Imaging prices at Jackson County Memorial Hospital Authority
Altus, OK · every code in this section with a posted price and a Medicare benchmark.
225 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) | $339.59 | $339.59 | 4.0× |
| Abdomen 2 views (74019) | $336.21 | $336.21 | 3.3× |
| Ankle 2 views (73600) | $401.10 | $401.10 | 4.8× |
| Arthrogram ankle (73615) | $585.62 | $585.62 | 1.7× |
| Arthrogram hip (73525) | $673.05 | $673.05 | 2.0× |
| Arthrogram Wrist (73115) | $673.05 | $673.05 | 2.0× |
| Bone age studies (77072) | $336.21 | $336.21 | 3.3× |
| Bone Imaging 3 Phase (78315) | $2,920.05 | $2,920.05 | 7.6× |
| Bone Imaging Limited Area (78300) | $1,702.05 | $1,702.05 | 4.4× |
| Bone Imaging Whole Body (78306) | $2,883.30 | $2,883.30 | 7.5× |
| Bone survey infant (77076) | $336.21 | $336.21 | 3.3× |
| Chest 1 view (71045) | $239.40 | $239.40 | 2.9× |
| Chest 2 views (71046) | $325 | $325 | 3.9× |
| Chest 3 views (71047) | $479.18 | $479.18 | 5.7× |
| Chest 4 or more views (71048) | $336.21 | $336.21 | 3.3× |
| Clavicle complete (73000) | $362.25 | $362.25 | 4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $229.89 | $229.89 | 2.3× |
| Contrast X-Ray Bladder (74430) | $1,145.43 | $1,145.43 | 3.4× |
| Contrast X-Ray Of Elbow (73085) | $917 | $917 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $673.05 | $673.05 | 2.0× |
| Contrast Xray Throat/Cerv Esopha (74210) | $546.60 | $546.60 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $4,318 | $4,318 | 12.8× |
| CT abdomen and pelvis without contrast (74176) | $2,392 | $2,392 | 10.4× |
| CT abdomen w contrast (74160) | $1,727.25 | $1,727.25 | 10.2× |
| CT abdomen w wo contrast (74170) | $2,329.95 | $2,329.95 | 13.8× |
| CT abdomen w/o contrast (74150) | $1,570.80 | $1,570.80 | 15.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,964 | $3,964 | 11.8× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,982–$2,919 | $1,982–$2,919 | varies |
| CT Angio Head (70496) | $1,843.80 | $1,843.80 | 10.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,630.65 | $1,630.65 | 9.6× |
| CT Angio Neck (70498) | $2,275.35 | $2,275.35 | 13.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,630.65 | $1,630.65 | 9.6× |
| CT cervical spine w/ contrast (72126) | $1,836.45 | $1,836.45 | 5.5× |
| CT cervical spine w/o contrast (72125) | $1,739.85 | $1,739.85 | 17.3× |
| CT cervical spine w/wo cont (72127) | $1,601 | $1,601 | 9.5× |
| CT chest w contrast (71260) | $1,834.35 | $1,834.35 | 10.8× |
| CT chest w/wo contrast (71270) | $2,423.40 | $2,423.40 | 14.3× |
| CT head/brain with contrast (70460) | $4,148.50 | $4,148.50 | 24.5× |
| CT head/brain without and with contrast (70470) | $2,411 | $2,411 | 14.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $192 | $192 | 2.3× |
| CT iac w contrast (70481) | $1,298.85 | $1,298.85 | 7.7× |
| CT l-spine w&w/o contrast (72133) | $2,634.98 | $2,634.98 | 15.6× |
| CT lower ext w/o (73700) | $1,365 | $1,365 | 13.5× |
| CT lower extremity w/contrast material (73701) | $1,559.25 | $1,559.25 | 9.2× |
| CT lumbar spine w contrast (72132) | $1,892.10 | $1,892.10 | 5.6× |
| CT lumbar spine w/o contrast (72131) | $1,756.65 | $1,756.65 | 17.4× |
| CT maxillofacial w contrast (70487) | $1,426.95 | $1,426.95 | 8.4× |
| CT maxillofacial wo contrast (70486) | $1,257.90 | $1,257.90 | 12.5× |
| CT neck tissue combo (70492) | $1,774.50 | $1,774.50 | 10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,691.55 | $1,691.55 | 10.0× |
| CT orbits w/o contrast (70480) | $1,127.70 | $1,127.70 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $2,219.70 | $2,219.70 | 13.1× |
| CT pelvis w/o contrast (72192) | $1,414.35 | $1,414.35 | 14.0× |
| CT scan of leg combo (73702) | $1,559.25 | $1,559.25 | 9.2× |
| CT scans face/jaw combo (70488) | $2,027 | $2,027 | 12.0× |
| CT soft tissue neck w contrast (70491) | $1,593.90 | $1,593.90 | 9.4× |
| CT soft tissue neck w/o contrast (70490) | $1,142.40 | $1,142.40 | 11.3× |
