Imaging prices at Kona Community Hospital

Kealakekua, HI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $4,218.50 $6,490 2.6×
Abdomen 1 View (74018) $276.90 $426 2.7×
Abdomen 2 views (74019) $410.15 $631 3.3×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,396.85 $2,149 3.0×
Ankle 2 views (73600) $309.40 $476 3.0×
Arthrogram hip (73525) $1,079.65 $1,661 2.6×
Basic radiation dosimetry calculation (77300) $557.70 $858 3.5×
Bone age studies (77072) $435.50 $670 3.5×
Bone Imaging 3 Phase (78315) $1,466.40 $2,256 3.1×
Bone Imaging Limited Area (78300) $1,396.20 $2,148 3.0×
Bone Imaging Multiple Areas (78305) $1,035.45 $1,593 2.2×
Bone Imaging Whole Body (78306) $1,466.40 $2,256 3.1×
Bone survey infant (77076) $382.85 $589 3.1×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,596.40 $2,456 2.5×
Chest 1 view (71045) $315.25 $485 3.1×
Chest 2 views (71046) $370.50 $570 3.6×
Chest 3 views (71047) $364 $560 3.5×
Chest 4 or more views (71048) $328.90 $506 2.7×
Clavicle complete (73000) $370.50 $570 3.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $549.25 $845 4.4×
Continuing medical physics consltj pr wk (77336) $591.50 $910 3.7×
Contrast X-Ray Bladder (74430) $789.10 $1,214 1.9×
Contrast X-Ray Of Knee Joint (73580) $1,322.10 $2,034 3.2×
CT abdomen and pelvis without and with contrast (74178) $2,771.60 $4,264 6.7×
CT abdomen and pelvis without contrast (74176) $1,970.80 $3,032 7.0×
CT abdomen w contrast (74160) $1,272.70 $1,958 6.1×
CT abdomen w wo contrast (74170) $1,366.95 $2,103 6.6×
CT abdomen w/o contrast (74150) $1,021.80 $1,572 8.3×
CT Angio Abdomen and Pelvis (74174) $2,486.90 $3,826 6.0×
CT Angio Chest (71275) $1,610.05 $2,477 7.8×
CT Angio Head (70496) $1,610.05 $2,477 7.8×
CT angio hrt w/3d image (75574) $980.20 $1,508 2.4×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,481.35 $2,279 7.1×
CT Angio Neck (70498) $1,610.05 $2,477 7.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,346.15 $2,071 6.5×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $672.75 $1,035 3.2×
CT cervical spine w/ contrast (72126) $1,469.65 $2,261 3.6×
CT cervical spine w/o contrast (72125) $1,000.35 $1,539 8.1×
CT cervical spine w/wo cont (72127) $1,272.70 $1,958 6.1×
CT chest w contrast (71260) $1,527.50 $2,350 7.4×
CT chest w/wo contrast (71270) $1,527.50 $2,350 7.4×
CT head/brain with contrast (70460) $1,412.45 $2,173 6.8×
CT head/brain without and with contrast (70470) $1,573 $2,420 7.6×
CT heart contrast eval cardiac structure&morph (75572) $980.20 $1,508 2.4×
CT heart no contrast quant eval coronry calcium (75571) $259.35 $399 2.5×
CT hrt w/3d image congen (75573) $980.20 $1,508 2.4×
CT iac w contrast (70481) $1,283.75 $1,975 6.2×
CT l-spine w&w/o contrast (72133) $1,336.40 $2,056 6.4×
CT lower ext w/o (73700) $1,124.50 $1,730 9.1×
CT lower extremity w/contrast material (73701) $1,272.70 $1,958 6.1×
CT lumbar spine w contrast (72132) $1,469.65 $2,261 3.6×
CT lumbar spine w/o contrast (72131) $1,000.35 $1,539 8.1×
CT maxillofacial w contrast (70487)
range across 2 matching MRF lines		 $739.70–$1,177.15 $1,138–$1,811 varies
CT maxillofacial wo contrast (70486) $1,019.20 $1,568 8.3×
CT neck tissue combo (70492) $1,527.50 $2,350 7.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,272.70 $1,958 6.1×
CT orbits w/o contrast (70480) $1,040 $1,600 8.4×
CT pelvis w&w/o contrast (72194) $1,527.50 $2,350 7.4×
CT pelvis w/o contrast (72192) $1,000.35 $1,539 8.1×
CT scan of leg combo (73702) $1,376.70 $2,118 6.6×
CT scans face/jaw combo (70488) $1,177.15 $1,811 5.7×
CT soft tissue neck w contrast (70491) $1,177.15 $1,811 5.7×
CT soft tissue neck w/o contrast (70490) $1,177.15 $1,811 9.5×
CT thoracic spine w contrast (72129) $1,177.15 $1,811 5.7×
CT thoracic spine w/o contrast (72128) $1,000.35 $1,539 8.1×
CT thoracic spine w/wo cont (72130) $1,336.40 $2,056 6.4×
CT thorax w/o contrast (71250) $1,145.95 $1,763 9.3×
CT upper ext wo (73200) $1,124.50 $1,730 9.1×
