Imaging prices at Maniilaq Health Center
Kotzebue, AK · every code in this section with a posted price and a Medicare benchmark.
199 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $516 | $516 | 5.3× |
| Abdomen 2 views (74019) | $636 | $636 | 5.5× |
| Ankle 2 views (73600) | $255 | $255 | 2.6× |
| Arthrogram ankle (73615) | $742 | $742 | 1.9× |
| Arthrogram hip (73525) | $779 | $779 | 2.0× |
| Arthrogram Wrist (73115) | $397 | $397 | 1.0× |
| Bone age studies (77072) | $318 | $318 | 2.7× |
| Bone survey infant (77076) | $828 | $828 | 7.1× |
| Cat Scan Follow-Up Study (76380) | $1,162 | $1,162 | 12.0× |
| Chest 1 view (71045) | $379 | $379 | 3.9× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$239–$264 | $239–$264 | varies |
| Chest 3 views (71047) | $332 | $332 | 3.4× |
| Chest 4 or more views (71048) | $362 | $362 | 3.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $389 | $389 | 3.4× |
| Clavicle complete (73000) | $321 | $321 | 3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $399 | $399 | 3.4× |
| Contrast X-Ray Bladder (74430) | $581 | $581 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $742 | $742 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $778 | $778 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,765–$3,766 | $3,765–$3,766 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,455 | $2,455 | 9.3× |
| CT abdomen w contrast (74160) | $1,986 | $1,986 | 10.2× |
| CT abdomen w wo contrast (74170) | $2,240 | $2,240 | 11.5× |
| CT abdomen w/o contrast (74150) | $1,338 | $1,338 | 11.5× |
| CT Angio Abdomen and Pelvis (74174) | $3,624 | $3,624 | 9.4× |
| CT Angio Chest (71275) | $2,736 | $2,736 | 14.1× |
| CT Angio Head (70496) | $2,382 | $2,382 | 12.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,604 | $3,604 | 18.5× |
| CT Angio Neck (70498) | $2,380 | $2,380 | 12.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,636 | $2,636 | 13.5× |
| CT bone density (77078) range across 2 matching MRF lines |
$520–$920 | $520–$920 | varies |
| CT cervical spine w/ contrast (72126) | $1,569 | $1,569 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,378 | $1,378 | 11.9× |
| CT cervical spine w/wo cont (72127) | $1,849 | $1,849 | 9.5× |
| CT chest w contrast (71260) | $2,343 | $2,343 | 12.0× |
| CT chest w/wo contrast (71270) | $1,863 | $1,863 | 9.6× |
| CT head/brain with contrast (70460) | $1,992 | $1,992 | 10.2× |
| CT head/brain without and with contrast (70470) | $2,035 | $2,035 | 10.5× |
| CT iac w contrast (70481) | $1,795 | $1,795 | 9.2× |
| CT l-spine w&w/o contrast (72133) | $2,101 | $2,101 | 10.8× |
| CT lower ext w/o (73700) | $1,245 | $1,245 | 10.7× |
| CT lower extremity w/contrast material (73701) | $1,556 | $1,556 | 8.0× |
| CT lumbar spine w contrast (72132) | $1,572 | $1,572 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,245 | $1,245 | 10.7× |
| CT maxillofacial w contrast (70487) | $1,796 | $1,796 | 9.2× |
| CT maxillofacial wo contrast (70486) | $1,621 | $1,621 | 14.0× |
| CT neck tissue combo (70492) | $1,965 | $1,965 | 10.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,988 | $1,988 | 10.2× |
| CT orbits w/o contrast (70480) | $1,609 | $1,609 | 13.9× |
| CT pelvis w&w/o contrast (72194) | $2,185 | $2,185 | 11.2× |
| CT pelvis w/o contrast (72192) | $1,260 | $1,260 | 10.9× |
| CT scan of leg combo (73702) | $1,872 | $1,872 | 9.6× |
| CT scans face/jaw combo (70488) | $2,065 | $2,065 | 10.6× |
| CT soft tissue neck w contrast (70491) | $1,792 | $1,792 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,720 | $1,720 | 14.8× |
| CT thoracic spine w contrast (72129) | $1,582 | $1,582 | 8.1× |
| CT thoracic spine w/o contrast (72128) | $1,249 | $1,249 | 10.8× |
| CT thoracic spine w/wo cont (72130) | $1,853 | $1,853 | 9.5× |
| CT thorax w/o contrast (71250) | $1,556 | $1,556 | 13.4× |
| CT upper ext wo (73200) | $1,437 | $1,437 | 12.4× |
| CT upper extremity w/o & w/contrast material (73202) | $2,231 | $2,231 | 11.5× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,786–$1,863 | $1,786–$1,863 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,904 | $3,904 | 20.1× |
| Cta Abdomen (74175) | $3,434 | $3,434 | 17.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $4,762 | $4,762 | 12.3× |
