×
CT lumbar spine w contrast (72132) $2,386.80 $3,315 6.4×
CT lumbar spine w/o contrast (72131) $1,982.16 $2,753 17.7×
CT maxillofacial w contrast (70487) $1,565.28 $2,174 8.3×
CT maxillofacial wo contrast (70486) $1,177.20 $1,635 10.5×
CT neck tissue combo (70492) $1,818 $2,525 9.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,024.64 $2,812 10.8×
CT orbits w/o contrast (70480) $1,565.28 $2,174 14.0×
CT pelvis w&w/o contrast (72194) $3,160.08 $4,389 16.8×
CT pelvis w/o contrast (72192) $2,143.44 $2,977 19.1×
CT scan of leg combo (73702) $2,494.80 $3,465 13.3×
CT scans face/jaw combo (70488) $2,024.64 $2,812 10.8×
CT soft tissue neck w contrast (70491) $1,764 $2,450 9.4×
CT soft tissue neck w/o contrast (70490) $1,668.24 $2,317 14.9×
CT thoracic spine w contrast (72129) $2,352.96 $3,268 12.5×
CT thoracic spine w/o contrast (72128) $1,928.16 $2,678 17.2×
CT thoracic spine w/wo cont (72130) $2,927.52 $4,066 15.6×
CT thorax w/o contrast (71250) $1,892.16 $2,628 16.9×
CT upper ext wo (73200) $1,732.32 $2,406 15.5×
CT upper extremity w/o & w/contrast material (73202) $2,494.80 $3,465 13.3×
CT upper extremity with contrast (73201) $1,965.60 $2,730 5.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $5,236.56 $7,273 27.9×
Cta Abdomen (74175) $2,521.44 $3,502 13.4×
CTA pelvis (72191) $2,715.84 $3,772 14.4×
Dxa Bone Density Axial (77080) $479.52 $666 4.3×
Esophagram (74220) $443.52 $616 2.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $267.12 $371 2.4×
Fluoroscopy up to 1 hr (76000) $522 $725 2.0×
Foot 2 views (73620) $476.64 $662 5.1×
Forearm 2 views (73090) $352.08 $489 3.8×
Gastric emptying imaging study (78264) $1,988.64 $2,762 4.6×
Gated Heart Planar Single (78472) $1,518.48 $2,109 3.5×
Hand 2 views (73120) $295.92 $411 2.6×
Hepatobil Syst Image W/Drug (78227) $1,170 $1,625 2.0×
Hepatobiliary System Imaging (78226) $1,170 $1,625 2.7×
Ht Muscle Image Spect Sing (78451) $3,831.84 $5,322 2.8×
Joint Survey Single View (77077) $459.36 $638 4.1×
K Flow/Funct Image Multiple (78709) $2,383.92 $3,311 4.1×
K Flow/Funct Image W/Drug (78708) $2,029.68 $2,819 3.5×
K Flow/Funct Image W/O Drug (78707) $1,905.12 $2,646 3.3×
Knee 3 Views (73562) $383.04 $532 4.1×
Liver & Spleen Imaging Static Only (78215) $1,152 $1,600 2.7×
Meckels Divert Exam (78290) $867.60 $1,205 2.0×
Mr safety determination physician/other qhp (76016) $190.08 $264 2.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $52.56 $73 1.7×
Mr safety implt electronics prepj supvj phys/qhp (76018) $198 $275 1.9×
Mr safety implt pos&/immoblj (76019) $128.16 $178 2.0×
Mr safety med physics xm customization plng&mntr (76017) $522 $725 2.0×
Mra Head W/O & W/Contrast Material (70546) $3,850.56 $5,348 10.3×
MRA head w/o contrast (70544) $2,770.56 $3,848 10.8×
MRA head with contrast (70545) $3,505.68 $4,869 9.4×
MRA neck w contrast (70548) $3,505.68 $4,869 9.4×
Mra Neck W/O &W/Contrast Material (70549) $3,850.56 $5,348 10.3×
MRA neck w/o contrast (70547) $2,854.08 $3,964 11.2×
MRI abdomen w contrast (74182) $3,620.16 $5,028 9.7×
MRI abdomen w/o contrast (74181) $2,881.44 $4,002 11.3×
MRI any jt lower extrem w/contrast material (73722) $3,594.24 $4,992 4.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,353.12 $6,046 11.6×
MRI any jt upper extremity w/contrast matrl (73222) $3,857.04 $5,357 4.6×
MRI cervical spine w contrast (72142) $3,880.80 $5,390 10.4×
MRI cervical spine w/o cont (72141) $3,620.16 $5,028 14.2×
MRI chest wo w contrast (71552) $4,079.52 $5,666 10.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,745.44 $5,202 10.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,881.44 $4,002 11.3×
