Imaging prices at Melissa Memorial Hospital
Holyoke, CO · every code in this section with a posted price and a Medicare benchmark.
188 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) | $245.60 | $307 | 2.7× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$311.20–$352 | $389–$440 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,216.80 | $2,771 | 5.3× |
| Ankle 2 views (73600) | $170.40 | $213 | 1.9× |
| Bone age studies (77072) | $206.40 | $258 | 1.9× |
| Bone Imaging 3 Phase (78315) | $2,037.60 | $2,547 | 4.8× |
| Bone Imaging Limited Area (78300) | $1,385.60 | $1,732 | 3.3× |
| Bone Imaging Multiple Areas (78305) | $1,520.80 | $1,901 | 3.6× |
| Bone Imaging Whole Body (78306) | $1,611.20 | $2,014 | 3.8× |
| Chest 1 view (71045) | $253.60 | $317 | 2.8× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$285.60–$289.60 | $357–$362 | varies |
| Chest 3 views (71047) | $304 | $380 | 3.3× |
| Chest 4 or more views (71048) | $349.60 | $437 | 3.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$236–$253.60 | $295–$317 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,982.40 | $4,978 | 10.8× |
| CT abdomen and pelvis without contrast (74176) | $3,188 | $3,985 | 12.7× |
| CT abdomen w contrast (74160) | $2,149.60 | $2,687 | 11.6× |
| CT abdomen w wo contrast (74170) | $2,528 | $3,160 | 13.7× |
| CT abdomen w/o contrast (74150) | $1,895.20 | $2,369 | 17.2× |
| CT Angio Abdomen and Pelvis (74174) | $4,261.60 | $5,327 | 11.6× |
| CT Angio Chest (71275) | $2,586.40 | $3,233 | 14.0× |
| CT Angio Head (70496) | $2,370.40 | $2,963 | 12.8× |
| CT angio hrt w/3d image (75574) | $2,564.80 | $3,206 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,458.40 | $3,073 | 13.3× |
| CT Angio Neck (70498) | $2,224 | $2,780 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,288.80 | $2,861 | 12.4× |
| CT bone density (77078) | $320 | $400 | 3.5× |
| CT cervical spine w/ contrast (72126) | $2,164.80 | $2,706 | 5.9× |
| CT cervical spine w/o contrast (72125) | $1,883.20 | $2,354 | 17.1× |
| CT cervical spine w/wo cont (72127) | $2,364 | $2,955 | 12.8× |
| CT chest w contrast (71260) | $2,052.80 | $2,566 | 11.1× |
| CT head/brain with contrast (70460) | $2,346.40 | $2,933 | 12.7× |
| CT head/brain without and with contrast (70470) | $2,497.60 | $3,122 | 13.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $384 | $480 | 4.2× |
| CT l-spine w&w/o contrast (72133) | $2,547.20 | $3,184 | 13.8× |
| CT lower ext w/o (73700) | $1,498.40 | $1,873 | 13.6× |
| CT lower extremity w/contrast material (73701) | $2,147.20 | $2,684 | 11.6× |
| CT lumbar spine w contrast (72132) | $2,248 | $2,810 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $1,965.60 | $2,457 | 17.8× |
| CT maxillofacial w contrast (70487) | $2,122.40 | $2,653 | 11.5× |
| CT maxillofacial wo contrast (70486) | $1,512 | $1,890 | 13.7× |
| CT neck tissue combo (70492) | $2,164.80 | $2,706 | 11.7× |
| CT orbits w/o contrast (70480) | $1,599.20 | $1,999 | 14.5× |
| CT pelvis w&w/o contrast (72194) | $2,852 | $3,565 | 15.4× |
| CT pelvis w/o contrast (72192) | $1,914.40 | $2,393 | 17.4× |
| CT scan of leg combo (73702) | $2,361.60 | $2,952 | 12.8× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,320.80–$2,542.40 | $2,901–$3,178 | varies |
| CT soft tissue neck w contrast (70491) | $1,932 | $2,415 | 10.4× |
| CT soft tissue neck w/o contrast (70490) | $1,667.20 | $2,084 | 15.1× |
| CT thoracic spine w contrast (72129) | $2,050.40 | $2,563 | 11.1× |
| CT thoracic spine w/o contrast (72128) | $1,864 | $2,330 | 16.9× |
| CT thoracic spine w/wo cont (72130) | $2,547.20 | $3,184 | 13.8× |
| CT thorax w/o contrast (71250) | $1,866.40 | $2,333 | 16.9× |
| CT upper ext wo (73200) | $1,866.40 | $2,333 | 16.9× |
| CT upper extremity w/o & w/contrast material (73202) | $2,136.80 | $2,671 | 11.5× |
| CT upper extremity with contrast (73201) | $2,052.80 | $2,566 | 5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,726.40 | $3,408 | 14.7× |
| Cta Abdomen (74175) | $2,547.20 | $3,184 | 13.8× |
| Dxa Bone Density Axial (77080) | $468.80 | $586 | 4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $421.60 | $527 | 3.8× |
| Fluoroscopy up to 1 hr (76000) | $584 | $730 | 2.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$211.20–$212 | $264–$265 | varies |
