Imaging prices at Madison Healthcare Services - Madison Hospital
Madison, MN · every code in this section with a posted price and a Medicare benchmark.
225 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $255 | $300 | 2.8× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$327.25–$335.75 | $385–$395 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,517.25 | $1,785 | 3.7× |
| Ankle 2 views (73600) | $244.80 | $288 | 2.7× |
| Bone age studies (77072) | $195.50 | $230 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,523.20 | $1,792 | 3.7× |
| Bone Imaging Limited Area (78300) | $997.05 | $1,173 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $1,040.40 | $1,224 | 2.5× |
| Bone Imaging Whole Body (78306) | $1,451.80 | $1,708 | 3.5× |
| Bone survey infant (77076) | $390.15 | $459 | 3.6× |
| Cat Scan Follow-Up Study (76380) | $1,167.05 | $1,373 | 13.0× |
| Chest 1 view (71045) | $264.35 | $311 | 2.9× |
| Chest 2 views (71046) | $310.25 | $365 | 3.5× |
| Chest 3 views (71047) | $229.50 | $270 | 2.6× |
| Chest 4 or more views (71048) | $238.85 | $281 | 2.2× |
| Clavicle complete (73000) | $243.10 | $286 | 2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,293.70 | $1,522 | 12.0× |
| Contrast X-Ray Bladder (74430) | $422.45 | $497 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,989.05 | $4,693 | 11.1× |
| CT abdomen and pelvis without contrast (74176) | $2,992 | $3,520 | 12.1× |
| CT abdomen w contrast (74160) | $1,572.50 | $1,850 | 8.7× |
| CT abdomen w wo contrast (74170) | $2,244 | $2,640 | 12.4× |
| CT abdomen w/o contrast (74150) | $1,640.50 | $1,930 | 15.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,191.75 | $3,755 | 8.9× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,062.95–$2,299.25 | $2,427–$2,705 | varies |
| CT Angio Head (70496) | $2,069.75 | $2,435 | 11.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,119.05 | $2,493 | 11.7× |
| CT Angio Neck (70498) | $2,095.25 | $2,465 | 11.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,103.75 | $2,475 | 11.6× |
| CT cervical spine w/ contrast (72126) | $1,705.10 | $2,006 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,653.25 | $1,945 | 15.3× |
| CT cervical spine w/wo cont (72127) | $1,872.55 | $2,203 | 10.3× |
| CT chest w contrast (71260) | $1,725.50 | $2,030 | 9.5× |
| CT chest w/wo contrast (71270) | $1,872.55 | $2,203 | 10.3× |
| CT head/brain with contrast (70460) | $1,921 | $2,260 | 10.6× |
| CT head/brain without and with contrast (70470) | $1,865.75 | $2,195 | 10.3× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,525.75–$1,640.50 | $1,795–$1,930 | varies |
| CT l-spine w&w/o contrast (72133) | $1,913.35 | $2,251 | 10.6× |
| CT lower ext w/o (73700) | $1,525.75 | $1,795 | 14.1× |
| CT lower extremity w/contrast material (73701) | $1,725.50 | $2,030 | 9.5× |
| CT lumbar spine w contrast (72132) | $1,860.65 | $2,189 | 5.2× |
| CT lumbar spine w/o contrast (72131) | $1,611.60 | $1,896 | 14.9× |
| CT maxillofacial w contrast (70487) | $2,001.75 | $2,355 | 11.1× |
| CT maxillofacial wo contrast (70486) | $1,504.50 | $1,770 | 13.9× |
| CT neck tissue combo (70492) | $1,737.40 | $2,044 | 9.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,772.25–$1,860.65 | $2,085–$2,189 | varies |
| CT orbits w/o contrast (70480) | $1,354.05 | $1,593 | 12.5× |
| CT pelvis w&w/o contrast (72194) | $1,790.95 | $2,107 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,725.50 | $2,030 | 16.0× |
| CT scan of leg combo (73702) | $1,847.90 | $2,174 | 10.2× |
| CT scans face/jaw combo (70488) | $1,800.30 | $2,118 | 9.9× |
| CT soft tissue neck w contrast (70491) | $1,802 | $2,120 | 10.0× |
| CT soft tissue neck w/o contrast (70490) | $1,623.50 | $1,910 | 15.0× |
| CT thoracic spine w contrast (72129) | $1,602.25 | $1,885 | 8.9× |
| CT thoracic spine w/o contrast (72128) | $1,522.35 | $1,791 | 14.1× |
| CT thoracic spine w/wo cont (72130) | $1,718.70 | $2,022 | 9.5× |
| CT thorax w/o contrast (71250) | $1,525.75 | $1,795 | 14.1× |
| CT upper ext wo (73200) | $1,521.50 | $1,790 | 14.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,772.25 | $2,085 | 9.8× |
| CT upper extremity with contrast (73201) | $1,571.65 | $1,849 | 4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,759.10 | $3,246 | 15.2× |
| Cta Abdomen (74175) | $1,922.70 | $2,262 | 10.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,265.25 | $2,665 | 6.3× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$510.85–$524.45 | $601–$617 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $534.65 | $629 | 6.0× |
| Esophagram (74220) | $399.50 | $470 | 2.2× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$595–$618.80 | $700–$728 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$459–$573.75 | $540–$675 | varies |
| Fluoroscopy up to 1 hr (76000) | $399.50 | $470 | 1.6× |
| Foot 2 views (73620) | $236.30 | $278 | 2.6× |
| Forearm 2 views (73090) | $243.10 | $286 | 2.7× |
| Gastric emptying imaging study (78264) | $1,563.15 | $1,839 | 3.8× |
| Hand 2 views (73120) | $245.65 | $289 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,534.25 | $1,805 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,432.25 | $1,685 | 3.5× |
