Imaging prices at Memorial Hospital

Seward, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $428 $428 3.9×
Acute gastrointestinal blood loss imaging (78278) $2,023 $2,023 4.9×
Ankle 2 views (73600) $287 $287 3.2×
Bone &/Joint Imaging Limited Area (78300) $1,473 $1,473 3.5×
Bone &/joint imaging whole body (78306) $2,491 $2,491 6.0×
Bone age studies (77072) $421 $421 3.9×
Bone Imaging 3 Phase (78315) $2,833 $2,833 6.8×
Bone survey complete (77075) $1,000 $1,000 9.2×
Cervical spine 2 or 3 views (72040) $385 $385 4.3×
Chest 1 view (71045) $308 $308 3.4×
Chest 3 views (71047) $485 $485 5.4×
Clavicle complete (73000) $339 $339 3.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $762 $762 7.0×
CT abdomen and pelvis without and with contrast (74178) $4,065 $4,065 11.2×
CT abdomen and pelvis without contrast (74176) $3,405 $3,405 13.7×
CT abdomen w contrast (74160) $3,172 $3,172 17.4×
CT abdomen w wo contrast (74170) $3,392 $3,392 18.6×
CT abdomen w/o contrast (74150) $2,742 $2,742 25.3×
CT c-spine w/o contrast (72125) $3,070 $3,070 28.3×
CT chest w/wo contrast (71270) $2,660 $2,660 14.6×
CT chest with contrast (71260) $2,430 $2,430 13.3×
CT head/brain with contrast (70460) $2,449 $2,449 13.4×
CT head/brain without and with contrast (70470) $2,655 $2,655 14.6×
CT heart no contrast quant eval coronry calcium (75571) $125 $125 1.4×
CT iac w contrast (70481) $3,438 $3,438 18.9×
CT lower ext w/o (73700) $2,731 $2,731 25.2×
CT lower extremity w wo contrast (73702) $3,381 $3,381 18.6×
CT lower extremity with contrast (73701) $3,166 $3,166 17.4×
CT lumbar spine w/o contrast (72131) $2,970 $2,970 27.4×
CT maxillofacial w contrast (70487) $2,764 $2,764 15.2×
CT maxillofacial w/o contrast (70486) $2,329 $2,329 21.5×
CT maxillofacial w/wo contrast (70488) $2,979 $2,979 16.4×
CT neck soft tissue w contrast (70491) $3,249 $3,249 17.8×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $3,653 $3,653 20.1×
CT orbits w/o contrast (70480) $3,003 $3,003 27.7×
CT pelvis w & w/o contrast (72194) $3,537 $3,537 19.4×
CT pelvis w/o contrast (72192) $2,887 $2,887 26.6×
CT soft tissue neck w/o & w/contrast material (70492) $3,464 $3,464 19.0×
CT soft tissue neck w/o contrast (70490) $2,814 $2,814 25.9×
CT thoracic spine w/o contrast (72128) $3,094 $3,094 28.5×
CT thorax w/o contrast (71250) $1,998 $1,998 18.4×
CT upper extremity w/o & w/contrast material (73202) $3,321 $3,321 18.2×
CT upper extremity w/o contrast rt (73200) $2,671 $2,671 24.6×
CT upper extremity with contrast (73201) $3,106 $3,106 8.6×
Cta Abdomen (74175) $4,083 $4,083 22.4×
CTA abdomen pelvis (74174) $3,964 $3,964 10.9×
CTA chest (71275) $4,466 $4,466 24.5×
Cta Head (70496) $2,742 $2,742 15.1×
Cta Neck (70498) $2,923 $2,923 16.0×
Dxa bone density study 1/> sites axial skel (77080) $526 $526 4.8×
Esophagus (74220) $766 $766 4.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $434.50 $434.50 4.0×
Fluoroscopy up to 1 hr (76000) $772 $772 3.1×
Foot 2 views (73620) $281 $281 3.1×
Forearm 2 views (73090) $332 $332 3.7×
Gated Heart Planar Single (78472) $2,321 $2,321 5.6×
Hand 2 views (73120) $267 $267 2.5×
Hand 3 views (73130) $367 $367 4.1×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,331 $2,331 4.1×
Hepatobiliary syst imaging including gallbladder (78226) $1,980 $1,980 4.8×
Ht muscle image spect sing (78451) $5,116 $5,116 3.8×
Humerus Min 2 Views Left (73060) $367 $367 4.1×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,924 $1,924 3.4×
Kidney img morphology vascular flow 1 w/rx (78708) $2,452 $2,452 4.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $2,656 $2,656 4.7×
Knee 3 views (73562) $415 $415 4.6×
Liver & spleen imaging static only (78215) $1,733 $1,733 4.2×
Lung perf&ventilat diferentl (78598) $2,517 $2,517 4.5×
Lung perfusion differential (78597) $2,025 $2,025 4.9×
Lymphoscintigraphy (78195) $2,508 $2,508 4.4×
Meckels Diverticulum (78290) $2,043 $2,043 4.9×
MRA head w & w/o contrast (70546) $5,187 $5,187 14.3×
