Imaging prices at Midwest Surgical Hospital LLC
Omaha, NE · every code in this section with a posted price and a Medicare benchmark.
148 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $3,048.75 | $4,065 | 2.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$125 | $213–$224 | 1.4× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$125 | $276–$290 | 1.4× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$438.75–$874.50 | $585–$1,166 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$125 | $557–$1,166 | 0.3× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$438.75–$874.50 | $585–$1,166 | varies |
| Cat Scan Follow-Up Study (76380) | $125 | $651 | 1.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$305.25–$321 | $407–$428 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$305.25–$321 | $407–$428 | varies |
| Clavicle complete (73000) | $125 | $585 | 1.4× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$438.75–$874.50 | $585–$1,166 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $438.75 | $585 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$550 | $1,423–$1,495 | 1.5× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$500 | $570–$599 | 2.0× |
| CT abdomen w contrast (74160) | $350 | $1,272 | 1.9× |
| CT abdomen w wo contrast (74170) | $350 | $1,598 | 1.9× |
| CT abdomen w/o contrast (74150) | $350 | $1,053 | 3.2× |
| CT Angio Chest (71275) | $400 | $1,593 | 2.2× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$350 | $1,874–$1,968 | 1.9× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$400 | $1,874–$1,968 | 2.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$550 | $1,248–$1,311 | 1.5× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$350 | $1,045–$1,098 | 3.2× |
| CT cervical spine w/wo cont (72127) | $350 | $1,636 | 1.9× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$350 | $1,517–$1,593 | 1.9× |
| CT chest w/wo contrast (71270) | $350 | $1,636 | 1.9× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$350 | $1,002–$1,053 | 1.9× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$350 | $1,248–$1,311 | 1.9× |
| CT iac w contrast (70481) | $350 | $927 | 1.9× |
| CT l-spine w&w/o contrast (72133) | $350 | $1,636 | 1.9× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$350 | $1,575–$3,308 | 3.2× |
| CT lower extremity w/contrast material (73701) | $350 | $1,389 | 1.9× |
| CT lumbar spine w contrast (72132) | $550 | $1,311 | 1.5× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$350 | $1,045–$1,098 | 3.2× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$350 | $1,216–$1,277 | 1.9× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$350 | $836–$878 | 3.2× |
| CT neck tissue combo (70492) | $350 | $1,311 | 1.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$350 | $1,311–$1,546 | 1.9× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$350 | $791–$1,043 | 3.2× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$350 | $1,497–$1,572 | 1.9× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$350 | $1,045–$1,098 | 3.2× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$500 | $1,311–$1,377 | 2.7× |
| CT scans face/jaw combo (70488) | $1,485 | $1,980 | 8.2× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$350 | $1,002–$1,053 | 1.9× |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$350 | $851–$894 | 3.2× |
| CT thoracic spine w contrast (72129) | $350 | $1,311 | 1.9× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$350 | $1,045–$1,098 | 3.2× |
| CT thoracic spine w/wo cont (72130) | $350 | $1,636 | 1.9× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$350 | $1,045–$1,098 | 3.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$350 | $878–$1,377 | 3.2× |
| CT upper extremity w/o & w/contrast material (73202) | $350 | $1,377 | 1.9× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$991.50–$1,041.75 | $1,322–$1,389 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,476 | $1,968 | 4.1× |
| Diskography lumbar (72295) | $1,282.50 | $1,710 | 0.6× |
| Fluoroscopy up to 1 hr (76000) | $500 | $912 | 2.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$125 | $176–$185 | 1.4× |
| Forearm 2 views (73090) | $125 | $185 | 1.4× |
| Hand 2 views (73120) | $150 | $290 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$125 | $276–$290 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $99 | $132 | 3.3× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$600 | $2,450–$2,573 | 1.7× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$500 | $1,885–$1,980 | 2.0× |
| MRA neck w contrast (70548) | $550 | $1,980 | 1.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $600 | $2,986 | 1.7× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$500 | $1,885–$1,980 | 2.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$550 | $1,857–$2,178 | 0.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 5 matching MRF lines |
$600 | $1,884–$3,756 | 1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$550 | $2,497–$2,622 | 0.7× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$550 | $2,450–$2,573 | 1.5× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$500 | $1,790–$1,880 | 2.0× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$500 | $1,885–$1,980 | 2.0× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,485 | $1,980 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$550 | $1,885–$1,980 | 2.2× |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$550 | $2,450–$2,573 | 1.5× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$500 | $1,823–$1,980 | 2.0× |
| MRI orbit face neck w contrast (70542) | $550 | $3,756 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $600 | $3,756 | 1.7× |
| MRI pelvis w contrast (72196) | $550 | $1,980 | 1.5× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$500 | $1,885–$1,980 | 2.0× |
| MRI spectroscopy (76390) | $500 | $1,568 | 5.5× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$500 | $2,073–$2,177 | 2.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $550 | $2,622 | 1.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$500 | $2,073–$2,177 | 2.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$600 | $2,283–$2,398 | 1.7× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| MRI, dorsal spine contrast (72147) | $550 | $2,573 | 1.5× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$500 | $1,885–$1,980 | 2.0× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$600 | $2,283–$2,398 | 1.7× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$600 | $3,577–$3,756 | 1.7× |
| Neck soft tissue (70360) | $217.50 | $290 | 2.4× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$150 | $407–$814 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$150 | $213–$224 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$125 | $569–$585 | 1.4× |
| Radex elbow complete minimum 3 views (73080) | $125 | $185 | 1.4× |
| Radex fingr minimum 2 views (73140) | $125 | $185 | 1.4× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$125 | $199–$418 | 1.4× |
| Radex Hand Minimum 3 Views (73130) | $125 | $185 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $125 | $185 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$125 | $557–$585 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $125 | $185 | 1.4× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$125 | $240–$480 | 1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $125 | $185 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$125 | $176–$185 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $125 | $185 | 1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $217.50 | $290 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $217.50 | $290 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $138.75 | $185 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $125 | $428 | 1.4× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$125 | $557–$585 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$125 | $569–$585 | 1.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$417.75–$438.75 | $557–$585 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$125 | $557–$1,166 | 0.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| Thoracic spine 3 views (72072) | $217.50 | $290 | 2.0× |
| Unlisted Dx Radiographic Procedure (76499) | $125 | $185 | 1.4× |
| Unlisted magnetic resonance procedure (76498) | $1,929.75 | $2,573 | 21.4× |
| Wrist 2 views (73100) | $125 | $185 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $125 | $290 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $321 | $428 | 3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$125 | $176–$185 | 1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $217.50 | $290 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$125 | $557–$585 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$417.75–$438.75 | $557–$585 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$150 | $1,110–$1,166 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $874.50 | $1,166 | 8.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $757.50 | $1,010 | 7.0× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$150 | $290–$397 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$125 | $276–$290 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $150 | $290 | 1.4× |
| X-ray eye for foreign body (70030) | $125 | $185 | 1.4× |
| X-ray humerus (73060) | $125 | $185 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $125 | $185 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$150 | $176–$185 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$125 | $176–$185 | 1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $125 | $290 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| X-Rays Bone Length Studies (77073) | $691.50 | $922 | 6.4× |
| X-Rays Bone Survey Complete (77075) | $160 | $454 | 1.5× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$150 | $276–$290 | 1.4× |
| XR Mastoids < 3 Views Bilateral (70120) | $150 | $185 | 1.4× |
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.