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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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $344 $344 3.8×
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 age studies (77072) $421 $421 3.9×
Bone Imaging 3 Phase (78315) $2,833 $2,833 6.8×
Bone Imaging Limited Area (78300) $1,473 $1,473 3.5×
Bone Imaging Whole Body (78306) $2,491 $2,491 6.0×
Bone survey infant (77076) $738 $738 6.8×
Chest 1 view (71045) $308 $308 3.4×
Chest 2 views (71046) $351 $351 3.9×
Chest 3 views (71047) $485 $485 5.4×
Chest 4 or more views (71048) $538 $538 5.0×
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 Angio Abdomen and Pelvis (74174) $3,964 $3,964 10.9×
CT Angio Chest (71275) $4,466 $4,466 24.5×
CT Angio Head (70496) $2,742 $2,742 15.1×
CT Angio Neck (70498) $2,923 $2,923 16.0×
CT cervical spine w/o contrast (72125) $3,070 $3,070 28.3×
CT chest w contrast (71260) $2,430 $2,430 13.3×
CT chest w/wo contrast (71270) $2,660 $2,660 14.6×
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/contrast material (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 wo contrast (70486) $2,329 $2,329 21.5×
CT neck tissue combo (70492) $3,464 $3,464 19.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) $3,381 $3,381 18.6×
CT scans face/jaw combo (70488) $2,979 $2,979 16.4×
CT soft tissue neck w contrast (70491) $3,249 $3,249 17.8×
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 ext wo (73200) $2,671 $2,671 24.6×
CT upper extremity w/o & w/contrast material (73202) $3,321 $3,321 18.2×
CT upper extremity with contrast (73201) $3,106 $3,106 8.6×
Cta Abdomen (74175) $4,083 $4,083 22.4×
Dxa Bone Density Axial (77080) $526 $526 4.8×
Esophagram (74220) $766 $766 4.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $377–$492 $377–$492 varies
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×
Gastric emptying imaging study (78264) $2,360 $2,360 5.7×
Gated Heart Planar Single (78472) $2,321 $2,321 5.6×
Hand 2 views (73120) $267 $267 2.5×
Hepatobil Syst Image W/Drug (78227) $2,331 $2,331 4.1×
Hepatobiliary System Imaging (78226) $1,980 $1,980 4.8×
Ht Muscle Image Spect Sing (78451) $5,116 $5,116 3.8×
Infant hip ultrasound with hip movement (dynamic) (76885) $728 $728 8.1×
K Flow/Funct Image Multiple (78709) $2,656 $2,656 4.7×
K Flow/Funct Image W/Drug (78708) $2,452 $2,452 4.3×
K Flow/Funct Image W/O Drug (78707) $1,924 $1,924 3.4×
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×
Lung Ventilat&Perfus Imaging (78582) $2,698 $2,698 4.8×
Lymph System Imaging (78195) $2,508 $2,508 4.4×
Meckels Divert Exam (78290) $2,043 $2,043 4.9×
Mra Head W/O & W/Contrast Material (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 contrast (74181) $4,332 $4,332 17.5×
MRI any jt lower extrem w/contrast material (73722) $2,955 $2,955 3.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,560 $3,560 9.8×
MRI cervical spine w contrast (72142) $4,536 $4,536 12.5×
MRI cervical spine w/o cont (72141) $4,136 $4,136 16.7×
MRI chest w/o contrast (71550) $4,360 $4,360 17.6×
MRI chest with contrast (71551) $4,760 $4,760 5.8×
MRI chest wo w contrast (71552) $5,255 $5,255 14.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,357 $4,357 12.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,522 $3,522 14.2×
MRI lumbar spine w contrast (72149) $3,450 $3,450 9.5×
Mri Neck Spine W/O & W/Dye (72156) $5,031 $5,031 13.9×
MRI orbit face &/neck w/o contrast (70540) $4,180 $4,180 16.9×
MRI orbit face neck w contrast (70542) $4,580 $4,580 12.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $5,075 $5,075 14.0×
MRI pelvis w contrast (72196) $4,269 $4,269 11.8×
MRI pelvis w/o & w contrast (72197) $4,764 $4,764 13.2×
MRI pelvis w/o contrast (72195) $3,869 $3,869 15.6×
MRI thoracic spine w/o contrast (72146) $4,272 $4,272 17.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,273 $3,273 13.2×
Mri Uppr Extremity W/O&W/Dye (73220) $4,118 $4,118 11.4×
MRI, abdomen, combo (74183) $5,227 $5,227 14.4×
MRI, dorsal spine combo (72157) $5,167 $5,167 14.3×
MRI, dorsal spine contrast (72147) $4,672 $4,672 12.9×
MRI, joint upper extrem (73221) $3,580 $3,580 14.4×
MRI, joint upper extrem combo (73223) $4,425 $4,425 12.2×
MRI, lumbar spine combo (72158) $3,945 $3,945 10.9×
Myocardial Spect Multiple Studies (78452) $3,786 $3,786 2.8×
Neck soft tissue (70360) $380 $380 4.2×
Nonvascular Shunt X-Ray (75809) $791 $791 7.3×
Parathyroid Planar Imaging (78070) $1,677 $1,677 4.0×
Parathyroid planar imaging w/wo subtraction (78071) $1,918 $1,918 4.6×
Pelvis 1 or 2 views (72170) $332 $332 3.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,716 $1,716 4.1×
Radex Ankle Complete Minimum 3 Views (73610) $362 $362 4.0×