MRA head w/o contrast (70544) $4,337 $4,337 17.5×
Mra Neck W/O &W/Contrast Material (70549) $4,789 $4,789 13.2×
MRI abdomen w contrast (74182) $4,732 $4,732 13.1×
MRI abdomen w/o & w/contrast material (74183) $5,227 $5,227 14.4×
MRI abdomen w/o contrast (74181) $4,332 $4,332 17.5×
MRI any jnt lwr ext with con lt (73722) $2,955 $2,955 3.6×
MRI c-spine with contrast (72142) $4,536 $4,536 12.5×
MRI cervical spine w/o contrast (72141) $4,136 $4,136 16.7×
MRI chest w/o & w/contrast material (71552) $5,255 $5,255 14.5×
MRI chest w/o contrast (71550) $4,360 $4,360 17.6×
MRI chest with contrast (71551) $4,760 $4,760 5.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,522 $3,522 14.2×
MRI orbit face &/neck w/o contrast (70540) $4,180 $4,180 16.9×
MRI orbit/face/neck w&w/o cont (70543) $5,075 $5,075 14.0×
MRI orbit/face/neck w/contrast (70542) $4,580 $4,580 12.6×
MRI pelvis w contrast (72196) $4,269 $4,269 11.8×
MRI pelvis w/o & w/contrast material (72197) $4,764 $4,764 13.2×
MRI pelvis w/o contrast (72195) $3,869 $3,869 15.6×
MRI scan of arm joint before and after contrast (73223) $4,425 $4,425 12.2×
MRI scan of leg joint before and after contrast (73723) $3,560 $3,560 9.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $5,031 $5,031 13.9×
MRI spinal canal lumbar w/contrast material (72149) $3,450 $3,450 9.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,945 $3,945 10.9×
MRI spinal canal thoracic w/contrast matrl (72147) $4,672 $4,672 12.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $5,167 $5,167 14.3×
MRI thoracic spine w/o contrast (72146) $4,272 $4,272 17.2×
MRI upper ext joint w/o contrast (73221) $3,580 $3,580 14.4×
MRI upper extrem other than jt w/o & w/contras (73220) $4,118 $4,118 11.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,273 $3,273 13.2×
Myocardial Spect Multiple Studies (78452) $3,786 $3,786 2.8×
Neck soft tissue (70360) $380 $380 4.2×
Nm gastric emptying study (78264) $2,360 $2,360 5.7×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $379 $379 3.5×
Osseous survey infant (77076) $738 $738 6.8×
Osseous survey limited (77074) $1,081 $1,081 10.0×
Parathyrd planar w/wo subtrj (78071) $1,918 $1,918 4.6×
Parathyroid imaging (78070) $1,677 $1,677 4.0×
Pelvis 1 or 2 views (72170) $332 $332 3.1×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,357 $4,357 12.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,716 $1,716 4.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,698 $2,698 4.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $477 $477 4.4×
Radex hips bilateral with pelvis 2 views (73521) $504 $504 4.6×
Radiolog exam mandible compl minimum 4 views (70110) $466 $466 4.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $344 $344 3.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $521 $521 4.8×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $351 $351 3.9×
Radiologic exam colon single contrast study (74270) $1,040 $1,040 5.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $783 $783 4.3×
Radiologic exam upr gi trc double contrast study (74246) $837 $837 4.6×
Radiologic exam upr gi trc single contrast study (74240) $802 $802 4.4×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $385 $385 4.3×
Radiological examination surgical specimen (76098) $648 $648 1.1×
Ribs bilateral 3 views (71110) $487 $487 4.5×
Rp loclzj tum spect 1 area single day imaging (78803) $2,865 $2,865 5.1×
Sacroiliac Joints < 3 Views (72200) $356 $356 3.3×
Scapula complete (73010) $362 $362 3.3×
Screening digital breast tomosynthesis (77063) $63 $63 2.7×
Shuntogram indwelling nonvascular shunt rs&i (75809) $791 $791 7.3×
Small bowel series (74250) $783 $783 4.3×
Spine thoracic 3 views (72072) $553 $553 5.1×
Thoracolumbar 2 views (72080) $388 $388 4.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,639 $1,639 3.9×
Ultrasound, abdomen limited (76705) $772 $772 7.1×
Unlisted Ultrasound Procedure (76999) $610 $610 6.8×
