Imaging prices at Medina Memorial Hospital

Medina, NY · 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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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $98 $245 0.9×
Abdomen 2 views (74019) $126 $315 1.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $572 $1,430 1.1×
Ankle 2 views (73600) $98 $245 0.9×
Bone age studies (77072) $124 $310 1.0×
Bone Imaging 3 Phase (78315) $666 $1,665 1.3×
Bone Imaging Limited Area (78300) $452 $1,130 0.9×
Bone Imaging Whole Body (78306) $626 $1,565 1.3×
Bone survey infant (77076) $142 $355 1.1×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $662 $1,655 1.3×
Chest 1 view (71045) $96 $240 0.9×
Chest 2 views (71046) $112 $280 1.0×
Chest 3 views (71047) $128 $320 1.2×
Chest 4 or more views (71048) $156 $390 1.2×
Clavicle complete (73000) $104 $260 1.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $166 $415 1.3×
Contrast X-Ray Bladder (74430) $262 $655 0.6×
CT abdomen and pelvis without and with contrast (74178) $1,314 $3,285 3.0×
CT abdomen and pelvis without contrast (74176) $930 $2,325 3.1×
CT abdomen w contrast (74160) $784 $1,960 3.6×
CT abdomen w wo contrast (74170) $912 $2,280 4.2×
CT abdomen w/o contrast (74150) $610 $1,525 4.7×
CT Angio Abdomen and Pelvis (74174) $1,158 $2,895 2.7×
CT Angio Chest (71275) $920 $2,300 4.2×
CT Angio Head (70496) $888 $2,220 4.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $846 $2,115 3.9×
CT Angio Neck (70498) $896 $2,240 4.1×
CT cervical spine w/ contrast (72126) $808 $2,020 1.9×
CT cervical spine w/o contrast (72125) $652 $1,630 5.0×
CT chest w contrast (71260) $762 $1,905 3.5×
CT chest w/wo contrast (71270) $874 $2,185 4.0×
CT head/brain with contrast (70460) $686 $1,715 3.1×
CT head/brain without and with contrast (70470) $816 $2,040 3.7×
CT iac w contrast (70481) $748 $1,870 3.4×
CT l-spine w&w/o contrast (72133) $882 $2,205 4.0×
CT lower ext w/o (73700) $568 $1,420 4.4×
CT lower extremity w/contrast material (73701) $706 $1,765 3.2×
CT lumbar spine w contrast (72132) $800 $2,000 1.8×
CT lumbar spine w/o contrast (72131) $644 $1,610 4.9×
CT maxillofacial w contrast (70487) $728 $1,820 3.3×
CT maxillofacial wo contrast (70486) $578 $1,445 4.4×
CT neck tissue combo (70492) $836 $2,090 3.8×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $852 $2,130 3.9×
CT orbits w/o contrast (70480) $604 $1,510 4.6×
CT pelvis w&w/o contrast (72194) $880 $2,200 4.0×
CT pelvis w/o contrast (72192) $600 $1,500 4.6×
CT scan of leg combo (73702) $816 $2,040 3.7×
CT scans face/jaw combo (70488) $844 $2,110 3.9×
CT soft tissue neck w contrast (70491) $738 $1,845 3.4×
CT soft tissue neck w/o contrast (70490) $588 $1,470 4.5×
CT thoracic spine w contrast (72129) $776 $1,940 3.5×
CT thoracic spine w/o contrast (72128) $630 $1,575 4.8×
CT thorax w/o contrast (71250) $610 $1,525 4.7×
CT upper ext wo (73200) $570 $1,425 4.4×
CT upper extremity w/o & w/contrast material (73202) $804 $2,010 3.7×
CT upper extremity with contrast (73201) $716 $1,790 1.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $942 $2,355 4.3×
Cta Abdomen (74175) $900 $2,250 4.1×
CTA pelvis (72191) $860 $2,150 3.9×
Dxa Bone Density Axial (77080) $166 $415 1.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $94 $235 0.9×
Esophagram (74220) $220 $550 1.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $230 $575 1.8×
Fluoroscopy up to 1 hr (76000) $214 $535 0.7×
Follow-Up Angiography (75898) $618 $1,545 0.2×
Foot 2 views (73620) $98 $245 0.9×
Forearm 2 views (73090) $104 $260 1.0×
Gastric emptying imaging study (78264) $570 $1,425 1.1×
Gated Heart Planar Single (78472) $650 $1,625 1.3×
Hand 2 views (73120) $102 $255 0.8×
Hepatobil Syst Image W/Drug (78227) $658 $1,645 1.0×
Hepatobiliary System Imaging (78226) $570 $1,425 1.1×
Ht Musc Image Planar Mult (78454) $1,026 $2,565 0.6×
Ht Muscle Image Spect Sing (78451) $1,092 $2,730 0.7×
K Flow/Funct Image Multiple (78709) $698 $1,745 1.0×
K Flow/Funct Image W/Drug (78708) $650 $1,625 1.0×
K Flow/Funct Image W/O Drug (78707) $616 $1,540 0.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $444 $1,110 0.9×
Knee 3 Views (73562) $122 $305 1.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $488 $1,220 1.0×
Lung Ventilat&Perfus Imaging (78582) $676 $1,690 1.0×