MRI lumbar spine w contrast (72149) $3,514.32 $4,881 9.4×
Mri Neck Spine W/O & W/Dye (72156) $4,568.40 $6,345 12.2×
MRI orbit face &/neck w/o contrast (70540) $2,967.84 $4,122 11.6×
MRI orbit face neck w contrast (70542) $3,620.16 $5,028 9.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,960.72 $5,501 10.6×
MRI pelvis w contrast (72196) $3,600 $5,000 9.6×
MRI pelvis w/o & w contrast (72197) $4,373.28 $6,074 11.7×
MRI pelvis w/o contrast (72195) $3,044.16 $4,228 11.9×
MRI thoracic spine w/o contrast (72146) $2,881.44 $4,002 11.3×
MRI upper extremity oth than jt w/contr matrl (73219) $3,412.08 $4,739 9.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,881.44 $4,002 11.3×
Mri Uppr Extremity W/O&W/Dye (73220) $3,857.04 $5,357 10.3×
MRI, abdomen, combo (74183) $3,745.44 $5,202 10.0×
MRI, dorsal spine combo (72157) $4,084.56 $5,673 10.9×
MRI, dorsal spine contrast (72147) $3,730.32 $5,181 10.0×
MRI, joint upper extrem (73221) $2,881.44 $4,002 11.3×
MRI, joint upper extrem combo (73223) $3,960.72 $5,501 10.6×
MRI, lumbar spine combo (72158) $4,084.56 $5,673 10.9×
Myocardial Spect Multiple Studies (78452) $5,333.04 $7,407 3.8×
Neck soft tissue (70360) $293.04 $407 3.1×
Parathyroid Planar Imaging (78070) $867.60 $1,205 2.0×
Parathyroid planar imaging w/wo subtraction (78071) $867.60 $1,205 2.0×
Pelvis 1 or 2 views (72170) $293.04 $407 2.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,170 $1,625 2.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $722.16 $1,003 6.4×
Radex Ankle Complete Minimum 3 Views (73610) $334.80 $465 3.6×
Radex Calcaneus Minimum 2 Views (73650) $352.08 $489 3.8×
Radex elbow complete minimum 3 views (73080) $387.36 $538 4.2×
Radex Facial Bones Complete Minimum 3 Views (70150) $498.96 $693 4.5×
Radex fingr minimum 2 views (73140) $293.04 $407 3.1×
Radex foot complete minimum 3 views (73630) $352.08 $489 3.8×
Radex Hand Minimum 3 Views (73130) $352.08 $489 3.8×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $447.84 $622 4.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $383.04 $532 4.1×
Radex Ribs Unilateral 2 Views (71100) $322.56 $448 3.5×
Radex shoulder complete minimum 2 views (73030) $412.56 $573 4.4×
Radex Sinuses Paransl < 3 Views (70210) $198.72 $276 2.1×
Radex Spine 1 View Specify Level (72020) $250.56 $348 2.7×
Radex Sternum Minimum 2 Views (71120) $383.04 $532 4.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $476.64 $662 5.1×
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines		 $293.04–$407 $407 varies
Radex upper extremity infant minimum 2 views (73092) $352.08 $489 3.1×
Radex Wrist Complete Minimum 3 Views (73110) $352.08 $489 3.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $412.56 $573 3.7×
Radiolog exam mandible compl minimum 4 views (70110) $508.32 $706 4.5×
Radiologic exam colon double contrast study (74280) $1,046.88 $1,454 5.6×
Radiologic exam colon single contrast study (74270) $732.24 $1,017 3.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $809.28 $1,124 4.3×
Radiologic exam knee complete 4/more views (73564) $436.32 $606 3.9×
Radiologic exam pelvis compl minimum 3 views (72190) $267.12 $371 2.4×
Radiologic exam swallow function contrast study (74230) $733.68 $1,019 3.9×
Radiologic exam upr gi trc double contrast study (74246) $773.28 $1,074 4.1×
Radiologic examination femur 1 view (73551) $352.08 $489 3.8×
Radiologic examination femur minimum 2 views (73552) $352.08 $489 3.8×
Radiologic examination knee 1/2 views (73560) $353.52 $491 3.8×
Radiologic examination tibia & fibula 2 views (73590) $352.08 $489 3.8×
Ribs bilateral 3 views (71110) $293.76 $408 2.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,819.52 $3,916 4.8×