| CT thoracic spine w contrast (72129) | $1,403.85 | $1,403.85 | 8.3× |
| CT thoracic spine w/o contrast (72128) | $1,275.75 | $1,275.75 | 12.6× |
| CT thorax w/o contrast (71250) | $1,681.05 | $1,681.05 | 16.7× |
| CT upper ext wo (73200) | $827.40 | $827.40 | 8.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,559.25 | $1,559.25 | 9.2× |
| CT upper extremity with contrast (73201) | $993.30 | $993.30 | 3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,963.75 | $3,963.75 | 23.4× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,982–$3,046.05 | $1,982–$3,046.05 | varies |
| Dxa Bone Density Axial (77080) | $336.21 | $336.21 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $239.40 | $239.40 | 2.9× |
| Esophagram (74220) | $546.60 | $546.60 | 3.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $506.10 | $506.10 | 5.0× |
| Foot 2 views (73620) | $370.65 | $370.65 | 4.4× |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$210.53–$421.05 | $210.53–$421.05 | varies |
| Gastric emptying imaging study (78264) | $2,329.95 | $2,329.95 | 6.0× |
| Hand 2 views (73120) | $328.65 | $328.65 | 3.3× |
| Hepatobiliary System Imaging (78226) | $2,598.75 | $2,598.75 | 6.7× |
| Hysterosalpingogram (74740) | $699.03 | $699.03 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $499.29 | $499.29 | 5.9× |
| Infant hip ultrasound, limited static exam (76886) | $239.40 | $239.40 | 2.9× |
| Infusion Ivp (74410) | $546.60 | $546.60 | 3.2× |
| Joint Survey Single View (77077) | $336.21 | $336.21 | 3.3× |
| K Flow/Funct Image Multiple (78709) | $1,844.85 | $1,844.85 | 3.5× |
| K Flow/Funct Image W/O Drug (78707) | $2,268 | $2,268 | 4.3× |
| Knee 3 Views (73562) | $548.10 | $548.10 | 6.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,729.35 | $1,729.35 | 3.3× |
| Lymph System Imaging (78195) | $2,108.40 | $2,108.40 | 4.0× |
| Meckels Divert Exam (78290) | $1,833.30 | $1,833.30 | 4.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,193 | $3,193 | 9.5× |
| MRA head w/o contrast (70544) | $2,965.20 | $2,965.20 | 12.9× |
| MRA head with contrast (70545) | $2,965.20 | $2,965.20 | 8.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,520.65 | $3,520.65 | 10.5× |
| MRA neck w/o contrast (70547) | $2,647.05 | $2,647.05 | 11.5× |
| MRI abdomen w contrast (74182) | $3,522.75 | $3,522.75 | 10.5× |
| MRI abdomen w/o contrast (74181) | $2,935.80 | $2,935.80 | 12.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,894.85 | $2,894.85 | 3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,633 | $3,633 | 10.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,290.70 | $3,290.70 | 4.4× |
| MRI cervical spine w contrast (72142) | $3,787.35 | $3,787.35 | 11.3× |
| MRI cervical spine w/o cont (72141) | $3,442.95 | $3,442.95 | 15.0× |
| MRI chest w/o contrast (71550) | $2,786.70 | $2,786.70 | 12.1× |
| MRI chest wo w contrast (71552) | $3,847.20 | $3,847.20 | 11.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,968.35 | $2,968.35 | 8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,323.25 | $3,323.25 | 9.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,698.50 | $2,698.50 | 11.7× |
| MRI lumbar spine w contrast (72149) | $3,924.90 | $3,924.90 | 11.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,527.60 | $4,527.60 | 13.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,326.80 | $2,326.80 | 10.1× |
| MRI orbit face neck w contrast (70542) | $2,974.13 | $2,974.13 | 8.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,895.50 | $3,895.50 | 11.6× |
| MRI pelvis w contrast (72196) | $3,619.35 | $3,619.35 | 10.8× |
| MRI pelvis w/o & w contrast (72197) | $4,340.70 | $4,340.70 | 12.9× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,371.28–$3,112.20 | $1,371.28–$3,112.20 | varies |
| MRI thoracic spine w/o contrast (72146) | $3,756.90 | $3,756.90 | 16.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,867.55 | $2,867.55 | 8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,607.15 | $2,607.15 | 11.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,286.50 | $3,286.50 | 9.8× |
