Imaging prices at Mitchell County Hospital Health Systems

Beloit, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $308.70 $343 3.2×
Acute gastrointestinal blood loss imaging (78278) $1,115.10 $1,239 3.0×
Ankle 2 views (73600) $177.30 $197 2.2×
Arthrogram hip (73525) $612 $680 1.9×
Arthrogram shoulder (73040) $612 $680 1.9×
Bone &/Joint Imaging Limited Area (78300) $691.20 $768 1.9×
Bone &/Joint Imaging Multiple Areas (78305) $839.70 $933 2.3×
Bone &/joint imaging whole body (78306) $1,204.20 $1,338 3.3×
Bone age studies (77072) $194.40 $216 2.0×
Bone Imaging 3 Phase (78315) $1,278.90 $1,421 3.5×
Bone survey complete (77075) $1,392.30 $1,547 14.5×
Brain image w/flow 4 + views (78606) $1,348.20 $1,498 2.7×
Brain Imaging Minimum 4 Static Views (78605) $1,348.20 $1,498 2.7×
Brain Imaging Vascular Flow Only (78610) $1,348.20 $1,498 2.7×
Cervical spine 2 or 3 views (72040) $249.30 $277 3.1×
Chest 1 view (71045) $255.15 $283.50 3.2×
Chest 3 views (71047) $304.20 $338 3.8×
Clavicle complete (73000) $208.80 $232 2.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $617.40 $686 6.4×
CT abdomen and pelvis without and with contrast (74178) $3,918.60 $4,354 12.2×
CT abdomen and pelvis without contrast (74176) $3,110.40 $3,456 14.2×
CT abdomen w contrast (74160) $1,859.40 $2,066 11.5×
CT abdomen w wo contrast (74170) $2,188.80 $2,432 13.6×
CT abdomen w/o contrast (74150) $1,668.60 $1,854 17.4×
CT c-spine w/o contrast (72125) $1,559.70 $1,733 16.2×
CT cervical spine w&w/o contrast (72127) $1,696.50 $1,885 10.5×
CT cervical spine with contrast (72126) $1,668.60 $1,854 5.2×
CT chest w/wo contrast (71270) $1,970.10 $2,189 12.2×
CT chest with contrast (71260) $1,833.30 $2,037 11.4×
CT head/brain with contrast (70460) $1,395 $1,550 8.6×
CT head/brain without and with contrast (70470) $1,696.50 $1,885 10.5×
CT heart no contrast quant eval coronry calcium (75571) $166.50 $185 2.1×
CT iac w contrast (70481) $1,532.70 $1,703 9.5×
CT limited/localized follow up study (76380) $885.60 $984 11.1×
CT lower ext w/o (73700) $1,422.90 $1,581 14.8×
CT lower extremity w wo contrast (73702) $1,668.60 $1,854 10.3×
CT lower extremity with contrast (73701) $1,532.70 $1,703 9.5×
CT lumbar spine w/o contrast (72131) $1,696.50 $1,885 17.6×
CT lumbar spine with contrast (72132) $1,668.60 $1,854 5.2×
CT maxillofacial w contrast (70487) $1,395 $1,550 8.6×
CT maxillofacial w/o contrast (70486) $1,286.10 $1,429 13.4×
CT maxillofacial w/wo contrast (70488) $1,532.70 $1,703 9.5×
CT neck soft tissue w contrast (70491) $1,559.70 $1,733 9.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,833.30 $2,037 11.4×
CT orbits w/o contrast (70480) $1,559.70 $1,733 16.2×
CT pelvis w & w/o contrast (72194) $1,970.10 $2,189 12.2×
CT pelvis w/o contrast (72192) $1,559.70 $1,733 16.2×
CT soft tissue neck w/o & w/contrast material (70492) $1,696.50 $1,885 10.5×
CT soft tissue neck w/o contrast (70490) $1,395 $1,550 14.5×
CT thoracic spine w/contrast (72129) $1,668.60 $1,854 10.3×
CT thoracic spine w/o contrast (72128) $1,532.70 $1,703 15.9×
CT thoracic spine w/wo contrast (72130) $1,806.30 $2,007 11.2×
CT thorax w/o contrast (71250) $1,696.50 $1,885 17.6×
CT upper extremity w/o & w/contrast material (73202) $1,668.60 $1,854 10.3×
CT upper extremity w/o contrast rt (73200) $1,422.90 $1,581 14.8×
CT upper extremity with contrast (73201) $1,532.70 $1,703 4.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,297.70 $2,553 14.2×
Cta Abdomen (74175) $1,602.90 $1,781 9.9×
CTA abdomen pelvis (74174) $2,276.10 $2,529 7.1×
CTA chest (71275) $2,297.70 $2,553 14.2×
Cta Head (70496) $1,721.70 $1,913 10.7×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,443.40 $3,826 10.7×
Cta Neck (70498) $1,721.70 $1,913 10.7×
Cystography minimum 3 views rs&i (74430) $411.30 $457 1.3×
Diskogram cervical (72285) $1,165.95 $1,295.50 0.6×
Diskography lumbar (72295) $1,146.60 $1,274 0.6×
