Imaging prices at Lane County Hospital

Dighton, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $198 $198 2.5×
Abdomen 2 views (74019) $278.30 $278.30 2.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $360 $360 1.0×
Ankle 2 views (73600) $181.50 $181.50 2.3×
Bone Imaging 3 Phase (78315) $355 $355 1.0×
Bone Imaging Limited Area (78300) $325 $325 0.9×
Bone Imaging Multiple Areas (78305) $355 $355 1.0×
Bone Imaging Whole Body (78306) $355 $355 1.0×
Cardiac MRI w/w/o contrast & further seq (75561) $875 $875 2.7×
Cat Scan Follow-Up Study (76380) $950 $950 11.9×
Chest 1 view (71045) $181.50 $181.50 2.3×
Chest 2 views (71046) $222.20 $222.20 2.8×
Chest 3 views (71047) $200 $200 2.5×
Chest 4 or more views (71048) $220 $220 2.3×
Clavicle complete (73000) $189.20 $189.20 2.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $950 $950 9.9×
CT abdomen and pelvis without and with contrast (74178) $1,100 $1,100 3.4×
CT abdomen and pelvis without contrast (74176) $950 $950 4.3×
CT abdomen w contrast (74160) $1,025 $1,025 6.4×
CT abdomen w wo contrast (74170) $1,100 $1,100 6.8×
CT abdomen w/o contrast (74150) $950 $950 9.9×
CT Angio Abdomen and Pelvis (74174) $2,672 $2,672 8.3×
CT Angio Chest (71275) $1,861 $1,861 11.5×
CT Angio Head (70496) $2,478.50 $2,478.50 15.4×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines		 $1,748.03–$1,923 $1,748.03–$1,923 varies
CT Angio Neck (70498) $2,478.50 $2,478.50 15.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,923 $1,923 11.9×
CT cervical spine w/ contrast (72126) $1,025 $1,025 3.2×
CT cervical spine w/o contrast (72125) $950 $950 9.9×
CT cervical spine w/wo cont (72127) $1,100 $1,100 6.8×
CT chest w contrast (71260) $1,025 $1,025 6.4×
CT chest w/wo contrast (71270) $1,100 $1,100 6.8×
CT head/brain with contrast (70460) $1,025 $1,025 6.4×
CT head/brain without and with contrast (70470) $1,100 $1,100 6.8×
CT iac w contrast (70481) $1,025 $1,025 6.4×
CT lower ext w/o (73700) $950 $950 9.9×
CT lower extremity w/contrast material (73701) $1,025 $1,025 6.4×
CT lumbar spine w contrast (72132) $1,100 $1,100 3.4×
CT lumbar spine w/o contrast (72131) $1,025 $1,025 10.7×
CT maxillofacial w contrast (70487) $1,025 $1,025 6.4×
CT maxillofacial wo contrast (70486) $950 $950 9.9×
CT neck tissue combo (70492) $1,100 $1,100 6.8×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,100 $1,100 6.8×
CT orbits w/o contrast (70480) $950 $950 9.9×
CT pelvis w&w/o contrast (72194) $1,100 $1,100 6.8×
CT pelvis w/o contrast (72192) $950 $950 9.9×
CT scan of leg combo (73702)
range across 2 matching MRF lines		 $1,100–$2,200 $1,100–$2,200 varies
CT scans face/jaw combo (70488) $1,100 $1,100 6.8×
CT soft tissue neck w contrast (70491) $1,025 $1,025 6.4×
CT soft tissue neck w/o contrast (70490) $950 $950 9.9×
CT thoracic spine w contrast (72129) $1,025 $1,025 6.4×
CT thoracic spine w/o contrast (72128) $950 $950 9.9×
CT thorax w/o contrast (71250) $950 $950 9.9×
CT upper ext wo (73200) $950 $950 9.9×
CT upper extremity w/o & w/contrast material (73202) $1,100 $1,100 6.8×
CT upper extremity with contrast (73201) $1,025 $1,025 3.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $2,016–$2,328.30 $2,016–$2,328.30 varies
Cta Abdomen (74175) $1,923 $1,923 11.9×
CTA pelvis (72191) $1,748.03 $1,748.03 10.8×
Dxa Bone Density Axial (77080) $272 $272 2.8×
Esophagram (74220) $401.50 $401.50 2.5×
Fetal Biophys Profile W/Nst (76818) $389 $389 4.0×
Fluoroscopy up to 1 hr (76000) $292.60 $292.60 1.3×
Foot 2 views (73620) $181.50 $181.50 2.3×
Forearm 2 views (73090) $189.20 $189.20 2.4×
Gastric emptying imaging study (78264) $355 $355 1.0×
Hand 2 views (73120)
range across 2 matching MRF lines		 $175.81–$247.65 $175.81–$247.65 varies
Joint Survey Single View (77077) $184 $184 1.9×
K Flow/Funct Image W/Drug (78708) $342 $342 0.7×