| CTA pelvis (72191) | $2,591 | $2,591 | 13.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$245–$318 | $245–$318 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $262 | $262 | 2.7× |
| Echo exam of fetal heart (76825) | $839 | $839 | 1.4× |
| Echo exam uterus (76831) | $436 | $436 | 1.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $588 | $588 | 2.2× |
| Esophagram (74220) | $773 | $773 | 4.0× |
| Fetal Biophys Profile W/Nst (76818) | $950 | $950 | 8.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $700 | $700 | 6.0× |
| Fluoroscopy up to 1 hr (76000) | $524 | $524 | 2.0× |
| Foot 2 views (73620) | $224 | $224 | 2.3× |
| Forearm 2 views (73090) | $232 | $232 | 2.4× |
| Hand 2 views (73120) | $245 | $245 | 2.1× |
| Hysterosalpingogram (74740) | $693 | $693 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,157 | $1,157 | 12.0× |
| Infant hip ultrasound, limited static exam (76886) | $534 | $534 | 5.5× |
| Joint Survey Single View (77077) | $370 | $370 | 3.2× |
| Knee 3 Views (73562) | $315 | $315 | 3.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $800 | $800 | 3.0× |
| Neck soft tissue (70360) | $247 | $247 | 2.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$109–$544 | $109–$544 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$42–$111 | $42–$111 | varies |
| Pelvis 1 or 2 views (72170) | $230 | $230 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $390 | $390 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $351 | $351 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $281 | $281 | 2.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $227 | $227 | 2.4× |
| Radex elbow complete minimum 3 views (73080) | $249 | $249 | 2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $370 | $370 | 3.2× |
| Radex fingr minimum 2 views (73140) | $287 | $287 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $264 | $264 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $281 | $281 | 2.9× |
| Radex lower extremity infant minimum 2 views (73592) | $245 | $245 | 2.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $481 | $481 | 4.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $292 | $292 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $287 | $287 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) | $267 | $267 | 2.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $249 | $249 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $195 | $195 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $281 | $281 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $415 | $415 | 4.3× |
| Radex Toe Minimum 2 Views (73660) | $227 | $227 | 2.4× |
| Radex upper extremity infant minimum 2 views (73092) | $293 | $293 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $313 | $313 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $342 | $342 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $743 | $743 | 6.4× |
| Radiologic exam colon double contrast study (74280) | $1,781 | $1,781 | 9.1× |
| Radiologic exam colon single contrast study (74270) | $1,240 | $1,240 | 6.4× |
| Radiologic exam knee complete 4/more views (73564) | $351 | $351 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $327 | $327 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $973 | $973 | 5.0× |
| Radiologic exam swallow function contrast study (74230) | $1,039 | $1,039 | 5.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,114 | $1,114 | 5.7× |
| Radiologic examination femur 1 view (73551) | $234 | $234 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $277 | $277 | 2.9× |
| Radiologic examination knee 1/2 views (73560) | $270 | $270 | 2.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $510 | $510 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $247 | $247 | 2.6× |
| Ribs bilateral 3 views (71110) | $344 | $344 | 3.0× |
| Scapula (73010) | $250 | $250 | 2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $444 | $444 | 19.0× |
| Shoulder 1 view (73020) | $188 | $188 | 1.9× |
| Shoulder Arthrography (73040) | $675 | $675 | 1.7× |
| Sialogram (70390) | $688 | $688 | 2.6× |
| Skull less than 4 views (70250) | $287 | $287 | 2.5× |
| Sternoclavicular joints (71130) | $321 | $321 | 3.3× |
| Thoracic spine 2 views (72070) | $255 | $255 | 2.2× |
| Thoracic spine 3 views (72072) | $309 | $309 | 2.7× |