Echoencephalography real time imaging (76506) $468 $520 4.9×
Esophagus (74220) $504 $560 3.1×
Fetal biophysical profile non-stress testing (76818) $352.80 $392 3.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $554.40 $616 5.8×
Fluoroscopy up to 1 hr (76000) $483.30 $537 2.2×
Foot 2 views (73620) $191.70 $213 2.4×
Forearm 2 views (73090) $206.10 $229 2.6×
Gated Heart Planar Single (78472) $1,233.90 $1,371 3.4×
Hand 2 views (73120) $181.80 $202 1.9×
Hand 3 views (73130) $234.90 $261 2.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,204.20 $1,338 2.4×
Hepatobiliary syst imaging including gallbladder (78226) $745.20 $828 2.0×
Ht muscle image spect sing (78451) $2,024.10 $2,249 1.7×
Humerus Min 2 Views Left (73060) $233.10 $259 2.9×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $195.30 $217 2.0×
Kidney imaging morphology (78700) $952.20 $1,058 2.6×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $944.10 $1,049 1.9×
Knee 3 views (73562) $239.40 $266 3.0×
Liver & spleen imaging static only (78215) $1,124.10 $1,249 3.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,124.10 $1,249 3.1×
Liver imaging static only (78201) $1,124.10 $1,249 2.3×
Liver imaging w/vascular flow (78202) $1,124.10 $1,249 2.3×
Lymphoscintigraphy (78195) $1,172.70 $1,303 2.3×
Meckels Diverticulum (78290) $801.90 $891 2.2×
MRA head w & w/o contrast (70546) $2,517.30 $2,797 7.8×
MRA head w/o contrast (70544) $2,407.50 $2,675 11.0×
MRA head with contrast (70545) $2,352.60 $2,614 7.3×
MRA neck w contrast (70548) $2,407.50 $2,675 7.5×
Mra Neck W/O &W/Contrast Material (70549) $2,379.60 $2,644 7.4×
MRA neck w/o contrast (70547) $2,052.90 $2,281 9.4×
MRI abdomen w contrast (74182) $2,489.40 $2,766 7.8×
MRI abdomen w/o & w/contrast material (74183) $2,653.20 $2,948 8.3×
MRI abdomen w/o contrast (74181) $2,326.50 $2,585 10.6×
MRI any jnt lwr ext with con lt (73722) $1,806.30 $2,007 2.5×
MRI any jt upper extremity w/contrast matrl (73222) $1,806.30 $2,007 2.5×
MRI c-spine with contrast (72142) $2,352.60 $2,614 7.3×
MRI cervical spine w/o contrast (72141) $2,407.50 $2,675 11.0×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,806.30 $2,007 5.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,806.30 $2,007 5.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,915.20 $2,128 8.7×
MRI orbit face &/neck w/o contrast (70540) $2,188.80 $2,432 10.0×
MRI orbit/face/neck w&w/o cont (70543) $2,517.30 $2,797 7.8×
MRI orbit/face/neck w/contrast (70542) $2,352.60 $2,614 7.3×
MRI pelvis w contrast (72196) $2,489.40 $2,766 7.8×
MRI pelvis w/o & w/contrast material (72197) $2,736 $3,040 8.5×
MRI pelvis w/o contrast (72195) $2,407.50 $2,675 11.0×
MRI scan of arm joint before and after contrast (73223) $1,970.10 $2,189 6.1×
MRI scan of leg joint before and after contrast (73723) $1,970.10 $2,189 6.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,736 $3,040 8.5×
MRI spinal canal lumbar w/contrast material (72149) $2,352.60 $2,614 7.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,736 $3,040 8.5×
MRI spinal canal thoracic w/contrast matrl (72147) $2,352.60 $2,614 7.3×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,736 $3,040 8.5×
MRI thoracic spine w/o contrast (72146) $2,407.50 $2,675 11.0×
MRI tmj (70336) $1,641.60 $1,824 7.5×
MRI upper ext joint w/o contrast (73221) $1,778.40 $1,976 8.1×
MRI upper extrem other than jt w/o & w/contras (73220) $1,970.10 $2,189 6.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,641.60 $1,824 7.5×
Myelogram Cervical (72240) $3,155.40 $3,506 4.4×
Myelogram Lumbar (72265) $3,329.10 $3,699 4.6×
Myelogram thoracic (72255) $3,155.40 $3,506 4.4×
Myocardial Spect Multiple Studies (78452) $2,730.60 $3,034 2.3×
Neck soft tissue (70360) $244.80 $272 3.1×
Nm gastric emptying study (78264) $1,116.90 $1,241 3.0×