CT upper extremity w/o & w/contrast material (73202) $1,336.40 $2,056 6.4×
CT upper extremity with contrast (73201) $1,469.65 $2,261 3.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,184.95 $1,823 5.7×
Cta Abdomen (74175) $1,628.90 $2,506 7.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,219.40 $1,876 3.0×
CTA pelvis (72191) $1,483.95 $2,283 7.2×
Echo exam uterus (76831) $942.50 $1,450 3.3×
Esophagram (74220) $625.95 $963 3.0×
Fetal Biophys Profile W/Nst (76818) $492.70 $758 4.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $492.70 $758 4.0×
Fluoroscopy up to 1 hr (76000) $564.85 $869 2.0×
Foot 2 views (73620) $309.40 $476 3.0×
Forearm 2 views (73090) $309.40 $476 3.0×
Gastric emptying imaging study (78264) $1,466.40 $2,256 3.1×
Gated Heart Planar Single (78472) $1,466.40 $2,256 3.1×
Hand 2 views (73120) $309.40 $476 2.5×
Hepatobil Syst Image W/Drug (78227) $1,571.70 $2,418 2.5×
Hepatobiliary System Imaging (78226) $1,466.40 $2,256 3.1×
Ht Muscle Image Spect Sing (78451) $3,701.75 $5,695 2.4×
Infant hip ultrasound with hip movement (dynamic) (76885) $324.35 $499 3.2×
K Flow/Funct Image W/Drug (78708) $1,280.50 $1,970 2.0×
K Flow/Funct Image W/O Drug (78707) $1,280.50 $1,970 2.0×
Knee 3 Views (73562) $372.45 $573 3.6×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,231.10 $1,894 2.6×
Liver imaging w/vascular flow (78202) $1,762.15 $2,711 2.7×
Lung Ventilat&Perfus Imaging (78582) $1,599.65 $2,461 2.5×
Lymph System Imaging (78195) $1,504.10 $2,314 2.3×
Meckels Divert Exam (78290) $1,222.65 $1,881 2.6×
Mlc imrt design & construction per imrt plan (77338) $2,398.50 $3,690 5.4×
MRA head w/o contrast (70544) $1,517.10 $2,334 5.4×
MRA head with contrast (70545) $1,481.35 $2,279 3.6×
MRA neck w contrast (70548) $1,469.65 $2,261 3.6×
Mra Neck W/O &W/Contrast Material (70549) $2,197.65 $3,381 5.3×
MRA neck w/o contrast (70547) $1,378.65 $2,121 4.9×
MRI abdomen w contrast (74182) $1,469.65 $2,261 3.6×
MRI abdomen w/o contrast (74181) $1,417 $2,180 5.0×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,197.65 $3,381 5.3×
MRI any jt upper extremity w/contrast matrl (73222) $2,204.15 $3,391 2.4×
MRI Breast W/O Contrast Bilateral (77047) $893.10 $1,374 3.2×
MRI Breast Without Contrast Material Unilateral (77046) $893.10 $1,374 3.2×
MRI cervical spine w/o cont (72141) $1,417 $2,180 5.0×
MRI chest w/o contrast (71550) $1,264.90 $1,946 4.5×
MRI chest wo w contrast (71552) $1,833 $2,820 4.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,469.65 $2,261 3.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,016.30 $3,102 4.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,391.65 $2,141 4.9×
Mri Neck Spine W/O & W/Dye (72156) $2,197.65 $3,381 5.3×
MRI orbit face &/neck w/o contrast (70540) $1,264.90 $1,946 4.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,016.30 $3,102 4.9×
MRI pelvis w/o & w contrast (72197) $2,016.30 $3,102 4.9×
MRI pelvis w/o contrast (72195) $1,391.65 $2,141 4.9×
MRI thoracic spine w/o contrast (72146) $1,391.65 $2,141 4.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,264.90 $1,946 4.5×
Mri Uppr Extremity W/O&W/Dye (73220) $2,016.30 $3,102 4.9×
MRI, abdomen, combo (74183) $2,016.30 $3,102 4.9×
MRI, dorsal spine combo (72157) $2,197.65 $3,381 5.3×
MRI, joint upper extrem (73221) $1,522.30 $2,342 5.4×
MRI, joint upper extrem combo (73223) $1,997.45 $3,073 4.8×
MRI, lumbar spine combo (72158) $2,237.30 $3,442 5.4×
Myocardial Spect Multiple Studies (78452) $3,855.15 $5,931 2.5×
N-invas est c ffr sw aly CTA (75580) $3,018.60 $4,644 3.0×
Neck soft tissue (70360) $309.40 $476 3.0×
Nm myocard infarct spect (78469) $1,859 $2,860 2.9×
Nonvascular Shunt X-Ray (75809) $460.20 $708 3.7×
Ntsty modul radthx pln dose-vol histos (77301) $4,218.50 $6,490 2.6×
Nuclear Rx Oral Admin (79005) $1,005.55 $1,547 3.6×
Ob us nuchal meas 1 gest (76813) $391.95 $603 3.2×
Parathyroid Planar Imaging (78070) $859.95 $1,323 1.8×