Scapula (73010) $412.56 $573 3.7×
Screening Digital Breast Tomosynthesis Bi (77063) $109.44 $152 4.7×
Shoulder 1 view (73020) $190.08 $264 2.0×
Skull less than 4 views (70250) $505.44 $702 4.5×
Sternoclavicular joints (71130) $412.56 $573 4.4×
Thoracic spine 2 views (72070) $274.32 $381 2.4×
Thoracic spine 3 views (72072) $412.56 $573 3.7×
Thyroid Imaging With Vascular Flow (78013) $867.60 $1,205 2.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $867.60 $1,205 2.0×
Ultrasound Breast Limited (76642) $749.52 $1,041 8.0×
Ultrasound Exam Aaa Screen (76706) $567.36 $788 5.1×
Ultrasound, abdomen limited (76705) $732.24 $1,017 6.5×
Upper gi w/o kub (74240) $837.36 $1,163 4.5×
Us breast unilateral complete (76641) $749.52 $1,041 6.7×
Us chest (76604) $412.56 $573 3.7×
Us complete joint (76881) $628.56 $873 5.6×
Us exam, pelvic, limited (76857) $668.88 $929 6.0×
Us kidney transplant (76776) $267.12 $371 2.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $450 $625 4.0×
Us ob limited 1 or more fetuses (76815) $267.12 $371 2.4×
Us ob transvaginal (76817) $765.36 $1,063 6.8×
Us pelvic non ob complete (76856) $837.36 $1,163 7.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $566.64 $787 5.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $822.96 $1,143 7.3×
Us retroperitoneal complete (76770) $786.24 $1,092 7.0×
Us retroperitoneal limited (76775) $716.40 $995 6.4×
Us scrotum and contents (76870) $637.92 $886 5.7×
Us thyroid (76536) $668.88 $929 6.0×
Wrist 2 views (73100) $331.92 $461 3.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $419.04 $582 4.5×
X-Ray Bend Only L-S Spine (72120) $267.12 $371 2.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $293.04 $407 3.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $412.56 $573 3.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $412.56 $573 3.7×
X-Ray Exam Hip Uni 1 View (73501) $165.60 $230 1.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $336.96 $468 3.6×
X-Ray Exam Hips Bi 2 Views (73521) $702.72 $976 6.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $702.72 $976 6.3×
X-Ray Exam Hips Bi 5/> Views (73523) $702.72 $976 6.3×
X-Ray Exam L-S Spine Bending (72114) $741.60 $1,030 6.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $696.96 $968 7.5×
X-Ray Exam Neck Spine 6/>Vws (72052) $612.72 $851 5.5×
X-Ray Exam Unilat Ribs/Chest (71101) $453.60 $630 4.0×
X-ray eye for foreign body (70030) $250.56 $348 2.7×
X-ray humerus (73060) $352.08 $489 3.8×
X-ray IV pyelogram (ivp) (74400) $794.88 $1,104 4.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $198.72 $276 2.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $383.04 $532 4.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $419.04 $582 3.7×
X-ray nose-rectum child f.b. (76010) $198.72 $276 2.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $573.84 $797 5.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $447.84 $622 4.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $267.12 $371 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $412.56 $573 4.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $498.96 $693 5.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $544.32 $756 4.9×
X-ray thoracic spine 4 vw (72074) $697.68 $969 6.2×
X-Rays Bone Length Studies (77073) $267.12 $371 2.4×
X-Rays Bone Survey Complete (77075) $1,149.84 $1,597 10.3×
Xr c-spine 4 or 5 views (72050) $573.84 $797 5.1×
Xr facial bones less than 3 views (70140) $399.60 $555 4.3×
Xr orbits complete 4 views (70200) $250.56 $348 2.2×

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.