Imaging prices at Memorial Community Hospital & Health System
Blair, NE · every code in this section with a posted price and a Medicare benchmark.
156 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) | $199.48 | $249.36 | 2.2× |
| Abdomen 2 views (74019) | $267.73 | $334.66 | 2.5× |
| Ankle 2 views (73600) | $178.40 | $223 | 2.0× |
| Arthrogram hip (73525) | $660 | $825 | 1.8× |
| Bone age studies (77072) | $200 | $250 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,402.40 | $1,753 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,296.80 | $1,621 | 3.1× |
| Chest 1 view (71045) | $185.86 | $232.33 | 2.1× |
| Chest 2 views (71046) | $232.76 | $290.95 | 2.6× |
| Clavicle complete (73000) | $224.11 | $280.14 | 2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,413.60 | $1,767 | 13.0× |
| CT abdomen and pelvis without and with contrast (74178) | $4,141.85 | $5,177.31 | 11.4× |
| CT abdomen and pelvis without contrast (74176) | $2,865 | $3,581.24 | 11.6× |
| CT abdomen w contrast (74160) | $2,096 | $2,620 | 11.5× |
| CT abdomen w wo contrast (74170) | $2,284.80 | $2,856 | 12.5× |
| CT abdomen w/o contrast (74150) | $1,741.60 | $2,177 | 16.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,969.93 | $4,962.41 | 11.0× |
| CT Angio Chest (71275) | $2,412.92 | $3,016.15 | 13.2× |
| CT Angio Head (70496) | $2,379.49 | $2,974.36 | 13.1× |
| CT Angio Neck (70498) | $2,365.23 | $2,956.54 | 13.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,300.80 | $2,876 | 12.6× |
| CT cervical spine w/o contrast (72125) | $1,614.73 | $2,018.41 | 14.9× |
| CT chest w contrast (71260) | $1,884.73 | $2,355.91 | 10.3× |
| CT head/brain without and with contrast (70470) | $1,910.40 | $2,388 | 10.5× |
| CT lower ext w/o (73700) | $1,398.30 | $1,747.87 | 12.9× |
| CT lower extremity w/contrast material (73701) | $1,689.71 | $2,112.14 | 9.3× |
| CT lumbar spine w contrast (72132) | $2,167.20 | $2,709 | 6.0× |
| CT lumbar spine w/o contrast (72131) | $1,653.39 | $2,066.73 | 15.2× |
| CT maxillofacial w contrast (70487) | $1,663.05 | $2,078.82 | 9.1× |
| CT maxillofacial wo contrast (70486) | $1,486.37 | $1,857.96 | 13.7× |
| CT neck tissue combo (70492) | $1,618.29 | $2,022.86 | 8.9× |
| CT orbits w/o contrast (70480) | $1,291.20 | $1,614 | 11.9× |
| CT pelvis w&w/o contrast (72194) | $2,729.60 | $3,412 | 15.0× |
| CT pelvis w/o contrast (72192) | $1,482.24 | $1,852.80 | 13.7× |
| CT soft tissue neck w contrast (70491) | $1,823.31 | $2,279.14 | 10.0× |
| CT soft tissue neck w/o contrast (70490) | $1,368 | $1,710 | 12.6× |
| CT thoracic spine w/o contrast (72128) | $1,656.87 | $2,071.09 | 15.3× |
| CT thorax w/o contrast (71250) | $1,539.22 | $1,924.02 | 14.2× |
| CT unlisted procedure (76497) | $2,000 | $2,500 | 22.1× |
| CT upper ext wo (73200) | $1,251.20 | $1,564 | 11.5× |
| CT upper extremity with contrast (73201) | $1,916.80 | $2,396 | 5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,809.87 | $3,512.33 | 15.4× |
| Cta Abdomen (74175) | $2,718.40 | $3,398 | 14.9× |
| Dxa Bone Density Axial (77080) | $384.21 | $480.26 | 3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $330.40 | $413 | 3.7× |
| Esophagram (74220) | $368 | $460 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $376.80 | $471 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $360 | $450 | 3.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$433.60–$436.06 | $542–$545.07 | varies |
| Foot 2 views (73620) | $188 | $235 | 2.1× |
| Forearm 2 views (73090) | $200.80 | $251 | 2.2× |
| Gastric emptying imaging study (78264) | $1,128 | $1,410 | 2.7× |
| Hand 2 views (73120) | $164.87 | $206.09 | 1.5× |
| Hepatobil Syst Image W/Drug (78227) | $1,372 | $1,715 | 2.4× |
| Knee 3 Views (73562) | $210.82 | $263.53 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $3,504.80 | $4,381 | 9.7× |
| MRA head w/o contrast (70544) | $2,576 | $3,220 | 10.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,044 | $2,555 | 5.6× |
| MRI abdomen w/o contrast (74181) | $1,667.04 | $2,083.80 | 6.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,624 | $2,030 | 2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,550.40 | $3,188 | 7.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,626.40 | $2,033 | 2.0× |
| MRI cervical spine w contrast (72142) | $3,816.80 | $4,771 | 10.5× |
| MRI cervical spine w/o cont (72141) | $2,644.62 | $3,305.77 | 10.7× |
| MRI chest w/o contrast (71550) | $2,691.20 | $3,364 | 10.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,549.17 | $3,186.46 | 7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,484.67 | $1,855.84 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,118.28 | $3,897.85 | 8.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,949.60 | $3,687 | 8.1× |
| MRI pelvis w/o & w contrast (72197) | $2,656 | $3,320 | 7.3× |
| MRI pelvis w/o contrast (72195) | $1,700.80 | $2,126 | 6.9× |
| MRI thoracic spine w/o contrast (72146) | $2,672.80 | $3,341 | 10.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,514.67 | $1,893.33 | 6.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,380.80 | $2,976 | 6.6× |
| MRI, abdomen, combo (74183) | $3,186.83 | $3,983.53 | 8.8× |
| MRI, dorsal spine combo (72157) | $3,342.40 | $4,178 | 9.2× |
| MRI, joint upper extrem (73221) | $1,876.70 | $2,345.88 | 7.6× |
| MRI, joint upper extrem combo (73223) | $2,296 | $2,870 | 6.3× |
