Imaging prices at Memorial Hospital & Manor
Bainbridge, GA · every code in this section with a posted price and a Medicare benchmark.
205 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) | $206.50 | $295 | 2.7× |
| Abdomen 2 views (74019) | $158.90 | $227 | 1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,073.80 | $1,534 | 3.1× |
| Ankle 2 views (73600) range across 9 matching MRF lines |
$143.50–$283.50 | $205–$405 | varies |
| Arthrogram hip (73525) | $249.20 | $356 | 0.8× |
| Arthrogram Wrist (73115) | $249.20 | $356 | 0.8× |
| Bone age studies (77072) | $238 | $340 | 2.6× |
| Bone Imaging 3 Phase (78315) | $716.80 | $1,024 | 2.0× |
| Bone Imaging Limited Area (78300) | $716.80 | $1,024 | 2.0× |
| Bone Imaging Whole Body (78306) | $716.80 | $1,024 | 2.0× |
| Chest 1 view (71045) | $123.90 | $177 | 1.6× |
| Chest 2 views (71046) | $275.80 | $394 | 3.6× |
| Chest 4 or more views (71048) | $222.60 | $318 | 2.4× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$167.30–$175 | $239–$250 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $305.90 | $437 | 3.3× |
| Contrast X-Ray Bladder (74430) | $454.30 | $649 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $332.50 | $475 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $515.20 | $736 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,604.70 | $3,721 | 8.5× |
| CT abdomen and pelvis without contrast (74176) | $2,249.10 | $3,213 | 10.8× |
| CT abdomen w contrast (74160) | $1,102.50 | $1,575 | 7.2× |
| CT abdomen w wo contrast (74170) | $1,192.80 | $1,704 | 7.8× |
| CT abdomen w/o contrast (74150) | $936.60 | $1,338 | 10.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,542.80 | $2,204 | 5.0× |
| CT Angio Chest (71275) | $1,992.90 | $2,847 | 13.0× |
| CT Angio Head (70496) | $968.80 | $1,384 | 6.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $663.60 | $948 | 4.3× |
| CT Angio Neck (70498) | $968.80 | $1,384 | 6.3× |
| CT cervical spine w/ contrast (72126) | $1,383.20 | $1,976 | 4.5× |
| CT cervical spine w/o contrast (72125) | $1,217.30 | $1,739 | 13.3× |
| CT chest w contrast (71260) | $1,526.70 | $2,181 | 9.9× |
| CT chest w/wo contrast (71270) | $1,316 | $1,880 | 8.6× |
| CT head/brain with contrast (70460) | $1,010.80 | $1,444 | 6.6× |
| CT head/brain without and with contrast (70470) | $1,107.40 | $1,582 | 7.2× |
| CT iac w contrast (70481) | $980 | $1,400 | 6.4× |
| CT l-spine w&w/o contrast (72133) | $1,963.50 | $2,805 | 12.8× |
| CT lower ext w/o (73700) | $1,328.60 | $1,898 | 14.5× |
| CT lower extremity w/contrast material (73701) | $1,194.20 | $1,706 | 7.8× |
| CT lumbar spine w/o contrast (72131) | $1,328.60 | $1,898 | 14.5× |
| CT maxillofacial w contrast (70487) | $1,022 | $1,460 | 6.6× |
| CT maxillofacial wo contrast (70486) | $1,067.50 | $1,525 | 11.7× |
| CT neck tissue combo (70492) | $1,404.20 | $2,006 | 9.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,064.70 | $1,521 | 6.9× |
| CT orbits w/o contrast (70480) | $1,022 | $1,460 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $1,276.80 | $1,824 | 8.3× |
| CT pelvis w/o contrast (72192) | $884.10 | $1,263 | 9.6× |
| CT scan of leg combo (73702) | $1,276.80 | $1,824 | 8.3× |
| CT scans face/jaw combo (70488) | $1,192.80 | $1,704 | 7.8× |
| CT soft tissue neck w contrast (70491) | $1,704.50 | $2,435 | 11.1× |
| CT soft tissue neck w/o contrast (70490) | $809.90 | $1,157 | 8.8× |
| CT thoracic spine w contrast (72129) | $1,732.50 | $2,475 | 11.3× |
| CT thoracic spine w/o contrast (72128) | $1,550.50 | $2,215 | 16.9× |
| CT thoracic spine w/wo cont (72130) | $1,183.70 | $1,691 | 7.7× |
| CT thorax w/o contrast (71250) | $893.90 | $1,277 | 9.8× |
| CT upper ext wo (73200) | $936.60 | $1,338 | 10.2× |
| CT upper extremity w/o & w/contrast material (73202) | $752.50 | $1,075 | 4.9× |
| CT upper extremity with contrast (73201) | $1,022 | $1,460 | 3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $749.70 | $1,071 | 4.9× |
| Cta Abdomen (74175) | $1,192.80 | $1,704 | 7.8× |
| CTA pelvis (72191) | $1,381.80 | $1,974 | 9.0× |
| Dxa Bone Density Axial (77080) | $245 | $350 | 2.7× |
| Esophagram (74220) | $256.20 | $366 | 1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$201.60–$363.30 | $288–$519 | varies |
| Fluoroscopy up to 1 hr (76000) | $454.30 | $649 | 2.2× |
| Foot 2 views (73620) range across 12 matching MRF lines |
$74.90–$204.40 | $107–$292 | varies |
| Forearm 2 views (73090) | $216.30 | $309 | 2.8× |
| Gastric emptying imaging study (78264) | $1,860.60 | $2,658 | 5.3× |
| Hand 2 views (73120) | $238 | $340 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,001.70 | $1,431 | 2.1× |
