Imaging prices at Lakeview Hospital

Stillwater, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $177.60 $480 1.6×
Acute gi blood loss imaging (78278) $1,042.66 $2,818 2.5×
Angiography extremity bilateral rs&i (75716) $2,905.24 $7,852 0.9×
Angiography extremity unilateral rs&i (75710) $2,905.24 $7,852 0.9×
Ankle 2 views (73600) $171.31 $463 1.9×
Aortogram thoracic (75605) $3,368.85 $9,105 0.6×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $2,905.24 $7,852 0.9×
Aortography abdominal serialography rs&i (75625) $3,368.85 $9,105 1.0×
Arthrogram ankle (73615) $442.15 $1,195 1.2×
Bone &/Joint Imaging Limited Area (78300) $621.60 $1,680 1.5×
Bone &/joint imaging whole body (78306) $749.99 $2,027 1.8×
Bone age studies (77072) $213.12 $576 1.9×
Bone Imaging 3 Phase (78315) $1,035.63 $2,799 2.5×
Bone Marrow Imaging Limited Area (78102) $565.36 $1,528 1.4×
Bone survey complete (77075) $341.14 $922 3.1×
Bowel imaging (78290) $993.45 $2,685 2.4×
Brain Imaging Pet Metabolic Evaluation (78608) $2,000.96 $5,408 1.3×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $745.18 $2,014 1.8×
Cervical spine 2 or 3 views (72040) $262.70 $710 2.9×
Chest 1 view (71045) $177.60 $480 1.9×
Chest xray 3 views (71047) $203.13 $549 2.2×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $279.72 $756 1.5×
Clavicle complete (73000) $174.27 $471 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $409.96 $1,108 3.7×
Contrast Xray Throat/Cerv Esopha (74210) $250.86 $678 1.4×
CT abdomen and pelvis without and with contrast (74178) $1,282.42 $3,466 3.5×
CT abdomen and pelvis without contrast (74176) $550.19 $1,487 2.2×
CT abdomen w contrast (74160) $982.35 $2,655 5.3×
CT abdomen w wo contrast (74170) $1,198.80 $3,240 6.5×
CT abdomen w/o contrast (74150) $704.48 $1,904 6.4×
CT angio lwr extr w/o&w/dye (73706) $1,559.55 $4,215 8.5×
CT angiography upper extremity lt (73206) $1,411.55 $3,815 7.7×
CT c-spine w/contrast (72126) $931.29 $2,517 2.5×
CT c-spine w/o contrast (72125) $752.21 $2,033 6.9×
CT cervical spine w&w/o contrast (72127) $1,171.79 $3,167 6.4×
CT chest w contrast (71260) $929.07 $2,511 5.1×
CT chest w/wo contrast (71270) $1,051.17 $2,841 5.7×
CT colonography screening (74263) $557.59 $1,507 2.2×
CT colonography w/dye (74262) $574.61 $1,553 3.1×
CT colonography w/o cntrst (74261) $574.61 $1,553 5.2×
CT head/brain with contrast (70460) $748.88 $2,024 4.1×
CT head/brain without and with contrast (70470) $923.15 $2,495 5.0×
CT heart w/o contrast quant eval coronary calcium (75571) $36.63 $99 0.4×
CT iac w contrast (70481) $772.19 $2,087 4.2×
CT lower ext w/o (73700) $722.61 $1,953 6.6×
CT lower extremity w wo contrast (73702) $1,196.58 $3,234 6.5×
CT lower extremity w/contrast material (73701) $900.21 $2,433 4.9×
CT lumbar spine w & w/o contrast (72133) $1,172.90 $3,170 6.4×
CT lumbar spine w/contrast (72132) $929.07 $2,511 2.5×
CT lumbar spine w/o contrast (72131) $748.88 $2,024 6.8×
CT maxillofacial w contrast (70487) $925 $2,500 5.0×
CT maxillofacial w/wo contrast (70488) $1,156.62 $3,126 6.3×
CT maxillofacial wo contrast (70486) $754.80 $2,040 6.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,256.52 $3,396 6.8×
CT orbits w/o contrast (70480) $915.75 $2,475 8.4×
CT pelvis w/o contrast (72192) $710.03 $1,919 6.5×
CT pelvis w/wo contrast (72194) $1,031.56 $2,788 5.6×
CT scan of arm combo (73202) $1,193.62 $3,226 6.5×
CT soft tissue neck w contrast (70491) $890.59 $2,407 4.8×
CT soft tissue neck w/o & w/contrast material (70492) $1,120.73 $3,029 6.1×
CT soft tissue neck w/o contrast (70490) $715.95 $1,935 6.5×
CT thoracic spine w/contrast (72129) $931.29 $2,517 5.1×
CT thoracic spine w/o contrast (72128) $751.47 $2,031 6.9×
CT thoracic spine w/wo contrast (72130) $1,175.12 $3,176 6.4×
CT thorax w/o contrast (71250) $748.88 $2,024 6.8×
