Imaging prices at Mayo Clinic Health System - New Prague

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

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

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ProcedureCash priceGross charge× Medicare
Angiography extremity bilateral rs&i (75716) $2,003.25 $2,671 0.6×
Angiography extremity unilateral rs&i (75710) $959.62 $1,279.50 0.3×
Angiography visceral slctv/supraslctv rs&i (75726) $3,082.50 $4,110 0.5×
Aortography abdominal serialography rs&i (75625) $1,057.50 $1,410 0.3×
Continuing medical physics consltj pr wk (77336) $567 $756 4.0×
Cystography minimum 3 views rs&i (74430) $275.25 $367 0.8×
Fluoroscopy up to 1 hr (76000) $313.50 $418 1.3×
Ntsty modul radthx pln dose-vol histos (77301) $5,723.25 $7,631 3.9×
PET image w/CT, skull-thigh (78815) $5,563.50 $7,418 3.7×
Radiation treatment delivery level 2 (77407) $2,684.62 $3,579.50 6.6×
Radiation treatment delivery level 3 (77412) $1,032 $1,376 1.8×
Radiologic exam chest 2 views (71046) $121.50 $162 1.3×
Rp therapy intra-arterial particulate admn (79445) $1,329 $1,772 5.4×
Special Physics Consult (77370) $704.25 $939 5.0×
Stereotactic Body Radiation Delivery (77373) $9,015 $12,020 4.8×
Tbs technical calculation only (77091) $193.50 $258 2.1×
Ultrasound, abdomen limited (76705) $325.50 $434 3.0×
Unlisted fluoroscopic procedure (76496) $969 $1,292 10.6×
Us breast unilateral limited (76642) $243.75 $325 2.7×
Us chest (76604) $240 $320 2.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $181.50 $242 1.7×
Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $652.50 $870 6.0×
Us ob limited (76815) $258 $344 2.4×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $183 $244 1.7×
Us retroperitoneal complete (76770) $362.25 $483 3.3×
Us retroperitoneal limited (76775) $199.50 $266 1.8×
Us soft tissue head/neck (76536) $336.75 $449 3.1×
Us, eye b-scan (76512) $202.50 $270 1.8×
Venogram extremity bilateral (75822) $843.75 $1,125 0.5×
Venography renal unilateral selective rs&i (75831) $2,517 $3,356 0.8×
X-ray retrograde pyelogram (74420) $412.50 $550 1.1×