Parathyroid planar imaging w/wo subtraction (78071) $1,401.40 $2,156 3.0×
Pelvis 1 or 2 views (72170) $295.10 $454 2.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $492.70 $758 4.0×
Radex Ankle Complete Minimum 3 Views (73610) $346.45 $533 3.4×
Radex Calcaneus Minimum 2 Views (73650) $308.75 $475 3.0×
Radex elbow complete minimum 3 views (73080) $372.45 $573 3.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $445.25 $685 3.6×
Radex fingr minimum 2 views (73140) $332.15 $511 3.2×
Radex foot complete minimum 3 views (73630) $309.40 $476 3.0×
Radex Hand Minimum 3 Views (73130) $372.45 $573 3.6×
Radex lower extremity infant minimum 2 views (73592) $269.10 $414 2.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $411.45 $633 4.0×
Radex Ribs Unilateral 2 Views (71100) $356.85 $549 3.5×
Radex shoulder complete minimum 2 views (73030) $377.65 $581 3.7×
Radex Sinuses Paransl < 3 Views (70210) $236.60 $364 2.3×
Radex Spine 1 View Specify Level (72020) $269.10 $414 2.6×
Radex Sternum Minimum 2 Views (71120) $336.70 $518 3.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $371.80 $572 3.6×
Radex Toe Minimum 2 Views (73660) $276.90 $426 2.7×
Radex upper extremity infant minimum 2 views (73092) $308.10 $474 2.5×
Radex Wrist Complete Minimum 3 Views (73110) $377.65 $581 3.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $526.50 $810 4.3×
Radiation treatment delivery level 1 (77402) $436.80 $672 3.6×
Radiation treatment delivery level 2 (77407) $938.60 $1,444 2.1×
Radiation treatment delivery level 3 (77412) $748.15 $1,151 1.1×
Radiolog exam mandible compl minimum 4 views (70110) $461.50 $710 3.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $460.20 $708 3.7×
Radiologic exam colon double contrast study (74280) $776.75 $1,195 3.7×
Radiologic exam colon single contrast study (74270) $682.50 $1,050 3.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $725.40 $1,116 3.5×
Radiologic exam knee complete 4/more views (73564) $388.70 $598 3.1×
Radiologic exam pelvis compl minimum 3 views (72190) $321.10 $494 2.6×
Radiologic Exam Small Int Single Contrast Study (74250) $725.40 $1,116 3.5×
Radiologic exam swallow function contrast study (74230) $556.40 $856 2.7×
Radiologic exam upr gi trc double contrast study (74246) $682.50 $1,050 3.3×
Radiologic examination femur 1 view (73551) $280.15 $431 2.7×
Radiologic examination femur minimum 2 views (73552) $308.75 $475 3.0×
Radiologic examination knee 1/2 views (73560) $395.85 $609 3.9×
Radiologic examination tibia & fibula 2 views (73590) $395.85 $609 3.9×
Ribs bilateral 3 views (71110) $337.35 $519 2.7×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,341.60 $2,064 2.8×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,374.15 $5,191 5.3×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,825.20 $2,808 2.8×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,200.30 $6,462 6.5×
Rp Therapy Intravenous Administration (79101) $1,005.55 $1,547 3.6×
Scapula (73010) $370.50 $570 3.0×
Screening Digital Breast Tomosynthesis Bi (77063) $118.30 $182 5.1×
Shoulder 1 view (73020) $309.40 $476 3.0×
Shoulder Arthrography (73040) $1,322.10 $2,034 3.2×
Skull less than 4 views (70250) $370.50 $570 3.0×
Special dosimetry (77331) $557.70 $858 3.5×
Special Physics Consult (77370) $591.50 $910 3.7×
Special teletherapy port plan (77321) $1,303.25 $2,005 2.9×
Special treatment procedure (77470) $2,013.70 $3,098 3.1×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,351.35 $2,079 3.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,351.35 $2,079 3.1×
Ther rad simulaj-aided field setting simple (77280) $591.50 $910 3.7×
Thoracic spine 2 views (72070) $372.45 $573 3.0×
Thoracic spine 3 views (72072) $372.45 $573 3.0×
Thoracolumbar 2 views (72080) $392.60 $604 3.8×
Thyroid Imaging With Vascular Flow (78013) $1,386.45 $2,133 2.9×
Thyroid Met Imaging Body (78018) $1,477.45 $2,273 2.3×
Thyroid Uptake Measurement (78012) $536.90 $826 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $915.20 $1,408 1.9×