K Flow/Funct Image W/O Drug (78707) $342 $342 0.7×
Knee 3 Views (73562) $227.70 $227.70 2.8×
Liver & Spleen Imaging Static Only (78215) $325 $325 0.9×
Liver imaging static only (78201) $325 $325 0.7×
Magnetic Image Jaw Joint (70336) $875 $875 4.0×
Meckels Divert Exam (78290) $290 $290 0.8×
Mra Head W/O & W/Contrast Material (70546) $1,012 $1,012 3.2×
MRA head w/o contrast (70544) $1,012 $1,012 4.6×
MRA head with contrast (70545) $1,012 $1,012 3.2×
MRA neck w contrast (70548) $1,012 $1,012 3.2×
Mra Neck W/O &W/Contrast Material (70549) $1,012 $1,012 3.2×
MRA neck w/o contrast (70547) $1,012 $1,012 4.6×
MRI abdomen w contrast (74182) $875 $875 2.7×
MRI abdomen w/o contrast (74181) $875 $875 4.0×
MRI any jt lower extrem w/contrast material (73722) $875 $875 1.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $875 $875 2.7×
MRI any jt upper extremity w/contrast matrl (73222) $875 $875 1.2×
MRI bone marrow blood supply (77084) $875 $875 4.0×
MRI cardiac w/o contrast (75557) $875 $875 4.0×
MRI cervical spine w contrast (72142) $875 $875 2.7×
MRI cervical spine w/o cont (72141) $875 $875 4.0×
MRI chest w/o contrast (71550) $875 $875 4.0×
MRI chest with contrast (71551) $875 $875 1.2×
MRI chest wo w contrast (71552) $875 $875 2.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $875 $875 2.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $875 $875 2.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $875 $875 4.0×
MRI lumbar spine w contrast (72149) $875 $875 2.7×
Mri Neck Spine W/O & W/Dye (72156) $875 $875 2.7×
MRI orbit face &/neck w/o contrast (70540) $875 $875 4.0×
MRI orbit face neck w contrast (70542) $875 $875 2.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $875 $875 2.7×
MRI pelvis w contrast (72196) $875 $875 2.7×
MRI pelvis w/o & w contrast (72197) $875 $875 2.7×
MRI pelvis w/o contrast (72195) $875 $875 4.0×
MRI thoracic spine w/o contrast (72146) $875 $875 4.0×
MRI upper extremity oth than jt w/contr matrl (73219) $875 $875 2.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $875 $875 4.0×
Mri Uppr Extremity W/O&W/Dye (73220) $875 $875 2.7×
MRI, abdomen, combo (74183) $875 $875 2.7×
MRI, dorsal spine combo (72157) $875 $875 2.7×
MRI, dorsal spine contrast (72147) $875 $875 2.7×
MRI, joint upper extrem (73221) $875 $875 4.0×
MRI, joint upper extrem combo (73223) $875 $875 2.7×
MRI, lumbar spine combo (72158) $875 $875 2.7×
Neck soft tissue (70360) $190.30 $190.30 2.4×
Pelvis 1 or 2 views (72170) $203.50 $203.50 2.1×
Pulmonary Perfusion Imaging Particulate (78580) $322 $322 0.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $388.30 $388.30 4.0×
Radex abscess/fistula/sinus tract rs&i (76080) $275 $275 0.5×
Radex Ankle Complete Minimum 3 Views (73610) $210.10 $210.10 2.6×
Radex Calcaneus Minimum 2 Views (73650) $181.50 $181.50 2.3×
Radex elbow complete minimum 3 views (73080) $223.30 $223.30 2.8×
Radex Facial Bones Complete Minimum 3 Views (70150) $278.30 $278.30 2.9×
Radex fingr minimum 2 views (73140) $159.50 $159.50 2.0×
Radex foot complete minimum 3 views (73630) $211.20 $211.20 2.6×
Radex Hand Minimum 3 Views (73130) $201.30 $201.30 2.5×
Radex lower extremity infant minimum 2 views (73592) $203.50 $203.50 2.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $216.70 $216.70 2.7×
Radex Ribs Unilateral 2 Views (71100) $189.44 $189.44 2.4×
Radex shoulder complete minimum 2 views (73030) $262.90 $262.90 3.3×
Radex Sinuses Paransl < 3 Views (70210) $169.40 $169.40 2.1×
Radex Spine 1 View Specify Level (72020) $251.90 $251.90 3.1×
Radex Sternum Minimum 2 Views (71120) $220 $220 2.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $322.30 $322.30 4.0×
Radex Toe Minimum 2 Views (73660) $159.50 $159.50 2.0×
Radex upper extremity infant minimum 2 views (73092) $181.50 $181.50 1.9×