Nuclear medicine study of kidney and blood flow (78701) $741.60 $824 2.0×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $1,386.90 $1,541 3.8×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $558.90 $621 1.5×
Nuclear medicine study to assess blood clot in vein of side (78457) $590.40 $656 1.2×
Nuclear Rx Oral Admin (79005) $944.10 $1,049 4.4×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $260.10 $289 2.7×
Osseous survey infant (77076) $419.40 $466 4.4×
Osseous survey limited (77074) $657 $730 6.8×
Parathyrd planar w/wo subtrj (78071) $2,250 $2,500 6.1×
Pelvis 1 or 2 views (72170) $209.70 $233 2.2×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,243.70 $2,493 7.0×
Pulmonary Perfusion Imaging Particulate (78580) $754.20 $838 2.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,485.90 $1,651 3.0×
Radex abscess/fistula/sinus tract rs&i (76080) $567 $630 1.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $259.20 $288 3.2×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $458.10 $509 4.8×
Radex hips bilateral with pelvis 2 views (73521) $233.10 $259 2.4×
Radex mastoids compl minimum 3 views pr side (70130) $248.40 $276 2.6×
Radiolog exam mandible compl minimum 4 views (70110) $262.80 $292 2.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $214.20 $238 2.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $431.10 $479 4.5×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $265.50 $295 3.3×
Radiologic exam colon single contrast study (74270) $868.05 $964.50 5.4×
Radiologic exam upr gi trc double contrast study (74246) $630.90 $701 3.9×
Radiologic exam upr gi trc single contrast study (74240) $469.80 $522 2.9×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $253.80 $282 3.2×
Radiological examination surgical specimen (76098) $116.10 $129 0.2×
Ribs bilateral 3 views (71110) $320.40 $356 3.3×
Rp loclzj tum spect 1 area single day imaging (78803) $1,147.50 $1,275 2.3×
Sacroiliac Joints < 3 Views (72200) $249.30 $277 2.6×
Scapula complete (73010) $219.60 $244 2.3×
Screening digital breast tomosynthesis (77063) $85.50 $95 3.7×
Sella turcica (70240) $215.10 $239 2.7×
Sialogram (70390) $471.60 $524 2.1×
Small bowel series (74250) $501.75 $557.50 3.1×
Spine thoracic 3 views (72072) $283.50 $315 2.9×
Spleen imaging only (78185) $1,072.80 $1,192 2.9×
Testicular Imaging With Vascular Flow (78761) $952.20 $1,058 2.6×
Thoracolumbar 2 views (72080) $276.30 $307 3.5×
Thyroid carcinoma metastases img whole body (78018) $1,245.60 $1,384 2.5×
Thyroid Imaging With Vascular Flow (78013) $455.40 $506 1.2×
Thyroid uptake measurement (78012) $441 $490 1.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $591.30 $657 1.6×
Tomogram (76100) $460.80 $512 4.8×
Ultrasound, abdomen limited (76705) $483.30 $537 5.0×
Upper Extremity Infant (73092) $206.10 $229 2.1×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $952.20 $1,058 2.6×
Urethrocystography voiding (74455) $416.70 $463 1.9×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $640.80 $712 4.0×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $738.90 $821 4.6×
Us abdl aorta screen aaa (76706) $589.50 $655 6.1×
Us breast unilateral complete (76641) $337.50 $375 3.5×
Us breast unilateral limited (76642) $170.10 $189 2.1×
Us chest (76604) $459 $510 4.8×
Us compl joint r-t w/image documentation (76881) $479.70 $533 5.0×
Us ob detailed single fetus (76811) $436.50 $485 2.0×
Us ob transvaginal (76817) $382.50 $425 4.0×
Us pelvic non ob complete (76856) $507.60 $564 5.3×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $191.70 $213 2.0×
Us pregnancy ltd (76815) $305.10 $339 3.2×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $323.10 $359 3.4×
Us retroperitoneal complete (76770) $589.50 $655 6.1×
Us retroperitoneal limited (76775) $425.70 $473 4.4×
Us scrotum and contents (76870) $440.10 $489 4.6×
Us soft tissue head/neck (76536) $543.60 $604 5.7×
