Imaging prices at Kit Carson County Memorial Hospital

Burlington, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018)
range across 2 matching MRF lines
$248.12–$250.75 $291.90–$295 varies
Abdomen 2 views (74019) $320.41 $376.95 2.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $812.64 $956.05 1.9×
Ankle 2 views (73600)
range across 3 matching MRF lines
$203.15–$366.79 $239–$431.52 varies
Bone age studies (77072) $280.38 $329.86 2.5×
Bone Imaging 3 Phase (78315) $1,406.75 $1,655 3.3×
Bone Imaging Limited Area (78300) $938.40 $1,104 2.2×
Bone Imaging Multiple Areas (78305) $869.64 $1,023.10 2.1×
Bone Imaging Whole Body (78306) $1,228.25 $1,445 2.9×
Bone survey infant (77076) $238.51 $280.60 2.2×
Cat Scan Follow-Up Study (76380) $402.73 $473.80 4.4×
Chest 1 view (71045) $194.65 $229 2.1×
Chest 2 views (71046)
range across 2 matching MRF lines
$238.85–$307.02 $281–$361.20 varies
Chest 3 views (71047) $250.04 $294.17 2.7×
Chest 4 or more views (71048) $285.90 $336.35 2.6×
Clavicle complete (73000)
range across 3 matching MRF lines
$233.75–$462.39 $275–$543.99 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $415.86 $489.25 3.8×
CT abdomen and pelvis without and with contrast (74178) $2,482 $2,920 6.7×
CT abdomen and pelvis without contrast (74176) $2,188.75 $2,575 8.7×
CT abdomen w contrast (74160) $1,207.01 $1,420.01 6.5×
CT abdomen w wo contrast (74170) $1,327.44 $1,561.69 7.2×
CT abdomen w/o contrast (74150) $963.05 $1,133 8.7×
CT Angio Abdomen and Pelvis (74174) $1,769.61 $2,081.89 4.8×
CT Angio Chest (71275) $1,692.34 $1,990.99 9.1×
CT Angio Head (70496) $1,207.01 $1,420.01 6.5×
CT Angio Neck (70498) $1,207.01 $1,420.01 6.5×
CT cervical spine w/ contrast (72126) $1,632 $1,920 4.4×
CT cervical spine w/o contrast (72125) $1,551.25 $1,825 14.1×
CT cervical spine w/wo cont (72127) $1,997.50 $2,350 10.8×
CT chest w contrast (71260) $1,627.75 $1,915 8.8×
CT chest w/wo contrast (71270) $1,997.50 $2,350 10.8×
CT head/brain with contrast (70460) $1,513 $1,780 8.2×
CT head/brain without and with contrast (70470) $1,827.50 $2,150 9.9×
CT heart no contrast quant eval coronry calcium (75571) $85 $100 0.9×
CT iac w contrast (70481)
range across 2 matching MRF lines
$758.40–$1,160.25 $892.24–$1,365 varies
CT l-spine w&w/o contrast (72133) $1,997.50 $2,350 10.8×
CT lower ext w/o (73700)
range across 21 matching MRF lines
$862.75–$1,368.41 $1,015–$1,609.89 varies
CT lower extremity w/contrast material (73701)
range across 20 matching MRF lines
$861.82–$1,402.50 $1,013.91–$1,650 varies
CT lumbar spine w contrast (72132) $1,632 $1,920 4.4×
CT lumbar spine w/o contrast (72131) $1,496 $1,760 13.6×
CT maxillofacial w contrast (70487) $780.07 $917.73 4.2×
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines
$756.50–$780.07 $890–$917.73 varies
CT neck tissue combo (70492) $1,207.01 $1,420.01 6.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482)
range across 2 matching MRF lines
$796.09–$1,275 $936.58–$1,500 varies
CT orbits w/o contrast (70480) $1,151.75 $1,355 10.4×
CT pelvis w&w/o contrast (72194) $1,997.50 $2,350 10.8×
CT pelvis w/o contrast (72192) $1,496 $1,760 13.6×
CT scan of leg combo (73702)
range across 18 matching MRF lines
$463.64–$1,445 $545.46–$1,700 varies
CT scans face/jaw combo (70488) $907.32 $1,067.44 4.9×
CT soft tissue neck w contrast (70491) $864.12 $1,016.61 4.7×
CT soft tissue neck w/o contrast (70490) $563.52 $662.96 5.1×
CT thoracic spine w contrast (72129) $1,632 $1,920 8.8×
CT thoracic spine w/o contrast (72128) $1,483.25 $1,745 13.4×
CT thoracic spine w/wo cont (72130) $1,997.50 $2,350 10.8×
CT thorax w/o contrast (71250) $1,513 $1,780 13.7×
CT unlisted procedure (76497) $402.73 $473.80 4.4×
CT upper ext wo (73200)
range across 21 matching MRF lines
$563.52–$845.73 $662.96–$994.98 varies
CT upper extremity w/o & w/contrast material (73202)