| Thoracolumbar 2 views (72080) | $275 | $275 | 2.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$706–$1,060 | $706–$1,060 | varies |
| Ultrasound Exam Aaa Screen (76706) | $918 | $918 | 7.9× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$101–$735 | $101–$735 | varies |
| Upper gi w/o kub (74240) | $968 | $968 | 5.0× |
| Urethrocystogram voiding (74455) | $783 | $783 | 3.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$863–$1,292 | $863–$1,292 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$99–$637 | $99–$637 | varies |
| Us complete joint (76881) | $626 | $626 | 5.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$85–$399 | $85–$399 | varies |
| Us head (76506) | $496 | $496 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$120–$461 | $120–$461 | varies |
| Us ob detailed single fetus (76811) | $1,430 | $1,430 | 5.4× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$113–$678 | $113–$678 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$129–$771 | $129–$771 | varies |
| Us pelvic non ob complete (76856) | $883 | $883 | 7.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $985 | $985 | 8.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $911 | $911 | 7.9× |
| Us retroperitoneal complete (76770) | $911 | $911 | 7.9× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$100–$474 | $100–$474 | varies |
| Us scrotum and contents (76870) | $846 | $846 | 7.3× |
| Us thyroid (76536) | $934 | $934 | 8.0× |
| Venography extremity bilateral rs&i (75822) | $1,405 | $1,405 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,439 | $1,439 | 0.8× |
| Venography Renal Bilateral (75833) | $2,192 | $2,192 | 0.6× |
| Venography Renal Unilateral (75831) | $1,390 | $1,390 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$711 | $711 | 0.1× |
| Wrist 2 views (73100) | $264 | $264 | 2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$35–$252 | $35–$252 | varies |
| X-Ray Bend Only L-S Spine (72120) | $318 | $318 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $230 | $230 | 2.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $334 | $334 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $602 | $602 | 5.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $255 | $255 | 2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $364 | $364 | 3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $449 | $449 | 3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $321 | $321 | 2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $417 | $417 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $474 | $474 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $477 | $477 | 4.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $306 | $306 | 3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $477 | $477 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $255 | $255 | 2.2× |
| X-ray eye for foreign body (70030) | $249 | $249 | 2.6× |
| X-ray humerus (73060) | $252 | $252 | 2.6× |
| X-ray IV pyelogram (ivp) (74400) | $1,028 | $1,028 | 5.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $277 | $277 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $414 | $414 | 4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $306 | $306 | 2.6× |
| X-ray nose-rectum child f.b. (76010) | $232 | $232 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $413 | $413 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $306 | $306 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $258 | $258 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $252 | $252 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $295 | $295 | 3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $355 | $355 | 3.1× |
| X-Ray Stress View (77071) | $429 | $429 | 4.4× |
| X-ray thoracic spine 4 vw (72074) | $347 | $347 | 3.0× |
| X-Ray Tmj Unilat (70328) | $270 | $270 | 2.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $476 | $476 | 1.2× |
| X-Rays Bone Length Studies (77073) | $355 | $355 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $766 | $766 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $406 | $406 | 3.5× |
| Xr facial bones less than 3 views (70140) | $252 | $252 | 2.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $295 | $295 | 2.5× |
| Xr orbits complete 4 views (70200) | $375 | $375 | 3.2× |
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.