Radex Wrist Complete Minimum 3 Views (73110) $210.10 $210.10 2.6×
Radiolog exam mandible compl minimum 4 views (70110) $310.20 $310.20 3.2×
Radiologic exam colon double contrast study (74280) $638 $638 4.0×
Radiologic exam colon single contrast study (74270) $481.80 $481.80 3.0×
Radiologic exam knee complete 4/more views (73564) $317.90 $317.90 3.3×
Radiologic exam pelvis compl minimum 3 views (72190) $405.90 $405.90 4.2×
Radiologic Exam Small Int Single Contrast Study (74250) $457.60 $457.60 2.8×
Radiologic exam swallow function contrast study (74230) $539 $539 3.3×
Radiologic exam upr gi trc double contrast study (74246) $503 $503 3.1×
Radiologic examination femur 1 view (73551) $220 $220 2.7×
Radiologic examination femur minimum 2 views (73552) $231 $231 2.9×
Radiologic examination knee 1/2 views (73560) $195.80 $195.80 2.4×
Radiologic examination tibia & fibula 2 views (73590) $205.70 $205.70 2.6×
Scapula (73010) $205.70 $205.70 2.1×
Screening Digital Breast Tomosynthesis Bi (77063) $150 $150 6.4×
Shoulder 1 view (73020) $213.40 $213.40 2.7×
Skull less than 4 views (70250) $210.10 $210.10 2.2×
Thoracic spine 2 views (72070) $261.80 $261.80 2.7×
Ultrasound Breast Limited (76642) $320 $320 4.0×
Ultrasound Exam Aaa Screen (76706) $395 $395 4.1×
Ultrasound, abdomen limited (76705) $380 $380 4.0×
Unlisted us procedure (76999) $325 $325 4.1×
Us breast unilateral complete (76641) $360 $360 3.7×
Us chest (76604) $349 $349 3.6×
Us complete joint (76881) $365 $365 3.8×
Us exam, pelvic, limited (76857) $375 $375 3.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $357 $357 3.7×
Us ob detailed single fetus (76811) $502.90 $502.90 2.3×
Us ob limited 1 or more fetuses (76815) $317 $317 3.3×
Us ob transvaginal (76817) $389 $389 4.0×
Us pelvic non ob complete (76856) $425 $425 4.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $405 $405 4.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $389 $389 4.0×
Us retroperitoneal complete (76770) $450 $450 4.7×
Us retroperitoneal limited (76775) $370 $370 3.8×
Us scrotum and contents (76870) $358.60 $358.60 3.7×
Us thyroid (76536) $843 $843 8.8×
Wrist 2 views (73100) $173.80 $173.80 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $249.70 $249.70 3.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $173.80 $173.80 2.2×
X-Ray Exam Entire Spi 1 Vw (72081) $217.80 $217.80 2.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $198 $198 2.1×
X-Ray Exam Hip Uni 1 View (73501) $209 $209 2.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $255.20 $255.20 3.2×
X-Ray Exam Hips Bi 2 Views (73521) $435.60 $435.60 4.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $234.30 $234.30 2.9×
X-Ray Exam Unilat Ribs/Chest (71101) $293.70 $293.70 3.1×
X-ray eye for foreign body (70030) $205 $205 2.6×
X-ray humerus (73060) $202.40 $202.40 2.5×
X-ray IV pyelogram (ivp) (74400) $707.30 $707.30 4.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $213.40 $213.40 2.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $198 $198 2.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $264 $264 2.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $377.30 $377.30 3.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $251.90 $251.90 2.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $209 $209 2.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $286 $286 3.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $310.20 $310.20 3.2×
X-ray thoracic spine 4 vw (72074) $334.40 $334.40 3.5×
X-Ray Tmj Unilat (70328) $205.70 $205.70 2.6×
X-Rays Bone Survey Complete (77075) $1,331 $1,331 13.8×
Xr c-spine 4 or 5 views (72050) $338.80 $338.80 3.5×
Xr facial bones less than 3 views (70140) $264 $264 3.3×
Xr orbits complete 4 views (70200) $292.60 $292.60 3.0×

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.