Tx Devices Design & Construction Complex (77334) $1,068.60 $1,644 2.4×
Tx devices design & construction simple (77332) $591.50 $910 3.7×
Ultrasound Breast Limited (76642) $378.95 $583 3.7×
Ultrasound elastography first target lesion (76982) $391.95 $603 3.2×
Ultrasound Elastography Parenchyma (76981) $391.95 $603 3.2×
Ultrasound Exam Aaa Screen (76706) $460.20 $708 3.7×
Ultrasound, abdomen limited (76705) $486.85 $749 3.9×
Umbilical-artery Doppler (OB) (76820) $460.20 $708 3.7×
Upper gi w/o kub (74240) $625.95 $963 3.0×
Urethrocystography retrograde (74450) $828.75 $1,275 2.9×
Us breast unilateral complete (76641) $384.15 $591 3.1×
Us chest (76604) $460.20 $708 3.7×
Us complete joint (76881) $492.70 $758 4.0×
Us exam, pelvic, limited (76857) $460.20 $708 3.7×
Us head (76506) $384.15 $591 3.1×
Us kidney transplant (76776) $460.20 $708 3.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $492.70 $758 4.0×
Us ob detailed single fetus (76811) $334.10 $514 1.2×
Us ob limited 1 or more fetuses (76815) $460.20 $708 3.7×
Us ob transvaginal (76817) $492.70 $758 4.0×
Us pelvic non ob complete (76856) $492.70 $758 4.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $492.70 $758 4.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $388.70 $598 3.1×
Us retroperitoneal complete (76770) $492.70 $758 4.0×
Us retroperitoneal limited (76775) $492.70 $758 4.0×
Us scrotum and contents (76870) $492.70 $758 4.0×
Us spinal canal and contents (76800) $460.20 $708 3.7×
Us thyroid (76536) $460.20 $708 3.7×
Venography extremity unilateral rs&i (75820) $2,036.45 $3,133 1.1×
Wrist 2 views (73100) $309.40 $476 3.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $354.25 $545 3.4×
X-Ray Bend Only L-S Spine (72120) $464.75 $715 3.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $309.40 $476 3.0×
X-Ray Exam Breast Specimen (76098) $1,888.25 $2,905 2.9×
X-Ray Exam Entire Spi 1 Vw (72081) $296.40 $456 2.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $460.20 $708 3.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $526.50 $810 4.3×
X-Ray Exam Hip Uni 1 View (73501) $286.65 $441 2.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $286.65 $441 2.8×
X-Ray Exam Hip Uni 4/> Views (73503) $454.35 $699 3.7×
X-Ray Exam Hips Bi 2 Views (73521) $460.20 $708 3.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $431.60 $664 3.5×
X-Ray Exam Hips Bi 5/> Views (73523) $526.50 $810 4.3×
X-Ray Exam L-S Spine Bending (72114) $487.50 $750 3.9×
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 4 matching MRF lines		 $371.80–$372.45 $572–$573 varies
X-Ray Exam Neck Spine 6/>Vws (72052) $483.60 $744 3.9×
X-Ray Exam Unilat Ribs/Chest (71101) $372.45 $573 3.0×
X-ray eye for foreign body (70030) $278.85 $429 2.7×
X-ray humerus (73060) $309.40 $476 3.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $369.20 $568 3.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $392.60 $604 3.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $372.45 $573 3.0×
X-ray nose-rectum child f.b. (76010) $247.65 $381 2.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $483.60 $744 3.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $336.70 $518 2.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $224.25 $345 1.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $372.45 $573 3.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $370.50 $570 3.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $460.20 $708 3.7×
X-ray thoracic spine 4 vw (72074) $352.95 $543 2.9×
X-Ray Urinary Tract Exam With Contrast Material (74420) $828.75 $1,275 2.0×
X-Rays Bone Length Studies (77073) $544.70 $838 4.4×
X-Rays Bone Survey Complete (77075) $460.20 $708 3.7×
Xr c-spine 4 or 5 views (72050) $460.20 $708 3.7×
Xr facial bones less than 3 views (70140) $295.75 $455 2.9×
Xr orbits complete 4 views (70200) $269.10 $414 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.