CT unlisted procedure (76497) $248.27 $671 2.7×
CT upper ext wo (73200) $721.13 $1,949 6.6×
CT upper extremity with contrast (73201) $892.81 $2,413 2.4×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,730.12 $4,676 9.4×
Cta Abdomen (74175) $1,025.27 $2,771 5.6×
CTA abdomen pelvis (74174) $1,633.92 $4,416 4.5×
CTA chest (71275) $1,051.17 $2,841 5.7×
Cta Head (70496) $1,297.96 $3,508 7.1×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $421.80 $1,140 1.2×
Cta Neck (70498) $1,297.96 $3,508 7.1×
Cta Pelvis (72191) $1,493.69 $4,037 8.1×
Cystography minimum 3 views rs&i (74430) $279.72 $756 0.8×
Dxa bone density study 1/> sites axial skel (77080) $313.02 $846 2.9×
Dxa bone density study 1/>sites appendiclr skel (77081) $124.69 $337 1.4×
Esophagus (74220) $288.60 $780 1.6×
Facial bones min 3 views (70150) $247.90 $670 2.3×
Fetal biophysical profile non-stress testing (76818) $286.01 $773 2.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $222.37 $601 2.0×
Fluoroscopy up to 1 hr (76000) $380.36 $1,028 1.5×
Foot 2 views (73620) $163.91 $443 1.8×
Forearm 2 views (73090) $171.31 $463 1.9×
Hand 2 views (73120) $168.72 $456 1.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,392.68 $3,764 2.4×
Hepatobiliary syst imaging including gallbladder (78226) $1,001.22 $2,706 2.4×
Hysterosalpingogram (74740) $225.33 $609 0.9×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $126.91 $343 1.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $685.98 $1,854 1.2×
Kidney img morphology vascular flow 1 w/rx (78708) $452.14 $1,222 0.8×
Knee 3 views (73562) $222.74 $602 2.4×
Lymphoscintigraphy (78195) $1,024.16 $2,768 1.8×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,390.46 $3,758 1.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,481.48 $4,004 4.1×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,997.26 $5,398 5.5×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $117.66 $318 1.3×
MRA head w & w/o contrast (70546) $2,601.47 $7,031 7.1×
MRA head w/o contrast (70544) $1,637.25 $4,425 6.6×
MRA head with contrast (70545) $1,626.15 $4,395 4.5×
MRA neck w contrast (70548) $1,712.36 $4,628 4.7×
Mra Neck W/O &W/Contrast Material (70549) $2,601.47 $7,031 7.1×
MRA neck w/o contrast (70547) $1,632.81 $4,413 6.5×
MRI abdomen w contrast (74182) $1,710.88 $4,624 4.7×
MRI abdomen w/o & w/contrast material (74183) $1,990.23 $5,379 5.4×
MRI abdomen w/o contrast (74181) $1,193.99 $3,227 4.8×
MRI any jt lower extrem w/contrast material (73722) $1,405.26 $3,798 1.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,405.26 $3,798 3.8×
MRI breast w/o contrast bilateral (77047) $1,460.02 $3,946 5.8×
MRI c-spine with contrast (72142) $1,490.73 $4,029 4.1×
MRI cervical spine w/o contrast (72141) $1,191.03 $3,219 4.8×
MRI chest w/o & w/contrast material (71552) $2,267.73 $6,129 6.2×
MRI chest w/o contrast (71550) $1,499.61 $4,053 6.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,484.44 $4,012 4.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,341.62 $3,626 3.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,341.62 $3,626 5.4×
MRI orbit face &/neck w/o contrast (70540) $1,330.15 $3,595 5.3×
MRI orbit face neck w contrast (70542) $1,253.93 $3,389 3.4×
MRI orbit/face/neck w&w/o cont (70543) $1,973.21 $5,333 5.4×
MRI pelvis w/o & w/contrast material (72197) $1,987.64 $5,372 5.4×
MRI pelvis w/o contrast (72195) $1,349.76 $3,648 5.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,889.96 $5,108 5.2×
MRI spinal canal lumbar w/contrast material (72149) $1,487.03 $4,019 4.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,887.37 $5,101 5.2×
MRI spinal canal thoracic w/contrast matrl (72147) $1,325.34 $3,582 3.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,764.53 $4,769 4.8×
