Imaging prices at Mahnomen Health

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $620.10 $689 5.7×
Ankle 2 views (73600) $363.60 $404 4.0×
Bone &/Joint Imaging Limited Area (78300) $1,593 $1,770 3.9×
Bone &/joint imaging whole body (78306) $1,906.20 $2,118 4.6×
Bone Imaging 3 Phase (78315) $1,868.40 $2,076 4.5×
Bone survey complete (77075) $943.20 $1,048 8.7×
Bone survey infant (77076) $684 $760 6.3×
Cervical spine 2 or 3 views (72040) $387 $430 4.3×
Chest 1 view (71045) $351.90 $391 3.9×
Chest xray 3 views (71047) $455.40 $506 5.1×
Clavicle complete (73000) $360 $400 4.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $675 $750 6.3×
CT abdomen and pelvis without and with contrast (74178) $5,037.30 $5,597 14.0×
CT abdomen and pelvis without contrast (74176) $3,643.20 $4,048 14.8×
CT abdomen w contrast (74160) $2,281.50 $2,535 12.6×
CT abdomen w wo contrast (74170) $2,498.40 $2,776 13.8×
CT abdomen w/o contrast (74150) $1,886.40 $2,096 17.5×
CT angio lwr extr w/o&w/dye (73706) $3,755.70 $4,173 20.7×
CT c-spine w/contrast (72126) $2,401.20 $2,668 6.7×
CT c-spine w/o contrast (72125) $2,187.90 $2,431 20.3×
CT chest w contrast (71260) $2,990.70 $3,323 16.5×
CT chest w/wo contrast (71270) $2,998.80 $3,332 16.6×
CT head/brain with contrast (70460) $2,265.30 $2,517 12.5×
CT head/brain without and with contrast (70470) $2,933.10 $3,259 16.2×
CT iac w contrast (70481) $2,502.90 $2,781 13.8×
CT lower ext w/o (73700) $2,030.40 $2,256 18.8×
CT lower extremity w wo contrast (73702) $4,335.30 $4,817 23.9×
CT lower extremity w/contrast material (73701) $2,956.50 $3,285 16.3×
CT lumbar spine w/contrast (72132) $2,700 $3,000 7.5×
CT lumbar spine w/o contrast (72131) $2,401.20 $2,668 22.3×
CT maxillofacial w contrast (70487) $2,071.80 $2,302 11.4×
CT maxillofacial w/wo contrast (70488) $2,961 $3,290 16.4×
CT maxillofacial wo contrast (70486) $2,071.80 $2,302 19.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,498.40 $2,776 13.8×
CT orbits w/o contrast (70480) $2,186.10 $2,429 20.3×
CT pelvis w/o contrast (72192) $2,130.30 $2,367 19.7×
CT pelvis w/wo contrast (72194) $5,850 $6,500 32.3×
CT soft tissue neck w contrast (70491) $2,450.70 $2,723 13.5×
CT soft tissue neck w/o & w/contrast material (70492) $3,564.90 $3,961 19.7×
CT soft tissue neck w/o contrast (70490) $2,187.90 $2,431 20.3×
CT thoracic spine w/contrast (72129) $2,626.20 $2,918 14.5×
CT thoracic spine w/o contrast (72128) $2,211.30 $2,457 20.5×
CT thorax w/o contrast (71250) $2,466 $2,740 22.9×
CT upper ext wo (73200) $2,030.40 $2,256 18.8×
CT upper extremity with contrast (73201) $2,157.30 $2,397 6.0×
Cta Abdomen (74175) $3,630.60 $4,034 20.1×
CTA abdomen pelvis (74174) $4,459.50 $4,955 12.4×
CTA chest (71275) $3,216.60 $3,574 17.8×
Cta Head (70496) $3,294 $3,660 18.2×
Cta Neck (70498) $3,236.40 $3,596 17.9×
Dxa bone density study 1/> sites axial skel (77080) $641.70 $713 5.9×
Dxa bone density study 1/>sites appendiclr skel (77081) $344.70 $383 3.8×
Facial bones min 3 views (70150) $338.40 $376 3.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $482.40 $536 4.5×
Foot 2 views (73620) $348.30 $387 3.9×
Forearm 2 views (73090) $357.30 $397 4.0×
Hand 2 views (73120) $349.20 $388 3.2×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,892.70 $2,103 3.4×
Knee 3 views (73562) $431.10 $479 4.8×
MRA head w/o contrast (70544) $3,280.50 $3,645 13.3×
MRA neck w contrast (70548) $4,378.50 $4,865 12.2×
Mra Neck W/O &W/Contrast Material (70549) $4,458.60 $4,954 12.4×
MRA neck w/o contrast (70547) $1,243.80 $1,382 5.1×
MRI abdomen w contrast (74182) $4,198.50 $4,665 11.7×
MRI abdomen w/o & w/contrast material (74183) $4,151.70 $4,613 11.5×
MRI abdomen w/o contrast (74181) $3,837.60 $4,264 15.6×
MRI any jt lower extrem w/contrast material (73722) $3,401.10 $3,779 4.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,486.60 $3,874 9.7×
MRI cervical spine w/o contrast (72141) $3,463.20 $3,848 14.1×
MRI chest w/o & w/contrast material (71552) $2,651.40 $2,946 7.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,170.60 $4,634 11.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,072.60 $3,414 12.5×
MRI orbit face neck w contrast (70542) $3,406.50 $3,785 9.5×
MRI orbit/face/neck w&w/o cont (70543) $3,406.50 $3,785 9.5×
MRI pelvis w/contrast (72196) $4,211.10 $4,679 11.7×
MRI pelvis w/o & w/contrast material (72197) $4,253.40 $4,726 11.8×
MRI pelvis w/o contrast (72195) $3,211.20 $3,568 13.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $5,023.80 $5,582 14.0×
MRI spinal canal lumbar w/contrast material (72149) $4,675.50 $5,195 13.0×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $5,109.30 $5,677 14.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $5,023.80 $5,582 14.0×
MRI thoracic spine w/o contrast (72146) $3,515.40 $3,906 14.3×
MRI up ext w/o contrast (73218) $3,400.20 $3,778 13.8×
MRI upper ext joint w/o contrast (73221) $3,486.60 $3,874 14.2×