| Ht Muscle Image Spect Sing (78451) | $2,656.25 | $3,125 | 2.0× |
| Joint Survey Single View (77077) | $229.50 | $270 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $1,213.80 | $1,428 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,547 | $1,820 | 2.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,487.50 | $1,750 | 2.7× |
| Kidney Imaging Morphol (78700) | $953.70 | $1,122 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,040.40 | $1,224 | 2.5× |
| Knee 3 Views (73562) | $277.10 | $326 | 3.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,040.40 | $1,224 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,712.75 | $2,015 | 3.1× |
| Lung Ventilation Imaging (78579) | $1,207 | $1,420 | 2.9× |
| Magnetic Image Jaw Joint (70336) | $1,820.70 | $2,142 | 7.4× |
| Meckels Divert Exam (78290) | $1,156.85 | $1,361 | 2.8× |
| Mra Head W/O & W/Contrast Material (70546) | $2,653.70 | $3,122 | 7.4× |
| MRA head w/o contrast (70544) | $2,278 | $2,680 | 9.3× |
| MRA head with contrast (70545) | $1,907.40 | $2,244 | 5.3× |
| MRA neck w contrast (70548) | $2,108.85 | $2,481 | 5.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,677.50 | $3,150 | 7.4× |
| MRA neck w/o contrast (70547) | $2,123.30 | $2,498 | 8.6× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,439.50–$2,609.50 | $2,870–$3,070 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,210–$2,258.45 | $2,600–$2,657 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,564.45 | $3,017 | 3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,765.90 | $3,254 | 7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,533 | $2,980 | 3.1× |
| MRI cervical spine w contrast (72142) | $2,497.30 | $2,938 | 6.9× |
| MRI cervical spine w/o cont (72141) | $2,358.75 | $2,775 | 9.6× |
| MRI chest w/o contrast (71550) | $2,030.65 | $2,389 | 8.2× |
| MRI chest with contrast (71551) | $2,329.85 | $2,741 | 2.9× |
| MRI chest wo w contrast (71552) | $2,753.15 | $3,239 | 7.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,353.65 | $2,769 | 6.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,720 | $3,200 | 7.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,231.25 | $2,625 | 9.1× |
| MRI lumbar spine w contrast (72149) | $2,532.15 | $2,979 | 7.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,057.45 | $3,597 | 8.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,078.25 | $2,445 | 8.4× |
| MRI orbit face neck w contrast (70542) | $2,266.95 | $2,667 | 6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,626.50 | $3,090 | 7.3× |
| MRI pelvis w contrast (72196) | $2,202.35 | $2,591 | 6.1× |
| MRI pelvis w/o & w contrast (72197) | $2,786.30 | $3,278 | 7.7× |
| MRI pelvis w/o contrast (72195) | $2,223.60 | $2,616 | 9.0× |
| MRI thoracic spine w/o contrast (72146) | $2,358.75 | $2,775 | 9.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,479.45 | $2,917 | 6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,195.55 | $2,583 | 8.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,867.90 | $3,374 | 8.0× |
| MRI, abdomen, combo (74183) | $3,031.95 | $3,567 | 8.4× |
| MRI, dorsal spine combo (72157) | $2,771.85 | $3,261 | 7.7× |
| MRI, dorsal spine contrast (72147) | $2,609.50 | $3,070 | 7.2× |
| MRI, joint upper extrem (73221) | $2,358.75 | $2,775 | 9.6× |
| MRI, joint upper extrem combo (73223) | $2,874.70 | $3,382 | 8.0× |
| MRI, lumbar spine combo (72158) | $3,238.50 | $3,810 | 9.0× |
| Myocardial Spect Multiple Studies (78452) | $3,672 | $4,320 | 2.7× |
| Neck soft tissue (70360) | $254.15 | $299 | 2.8× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $65.45 | $77 | 2.2× |
| Parathyroid Planar Imaging (78070) | $1,227.40 | $1,444 | 3.0× |
| Pelvis 1 or 2 views (72170) | $272 | $320 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,040.40 | $1,224 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $355.30 | $418 | 3.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $277.10 | $326 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $238.85 | $281 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $277.10 | $326 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $369.75 | $435 | 3.4× |
| Radex fingr minimum 2 views (73140) | $224.40 | $264 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $268.60 | $316 | 3.0× |
| Radex Hand Minimum 3 Views (73130) | $255 | $300 | 2.8× |
| Radex lower extremity infant minimum 2 views (73592) | $249.90 | $294 | 2.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $260.10 | $306 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $289 | $340 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $323 | $380 | 3.6× |
| Radex shoulder complete minimum 2 views (73030) | $280.50 | $330 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $229.50 | $270 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $241.40 | $284 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $272.85 | $321 | 3.0× |
| Radex Toe Minimum 2 Views (73660) | $241.40 | $284 | 2.7× |