| Forearm 2 views (73090) | $240.80 | $301 | 2.6× |
| Gastric emptying imaging study (78264) | $783.20 | $979 | 1.9× |
| Hand 2 views (73120) | $211.20 | $264 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $2,316.80 | $2,896 | 4.0× |
| Hepatobiliary System Imaging (78226) | $2,106.40 | $2,633 | 5.0× |
| K Flow/Funct Image Multiple (78709) | $1,432 | $1,790 | 2.5× |
| Knee 3 Views (73562) | $312.80 | $391 | 3.4× |
| Liver & Spleen Imaging Static Only (78215) | $1,301.60 | $1,627 | 3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,106.40 | $2,633 | 5.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,357.60 | $2,947 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,357.60 | $2,947 | 4.1× |
| Lymph System Imaging (78195) | $1,262.40 | $1,578 | 2.2× |
| Magnetic Image Jaw Joint (70336) | $2,409.60 | $3,012 | 9.6× |
| MRA head w/o contrast (70544) | $2,394.40 | $2,993 | 9.5× |
| MRA neck w contrast (70548) | $2,888.80 | $3,611 | 7.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,126.40 | $5,158 | 11.2× |
| MRA neck w/o contrast (70547) | $2,751.20 | $3,439 | 10.9× |
| MRI abdomen w contrast (74182) | $2,584 | $3,230 | 7.0× |
| MRI abdomen w/o contrast (74181) | $2,264.80 | $2,831 | 9.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,808 | $3,510 | 3.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,385.60 | $4,232 | 9.2× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,506.40–$2,856 | $3,133–$3,570 | varies |
| MRI cervical spine w contrast (72142) | $2,835.20 | $3,544 | 7.7× |
| MRI cervical spine w/o cont (72141) | $2,454.40 | $3,068 | 9.8× |
| MRI chest w/o contrast (71550) | $2,048.80 | $2,561 | 8.1× |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$2,982.40–$3,382.40 | $3,728–$4,228 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,616 | $3,270 | 7.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,385.60 | $4,232 | 9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,140 | $2,675 | 8.5× |
| MRI lumbar spine w contrast (72149) | $3,980 | $4,975 | 10.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,239.20 | $4,049 | 8.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,297.60 | $2,872 | 9.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,757.60 | $2,197 | 4.8× |
| MRI pelvis w/o & w contrast (72197) | $3,385.60 | $4,232 | 9.2× |
| MRI pelvis w/o contrast (72195) | $2,439.20 | $3,049 | 9.7× |
| MRI thoracic spine w/o contrast (72146) | $2,741.60 | $3,427 | 10.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,595.20 | $3,244 | 7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,242.40 | $2,803 | 8.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,792 | $4,740 | 10.3× |
| MRI, abdomen, combo (74183) | $3,385.60 | $4,232 | 9.2× |
| MRI, dorsal spine combo (72157) | $3,896.80 | $4,871 | 10.6× |
| MRI, dorsal spine contrast (72147) | $3,542.40 | $4,428 | 9.6× |
| MRI, joint upper extrem (73221) | $2,324.80 | $2,906 | 9.2× |
| MRI, joint upper extrem combo (73223) | $3,385.60 | $4,232 | 9.2× |
| MRI, lumbar spine combo (72158) | $4,378.40 | $5,473 | 11.9× |
| Myocardial Spect Multiple Studies (78452) | $3,697.60 | $4,622 | 2.7× |
| Neck soft tissue (70360) | $230.40 | $288 | 2.5× |
| Parathyroid Planar Imaging (78070) | $1,895.20 | $2,369 | 4.5× |
| Pelvis 1 or 2 views (72170) | $260 | $325 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $443.20 | $554 | 4.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $280.80 | $351 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$200–$223.20 | $250–$279 | varies |
| Radex elbow complete minimum 3 views (73080) | $287.20 | $359 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $283.20 | $354 | 2.6× |
| Radex fingr minimum 2 views (73140) | $208.80 | $261 | 2.3× |
| Radex foot complete minimum 3 views (73630) | $269.60 | $337 | 2.9× |
| Radex Hand Minimum 3 Views (73130) | $265.60 | $332 | 2.9× |
| Radex lower extremity infant minimum 2 views (73592) | $282.40 | $353 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $202.40 | $253 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) | $287.20 | $359 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $232 | $290 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $267.20 | $334 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $334.40 | $418 | 3.6× |