MRI, joint upper extrem combo (73223) $3,400.20 $3,778 9.4×
Neck soft tissue (70360) $369 $410 4.1×
Pelvis 1 or 2 views (72170) $453.60 $504 4.2×
Radex Ankle Compl Minimum 3 Views (73610) $430.20 $478 4.8×
Radex Calcaneus Minimum 2 Views (73650) $344.70 $383 3.8×
Radex Elbw Compl Minimum 3 Views (73080) $431.10 $479 4.8×
Radex fingr minimum 2 views (73140) $348.30 $387 3.9×
Radex Foot Compl Minimum 3 Views (73630) $402.30 $447 4.5×
Radex Hand Minimum 3 Views (73130) $381.60 $424 4.2×
Radex Hip Unilateral With Pelvis 1 View (73501) $340.20 $378 3.8×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $476.10 $529 4.4×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $476.10 $529 4.4×
Radex Humerus Minimum 2 Views (73060) $414 $460 4.6×
Radex Kne 1/2 Views (73560) $399.60 $444 4.4×
Radex Kne Compl 4/More Views (73564) $565.20 $628 5.2×
Radex Mndbl Compl Minimum 4 Views (70110) $504.90 $561 4.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $368.10 $409 4.1×
Radex Pelvis Compl Minimum 3 Views (72190) $332.10 $369 3.1×
Radex Sho Compl Minimum 2 Views (73030) $509.40 $566 5.7×
Radex Sinuses Paransl < 3 Views (70210) $261 $290 2.9×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $292.50 $325 2.7×
Radex Toe Minimum 2 Views (73660) $369.90 $411 4.1×
Radex upper extremity infant minimum 2 views (73092) $270.90 $301 2.5×
Radex Wrst Compl Minimum 3 Views (73110) $435.60 $484 4.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $921.60 $1,024 8.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $620.10 $689 6.9×
Radiologic exam chest 2 views (71046) $412.20 $458 4.6×
Radiologic examination femur 1 view (73551) $409.50 $455 4.6×
Radiologic examination tibia & fibula 2 views (73590) $394.20 $438 4.4×
Ribs bilateral 3 views (71110) $787.50 $875 7.3×
Rp loclzj tum spect 1 area single day imaging (78803) $4,436.10 $4,929 7.9×
Scapula (73010) $388.80 $432 3.6×
Screening Digital Breast Tomosynthesis Bi (77063) $104.40 $116 4.5×
Shoulder 1 view (73020) $339.30 $377 3.8×
Spine thoracic 3 views (72072) $603 $670 5.6×
Thoracolumbar 2 views (72080) $511.20 $568 5.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,890 $2,100 4.6×
Tmj unilateral (70328) $288 $320 3.2×
Ultrasound Exam Aaa Screen (76706) $495.90 $551 4.6×
Ultrasound, abdomen limited (76705) $442.80 $492 4.1×
Umbilical-artery Doppler (OB) (76820) $198.90 $221 1.8×
Us chest (76604) $682.20 $758 6.3×
Us compl joint r-t w/image documentation (76881) $508.50 $565 4.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $569.70 $633 5.3×
Us ob limited (76815) $409.50 $455 3.8×
Us ob transvaginal (76817) $592.20 $658 5.5×
Us pelvic non ob complete (76856) $531.90 $591 4.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $422.10 $469 3.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $620.10 $689 5.7×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $418.50 $465 3.9×
Us retroperitoneal complete (76770) $594 $660 5.5×
Us retroperitoneal limited (76775) $594 $660 5.5×
Us scrotum and contents (76870) $569.70 $633 5.3×
Us soft tissue head/neck (76536) $490.50 $545 4.5×
Wrist 2 views (73100) $376.20 $418 4.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $796.50 $885 7.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $539.10 $599 6.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $361.80 $402 4.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $408.60 $454 4.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $408.60 $454 3.8×
X-ray exam of femur 2/> (73552) $520.20 $578 5.8×
X-ray eye for foreign body (70030) $260.10 $289 2.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $338.40 $376 3.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $112.50 $125 1.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $376.20 $418 4.2×
X-ray leg, infant (73592) $257.40 $286 2.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $435.60 $484 4.0×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $882 $980 8.2×
X-ray nose-rectum child f.b. (76010) $388.80 $432 4.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $333.90 $371 3.1×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $363.60 $404 4.0×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $468.90 $521 4.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $774.90 $861 7.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $274.50 $305 2.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $387 $430 4.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $769.50 $855 8.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $560.70 $623 5.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $321.30 $357 3.0×
X-Ray Spine One View - Xr Spine (72020) $242.10 $269 2.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $453.60 $504 5.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $504 $560 4.7×
Xr c-spine 4 or 5 views (72050) $572.40 $636 5.3×
Xr c-spine 6 or more views (72052) $684 $760 6.3×