Radex Calcaneus Minimum 2 Views (73650) $257 $257 2.8×
Radex elbow complete minimum 3 views (73080) $391 $391 4.3×
Radex Facial Bones Complete Minimum 3 Views (70150) $533 $533 4.9×
Radex fingr minimum 2 views (73140) $269 $269 3.0×
Radex foot complete minimum 3 views (73630) $374 $374 4.1×
Radex Hand Minimum 3 Views (73130) $367 $367 4.1×
Radex lower extremity infant minimum 2 views (73592) $231 $231 2.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $374 $374 4.1×
Radex Ribs Unilateral 2 Views (71100) $392 $392 4.3×
Radex shoulder complete minimum 2 views (73030) $404 $404 4.5×
Radex Sinuses Paransl < 3 Views (70210) $378 $378 4.2×
Radex Spine 1 View Specify Level (72020) $271 $271 3.0×
Radex Sternum Minimum 2 Views (71120) $345 $345 3.8×
Radex Toe Minimum 2 Views (73660) $287 $287 3.2×
Radex upper extremity infant minimum 2 views (73092) $256 $256 2.4×
Radex Wrist Complete Minimum 3 Views (73110) $362 $362 4.0×
Radiolog exam mandible compl minimum 4 views (70110) $466 $466 4.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $521 $521 4.8×
Radiologic exam colon double contrast study (74280) $1,366 $1,366 7.5×
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 knee complete 4/more views (73564) $445 $445 4.1×
Radiologic exam pelvis compl minimum 3 views (72190) $380 $380 3.5×
Radiologic Exam Small Int Single Contrast Study (74250) $783 $783 4.3×
Radiologic exam upr gi trc double contrast study (74246) $837 $837 4.6×
Radiologic examination femur 1 view (73551) $306 $306 3.4×
Radiologic examination femur minimum 2 views (73552) $385 $385 4.3×
Radiologic examination knee 1/2 views (73560) $385 $385 4.3×
Radiologic Examination Osseous Survey Limited (77074) $1,081 $1,081 10.0×
Radiologic examination tibia & fibula 2 views (73590) $356 $356 3.9×
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×
Scapula (73010) $362 $362 3.3×
Screening Digital Breast Tomosynthesis Bi (77063) $63 $63 2.7×
Shoulder 1 view (73020) $290 $290 3.2×
Skull less than 4 views (70250) $344 $344 3.2×
Sternoclavicular joints (71130) $341 $341 3.8×
Thoracic spine 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 Breast Limited (76642) $505 $505 5.6×
Ultrasound Exam Aaa Screen (76706) $629 $629 5.8×
Ultrasound, abdomen limited (76705) $772 $772 7.1×
Unlisted us procedure (76999) $610 $610 6.8×
Upper gi w/o kub (74240) $802 $802 4.4×
Us breast unilateral complete (76641) $618 $618 5.7×
Us chest (76604) $642 $642 5.9×
Us exam, pelvic, limited (76857) $406 $406 3.7×
Us kidney transplant (76776) $951 $951 8.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $648 $648 6.0×
Us ob detailed single fetus (76811) $903 $903 3.6×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $391–$444 $391–$444 varies
Us ob transvaginal (76817) $575 $575 5.3×
Us pelvic non ob complete (76856) $959 $959 8.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $647 $647 6.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $379 $379 3.5×
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 thyroid (76536) $737 $737 6.8×
Wrist 2 views (73100) $256 $256 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $392 $392 4.3×
X-Ray Bend Only L-S Spine (72120) $497 $497 4.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $310 $310 3.4×
X-Ray Exam Breast Specimen (76098) $648 $648 1.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $477 $477 4.4×
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 2 Views (73521) $504 $504 4.6×
X-Ray Exam Hips Bi 5/> Views (73523) $582 $582 5.4×
X-Ray Exam L-S Spine Bending (72114) $746 $746 6.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $385 $385 4.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $756 $756 7.0×
X-Ray Exam Unilat Ribs/Chest (71101) $469 $469 4.3×
X-ray eye for foreign body (70030) $272 $272 3.0×
X-ray humerus (73060) $367 $367 4.1×
X-ray IV pyelogram (ivp) (74400) $1,444 $1,444 7.9×
X-ray IV pyelogram+tomography (74415) $1,651 $1,651 9.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $334 $334 3.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $291 $291 3.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $497 $497 4.6×
X-ray nose-rectum child f.b. (76010) $416 $416 4.6×
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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $356 $356 3.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $350 $350 3.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $538 $538 6.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $716 $716 6.6×
X-Rays Bone Survey Complete (77075) $1,000 $1,000 9.2×
Xr c-spine 4 or 5 views (72050) $577 $577 5.3×
Xr facial bones less than 3 views (70140) $301 $301 3.3×
Xr orbits complete 4 views (70200) $606 $606 5.6×

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.