Us spinal canal and contents (76800) $401.40 $446 4.2×
Us transrectal (76872) $459.90 $511 4.8×
Us xtr non-vasc lmtd (76882) $383.40 $426 4.0×
Venogram extremity bilateral (75822) $1,113.30 $1,237 0.8×
Venography extremity unilateral rs&i (75820) $789.30 $877 0.5×
Wrist 2 views (73100) $176.40 $196 2.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $431.10 $479 4.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $236.70 $263 3.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $233.10 $259 2.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $761.40 $846 4.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $199.80 $222 2.5×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $234 $260 2.9×
X-ray exam hip uni 1 view (73501) $176.40 $196 2.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $233.10 $259 2.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $389.70 $433 4.1×
X-Ray Exam Hips Bi 5/> Views (73523) $404.10 $449 4.2×
X-ray exam of femur 1 (73551) $198.90 $221 2.5×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $248.40 $276 2.6×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $209.70 $233 2.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $234 $260 2.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $185.40 $206 2.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $203.40 $226 2.5×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $255.60 $284 2.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $201.60 $224 2.5×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $236.70 $263 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $294.30 $327 3.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $454.50 $505 4.7×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $294.30 $327 3.1×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $244.80 $272 3.1×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $208.80 $232 2.6×
X-ray of voice box or throat (70370) $380.70 $423 4.8×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $284.40 $316 3.0×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $307.80 $342 3.2×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $486.90 $541 1.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $236.70 $263 3.0×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $318.60 $354 3.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $400.50 $445 4.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $269.10 $299 2.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $215.10 $239 2.7×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $252 $280 3.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $252.90 $281 3.2×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $206.10 $229 2.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $285.30 $317 3.0×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $226.80 $252 2.4×
X-Ray Spine One View - Xr Spine (72020) $203.40 $226 2.5×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $201.60 $224 2.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $246.60 $274 3.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $276.30 $307 2.9×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $289.80 $322 3.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $185.40 $206 2.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $223.20 $248 2.8×
Xr c-spine 6 or more views (72052) $448.20 $498 4.7×
Xr chest 4+ views (71048) $403.20 $448 4.2×
Xr finger(s) 2+ views (73140) $176.40 $196 2.2×
Xr internal auditory meati complete (70134) $260.10 $289 0.5×
XR Mastoids < 3 Views Bilateral (70120) $215.10 $239 2.2×
Xr optic foramina (70190) $167.40 $186 2.1×
Xr shoulder 1 view (73020) $171.90 $191 2.1×
Xr spine cervical 4 or 5 views (72050) $397.80 $442 4.1×
Xr tibia/fibula 2 views (73590) $236.70 $263 3.0×
Xr tmj bilateral (70330) $252 $280 3.1×
Xray knee 1 or 2 views rt (73560) $219.60 $244 2.7×