| Hysterosalpingogram (74740) | $832.30 | $1,189 | 4.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $501.20 | $716 | 6.6× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$142.10–$182 | $203–$260 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,044.40 | $1,492 | 2.2× |
| Lymph System Imaging (78195) | $2,024.40 | $2,892 | 4.3× |
| Magnetic Image Jaw Joint (70336) | $1,272.60 | $1,818 | 6.1× |
| MRA head w/o contrast (70544) | $851.90 | $1,217 | 4.1× |
| MRA neck w contrast (70548) | $1,577.10 | $2,253 | 5.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,362.20 | $1,946 | 4.5× |
| MRA neck w/o contrast (70547) | $851.90 | $1,217 | 4.1× |
| MRI abdomen w contrast (74182) | $1,987.30 | $2,839 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,192.80 | $1,704 | 5.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,362.20 | $1,946 | 4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,232.30 | $3,189 | 3.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,352 | $3,360 | 11.2× |
| MRI cervical spine w contrast (72142) | $1,745.80 | $2,494 | 5.7× |
| MRI cervical spine w/o cont (72141) | $1,550.50 | $2,215 | 7.4× |
| MRI chest w/o contrast (71550) | $1,413.30 | $2,019 | 6.8× |
| MRI chest with contrast (71551) | $1,712.90 | $2,447 | 2.5× |
| MRI chest wo w contrast (71552) | $2,888.90 | $4,127 | 9.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,157.80 | $1,654 | 3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,852.20 | $2,646 | 6.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,022 | $1,460 | 4.9× |
| MRI lumbar spine w contrast (72149) | $2,228.10 | $3,183 | 7.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,873.20 | $2,676 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,553.30 | $2,219 | 7.4× |
| MRI orbit face neck w contrast (70542) | $1,833.30 | $2,619 | 6.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,617 | $2,310 | 5.3× |
| MRI pelvis w contrast (72196) | $1,712.20 | $2,446 | 5.6× |
| MRI pelvis w/o & w contrast (72197) | $1,873.20 | $2,676 | 6.1× |
| MRI pelvis w/o contrast (72195) | $1,336.30 | $1,909 | 6.4× |
| MRI thoracic spine w/o contrast (72146) | $1,192.80 | $1,704 | 5.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,980.30 | $2,829 | 6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,107.40 | $1,582 | 5.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,447.60 | $2,068 | 4.7× |
| MRI, abdomen, combo (74183) | $1,957.90 | $2,797 | 6.4× |
| MRI, dorsal spine combo (72157) | $1,873.20 | $2,676 | 6.1× |
| MRI, dorsal spine contrast (72147) | $1,745.80 | $2,494 | 5.7× |
| MRI, joint upper extrem (73221) | $1,677.90 | $2,397 | 8.0× |
| MRI, joint upper extrem combo (73223) | $1,447.60 | $2,068 | 4.7× |
| MRI, lumbar spine combo (72158) | $1,873.20 | $2,676 | 6.1× |
| Neck soft tissue (70360) | $144.20 | $206 | 1.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $57.40 | $82 | 2.3× |
| Pelvis 1 or 2 views (72170) | $309.40 | $442 | 3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $618.80 | $884 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $389.20 | $556 | 4.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 8 matching MRF lines |
$239.40–$366.10 | $342–$523 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 10 matching MRF lines |
$143.50–$312.90 | $205–$447 | varies |
| Radex elbow complete minimum 3 views (73080) | $270.20 | $386 | 3.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $238 | $340 | 2.6× |
| Radex fingr minimum 2 views (73140) range across 40 matching MRF lines |
$143.50–$189 | $205–$270 | varies |
| Radex foot complete minimum 3 views (73630) | $205.80 | $294 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $448 | $640 | 5.9× |
| Radex lower extremity infant minimum 2 views (73592) | $329 | $470 | 4.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $143.50 | $205 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $166.60 | $238 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 13 matching MRF lines |
$148.40–$382.20 | $212–$546 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$150.50–$153.30 | $215–$219 | varies |
| Radex Sternum Minimum 2 Views (71120) | $143.50 | $205 | 1.9× |
| Radex Toe Minimum 2 Views (73660) range across 40 matching MRF lines |
$143.50–$189 | $205–$270 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $238 | $340 | 2.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 7 matching MRF lines |