range across 18 matching MRF lines
$463.64–$1,445 $545.46–$1,700 varies
CT upper extremity with contrast (73201)
range across 20 matching MRF lines
$1,224–$1,351.34 $1,440–$1,589.81 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,207.01 $1,420.01 6.5×
Cta Abdomen (74175) $1,207.01 $1,420.01 6.5×
Dxa Bone Density Axial (77080) $489.06 $575.36 4.4×
Dxa bone density study (77085) $731.04 $860.05 6.6×
Echo exam uterus (76831) $459.64 $540.75 1.8×
Fetal Biophys Profile W/Nst (76818) $683.77 $804.43 6.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $275.78 $324.45 2.5×
Fluoroscopy up to 1 hr (76000) $503.41 $592.25 2.0×
Foot 2 views (73620)
range across 3 matching MRF lines
$203.15–$373.23 $239–$439.09 varies
Forearm 2 views (73090)
range across 3 matching MRF lines
$233.75–$449.52 $275–$528.85 varies
Gastric emptying imaging study (78264) $992.80 $1,168 2.4×
Gastric Mucosa Imaging (78261) $812.64 $956.05 1.9×
Gated Heart Planar Single (78472) $908.24 $1,068.52 2.2×
Hand 2 views (73120)
range across 3 matching MRF lines
$204–$311.10 $240–$366 varies
Hepatobil Syst Image W/Drug (78227) $1,309.97 $1,541.14 2.3×
Hepatobiliary System Imaging (78226) $1,170.93 $1,377.56 2.8×
Ht Musc Image Planar Mult (78454) $1,143.40 $1,345.18 0.8×
Ht Muscle Image Spect Sing (78451) $2,099.63 $2,470.15 1.5×
Hysterosalpingogram (74740) $941.59 $1,107.75 3.7×
K Flow/Funct Image Multiple (78709) $1,111.18 $1,307.27 1.9×
K Flow/Funct Image W/Drug (78708) $1,202.75 $1,415 2.1×
K Flow/Funct Image W/O Drug (78707) $810.80 $953.88 1.4×
Kidney Imaging Morphol (78700) $784.14 $922.52 1.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $784.14 $922.52 1.9×
Knee 3 Views (73562)
range across 3 matching MRF lines
$277.10–$554.20 $326–$652 varies
Liver & Spleen Imaging Static Only (78215) $936.74 $1,102.05 2.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $936.74 $1,102.05 2.2×
Lung Ventilat&Perfus Imaging (78582) $1,166.56 $1,372.42 2.0×
Magnetic Image Jaw Joint (70336) $1,093.94 $1,286.99 4.3×
Meckels Divert Exam (78290) $812.64 $956.05 1.9×
Mra Head W/O & W/Contrast Material (70546) $1,507.61 $1,773.66 4.1×
MRA head w/o contrast (70544) $1,367.88 $1,609.27 5.4×
MRA neck w contrast (70548) $2,477.75 $2,915 6.7×
Mra Neck W/O &W/Contrast Material (70549) $2,720 $3,200 7.4×
MRA neck w/o contrast (70547) $2,341.75 $2,755 9.3×
MRI abdomen w contrast (74182) $2,337.50 $2,750 6.4×
MRI abdomen w/o contrast (74181) $2,125 $2,500 8.4×
MRI any jt lower extrem w/contrast material (73722)
range across 12 matching MRF lines
$1,415.68–$2,123.53 $1,665.51–$2,498.27 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 11 matching MRF lines
$1,851.68–$2,439.14 $2,178.45–$2,869.58 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 10 matching MRF lines
$1,608.74–$2,413.10 $1,892.63–$2,838.94 varies
MRI cervical spine w contrast (72142) $2,125 $2,500 5.8×
MRI cervical spine w/o cont (72141) $1,955 $2,300 7.8×
MRI chest w/o contrast (71550) $781.39 $919.28 3.1×
MRI chest with contrast (71551) $1,286.99 $1,514.10 1.6×
MRI chest wo w contrast (71552) $1,415.68 $1,665.51 3.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 10 matching MRF lines
$1,608.74–$2,413.10 $1,892.63–$2,838.94 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 10 matching MRF lines
$1,769.61–$2,654.86 $2,081.89–$3,123.37 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 10 matching MRF lines
$1,367.88–$2,051.82 $1,609.27–$2,413.91 varies
MRI lumbar spine w contrast (72149) $2,125 $2,500 5.8×
Mri Neck Spine W/O & W/Dye (72156) $2,635 $3,100 7.2×
MRI orbit face &/neck w/o contrast (70540) $1,367.88 $1,609.27 5.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,507.61 $1,773.66 4.1×
MRI pelvis w contrast (72196) $2,380 $2,800 6.5×
MRI pelvis w/o & w contrast (72197) $2,635 $3,100 7.2×
MRI pelvis w/o contrast (72195) $1,870 $2,200 7.4×