| MRI, abdomen, combo (74183) | $4,053 | $4,053 | 12.0× |
| MRI, dorsal spine combo (72157) | $4,580.10 | $4,580.10 | 13.6× |
| MRI, dorsal spine contrast (72147) | $4,132.80 | $4,132.80 | 12.3× |
| MRI, joint upper extrem (73221) | $2,991.45 | $2,991.45 | 13.0× |
| MRI, joint upper extrem combo (73223) | $3,688.65 | $3,688.65 | 11.0× |
| MRI, lumbar spine combo (72158) | $4,688.25 | $4,688.25 | 13.9× |
| Myocardial Spect Multiple Studies (78452) | $5,420.10 | $5,420.10 | 4.3× |
| Neck soft tissue (70360) | $239.40 | $239.40 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $336.21 | $336.21 | 3.3× |
| Parathyroid Planar Imaging (78070) | $1,948.80 | $1,948.80 | 5.1× |
| Pelvis 1 or 2 views (72170) | $336.21 | $336.21 | 3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,259.60 | $2,259.60 | 5.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $336.21 | $336.21 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,444.59 | $1,444.59 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $522.90 | $522.90 | 6.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $330.75 | $330.75 | 3.9× |
| Radex elbow complete minimum 3 views (73080) | $537.60 | $537.60 | 6.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $336.21 | $336.21 | 3.3× |
| Radex fingr minimum 2 views (73140) | $380.10 | $380.10 | 4.5× |
| Radex foot complete minimum 3 views (73630) | $444.15 | $444.15 | 5.3× |
| Radex Hand Minimum 3 Views (73130) | $442.05 | $442.05 | 5.3× |
| Radex lower extremity infant minimum 2 views (73592) | $321.05 | $321.05 | 3.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $336.21 | $336.21 | 3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $239.40 | $239.40 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $535.50 | $535.50 | 6.4× |
| Radex shoulder complete minimum 2 views (73030) | $551.25 | $551.25 | 6.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $239.40 | $239.40 | 2.9× |
| Radex Spine 1 View Specify Level (72020) | $239.40 | $239.40 | 2.9× |
| Radex Sternum Minimum 2 Views (71120) | $239.40 | $239.40 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $239.40 | $239.40 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $334.95 | $334.95 | 4.0× |
| Radex upper extremity infant minimum 2 views (73092) | $237.04 | $237.04 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $430.50 | $430.50 | 5.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $336.21 | $336.21 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $546.60 | $546.60 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $546.60 | $546.60 | 3.2× |
| Radiologic exam knee complete 4/more views (73564) | $597.45 | $597.45 | 5.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $336.21 | $336.21 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $546.60 | $546.60 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $546.60 | $546.60 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $546.60 | $546.60 | 3.2× |
| Radiologic examination femur 1 view (73551) | $226.23 | $226.23 | 2.7× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$219.45–$438.90 | $219.45–$438.90 | varies |
| Radiologic examination knee 1/2 views (73560) | $429.45 | $429.45 | 5.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$210.53–$421.05 | $210.53–$421.05 | varies |
| Ribs bilateral 3 views (71110) | $336.21 | $336.21 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$2,345.70–$3,079.65 | $2,345.70–$3,079.65 | varies |
| Scapula (73010) | $416.85 | $416.85 | 4.1× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$238.35–$239.40 | $238.35–$239.40 | varies |
| Shoulder Arthrography (73040) | $673.05 | $673.05 | 2.0× |
| Skull less than 4 views (70250) | $336.21 | $336.21 | 3.3× |
| Sternoclavicular joints (71130) | $239.40 | $239.40 | 2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $546.60 | $546.60 | 3.2× |
| Thoracic spine 2 views (72070) | $336.21 | $336.21 | 3.3× |