MRI temporomandibular joint (70336) $997.89 $2,697 4.0×
MRI thoracic spine w/o contrast (72146) $1,220.26 $3,298 4.9×
MRI up ext w/o contrast (73218) $1,369.37 $3,701 5.5×
MRI upper ext joint w/o contrast (73221) $1,283.53 $3,469 5.1×
MRI, joint upper extrem combo (73223) $1,390.46 $3,758 3.8×
Myocardial Spect Multiple Studies (78452) $1,589.89 $4,297 1.2×
Myocardial spect single study at rest or stress (78451) $821.77 $2,221 0.6×
Neck soft tissue (70360) $156.14 $422 1.7×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $283.79 $767 0.7×
Nm cisternogram (78630) $1,062.64 $2,872 1.9×
Nm gastric emptying study (78264) $870.61 $2,353 2.1×
Nuclear Rx Oral Admin (79005) $209.42 $566 0.9×
Parathyrd planar w/spect&CT (78072) $1,270.58 $3,434 2.2×
Parathyroid planar imaging w/wo subtraction (78071) $1,113.70 $3,010 2.7×
Pelvis 1 or 2 views (72170) $176.86 $478 1.6×
PET image w/CT, skull-thigh (78815) $3,100.97 $8,381 2.1×
PET imaging for CT attenuation whole body (78816) $3,173.12 $8,576 2.1×
Pulmonary Perfusion Imaging Particulate (78580) $624.19 $1,687 1.5×
Pulmonary Ventilation & Perfusion Imaging (78582) $926.48 $2,504 1.6×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $527.25 $1,425 0.5×
Radex abscess/fistula/sinus tract rs&i (76080) $234.95 $635 0.4×
Radex Ankle Compl Minimum 3 Views (73610) $202.02 $546 2.2×
Radex Calcaneus Minimum 2 Views (73650) $168.72 $456 1.9×
Radex Elbw Compl Minimum 3 Views (73080) $228.66 $618 2.5×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $83.62 $226 0.9×
Radex fingr minimum 2 views (73140) $206.09 $557 2.3×
Radex Foot Compl Minimum 3 Views (73630) $198.32 $536 2.2×
Radex Hand Minimum 3 Views (73130) $202.02 $546 2.2×
Radex Hip Unilateral With Pelvis 1 View (73501) $88.80 $240 1.0×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $64.75 $175 0.6×
Radex Hips Bilateral With Pelvis 2 Views (73521) $120.99 $327 1.1×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $165.39 $447 1.5×
Radex Humerus Minimum 2 Views (73060) $178.34 $482 2.0×
Radex Kne 1/2 Views (73560) $178.34 $482 2.0×
Radex Kne Compl 4/More Views (73564) $257.15 $695 2.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $198.32 $536 2.2×
Radex Pelvis Compl Minimum 3 Views (72190) $293.41 $793 2.7×
Radex Sho Compl Minimum 2 Views (73030) $178.34 $482 2.0×
Radex Sinuses Paransl < 3 Views (70210) $179.45 $485 2.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $293.04 $792 3.2×
Radex Toe Minimum 2 Views (73660) $190.92 $516 2.1×
Radex upper extremity infant minimum 2 views (73092) $181.30 $490 1.7×
Radex Wrst Compl Minimum 3 Views (73110) $233.10 $630 2.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $172.05 $465 1.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $177.60 $480 1.6×
Radiologic exam chest 2 views (71046) $190.55 $515 2.1×
Radiologic exam colon single contrast study (74270) $408.11 $1,103 2.2×
Radiologic exam upr gi trc single contrast study (74240) $340.77 $921 1.9×
Radiologic examination femur 1 view (73551) $83.62 $226 0.9×
Radiologic examination tibia & fibula 2 views (73590) $163.91 $443 1.8×
Radiological examination surgical specimen (76098) $246.42 $666 0.4×
Ribs bilateral 3 views (71110) $306.36 $828 2.8×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,620.60 $4,380 2.8×
Rp loclzj tum plnr whole body single day imaging (78802) $1,013.43 $2,739 1.8×
Rp loclzj tum spect 1 area single day imaging (78803) $1,270.58 $3,434 2.2×
Sacroiliac Joints < 3 Views (72200) $169.46 $458 1.5×
Saline Infus Sonohysterography W/Color Doppler (76831) $253.82 $686 1.0×
Scapula (73010) $178.34 $482 1.6×
Screening Digital Breast Tomosynthesis Bi (77063) $40.70 $110 1.7×
Shoulder 1 view (73020) $140.60 $380 1.5×
Small bowel series (74250) $352.61 $953 1.9×
Spine thoracic 3 views (72072) $270.10 $730 2.5×