Lung Ventilation Imaging (78579) $396 $990 0.8×
Magnetic Image Jaw Joint (70336) $864 $2,160 2.9×
Meckels Divert Exam (78290) $460 $1,150 0.9×
Mra Head W/O & W/Contrast Material (70546) $1,278 $3,195 2.9×
MRA head w/o contrast (70544) $890 $2,225 3.0×
MRA head with contrast (70545) $956 $2,390 2.2×
MRA neck w contrast (70548) $990 $2,475 2.3×
Mra Neck W/O &W/Contrast Material (70549) $1,250 $3,125 2.9×
MRA neck w/o contrast (70547) $884 $2,210 3.0×
MRI abdomen w contrast (74182) $1,024 $2,560 2.4×
MRI abdomen w/o contrast (74181) $940 $2,350 3.2×
MRI any jt lower extrem w/contrast material (73722) $1,092 $2,730 1.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,280 $3,200 2.9×
MRI any jt upper extremity w/contrast matrl (73222) $1,082 $2,705 1.1×
MRI cervical spine w contrast (72142) $1,070 $2,675 2.5×
MRI cervical spine w/o cont (72141) $932 $2,330 3.1×
MRI chest w/o contrast (71550) $888 $2,220 3.0×
MRI chest with contrast (71551) $1,018 $2,545 1.0×
MRI chest wo w contrast (71552) $1,348 $3,370 3.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,108 $2,770 2.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,246 $3,115 2.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $884 $2,210 3.0×
MRI lumbar spine w contrast (72149) $1,070 $2,675 2.5×
Mri Neck Spine W/O & W/Dye (72156) $1,372 $3,430 3.2×
MRI orbit face &/neck w/o contrast (70540) $898 $2,245 3.0×
MRI orbit face neck w contrast (70542) $1,044 $2,610 2.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,314 $3,285 3.0×
MRI pelvis w contrast (72196) $1,016 $2,540 2.3×
MRI pelvis w/o & w contrast (72197) $1,346 $3,365 3.1×
MRI pelvis w/o contrast (72195) $906 $2,265 3.0×
MRI thoracic spine w/o contrast (72146) $936 $2,340 3.1×
MRI upper extremity oth than jt w/contr matrl (73219) $1,084 $2,710 2.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $882 $2,205 3.0×
Mri Uppr Extremity W/O&W/Dye (73220) $1,248 $3,120 2.9×
MRI, abdomen, combo (74183) $1,344 $3,360 3.1×
MRI, dorsal spine combo (72157) $1,392 $3,480 3.2×
MRI, dorsal spine contrast (72147) $1,042 $2,605 2.4×
MRI, joint upper extrem (73221) $876 $2,190 2.9×
MRI, joint upper extrem combo (73223) $1,286 $3,215 3.0×
MRI, lumbar spine combo (72158) $1,378 $3,445 3.2×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $828 $2,070 0.5×
Myocardial Spect Multiple Studies (78452) $1,436 $3,590 0.9×
Neck soft tissue (70360) $102 $255 0.9×
Parathyroid Planar Imaging (78070) $486 $1,215 1.0×
Parathyroid planar imaging w/wo subtraction (78071) $558 $1,395 1.1×
Pelvis 1 or 2 views (72170) $110 $275 0.8×
Pulmonary Perfusion Imaging Particulate (78580) $466 $1,165 0.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $176 $440 1.3×
Radex abscess/fistula/sinus tract rs&i (76080) $296 $740 0.4×
Radex Ankle Complete Minimum 3 Views (73610) $114 $285 1.0×
Radex Calcaneus Minimum 2 Views (73650) $98 $245 0.9×
Radex elbow complete minimum 3 views (73080) $114 $285 1.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $146 $365 1.1×
Radex fingr minimum 2 views (73140) $94 $235 0.9×
Radex foot complete minimum 3 views (73630) $114 $285 1.0×
Radex Hand Minimum 3 Views (73130) $112 $280 1.0×
Radex lower extremity infant minimum 2 views (73592) $76 $190 0.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $126 $315 1.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $114 $285 1.0×
Radex Ribs Unilateral 2 Views (71100) $114 $285 1.0×
Radex shoulder complete minimum 2 views (73030) $118 $295 1.1×
Radex Sinuses Paransl < 3 Views (70210) $90 $225 0.8×
Radex Spine 1 View Specify Level (72020) $104 $260 1.0×
Radex Sternum Minimum 2 Views (71120) $114 $285 1.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $138 $345 1.3×
Radex Toe Minimum 2 Views (73660) $92 $230 0.8×
Radex upper extremity infant minimum 2 views (73092) $88 $220 0.7×
Radex Wrist Complete Minimum 3 Views (73110) $112 $280 1.0×
Radiolog exam mandible compl minimum 4 views (70110) $146 $365 1.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $142 $355 1.1×
Radiologic exam colon single contrast study (74270) $304 $760 1.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $234 $585 1.1×
Radiologic exam knee complete 4/more views (73564) $146 $365 1.1×
Radiologic exam pelvis compl minimum 3 views (72190) $134 $335 1.0×
