Imaging prices at Jasper Memorial Hospital
Monticello, GA · every code in this section with a posted price and a Medicare benchmark.
140 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) range across 2 matching MRF lines |
$80.20–$81.80 | $160.40–$163.60 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$98.35–$98.95 | $196.70–$197.90 | varies |
| Bone age studies (77072) | $105.15 | $210.30 | 1.0× |
| Bone survey infant (77076) | $74.10 | $148.20 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $533.40 | $1,066.80 | 6.1× |
| Chest 1 view (71045) | $64.40 | $128.80 | 0.7× |
| Chest 2 views (71046) | $127.95 | $255.90 | 1.5× |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$95.90–$105.85 | $191.80–$211.70 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$91.25–$136.80 | $182.50–$273.60 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $705.70 | $1,411.40 | 6.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,842.80 | $3,685.60 | 5.3× |
| CT abdomen and pelvis without contrast (74176) | $1,332.55 | $2,665.10 | 5.6× |
| CT abdomen w contrast (74160) | $849.85 | $1,699.70 | 4.8× |
| CT abdomen w wo contrast (74170) | $1,002 | $2,004 | 5.7× |
| CT abdomen w/o contrast (74150) | $726.35 | $1,452.70 | 6.9× |
| CT Angio Chest (71275) | $1,373.25 | $2,746.50 | 7.8× |
| CT cervical spine w/ contrast (72126) | $663.15 | $1,326.30 | 1.9× |
| CT cervical spine w/o contrast (72125) | $728.10 | $1,456.20 | 6.9× |
| CT cervical spine w/wo cont (72127) | $797.25 | $1,594.50 | 4.5× |
| CT chest w contrast (71260) | $844.40 | $1,688.80 | 4.8× |
| CT chest w/wo contrast (71270) | $1,009.65 | $2,019.30 | 5.7× |
| CT head/brain with contrast (70460) | $689 | $1,378 | 3.9× |
| CT head/brain without and with contrast (70470) | $1,013.30 | $2,026.60 | 5.8× |
| CT iac w contrast (70481) | $705.50 | $1,411 | 4.0× |
| CT l-spine w&w/o contrast (72133) | $797.25 | $1,594.50 | 4.5× |
| CT lower ext w/o (73700) | $518.50 | $1,037 | 4.9× |
| CT lower extremity w/contrast material (73701) | $581.40 | $1,162.80 | 3.3× |
| CT lumbar spine w contrast (72132) | $663.15 | $1,326.30 | 1.9× |
| CT lumbar spine w/o contrast (72131) | $651.90 | $1,303.80 | 6.2× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$613.80–$736.90 | $1,227.60–$1,473.80 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$673.25–$673.45 | $1,346.50–$1,346.90 | varies |
| CT neck tissue combo (70492) | $853.65 | $1,707.30 | 4.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $831.05 | $1,662.10 | 4.7× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$635–$710.10 | $1,270–$1,420.20 | varies |
| CT pelvis w&w/o contrast (72194) | $841 | $1,682 | 4.8× |
| CT pelvis w/o contrast (72192) | $606.20 | $1,212.40 | 5.8× |
| CT scan of leg combo (73702) | $663.15 | $1,326.30 | 3.8× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$804.30–$957.35 | $1,608.60–$1,914.70 | varies |
| CT soft tissue neck w contrast (70491) | $773.40 | $1,546.80 | 4.4× |
| CT soft tissue neck w/o contrast (70490) | $670.20 | $1,340.40 | 6.4× |
| CT thoracic spine w contrast (72129) | $664 | $1,328 | 3.8× |
| CT thoracic spine w/o contrast (72128) | $728.10 | $1,456.20 | 6.9× |
| CT thoracic spine w/wo cont (72130) | $797.25 | $1,594.50 | 4.5× |
| CT thorax w/o contrast (71250) | $705.70 | $1,411.40 | 6.7× |
| CT upper ext wo (73200) | $570.70 | $1,141.40 | 5.4× |
| CT upper extremity w/o & w/contrast material (73202) | $670.20 | $1,340.40 | 3.8× |
| CT upper extremity with contrast (73201) | $562.35 | $1,124.70 | 1.6× |
| Dxa Bone Density Axial (77080) | $119.50 | $239 | 1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $65.65 | $131.30 | 0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $237.35 | $474.70 | 2.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$150.45–$180.65 | $300.90–$361.30 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$80–$127.65 | $160–$255.30 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$92.40–$184.95 | $184.80–$369.90 | varies |
| Magnetic Image Jaw Joint (70336) | $888.95 | $1,777.90 | 3.7× |
| Neck soft tissue (70360) | $85 | $170 | 1.0× |
| Optic foramina (70190) | $66 | $132 | 0.8× |
| Pelvis 1 or 2 views (72170) | $104.55 | $209.10 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $128.10 | $256.20 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$91.35–$182.55 | $182.70–$365.10 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$69.35–$138.65 | $138.70–$277.30 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$73.65–$92.70 | $147.30–$185.40 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$128.55–$128.95 | $257.10–$257.90 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$51.10–$70.65 | $102.20–$141.30 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$91.35–$173.50 | $182.70–$347 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$67.60–$135.15 | $135.20–$270.30 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $86.75 | $173.50 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $79.05 | $158.10 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $104.50 | $209 | 1.2× |