| Radex Toe Minimum 2 Views (73660) | $268 | $335 | 2.9× |
| Radex upper extremity infant minimum 2 views (73092) | $242.40 | $303 | 2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $252.80 | $316 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $296 | $370 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $316 | $395 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $373.60 | $467 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $648 | $810 | 3.5× |
| Radiologic examination femur minimum 2 views (73552) | $332 | $415 | 3.6× |
| Radiologic examination knee 1/2 views (73560) | $269.60 | $337 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $276.80 | $346 | 3.0× |
| Ribs bilateral 3 views (71110) | $504 | $630 | 4.6× |
| Scapula (73010) range across 2 matching MRF lines |
$236–$253.60 | $295–$317 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $48 | $60 | 2.1× |
| Shoulder 1 view (73020) | $176 | $220 | 1.9× |
| Skull less than 4 views (70250) | $273.60 | $342 | 2.5× |
| Sternoclavicular joints (71130) | $275.20 | $344 | 3.0× |
| Thoracic spine 2 views (72070) | $334.40 | $418 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $1,280.80 | $1,601 | 3.0× |
| Ultrasound Breast Limited (76642) | $248.80 | $311 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) | $457.60 | $572 | 4.1× |
| Ultrasound, abdomen limited (76705) | $567.20 | $709 | 5.1× |
| Umbilical-artery Doppler (OB) (76820) | $240 | $300 | 2.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$279.20–$335.20 | $349–$419 | varies |
| Us chest (76604) | $545.60 | $682 | 4.9× |
| Us complete joint (76881) | $678.40 | $848 | 6.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$436–$523.20 | $545–$654 | varies |
| Us kidney transplant (76776) | $692 | $865 | 6.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $512 | $640 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $361.60 | $452 | 3.3× |
| Us ob transvaginal (76817) | $496.80 | $621 | 4.5× |
| Us pelvic non ob complete (76856) | $627.20 | $784 | 5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $435.20 | $544 | 3.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $188.80 | $236 | 1.7× |
| Us retroperitoneal complete (76770) | $635.20 | $794 | 5.8× |
| Us retroperitoneal limited (76775) | $448 | $560 | 4.1× |
| Us scrotum and contents (76870) | $600 | $750 | 5.4× |
| Us thyroid (76536) | $595.20 | $744 | 5.4× |
| Wrist 2 views (73100) | $222.40 | $278 | 2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $402.40 | $503 | 4.4× |
| X-Ray Bend Only L-S Spine (72120) | $349.60 | $437 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $268 | $335 | 2.9× |
| X-Ray Exam Breast Specimen (76098) | $575.20 | $719 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $228.80 | $286 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $340 | $425 | 3.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $448.80 | $561 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $768 | $960 | 7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $317.60 | $397 | 3.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $459.20 | $574 | 4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $368 | $460 | 3.3× |
| X-ray eye for foreign body (70030) | $262.40 | $328 | 2.9× |
| X-ray humerus (73060) | $265.60 | $332 | 2.9× |
| X-ray IV pyelogram (ivp) (74400) | $893.60 | $1,117 | 4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $160 | $200 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $184 | $230 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $380 | $475 | 3.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $306.40 | $383 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $306.40 | $383 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $302.40 | $378 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $362.40 | $453 | 3.3× |
| X-Rays Bone Length Studies (77073) | $211.20 | $264 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $570.40 | $713 | 5.2× |
| Xr c-spine 4 or 5 views (72050) | $521.60 | $652 | 4.7× |
| Xr orbits complete 4 views (70200) | $332.80 | $416 | 3.0× |
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.