Radiologic Exam Small Int Single Contrast Study (74250) $244 $610 1.1×
Radiologic exam swallow function contrast study (74230) $224 $560 1.0×
Radiologic exam upr gi trc double contrast study (74246) $288 $720 1.3×
Radiologic examination femur 1 view (73551) $90 $225 0.8×
Radiologic examination femur minimum 2 views (73552) $104 $260 1.0×
Radiologic examination knee 1/2 views (73560) $102 $255 0.9×
Radiologic examination tibia & fibula 2 views (73590) $106 $265 1.0×
Ribs bilateral 3 views (71110) $148 $370 1.1×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,248 $3,120 1.8×
Scapula (73010) $118 $295 0.9×
Screening Digital Breast Tomosynthesis Bi (77063) $54 $135 2.3×
Shoulder 1 view (73020) $92 $230 0.8×
Skull less than 4 views (70250) $126 $315 1.0×
Sternoclavicular joints (71130) $114 $285 1.0×
Thoracic spine 2 views (72070) $126 $315 1.0×
Thoracic spine 3 views (72072) $144 $360 1.1×
Thyroid Imaging With Vascular Flow (78013) $294 $735 0.6×
Thyroid Uptake Measurement (78012) $220 $550 0.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $450 $1,125 0.9×
Ultrasound Exam Aaa Screen (76706)
range across 2 matching MRF lines		 $35–$178 $89–$445 varies
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $50–$252 $126–$630 varies
Unlisted Dx Radiographic Procedure (76499) $114 $285 1.0×
Us breast unilateral complete (76641)
range across 6 matching MRF lines		 $40–$303 $101–$758 varies
Us chest (76604) $206 $515 1.6×
Us complete joint (76881)
range across 4 matching MRF lines		 $48–$244 $122–$610 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $37–$188 $94–$470 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $31–$158 $79–$395 varies
Us ob limited 1 or more fetuses (76815) $210 $525 1.6×
Us ob transvaginal (76817) $238 $595 1.8×
Us pelvic non ob complete (76856)
range across 2 matching MRF lines		 $54–$284 $135–$710 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $264 $660 2.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $204 $510 1.6×
Us retroperitoneal complete (76770)
range across 2 matching MRF lines		 $56–$284 $142–$710 varies
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $45–$228 $114–$570 varies
Us scrotum and contents (76870)
range across 2 matching MRF lines		 $51–$258 $129–$645 varies
Us spinal canal and contents (76800) $218 $545 1.7×
Us thyroid (76536)
range across 2 matching MRF lines		 $50–$250 $125–$625 varies
Vascular Flow Imaging (78445) $432 $1,080 0.9×
Wrist 2 views (73100) $98 $245 0.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $126 $315 1.2×
X-ray antegrade pyelogram tube (74425) $304 $760 0.7×
X-Ray Bend Only L-S Spine (72120) $142 $355 1.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $98 $245 0.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $154 $385 1.2×
X-Ray Exam Entire Spi 4/5 Vw (72083) $196 $490 1.5×
X-Ray Exam Hip Uni 1 View (73501) $92 $230 0.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $110 $275 1.0×
X-Ray Exam Hip Uni 4/> Views (73503) $148 $370 1.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $156 $390 1.2×
X-Ray Exam L-S Spine Bending (72114) $212 $530 1.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $124 $310 1.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $200 $500 1.5×
X-Ray Exam Unilat Ribs/Chest (71101) $148 $370 1.1×
X-ray eye for foreign body (70030) $92 $230 0.8×
X-ray humerus (73060) $106 $265 1.0×
X-ray IV pyelogram (ivp) (74400) $342 $855 1.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $106 $265 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $136 $340 1.0×
X-ray nose-rectum child f.b. (76010) $86 $215 0.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $188 $470 1.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $126 $315 1.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $112 $280 1.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $136 $340 1.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $170 $425 1.3×
X-ray thoracic spine 4 vw (72074) $148 $370 1.1×
X-Ray Urinary Tract Exam With Contrast Material (74420) $340 $850 0.8×
X-Rays Bone Length Studies (77073) $140 $350 1.1×
X-Rays Bone Survey Complete (77075) $250 $625 1.9×
Xr c-spine 4 or 5 views (72050) $178 $445 1.4×
Xr orbits complete 4 views (70200) $138 $345 1.1×

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.