| Radex Ribs Unilateral 2 Views (71100) | $113.15 | $226.30 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$104.90–$209.85 | $209.80–$419.70 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $61.80 | $123.60 | 0.7× |
| Radex Spine 1 View Specify Level (72020) | $66.85 | $133.70 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $103.70 | $207.40 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $112.15 | $224.30 | 1.3× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$60.25–$60.80 | $120.50–$121.60 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $86.75 | $173.50 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$78.25–$125.65 | $156.50–$251.30 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $124.40 | $248.80 | 1.2× |
| Radiologic exam knee complete 4/more views (73564) | $99.05 | $198.10 | 0.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $125.80 | $251.60 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $201.35 | $402.70 | 1.1× |
| Radiologic exam swallow function contrast study (74230) | $157.15 | $314.30 | 0.9× |
| Radiologic examination femur 1 view (73551) | $92.25 | $184.50 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$91.35–$182.55 | $182.70–$365.10 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$77.35–$154.75 | $154.70–$309.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $151.75 | $303.50 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$82.85–$165.70 | $165.70–$331.40 | varies |
| Ribs bilateral 3 views (71110) | $115.60 | $231.20 | 1.1× |
| Scapula (73010) range across 2 matching MRF lines |
$98–$98.20 | $196–$196.40 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$41.20–$64.40 | $82.40–$128.80 | varies |
| Sella turcica (70240) | $59.75 | $119.50 | 0.7× |
| Shoulder 1 view (73020) | $67.20 | $134.40 | 0.8× |
| Skull less than 4 views (70250) | $73.35 | $146.70 | 0.7× |
| Sternoclavicular joints (71130) | $88.25 | $176.50 | 1.0× |
| Thoracic spine 2 views (72070) | $94.55 | $189.10 | 0.9× |
| Thoracic spine 3 views (72072) | $111.25 | $222.50 | 1.1× |
| Thoracolumbar 2 views (72080) | $79.25 | $158.50 | 0.9× |
| Ultrasound Breast Limited (76642) | $203.75 | $407.50 | 2.3× |
| Ultrasound Exam Aaa Screen (76706) | $220.20 | $440.40 | 2.1× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$222.35–$222.40 | $444.70–$444.80 | varies |
| Umbilical-artery Doppler (OB) (76820) | $159.25 | $318.50 | 1.5× |
| Unlisted us procedure (76999) | $169.50 | $339 | 1.9× |
| Us breast unilateral complete (76641) | $203.75 | $407.50 | 1.9× |
| Us chest (76604) | $221.25 | $442.50 | 2.1× |
| Us complete joint (76881) | $116.90 | $233.80 | 1.1× |
| Us exam, pelvic, limited (76857) | $169.60 | $339.20 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $92.25 | $184.50 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $166.35 | $332.70 | 1.6× |
| Us ob transvaginal (76817) | $193.30 | $386.60 | 1.8× |
| Us pelvic non ob complete (76856) | $223.15 | $446.30 | 2.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $244.50 | $489 | 2.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $144.55 | $289.10 | 1.4× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$220.20–$250.50 | $440.40–$501 | varies |
| Us scrotum and contents (76870) | $232.95 | $465.90 | 2.2× |
| Us thyroid (76536) | $246.90 | $493.80 | 2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $74.10 | $148.20 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $124.80 | $249.60 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $82.85 | $165.70 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $92.25 | $184.50 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $73.10 | $146.20 | 0.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $92.25 | $184.50 | 1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $88.65 | $177.30 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $107.40 | $214.80 | 1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $271.90 | $543.80 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $173.15 | $346.30 | 1.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $78.85 | $157.70 | 0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $155.25 | $310.50 | 1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $134.45 | $268.90 | 1.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$87.25–$137.70 | $174.50–$275.40 | varies |
| X-ray IV pyelogram (ivp) (74400) | $335.75 | $671.50 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $95.95 | $191.90 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $172 | $344 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $120.70 | $241.40 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $104.90 | $209.80 | 1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $127.95 | $255.90 | 1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $146.80 | $293.60 | 1.4× |
| X-Rays Bone Length Studies (77073) | $81.35 | $162.70 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $195.80 | $391.60 | 1.9× |
| Xr c-spine 4 or 5 views (72050) | $135.50 | $271 | 1.3× |
| Xr orbits complete 4 views (70200) | $110.05 | $220.10 | 1.0× |
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.