MRI thoracic spine w/o contrast (72146) $1,955 $2,300 7.8×
MRI upper extremity oth than jt w/contr matrl (73219)
range across 12 matching MRF lines
$1,286.99–$1,930.48 $1,514.10–$2,271.15 varies
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 12 matching MRF lines
$2,235.68–$3,353.51 $2,630.21–$3,945.31 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 12 matching MRF lines
$1,544.38–$2,316.57 $1,816.92–$2,725.38 varies
MRI, abdomen, combo (74183) $2,635 $3,100 7.2×
MRI, dorsal spine combo (72157) $2,635 $3,100 7.2×
MRI, joint upper extrem (73221)
range across 10 matching MRF lines
$1,373.66–$2,419.01 $1,616.07–$2,845.89 varies
MRI, joint upper extrem combo (73223)
range across 10 matching MRF lines
$1,769.61–$2,654.86 $2,081.89–$3,123.37 varies
MRI, lumbar spine combo (72158) $2,635 $3,100 7.2×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $908.24 $1,068.52 2.2×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,143.40 $1,345.18 0.8×
Myocardial Spect Multiple Studies (78452) $2,805.10 $3,300.12 2.1×
Neck soft tissue (70360) $291.54 $342.99 3.2×
Optic foramina (70190) $170.07 $200.08 1.9×
Parathyroid Planar Imaging (78070) $1,138.15 $1,339 2.7×
Pelvis 1 or 2 views (72170) $295.09 $347.16 2.7×
Pulmonary Perfusion Imaging Particulate (78580) $717.03 $843.57 1.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $408.85 $481 3.7×
Radex abscess/fistula/sinus tract rs&i (76080) $941.59 $1,107.75 1.6×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$260.10–$448.80 $306–$528 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines
$233.75–$421.95 $275–$496.41 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines
$334.05–$535.02 $393–$629.43 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $219.30 $258 2.0×
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines
$203.15–$369.55 $239–$434.76 varies
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines
$317.90–$466.65 $374–$549 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines
$233.75–$466.65 $275–$549 varies
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines
$170.07–$255.56 $200.08–$300.66 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $280.38 $329.86 2.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $215.73 $253.80 2.4×
Radex Ribs Unilateral 2 Views (71100) $308.55 $363 3.4×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines
$251.60–$457.30 $296–$538 varies
Radex Sinuses Paransl < 3 Views (70210) $273.95 $322.29 3.0×
Radex Spine 1 View Specify Level (72020)
range across 2 matching MRF lines
$143.18–$289.17 $168.45–$340.20 varies
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines
$206.39–$299.20 $242.81–$352 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $315.31 $370.95 3.4×
Radex Toe Minimum 2 Views (73660) $203.15 $239 2.2×
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines
$280.38–$421.03 $329.86–$495.33 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines
$251.60–$604.89 $296–$711.63 varies
Radiolog exam mandible compl minimum 4 views (70110) $285.60 $336 2.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $317.73 $373.80 2.9×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines
$483.65–$794.26 $569–$934.42 varies
Radiologic exam pelvis compl minimum 3 views (72190) $312.77 $367.97 2.8×
Radiologic exam swallow function contrast study (74230) $258.57 $304.20 1.4×
Radiologic exam upr gi trc double contrast study (74246) $249.90 $294 1.4×
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$299.23–$448.60 $352.03–$527.77 varies
Radiologic examination knee 1/2 views (73560)
range across 4 matching MRF lines
$254.15–$439.45 $299–$517 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines
$299.20–$597.55 $352–$703 varies
Salivary Gland Imaging (78230) $812.64 $956.05 1.9×
Scapula (73010)
range across 3 matching MRF lines
$234.41–$352.08 $275.78–$414.21 varies