Ther rad simulaj-aided field setting complex (77290) $1,969.14 $5,322 5.0×
Thoracolumbar 2 views (72080) $82.14 $222 0.9×
Thyroid carcinoma metastases img whole body (78018) $986.79 $2,667 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $275.28 $744 0.7×
Treatment devices simple (77332) $231.25 $625 1.6×
Ultrasound breast complete (76641) $294.52 $796 2.7×
Ultrasound Exam Aaa Screen (76706) $311.91 $843 2.8×
Ultrasound, abdomen limited (76705) $185.18 $500.50 1.7×
Umbilical-artery Doppler (OB) (76820) $101.38 $274 0.9×
Urethrocystogram voiding (74455) $322.64 $872 1.3×
Urethrocystography retrograde rs&i (74450) $260.85 $705 1.0×
Us breast unilateral limited (76642) $152.07 $411 1.7×
Us chest (76604) $137.82 $372.50 1.3×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $909.83 $2,459 4.0×
Us compl joint r-t w/image documentation (76881) $152.81 $413 1.4×
Us encephalogram (76506) $297.11 $803 2.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $70.67 $191 0.6×
Us ob detailed single fetus (76811) $692.27 $1,871 2.8×
Us ob limited (76815) $58.83 $159 0.5×
Us ob transvaginal (76817) $268.25 $725 2.4×
Us pelvic non ob complete (76856) $361.86 $978 3.3×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $169.64 $458.50 1.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $332.63 $899 3.0×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $296.74 $802 2.7×
Us retroperitoneal complete (76770) $390.72 $1,056 3.6×
Us retroperitoneal limited (76775) $195.18 $527.50 1.8×
Us scrotum and contents (76870) $367.04 $992 3.4×
Us soft tissue head/neck (76536) $201.65 $545 1.8×
Us spinal canal and contents (76800) $170.94 $462 1.6×
Us transrectal (76872) $438.08 $1,184 4.0×
Us, eye b-scan (76512) $148 $400 1.4×
Us,transplanted kidney, real time/ doppler (76776) $365.93 $989 3.3×
Venogram Extremity Unilateral (75820) $1,010.84 $2,732 0.6×
Wrist 2 views (73100) $185.74 $502 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $200.54 $542 2.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $690.79 $1,867 3.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $174.27 $471 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $125.06 $338 1.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $147.26 $398 1.3×
X-ray exam of femur 2/> (73552) $97.68 $264 1.1×
X-ray eye for foreign body (70030) $165.39 $447 1.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $208.68 $564 2.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $178.34 $482 2.0×
X-ray leg, infant (73592) $185.74 $502 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $281.57 $761 2.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $137.64 $372 1.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $106.19 $287 1.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $241.61 $653 2.7×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $293.41 $793 2.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $407 $1,100 3.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $250.49 $677 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $207.20 $560 2.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $222 $600 2.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $253.82 $686 2.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $202.02 $546 1.8×
X-Ray Spine One View - Xr Spine (72020) $160.95 $435 1.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $110.63 $299 1.2×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $249.75 $675 2.7×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $227.55 $615 2.1×
Xr bone length studies (77073) $157.62 $426 1.4×
Xr c-spine 4 or 5 views (72050) $367.04 $992 3.4×
Xr c-spine 6 or more views (72052) $228.66 $618 2.1×
Xr chest 4+ views (71048) $214.97 $581 2.0×
Xr urogram antegrade (74425) $304.14 $822 0.8×