$170.80–$259.35 | $244–$370.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $238 | $340 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $454.30 | $649 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $291.90 | $417 | 1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $319.20 | $456 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $259 | $370 | 2.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $280 | $400 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $238 | $340 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $249.20 | $356 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $275.80 | $394 | 1.8× |
| Radiologic examination femur 1 view (73551) | $68.60 | $98 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) | $186.20 | $266 | 2.4× |
| Radiologic examination knee 1/2 views (73560) range across 12 matching MRF lines |
$143.50–$275.10 | $205–$393 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $720.30 | $1,029 | 7.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $221.20 | $316 | 2.9× |
| Ribs bilateral 3 views (71110) | $201.60 | $288 | 2.2× |
| Scapula (73010) | $177.80 | $254 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $142.10 | $203 | 6.1× |
| Shoulder 1 view (73020) | $83.30 | $119 | 1.1× |
| Shoulder Arthrography (73040) | $832.30 | $1,189 | 2.7× |
| Skull less than 4 views (70250) | $238 | $340 | 2.6× |
| Sternoclavicular joints (71130) | $102.20 | $146 | 1.3× |
| Thoracic spine 2 views (72070) | $170.10 | $243 | 1.9× |
| Thoracic spine 3 views (72072) | $309.40 | $442 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $876.40 | $1,252 | 2.5× |
| Ultrasound Breast Limited (76642) | $282.80 | $404 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $197.40 | $282 | 2.2× |
| Ultrasound, abdomen limited (76705) | $472.50 | $675 | 5.2× |
| Unlisted us procedure (76999) | $217.70 | $311 | 2.9× |
| Upper gi w/o kub (74240) | $319.20 | $456 | 2.1× |
| Urethrocystogram voiding (74455) | $435.40 | $622 | 2.1× |
| Us breast unilateral complete (76641) | $270.90 | $387 | 3.0× |
| Us chest (76604) | $285.60 | $408 | 3.1× |
| Us complete joint (76881) | $452.20 | $646 | 4.9× |
| Us exam, pelvic, limited (76857) | $296.80 | $424 | 3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $277.90 | $397 | 3.0× |
| Us ob detailed single fetus (76811) | $363.30 | $519 | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $363.30 | $519 | 4.0× |
| Us ob transvaginal (76817) | $314.30 | $449 | 3.4× |
| Us pelvic non ob complete (76856) | $303.80 | $434 | 3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $363.30 | $519 | 4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $201.60 | $288 | 2.2× |
| Us retroperitoneal complete (76770) | $472.50 | $675 | 5.2× |
| Us retroperitoneal limited (76775) | $252 | $360 | 2.8× |
| Us scrotum and contents (76870) | $742.70 | $1,061 | 8.1× |
| Us spinal canal and contents (76800) | $217.70 | $311 | 2.4× |
| Us thyroid (76536) | $472.50 | $675 | 5.2× |
| Us transrectal (76872) | $363.30 | $519 | 4.0× |
| Venography extremity unilateral rs&i (75820) | $539.70 | $771 | 0.4× |
| Wrist 2 views (73100) range across 11 matching MRF lines |
$143.50–$259.70 | $205–$371 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $130.20 | $186 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $226.80 | $324 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 8 matching MRF lines |
$110.60–$351.40 | $158–$502 | varies |
| X-Ray Exam Breast Specimen (76098) | $832.30 | $1,189 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $233.10 | $333 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $143.50 | $205 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $186.20 | $266 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $238 | $340 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $272.30 | $389 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $288.40 | $412 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $288.40 | $412 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $205.80 | $294 | 2.2× |
| X-ray humerus (73060) | $178.50 | $255 | 2.3× |
| X-ray IV pyelogram (ivp) (74400) | $532 | $760 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 10 matching MRF lines |
$173.60–$534.10 | $248–$763 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $309.40 | $442 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $238 | $340 | 2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $238 | $340 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $202.30 | $289 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $289.80 | $414 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $318.50 | $455 | 3.5× |
| X-Rays Bone Length Studies (77073) | $143.50 | $205 | 1.6× |
| X-Rays Bone Survey Complete (77075) | $470.40 | $672 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $288.40 | $412 | 3.1× |
| Xr orbits complete 4 views (70200) | $175.70 | $251 | 1.9× |
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.