Screening Digital Breast Tomosynthesis Bi (77063) $55.16 $64.89 2.4×
Shoulder 1 view (73020)
range across 3 matching MRF lines
$203.15–$399.88 $239–$470.45 varies
Skull less than 4 views (70250) $471.89 $555.17 4.3×
Sternoclavicular joints (71130) $170.07 $200.08 1.9×
Thoracic spine 2 views (72070) $281.35 $331 2.6×
Thoracic spine 3 views (72072) $298.58 $351.27 2.7×
Thoracolumbar 2 views (72080) $241.40 $284 2.6×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$242.51–$484.50 $285.31–$570 varies
Ultrasound, abdomen limited (76705) $574.55 $675.94 5.2×
Unlisted Dx Radiographic Procedure (76499) $165.11 $194.25 1.8×
Unlisted magnetic resonance procedure (76498) $781.39 $919.28 8.5×
Unlisted us procedure (76999) $344.73 $405.56 3.8×
Us breast unilateral complete (76641)
range across 3 matching MRF lines
$295.04–$590.75 $347.11–$695 varies
Us chest (76604) $344.73 $405.56 3.1×
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines
$85–$290.70 $100–$342 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $482.62 $567.79 4.4×
Us ob limited 1 or more fetuses (76815) $485.03 $570.62 4.4×
Us ob transvaginal (76817) $557.69 $656.11 5.1×
Us pelvic non ob complete (76856) $536.35 $631 4.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $584.80 $688 5.3×
Us preg uterus real time f/u trnsabdl per fetus (76816) $252.80 $297.41 2.3×
Us retroperitoneal complete (76770) $684.86 $805.72 6.2×
Us scrotum and contents (76870) $552.50 $650 5.0×
Us thyroid (76536) $702.10 $826 6.4×
Venography extremity unilateral rs&i (75820) $1,789.46 $2,105.25 1.1×
Venous thrombosis imaging (78457) $449.52 $528.85 0.8×
Venous Thrombosis Imaging Venogram Bilateral (78458) $449.52 $528.85 1.1×
Wrist 2 views (73100)
range across 3 matching MRF lines
$204–$382.42 $240–$449.90 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $236.39 $278.10 2.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines
$203.15–$406.30 $239–$478 varies
X-Ray Exam Breast Specimen (76098) $969.83 $1,140.98 1.7×
X-Ray Exam Entire Spi 1 Vw (72081) $281.35 $331 3.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $486.29 $572.11 4.4×
X-Ray Exam Hip Uni 1 View (73501)
range across 3 matching MRF lines
$284.98–$415.01 $335.27–$488.25 varies
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 3 matching MRF lines
$400.80–$583.70 $471.53–$686.70 varies
X-Ray Exam Hips Bi 2 Views (73521) $601.21 $707.30 5.5×
X-Ray Exam L-S Spine Bending (72114) $525.30 $618 4.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $394.40 $464 4.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $708.28 $833.27 6.4×
X-Ray Exam Unilat Ribs/Chest (71101) $470.14 $553.11 4.3×
X-ray eye for foreign body (70030) $153 $180 1.7×
X-ray humerus (73060)
range across 3 matching MRF lines
$228.65–$457.30 $269–$538 varies
X-ray IV pyelogram (ivp) (74400) $718.46 $845.25 3.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $170.07 $200.08 1.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $319.46 $375.83 3.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $360.40 $424 3.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $487.22 $573.20 4.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $367.20 $432 3.3×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $258.60 $304.24 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $299.20 $352 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $368.59 $433.63 4.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $315.31 $370.95 2.9×
X-Ray Tmj Unilat (70328) $165.11 $194.25 1.8×
X-Rays Bone Length Studies (77073) $300.90 $354 2.7×
X-Rays Bone Survey Complete (77075) $490.89 $577.52 4.5×
Xr c-spine 4 or 5 views (72050) $483.65 $569 4.4×
Xr facial bones less than 3 views (70140) $203.15 $239 2.2×
Xr orbits complete 4 views (70200) $300.90 $354 2.7×

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.