| MRI, lumbar spine combo (72158) | $2,928.88 | $3,661.10 | 8.1× |
| Neck soft tissue (70360) | $228.23 | $285.29 | 2.5× |
| Pelvis 1 or 2 views (72170) | $209.60 | $262 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,244.80–$5,396.87 | $6,556–$6,746.09 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $331.20 | $414 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $188.37 | $235.47 | 2.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $199.20 | $249 | 2.2× |
| Radex elbow complete minimum 3 views (73080) | $257.48 | $321.85 | 2.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $258.40 | $323 | 2.4× |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$155.20–$160.96 | $194–$201.20 | varies |
| Radex foot complete minimum 3 views (73630) | $222.40 | $278 | 2.5× |
| Radex Hand Minimum 3 Views (73130) | $184.53 | $230.67 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $226.93 | $283.67 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $228.31 | $285.39 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) | $240.73 | $300.92 | 2.7× |
| Radex Spine 1 View Specify Level (72020) | $178.40 | $223 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $210.40 | $263 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $303.60 | $379.50 | 3.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$161.60–$162 | $202–$202.50 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $213.26 | $266.58 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $263.20 | $329 | 2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $328.80 | $411 | 1.8× |
| Radiologic exam knee complete 4/more views (73564) | $213.67 | $267.09 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $376.83 | $471.04 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) | $232.80 | $291 | 2.6× |
| Radiologic examination knee 1/2 views (73560) | $196.02 | $245.03 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$40–$216.36 | $50–$270.45 | varies |
| Ribs bilateral 3 views (71110) | $261.60 | $327 | 2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,360 | $1,700 | 2.4× |
| Scapula (73010) | $202.40 | $253 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $84.30 | $105.37 | 3.6× |
| Shoulder 1 view (73020) | $166.96 | $208.71 | 1.8× |
| Shoulder Arthrography (73040) | $622.40 | $778 | 1.7× |
| Skull less than 4 views (70250) | $201.60 | $252 | 1.9× |
| Thoracic spine 2 views (72070) | $237.34 | $296.67 | 2.2× |
| Thoracic spine 3 views (72072) | $316.32 | $395.40 | 2.9× |
| Thoracolumbar 2 views (72080) | $222.40 | $278 | 2.5× |
| Ultrasound Breast Limited (76642) | $248.80 | $311 | 2.8× |
| Ultrasound Exam Aaa Screen (76706) | $449.60 | $562 | 4.1× |
| Ultrasound, abdomen limited (76705) | $463.55 | $579.43 | 4.3× |
| Us breast unilateral complete (76641) | $308 | $385 | 2.8× |
| Us chest (76604) | $370.40 | $463 | 3.4× |
| Us exam, pelvic, limited (76857) | $219.60 | $274.50 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $336.76 | $420.95 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $336.53 | $420.67 | 3.1× |
| Us ob transvaginal (76817) | $412.12 | $515.15 | 3.8× |
| Us pelvic non ob complete (76856) | $543.10 | $678.87 | 5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $613.30 | $766.62 | 5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $301.85 | $377.31 | 2.8× |
| Us retroperitoneal complete (76770) | $569.99 | $712.48 | 5.3× |
| Us retroperitoneal limited (76775) | $445.60 | $557 | 4.1× |
| Us scrotum and contents (76870) | $443.98 | $554.98 | 4.1× |
| Us thyroid (76536) | $450.32 | $562.89 | 4.1× |
| Wrist 2 views (73100) | $178.67 | $223.33 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $207.11 | $258.89 | 2.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $208.80 | $261 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $415.20 | $519 | 3.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $219.20 | $274 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $284.80 | $356 | 3.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $582.40 | $728 | 5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $450.40 | $563 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $321.60 | $402 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $234.92 | $293.65 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $409.20 | $511.50 | 3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $278.22 | $347.77 | 2.6× |
| X-ray eye for foreign body (70030) | $188 | $235 | 2.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$32.80–$221.11 | $41–$276.39 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $186.29 | $232.86 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $292.06 | $365.07 | 2.7× |
| X-ray nose-rectum child f.b. (76010) | $216 | $270 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $370.08 | $462.60 | 3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $297.90 | $372.38 | 2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $265.87 | $332.33 | 2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $203.52 | $254.40 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $271.20 | $339 | 3.0× |
| X-Rays Bone Length Studies (77073) | $458.40 | $573 | 4.2× |
| Xr c-spine 4 or 5 views (72050) | $334.80 | $418.50 | 3.1× |
| Xr orbits complete 4 views (70200) | $405.60 | $507 | 3.7× |
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.