Imaging prices at Indianhead Medical Center Shell Lake
Shell Lake, WI · every code in this section with a posted price and a Medicare benchmark.
151 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $332 | $415 | 3.3× |
| Ankle 2 views (73600) | $332 | $415 | 3.9× |
| Bone Imaging 3 Phase (78315) | $771.28 | $964.10 | 2.0× |
| Bone Imaging Limited Area (78300) | $506.72 | $633.40 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $636.48 | $795.60 | 1.6× |
| Bone Imaging Whole Body (78306) | $711.36 | $889.20 | 1.8× |
| Chest 1 view (71045) | $268.80 | $336 | 3.2× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$205.80–$336 | $257.25–$420 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$249.60–$280 | $312–$350 | varies |
| Chest 4 or more views (71048) | $416.64 | $520.80 | 4.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$134.40–$332 | $168–$415 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,391.20 | $5,489 | 13.0× |
| CT abdomen and pelvis without contrast (74176) | $3,196 | $3,995 | 13.8× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$912.16–$2,360 | $1,140.20–$2,950 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,024.68–$4,160 | $1,280.85–$5,200 | varies |
| CT abdomen w/o contrast (74150) | $1,073.27 | $1,341.59 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,310.40 | $5,388 | 12.7× |
| CT cervical spine w/ contrast (72126) | $1,520 | $1,900 | 4.5× |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$345.76–$2,480 | $432.20–$3,100 | varies |
| CT chest w contrast (71260) | $1,888 | $2,360 | 11.1× |
| CT chest w/wo contrast (71270) | $1,800 | $2,250 | 10.6× |
| CT head/brain with contrast (70460) | $2,880 | $3,600 | 16.9× |
| CT head/brain without and with contrast (70470) | $2,440 | $3,050 | 14.3× |
| CT iac w contrast (70481) | $1,040 | $1,300 | 6.1× |
| CT lumbar spine w contrast (72132) | $1,520 | $1,900 | 4.5× |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$345.76–$1,960 | $432.20–$2,450 | varies |
| CT maxillofacial w contrast (70487) | $960 | $1,200 | 5.6× |
| CT maxillofacial wo contrast (70486) | $2,000 | $2,500 | 19.7× |
| CT neck tissue combo (70492) | $1,591.40 | $1,989.25 | 9.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,280 | $1,600 | 7.5× |
| CT orbits w/o contrast (70480) | $719.20 | $899 | 7.1× |
| CT pelvis w&w/o contrast (72194) | $1,520 | $1,900 | 8.9× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$391.32–$1,229.60 | $489.15–$1,537 | varies |
| CT scan of leg combo (73702) | $960 | $1,200 | 5.6× |
| CT scans face/jaw combo (70488) | $1,288 | $1,610 | 7.6× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,440–$2,392 | $1,800–$2,990 | varies |
| CT soft tissue neck w/o contrast (70490) | $1,440 | $1,800 | 14.2× |
| CT thoracic spine w contrast (72129) | $1,269.60 | $1,587 | 7.5× |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$345.76–$865.28 | $432.20–$1,081.60 | varies |
| CT thorax w/o contrast (71250) | $1,840 | $2,300 | 18.1× |
| CT upper ext wo (73200) | $1,440 | $1,800 | 14.2× |
| CT upper extremity w/o & w/contrast material (73202) | $960 | $1,200 | 5.6× |
| CT upper extremity with contrast (73201) | $800 | $1,000 | 2.4× |
| Cta Abdomen (74175) | $3,710.40 | $4,638 | 21.8× |
| Dxa Bone Density Axial (77080) | $500.80 | $626 | 4.9× |
| Esophagram (74220) | $508.12 | $635.15 | 3.0× |
| Foot 2 views (73620) | $332 | $415 | 3.9× |
| Forearm 2 views (73090) | $356 | $445 | 4.2× |
| Hysterosalpingogram (74740) | $376 | $470 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $612.32 | $765.40 | 1.2× |
| Kidney Imaging Morphol (78700) | $372.72 | $465.90 | 1.0× |
| Knee 3 Views (73562) | $368 | $460 | 4.4× |
| Magnetic Image Jaw Joint (70336) | $2,380 | $2,975 | 10.3× |
| MRA head w/o contrast (70544) | $3,514.40 | $4,393 | 15.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,468 | $6,835 | 16.1× |
| MRI abdomen w contrast (74182) | $2,640 | $3,300 | 7.8× |
| MRI abdomen w/o contrast (74181) | $2,376 | $2,970 | 10.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,120 | $2,650 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,744 | $4,680 | 11.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,960 | $3,700 | 3.9× |
| MRI cervical spine w contrast (72142) | $2,520 | $3,150 | 7.4× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,586.40–$3,196 | $1,983–$3,995 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,120 | $2,650 | 6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,600 | $4,500 | 10.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,360–$3,040 | $2,950–$3,800 | varies |
| MRI lumbar spine w contrast (72149) | $2,620.80 | $3,276 | 7.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,780 | $4,725 | 11.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,352 | $2,940 | 10.1× |
| MRI orbit face neck w contrast (70542) | $2,604 | $3,255 | 7.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,780 | $4,725 | 11.2× |
| MRI pelvis w contrast (72196) | $2,400 | $3,000 | 7.1× |
| MRI pelvis w/o & w contrast (72197) | $3,800 | $4,750 | 11.2× |
| MRI pelvis w/o contrast (72195) | $2,640 | $3,300 | 11.4× |