| Thoracic spine 3 views (72072) | $336.21 | $336.21 | 3.3× |
| Thoracolumbar 2 views (72080) | $239.40 | $239.40 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,145.15 | $2,145.15 | 5.6× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$434.96–$869.92 | $434.96–$869.92 | varies |
| Ultrasound Exam Aaa Screen (76706) | $332.85 | $332.85 | 3.3× |
| Ultrasound, abdomen limited (76705) | $724.50 | $724.50 | 7.2× |
| Upper gi w/o kub (74240) | $546.60 | $546.60 | 3.2× |
| Urethrocystogram voiding (74455) | $699.03 | $699.03 | 3.0× |
| Urethrocystography retrograde (74450) | $699.03 | $699.03 | 3.0× |
| Us breast unilateral complete (76641) | $499.80 | $499.80 | 5.0× |
| Us chest (76604) | $499.80 | $499.80 | 5.0× |
| Us complete joint (76881) | $660.45 | $660.45 | 6.5× |
| Us exam, pelvic, limited (76857) | $579.60 | $579.60 | 5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $582.75 | $582.75 | 5.8× |
| Us ob limited 1 or more fetuses (76815) | $519.75 | $519.75 | 5.2× |
| Us ob transvaginal (76817) | $547.05 | $547.05 | 5.4× |
| Us pelvic non ob complete (76856) | $761.25 | $761.25 | 7.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $505.05 | $505.05 | 5.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $370.65 | $370.65 | 3.7× |
| Us retroperitoneal complete (76770) | $956.55 | $956.55 | 9.5× |
| Us retroperitoneal limited (76775) | $354.90 | $354.90 | 3.5× |
| Us scrotum and contents (76870) | $675.15 | $675.15 | 6.7× |
| Us spinal canal and contents (76800) | $545 | $545 | 5.4× |
| Us thyroid (76536) | $676.20 | $676.20 | 6.7× |
| Wrist 2 views (73100) | $320.25 | $320.25 | 3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $239.40 | $239.40 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $401.10 | $401.10 | 4.8× |
| X-Ray Exam Breast Specimen (76098) | $1,181.25 | $1,181.25 | 2.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $535.50 | $535.50 | 6.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $535.50 | $535.50 | 5.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $240.45 | $240.45 | 2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $385.35 | $385.35 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $336.21 | $336.21 | 3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $337.62 | $337.62 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $336.21 | $336.21 | 3.3× |
| X-Ray Exam L-S Spine Bending (72114) | $336.21 | $336.21 | 3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $239.40 | $239.40 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $336.21 | $336.21 | 3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $590.10 | $590.10 | 5.9× |
| X-ray eye for foreign body (70030) | $239.40 | $239.40 | 2.9× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$210.53–$421.05 | $210.53–$421.05 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $239.40 | $239.40 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $239.40 | $239.40 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $336.21 | $336.21 | 3.3× |
| X-ray nose-rectum child f.b. (76010) | $239.40 | $239.40 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $336.21 | $336.21 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $385.35 | $385.35 | 3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $393.75 | $393.75 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $239.40 | $239.40 | 2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $239.40 | $239.40 | 2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,145.43 | $1,145.43 | 3.4× |
| X-Rays Bone Length Studies (77073) | $336.21 | $336.21 | 3.3× |
| X-Rays Bone Survey Complete (77075) | $336.21 | $336.21 | 3.3× |
| Xr c-spine 4 or 5 views (72050) | $336.21 | $336.21 | 3.3× |
| Xr facial bones less than 3 views (70140) | $416.85 | $416.85 | 5.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $336.21 | $336.21 | 3.3× |
| Xr orbits complete 4 views (70200) | $336.21 | $336.21 | 3.3× |
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.