| Radex upper extremity infant minimum 2 views (73092) | $258.40 | $304 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $257.55 | $303 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $328.10 | $386 | 3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $216.75 | $255 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $317.05 | $373 | 2.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $335.75 | $395 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $430.10 | $506 | 2.4× |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$111.35–$483.65 | $131–$569 | varies |
| Radiologic examination femur 1 view (73551) | $212.50 | $250 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $285.60 | $336 | 3.2× |
| Radiologic examination knee 1/2 views (73560) | $260.10 | $306 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $273.70 | $322 | 3.0× |
| Ribs bilateral 3 views (71110) | $342.55 | $403 | 3.2× |
| Scapula (73010) | $249.90 | $294 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$92.65–$121.55 | $109–$143 | varies |
| Shoulder 1 view (73020) | $212.50 | $250 | 2.4× |
| Skull less than 4 views (70250) | $291.55 | $343 | 2.7× |
| Sternoclavicular joints (71130) | $283.90 | $334 | 3.2× |
| Thoracic spine 2 views (72070) | $288.15 | $339 | 2.7× |
| Thoracic spine 3 views (72072) | $378.25 | $445 | 3.5× |
| Thoracolumbar 2 views (72080) | $235.45 | $277 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $1,040.40 | $1,224 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,167.90 | $1,374 | 2.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$436.05–$447.10 | $513–$526 | varies |
| Ultrasound Exam Aaa Screen (76706) | $623.05 | $733 | 5.8× |
| Ultrasound, abdomen limited (76705) | $632.40 | $744 | 5.9× |
| Umbilical-artery Doppler (OB) (76820) | $344.25 | $405 | 3.2× |
| Unlisted us procedure (76999) | $405.45 | $477 | 4.5× |
| Us breast unilateral complete (76641) | $524.45 | $617 | 4.9× |
| Us chest (76604) | $511.70 | $602 | 4.7× |
| Us complete joint (76881) | $381.65 | $449 | 3.5× |
| Us exam, pelvic, limited (76857) | $382.50 | $450 | 3.5× |
| Us head (76506) | $498.10 | $586 | 4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $491.30 | $578 | 4.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$358.70–$476 | $422–$560 | varies |
| Us ob transvaginal (76817) | $524.45 | $617 | 4.9× |
| Us pelvic non ob complete (76856) | $600.10 | $706 | 5.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $579.70 | $682 | 5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $498.10 | $586 | 4.6× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$724.20–$781.15 | $852–$919 | varies |
| Us retroperitoneal limited (76775) | $611.15 | $719 | 5.7× |
| Us scrotum and contents (76870) | $589.05 | $693 | 5.5× |
| Us thyroid (76536) | $616.25 | $725 | 5.7× |
| Vascular Flow Imaging (78445) | $524.45 | $617 | 1.3× |
| Wrist 2 views (73100) | $241.40 | $284 | 2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $250.75 | $295 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $242.25 | $285 | 2.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $295.80 | $348 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $328.95 | $387 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $249.05 | $293 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $301.75 | $355 | 3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $550.80 | $648 | 5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $391 | $460 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $466.65 | $549 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $323 | $380 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $357 | $420 | 3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $399.50 | $470 | 3.7× |
| X-ray eye for foreign body (70030) | $227.80 | $268 | 2.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$256.70–$263.50 | $302–$310 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $216.75 | $255 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$244.80–$263.50 | $288–$310 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $374 | $440 | 3.5× |
| X-ray nose-rectum child f.b. (76010) | $238.85 | $281 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $476 | $560 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $306.85 | $361 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $252.45 | $297 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $272 | $320 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $354.45 | $417 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $298.35 | $351 | 2.8× |
| X-ray thoracic spine 4 vw (72074) | $305.15 | $359 | 2.8× |
| X-Ray Tmj Unilat (70328) | $241.40 | $284 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $536.35 | $631 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $1,548.70 | $1,822 | 14.4× |
| Xr c-spine 4 or 5 views (72050) | $364.65 | $429 | 3.4× |
| Xr facial bones less than 3 views (70140) | $233.75 | $275 | 2.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $216.75 | $255 | 2.0× |
| Xr orbits complete 4 views (70200) | $277.10 | $326 | 2.6× |
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.