| MRI thoracic spine w/o contrast (72146) | $3,080 | $3,850 | 13.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,120 | $2,650 | 6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,960 | $2,450 | 8.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,960–$3,600 | $2,450–$4,500 | varies |
| MRI, abdomen, combo (74183) | $3,040 | $3,800 | 9.0× |
| MRI, dorsal spine combo (72157) | $3,600 | $4,500 | 10.6× |
| MRI, dorsal spine contrast (72147) | $2,720 | $3,400 | 8.0× |
| MRI, joint upper extrem (73221) | $3,520 | $4,400 | 15.2× |
| MRI, joint upper extrem combo (73223) | $2,960 | $3,700 | 8.7× |
| MRI, lumbar spine combo (72158) | $3,900 | $4,875 | 11.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$735.80–$2,852.10 | $919.75–$3,565.12 | varies |
| Pelvis 1 or 2 views (72170) | $309.12 | $386.40 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$320–$325.92 | $400–$407.40 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $372 | $465 | 4.4× |
| Radex elbow complete minimum 3 views (73080) | $352 | $440 | 4.2× |
| Radex fingr minimum 2 views (73140) | $332 | $415 | 3.9× |
| Radex foot complete minimum 3 views (73630) | $360 | $450 | 4.3× |
| Radex Hand Minimum 3 Views (73130) | $360 | $450 | 4.3× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$424–$488 | $530–$610 | varies |
| Radex shoulder complete minimum 2 views (73030) | $332 | $415 | 3.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $332 | $415 | 3.9× |
| Radex Spine 1 View Specify Level (72020) | $196 | $245 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) | $231.84 | $289.80 | 2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $445.38 | $556.72 | 5.3× |
| Radex Toe Minimum 2 Views (73660) | $228 | $285 | 2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $368 | $460 | 4.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$352–$392 | $440–$490 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $349.44 | $436.80 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $441.04 | $551.30 | 2.6× |
| Radiologic examination femur 1 view (73551) | $164.64 | $205.80 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) | $292 | $365 | 3.5× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$164.64–$332 | $205.80–$415 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$232–$292 | $290–$365 | varies |
| Ribs bilateral 3 views (71110) | $464.56 | $580.70 | 4.6× |
| Scapula (73010) | $260 | $325 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $188 | $235 | 8.0× |
| Sella turcica (70240) | $140.32 | $175.40 | 1.7× |
| Shoulder 1 view (73020) | $189.34 | $236.67 | 2.2× |
| Shoulder Arthrography (73040) | $784.80 | $981 | 2.3× |
| Skull less than 4 views (70250) | $276.40 | $345.50 | 2.7× |
| Testicular Imaging W/Flow (78761) | $290.08 | $362.60 | 0.7× |
| Thoracic spine 2 views (72070) | $317.86 | $397.33 | 3.1× |
| Thoracic spine 3 views (72072) | $492 | $615 | 4.8× |
| Ultrasound Breast Limited (76642) | $500 | $625 | 5.9× |
| Ultrasound Exam Aaa Screen (76706) | $561.88 | $702.35 | 5.5× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$343.37–$752 | $429.21–$940 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$442.40–$493.60 | $553–$617 | varies |
| Unlisted us procedure (76999) | $330.16 | $412.70 | 3.9× |
| Upper gi w/o kub (74240) | $400.94 | $501.17 | 2.4× |
| Us breast unilateral complete (76641) | $560 | $700 | 5.5× |
| Us chest (76604) range across 2 matching MRF lines |
$387.44–$560 | $484.30–$700 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$94.40–$330.16 | $118–$412.70 | varies |
| Us exam, pelvic, limited (76857) | $660 | $825 | 6.5× |
| Us pelvic non ob complete (76856) | $920 | $1,150 | 9.1× |
| Us retroperitoneal complete (76770) | $504 | $630 | 5.0× |
| Us retroperitoneal limited (76775) | $960 | $1,200 | 9.5× |
| Us scrotum and contents (76870) | $520 | $650 | 5.1× |
| Us thyroid (76536) range across 3 matching MRF lines |
$330.16–$876 | $412.70–$1,095 | varies |
| Wrist 2 views (73100) | $332 | $415 | 3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $332 | $415 | 3.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $276.40 | $345.50 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $266.62 | $333.27 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$580–$597.60 | $725–$747 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$276.40–$440 | $345.50–$550 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $480 | $600 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $598 | $747.50 | 5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $440 | $550 | 5.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$424–$440 | $530–$550 | varies |
| X-ray humerus (73060) | $260 | $325 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$318.40–$352 | $398–$440 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$400–$688 | $500–$860 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $306.46 | $383.08 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $479.14 | $598.92 | 5.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $304.96 | $381.20 | 3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $363.42 | $454.27 | 3.6× |
| X-Ray Tmj Unilat (70328) | $264.64 | $330.80 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $880 | $1,100 | 8.7× |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$343.20–$741.60 | $429–$927 | varies |
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.