Upper Extremity Infant (73092) $256 $256 2.4×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,444 $1,444 7.9×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $1,651 $1,651 9.1×
Us abdl aorta screen aaa (76706) $629 $629 5.8×
Us breast unilateral complete (76641) $618 $618 5.7×
Us breast unilateral limited (76642) $505 $505 5.6×
Us chest (76604) $642 $642 5.9×
Us infant hips dynamic (76885) $728 $728 8.1×
Us kidney transplant (76776) $951 $951 8.8×
Us ob detailed single fetus (76811) $903 $903 3.6×
Us ob transvaginal (76817) $575 $575 5.3×
Us pelvic non ob complete (76856) $959 $959 8.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $406 $406 3.7×
Us pregnancy ltd (76815) $417.50 $417.50 3.8×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $647 $647 6.0×
Us retroperitoneal complete (76770) $1,086 $1,086 10.0×
Us retroperitoneal limited (76775) $693 $693 6.4×
Us scrotum and contents (76870) $867 $867 8.0×
Us soft tissue head/neck (76536) $737 $737 6.8×
Us xtr non-vasc lmtd (76882) $648 $648 6.0×
Wrist 2 views (73100) $256 $256 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $392 $392 4.3×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $362 $362 4.0×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,366 $1,366 7.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $310 $310 3.4×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $391 $391 4.3×
X-ray exam hip uni 1 view (73501) $264 $264 2.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $428 $428 4.7×
X-Ray Exam Hips Bi 5/> Views (73523) $582 $582 5.4×
X-ray exam of femur 1 (73551) $306 $306 3.4×
X-ray eye for foreign body (70030) $272 $272 3.0×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $533 $533 4.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $301 $301 3.3×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $374 $374 4.1×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $257 $257 2.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $334 $334 3.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $445 $445 4.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $291 $291 3.2×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $231 $231 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $497 $497 4.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $746 $746 6.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $497 $497 4.6×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $374 $374 4.1×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $416 $416 4.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $606 $606 5.6×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $380 $380 3.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $392 $392 4.3×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $469 $469 4.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $624 $624 5.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $423 $423 3.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $350 $350 3.9×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $404 $404 4.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $538 $538 6.0×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $378 $378 4.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $716 $716 6.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $344 $344 3.2×
X-Ray Spine One View - Xr Spine (72020) $271 $271 3.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $341 $341 3.8×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $345 $345 3.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $287 $287 3.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $362 $362 4.0×
Xr c-spine 6 or more views (72052) $756 $756 7.0×
Xr chest 4+ views (71048) $538 $538 5.0×
Xr finger(s) 2+ views (73140) $269 $269 3.0×
Xr shoulder 1 view (73020) $290 $290 3.2×
Xr spine cervical 4 or 5 views (72050) $577 $577 5.3×
Xr tibia/fibula 2 views (73590) $356 $356 3.9×
Xray knee 1 or 2 views rt (73560) $385 $385 4.3×